Current Perspectives in Atrophic Gastritis

被引:44
作者
Lahner E. [1 ]
Conti L. [1 ]
Annibale B. [1 ]
Corleto V.D. [1 ]
机构
[1] Department of Medical-Surgical Sciences and Translational Medicine, Sant’Andrea Hospital, Sapienza University of Rome, Via di Grottarossa, 1035 -, Rome
关键词
Atrophic gastritis; Chromoendoscopy; Gastric cancer; Gastric microbiota; Helicobacter pylori; Intestinal metaplasia;
D O I
10.1007/s11894-020-00775-1
中图分类号
学科分类号
摘要
Purpose of the Review: Atrophic gastritis is a complex syndrome with gastric atrophy as a common trait. Helicobacter pylori infection and autoimmunity are the two main contexts in which it develops. It is slightly symptomatic, affects various aspects of general health, and remains a predisposing factor for gastric cancer. This review will update current knowledge and progress on atrophic gastritis. Recent Findings: Atrophic gastritis affects mostly adults with persistent dyspepsia, deficient anemia, autoimmunity disease, long-term proton pump inhibitor use, and a family history of gastric cancer. Gastric biopsies, expressed as Sydney system grade and OLGA/OLGIM classifications, represent the gold standard for diagnosis and cancer risk stage, respectively. Recently, electronic chromoendoscopy has allowed “targeted biopsies” of intestinal metaplasia. The associated hypochlorhydria affects the gastric microbiota composition suggesting that non-Helicobacter pylori microbiota may participate in the development of gastric cancer. Summary: Physicians should be aware of multifaceted clinical presentation of atrophic gastritis. It should be endoscopically monitored by targeted gastric biopsies. Autoimmune and Helicobacter pylori-induced atrophic gastritis are associated with different gastric microbial profiles playing different roles in gastric tumorigenesis. © 2020, Springer Science+Business Media, LLC, part of Springer Nature.
引用
收藏
相关论文
共 98 条
[1]  
Lahner E., Zagari R.M., Zullo A., Di Sabatino A., Meggio A., Cesaro P., Et al., Chronic atrophic gastritis: natural history, diagnosis and therapeutic management. A position paper by the Italian Society of Hospital Gastroenterologists and Digestive Endoscopists [AIGO], the Italian Society of Digestive Endoscopy [SIED], the Italian Society of Gastroenterology [SIGE], and the Italian Society of Internal Medicine [SIMI], Dig Liver Dis, 51, pp. 1621-1632, (2019)
[2]  
D'Elios M.M., Bergman M.P., Azzurri A., Et al., H[+],K[+]-atpase [proton pump] is the target autoantigen of Th1-type cytotoxic T cells in autoimmune gastritis, Gastroenterology, 120, pp. 377-386, (2001)
[3]  
Toh B.H., Sentry J.W., Alderuccio F., The causative H+/K+ ATPase antigen in the pathogenesis of autoimmune gastritis, Immunol Today, 21, pp. 348-354, (2000)
[4]  
Pikkarainen S., Martelius T., Ristimaki A., Siitonen S., Seppanen M.R.J., Farkkila M., A high prevalence of gastrointestinal manifestations in common variable immunodeficiency, Am J Gastroenterol, 114, pp. 648-655, (2019)
[5]  
Correa P., The biological model of gastric carcinogenesis, IARC Sci Publ, 157, pp. 301-310, (2004)
[6]  
Ford A.C., Yuan Y., Moayyedi P., Helicobacter pylori eradication therapy to prevent gastric cancer: Systematic review and meta-analysis, Gut, (2020)
[7]  
Hwang Y.J., Kim N., Lee H.S., Lee J.B., Choi Y.J., Yoon H., Shin C.M., Park Y.S., Lee D.H., Reversibility of atrophic gastritis and intestinal metaplasia after Helicobacter pylori eradication - a prospective study for up to 10 years, Aliment Pharmacol Ther, 47, pp. 380-390, (2018)
[8]  
Minalyan A., Benhammou J.N., Artashesyan A., Lewis M.S., Pisegna J.R., Autoimmune atrophic gastritis: current perspectives, Clin Exp Gastroenterol, 10, pp. 19-27, (2017)
[9]  
Lahner E., Brigatti C., Marzinotto I., Carabotti M., Scalese G., Davidson H.W., Wenzlau J.M., Bosi E., Piemonti L., Annibale B., Lampasona V., Luminescent immunoprecipitation system [LIPS] for detection of autoantibodies against ATP4A and ATP4B subunits of gastric proton pump H+,K+-ATPase in atrophic body gastritis patients, Clin Transl Gastroenterol, 8, (2017)
[10]  
Lenti M.V., Rugge M., Lahner E., Miceli E., Toh B.-H., Genta R.M., Et al., Nature Reviews Disease Primers, (2020)