Intestinal adaptation: structure, function, and regulation.
Intestinal adaptation: structure, function, and regulation.
复制标题
DOI：
10.1053/spsu.2001.22383
复制
发表时间：
2001-05-01
影响因子：
1.7
通讯作者：
Warner, B W
中科院分区：
文献类型：
--
作者：
O'Brien, D P;Nelson, L A;Warner, B W
在大量小肠切除（SBR）后，剩余肠道会经历一个适应过程，其特征是湿重、蛋白质和DNA含量、绒毛高度和隐窝深度以及吸收表面积增加。这些变化是一种增殖刺激的结果，该刺激增加隐窝细胞有丝分裂，并促进细胞沿绒毛轴的进展。在功能上，钠/葡萄糖协同转运蛋白、钠/氢交换体以及其他参与肠道消化和吸收的酶会上调。这些生理事件是剩余肠道对消化和吸收能力突然丧失的一种代偿性反应。肠道适应不良的一个主要后果是终身依赖肠外营养，这最终会导致胆汁淤积性肝功能障碍。此外，适应可能与肠道通透性的改变以及细菌移位和败血症风险增加有关。已经提出了几种被认为对切除术后适应反应不可或缺的介质，包括肠腔内营养物质、胃肠分泌物和体液因子。对肠道适应的透彻理解对于合理开发新的和创新性的疗法以增强这一复杂但重要的过程至关重要。
After massive small bowel resection (SBR), the remnant intestine undergoes an adaptive process characterized by increases in wet weight, protein and DNA content, villus height and crypt depth, and absorptive surface area. These changes are the result of a proliferative stimulus that increases crypt cell mitosis and augments cellular progression along the villus axis. Functionally, there is upregulation of the Na(+)/glucose cotransporter, Na(+)/H(+) exchanger, and other enzymes involved in intestinal digestion and absorption. These physiologic events are a compensatory response to the sudden loss of digestive and absorptive capacity by the remnant intestine. A major consequence of inadequate intestinal adaptation is lifelong dependence on parenteral nutrition, which results ultimately in cholestatic liver dysfunction. Furthermore, adaptation may be associated with changes in intestinal permeability and an increased risk of bacterial translocation and sepsis. Several mediators thought to be integral to the postresection adaptive response have been proposed, including luminal nutrients, gastrointestinal secretions, and humoral factors. A thorough understanding of intestinal adaptation will be essential in the rational development of new and innovative therapies that amplify this complex but important process.