Johnson Trevor N, Thomson Mike
Pharmacy Department, Sheffield Children's Hospital, Western Bank, Sheffield S10 2TH, UK.
J Pediatr Gastroenterol Nutr. 2008 Jul;47(1):3-10. doi: 10.1097/MPG.0b013e31816a8cca.
The presence of cytochrome P450 enzymes in the small bowel results in the reduced bioavailability of several drugs. Recently, there has been much research on the interplay between these enzymes and transporter proteins such as P-glycoprotein. Intestinal drug metabolism not only has an effect on drug disposition but also may have a role in protecting the host from xenobiotics. Although there is some information on how both the enzymes and transporters develop in the small bowel with age, there is little information regarding the clinical effects of these changes. In addition to developmental changes, the influence of gastrointestinal disease and nutrition are additional covariates in the intestinal metabolism of drugs.
小肠中细胞色素P450酶的存在会导致几种药物的生物利用度降低。最近，对这些酶与转运蛋白（如P-糖蛋白）之间的相互作用进行了大量研究。肠道药物代谢不仅会影响药物处置，还可能在保护宿主免受外源性物质影响方面发挥作用。尽管有一些关于这些酶和转运蛋白如何随年龄在小肠中发育的信息，但关于这些变化的临床影响的信息却很少。除了发育变化外，胃肠道疾病和营养的影响是药物肠道代谢中的其他协变量。
