Ageing and Small-Bowel Mucosa: A Morphometric Study

Frazzoni, Marzio; Gatto, Maria Rosaria; Gasbarrini, Giovanni

doi:10.1159/000212766

Cited by 60 publications

(23 citation statements)

References 15 publications

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“…Based upon older studies, there is the misconception that small intestinal villus height and surface area are reduced compared with that in young controls. However, careful evaluation of jejunal biopsy specimens from healthy elderly volunteers shows that the anatomy of epithelial cells and the surface area does not differ from that found in the young [1] . In the rat, although villus cell numbers in the proximal small intestine are similar in the young and old, crypt cell numbers are greater in Fischer 344 rats over age 24 months [2] accompanied by increased epithelial cell proliferation [3] and altered controls of cell production [4] .…”

Section: Structural and Functional Changes In The Small Intestinementioning

confidence: 89%

Intestinal Malabsorption in the Elderly

Holt¹

2007

Dig Dis

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Background: Intestinal malabsorption in the elderly is infrequent, and clinical features are muted so that the diagnosis is often missed. Physiologic changes with aging are restricted to altered absorption of calcium and perhaps zinc and magnesium; however, achlorhydria can lead to impaired absorption of vitamin B₁₂, folic acid, and calcium. Methods and Results: Small bowel bacterial overgrowth occurs more commonly in elderly than in younger patients, accompanying gastric hypochlorhydria, altered intestinal motor activity, or diseases such as Parkinson’s disease. Changes in pancreatic anatomy and secretion occur but are insufficient to produce macronutrient malabsorption. In addition to pancreatic cancer and pancreatic stones, older patients may present with severe pancreatic insufficiency of unknown etiology. Celiac disease is recognized as very common at all ages and may not become evident until late in life. Manifestations of celiac disease in the elderly are occult and the diagnosis often is not considered until serologic tests are performed and confirmed by upper small intestinal biopsy. Associated intestinal lymphoma, esophageal carcinoma, intestinal pseudo-obstruction, and splenic atrophy may be more common in the elderly. Treatment of older patients with celiac disease with a gluten-free diet may be difficult, and intensive vitamin and micronutrient replacement is mandatory. A pragmatic approach to the evaluation of malabsorption in elderly patients is discussed.

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Section: Structural and Functional Changes In The Small Intestinementioning

confidence: 89%

Intestinal Malabsorption in the Elderly

Holt¹

2007

Dig Dis

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“…Although earlier studies reported significant apparently age-related effects including reduced gastric acid secretion [37,38] and gastric emptying [39], reduced splanchnic blood flow [40], and absorptive capacity of the small intestine [41], probably due to the effects of disease states, more recent reports have not confirmed these findings in healthy subjects [23,25,42,43].…”

Section: Drug Absorptionmentioning

confidence: 90%

Age‐related changes in pharmacokinetics and pharmacodynamics: basic principles and practical applications

Mangoni

Jackson

2003

Brit J Clinical Pharma

1,338

911

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Advancing age is characterized by impairment in the function of the many regulatory processes that provide functional integration between cells and organs. Therefore, there may be a failure to maintain homeostasis under conditions of physiolog ical stress. The reduced homeostatic ability affects different regulatory systems in different subjects, thus explaining at least partly the increased interindividual variability occurring as people get older. Important pharmacokinetic and pharmacodynamic changes occur with advancing age. Pharmacokinetic changes include a reduction in renal and hepatic clearance and an increase in volume of distribution of lipid soluble drugs (hence prolongation of elimination half-life) whereas pharmacodynamic changes involve altered (usually increased) sensitivity to several classes of drugs such as anticoagulants, cardiovascular and psychotropic drugs. This review focuses on the main age-related physiological changes affecting different organ systems and their implications for pharmacokinetics and pharmacodynamics of drugs.

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“…Careful morphometric studies agree that ageing in humans is not associated with a reduction in the extent of the absorptive area [1,2]. This preservation of normal morphology seems to be due to an increased enterocyte turnover and to an expansion of the proliferative zone of small intestinal mucosa [3].…”

Section: Introductionmentioning

confidence: 90%

Small Bowel Enterocyte Apoptosis and Proliferation Are Increased in the Elderly

Ciccocioppo¹,

Sabatino

Luinetti

et al. 2002

Gerontology

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Background: It is known that in the elderly the small bowel does not reveal structural and functional deteriorations in normal conditions, whereas the absorptive function is impaired in stress conditions. Objective: The balance between enterocyte apoptosis and proliferation being responsible for the maintenance of tissue size, mucosal morphology and function in the gastrointestinal tract, the aim of our study was to evaluate the rates of enterocyte apoptosis and proliferation in the duodenal mucosa of aged human beings in comparison to adults. Methods: For this purpose, the terminal deoxynucleotidyl transferase-mediated digoxigenin-deoxyuridine triphosphate nick end labelling (TUNEL) technique and immunohistochemistry for MIB-1 detection were applied on histological sections of endoscopic duodenal biopsy specimens obtained from 12 healthy elderly subjects (mean age 77.6 years; M/F 7/5) and 12 healthy adult subjects (mean age 37.7 years; M/F 8/4). Counts were performed, at a constant magnification (×200), by computer-aided analysis and the results expressed as median percentages of positive enterocytes. Results: The results showed a significant increase in enterocyte apoptosis in the elderly (15.3 vs. 2.1% in the adults, p < 0.001) which was positively correlated (r_s = 0.65, p < 0.05) with a significant increase in enterocyte proliferation (37.7 vs. 15.8% in the adults, p < 0.0001). Conclusions: These data suggest that the maintenance of mucosal architecture throughout the process of aging is due to either a hyperproliferative state or an exaggerated apoptosis with a consequent cellular immaturity, which may impair the absorptive function observed in stress conditions.

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Ageing and Small-Bowel Mucosa: A Morphometric Study

Cited by 60 publications

References 15 publications

Intestinal Malabsorption in the Elderly

Intestinal Malabsorption in the Elderly

Age‐related changes in pharmacokinetics and pharmacodynamics: basic principles and practical applications

Small Bowel Enterocyte Apoptosis and Proliferation Are Increased in the Elderly

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