Gastroduodenal injury and repair: novel targets for therapeutic intervention

Abstract

Purpose of reviewAlthough the mucosal barrier serves as a primary interface between the environment and host, little is understood about the repair of acute, superficial lesions or deeper, persistent lesions that if not healed, can be the site of increased permeability to luminal antigens, inflammation and/or neoplasia development. Recent findingsRecent studies have focused on focal adhesion kinase, which regulates controlled matrix adhesion during restitution after superficial injury. Actin polymerization regulates cell migration and the importance of actinrelated proteins was also highlighted. Work on SARS-CoV-2 infection lent important new insights on gastroduodenal mucosal injury in patients with Covid-19 infection and work done with organoids and intestine-on-a-chip contributed new understanding about how coronaviruses infect gastrointestinal tissues and its resulting barrier dysfunction. A novel risk stratification paradigm was proposed to assist with decision making about repeat endoscopy for patients with gastric or duodenal ulcers and new therapeutic options were studied for ulcer disease. Lastly, work to support the mechanism of metaplasia development after deep injury and parietal cell loss was provided using novel transgenic mouse models. SummaryRecent studies highlight novel molecular targets to promote mucosal healing after injury of the gastroduodenal mucosa.

Circular RNA Cdr1as inhibits proliferation and delays injury-induced regeneration of the intestinal epithelium

“…The mammalian intestinal mucosa elicits a spectrum of responses after acute injury and repairs itself rapidly to restore epithelial integrity (1)(2)(3). The repair of the intestinal mucosa after injury is a complex process consisting of epithelial restitution characterized by stages of cell spreading and migration into the wounded area, replacement of lost cells by cell proliferation, and epithelial remodeling via differentiation (3)(4)(5).…”

Pharmacological targeting of gastric mucosal barrier with traditional Chinese medications for repairing gastric mucosal injury

“…Due to its diversity of etiologies and complexity of condition, along with its pathological characteristics usually involve all levels of the mucosa, making its treatment and complete cure very challenging, so much so that some researchers have referred to it as the new plague of the 21st century ( Sánchez-Mendoza, et al, 2022 ; O'Malley, 2003 ). However, predisposing various gastric mucosal lesions, of whatever types or degree of assault, originally show the stages-specific, advances-rapid, and involvement-extensive response in an orderly stepwise progression ( Hagen, 2022 ). The gastric mucosa (GM) employs two kinds of overlapping, depth-dependent and programmed mechanisms to effectively respond to diverse types of irritants and injuries affecting the stomach.…”