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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_6035_Библиотеки_им_академика_М_И_Перельмана.pdf
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- •About the Editor
- •Contents
- •Contributors
- •Abbreviations
- •Preface
- •1. Natural Products as Drug Candidates
- •1.1 Introduction
- •1.2 An array of natural products
- •1.2.1 Plant-derived natural products
- •1.2.2 Microbial natural products
- •1.3 Importance of analytical techniques
- •1.3.1 A glance at extraction techniques
- •1.3.2 Microbial culturing techniques
- •1.3.3 Outlook and perspectives in nanoparticles
- •1.4 Natural products as a guide in drug design and synthesis
- •1.5 Natural products as promising drug candidates
- •1.5.1 Antiviral drug candidates
- •1.5.2 Antiparasitic drug candidates
- •1.5.3 Neuroprotective agents
- •1.6 Conclusion
- •Keywords
- •References
- •2. Traditional Knowledge for Drug Discovery
- •2.1 Introduction
- •2.2 Databases on indian remedial flora, indigenous medicines, and phytochemicals
- •2.2.1 Cultural preservation
- •2.2.2 Sustainable practices
- •2.2.3 Biodiversity conservation
- •2.2.4 Health and medicine
- •2.2.5 Climate change adaptation
- •2.2.6 Interconnectedness and wisdom
- •2.3 History of traditional knowledge
- •2.3.1 Indigenous healing practices
- •2.3.2 Aboriginal dreamtime
- •2.3.3 Traditional agriculture
- •2.3.4 Traditional crafts
- •2.3.5 Indigenous cosmologies
- •2.3.6 Traditional music and dance
- •2.3.7 Traditional navigation
- •2.4 Traditional medicine in plant formulations
- •2.4.1 Ayurveda
- •2.4.2 Traditional chinese medicine
- •2.4.3 Indigenous healing practices
- •2.5 Drug discovery
- •2.6 Aspects of developing plant-based drugs
- •2.6.1 Selection criteria for plants
- •2.6.2 Plant material authentication
- •2.6.3 Extraction methods
- •2.6.4 Isolation and structure elucidation of bioactive components
- •2.6.5 Standardization of plant formulations
- •2.7 Conclusions
- •References
- •3. Herbal Healing: Plant-Based Natural Products
- •3.1 Introduction
- •3.2 Classification of secondary metabolites
- •3.2.1 Phenolic compounds
- •3.2.2 Terpenes
- •3.2.3 Alkaloids
- •3.3 History of natural products
- •3.4 Drug discovery from natural products
- •3.5 Drugs derived from the plants
- •3.6 Conclusions
- •Keywords
- •References
- •4. Natural Products with Antimicrobial Properties
- •4.1 Introduction
- •4.2 Plants as antimicrobial agents
- •4.3 Marine sources as antimicrobial agents
- •4.4 Antimicrobial products derived from microorganisms
- •4.5 Conclusions and future trends
- •Keywords
- •References
- •5. Natural Products with Immunomodulatory Properties
- •5.1 Introduction
- •5.2.1 Aloe vera (l.) burm.f. (family: asphodelaceae)
- •5.2.2 Andrographis paniculata (burm. f.) wall.ex.nees. (family: acanthaceae)
- •5.2.3 Acorus calamus l. (family: araceae)
- •5.2.4 Allium sativum l. (family: alliaceae)
- •5.2.5 Azadirachta indica a. juss. (family: meliaceae)
- •5.2.6 Argyreia speciosa (l.f.) sweet (family: convolvulaceae)
- •5.2.7 Bidens pilosa l. (family: asteraceae)
- •5.2.8 Baliospermum montanum (willd.) müll.arg. (family: euphorbiaceae)
- •5.2.9 Boerhaavia diffusa l. (family: nyctaginaceae)
- •5.2.10 Boswellia serrata roxb. excolebr. (family: burseraceae)
- •5.2.11 Camellia sinensis (l.) kuntze (family: theaaceae)
- •5.2.12 Capparis zeylanica l. (family: capparidaceae)
- •5.2.13 Calendula officinalis l. (family: asteraceae)
- •5.2.14 Chelidonium majus l. (family: papaveraceae)
- •5.2.15 Carica papaya l. (family: caricaceae)
- •5.2.26 Glycyrrhiza glabra l. (family: leguminosae)
- •5.2.27 Hypericum perforatum l. (family: hypericaceae)
- •5.2.28 Hippophae rhamnoides l. (family: elaeagnaceae)
- •5.2.29 Hydrastis canadensis l. (family: ranunculaceae)
- •5.2.30 Jatropha curcas l. (family: euphorbiaceae)
- •5.2.31 Mangifera indica l. (family: anacardiaceae)
- •5.2.32 Mollugo verticillata l. (family: molluginaceae)
- •5.2.33 Matricaria chamomilla l. (family: asteraceae)
- •5.2.34 Momordica charantia l. (family: cucurbitaceae)
- •5.2.35 Morinda citrifolia l. (family: rubiaceae)
- •5.2.36 Nigella sativa l. (family: ranunculaceae)
- •5.2.37 Nelumbo nucifera gaertn. (family: nymphaeceae)
- •5.2.38 Nerium oleander l. (family: apocynaceae)
- •5.2.39 Ocimum tenuiflorum l. (family: labiatae)
- •5.2.40 Premna tomentosa willd. (family: verbanaceae)
- •5.2.41 Plantago sp. (plantago major l. and plantago asiatica l.) (family: plantaginaceae)
- •5.2.42 Psoralea corylifolia l. (family: fabaceae)
- •5.2.43 Prunella vulgaris l. (family: lamiaceae)
- •5.2.44 Punica granatum l. (family: punicaceae)
- •5.2.45 Rhinacanthus nasutus (l.) kurz (family: acanthaceae)
- •5.2.46 Salvia officinalis l. (family: lamiaceae)
- •5.2.47 Tamarindus indica l. (family: leguminosae)
- •5.2.48 Tinospora cordifolia (willd.) miers (family: menispermaceae)
- •5.2.16 Centella asiatica (l.) urb. (family: umbelliferae)
- •5.2.17 Cichorium intybus l. (family: asteraceae)
- •5.2.18 Cryptolepis dubia (burm.f.) m.r. almeida (family: apocynaceae)
- •5.2.19 Citrus aurantiifolia (christm.) swingle (family: rutaceae)
- •5.2.20 Curcuma longa l. (family: zingiberaceae)
- •5.2.21 Desmodium gangeticum (l.) dc. (family: fabaceae)
- •5.2.22 Eclipta prostrata (l.) (family: asteraceae)
- •5.2.23 Phyllanthus emblica l. (family: euphorbiaceae)
- •5.2.24 Evolvulus alsinoides (l.) (family: convolvulaceae)
- •5.2.25 Ficus benghalensis l. (family: moraceae)
- •5.2.49 Terminalia chebula retz. (family: combretaceae)
- •5.2.51 Urtica dioica l. (family: urticaceae)
- •5.2.52 Withania somnifera (l.) dunal (cultivated var.) (family: solanaceae)
- •5.3 Traditional importance of research to society and researchers
- •5.4 Conclusion
- •Keywords
- •References
- •6. Natural Products with Anticancerous Properties
- •6.1 Introduction
- •6.2 Plant-derived anticancer compounds
- •6.2.1 Polyphenols
- •6.2.2 Flavanoids
- •6.2.3 Brassinosteroids
- •6.2.4 Vinca alkaloids
- •6.2.5 Taxanes
- •6.2.6 Campothecin derivatives
- •6.3 Microorganisms-based anticancer compounds
- •6.3.1 Primary metabolites
- •6.3.2 Secondary metabolites
- •6.4 Selected medicinal plants with anticancerous activities
- •6.4.1 Curcuma longa l.
- •6.4.2 Viscum album l.
- •6.4.3 Colchicum autumnale l.
- •6.4.4 Raphanus sativus l.
- •6.4.5 Tinospora cordifolia wild
- •6.4.6 Nigella sativa l.
- •6.5 Therapeutic enzymes
- •6.6 Future perspective
- •6.7 Conclusion
- •Keywords
- •References
- •7. Natural Products with Antiviral Properties
- •7.1 Introduction
- •7.2 Source of natural products with antiviral activity
- •7.3 Main components of natural products
- •7.3.1 Flavonoids
- •7.3.2 Polyphenols
- •7.3.3 Polysaccharides
- •7.3.4 Terpenoids
- •7.4 Mechanisms of action of natural compounds in viral infections
- •7.4.1 Direct antiviral effect
- •7.4.2 Anti-inflammatory effect in viral infections
- •7.4.3 Effect on autophagy process
- •7.6 Conclusions
- •Keywords
- •References
- •8. Approaches to Develop Drugs from Natural Products
- •8.1 Introduction
- •8.2 Scenario of drug discovery
- •8.3 Efficient drug discovery engines
- •8.4 Drug discovery approaches using plants
- •8.4.1 Plant selection for screening purpose
- •8.4.2 Authentication of plants
- •8.4.3 Types of molecular markers
- •8.5.1 Parallel approach
- •8.5.2 Sequential approach
- •8.6 Structure elucidation of isolated compounds
- •8.7 Biological screening of extracts/fraction/isolates
- •8.7.1 Cell culture-based assay
- •8.7.2 Dialysis
- •8.7.3 Microdialysis
- •8.7.4 Ultrafiltration
- •8.7.5 Chromatography
- •8.7.6 Ligand fishing
- •8.8 Limitations
- •8.9 Molecular modelling and np database
- •8.10 Future thrust
- •8.11 Conclusion
- •Keywords
- •References
- •9. Strategies for Isolation and Identification of Bioactive Molecules from Natural Sources
- •9.1 Introduction
- •9.2 Bioactive compounds in natural sources and their pharmacological properties
- •9.3.1 Selection of materials
- •9.3.3 Types and properties of solvent for extraction
- •9.4 Extraction methods (conventional and modern)
- •9.4.1 Conventional methods
- •9.4.2 Novel extraction methods
- •9.5 Concentration and purification of bioactive molecules using chromatographic techniques
- •9.5.1 Separation based on adsorption properties
- •9.5.2 Separation based on partition coefficient
- •9.5.3 Separation based on the molecular size
- •9.5.4 Separation based on ionic strength
- •9.5.5 Other modern separation techniques
- •9.6 Identification and characterization of bioactive molecules
- •9.6.1 Qualitative and quantitative techniques/chromatographic or nonchromatographic techniques
- •9.7 Conclusions
- •Keywords
- •References
- •10. Role of Omics in Natural Product-Based Drug Discovery
- •10.1 Introduction
- •10.2 Genomics and transcriptomics in natural product discovery
- •10.2.1 Case studies and examples of natural product discovery using genomics and transcriptomics
- •10.2.2 Limitations and challenges of using genomics and transcriptomics in natural product discovery
- •10.3 Proteomics and metabolomics in natural product discovery
- •10.3.1 Case studies and examples of natural product discovery using proteomics and metabolomics
- •10.4 Bioinformatics in natural product-based drug discovery
- •10.4.1 Role of bioinformatics in natural product-based drug discovery
- •10.4.2 The use of bioinformatics to predict and annotate natural product biosynthetic pathways, gene clusters, and metabolomics
- •10.7 Future perspectives and potential impact of omics in natural product-based drug discovery
- •10.9 Potential impact on drug discovery and development
- •10.10 Conclusion
- •Keywords
- •References
- •11. Natural Products from Endophytic Microorganisms
- •11.1 Introduction
- •11.1.1 Rational/why endophytes?
- •11.2 Diversity of endophytic microorganisms
- •11.2.1 Endophytic bacteria and endophytic actinomycetes
- •11.2.2 Endophytic fungi
- •11.3.1 ISolation methods
- •11.3.1.1.1 Dilution Plating
- •11.3.1.1.2 Direct Plating
- •11.3.2 Identification methods
- •11.4 Bioactive compounds from endophytic microorganisms
- •11.4.1 Antibiotics
- •11.4.2 Antifungal agents
- •11.4.3 Antimalarial agents
- •11.4.4 Antiviral agents
- •11.4.5 Anticancer agents
- •11.4.6 Antioxidants
- •11.5 Stepwise methods for natural product discovery from endophytic microorganisms
- •11.5.1 Plant selection rationale
- •11.5.2 Isolation and cultivation of endophytes
- •11.5.3 Characterization of endophytes
- •11.5.4 Extraction of natural products
- •11.5.5 Purification of natural products
- •11.6 Biosynthesis and strategies for the optimization of natural product discovery from endophytic microorganisms
- •11.6.1 Exploration of novel microbial sources
- •11.6.2 Metabolomics-guided discovery
- •11.6.3 Coculture
- •11.6.4 Genome mining
- •11.6.5 Modulation by ultraviolent irradiation
- •11.7 Future directions and challenges
- •11.7.1 Improving the efficiency and accuracy of screening methods
- •11.7.2 Enhancing the scalability and affordability of production methods
- •11.7.3 Ensure natural product safety and efficacy
- •11.8 Conclusions
- •References
- •12. Natural Products with Antidiabetic Properties
- •12.1 Introduction
- •12.2 Natural products that regulate glucose absorption
- •12.2.1 Serotonin-derived products
- •12.2.2 Butyl-isobutyl-phthalate from laminaria japonica
- •12.2.3 Bioactive compounds of allium cepa and allium sativum
- •12.2.4 Elatosides E and F of aralia elata
- •12.2.5 Bioactive compounds of bauhinia candicans and bauhinia forficate
- •12.3 Natural products that enhance insulin sensitivity
- •12.3.1 Astragalus membranaceus polysaccharides
- •12.3.2 Bioactive compounds of litchi chinensis
- •12.3.3 Bioactive compounds of fenugreek
- •12.3.4 Bioactive compounds of cinnamon
- •12.3.5 Bioactive compounds of gastrodia elata
- •12.3.6 Polysaccharides of dioscorea
- •12.3.7 Anthocyanins of blueberries
- •12.3.8 Bioactive compounds of psidium guajava
- •12.4.1 Gingerol from zingiber officinale
- •12.4.2 Curcumin from curcuma longa
- •12.4.3 Berberine
- •12.4.4 Capsaicin of pepper
- •12.4.5 Bioactive compounds of bitter melon
- •12.4.6 Ginsenosides of ginseng
- •12.4.7 Bioactive compounds of aloe vera
- •12.4.8 Quinides of coffee
- •12.4.9 Bioactive compounds of tinospora cordifolia
- •12.4.10 Bioactive compounds of pterocarpus marsupium
- •12.4.11 Eugenol of ocimum sanctum
- •12.4.12 Bioactive compounds of syzygium densiflorum
- •12.5 Clinical trials based on antidiabetic effects of natural products derived from plants
- •12.5.1 Gymnema sylvestre (gurmar)
- •12.5.2 Fenugreek (trigonella foenum-graecum)
- •12.5.3 Tea catechins
- •12.5.4 Coffee
- •12.5.5 Rosemary (rosmarinus officinalis)
- •12.6 Conclusion
- •12.7 Future scope
- •Keywords
- •References
- •13. Marine-Derived Natural Products with Anticancer Properties
- •13.1 Introduction
- •13.2 Marine bioactive compounds
- •13.3 Anticancer activity of marine plants
- •13.4 Anticancer agents from marine floras
- •13.5.1 Antioxidants
- •13.5.2 Immunomodulation and apoptosis
- •13.5.3 Nutritional values and anticancer effects
- •13.6 Nature and cancer chemotherapy
- •13.7 Marine organisms and cancer chemotherapy
- •13.8 Anticancer agents from marine floras
- •13.9 Marine plants
- •13.9.1 Macro algae (seaweed)
- •13.9.2 Mangroves and other higher plants
- •13.9.3 Cyanobacteria
- •13.9.4 Bacteria
- •13.9.5 Proteobacteria
- •13.9.6 Cyanobacteria
- •13.9.7 Actinomycetes
- •13.9.8 Marine fungi
- •13.9.9 Soft corals
- •13.9.10 Marine sponges
- •13.10 Anticancer bioactive antibiotics derived from marine sources
- •13.10.1 Polyphenols
- •13.10.2 Polysaccharides
- •13.10.3 Alkaloids
- •13.11 Other marine sources for anticancer compounds
- •13.11.1 Peptides
- •13.11.2 Plitidepsin
- •13.11.3 Trabectedin
- •13.11.4 Lurbinectedin
- •13.12 Marine natural products as anticancer drugs
- •13.13.1 Aquaculture/cultivation
- •13.13.2 Genetic engineering
- •13.13.3 Synthesis/semisynthesis/modification
- •13.14 Conclusions and future prospects
- •References
- •14. Natural Products as Novel Opportunities for Cathepsin Inhibitors
- •14.1 Introduction
- •14.2 Cysteine proteases (CPs)
- •14.2.1 Cathepsin
- •14.2.2 Structure and mechanism of action of cathepsins
- •14.3 NPs as cathepsins inhibitors
- •14.3.1 NPs From bacteria as cathepsin inhibitors
- •14.3.2 NPs from fungus as cathepsin inhibitors
- •14.3.3 NPs from marine organism as cathepsin inhibitors
- •14.3.4 NPs from plants as cathepsin inhibitors
- •14.4 Conclusion and future pespectives
- •Keywords
- •References
- •15. Phytoestrogens in Drug Discovery: A Focus on Mechanisms of Action and Safety Assessment
- •15.1 Introduction
- •15.2 Phytoestrogens and estrogen receptors
- •15.3 Nonestrogen receptor-mediated effects of phytoestrogens
- •15.3.1 Mitogen-activated protein kinase (MAPK) pathway
- •15.3.2 PI3K/AKT pathway
- •15.3.3 WNT pathway
- •15.3.4 G-protein-coupled estrogen receptor (GPER)
- •15.4 Structure–activity relationship (SAR) of phytoestrogens
- •15.4.1 Isoflavones
- •15.4.2 Lignans
- •15.4.3 Coumestans
- •15.4.4 Stilbenes
- •15.4.5 Diarylheptanoids
- •15.5 Comparing potency and efficacy of phytoestrogens on various pathways
- •15.5.1 Potency and efficacy of phytoestrogens on different pathways
- •15.5.2 Possible synergistic effects of phytoestrogens with other drugs
- •15.6 Effects of phytoestrogens on the human organs
- •15.7 Safety Assessment of phytoestrogens
- •15.7.1 Toxicity assays used to evaluate the safety of phytoestrogens
- •15.7.2 Potential adverse effects of phytoestrogens
- •15.8 Case study
- •15.8.1 Vaginal cellular differentiation assay
- •15.8.2 Changes in rat body weight
- •15.8.3 Changes in rats’ uterus weight
- •15.9 Current trends in phytoestrogen research
- •15.9.1 Publication trends
- •15.9.2 Analysis of contributing countries and contributing institutions
- •15.9.3 Analysis of contributing publishers and journals
- •15.9.4 Publication evolution and research areas
- •15.9.5 Limitations
- •15.10 Future directions
- •15.10.1 Exploration of unexplored plant sources
- •15.10.2 Understanding mechanisms of action
- •15.10.3 Synthesis of novel compounds
- •15.10.4 Development of SPERMs
- •15.10.5 Safety assessment
- •15.11 Conclusion
- •Keywords
- •References
- •16. Honey Bee Products with Antimicrobial Properties
- •16.1 Introduction
- •16.2 Honey
- •16.3 Bee bread (perga)
- •16.4 Bee pollen
- •16.5 Bee propolis
- •16.6 Conclusion
- •Keywords
- •References
- •17. Natural Products for the Prevention of Leaky Gut
- •17.1 Introduction
- •17.2 The physical and chemical barriers of the intestine
- •17.2.1 Thick mucus layer
- •17.2.2 Intestinal epithelial cells (IECS)
- •17.2.3 Intestinal junctional complexes
- •17.2.4 Lamina propria
- •17.2.5 Intestinal regulatory T cells
- •17.2.6 Intestinal alkaline phosphatase
- •17.2.7 Antimicrobial peptides
- •17.2.8 Lysozyme
- •17.3 Mechanistic view of factors leading to a leaky gut
- •17.3.1 Gut dysbiosis
- •17.3.2 Mucosal inflammation and oxidative stress
- •17.3.3 TJ disruption
- •17.3.4 Genetics
- •17.3.5 Drugs
- •17.4 Pathological implications of a leaky gut
- •17.5 Natural product improving gut microbial dysbiosis
- •17.5.1 Traditional herbs and polyherbal formulations managing gut micro flora
- •17.5.2 Phytocompounds in the management of intestinal barrier integrity through balancing gut microflora
- •17.6.1 Anti-inflammatory traditional medicine and plant extracts ameliorating intestinal mucosal injury
- •17.6.2 Plant active constituents preventing mucosal injury and oxidative damage
- •17.7 Traditional medicine and natural products upregulating the TJ proteins
- •17.7.1 Traditional medicine and herbal extracts promoting junction protein protection
- •17.7.2 Phytocompounds for junction protein protection
- •17.8 Natural products averting pathological conditions through maintaining intestinal barrier function
- •17.9 Conclusion
- •Keywords
- •References
- •18. Role of Natural Products in the Pharmacotherapy of Osteoporosis
- •18.1 Introduction
- •18.1.1 Effect of traditional chinese medicine (TCM)
- •18.1.2 Effect of malay traditional medicine
- •18.1.3 Antiosteoporotic agents extracted from plant sources
- •18.1.4 Treatment by different pigments
- •18.1.5 Other herbal sources
- •18.1.6 Natural plant-based alkaloids
- •18.1.7 Essential markers involved in bone formation and resorption for osteoporosis treatment
- •18.2 Conclusion
- •Keywords
- •References
- •19. Gel-Based Natural Therapeutics: Potential Alternatives to Traditional Drug Delivery Systems in Aquaculture
- •19.1 INtroduction
- •19.2 DDS
- •19.2.1 Water medication
- •19.3 Oral administration
- •19.3.1 Gavage

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CHAPTER 17
Natural Products for the Prevention of Leaky Gut
DEVI BASUMATARY
1
1,3
, PRANAMIKA SARMA
1,2
, and JAGAT C. BORAH
1,4,*
2
3
4
*Corresponding author
ABSTRACT
The intestinal epithetlial layer, which acts as a protective interface between the human
body and the external environment, is spread throughout the digestive system in the form
of a mucosal layer providing multifold functions including nutrient uptake, absorption and
regulation; mucus secretion; providing innate immunity; antigen sensitization, etc. The
epithelial cells are connected by a network of multiprotein clusters, organized as tight
junctions forming channels aiding in paracellular transport, allowing selective passage of
essential nutrients from the gut milieu to the body. The intestine or human gut contains a
diverse microbial flora which maintains the overall physiology of the gut through various
signaling and metabolic pathways. Disturbance in intestinal homeostasis activates a series
of signal transduction pathways causing an inflammatory cascade, a precursor in the
tight junction disruption leading to a disease condition leaky gut. Natural products play
an important role in the mitigation of leaky gut condition through the management of
gut homeostasis. This chapter briefs the various physiological and environmental factors
causing intestinal disruption and leaky gut and the development in natural product research
for its prevention. Further, different physiological conditions arising due to the translocation of endotoxins through the disrupted intestinal membrane have also been discussed.
17.1 INTRODUCTION
Our intestines are lined by protective physical and chemical barriers which constitute a
thick mucus layer, a layer of intestinal epithelial cells known as the intestinal epithelium

426
and lamina propria. The intestinal epithelium is a critical interface between the internal
and external environment of a human body. It protects the human body system against the
external environment that includes antigens from ingested food, resident bacteria of the
food, pathogenic microorganisms, and so on. It is a barrier performing a defensive function
in preventing the entry of potentially harmful substances into the system in addition to its
basic function of transporting water, electrolytes, essential nutrients, and so on to the body.
These functions are enabled by structural adaptations of epithelial cells of the intestinal
epithelium, known as the intestinal epithelial cells, a single layer with diverse cell types.
The intestinal epithelium is made up of cells like enterocytes, goblet cells, paneth cells,
neuroendocrine cell, dendritic cell, and so on, of which the enterocytes being the major
types of cells. Each cell type performs a different type of function for maintenance and
balance of intestinal homeostasis (Kong et al., 2018).
Enterocytes are columnar epithelial cells playing fundamental roles in nutrient absorption (e.g., ions, water, sugar, peptides, and lipids) and in immuno-surveillance activities.
The selectively permeable nature of the intestinal epithelium is maintained by complex
protein-protein interactions, in between the enterocytes, maintaining a sealed gate allowing
only the entry of essential nutrients and macromolecules inside the system (Snoeck et al.,
2005). These complex interactions between different proteins also maintain the integrity of
the intestinal epithelial barrier, keeping the barrier intact. These interactions are called the
junctional complexes which include tight junctions (TJs), gap junctions, adherens junctions,
and desmosomes (Ulluwishewa et al., 2011). The transmembrane proteins of adhesive junctional complexes link adjacent cells to the actin cytoskeleton via cytoplasmic scaffolding
proteins. The adhesive junctions (AJs) and desmosomes act in the mechanical linkage of
adjacent cells, whereas the TJs are the apical-most junctional complex (Groschwitz and
Hogan, 2009). These junctional complexes are dynamic structures and are remodeled in
response to external stimuli like pathogen encounters (Farquhar and Palade, 1963).
When the junctional complexes are compromised, the integrity of intestinal barrier
gets disrupted. Under compromised conditions, the disruption of the intestinal epithelium
creates a condition known as “leaky gut” where the permeability of the intestinal barrier
increases favoring the entry of pathogens, proinammatory cytokines, and antigens into the
systemic circulation. Increased intestinal permeability is associated with various chronic
diseases like inammatory bowel disease (IBD), irritable liver disease, nonalcoholic fatty
liver disease (NAFLD), cardiovascular diseases (CVDs), and so on. Figure 17.1 shows
different conditions leading to leaky gut progression.
“All diseases begin in the gut”—The classical Greek physician Hippocrates claimed
more than 2000 years ago. However, modern scientic investigations have recently started
validating this age-old claim as new ndings disclose that most of the chronic and inamma-
tory diseases being caused through a “leaky gut.” Natural products and herbal compositions
have been playing a major role in the human health and well-being. About 25% modern
medicines in practice today are of natural product origin with another bunch being inspired
by natural products (Atanasov et al., 2021). Traditional medicine systems and healing
practices mention many plant-based formulations and single herbs for the management
and prevention of gastrointestinal disorders, many of which have now been scientically
validated and their benecial potential been explored with modern tools and techniques.

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This state-of-art explored the various physiological conditions leading to leaky gut condition and relates the available literature for prevention of leaky gut condition with natural
products. This chapter further summarizes the related pathological complications which
may result from a leaky gut ranging from minor gastrointestinal complications to deadly
diseases like cancer. Further studies describing the benecial potential of natural products
in the management of various pathological ailments through the management of intestinal
axis were also explored.
FIGURE 17.1 Different physiological and environmental factors affecting the progression of leaky gut.
⏎
17.2 THE PHYSICAL AND CHEMICAL BARRIERS OF THE INTESTINE
The gastrointestinal tract and its complex operations are maintained by the constitution of
different dynamic layers of critical barriers. The complex physical and chemical intestinal
barriers are primarily composed of an outer mucus layer, intermediate epithelial cells,
inner lamina propria, antimicrobial peptides (AMPs), and secretory immunoglobulins.
Figure 17.2 depicts different layers of the intestinal epithelium acting as a physical barrier.
17.2.1 THICK MUCUS LAYER
The goblet cells secrete a thick coating of mucus that covers the colon and functions as the
initial “physical defense” separating the host immunity from the gut microbiota and other

428
invaders preventing a harmful interaction (Okumura and Takeda, 2017). The mucus layer
is a requisite part of the intestine’s structural makeup, working as a conduit for screening,
lubrication, and translocation of the luminal contents through the epithelial layer. The main
gel-forming high molecular weight glycoprotein components known as mucins are what
provide mucus its viscoelastic, polymer-like qualities (Deplancke and Gaskins, 2001).
These mucins can be generically categorized as either transmembrane mucins, which
create the glycocalyx protecting the underlying epithelial cells, or gel-forming mucins
crucial for the structural framework for the mucosal barrier (Grondin et al., 2020). Because
of the host’s disproportionate immune responses to gut bacteria, impaired mucosal barriers
allow gut microbes and associated toxins to easily infiltrate the mucosa and cause intestinal
inflammation.
FIGURE 17.2 Cross-sectional view of the four different layers of intestinal barrier.
⏎
17.2.2 INTESTINAL EPITHELIAL CELLS (IECS)
The intestinal epithelial cells (IECs) are covered by a cell monolayer called intestinal
epithelial cells. As part of its inherent defense mechanism, which prevents bacterial
colonization, intestinal epithelium can renew itself every few days through a cycle of
regeneration and migration made by stem cells present in crypts of the intestinal glands
(Sansonetti, 2004). Enterocytes, goblet cells, paneth cells, and neuroendocrine cells
are the diverse cell types present in the intestinal epithelium. The enterocyte is the
most common type of cell in the intestinal epithelial monolayer. They are columnar
epithelial cells essential for both the release of immunoglobulins and the absorption of
essential molecules. The goblet cells, which make up about 10% of the IECs, release a
coating of protective mucus that serves to lubricate and protect the intestinal wall from
chemical and physical damages caused by digestive enzymes, associated microbes, and
their toxins while food passes through the intestines (Gustafsson and Johansson, 2022;
Kim and Ho, 2010). Paneth cells are granular-rich small intestine crypt-based epithelial
cells that synthesize and release AMPs and proteins. Paneth cells use cell-autonomous
MyD88 activation to identify enteric bacteria, which causes the development of several

429
antimicrobial factors (Adolph et al., 2018; Vaishnava et al., 2008). In response to
external stimuli, the neuroendocrine cells release intestinal hormones or peptides into the
bloodstream and activate neural reactions. These intestinal hormones or peptides serve as
chemoreceptors, which functions in digestive actions, identify hazardous chemicals, and
provide protection.
17.2.3 INTESTINAL JUNCTIONAL COMPLEXES
Immune homeostasis depends on an intact intestinal barrier, and its disruption triggers the
activation of the immune system causing chronic inflammation and diseases. A variety of
protein complexes known as apical junctional complexes keep intestinal barrier intact.
TJs, desmosomes, and adheren junctions are such protein complexes that maintain the
integrity of the intestinal barrier (Alizadeh et al., 2022). TJs are made up of different
junctional molecules like claudin, occludin, tricellulin, junctional adhesion molecule A,
and zonula occludens (ZO). These junctional molecules regulate the paracellular transport of water, ions, and other macromolecules in neighboring cells. They also inhibit
the paracellular transit of pathogens and endotoxins produced from pathogens (Suzuki,
2020). The adherens junctions initiate and sustain cell–cell adhesion and regulate intracellular signaling and transcription of essential factors (Hartsock and Nelson, 2008).
The primary transmembrane protein of the AJ is the classical E-cadherin which has five
extracellular cadherin repeat domains binding to the cadherin on the opposing cell in a
calcium-dependent way. The formation, maintenance, and function of AJs are regulated
by E-cadherin along with the catenin family members (Garcia et al., 2018; Hartsock and
Nelson, 2008).
Desmosomes are associations between cells connecting the plasma membrane with
intermediate laments. Desmogleins and desmocollins belonging to the cadherin superfamily mediate adhesion at desmosomes. Desmosomes play an important role in cell–cell
adhesion upholding the intestinal epithelial integrity (Delva et al., 2019).
17.2.4 LAMINA PROPRIA
The connective tissue present in the villi core is formed by the lamina propria which surrounds
the crypt of the epithelium. The basal lamina supports the underlying epithelium and acts as
a filter, permitting only water and tiny particles to pass through. Additionally, it prevents
communication between tissue’s epithelial cells and other cell types. To act as a strong
secondary line of defense, lamina propria has a large number of immune-functioning cells
that protects the mucosal epithelium’s relative fragility and vulnerability which is because of
the ease with which potential invading microbes can penetrate it, compared to the epidermis
(Tong and Tang, 2017; Zeitz et al., 1991). The lamina propria hosts the immunological
responses due to the high number of macrophages and lymphoid cells there. It is an element
of the defensive mechanism that safeguards internal tissues against hazardous external
microorganisms, notably those from the gastrointestinal system (Bischoff et al., 2014).

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17.2.5 INTESTINAL REGULATORY T CELLS
For the intestinal immune system to respond appropriately to self- and nonself antigens,
regulatory T cells (T regs) are crucial. The inflammation brought on by a lack of Treg production, activity, or stability in the gut serves as an example of its significance in maintaining
intestinal homeostasis (Figliuolo da Paz et al., 2021). Intestinal diseases like IBD, food
allergies, and so on are frequently brought on by inappropriate immune responses to these
harmless antigens. Immunological tolerance to these harmless foreign antigens is produced
by Tregs through mucosal tolerance. Forkhead box P3 (Foxp3), expressed by Treg cells,
inhibits the immune system’s reaction to harmless foreign antigens. High-affinity interleukin-2 (IL-2) receptor CD25 and suppressor cytokines including IL-10 and transforming
growth factor 1 (TGF-1) expressed by Treg cells prevent activation of neighboring ef fector
T cells (Sakaguchi et al., 2010).
17.2.6 INTESTINAL ALKALINE PHOSPHATASE
The brush border enzyme intestinal alkaline phosphatase (IAP) of alkaline phosphatase
family is secreted by the IECs. It is made in the intestinal lumen and acts as a “functional
barrier” to neutralize bacterial lipopolysaccharides (LPS), dephosphorylate proinflammatory nucleotides and pathogen-associated molecular patterns, control bicarbonate secretion
and pH of the duodenal surface, absorb intestinal long-chain fatty acids, and regulate the
gut microbiome (Singh et al., 2020). Systemic infections and inflammatory conditions such
as IBD, metabolic syndrome, cystic fibrosis, necrotizing enterocolitis, and diabetes are
linked to a reduced expression of IAP (Fawley and Gourlay, 2016).
17.2.7 ANTIMICROBIAL PEPTIDES
AMPs are diverse bioactive compounds playing critical roles in host defense and providing
protection against enteric infections. AMPs are innate immune system effector chemicals
that have been preserved throughout evolution. They promote innate immunity by inducing
inflammatory and antibacterial responses (Gao et al., 2020). They are expressed by the
paneth cells in the gastrointestinal tract (Gubatan et al., 2021). Located in tiny groups at the
base of crypts of Lieberkühn, paneth cells are secretory cells present in the small intestine’s
epithelium. The effector molecules are released by the antimicrobial-rich granules found in
these cells into the crypt lumen and diffuse into the mucous layer that covers the mucosal
epithelium, where they help to create the mucosal antimicrobial barrier. The antimicrobials
hunt out microbes, including the small intestine’s native microbiota and invasive pathogens
(Bevins and Salzman, 2011).
17.2.8 LYSOZYME
The host’s natural defensive mechanism is largely comprised of lysozyme (1,4-N-acetyl-
muramidase). In the human small intestine and ascending colon, paneth cells generate this

431
antimicrobial protein (Zigdon and Bel, 2020). The major source of luminal lysozyme that
directly interacts with commensal bacteria comes from paneth cells, which exude lysozyme
into the intestinal lumen. The intestinal lamina propria contains significant amounts of lysozyme produced by neutrophils and macrophages (Yu et al., 2020). It works to kill bacteria
by activating AMPs and hydrolyzing peptidoglycans. By cleaving the β-1,4 links between
N-acetylglucosamine and N-acetylmuramic acid of peptidoglycan, lysozyme selectively
catalyzes the breakdown of bacterial cell walls (Ellison and Giehl, 1991). Lysozyme has
a great resistance to being hydrolyzed by acids, proteases, and gastrointestinal digestion.
17.3 MECHANISTIC VIEW OF FACTORS LEADING TO A LEAKY GUT
Compromised intestinal barrier integrity results from various genetic and environmental
factors. One of the main physiological concerns is the loss of barrier integrity, which has
been associated with the initiation and development of several pathophysiological diseases.
Studies over the years have helped us to grasp the intricate mechanisms that may increase
intestinal barrier permeability and cause the barrier to lose both its structural integrity and
function. Understanding the many underlying processes is crucial for creating new and
effective treatment targets.
17.3.1 GUT DYSBIOSIS
Gut dysbiosis is the loss of the microbial population’s equilibrium in the gut. In this condition, the population of commensal microorganisms declines while the number of pathogenic
microbes increases. Dysbiosis results in immunological dysregulation and proinflammatory
effects that are associated to a variety of disease states, such as autoimmune illnesses, type
2 diabetes, CVDs, and fatty liver (Martinez et al., 2021). Mucosal immunity, genetic, and
environmental variables tightly control the gut microbiota’s homeostasis (Lee et al., 2011;
Swidsinski et al., 2007; Yatsunenko et al., 2012). Gut dysbiosis and its associated factors,
such as small intestinal bacterial overgrowth, rise in pathogen population, increase in endotoxin levels, rise in microbial energy harvesting capacity , mucosal inflammation, and so on
work together to cause a leaky gut. Commensal microorganisms can protect the integrity
of the intestinal barrier by secreting antibacterial compounds like bacteriocins and creating
short-chain fatty acids (SCFAs) with anti-inflammatory characteristics like butyrate from
dietary fibers. Gut dysbiosis induces increased bacterial metabolites like LPS, toxins, and
so on which causes mild to severe inflammations in the intestinal epithelium leading to
an impaired intestinal barrier. The unfavorable synthesis of zonulin, a protein crucial for
regulating TJs and eventually leading to the disintegration of gut barrier, is another way
that gut dysbiosis can manifest as a leaky gut disorder (Fasano, 2020).
17.3.2
MUCOSAL INFLAMMATION AND OXIDATIVE STRESS
Mucosal inflammation caused by a dysbiotic gut, immune response to infections, antigens,
and so on is a precursor for increased intestinal permeability which starts from a low-grade

432
systemic inflammation. An imbalanced immune response to the host intestinal microbiota
causes idiopathic diseases like IBD, which is caused by mucosal inflammation. Loss of
intestinal barrier function has been linked to mucosal inflammation in both microbiomedependent and -independent ways. According to reports, TNF-induced decreases in ZO-1
production and oculocerebrocutaneous syndrome endocytosis offer convincing proof that
inflammation reduces intestinal barrier function through the activation of myosin light
chain kinase (Ma et al., 2004).
Another major cause of intestinal barrier disruption is oxidative stress. Oxidative
stress is the outcome of an imbalance between the generation and clearance of reactive
oxygen species (ROS). Intestine is a signicant source of ROS due to its constant contact
to external chemicals and microbial infections (Wang et al., 2020). Intestinal and systemic
inammation are brought on by increased TJ permeability caused by oxidative damage
(Hasegawa et al., 2021).
17.3.3 TJ DISRUPTION
The tight junction proteins (TJPs) of epithelial intracellular junctions positioned in the
apical region of the intestinal epithelium have a selective barrier function that permits the
passage and transportation of vital solutes and compounds but restricts the transport of
proteins, lipids, and peptides generated from microorganisms. Claudins, occludins, zona
occludens, cingulin, and so on are a few of the proteins that make up TJs which form a
framework connecting the actin cytoskeleton with the transmembrane proteins (Bhat et al.,
2019). IBD, multiple sclerosis, and cancer are all inflammation-related disorders caused by
dysregulation of TJ proteins which promotes altered barrier function affecting the amounts
of inflammatory cytokines like IFN-alpha, IFN-gamma, IL-6, and IL-1 (Chen et al., 2006;
Kim et al., 2022; Lee et al., 2018; Li et al., 2022). Intestinal permeability may rise as a
result of variables such as proinflammatory cytokines, pathogenic bacteria, LPS, and other
clinical circumstances that impair TJ homeostasis (Lee et al., 2018).
17.3.4 GENETICS
Since the intestinal epithelial barrier is not fully impermeable and is not designed to be,
we all have a certain amount of leaky gut, although some of us may be more susceptible to
alterations in the digestive system due to a genetic predisposition. In contrast to unrelated
relatives and controls, relatives of Crohn’s disease patients have higher intestinal permeability , according to a research by Buhner et al. The increased permeability was connected
to a mutation in the caspase recruitment domain (Buhner et al., 2016). Genetic and environmental variables also have an influence on the makeup of the gut’s microbes, and they can
either directly or indirectly lead to inflammation that compromises the epithelial barrier
et al., 2017). Another investigation found that the gut epithelium becomes more
(Mu
permeable as a result of a rare mutation in the protein tyrosine phosphatase nonreceptor
type 2 gene (Marchelletta et al., 2021). In persons with genetic predispositions, increased
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