Progress on the developmental physiology of digestive system in children

doi:10.11852/zgetbjzz2019-0285

Abstract

Abstract: The requirements of nutrients for children are different from adults′,and the digestive functions in children are immature.In the present review,the progress on developmental physiology of children in digestive system related to oral,gastric motility,and enzymes secretions were summarized.The main features include a higher pH in gastric fluid,a lower enzymes output and activities in secretions in stomach and pancreas,a slower gastric empty rate and intestinal motility,and the immature of intestinal barrier than those in adults.This review aims to provide knowledge for health care,nutrients supply,development of food and in vitro digestive models for children,thereby proposing future directions in related fields.

Key words: digestivesystem, developmentalphysiology, children

摘要： 儿童营养需求与成人不同,而其消化系统功能却还不成熟。本文对儿童消化系统中口腔、胃肠运动、消化酶发育生理特点进行总结,其特点包括胃内pH高、胃肠酶分泌量和活性低、胃排空和肠蠕动慢、肠屏障功能低下,为儿童保健、营养供应、儿童食品的开发及体外消化模型提供参考,并提出了未来的研究方向。

关键词: 消化系统, 生理发育, 儿童

CLC Number:

R179

XU Xiao-fei, CHEN Hui-ping, YANG Ji-guo. Progress on the developmental physiology of digestive system in children[J]. journal1, 2019, 27(11): 1196-1200.

徐晓飞, 陈慧萍, 杨继国. 儿童消化系统发育生理研究进展[J]. 中国儿童保健杂志, 2019, 27(11): 1196-1200.

References

[1] 王卫平,孙锟,常立文.儿科学[M].9版.北京:人民卫生出版社,2018:2-3.
[2] Michaelsen KF,Greer FR.Protein needs early in life and long-term health[J].Am J Clin Nutr,2014,99(Suppl 3):718-722.
[3] 陈荣华,赵正言,刘湘云.儿童保健学[M].5版.南京:江苏凤凰科学技术出版社,2017:71-72.
[4] Pereira LJ,van der Bilt A.The influence of oral processing,food perception and social aspects on food consumption:a review[J].J Oral Rehabil,2016,43(8):630-648.
[5] Marsh PD,Do T,Beighton D,et al.Influence of saliva on the oral microbiota[J].Periodontol,2000, 2016,70(1):80-92.
[6] Bourlieu C,Olivia Ménard,Bouzerzour K,et al.Specificity of infant digestive conditions:some clues for developing relevant in vitro models[J].Crit Rev Food Sci Nutr,2014,54(11):1427-1457.
[7] Lau C.Development ofsuck and swallow mechanisms in infants[J].Ann Nutr Metab,2015,66(5):7-14.
[8] Gan J,Bornhorst GM,Henrick BM,et al.Development of baby foods:study approaches and implications for infant health[J].Mol Nutr Food Res,2018,62(1):1700231.
[9] Abu-Alhaija E,Owais AI,Obaid H.Maximum occlusal bite force in pre-school children with different occlusal patterns[J].J Clin Exp Dent,2018,10(11):e1063-e1068.
[10] Sun KT,Chen SC,Li YF,et al.Bite-force difference among obese adolescents in central Taiwan[J].J Formos Med Assoc,2016,115(6):404-410.
[11] Poquet L,Wooster TJ .Infant digestion physiology & the relevance of in vitro biochemical models to test infant formula lipid digestion[J].Mol Nutr Food Res,2016,60(8):1876-1895.
[12] Yu G,Zheng QS,Li GF .Similarities and differences in gastrointestinal physiology between neonates and adults:a physiologically based pharmacokinetic modeling perspective[J].The AAPS Journal,2014,16(6):1162-1166.
[13] Van Den Abeele J,Rayyan M,Hoffman I,et al.Gastric fluid composition in a paediatric population:Age-dependent changes relevant for gastrointestinal drug disposition[J].Eur J Pharm Sci,2018,123:301-311.
[14] Demers-Mathieu V,Underwood MA,Beverly RL,et al.Comparison of human milk immunoglobulin survival during gastric digestion between preterm and term infants[J].Nutrients,2018,10(5):E631.
[15] Bodé S,Dreyer M,Greisen G.Gastric emptying and small intestinal transit time in preterm infants:a scintigraphic method[J].J Pediatr Gastroenterol Nutr,2004,39(4):378-382.
[16] Bouras EP,Burton DD,Camilleri M,et al.Effect of cyclooxygenase-2 inhibitors on gastric emptying and small intestinal transit in humans[J].Neurogastroenterol Motil,2004,16(6):729-735.
[17] Leggett R,Annex C.Review of transit times through major segments of the alimentary tract.In:ICRP.Human alimentary tract model for radiological protection[M].ICRP Publication 100,Amsterdam:Elsevier Health Sciences,2006:203-232.
[18] Ferreira Cristina HF,Martinez Francisco E,Crott Gerson C,et al.Gavage feed volume determines the gastric emptying rate in preterm infants[J].Pediatr Gastroenterol Nutr,2018,67(3):e43-e46.
[19] Perrella Sharon L,Hepworth Anna R,Gridneva Zoya,et al.Gastric emptying of different meal volumes of identical composition in preterm infants:a time series analysis [J] .Pediatr Res,2018,83:778-783.
[20] Meyer R,Foong RX,Thapar N,et al.Systematic review of the impact of feed protein type and degree of hydrolysis on gastric emptying in children[J].BMC Gastroenterol,2015,15:137.
[21] Du T,Hill L,Ding L,et al.Gastric emptying for liquids of different compositions in children [J] .Br J Anaesth,2017,119(5):948-955.
[22] Lenfestey MW,Neu J.Gastrointestinal development:implications for management of preterm and term infants[J].Gastroenterol Clin North Am,2018,47(4):773-791.
[23] Bode S,Dreyer T,Greisen G.Gastric emptying and small intestinal transit time in preterm infants:a scintigraphic method[J].Pediatr Gastroenterol Nutr,2004,39:378-382.
[24] 周姗姗,李晓南.胰腺脂肪酶相关研究进展[J].生理科学进展,2015,59(1):6-10.
[25] Casper C,Hascoet JM,Ertl T,et al.Recombinant bile salt-stimulated lipase in preterm infant feeding:a randomized phase 3 study[J].PLoS One,2016,11(5):e0156071.
[26] Alfaro Cruz L,Parniczky A,Mayhew A,et al.Utility of direct pancreatic function testing in children[J].Pancreas,2017,46(2):177-182.
[27] Jahnel J,Zöhrer E,Scharnagl H,et al.Reference ranges of serum bile acids in children and adolescents[J].Clin Chem Lab Med,2015,53(11):1807-1813.
[28] Takiishi T,Fenero CIM,Camara NOS.Intestinal barrier and gut microbiota:shaping our immune responses throughout life[J].Tissue Barriers,2017,5(4):e1373208.
[29] Yang Y,Rader E,Peters-Carr M,et al.Ontogeny of alkaline phosphatase activity in infant intestines and breast milk[J].BMC Pediatr,2019,19(1):2.
[30] Miyoshi H,Ajima R,Luo CT,et al.Wnt5 a potentiates TGF-signaling to promote colonic crypt regeneration after tissue injury[J].Science,2012,338(6103):108-113.
[31] Dudhwala ZM,Drew PA,Howarth GS,et al.Active β-catenin signaling in the small intestine of humans during infancy[J].Dig Dis Sci,2019,64(1):76-83.
[32] Bunesova V,Lacroix C,Schwab C.Mucin cross-feeding of infant Bifidobacteria and Eubacterium hallii[J].Microb Ecol,2018,75(1):228-238.
[33] Corfield AP.The interaction of the gut microbiota with the mucus barrier in health and disease in human[J].Microorganisms,2018,6(3):E78.
[34] Macierzanka A,Mackie AR,Bajka BH,et al.Transport of particles in intestinal mucus under simulated infant and adult physiological conditions:impact of mucus structure and extracellular DNA[J].PLoS One,2014,22,9(4):e95274.
[35] Tanaka M,Nakayama J.Development of the gut microbiota in infancy and its impact on health in later life[J].Allergol Int,2017,66(4):515-522.
[36] Nguyen TTB,Chung HJ,Kim HJ,et al.Establishment of an ideal gut microbiota to boost healthy growth of neonates[J].Crit Rev Microbiol,2019:1-12.doi:10.1080/1040841x.2018.1561643
[37] Dupont D,Mandalari G,Molle D,et al.Comparative resistance of food proteins to adult and infant in vitro digestion models[J].Mol Nutr Food Res,2010,54(6),767-780.
[38] de Oliveira S C,Bourlieu C,Ménard,Olivia,et al.Impact of pasteurization of human milk on preterm newborn in vitro digestion:Gastrointestinal disintegration,lipolysis and proteolysis[J].Food Chem,2016,211:171-179.
[39] de Oliveira S C,Bellanger A,Ménard O,et al.Impact of human milk pasteurization on gastric digestion in preterm infants:a randomized controlled trial [J].Am J Clin Nutr,2017,89(Suppl 2):663-667.