Immunologic regulation of toll-like receptors in gut epithelium.

PURPOSE OF REVIEW: In response to the presence of pathogens in the environment, the innate immune system has evolved to provide a rapid defense against microbes. This response involves the recognition of molecular patterns present in diverse microbes by a series of receptors termed toll-like receptors. The focus of this article is the regulation of toll-like receptor signaling in the intestinal epithelium. The intestinal epithelium is continually exposed to a high concentration of diverse bacteria. In spite of the density of commensal bacteria, the normal intestine is not inflamed. Idiopathic inflammatory bowel disease in humans and animals is characterized by aberrant host-microbial interactions. RECENT
FINDINGS: Several studies demonstrate that intestinal epithelial cells are poorly responsive to microbial products. The reason for this hyporesponsiveness is decreased or polarized expression of toll-like receptor molecules. Inflammatory cytokines upregulate expression of toll-like receptors.
SUMMARY: The intestinal epithelium has evolved under the pressure of the microbiota to mute a response to commensal bacteria while maintaining the ability to respond to pathogens. In inflammatory bowel disease, the loss of tolerance to the normal flora may be due in part to inappropriate toll-like receptor signaling.