Dimethyl Fumarate and Intestine: From Main Suspect to Potential Ally against Gut Disorders

Abstract

Dimethyl fumarate (DMF) is a well-characterized molecule that exhibits immuno-modulatory, anti-inflammatory, and antioxidant properties and that is currently approved for the treatment of psoriasis and multiple sclerosis. Due to its Nrf2-dependent and independent mechanisms of action, DMF has a therapeutic potential much broader than expected. In this comprehensive review, we discuss the state-of-the-art and future perspectives regarding the potential repurposing of DMF in the context of chronic inflammatory diseases of the intestine, such as inflammatory bowel disorders (i.e., Crohn’s disease and ulcerative colitis) and celiac disease. DMF’s mechanisms of action, as well as an exhaustive analysis of the in vitro/in vivo evidence of its beneficial effects on the intestine and the gut microbiota, together with observational studies on multiple sclerosis patients, are here reported. Based on the collected evidence, we highlight the new potential applications of this molecule in the context of inflammatory and immune-mediated intestinal diseases.

Guardians at the Gate: Immune System in Gastrointestinal Diseases

“…Alterations in the intestinal mucosal barrier lead to conditions such as leaky gut syndrome, which is characterized by increased intestinal permeability and is a potential contributor not only to various GI pathologies, but also to systemic conditions including metabolic syndrome, neurodegenerative diseases, or autoimmune disorders. In fact, autoimmune pathology treatments such as dimethyl fumarate could not only improve psoriasis or multiple sclerosis, but may also be a new potential therapy in the context of inflammatory and immune-mediated intestinal diseases [ 25 ].…”