Mucosal pathogenesis in gastro‐esophageal reflux disease
| Autor: | Philip Woodland, Rhonda F. Souza, Stuart J. Spechler, Ahsen Ustaoglu, Daniel Sifrim, Anh D Nguyen |
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| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Esophageal Mucosa Physiology Inflammation Disease Gastroenterology Receptors Gastrointestinal Hormone Pathogenesis 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Animals Humans Receptor Endocrine and Autonomic Systems business.industry Reflux Heartburn medicine.disease digestive system diseases 030104 developmental biology Gastric Mucosa Gastroesophageal Reflux Nociceptor GERD 030211 gastroenterology & hepatology medicine.symptom business |
| Zdroj: | Neurogastroenterology & Motility. 32 |
| ISSN: | 1365-2982 1350-1925 |
| Popis: | Background Despite gastro-esophageal reflux disease affecting up to 20% of Western populations, relatively little is known about the molecular mechanisms underlying its most troublesome symptom: heartburn. Recent findings have unveiled the role of components of the esophageal mucosa in the pathogenesis of GERD including sensory nociceptive nerves and inflammatory mediators. Erosive esophagitis was long believed to develop as a result of acid injury at the esophageal lumen, but novel concepts suggest the generation of reflux-induced esophageal injury as a result of cytokine-mediated inflammation. Moreover, the localization and characterization of mucosal afferent nerves vary between GERD phenotypes and could explain the heterogeneity of symptom perception between patients who experience similar levels of acid reflux. Purpose The purpose of this review is to consider the crosstalk of different factors of the esophageal mucosa in the pathogenesis of GERD, with a particular focus on mucosal innervation and molecular basis of acid-induced cytokine response. We discuss the current understanding of the mucosal response to acid injury, the nociceptive role of acid-sensitive receptors expressed in the esophageal mucosa, and the role of esophageal epithelial cells in initiating the onset of erosive esophagitis. |
| Databáze: | OpenAIRE |
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