Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: EC:6.3.4.6 (urease)
 7,490 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors review recent progresses made in the understanding of the disturbed gastrin homeostasis in Helicobacter pylori infection and in pernicious anaemia. Regulation of gastrin release in a complex mechanism involving inhibition by a low gastric pH and several peptides including somatostatin, and stimulation by different factors, mainly alimentary peptides and amino-acids. The hypergastrinaemia observed in patients with Helicobacter pylori infection occurs despite a normal intraluminal pH. This may be through alkalinisation of the gastric mucus layer due to the production of ammonia by the bacterial urease or through local release of inflammatory mediators. In pernicious anaemia a factor present in the antacid gastric juice could explain the important hypergastrinaemia observed. The gastrin releasing activity of the gastric juice itself was demonstrated by a decrease of the patients' plasma gastrin concentration during a neutral gastric lavage and by a rise of the gastrin levels in rats whose stomachs were perfused with gastric juice from pernicious anaemia patients. A better understanding of the relation between gastric pH and gastrin release is important not only for these pathological states but also for treatments which suppress acid secretion.
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PMID:[Mechanisms in hypergastrinemia in autoimmune atrophic gastritis and Helicobacter pylori infection]. 826 64

Chronic autoimmune atrophic gastritis (CAAG) is an organ-specific autoimmune disease, which affects the corpus-fundus gastric mucosa. Although it has been described for several years, the real pathophysiological mechanisms, the natural history and the possible neoplastic complications are not completely known. Atrophy of the gastric mucosa is the endpoint of the chronic processes, with the loss of glandular cells and their replacement by intestinal-type epithelium, pyloric-type glands, and fibrous tissue. As a consequence, hydrochloric acid, pepsin and intrinsic-factor is impaired resulting in pernicious anemia. The exact causal agent is not yet known, but both genetic and environmental factors seem to play a decisive role. Moreover, the clinical onset may assume different characteristics; differently from what previously observed, recent evidence has reported the onset of CAAG at a younger age, frequently with iron deficiency anemia or upper gastro-intestinal symptoms. The diagnosis of CAAG might be challenging and usually requires the combination of clinical, serological and histopathologic data; moreover, CAAG patients are often misdiagnosed as refractory to HP eradication therapy, probably because achlorhydria might allow urease-positive bacteria other than H pylori to colonize the stomach, causing positive 13C-urea breath test results. However, biopsy is the most reliable method to evaluate the presence of metaplastic atrophic gastritis. In order to assess the severity of gastric atrophy and intestinal metaplasia, OLGA and OLGIM staging systems have been proposed and seem to correlate with the risk of developing gastric adenocarcinoma. Indeed, CAAG represents a pre-neoplastic condition, as patients with CAAG are very likely to develop either type-1 gastric neuroendocrine tumors and gastric adenocarcinomas, as well as several other neoplastic diseases. To date, the need, the intervals and cost-effectiveness of endoscopic/histological surveillance for patients with CAAG/pernicious anemia are yet to be established.
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PMID:The changing face of chronic autoimmune atrophic gastritis: an updated comprehensive perspective. 3063 39