Dietschy J M, Spady D K
Agents Actions Suppl. 1984;16:177-90. doi: 10.1007/978-3-0348-7235-5_21.
These various observations suggest that the intestinal-hepatic axis plays a key role in the regulation of cholesterol balance in the whole animal and the circulating levels of LDL-cholesterol. Nearly all sterol which enters or leaves the body must do so through the intestine and liver. Changes in the rate of entry or exit of cholesterol (or bile acids) from the animal are met by appropriate reciprocal changes in the rates of cholesterol synthesis in these two organs. As long as these adaptive changes in synthesis are adequate to meet the changing needs for cholesterol in the animal, the rates of receptor-mediated LDL degradation by the liver and intestine remain essentially unchanged as does the plasma LDL-cholesterol concentration. Only when the changes in cholesterol synthesis are inadequate to meet the changing sterol needs (or are blocked by drug administration (22] does the liver increase its rate of receptor-mediated LDL uptake which, in turn, results in significant alterations in circulating plasma LDL-cholesterol levels.
这些不同的观察结果表明,肠肝轴在调节全动物体内胆固醇平衡以及低密度脂蛋白胆固醇的循环水平方面起着关键作用。几乎所有进出身体的固醇都必须通过肠道和肝脏。动物体内胆固醇(或胆汁酸)进出速率的变化会通过这两个器官中胆固醇合成速率的相应反向变化来应对。只要这些合成方面的适应性变化足以满足动物对胆固醇不断变化的需求,肝脏和肠道通过受体介导的低密度脂蛋白降解速率以及血浆低密度脂蛋白胆固醇浓度就基本保持不变。只有当胆固醇合成的变化不足以满足不断变化的固醇需求时(或者被药物给药阻断时[22]),肝脏才会增加其通过受体介导的低密度脂蛋白摄取速率,进而导致循环血浆低密度脂蛋白胆固醇水平发生显著变化。