Epithelial Barrier Theory

Epithelial Barrier Theory in 9 Lectures

Lecture 1: Introduction

“Epihelial Barrier Theory” proposes that increased exposure to epithelial barrier damaging agents linked to industrialization, urbanization and modern life underlies the rise in allergic, autoimmune and other chronic conditions. It discusses whether the immune response to dysbiotic microbiota that cross the damaged barrier are involved in the development of these diseases. 

Lecture 2: The problem: Pandemic of many chronic noncommunicable diseases starting after 1960s and increasing after 2000s.

The incidence of allergic asthma and atopic dermatitis started to grow to epidemic proportions after the 1960s (see also Box 1). Since 2000, the prevalence of food allergy, eosinophilic esophagitis and drug-induced anaphylaxis has risen to epidemic proportions 9-11.

Epithelial Barrrier Theory” was featured in the World Economic Forum

Epithelial Barrier Theory was in the Imagination in Action (MIT) session Innovation in Action Summit. It was presented in the DOME in a full day session organized by the MIT “Imagination in Action”.

Please see the links for the Demo and Podium.
“Imagination in Action Davos 2024, a convergence of global visionaries and innovators, is scheduled for January 17 in Davos, Switzerland. This event, harmonizing with the World Economic Forum’s Annual Meeting, highlights a dynamic assembly of change-makers and business leaders, complemented by technology and science leadership at MIT.” Read more here.


Original Articles

Electrical impedance spectroscopy, an efficient method for skin barrier detection.

Rinaldi AO, Korsfeldt A, Ward S, Burla D, Dreher A, Gautschi M, Stolpe B, Tan G, Bersuch E, Melin D, Askary Lord N, Grant S, Svedenhag P, Tsekova K, Schmid-Grendelmeier P, Möhrenschlager M, Renner ED, Akdis CA. Allergy. 2021 Oct;76(10):3066-3079.

Rinaldi AO, Morita H, Wawrzyniak P, Dreher A, Grant S, Svedenhag P, Akdis CA. Allergy. 2019 Oct;74(10):1934-1944. doi: 10.1111/all.13824.

Electrical impedance spectroscopy

The quantitative assessment of the skin barrier’s integrity in vivo holds significant potential across various clinical applications, encompassing diagnosis, ongoing monitoring, preventative measures, and the evaluation of therapeutic interventions. Both invasive and non-invasive techniques have been developed to investigate the functionality of the skin barrier. Among the non-invasive approaches, examples include the measurement of skin hydration, colorimetry, skin surface pH, and sebometry. However, these methods offer limited insights into diverse skin attributes and states, lacking a direct measurement of the skin barrier’s performance. A widely employed technique, known as trans-epidermal water loss (TEWL), is susceptible to the influence of various environmental factors. Its accuracy is dependent upon factors such as humidity, temperature, and the level of skin hydration.

Negative impact of professional dishwasher rinse aid on gut health.

Ogulur I, Pat Y, Aydin T, Yazici D, Rückert B, Peng Y, Kim J, Radzikowska U, Westermann P, Sokolowska M, Dhir R, Akdis M, Nadeau K, Akdis CA. J Allergy Clin Immunol. 2023 Feb;151(2):469-484.

According to the epithelial barrier theory, exposure to many toxic substances in humans and animals damages the epithelium, the thin layer of cells that covers the surface of our skin, lungs and intestine. A number of diseases, including food allergy, esophagitis, gastritis, diabetes, obesity, fatty liver, autoimmune hepatitis, liver cirrhosis, rheumatoid arthritis, multiple sclerosis, autism spectrum diseases, chronic depression, Alzheimer’s and Parkinson’s diseases have been linked to defective epithelial barriers in the digestive system and dysbiosis in the microbiota particularly in the gut. In general, it has been proposed that damaged epithelial barriers contribute to the pathogenesis of two billion patients.


Cezmi Akdis in Imagination in Action, World Economic Forum MIT day January 2024

Introduction and why 2 billion patients after 1960s

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On the way to epithelial barrier theory and molecular evidence

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Overall mechanisms and conclusion

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The whole story July 2023

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Recent Video from Cezmi Akdis on Epithelial Barrier Theory

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From the outside in: Chemical exposures & gut/skin barrier damage

2023 Chlidhood Eczema Prevention Annual Research Symposium