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The tight junction complex in the anorectal mucosa is a specialized intercellular structure that regulates the paracellular movement of ions, water, and macromolecules while maintaining a physical barrier against pathogens and toxins [1, 4]. It is composed of transmembrane proteins such as claudins and occludin, which are anchored to the actin cytoskeleton by scaffold proteins like zonula occludens (ZO-1, ZO-2, ZO-3) [2]. In the anorectal region, this barrier is critical for preventing the entry of fecal bacteria and inflammatory mediators into the systemic circulation [3]. Dysfunction of these complexes is associated with conditions such as proctitis, inflammatory bowel disease, and increased susceptibility to sexually transmitted infections [2, 4]. Therapeutic strategies often focus on either strengthening this barrier to treat inflammation or transiently opening it to facilitate the delivery of rectally administered drugs [1, 3].
Modulation of paracellular permeability through the reorganization or regulation of tight junction proteins such as claudins, occludin, and zonula occludens proteins.
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