Autoimmune gastritis: an organ-specific disease or a model of systemic autoimmunity? Parallels, divergences, and emerging insights.

IF 3.8 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-06-19 DOI:10.1080/17474124.2025.2522284

Sara Massironi

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引用次数: 0

Abstract

Introduction: Autoimmune gastritis (AIG) is traditionally classified as an organ-specific autoimmune disease; however, emerging evidence highlights its immunological overlap with systemic autoimmunity, warranting a reevaluation of its pathophysiological framework.

Areas covered: This review delineates the immunopathogenic basis of AIG, with particular emphasis on the breakdown of central and peripheral tolerance, the predominance of autoreactive CD4⁺ T-cell subsets, and the contributions of Th1 and Th17 cytokine profiles. The role of humoral immunity, including autoantibodies as potential biomarkers, is critically appraised. Literature was selected through a targeted search of PubMed and Scopus, prioritizing mechanistic studies, translational research, and recent therapeutic advances, covering the period from January 2000 to March 2025.

Expert opinion: AIG represents a paradigm of localized autoimmunity with systemic immunological features, including cytokine dysregulation and epitope spreading. Although serologic markers are valuable for screening, their prognostic utility remains limited. Therapeutic approaches currently focus on complication prevention rather than immune modulation. Future research should prioritize the identification of predictive biomarkers of disease progression and the development of targeted immunotherapies aimed at restoring immune tolerance and preserving gastric mucosal integrity.

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自身免疫性胃炎：器官特异性疾病还是全身性自身免疫模型？相似之处、分歧和新见解。

自身免疫性胃炎（AIG）传统上被归类为器官特异性自身免疫性疾病；然而，新出现的证据强调其与系统性自身免疫的免疫学重叠，需要对其病理生理框架进行重新评估。涵盖领域：本文概述了AIG的免疫致病基础，特别强调了中枢和外周耐受性的破坏，自身反应性CD4+ t细胞亚群的优势，以及Th1和Th17细胞因子谱的贡献。体液免疫的作用，包括自身抗体作为潜在的生物标志物，被严格地评估。通过对PubMed和Scopus进行有针对性的搜索来选择文献，优先考虑机制研究、转化研究和最近的治疗进展，涵盖时间从2000年1月到2025年3月。专家意见：AIG代表了局部自身免疫的范例，具有全身免疫特征，包括细胞因子失调和表位扩散。尽管血清学标记物对筛查有价值，但其预后效用仍然有限。目前的治疗方法侧重于并发症的预防，而不是免疫调节。未来的研究应优先确定疾病进展的预测性生物标志物，并开发旨在恢复免疫耐受和保持胃粘膜完整性的靶向免疫疗法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Gastroenterology & Hepatology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

6.80

自引率

2.60%

发文量

审稿时长

6-12 weeks

期刊介绍： The enormous health and economic burden of gastrointestinal disease worldwide warrants a sharp focus on the etiology, epidemiology, prevention, diagnosis, treatment and development of new therapies. By the end of the last century we had seen enormous advances, both in technologies to visualize disease and in curative therapies in areas such as gastric ulcer, with the advent first of the H2-antagonists and then the proton pump inhibitors - clear examples of how advances in medicine can massively benefit the patient. Nevertheless, specialists face ongoing challenges from a wide array of diseases of diverse etiology.