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[细胞抑制剂与小肠(作者译)]

[Cytostatica and small intestine (author's transl)].

作者信息

Ecknauer R, Rommel K

出版信息

Klin Wochenschr. 1978 Jun 15;56(12):579-92. doi: 10.1007/BF01477006.

Abstract

Cytostatica not only suppress proliferation in tumor cells but it also checks proliferation in small intestinal epithelium. The consequence is cell reduction and damage resulting in a diminished function. Because of the high reserve capacity of the small intestinal epithelium, clinical signs of diminished function are mostly seen after repeated high doses or one extremely high doses of Cytostatica. Although there is abundant information on the effect of Cytostatica on the small intestinal epithelium (cell turnover, morphology, digestive enzymes and absorption) there are other areas that are as urgent for the interested clinician to work on: 1. Would it be possible to coincide the dose and dosage rate with the cell cycles to reduce the chance of damage to small intestinal epithelium? 2. Which role has the luminal content when there is damage from Cytostatica? Is it possible to concentrate on changing the luminal contents (antibiotics, "elemental diet", cultivate desirable microflora, etc.) Therefore diminishing the damage from Cytostatica? 3. How would Cytostatica influence the barrier function on the intestinal wall? Should the patient on Cytostatica therapy receive special protection against intestinal infection? 4. Does Cytostatica affect the biotransformation in the small intestinal epithelium, especially when taken orally? How important is this biotransformation in small intestinal epithelium damaged by Cytostatica therapy? 5. What factors determine the regeneration of the small intestinal epithelium after Cytostatica damage?

摘要

细胞抑制剂不仅能抑制肿瘤细胞的增殖,还能抑制小肠上皮细胞的增殖。其结果是细胞数量减少和损伤,导致功能减退。由于小肠上皮具有较高的储备能力,功能减退的临床症状大多在反复高剂量或单次极高剂量使用细胞抑制剂后出现。尽管关于细胞抑制剂对小肠上皮的影响(细胞更新、形态、消化酶和吸收)已有大量信息,但对于感兴趣的临床医生来说,还有其他同样迫切需要研究的领域:1. 能否使剂量和给药速率与细胞周期相匹配,以减少对小肠上皮的损伤几率?2. 当细胞抑制剂造成损伤时,肠腔内容物起什么作用?是否有可能专注于改变肠腔内容物(抗生素、“要素饮食”、培养有益微生物群等),从而减轻细胞抑制剂造成的损伤?3. 细胞抑制剂如何影响肠壁的屏障功能?接受细胞抑制剂治疗的患者是否应接受特殊的肠道感染防护?4. 细胞抑制剂是否会影响小肠上皮的生物转化,尤其是口服时?这种生物转化在细胞抑制剂治疗导致损伤的小肠上皮中有多重要?5. 哪些因素决定了细胞抑制剂损伤后小肠上皮的再生?

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