Chronic atrophic autoimmune gastritis (CAAG) is an organ-specific autoimmune disease characterized by an immune response, which is directed towards the parietal cells and intrinsic factor of the gastric body and fundu...Chronic atrophic autoimmune gastritis (CAAG) is an organ-specific autoimmune disease characterized by an immune response, which is directed towards the parietal cells and intrinsic factor of the gastric body and fundus and leads to hypochlorhydria, hypergastrinemia and inadequate production of the intrinsic factor. As a result, the stomach’s secretion of essential substances, such as hydrochloric acid and intrinsic factor, is reduced, leading to digestive impairments. The most common is vitamin B12 deficiency, which results in a megaloblastic anemia and iron malabsorption, leading to iron deficiency anemia. However, in the last years the deficiency of several other vitamins and micronutrients, such as vitamin C, vitamin D, folic acid and calcium, has been increasingly described in patients with CAAG. In addition the occurrence of multiple vitamin deficiencies may lead to severe hematological, neurological and skeletal manifestations in CAAG patients and highlights the importance of an integrated evaluation of these patients. Nevertheless, the nutritional deficiencies in CAAG are largely understudied. We have investigated the frequency and associated features of nutritional deficiencies in CAAG in order to focus on any deficit that may be clinically significant, but relatively easy to correct. This descriptive review updates and summarizes the literature on different nutrient deficiencies in CAAG in order to optimize the treatment and the follow-up of patients affected with CAAG.展开更多
现关于中医药干预慢性萎缩性胃炎(chronic atrophic gastritis,CAG)的临床研究和基础实验研究已成为消化系统疾病中的研究热点。Janus蛋白酪氨酸激酶(Janus protein tyrosine kinase,JAK)/信号转导子与激活子(signal transducer and act...现关于中医药干预慢性萎缩性胃炎(chronic atrophic gastritis,CAG)的临床研究和基础实验研究已成为消化系统疾病中的研究热点。Janus蛋白酪氨酸激酶(Janus protein tyrosine kinase,JAK)/信号转导子与激活子(signal transducer and activator of transcription,STAT)信号通路的状态与消化道疾病的发生与进展十分密切。诸多研究表明中药可通过多种机制调控该信号通路干预CAG的进展,大致可分为以下几个方面:通过抑制JAK2/STAT3、核转录因子-κB/STAT1通路激活或促使白介素-4(interleukin-4,IL-4)/STAT6激活达到干预CAG的目的;同时降低IL-6、IL-1β等相关炎症因子表达,不仅可抑制相关通路激活,亦可起到减轻胃黏膜炎症的作用;再者上调抑癌基因p21、下调原癌基因表达防止受损的胃黏膜进一步恶化;最后还可调节生存素、B淋巴细胞瘤2家族调控细胞凋亡/增殖平衡机制逆转胃黏膜萎缩及肠化生。展开更多
文摘Chronic atrophic autoimmune gastritis (CAAG) is an organ-specific autoimmune disease characterized by an immune response, which is directed towards the parietal cells and intrinsic factor of the gastric body and fundus and leads to hypochlorhydria, hypergastrinemia and inadequate production of the intrinsic factor. As a result, the stomach’s secretion of essential substances, such as hydrochloric acid and intrinsic factor, is reduced, leading to digestive impairments. The most common is vitamin B12 deficiency, which results in a megaloblastic anemia and iron malabsorption, leading to iron deficiency anemia. However, in the last years the deficiency of several other vitamins and micronutrients, such as vitamin C, vitamin D, folic acid and calcium, has been increasingly described in patients with CAAG. In addition the occurrence of multiple vitamin deficiencies may lead to severe hematological, neurological and skeletal manifestations in CAAG patients and highlights the importance of an integrated evaluation of these patients. Nevertheless, the nutritional deficiencies in CAAG are largely understudied. We have investigated the frequency and associated features of nutritional deficiencies in CAAG in order to focus on any deficit that may be clinically significant, but relatively easy to correct. This descriptive review updates and summarizes the literature on different nutrient deficiencies in CAAG in order to optimize the treatment and the follow-up of patients affected with CAAG.
文摘现关于中医药干预慢性萎缩性胃炎(chronic atrophic gastritis,CAG)的临床研究和基础实验研究已成为消化系统疾病中的研究热点。Janus蛋白酪氨酸激酶(Janus protein tyrosine kinase,JAK)/信号转导子与激活子(signal transducer and activator of transcription,STAT)信号通路的状态与消化道疾病的发生与进展十分密切。诸多研究表明中药可通过多种机制调控该信号通路干预CAG的进展,大致可分为以下几个方面:通过抑制JAK2/STAT3、核转录因子-κB/STAT1通路激活或促使白介素-4(interleukin-4,IL-4)/STAT6激活达到干预CAG的目的;同时降低IL-6、IL-1β等相关炎症因子表达,不仅可抑制相关通路激活,亦可起到减轻胃黏膜炎症的作用;再者上调抑癌基因p21、下调原癌基因表达防止受损的胃黏膜进一步恶化;最后还可调节生存素、B淋巴细胞瘤2家族调控细胞凋亡/增殖平衡机制逆转胃黏膜萎缩及肠化生。
