@Elph68
It seems that you are right that a loss of epithelial cells can increase intestinal permeability, but the study you quoted says this happens in the context of inflammatory bowel diseases (IBD), which are a set of severe bowel conditions, such as Crohn's and ulcerative colitis (UC).
However, ME/CFS patients generally do not have Crohn's or UC or other forms of IBD, so this epithelial cell damage probably does not apply to ME/CFS, or to most other diseases. Most diseases do not involve severe bowel inflammation.
Many ME/CFS patients do have irritable bowel syndrome (IBS), myself included, but if there is any inflammation in IBS, it is very subtle and weak, not like the severe bowel inflammation found in Crohn's or UC.
I should think that outside of IBD, you will not get loss of epithelial cells, and so I would think that outside of IBD, leaky gut when it does occur will be only be caused by tight junction dysfunction in most people.
Incidentally, I have speculated that a leaky gut from tight junction dysfunction may promote the coxsackievirus B infections that are strongly linked to ME/CFS.
The receptor that many coxsackievirus B species attach to in order to enter and infect human cells is called the coxsackievirus and adenovirus receptor (CAR). The interesting thing about CAR is that it is found in an inaccessible location: CAR is actually part of the tight junction that binds together the epithelial cells in the intestinal lining, and tight junctions are normally closed, making CAR inaccessible.
So how does coxsackievirus B attach itself to CAR?
This passage explains it:
So I can't help wondering whether having leaky gut, where your tight junctions are open and dysfunctional, may allow a coxsackievirus B infection in the gut to become worse than normal, as one might speculate that a leaky gut will make the CAR receptors more accessible to coxsackievirus B.
But this is all just pure speculation.
Hi Hip,
IBD (Crohns & Ulcerative Colitis) is classed as an auto-immune disease ..... Same/similar symptoms as CFS .... Patients with IBD still have IBS, And how does anyone know for sure that IBS is not in fact a very mild form of IBD??
The papers say that the same bacteria are implicated in IBS and IBD ....
I believe there is not a single cause for this disease ... I believe Brain Fog etc = TOO MUCH SUGARS (Acidosis) Auto-immunity = bugs (bacteria/viruses) in lymphatic system .....
over 50% however, are viridans streptococcus/enterococcus based