Paradoxical association between dyspepsia and autoimmune chronic atrophic gastritis: Insights into mechanisms, pathophysiology, and treatment options

Rossi, Roberta; Elvevi, Alessandra; Sciola, V.; Mandarino, Francesco Vito; Danese, Silvio; Invernizzi, Pietro; Massironi, Sara

doi:10.3748/wjg.v29.i23.3733

Cited by 9 publications

(3 citation statements)

References 82 publications

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“…Gastrointestinal symptoms of AAG are supposed to result from gastric-duodenal bacterial overgrowth and reduced gastric motility due to achlorhydria. Dyspepsia is the earliest gastrointestinal symptom [40,41], and paradoxically, when it is the only presentation symptom, it is the one associated with the highest diagnostic delay (>24 months) [11]. The most commonly reported dyspeptic symptoms are early fullness, post-prandial bloating, and epigastric discomfort.…”

Section: Epidemiological Pathogenetic Clinical and Diagnostic Issues ...mentioning

confidence: 99%

Autoimmune Gastritis and Hypochlorhydria: Known Concepts from a New Perspective

Vavallo,

Cingolani,

Cozza

et al. 2024

IJMS

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Autoimmune atrophic gastritis is an immune-mediated disease resulting in autoimmune destruction of the specialized acid-producing gastric parietal cells. As a consequence, in autoimmune atrophic gastritis, gastric acid secretion is irreversibly impaired, and the resulting hypochlorhydria leads to the main clinical manifestations and is linked, directly or indirectly, to the long-term neoplastic complications of this disease. In the last few years, autoimmune atrophic gastritis has gained growing interest leading to the acquisition of new knowledge on different aspects of this disorder. Although reliable serological biomarkers are available and gastrointestinal endoscopy techniques have substantially evolved, the diagnosis of autoimmune atrophic gastritis is still affected by a considerable delay and relies on histopathological assessment of gastric biopsies. One of the reasons for the diagnostic delay is that the clinical presentations of autoimmune atrophic gastritis giving rise to clinical suspicion are very different, ranging from hematological to neurological–psychiatric up to gastrointestinal and less commonly to gynecological–obstetric symptoms or signs. Therefore, patients with autoimmune atrophic gastritis often seek advice from physicians of other medical specialties than gastroenterologists, thus underlining the need for increased awareness of this disease in a broad medical and scientific community.

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Section: Epidemiological Pathogenetic Clinical and Diagnostic Issues ...mentioning

confidence: 99%

Autoimmune Gastritis and Hypochlorhydria: Known Concepts from a New Perspective

Vavallo,

Cingolani,

Cozza

et al. 2024

IJMS

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“…Multiple mechanisms contribute to the complex pathophysiology of the disorder, including vagal nerve dysfunction, visceral hypersensivity, impaired fundic accommodation (FA), antral hypomotility, gastric dysrhythmias, and increased pylorus tone, defined as "pylorospasm" [68]. It has been speculated that the microbiota and duodenal dysbiosis influence the development of GP [69], as seen in other gastrointestinal diseases [70][71][72][73].…”

Section: Gastric Peroral Endoscopic Myotomy (Gpoem)mentioning

confidence: 99%

Precision Endoscopy in Peroral Myotomies for Motility Disorders of the Upper Gastrointestinal Tract: Current Insights and Prospective Avenues—A Comprehensive Review

Mandarino,

Vespa,

Barchi

et al. 2023

Life

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Our review delves into the realm of peroral endoscopic myotomies (POEMs) in the upper gastrointestinal tract (UGT). In recent years, POEMs have brought about a revolution in the treatment of UGT motility disorders. Esophageal POEM, the first to be introduced, has now been validated as the primary treatment for achalasia. Subsequently developed, G-POEM displays promising results in addressing refractory gastroparesis. Over time, multiple endoscopic myotomy techniques have emerged for the treatment of Zenker’s diverticulum, including Z-POEM, POES, and hybrid approaches. Despite the well-established efficacy outcomes, new challenges arise in the realm of POEMs in the UGT. For esophageal POEM, the future scenario lies in customizing the myotomy extent to the minimum necessary, while for G-POEM, it involves identifying patients who can optimally benefit from the treatment. For ZD, it is crucial to validate an algorithm that considers various myotomy options according to the diverticulum’s size and in relation to individual patients. These challenges align with the concept of precision endoscopy, personalizing the technique for each subject. Within our text, we comprehensively examine each myotomy technique, analyzing indications, outcomes, and adverse events. Additionally, we explore the emerging challenges posed by myotomies within the context of the evolving field of precision endoscopy.

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“…Treatment of chronic atrophic gastritis mainly focuses on improving symptoms and inhibiting inflammatory responses [ 4 ]. Recently, some new drugs, such as immunomodulators and antioxidants, have shown efficacy in clinical trials [ 5 , 6 ]. However, owing to their therapeutic and long-term side effects, further development has limitations [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Luteolin targets the AGE-RAGE signaling to mitigate inflammation and ferroptosis in chronic atrophic gastritis

Zhang,

Chen,

Liang

et al. 2024

Aging

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Chronic atrophic gastritis (CAG) is a chronic inflammatory disease and precancerous lesion in stomach cancer. Abnormal activation cellular ferroptosis further damages gastric tissue, which is susceptible to inflammation. Luteolin has powerful anti-inflammatory and regulatory potential for cellular ferroptosis. We aimed to clarify the involvement of luteolin in inflammation and ferroptosis during CAG. Luteolin targets were searched to identify intersecting genes in the chronic atrophic gastritis disease database. The AGE-RAGE pathway is a potential target of luteolin for the treatment of chronic atrophic gastritis and a binding site between luteolin and RAGE was predicted through a computer simulation of molecular docking. We established a CAG rat model using N-methyl-N-nitro-N-nitroguanidine. The therapeutic effect of luteolin on CAG was detected using western blotting, qPCR, hematoxylin and eosin staining, lipid oxidation (MDA), and Fe 2+ assays. Luteolin inhibited the AGE-RAGE signaling pathway and reduced the inflammatory response in gastric tissues. Additionally, luteolin downregulated the concentration of (MDA) and Fe 2+ , and CAG downregulated the expression levels of ACSL4 and NOX1 and upregulated the expression levels of FIH1 and GPX4 ferroptosis-related proteins, thus inhibiting the ferroptosis of gastric tissue cells, which had a therapeutic effect on CAG.

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Paradoxical association between dyspepsia and autoimmune chronic atrophic gastritis: Insights into mechanisms, pathophysiology, and treatment options

Cited by 9 publications

References 82 publications

Autoimmune Gastritis and Hypochlorhydria: Known Concepts from a New Perspective

Autoimmune Gastritis and Hypochlorhydria: Known Concepts from a New Perspective

Precision Endoscopy in Peroral Myotomies for Motility Disorders of the Upper Gastrointestinal Tract: Current Insights and Prospective Avenues—A Comprehensive Review

Luteolin targets the AGE-RAGE signaling to mitigate inflammation and ferroptosis in chronic atrophic gastritis

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