Zonulin’s Impact on Intestinal Permeability and the Development of Infant Colic: Mechanisms of Interrelation

Objective. To identify the mechanisms of the relationship between the effect of zonulin protein on the intestinal wall and the occurrence of infantile colic based on the study of scientific sources. Materials and Methods. Scientific articles were searched in PubMed, Scopus, Web of Science, and F1000Research databases. Ninety-six sources published between 1991 and 2023 were selected. Results. The history of the discovery of the zonulin protein is presented, together with a modern view of the structure of the dense intercellular junctions of the intestinal epithelium, and the processes by which the effect of zonulin on altering the permeability of the intestinal barrier is realised are described. The data of several studies in which increased levels of zonulin were found in groups of children with colic and with GI dysfunction are presented. There is a review of works in which the connection of zonulin with extraintestinal pathology - psychiatric disorders, endocrine, autoimmune, cardiopulmonary, allergic, infectious diseases - has been noted. Zonulin is a promising pharmacological target - to date, there is a specific zonulin inhibitor molecule showing efficacy in the treatment of celiac disease and multisystemic inflammatory syndrome in children. Conclusion. The analysis of publications shows the undoubted relevance of the study of zonulin as a factor affecting the permeability of the intestinal wall and a number of other processes. Its role in the formation of intestinal colic requires more detailed study, as discoveries in this area can be actively integrated into clinical practice.