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World J Gastroenterol. Nov 28, 2012; 18(44): 6357-6375
Published online Nov 28, 2012. doi: 10.3748/wjg.v18.i44.6357
Intestinal mucosal atrophy and adaptation
Darcy Shaw, Kartik Gohil, Marc D Basson
Darcy Shaw, Kartik Gohil, Marc D Basson, Department of Surgery, College of Human Medicine, Michigan State University, Lansing, MI 48906, United States
Author contributions: All authors contributed equally to this manuscript.
Supported by NIH Grant R56 DK096137-01 in part
Correspondence to: Dr. Marc D Basson, MD, PhD, MBA, Professor and Chair, Department of Surgery, College of Human Medicine, Michigan State University, 1200 East Michigan Avenue, Suite 655, Lansing, MI 48906, United States. marc.basson@hc.msu.edu
Telephone: +1-517-2672486 Fax: +1-517-2672488
Received: August 6, 2012
Revised: November 6, 2012
Accepted: November 14, 2012
Published online: November 28, 2012
Processing time: 133 Days and 23.5 Hours
Abstract

Mucosal adaptation is an essential process in gut homeostasis. The intestinal mucosa adapts to a range of pathological conditions including starvation, short-gut syndrome, obesity, and bariatric surgery. Broadly, these adaptive functions can be grouped into proliferation and differentiation. These are influenced by diverse interactions with hormonal, immune, dietary, nervous, and mechanical stimuli. It seems likely that clinical outcomes can be improved by manipulating the physiology of adaptation. This review will summarize current understanding of the basic science surrounding adaptation, delineate the wide range of potential targets for therapeutic intervention, and discuss how these might be incorporated into an overall treatment plan. Deeper insight into the physiologic basis of adaptation will identify further targets for intervention to improve clinical outcomes.

Keywords: Adaptation; Intestine mucosa; Mucosal differentiation; Short bowel syndrome