Petschow Bryon W, Burnett Bruce P, Shaw Audrey L, Weaver Eric M, Klein Gerald L
Entera Health, Inc., 2000 Regency Parkway, Suite 255, Cary, NC, 27518, USA,
Dig Dis Sci. 2015 Jan;60(1):13-23. doi: 10.1007/s10620-014-3322-0. Epub 2014 Aug 21.
A variety of human disease conditions are associated with chronic intestinal disorders or enteropathies that are characterized by intestinal inflammation, increased gut permeability, and reduced capacity to absorb nutrients. Such disruptions in the homeostasis of the gastrointestinal (GI) tract can lead to symptoms of abdominal pain and discomfort, bloating, abnormal bowel function, and malabsorption of nutrients. While significant advances have been made in understanding the factors that influence the complex and fragile balance between the gut microbiota, intestinal epithelial cell integrity, and the underlying immune system, effective therapies for restoring intestinal balance during enteropathy are still not available. Numerous studies have demonstrated the ability of oral immunoglobulins to improve weight gain, support gut barrier function, and reduce the severity of enteropathy in animals. More recently, studies in humans provide evidence that serum-derived bovine immunoglobulin/protein isolate is safe and improves nutritional status and GI symptoms in patients with enteropathy associated with irritable bowel syndrome or infection with the human immunodeficiency virus. This review summarizes studies showing the impact of enteropathy on nutritional status and how specially formulated bovine immunoglobulins may help restore intestinal homeostasis and nutritional status in patients with specific enteropathies. Such protein preparations may provide distinct nutritional support required for the dietary management of patients who, because of therapeutic or chronic medical needs, have limited or impaired capacity to digest, absorb, or metabolize ordinary foodstuffs or certain nutrients, or other special medically determined nutrient requirements that cannot be satisfied by changes to the normal diet alone.
多种人类疾病状况与慢性肠道疾病或肠病相关,这些疾病的特征是肠道炎症、肠道通透性增加以及营养吸收能力下降。胃肠道(GI)稳态的这种破坏可导致腹痛、不适、腹胀、肠道功能异常以及营养吸收不良等症状。尽管在理解影响肠道微生物群、肠道上皮细胞完整性和潜在免疫系统之间复杂而脆弱平衡的因素方面取得了重大进展,但在肠病期间恢复肠道平衡的有效疗法仍然不可用。大量研究表明,口服免疫球蛋白能够促进动物体重增加、支持肠道屏障功能并减轻肠病的严重程度。最近,针对人类的研究提供了证据,表明血清来源的牛免疫球蛋白/蛋白分离物是安全的,并且可以改善患有肠易激综合征或感染人类免疫缺陷病毒相关肠病患者的营养状况和胃肠道症状。这篇综述总结了相关研究,这些研究展示了肠病对营养状况的影响,以及特殊配方的牛免疫球蛋白如何有助于恢复特定肠病患者的肠道稳态和营养状况。此类蛋白质制剂可为因治疗需求或慢性医疗需求而消化、吸收或代谢普通食物或某些营养素的能力有限或受损,或仅通过改变正常饮食无法满足其他特殊医学确定的营养需求的患者的饮食管理提供所需的独特营养支持。