[Progress in intestinal adaptation after enterectomy].

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
Read More Add to Saved list
  • Additional Information
    • Source:
      Publisher: Zhongshan da xue Country of Publication: China NLM ID: 101177990 Publication Model: Print Cited Medium: Print ISSN: 1671-0274 (Print) Linking ISSN: 16710274 NLM ISO Abbreviation: Zhonghua Wei Chang Wai Ke Za Zhi Subsets: MEDLINE
    • Publication Information:
      Original Publication: Guangzhou : Zhongshan da xue
    • Subject Terms:
      Intestines*/surgery ; Short Bowel Syndrome*/surgery; Humans ; Adaptation, Physiological ; Glucagon-Like Peptide 2/therapeutic use ; Parenteral Nutrition
    • Abstract:
      Intestinal adaptation is a spontaneous compensation of the remanent bowel after extensive enterectomy, which improves the absorption capacity of the remanent bowel to energy, fluid and other nutrients. Intestinal adaptation mainly occurs within 2 years after enterectomy, including morphological changes, hyperfunction and hyperphagia. Intestinal adaptation is the key factor for patients with short bowel syndrome to weaning off parenteral nutrition dependence and mainly influenced by length of remanent bowel, type of surgery and colon continuity. In addition, multiple factors including enteral feeding, glucagon-like peptide 2 (GLP-2), growth hormone, gut microbiota and its metabolites regulate intestinal adaptation via multi-biological pathways, such as proliferation and differentiation of stem cell, apoptosis, angiogenesis, nutrients transport related protein expression, gut endocrine etc. Phase III clinical trials have verified the safety and efficacy of teduglutide (long-acting GLP-2) and somatropin (recombinant human growth hormone) in improving intestinal adaptation, and both have been approved for clinical use. We aim to review the current knowledge about characteristics, mechanism, evaluation methods, key factors, clinical strategies of intestinal adaptation.
    • Grant Information:
      U2004112 National Natural Science Foundation of China; LHGJ20200276 Joint Construction Project of Henan Medical Science and Technology Research Program
    • Contributed Indexing:
      Local Abstract: [Publisher, Chinese] 广泛肠切除术后，残余肠道出现自发性代偿性改变，以此来增加能量、液体和营养要素的吸收能力被称为“肠道适应”现象。这主要发生在肠切除术后2年内，表现为残余肠道的形态改变、功能亢进及患者的行为学变化。肠道适应的程度是短肠综合征患者能否摆脱肠外营养依赖的关键，这主要与残余肠道长度、手术解剖类型和是否保留结肠连续性有关。此外，肠腔内营养物质刺激、胰高血糖素样肽-2（GLP-2）、生长激素、肠道菌群及其代谢产物等因素可通过多种途径调控肠道适应，如干细胞增殖与分化、细胞凋亡、血管生成、营养物质转运相关蛋白表达和肠道内分泌功能等。三期临床试验已经验证了Teduglutide（长效GLP-2）和Somatropin（重组人生长激素）用于改善肠道适应的安全性和有效性，并获批应用于临床。本文旨在梳理肠道适应特征、发生机制、评估方法、影响因素和临床策略等方面的研究进展。.
    • Accession Number:
      0 (Glucagon-Like Peptide 2)
    • Publication Date:
      Date Created: 20221223 Date Completed: 20221228 Latest Revision: 20230103
    • Publication Date:
      20230104
    • Accession Number:
      10.3760/cma.j.cn441530-20220510-00208
    • Accession Number:
      36562240