Chandwe Kanta, Kelly Paul
Tropical Gastroenterology & Nutrition Group, University of Zambia School of Medicine, Lusaka 10101, Zambia.
Blizard Institute, Barts & The London School of Medicine, Queen Mary University of London, London E1 2AT, UK.
Nutrients. 2021 Jun 7;13(6):1956. doi: 10.3390/nu13061956.
There is increasing awareness that a broad range of gastrointestinal diseases, and some systemic diseases, are characterized by failure of the mucosal barrier. Bovine colostrum is a complex biological fluid replete with growth factors, nutrients, hormones, and paracrine factors which have a range of properties likely to contribute to mucosal healing in a wide range of infective, inflammatory, and injury conditions. In this review, we describe the anatomy and physiology of the intestinal barrier and how it may fail. We survey selected diseases in which disordered barrier function contributes to disease pathogenesis or progression, and review the evidence for or against efficacy of bovine colostrum in management. These disorders include enteropathy due to non-steroidal anti-inflammatory drugs (NSAIDs), inflammatory bowel disease (IBD), necrotizing enterocolitis, infectious diarrhea, intestinal failure, and damage due to cancer therapy. In animal models, bovine colostrum benefits NSAID enteropathy, IBD, and intestinal failure. In human trials, there is substantial evidence of efficacy of bovine colostrum in inflammatory bowel disease and in infectious diarrhea. Given the robust scientific rationale for using bovine colostrum as a promoter of mucosal healing, further work is needed to define its role in therapy.
人们越来越意识到,多种胃肠道疾病以及一些全身性疾病的特征是黏膜屏障功能障碍。牛初乳是一种复杂的生物液体,富含生长因子、营养物质、激素和旁分泌因子,这些物质具有一系列特性,可能有助于在多种感染性、炎症性和损伤性疾病中促进黏膜愈合。在这篇综述中,我们描述了肠道屏障的解剖结构和生理功能以及其可能失效的方式。我们调查了一些特定疾病,其中屏障功能紊乱会导致疾病的发病机制或病情进展,并回顾了支持或反对牛初乳在治疗中有效性的证据。这些疾病包括非甾体抗炎药(NSAIDs)引起的肠病、炎症性肠病(IBD)、坏死性小肠结肠炎、感染性腹泻、肠衰竭以及癌症治疗造成的损伤。在动物模型中,牛初乳对NSAIDs肠病、IBD和肠衰竭有益。在人体试验中,有大量证据表明牛初乳对炎症性肠病和感染性腹泻有效。鉴于使用牛初乳作为黏膜愈合促进剂有充分的科学依据,需要进一步研究来确定其在治疗中的作用。