Fig. 2

Pathogenetic relevance of the trilateral relationship among ASNP, intestinal mucosa and microbiota. Adverse outcomes (here focused on the intestine but potentially involving other organs) derive from a relatively limited number of main pathogenetic mechanisms activated by the interactions among ASNP, microbiota and intestinal mucosa. Each of these can influence the other two. Depending on their biological identities, ASNP can modify microbiota and damage intestinal mucosa (see text). In turn, through the secretion of products and metabolites, gut cells and microbiota can modify the biological identity of ASNP and, hence, their biological effects. The bidirectional interaction between microbiota and the intestinal mucosa is documented by a rich literature