Department of Medicine, Division of Gastroenterology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Prog Mol Biol Transl Sci. 2010;96:231-70. doi: 10.1016/B978-0-12-381280-3.00010-5.
Intestinal metaplasia (IM) is a biologically interesting and clinically relevant condition in which one differentiated type of epithelium is replaced by another that is morphologically similar to normal intestinal epithelium. Two classic examples of this are gastric IM and Barrett's esophagus (BE). In both, a chronic inflammatory microenvironment, provoked either by Helicobacter pylori infection of the stomach or acid and bile reflux into the esophagus, precedes the metaplasia. The Caudal-related homeodomain transcription factors Cdx1 and Cdx2 are critical regulators of the normal intestinal epithelial cell phenotype. Ectopic expression of Cdx1 and Cdx2 occurs in both gastric IM as well as in BE. This expression precedes the onset of the metaplasia and implies a causal role for these factors in this process. We review the observations regarding the role of chronic inflammation and the Cdx transcription factors in the pathogenesis of gastric IM and BE.
肠上皮化生（IM）是一种生物学上有趣且与临床相关的情况，其中一种分化型上皮被形态上类似于正常肠上皮的另一种上皮所取代。这种情况的两个典型例子是胃 IM 和 Barrett 食管（BE）。在这两种情况下，慢性炎症微环境，无论是由胃幽门螺杆菌感染还是胃酸和胆汁反流引起的，都先于化生发生。尾相关同源域转录因子 Cdx1 和 Cdx2 是正常肠上皮细胞表型的关键调节因子。Cdx1 和 Cdx2 的异位表达既发生在胃 IM 中，也发生在 BE 中。这种表达先于化生的发生，暗示这些因素在这个过程中起因果作用。我们回顾了关于慢性炎症和 Cdx 转录因子在胃 IM 和 BE 发病机制中的作用的观察结果。
