Wolvekamp M C, Heineman E, Taylor R G, Fuller P J
Prince Henry's Institute of Medical Research, Clayton, Vic, Australia.
Dig Dis. 1996 Jan-Feb;14(1):59-72. doi: 10.1159/000171539.
When bowel is lost due to disease or surgery, the residual bowel increases its functional capacity in order to compensate for the loss of absorptive capacity. The success and extent of this adaptive process is critical to recovery. This article reviews the current understanding of the intestinal adaptation. Adaptation is a complex process which as yet is poorly understood and thus it is difficult to develop strategies to enhance the out-come of the adaptation phase. Extensive loss of bowel brings about functional as well as morphologic changes in the remaining intestine. The exact relationship between histologic changes and function is still unknown and some studies show that histologic changes may precede functional changes. Both nonnutritive and nutritive factors have been identified as major stimuli to the adaptive process. The importance of oral intake as a positive stimulus has been demonstrated and the role of diet composition rather than diet complexity being recognized. Recent studies attempt to understand the molecular basis of intestinal adaptation by seeking to characterize the nature of humoral factors involved and to establish alterations in the patterns of gene expression. These new approaches may facilitate the identification of both nutritional and pharmacological methods to manipulate the intestinal adaptation process.
当肠道因疾病或手术而缺失时，残余肠道会增加其功能能力，以补偿吸收能力的丧失。这一适应性过程的成功与否及程度对恢复至关重要。本文综述了目前对肠道适应的认识。适应是一个复杂的过程，目前人们对此了解甚少，因此难以制定策略来提高适应阶段的结果。大量肠道缺失会导致剩余肠道出现功能和形态学变化。组织学变化与功能之间的确切关系仍不清楚，一些研究表明组织学变化可能先于功能变化。非营养性和营养性因素均已被确定为适应性过程的主要刺激因素。口服摄入作为一种积极刺激因素的重要性已得到证实，并且人们认识到饮食组成而非饮食复杂性的作用。最近的研究试图通过确定所涉及的体液因子的性质并建立基因表达模式的改变来理解肠道适应的分子基础。这些新方法可能有助于识别调控肠道适应过程的营养和药理学方法。
