Crooks Benjamin, Stamataki Nikoleta S, McLaughlin John T
Division of Diabetes, Endocrinology & Gastroenterology, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.
Department of Gastroenterology, Salford Royal NHS Foundation Trust, Stott Lane, Salford, UK.
Proc Nutr Soc. 2021 Feb;80(1):50-58. doi: 10.1017/S0029665120006965. Epub 2020 May 4.
The enteroendocrine system is located in the gastrointestinal (GI) tract, and makes up the largest endocrine system in the human body. Despite that, its roles and functions remain incompletely understood. Gut regulatory peptides are the main products of enteroendocrine cells, and play an integral role in the digestion and absorption of nutrients through their effect on intestinal secretions and gut motility. Several peptides, such as cholecystokinin, polypeptide YY and glucagon-like peptide-1, have traditionally been reported to suppress appetite following food intake, so-called satiety hormones. In this review, we propose that, in the healthy individual, this system to regulate appetite does not play a dominant role in normal food intake regulation, and that there is insufficient evidence to wholly link postprandial endogenous gut peptides with appetite-related behaviours. Instead, or additionally, top-down, hedonic drive and neurocognitive factors may have more of an impact on food intake. In GI disease however, supraphysiological levels of these hormones may have more of an impact on appetite regulation as well as contributing to other unpleasant abdominal symptoms, potentially as part of an innate response to injury. Further work is required to better understand the mechanisms involved in appetite control and unlock the therapeutic potential offered by the enteroendocrine system in GI disease and obesity.
肠内分泌系统位于胃肠道，是人体最大的内分泌系统。尽管如此，其作用和功能仍未被完全了解。肠道调节肽是肠内分泌细胞的主要产物，通过影响肠道分泌和肠道蠕动，在营养物质的消化和吸收中发挥不可或缺的作用。传统上，一些肽，如胆囊收缩素、多肽YY和胰高血糖素样肽-1，被报道在进食后会抑制食欲，即所谓的饱腹感激素。在本综述中，我们提出，在健康个体中，这个调节食欲的系统在正常食物摄入调节中并不起主导作用，而且没有足够的证据将餐后内源性肠道肽与食欲相关行为完全联系起来。相反，或者此外，自上而下的享乐驱动和神经认知因素可能对食物摄入有更大影响。然而，在胃肠道疾病中，这些激素的超生理水平可能对食欲调节有更大影响，并导致其他令人不适的腹部症状，这可能是对损伤的一种固有反应的一部分。需要进一步开展研究，以更好地理解食欲控制所涉及的机制，并挖掘肠内分泌系统在胃肠道疾病和肥胖症中所提供的治疗潜力。
