Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium.
Translational Research in Gastrointestinal Disorders, KU Leuven, Leuven, Belgium.
Gut. 2020 Mar;69(3):591-600. doi: 10.1136/gutjnl-2019-318536. Epub 2019 Nov 29.
Emerging data increasingly point towards the duodenum as a key region underlying the pathophysiology of functional dyspepsia (FD), one of the most prevalent functional GI disorders. The duodenum plays a major role in the control and coordination of gastroduodenal function. Impaired duodenal mucosal integrity and low-grade inflammation have been associated with altered neuronal signalling and systemic immune activation, and these alterations may ultimately lead to dyspeptic symptoms. Likely luminal candidates inducing the duodenal barrier defect include acid, bile, the microbiota and food antigens although no causal association with symptoms has been convincingly demonstrated. Recognition of duodenal pathology in FD will hopefully lead to the discovery of new biomarkers and therapeutic targets, allowing biologically targeted rather than symptom-based therapy. In this review, we summarise the recent advances in the diagnosis and treatment of FD with a focus on the duodenum.
越来越多的新兴数据指向十二指肠是功能性消化不良 (FD) 病理生理学的关键区域，FD 是最常见的功能性胃肠道疾病之一。十二指肠在控制和协调胃十二指肠功能方面起着主要作用。十二指肠黏膜完整性受损和低度炎症与改变的神经元信号和全身免疫激活有关，这些改变最终可能导致消化不良症状。可能导致十二指肠屏障缺陷的腔内候选物包括酸、胆汁、微生物群和食物抗原，尽管尚未令人信服地证明与症状之间存在因果关系。在 FD 中识别十二指肠病变有望发现新的生物标志物和治疗靶点，从而实现基于生物学靶点的治疗，而不是基于症状的治疗。在这篇综述中，我们总结了 FD 的诊断和治疗方面的最新进展，重点是十二指肠。
