Priority Research Centre for Digestive Health and Neurogastroenterology, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia.
Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.
Neurogastroenterol Motil. 2020 May;32(5):e13854. doi: 10.1111/nmo.13854.
The duodenal epithelium plays a pivotal role in the uptake and transport of dietary nutrients while simultaneously acting as physical and biochemical barrier to protect against harmful bacteria and antigens. In the case of functional dyspepsia (FD), the duodenum is of particular interest, due to observed local immune involvement and the proximity to the stomach and exposure to acidopeptic secretions. Recent observations in FD pathophysiology, including those reported by Beeckmans et al in this issue of the journal, have identified a loss of barrier function in the duodenal epithelium, an altered duodenal microbiome and alterations in intestinal bile acid pools. Because FD symptoms coincide with food intake and, thus, secretion of bile acids, these findings may indicate loss or imbalance of bile-acid-microbiota-epithelial homeostasis as a process driving FD. Here, we review the evidence linking these observations to FD symptoms.
十二指肠上皮在摄取和转运膳食营养素方面发挥着关键作用，同时作为物理和生化屏障，防止有害细菌和抗原的侵害。在功能性消化不良 (FD) 的情况下，由于观察到局部免疫参与以及与胃的接近和接触酸性消化液，十二指肠尤其受到关注。FD 病理生理学的最新观察结果，包括 Beeckmans 等人在本期杂志中报告的结果，已经确定了十二指肠上皮屏障功能的丧失、十二指肠微生物组的改变以及肠道胆汁酸池的改变。由于 FD 症状与食物摄入有关，因此与胆汁酸分泌有关，这些发现可能表明胆汁酸-微生物群-上皮动态平衡的丧失或失衡是驱动 FD 的过程。在这里，我们回顾了将这些观察结果与 FD 症状联系起来的证据。
