Monday, January 08, 2007

Leaky gut with normal biospsies:Lymphocytic enteritis and TNF

Leaky gut can occur without visible or microscopic signs: Obvious visually apparent defects of the lining of the intestine or mucosa such as ulcerations and erosions or atrophy are associated with increased intestinal permeability but ultra structural studies have shown that areas of the lining can have gaps in the intestinal barrier. Your gut can be leaky though it may look normal during endoscopy. Your gut can be leaky with a normal or minimally abnormal biopsy.

Lymphocytic enteritis is probably the earliest microscopic sign of a leaky gut. This relatively new term refers to biopsy findings of increased intraepithelial lymphocytes without villous atrophy or blunting. Since lymphocytes release chemical mediators such as tumor necrosis factor (TNF) it makes sense that increased numbers of lymphocytes in the villi releasing TNF can result in a leaky gut. With only intraepithelial lymphocytois malabsorption and symptoms can occur. An increase risk of celiac disease and Crohn’s and colitis, especially in genetically predisposed individuals is probably likely, especially if altered gut bacteria and yeast levels are present.

Tumor necrosis factor release results in leaky gut. Anti-tumor necrosis factor (anti-TNF) therapy in the form of remicade (infliximab) and humira (adalimubab) are highly effective in treating Crohn’s disease, rheumatoid arthritis and more recently ulcerative colitis. Unfortunately, such therapy is directed at the an inceased TNF already released, not the underlying cause or predisposition. Be sure to subscribe to the food doc blog for more updates.
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Dr. Scot Lewey
the food doc
Box 51460
Colorado Springs, CO 80949
Fax 719 320 6000

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