Among the several triggering factors of leaky
gut, the abuse on therapeutic drugs might be playing a protagonist role . In
particular the indiscriminate consumption of Antibiotics  and Non- Steroidal
Anti-Inflammatory Drugs (NSAIDs) -  are alleged to be respectively
leading toward microbiota and intestinal wall malfunctioning, which then might
result into such widespread incidence of leaky gut that is being observed
during lasts years.
Though it is broadly well recognized that
antibiotic abuse is a nowadays major problem because of the huge increase on
circulating antibiotic-resistant pathogenic strains, much less attention is
given to the tremendous negative impact that antibiotic consumption causes on the
homeostasis of gut microbiota . Conscious of the fundamental role of gut microbiota
on regulating many of the overall organism inter-regulatory pathways, it won’t
be difficult to foresee that, in addition to local gastrointestinal
disturbances, antibiotic abuse might be importantly altering systemic
homeostasis. Beyond altering the equilibrium among the many commensal strains,
therefore favoring Pathogenic Small Intestine Bacterial Outgrowth (SIBO) which
then triggers gut inflammation, microbiota dysfunction might result into a relevant
imbalance of vitamins, nutrient and regulatory molecules that would be
certainly reflected on many systemic disorders , .
Similarly, beyond the very well known gastric
injury associated to NSAIDs, which is partially circumvented by
co-administering Protein Pump Inhibitors (PPI) or by using COX-2 specific
NSAIDs (COXIBs), it would be crucial to pay further careful attention to the
NSAIDs derived impairment on the lower intestinal tract , . Mitochondrial
uncoupling is a well known off target mechanism common to all NSAIDs (including
COXIBs), which it is supposed to be behind an abnormal increase on intestinal
permeability. As matter of fact, following the administration of NSAIDs it is
registered a relevant boost on intestinal permeability that leads to an
abnormal inflow of entero-bacteria, toxins and/or undigested molecules into the
bloodstream. Such massive challenge represents an important insult to the
organism, which react by triggering a commensurate local and systemic
inflammatory response. At this point, influenced also by additional factors
such as wrong dietary practices, psychical stress and/or genetic vulnerability,
the insidious increase in gut permeability might become clinically relevant
from subject to subject through a disparate range of apparently distant
disorders harboring a systemic inflammatory background . Shockingly, worth
mentioning that very often such secondary inflammatory disorders are
counteracted with an extra use of NSAIDs, without realizing that an additional
induction/maintenance of leaky gut might be actually further fostering a systemic
pro-inflammatory stage .
Indeed, in spite of the noticeable leaky gut
consciousness registered on lasts years , much more have yet to be done.
More accurate and easy to perform diagnostic tools, would be certainly a major
and very valuable goal to be pursued in order to further extend the attentiveness
on this subject. Nonetheless, in the mean time, with the biomarkers and
diagnostic tools already available it would be possible to implement systematic
and more accurate procedures to deal with this growing and insidious disorder
that is hidden at the base of a myriad of many other patho-physiological
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