Published online Jan 14, 2023. doi: 10.3748/wjg.v29.i2.332
Peer-review started: August 10, 2022
First decision: October 20, 2022
Revised: October 25, 2022
Accepted: November 18, 2022
Article in press: November 18, 2022
Published online: January 14, 2023
Processing time: 145 Days and 3.5 Hours
Magnesium (Mg2+) has an important role in numerous biological functions, and Mg2+ deficiency is associated with several diseases. Therefore, adequate intestinal absorption of Mg2+ is vital for health. The small intestine was previously thought to absorb digested Mg2+ exclusively through an unregulated paracellular mechanism, which is responsible for approximately 90% of total Mg2+ absorption. Recent studies, however, have revealed that the duodenum, jejunum, and ileum absorb Mg2+ through both transcellular and paracellular routes. Several regulatory factors of small intestinal Mg2+ uptake also have been explored, e.g., parathyroid hormone, fibroblast growth factor-23, apical acidity, proton pump inhibitor, and pH-sensing channel and receptors. The mechanistic factors underlying proton pump inhibitor suppression of small intestinal Mg2+, such as magnesiotropic protein dysfunction, higher mucosal bicarbonate secretion, Paneth cell dysfunction, and intestinal inflammation, are currently being explored. The potential role of small intestinal microbiomes in Mg2+ absorption has also been proposed. In this article, we reviewed the current knowledge on the mechanisms and regulatory factors of small intestinal Mg2+ absorption.
Core Tip: Small intestinal epithelium absorbs digested magnesium (Mg2+) through both transcellular active and paracellular passive mechanisms. Several regulatory factors of small intestinal Mg2+ uptake have been reported. Parathyroid hormone and fibroblast growth factor-23 directly inhibit transcellular Mg2+ absorption in the duodenum, jejunum, and ileum. The apical proton triggers acid-sensing ion-channel 1a and purinergic P2Y2 receptor activities, which stimulates mucosal bicarbonate secretion and induces MgCO3 precipitation to suppress absorption. Omeprazole suppresses Mg2+ absorption in the duodenum, jejunum, and ileum.