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World J Gastroenterol. Apr 28, 2014; 20(16): 4467-4482
Published online Apr 28, 2014. doi: 10.3748/wjg.v20.i16.4467
Increased susceptibility of aging gastric mucosa to injury: The mechanisms and clinical implications
Andrzej S Tarnawski, Amrita Ahluwalia, Michael K Jones
Andrzej S Tarnawski, Amrita Ahluwalia, Michael K Jones, University of California Irvine and the Veterans Administration Long Beach Healthcare System, 5901 E. 7th Street, Long Beach, CA 90822-5201, United States
Author contributions: Tarnawski AS, Ahluwalia A and Jones M contributed to this paper; Tarnawski AS designed the overall concept and outline of the manuscript; Ahluwalia A and Jones MK contributed to the discussion and design of the manuscript; Tarnawski AS, Ahluwalia A and Jones MK contributed to the writing, editing and revision of the manuscript, illustrations, and review of literature (55%, 30% and 15%, respectively).
Supported by VA Merit Review grant to Tarnawski AS
Correspondence to: Andrzej S Tarnawski, MD, PhD, DSc, University of California Irvine and the Veterans Administration Long Beach Healthcare System, 5901 E. 7th Street (09/151), Long Beach, CA 90822-5201, United States. atarnawski@yahoo.com
Telephone: +1-562-8265437 Fax: +1-714-8464496
Received: January 13, 2014
Revised: January 30, 2014
Accepted: April 1, 2014
Published online: April 28, 2014
Core Tip

Core tip: This review focuses on aging gastric mucosa and its increased susceptibility to injury. The following events occur in aging gastric mucosa: reduced mucosal blood flow and hypoxia, upregulates PTEN that activates pro-apoptotic caspases and reduces anti-apoptosis protein, survivin. The imbalance between pro- and anti-apoptosis mediators results in increased apoptosis and increased susceptibility to injury. Aging gastropathy is an important and clinically relevant issue because of: (1) an aging world population; (2) older patients have much greater risk of gastroduodenal ulcers and gastrointestinal complications (e.g., non-steroidal anti-inflammatory drugs-induced gastric injury) than younger patients; and (3) increased injury of aging gastric mucosa can be reversed pharmacologically.