Department of Medicine, Providence Veterans Administration Medical Center, Brown University Teaching Hospital, 830 Chaulkstone Avenue, Providence RI 02904, USA.
Med Hypotheses. 2013 Mar;80(3):230-3. doi: 10.1016/j.mehy.2012.11.034. Epub 2012 Dec 20.
Irritable bowel syndrome (IBS), non-erosive reflux disorder (NERD), and functional dyspepsia (FD) are best classified as immuno-neuronal disorders of the mucosa or functional mucosal syndromes (FMS). Each appears to be clinically reversible using high potency sucralfate (HPS). In FMS of the GI tract, postprandial nausea, altered motility, discordant peristalsis, vomiting, diarrhea, and hyperalgesia are the clinical expressions of a mucosal imbalance between pro-inflammatory cytokines of up-regulated intra-epithelial lymphocytes (IELs) and feedback anti-inflammatory cytokines tasked with moderating the antigenic response of IELs. Normal functioning GI tract requires an operative balance between pro-inflammatory and anti-inflammatrory cytokines, a balance governed by locally expressed growth factors. The surface concentration of sucralfate can be enhanced 7-23-fold by suspending it in a select concentration of cations and multi-dentate cationic chelators. Increased surface concentration of sucralfate facilitates novel dose effects which include efficient activation of growth factors, quiescence of gated-nociceptor firing and resultant restoration of normal GI function.
肠易激综合征（IBS）、非糜烂性反流病（NERD）和功能性消化不良（FD）最好被归类为黏膜免疫神经障碍或功能性黏膜综合征（FMS）。高浓度蔗糖硫酸酯（HPS）似乎可以使每种疾病在临床上得到逆转。在胃肠道 FMS 中，餐后恶心、运动改变、不协调的蠕动、呕吐、腹泻和痛觉过敏是黏膜失衡的临床表现，这种失衡表现为上皮内淋巴细胞（IEL）上调的促炎细胞因子与负责调节 IEL 抗原反应的反馈抗炎细胞因子之间的失衡。正常运作的胃肠道需要促炎和抗炎细胞因子之间的有效平衡，这种平衡受局部表达的生长因子调节。通过将蔗糖硫酸酯悬浮在特定浓度的阳离子和多齿阳离子螯合剂中，蔗糖硫酸酯的表面浓度可以增强 7-23 倍。蔗糖硫酸酯表面浓度的增加促进了新的剂量效应，包括生长因子的有效激活、门控伤害感受器放电的静止以及正常胃肠道功能的恢复。
