{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T19:56:03Z","timestamp":1787601363661,"version":"build-2736575974"},"reference-count":206,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Short bowel syndrome (SBS) develops when the remaining intestine is unable to sustain adequate nutrient and electrolyte absorption following extensive bowel resection. The condition is characterized by malabsorption and significant fluid losses which lead to dehydration and progressive weight loss, thus promoting patient dependence on parenteral fluids or nutrition. After an initial acute phase marked by accelerated intestinal transit and gastric hypersecretion, long-term clinical outcomes are largely determined by the capacity of the remaining bowel for intestinal adaptation\u2014a sustained process of structural, functional, and molecular remodeling that enhances absorptive efficiency and restores fluid and nutrient homeostasis. This review summarizes the key histological and cellular features of the adaptive response, including crypt and villus remodeling, mucosal hyperplasia, and smooth muscle hypertrophy, and integrates emerging concepts in crypt biology that define the dynamic cross-talk between intestinal stem cells and the mesenchymal niche, together with their upstream regulatory pathways.<\/jats:p>","DOI":"10.3390\/ijms27052105","type":"journal-article","created":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T15:05:27Z","timestamp":1771945527000},"page":"2105","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Molecular Mechanisms of Intestinal Adaptation in Short Bowel Syndrome: A Comprehensive Review"],"prefix":"10.3390","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-9700-0215","authenticated-orcid":false,"given":"Du\u0161an","family":"Radojevi\u0107","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac, Svetozara Markovica 69, 34000 Kragujevac, Serbia"},{"name":"Clinic for Gastroenterology and Hepatology, University Clinical Centre Kragujevac, Zmaj Jovina 30, 34000 Kragujevac, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1938-8298","authenticated-orcid":false,"given":"Mihailo","family":"Bezmarevi\u0107","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery, Clinic for General Surgery, Military Medical Academy, 11000 Belgrade, Serbia"},{"name":"Faculty of Medicine of the Military Medical Academy, University of Defence, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maja","family":"Pe\u0161i\u0107","sequence":"additional","affiliation":[{"name":"Center for Laboratory Diagnostics, University Clinical Centre Kragujevac, Zmaj Jovina 30, 34000 Kragujevac, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6115-612X","authenticated-orcid":false,"given":"Bojan","family":"Stojanovi\u0107","sequence":"additional","affiliation":[{"name":"Clinic for Surgery, University Clinical Centre Kragujevac, Zmaj Jovina 30, 34000 Kragujevac, Serbia"},{"name":"Department of Surgery, Faculty of Medical Sciences, University of Kragujevac, Svetozara Markovica 69, 34000 Kragujevac, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milo\u0161","family":"Stankovi\u0107","sequence":"additional","affiliation":[{"name":"Clinic for Surgery, University Clinical Centre Kragujevac, Zmaj Jovina 30, 34000 Kragujevac, Serbia"},{"name":"Department of Surgery, Faculty of Medical Sciences, University of Kragujevac, Svetozara Markovica 69, 34000 Kragujevac, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mladen","family":"Pavlovi\u0107","sequence":"additional","affiliation":[{"name":"Clinic for Surgery, University Clinical Centre Kragujevac, Zmaj Jovina 30, 34000 Kragujevac, Serbia"},{"name":"Department of Surgery, Faculty of Medical Sciences, University of Kragujevac, Svetozara Markovica 69, 34000 Kragujevac, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6345-6959","authenticated-orcid":false,"given":"Nenad","family":"Markovi\u0107","sequence":"additional","affiliation":[{"name":"Clinic for Surgery, University Clinical Centre Kragujevac, Zmaj Jovina 30, 34000 Kragujevac, Serbia"},{"name":"Department of Surgery, Faculty of Medical Sciences, University of Kragujevac, Svetozara Markovica 69, 34000 Kragujevac, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marijana","family":"Stanojevi\u0107-Pirkovi\u0107","sequence":"additional","affiliation":[{"name":"Center for Laboratory Diagnostics, University Clinical Centre Kragujevac, Zmaj Jovina 30, 34000 Kragujevac, Serbia"},{"name":"Department of Medical Biochemistry, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jelena","family":"\u017divkovi\u0107","sequence":"additional","affiliation":[{"name":"Clinic for Surgery, University Clinical Centre Kragujevac, Zmaj Jovina 30, 34000 Kragujevac, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Branko","family":"An\u0111elkovi\u0107","sequence":"additional","affiliation":[{"name":"Clinic for Surgery, University Clinical Centre Kragujevac, Zmaj Jovina 30, 34000 Kragujevac, Serbia"},{"name":"Department of Surgery, Faculty of Medical Sciences, University of Kragujevac, Svetozara Markovica 69, 34000 Kragujevac, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5863-1089","authenticated-orcid":false,"given":"Ivan","family":"Radosavljevi\u0107","sequence":"additional","affiliation":[{"name":"Clinic for Surgery, University Clinical Centre Kragujevac, Zmaj Jovina 30, 34000 Kragujevac, Serbia"},{"name":"Department of Surgery, Faculty of Medical Sciences, University of Kragujevac, Svetozara Markovica 69, 34000 Kragujevac, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6875-4253","authenticated-orcid":false,"given":"Natalija","family":"Vukovi\u0107","sequence":"additional","affiliation":[{"name":"Clinic for Anesthesiology, Reanimation, and Intensive Care, University Clinical Center Nis, 18000 Ni\u0161, 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