The small intestine is an incredibly adaptable, “plastic” organ, the tissues of which are involved intimately
in endocrine regulation, immune surveillance, multiple aspects of metabolism, excretion
of metabolites, symbiosis with the enteric microbiome, and, of course, absorption
of ingested nutrients. As the primary site of nutrient absorption, the gut must be
adaptable to the quality, quantity, and timing of nutrient availability to optimize
nutrient absorption and maintain health. Indeed, intestinal adaptation, as evident
by changes in gene expression as the neonate grows older and transitions from breast
milk to oral nutrients (ontogeny), is well described. Similarly, chronic changes in
diet/nutrient supply alter gene expression resulting in different levels of nutrient
transporters by the enterocytes. A dramatic example of this remodeling of the gut
mucosa was demonstrated by Secor and Diamond in studying the onset of hyperplasia/hypertrophy
in Burmese pythons in response to ingestion of a meal.
1
Indeed, these forms of classic, genomic-mediated adaptation result in a change not
only in function but also in structure of the mucosa, and typically occur over days.
Similarly, when major parts of the intestinal absorptive surface area are lost (via
resection for trauma, neoplasm, or disease) or bypassed (jejunoileal bypass), a remarkable
hypertrophy/hyperplasia occurs, again through a complex set of changes in gene expression
and cellular proliferation leading to villus hypertrophy and cellular hyperplasia.To read this article in full you will need to make a payment
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References
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Article info
Publication history
Accepted:
February 10,
2011
Footnotes
AT is supported by a KL2 Medical Research Investigator Training (MeRIT) grant awarded via Harvard Catalyst | The Harvard Clinical and Translational Science Center (NIH grant #1KL2RR025757-01 and financial contributions from Harvard University and its affiliated academic health care centers). MGS has support from The Groff Foundation and NIH R01 DK39337.
Identification
Copyright
© 2011 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
