Short-chain fatty acids in the human colon: Relation to gastrointestinal health and disease
Short-chain fatty acids in the human colon: Relation to gastrointestinal health and disease
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DOI：
10.3109/00365529609094568
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发表时间：
1996-01-01
影响因子：
1.9
通讯作者：
Clausen, MR
中科院分区：
文献类型：
--
作者：
Mortensen, PB;Clausen, MR
发酵是厌氧细菌将碳水化合物分解成短链（C-2-C-6）脂肪酸（SCFAs）的过程，是大肠的重要功能。scfa约占结肠阴离子浓度的三分之二（70-130 mmol/l），主要以醋酸盐、丙酸盐和丁酸盐的形式存在。尽管存在这些事实，胃肠病学家对这一科学领域的研究却姗姗来迟，这与兽医形成了鲜明对比。几十年来，兽医一直认为，发酵产生scfa是食草动物肠道消化的主要机制。近10年来，由于胃肠道功能和有益作用与这些酸有关，人们对短链脂肪酸对人体机体的影响的兴趣迅速增长。短链脂肪酸在了解膳食纤维的生理功能及其在结肠肿瘤中的可能作用方面具有重要意义。短链脂肪酸的产生和吸收与结肠黏膜的营养、钠和水的吸收以及腹泻的机制密切相关。严重吸收不良的患者通过发酵将渗透性活性糖转化为短链脂肪酸来补偿，短链脂肪酸很容易被吸收并在机体中用作能量燃料。从膳食碳水化合物中产生短链脂肪酸是一种机制，如果调整饮食治疗，短肠患者可以通过这种机制节省大量的卡路里，从而保留结肠功能。SCFA灌肠是一种治疗溃疡性结肠炎的新方法。这种效应归因于结肠炎细胞中scfa的氧化。大量的论文描述了丁酸盐对各种细胞功能的影响，其意义尚不清楚。到目前为止，人们的注意力主要集中在癌症的预防和治疗上。SCFAs的产生减少似乎与抗生素相关的腹泻、转移性结肠炎以及可能的袋炎有关。细菌发酵、氨代谢、细菌生长和蛋白质合成之间的相互作用似乎是乳果糖治疗肝性昏迷的主要作用机制。病理性和极高的糖类发酵率解释了d -乳酸酸中毒患者的严重恶化。因此，对于临床工作的胃肠病学家来说，这一科学领域来得很晚，但随着工作的进展，大肠中scfa的产生与几种众所周知的肠道疾病有关。
Fermentation, the process whereby anaerobic bacteria break down carbohydrates to short-chain (C-2-C-6) fatty acids (SCFAs), is an important function of the large bowel. SCFAs constitute approximately two-thirds of the colonic anion concentration (70-130 mmol/l), mainly as acetate, propionate, and butyrate. Gastroenterologists have, in spite of these facts, addressed this scientific field surprisingly late, in contrast to veterinarians, for whom the fermentative production of SCFAs has been acknowledged as a principal mechanism of intestinal digestion in plant-eating animals for decades. Interest in the effects of SCFA production on the human organism has been growing rapidly in the last 10 years, because gastrointestinal functions and beneficial effects are associated with these acids. SCFAs are of major importance in the understanding of the physiological function of dietary fibre and their possible role for colonic neoplasia. SCFA production and absorption are closely related to the nourishment of the colonic mucosa and sodium and water absorption, and mechanisms of diarrhoea. Patients with severe malabsorption compensate by the fermentation of otherwise osmotic active saccharides to SCFAs, which are readily absorbed and used as energy fuels in the organism. SCFA production from dietary carbohydrates is a mechanism whereby considerable amounts of calories can be salvaged in short-bowel patients with remaining colonic function if dietary treatment is adjusted. SCFA enemas are a new and promising treatment modality for patients with ulcerative colitis. The effect has been attributed to the oxidation of SCFAs in the colonocytes. An impressive number of papers have described the effects of butyrate on various cell functions, the significance of which is still unknown. Up until now, attention has been related especially to cancer prophylaxis and treatment. Diminished production of SCFAs appears to be involved in antibiotic-associated diarrhoea, diversion colitis, and possibly in pouchitis. The interaction between bacterial fermentation, ammonia metabolism, and bacterial growth and protein synthesis appears to be the main mechanism of action of lactulose treatment in hepatic coma. Pathological and extremely high rates of saccharide fermentation explain the severe deterioration in patients with D-lactate acidosis. Hence, this scientific field has come late to clinical working gastroenterologists, but as work is progressing the production of SCFAs in the large bowel becomes involved in several well-known intestinal disorders.