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The intestine, particularly the small bowel, represents a large
surface (in the adult 2 human approximately 200m ) through which
the body is exposed to its environment. A vigorous substrate
exchange takes place across this large surface: nutrients and
xenobiotics are absorbed from the lumen into the bloodstream or the
lymph, and simultaneously, the same types of substrate pass back
into the lumen. The luminal surface of the intestine is lined with
a "leaky" epithelium, thus the passage of the substrates, in either
direction, proceeds via both transcellular and intercellular
routes. Simple and carrier-mediated diffusion, active transport,
pinocytosis, phagocytosis and persorption are all involved in this
passage across the intestinal wall. The term "intestinal
permeation" refers to the process of passage of various substances
across the gut wall, either from the lumen into the blood or lymph,
or in the opposite direction. "Permeability" is the condition of
the gut which governs the rate of this complex two-way passage. The
pharmacologist's interest in the problem of intestinal permeation
is twofold: on the one hand, this process determines
thebioavailability of drugs and contributes significantly to the
pharmacokinetics and toxicokinetics of xeno biotics; on the other
hand, the pharmacodynamic effects of many drugs are manifested in a
significant alteration of the physiological process of intestinal
permeation.
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