Tappenden Kelly A
Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, 443 Bevier Hall, 905 S Goodwin Ave, Urbana, IL 61821, USA.
Arch Surg. 2010 Jun;145(6):528-32. doi: 10.1001/archsurg.2010.102.
Given the immeasurable human distress and health care burden associated with intestinal failure, medical therapies aimed at intestinal rehabilitation are needed. Following massive small-bowel resection, the residual intestine is known to adapt structurally and functionally in an attempt to compensate for the resected portion. However, parenteral nutrition may be associated with many short- and long-term complications, including prevention of intestinal adaptation and promotion of mucosal atrophy due to lack of stimulus provided by oral or enteral nutrition. However, data herein demonstrate that the addition of butyrate, a short-chain fatty acid produced in the colon by dietary fiber fermentation, stimulates intestinal adaptation when added to parenteral nutrition, indicating that current solutions could be formulated to optimize intestinal adaptation and to reduce dependence of individuals with intestinal failure receiving long-term parenteral nutrition regimens.
鉴于与肠衰竭相关的巨大人类痛苦和医疗负担,需要旨在肠道康复的医学疗法。在进行大量小肠切除术后,已知残余肠道会在结构和功能上发生适应性变化,以试图补偿切除的部分。然而,肠外营养可能与许多短期和长期并发症相关,包括由于缺乏口服或肠内营养提供的刺激而阻碍肠道适应并促进黏膜萎缩。然而,本文数据表明,添加丁酸盐(一种由膳食纤维在结肠中发酵产生的短链脂肪酸)到肠外营养中时,可刺激肠道适应,这表明可以配制当前的溶液以优化肠道适应,并减少接受长期肠外营养方案的肠衰竭患者的依赖性。