Division of Surgery and Interventional Science, University College, London, UK.
Phytother Res. 2013 Sep;27(9):1265-9. doi: 10.1002/ptr.4865. Epub 2012 Oct 24.
The prevalence of duodenal ulceration in regions of developing countries with a stable diet is related to the staple food(s) in that diet. A higher prevalence occurs in areas where the diet is principally milled rice, refined wheat or maize, yams, cassava, sweet potato or green bananas, and a lower prevalence in areas where the staple diet is based on unrefined wheat or maize, soya, certain millets or certain pulses. Experiments using animal peptic ulcer models showed that the lipid fraction in foods from the staple diets of low prevalence areas gave protection against both gastric and duodenal ulceration, including ulceration due to non-steroidal anti-inflammatory drugs (NSAIDs), and also promoted healing of ulceration. The protective activity was found to lie in the phospholipid, sterol and sterol ester fractions of the lipid. Amongst individual phospholipids present in the phospholipid fraction, phosphatidyl ethanolamine (cephalin) and phosphatidyl choline (Lecithin) predominated. The sterol fraction showing activity contained β-sitosterol, stigmasterol and an unidentified isomer of β-sitosterol. The evidence shows that dietary phytosterols and phospholipids, both individually and in combination, have a protective effect on gastroduodenal mucosa. These findings may prove to be important in the prevention and management of duodenal and gastric ulceration including ulceration due to NSAIDs.
发展中国家稳定饮食地区十二指肠溃疡的患病率与该饮食中的主食有关。在以大米、精制小麦或玉米、山药、木薯、甘薯或绿香蕉为主食的地区，患病率较高；而在以未精制小麦或玉米、大豆、某些小米或某些豆类为主食的地区，患病率较低。动物消化性溃疡模型实验表明，低患病率地区主食中的脂质部分对胃和十二指肠溃疡均有保护作用，包括非甾体抗炎药（NSAIDs）引起的溃疡，也促进溃疡愈合。保护活性存在于脂质的磷脂、固醇和固醇酯部分。在存在于磷脂部分的单个磷脂中，磷脂酰乙醇胺（脑磷脂）和磷脂酰胆碱（卵磷脂）占优势。具有活性的固醇部分含有β-谷甾醇、豆甾醇和β-谷甾醇的一种未知异构体。证据表明，膳食植物甾醇和磷脂单独和联合使用对胃十二指肠黏膜具有保护作用。这些发现可能对预防和治疗十二指肠和胃溃疡包括 NSAIDs 引起的溃疡具有重要意义。
