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Review
. 2015 Nov 14;21(42):12179-89.
doi: 10.3748/wjg.v21.i42.12179.

Autoimmune gastritis: Pathologist's viewpoint

Irene Coati  1 , Matteo Fassan  1 , Fabio Farinati  1 , David Y Graham  1 , Robert M Genta  1 , Massimo Rugge  1
Affiliations
Review

Autoimmune gastritis: Pathologist's viewpoint

Irene Coati et al. World J Gastroenterol. .

Abstract

Western countries are seeing a constant decline in the incidence of Helicobacter pylori-associated gastritis, coupled with a rising epidemiological and clinical impact of autoimmune gastritis. This latter gastropathy is due to autoimmune aggression targeting parietal cells through a complex interaction of auto-antibodies against the parietal cell proton pump and intrinsic factor, and sensitized T cells. Given the specific target of this aggression, autoimmune gastritis is typically restricted to the gastric corpus-fundus mucosa. In advanced cases, the oxyntic epithelia are replaced by atrophic (and metaplastic) mucosa, creating the phenotypic background in which both gastric neuroendocrine tumors and (intestinal-type) adenocarcinomas may develop. Despite improvements in our understanding of the phenotypic changes or cascades occurring in this autoimmune setting, no reliable biomarkers are available for identifying patients at higher risk of developing a gastric neoplasm. The standardization of autoimmune gastritis histology reports and classifications in diagnostic practice is a prerequisite for implementing definitive secondary prevention strategies based on multidisciplinary diagnostic approaches integrating endoscopy, serology, histology and molecular profiling.

Keywords: Autoimmune gastritis; Carcinoids; Metaplasia; Operative link for gastritis assessment staging.

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Figures

Figure 1
Figure 1
Helicobacter pylori-related vs autoimmune gastritis. Main differences in clinical presentation, serology (immunological and functional profiles), pathology, and neoplastic risk. H. pylori: Helicobacter pylori.
Figure 2
Figure 2
Schematic representation of the main diagnostic histological pictures seen in autoimmune gastritis. Metaplastic changes in the antrum and corpus are staged using the OLGA system. IHC: Immunohistochemistry; ECL: Enterochromaffin-like; IEN: Intraepithelial neoplasia; LG-IEN: Low-grade IEN; HG-IEN: High-grade IEN; GC: Gastric carcinoma; OLGA: Operative link for gastritis assessment; AIG: Autoimmune gastritis; PPI: Proton pump inhibitor.
See this image and copyright information in PMC

References

    1. Faber K. Gastritis and Its Consequences. JAMA. 1935;105:2098.
    1. Bizzozero G. "Ueber die schlauchförmigen Drüsen des Magendarmkanals und die Beziehungen ihres Epitheles zu dem Oberflächenepithel der Schleimhaut". Archiv für mikroskopische Anatomie. 1893;42:82–152.
    1. Vojdani A. A Potential Link between Environmental Triggers and Autoimmunity. Autoimmune Dis. 2014;2014:437231. - PMC - PubMed
    1. Kamradt T, Göggel R, Erb KJ. Induction, exacerbation and inhibition of allergic and autoimmune diseases by infection. Trends Immunol. 2005;26:260–267. - PubMed
    1. Kondrashova A, Seiskari T, Ilonen J, Knip M, Hyöty H. The ‘Hygiene hypothesis’ and the sharp gradient in the incidence of autoimmune and allergic diseases between Russian Karelia and Finland. APMIS. 2013;121:478–493. - PubMed

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