There is little doubt that the pathogenesis of gastrointestinal disorders, diagnosis as well as the therapy is a pertinent scientific focus and one of the largest and most intriguing areas in medicine. Likewise, it has been generally accepted that most of the therapy and understanding of pathophysiology in the gastrointestinal tract is well and should be validated in clinical practice. Therefore, there is still an open door for one or more new ways. Hopefully, the most recent findings may provide a new insight into future developments. In this, I hope, in scope of Emerging Drugs in Gastrointestinal Tract, these papers may contribute a new view that may likely improve the future understanding of pathogenesis and therapy in gastrointestinal tract. In this issue, Yanaka (Faculty of Pharmaceutical Sciences, Tokyo University of Science, Japan) reviewed cellular mechanisms by which the nrf2-keap1 system contributes to induction of a variety of antioxidant enzymes during exposure to oxidative stress and introduced the beneficial effects of sulforaphane, an isothiocyanate family, rich in broccoli sprouts, on the gastric mucosa through such mechanisms [1]. Brzozowski and collaborators (Jagiellonian University Medical College, Cracow, Poland and Thuringia-Clinic, Saalfeld, Germany) reviewed COX-2 derived products, “lipoxins” in the mechanism of gastric mucosal defense. Aspirin-triggered lipoxin synthesis via COX-2 plays also an important role in gastric adaptation during chronic aspirin administration, in addition to the mechanism of injury, gastroprotection and healing of acute and chronic gastric ulcers in the gut [2]. Chen and Zhao (Norwegian University of Science and Technology, Trondheim, Norway)reviewed gut-bone axis, based on the various factors affecting bone mass, an issue that may be particularly important. They examined critically the influence of ; acid, serotonin, lowdensity lipoprotein receptor-related protein5, etc, affecting bone mass. They concluded that evidence still could not completely prove a close relationship between these factors and bone mass [3]. Historically, the phenomenon of “cytoprotection” caused a big impact to many GI investigators, like “an epoch-making finding”, and although caused major impacts on GI research & development, the current clinic did not gain adequate advantage. In this, Mozsik (University of Pecs, Hungary) extensively reviewed gastrointestinal cytoprotection (at the level of isolated cells, animal experiments, healthy human beings and patients with different gastrointestinal disorders), including the historic lookback, reviewing the huge range of agents supposed to be involved in cytoprotection [4]. Wood (The Ohio State University College of Medicine Columbus, Ohio, USA)focused on chronic functional abdominal and pelvic pain syndromes. Within the scope of Visceral Pain: Spinal Afferents, Enteric Mast Cells, Enteric Nervous System and Stress, Wood reviews and expands the understanding of visceral hypersensitivity and functional abdominal pain of intestinal origin in relation to the enteric nervous system, spinal sensory neurons and enteric mast cells [5]. Until recently, fat was considered a relatively inactive tissue serving only as a depot for the storage of excess lipid around the body. Over the last decade, however, several studies have established fat as a metabolically active endocrine organ able to affect human pathophysiology at multiple levels. Karagainides and collaborators (David Geffen School of Medicine at the University of California Los Angeles, USA) reviewed the potential pathways by which changes in fat physiology may affect the development and progress of intestinal pathological conditions such as inflammatory bowel disease, and especially discussed the central role of neuropeptides in the pathogenesis and course of inflammatory bowel disease, via adipose tissue associated responses as well as the potential crosstalk between obesity-associated fat tissue and neuropeptides [6]. The role of constitutive and inducible antibacterial peptides has been investigated thoroughly over the recent years ; especially in the gastrointestinal tract, where the balance between luminal bacteria and antibacterial peptides is crucial. Wong and collaborators (The Chinese University of Hong Kong, Shatin, Hong Kong, China) focused on and emphasized the role of defensins and cathelicidins, two of the most popular mammalian antibacterial peptides (produced by neutrophils and epithelial cells and are highly expressed during infection), in gastrointestinal inflammation and cancers as well as other physiological processes such as cell proliferation, wound healing and so on. In addition, they also proposed that the dysregulation of their expressions could be used as a biomarker for early diagnosis, especially for H. pylori-related diseases as well as cancers in the gastrointestinal tract [7]
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Aug 27, 2023
Junxi Chi + 4
Open Access
