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World J Gastroenterol. Nov 21, 2013; 19(43): 7531-7543
Published online Nov 21, 2013. doi: 10.3748/wjg.v19.i43.7531
Published online Nov 21, 2013. doi: 10.3748/wjg.v19.i43.7531
Enteric bacterial proteases in inflammatory bowel disease- pathophysiology and clinical implications
Ian M Carroll, Division of Gastroenterology and Hepatology, Center for Gastrointestinal Biology and Disease, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
Nitsan Maharshak, Department of Gastroenterology and Liver Disease, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv 69643, Israel
Author contributions: Carroll IM and Maharshak N contributed equally to this work, reviewed the literature, wrote and drafted the paper.
Supported by The national institutes of health (DK092330) to Carroll IM
Correspondence to: Nitsan Maharshak, MD, Assistant Professor of Medicine, IBD Center, Department of Gastroenterology and Liver Disease, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University, 6 Weizmann St., Tel Aviv 69643, Israel. nitsanm@tlvmc.gov.il
Telephone: +972-3-6947304 Fax: +972-3-6974622
Received: September 17, 2013
Revised: October 15, 2013
Accepted: November 3, 2013
Published online: November 21, 2013
Processing time: 92 Days and 7.7 Hours
Revised: October 15, 2013
Accepted: November 3, 2013
Published online: November 21, 2013
Processing time: 92 Days and 7.7 Hours
Core Tip
Core tip: It is currently accepted that an enteric dysbiosis (alteration of the normal bacterial flora) is involved in the pathophysiology of inflammatory bowel diseases (IBD). One of the suggested mechanisms that ties an intestinal dysbiosis to the pathophysiology of IBD involves the release of enteric bacterial proteases that interact with protease activated receptors on epithelial cells, resulting in intestinal barrier dysfunction and exposure of the enteric immune system to luminal antigens. We have reviewed the literature that examined the role of microbial proteases and their enteric receptors in the pathogenesis of IBD, their suggested pathways of action, and discuss future therapeutic implications.