Abstract

Epidemiological and experimental evidence has emerged that a dysregulated inflammation is associated with most of the tumors, and many studies have begun to unravel the molecular pathways linking inflammation and cancer. As a typical example linking these associations, Helicobacter pylori (H. pylori) infection-associated atrophic gastritis has been recognized as precursor lesion of gastric cancer. The identification of transcription factors such as NF-κB and STAT3, and their gene products such as IL-8, COX-2, iNOS, cytokines, chemokines and their receptors, etc have laid the molecular foundation for our understanding of the decisive role of inflammation in carcinogenesis. In addition to the role as the initiator of cancer, inflammation contributes to survival and proliferation of malignant cells, tumor angiogenesis, and even metastasis. In this review, the fundamental mechanisms of H. pylori-induced carcinogenesis as well as the possibility of cancer prevention through suppressing H. pylori-induced inflammation are introduced. We infer that targeting inflammatory pathways have a potential role to detour the unpleasant journey to H. pylori-associated gastric carcinogenesis.

Highlights

  • Gastric cancer is a major contributor to cancer-related death worldwide

  • In a subset of the H. pylori-infected population the gastric inflammation may evolve toward chronic active gastritis, and be implicated in more severe gastric diseases such as chronic atrophic gastritis and intestinal metaplasia, known as a precursor of gastric carcinogenesis, peptic ulcers, mucosa-associated lymphoid tissue lymphoma, and gastric cancer

  • Chronic persistent, uncontrolled gastric inflammations are possible basis for ensuing gastric carcinogenesis and H. pylori infection increased COX-2 expressions, which might be the one of the mechanisms leading to gastric cancer

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Summary

Introduction

Gastric cancer is a major contributor to cancer-related death worldwide. gastric cancer incidence and mortality have declined in most areas of the World, gastric cancer is still the fourth most common cancer worldwide and ranks the third most common cause of cancer-related deaths [1].Among the etiologies of gastric cancer, the Gram-negative bacterium Helicobacter pylori (H. pylori) is a well-established etiologic factor and has been classified as a class 1 carcinogen because of its causative role in the development of gastric cancer [2]. COX-2 expression is increased reased in gastric epithelial cells treated with H. pylori,, within infected human gastric mucosa and further within gastric premalignant and malignant lesions, and COX inhibitors such as aspirin and other NSAIDs decrease the risk of distal gastric cancer [16].

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