Wirth Hans-Peter, Yang Manqiao
GastroZentrumKreuzlingen, Kreuzlingen, Switzerland.
Inflamm Intest Dis. 2016 Oct;1(3):113-122. doi: 10.1159/000446300. Epub 2016 May 14.
Gastritis results from multifactorial gastric mucosal injury. is the main cause, and associated diseases have typical underlying patterns of gastritis. Gastric ulcer and gastric cancer (GC) develop from chronic atrophic corpus gastritis (CAG) which therefore represents the most important pattern. GC incidences in East Asia are substantially higher than elsewhere, and this should be also reflected by higher prevalences of CAG and characteristic differences in pathophysiology compared to the West.
The few available comparative studies of gastritis in Eastern and Western patients are summarized. The main pathogenic factors of gastritis are discussed together with their limitations to explain local differences in disease outcome. Emphasis was put to also include less well-established pathogenic host and environmental factors of possible impact.
CAG is more prevalent in East Asian areas with high GC incidences than the West. Geographic heterogeneity of associated diseases is due to differences in prevalence and virulence as well as modulating host and environmental factors. The following may contribute to the higher burden of CAG in the East: ABD type of CagA with s1 and alleles of , host Lewis(b) expression in nonsecretors, , low parietal cell mass, high sodium and nitrate intake, preferences in vegetable and fruit consumption, cigarette smoking, air pollution, alcohol. Conversely, green tea, nonfermented soy products and rice may confer protective effects. is on the decline, but also in a world cleared from this bacterium, differences in host genetics will continue to modify gastric disease outcome together with maintained customs as part of cultural diversity.
胃炎是由多因素导致的胃黏膜损伤引起。幽门螺杆菌是主要病因，相关疾病具有典型的胃炎潜在模式。胃溃疡和胃癌由慢性萎缩性胃体炎发展而来，因此慢性萎缩性胃体炎是最重要的模式。东亚地区的胃癌发病率显著高于其他地区，与西方相比，这也应体现在慢性萎缩性胃体炎的更高患病率以及病理生理学的特征差异上。
总结了少数关于东西方患者胃炎的比较研究。讨论了胃炎的主要致病因素及其在解释疾病结局局部差异方面的局限性。重点还包括可能有影响但尚未充分确立的致病宿主和环境因素。
在胃癌发病率高的东亚地区，慢性萎缩性胃体炎比西方更普遍。相关疾病的地理异质性是由于幽门螺杆菌患病率和毒力的差异以及调节宿主和环境因素的差异所致。以下因素可能导致东方慢性萎缩性胃体炎负担更高：具有s1和等位基因的CagA的ABD型、非分泌者中宿主Lewis(b)表达、、壁细胞量低、高钠和硝酸盐摄入、蔬菜水果消费偏好、吸烟、空气污染、饮酒。相反，绿茶、未发酵豆制品和大米可能具有保护作用。幽门螺杆菌感染率在下降，但即使在一个根除了这种细菌的世界里，宿主遗传学差异仍将与作为文化多样性一部分的习俗保持一起继续改变胃部疾病的结局。
