Immunopathological and molecular basis of functional dyspepsia and current therapeutic approaches

Mounika Addula, Victoria E.D. Wilson, Savio Reddymasu, Devendra K. Agrawal

    Research output: Contribution to journalReview articlepeer-review

    2 Scopus citations

    Abstract

    Introduction: Functional dyspepsia (FD) is widespread with 20% prevalence worldwide and a significant economic burden due to health care cost and constraints on daily activities of patients. Despite extensive investigation, the underlying causes of dyspepsia in a majority of patients remain unknown. Common complaints include abdominal discomfort, pain, burning, nausea, early satiety, and bloating. Motor dysfunction of the gut was long considered a major cause, but recent investigations suggest immune-based pathophysiological and molecular events in the duodenum are more probable contributing factors. Areas Covered: Inflammatory mediators and immune cells including duodenal eosinophils, intraepithelial lymphocytes, and T-cells have been implicated in the underlying cause of disease process, as have genetic factors. In this article, we critically reviewed findings, identified gaps in knowledge and suggested future directions for further investigation to identify targets and develop better therapeutic approaches. Expert commentary: Impaired gastric accommodation, slow gastric emptying, and increased visceral sensitivity have long been thought of as main causal factors of FD. However, more recent identification of eosinophilic degranulation and recruitment of T cells that induce mild duodenal inflammation are giving rise to new insights into immune-mediated pathophysiology. These insights offer promising avenues to explore for immune-mediated therapy in the future.

    Original languageEnglish (US)
    Pages (from-to)831-840
    Number of pages10
    JournalExpert Review of Clinical Immunology
    Volume14
    Issue number10
    DOIs
    StatePublished - Oct 3 2018

    All Science Journal Classification (ASJC) codes

    • Immunology and Allergy
    • Immunology

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