Different Pathophysiology of Gastritis between East and West? An Asian Perspective.

BACKGROUND

The incidence of gastric cancer in Asia is higher than that in Europe and Northern America. infection is the most important factor for the development of atrophic gastritis and gastric cancer. The geographical distribution of the prevalence and virulence factors of are important to understand the difference between gastritis in the East and West.

SUMMARY

Articles comparing gastritis cases between eastern and western countries showed that the severity of gastritis is closely related to the risk of gastric cancer, and the severity of gastritis is more advanced in East Asia. Although the prevalence of infection is closely associated with the incidence of gastric cancer in European countries, the severity of gastritis and the high incidence of gastric cancer in East Asia are not dependent only on the prevalence of infection itself. From the viewpoint of the virulence factors of , the East Asian CagA-positive strain (EPIYA motif ABD type) is peculiar in East Asia. Considering comprehensively the geographical distribution of subtypes is the most important factor among all prospected risk factors for the incidence of gastric cancer and the rate of development of gastritis. While eating habits, such as salty foods, vegetables and fruits, might influence the progression of gastritis, such factors might be responsible for the geographic heterogeneity of gastritis.

KEY MESSAGE

East Asian CagA-positive is the strongest risk factor for gastric carcinogenesis and the development of gastritis.