Tovey Frank I
Frank I Tovey, Division of Surgery and Interventional Science, University College London, London W1W 7EJ, United Kingdom.
World J Gastroenterol. 2015 Feb 7;21(5):1377-84. doi: 10.3748/wjg.v21.i5.1377.
Geographically the prevalence of duodenal ulceration is related to the staple foods in the diet in regions of developing countries where the diet is stable. It is higher in regions where the diet is based on milled rice, refined wheat or maize, yams, cassava, sweet potato, or green bananas, and is lower in regions where the staple diet is based on unrefined wheat or maize, soya, certain millets or certain pulses. Experiments on rat gastric and duodenal ulcer models showed that it was the lipid fraction in staple foods from low prevalence areas that was protective against both gastric and duodenal ulceration, including ulceration due to non-steroidal anti-inflammatory drugs (NSAIDs). It also promoted ulcer healing. The lipid from the pulse, Dolichos biflorus, horse gram which was highly protective was used to identify the fractions with protective activity in the lipid. The protective activity lay in the phospholipid, sterol and sterol ester fractions. In the phospholipid fraction phosphatidyl choline (lethicin) and phosphatidyl ethanolamine (cephalin) were predominant. In the sterol fraction the sub-fractions showing protective activity contained β-sitosterol, stigmasterol, and an unidentified isomer of β-sitosterol. The evidence from animal models shows that certain dietary phospholipids and phytosterols have a protective action against gastroduodenal ulceration, both singly and in combination. This supports the protective role of staple diets in areas of low duodenal ulcer prevalence and may prove to be of importance in the prevention and treatment of duodenal ulceration and management of recurrent ulcers. A combination of phospholipids and phytosterols could also play an important role in protection against ulceration due to NSAIDs.
在发展中国家饮食结构稳定的地区，十二指肠溃疡的患病率在地理上与饮食中的主食相关。在以碾磨大米、精制小麦或玉米、山药、木薯、红薯或青香蕉为主食的地区，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。对大鼠胃和十二指肠溃疡模型的实验表明，低患病率地区主食中的脂质部分对胃和十二指肠溃疡具有保护作用，包括对非甾体抗炎药（NSAIDs）引起的溃疡。它还能促进溃疡愈合。来自双花扁豆（Dolichos biflorus）、马豆（horse gram）这种具有高度保护作用的豆类的脂质，被用于鉴定脂质中具有保护活性的成分。保护活性存在于磷脂、甾醇和甾醇酯成分中。在磷脂成分中，磷脂酰胆碱（卵磷脂）和磷脂酰乙醇胺（脑磷脂）占主导。在甾醇成分中，显示出保护活性的亚成分含有β-谷甾醇、豆甾醇以及一种未鉴定的β-谷甾醇异构体。动物模型的证据表明，某些膳食磷脂和植物甾醇对胃十二指肠溃疡具有单独或联合的保护作用。这支持了低十二指肠溃疡患病率地区主食的保护作用，并且可能在十二指肠溃疡的预防和治疗以及复发性溃疡的管理中具有重要意义。磷脂和植物甾醇的组合在预防NSAIDs引起的溃疡方面也可能发挥重要作用。
