Gastric Biopsies in Gastroparesis: Insights into Gastric Neuromuscular Disorders to Aid Treatment

Gastroenterol Clin North Am. 2020 Sep;49(3):557-570. doi: 10.1016/j.gtc.2020.04.009. Epub 2020 Jun 14.

Abstract

The cellular and molecular understanding of human gastroparesis has markedly improved due to studies on full-thickness gastric biopsies. A decrease in the number of interstitial cells of Cajal (ICC) and functional changes in ICC constitutes the hallmark cellular feature of gastroparesis. More recently, in animal models, macrophages have also been identified to play a central role in development of delayed gastric emptying. Activation of macrophages leads to loss of ICC. In human gastroparesis, loss of anti-inflammatory macrophages in gastric muscle has been shown. Deeper molecular characterization using transcriptomics and proteomics has identified macrophage-based immune dysregulation in human gastroparesis.

Keywords: Diabetes; Enteric nervous system; Gastric emptying; Immune cells.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Animals
  • Biopsy / methods*
  • Diabetes Complications / complications
  • Disease Models, Animal
  • Female
  • Gastric Emptying
  • Gastroparesis / diagnosis*
  • Gastroparesis / epidemiology
  • Gastroparesis / etiology
  • Gastroparesis / pathology*
  • Humans
  • Interstitial Cells of Cajal / pathology
  • Macrophages / immunology
  • Male
  • Tissue and Organ Procurement / methods