NF-κB: A novel therapeutic pathway for gastroesophageal reflux disease?

Abstract

Although gastroesophageal reflux disease (GERD), a common chronic disease in clinical practice, has been widely studied, its potential adverse impact on patients is still a significant clinical concern. It is necessary to understand the pathogenesis of the disease and choose appropriate treatment according to its mechanism. The pathogenesis of GERD is diverse and complex. As the traditional treatment methods are expensive and ineffective in alleviating symptoms in some patients, new treatment options need to be explored. Our previous study suggested that the activation of nuclear factor-kappa beta (NF-κB) in esophageal mucosa may be related to the injury of epithelial barrier function caused by reflux. Based on the literature and our previous study results, it is speculated that inhibition of NF-κB activation may block the insult of GERD on the esophageal mucosal barrier. NF-κB may play an important role in the development of GERD. This article reviews the pathogenesis of GERD and the relationship between NF-κB and GERD, in order to provide new strategies for the treatment of GERD.

Efficacy and safety of tegoprazan in the treatment of gastroesophageal reflux disease: A protocol for meta-analysis and systematic review

“…Some adverse effects of long-term proton pump inhibitors and prokinetic drugs have received attention in recent years: long-term use of proton pump inhibitors has led to the development of gastric adenocarcinoma, osteoporosis in the elderly, and bacterial overgrowth in the intestinal tract [ 11 , 12 ], and the 5-hydroxytryptamine-4 agonist tegaserod has been discontinued because of the increase in serious cardiovascular system adverse effects. On the other hand, duodenal gastroesophageal reflux disease is a complex reflux disease with independent risk factors, and proton pump inhibitors are not effective in its treatment [ 13 ]. In recent years, a new potassium-competitiveacid blocker (P-CAB) has gained much attention because it can better overcome the disadvantages of PPIs.…”

Gastroesophageal Reflux Disease: A Potentially Infectious Disease?

“…[1][2][3] The pathogenesis of GERD is influenced by a number of factors, characterized by an imbalance between harmful factors (reflux frequency, acidity of refluxate, esophageal mucosal contact time) and protective factors (esophageal acid clearance, mucosal integrity, lower esophageal sphincter pressure, anti-reflux barrier). 4 Recent studies suggest that this multifactorial process is influenced by the esophageal microbiome, which can induce an immune response that eventually triggers inflammation and subsequent GERD. 5, 6 The microbiome is a collection of microorganisms, primarily bacteria, fungi (mostly yeasts), archaea, and viruses, that live in specific environments, such as the skin, mouth, respiratory tract, and GI tract.…”