Intestinal Adaptation

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Abstract
(Second of Two Parts)Intrinsic Regulation of Cell RenewalIn normal circumstances, the constant turnover of the small-bowel mucosa is maintained by a dynamic equilibrium between cell production at the base of the crypt and cell loss at the tip of the villus. This turnover recapitulates the embryologic development of the intestinal epithelium from undifferentiated stem cells to mature enterocytes in intimate relation to the lamina propria.171 Even in atrophic defunctioned bowel or mucosal biopsies maintained by organ culture, epithelial cells continue to replicate in the crypts and differentiate during migration onto the villi.7,48,86 The failure of mitotic inhibition by . . .