Intestinal phosphorus absorption: recent findings in translational and clinical research.
Intestinal phosphorus absorption: recent findings in translational and clinical research.
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DOI：
10.1097/mnh.0000000000000719
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发表时间：
2021-07-01
影响因子：
3.2
通讯作者：
Vorland CJ
中科院分区：
文献类型：
--
作者：
Hill Gallant KM;Vorland CJ
本综述的目的是讨论肠道磷吸收途径的最新发现，特别是细胞旁吸收和跨细胞吸收的贡献，以及在实验动物研究中使用体外和体内评估磷吸收的研究结果的差异。实验动物研究表明，低磷饲料、1,25 d和慢性肾脏疾病对肠道磷吸收效率的体内影响与先前建立的离体/体外影响相矛盾。最近的体内研究还表明，在极低至高的腔内磷酸盐浓度下，动物的大部分磷吸收是通过细胞旁途径进行的。实验动物研究的数据与最近的人体研究相一致，显示了靶向抑制细胞旁磷酸盐吸收的有效性。此外，最近的人体研究表明，单独抑制NaPi-2b似乎不能有效降低CKD患者的血清磷酸盐水平。寻求其他跨细胞磷酸转运蛋白抑制剂可能仍有希望。体内动物和人体研究增加了我们对肠道磷吸收途径、调节和机制的理解。这有助于制定有效的新策略来管理慢性肾脏疾病患者的磷酸盐。
The purpose of this review is to discuss recent findings in intestinal phosphorus absorption pathways, particularly the contributions of paracellular versus transcellular absorption, and the differential findings from studies using in vitro versus in vivo techniques of assessing phosphorus absorption in experimental animal studies. Experimental animal studies show that in vivo effects of low phosphorus diets, 1,25D, and chronic kidney disease on intestinal phosphorus absorption efficiency contradict effects previously established ex vivo/in vitro. Recent in vivo studies also suggest that the paracellular pathway accounts for the majority of phosphorus absorption in animals across very low to high luminal phosphate concentrations. The data from experimental animal studies correspond to recent human studies showing effectiveness of targeted inhibition of paracellular phosphate absorption. Additionally, recent human studies have demonstrated that NaPi-2b inhibition alone does not appear to be effective in lowering serum phosphate levels in patients with CKD. Pursuit of other transcellular phosphate transporter inhibitors may still hold promise. In vivo animal and human studies have added to our understanding of intestinal phosphorus absorption pathways, regulation, and mechanisms. This is beneficial for developing effective new strategies for phosphate management in patients with chronic kidney disease.