Abstract
Chronic gastritis, or chronic inflammation in gastric antral and/or corpus mucosa, is a common pathological condition affecting over half the general population. Progression of chronic gastritis from Helicobacter pylori infection to severe gastric mucosal atrophy usually takes decades and varies considerably from person to person. Therefore, studies of clinically selected material cannot provide a complete picture of natural evolution of the disease or its wide variability. An overview of immunological and morphological aspects of chronic gastritis in an epidemiological context, based on data from the literature and the author's studies, reveal dynamic interaction between H. pylori infection and host response to the organism's antigens, and to gastric autoantigens including gastric H+K+ ATPase. Further population and followup studies of antral and corpus gastritis at different stages of evolution are needed, in combination with new methods, to elucidate further the roles of infection, and gastric-antrum- and corpus-mucosa-related autoimmune responses, in the pathogenesis of chronic gastritis.
Notes
The author is grateful to colleagues at University of Tartu and the outpatient departments of different Estonian communities and collaborators in Finland, Sweden, and Germany whose observations form the basis of this review. The author thanks Dr. Ian Mackay and Dr. Ban-Hock Toh for their valuable remarks in preparing the review. This work is supported by Grant No. 4631 of the Estonian Science Foundation.