Gastroduodenal mucosal defense.
The gastroduodenal mucosa withstands injury from acid, drugs, foodstuffs, and other factors. Defense mechanisms include pre-epithelial and epithelial barriers, submucosal acid sensors, prostaglandin generation, endogenous protective gases, and other chemical mediators. Recent studies have focused on proteinase-activated receptors and their linkage to prostaglandin formation, as well as on antioxidants targeted to reduce harmful reactive oxygen species. Investigation continues into the protective roles of calcitonin gene-related peptide, hydrogen sulfide, annexin-1, survivin, and methylnicotinamide. This article also summarizes some new findings on the genetics of ulcer formation and the effects of age and gender on mucosal defense and touches on current developments in drugs, including considerations for future therapeutic agents.
Zhu
Amy
A
West Los Angeles VA Medical Center, 11301 Wilshire Boulevard, Los Angeles, CA 90073, USA.
Kaunitz
Jonathan
J
D000367:Age Factors; D000818:Animals; D017302:Annexins / Q000378:metabolism; D015740:Calcitonin Gene-Related Peptide / Q000378:metabolism; D002940:Circadian Rhythm; D005753:Gastric Mucosa / Q000098:blood supply / Q000187:drug effects / Q000378:metabolism*; D006801:Humans; D006862:Hydrogen Sulfide / Q000378:metabolism; D018836:Inflammation Mediators / Q000378:metabolism; D051034:Inhibitor of Apoptosis Proteins; D007413:Intestinal Mucosa / Q000098:blood supply / Q000187:drug effects / Q000378:metabolism*; D020782:Matrix Metalloproteinases / Q000378:metabolism; D008550:Melatonin / Q000378:metabolism; D008869:Microtubule-Associated Proteins / Q000378:metabolism; D009536:Niacinamide / Q000378:metabolism; D010437:Peptic Ulcer / Q000188:drug therapy / Q000235:genetics; D017382:Reactive Oxygen Species / Q000378:metabolism; D044462:Receptors, Proteinase-Activated / Q000378:metabolism; D012737:Sex Factors; D000077022:Survivin
D017302:Annexins; C107489:BIRC5 protein, human; D018836:Inflammation Mediators; D051034:Inhibitor of Apoptosis Proteins; D008869:Microtubule-Associated Proteins; D017382:Reactive Oxygen Species; D044462:Receptors, Proteinase-Activated; D000077022:Survivin; D009536:Niacinamide; D020782:Matrix Metalloproteinases; D015740:Calcitonin Gene-Related Peptide; D008550:Melatonin; D006862:Hydrogen Sulfide