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Autoimmune gastritis: historical antecedents, outstanding discoveries, and unresolved problems.
Int Rev Immunol. 2005 Jan-Apr; 24(1-2):1-29.IR

Abstract

The earliest recorded history of autoimmune gastritis can be traced to 1849 in London, when Thomas Addison described "a very remarkable form of anemia" later called pernicious (fatal) anemia (PA). This was followed by the recognition of a gastric mucosal defect suspected to have a nutritional basis, the discovery of the megaloblast that characterized the anemia, the insufficiency of a dietary extrinsic factor characterized as vitamin B12 (cobalamin), and a gastric-secreted intrinsic factor. Treatment with vitamin B12 proved curative. The link between PA and gastritis and atrophy was first confirmed histologically after immediate fixation of the stomach postmortem and later, in the 1940s, by peroral tube biopsy. The causes of gastritis remained enigmatic until the era of autoimmunity, when autoantibodies were detected first to gastric intrinsic factor and then to gastric parietal cells. Hints of a dichotomy in pathogenesis of gastritis were crystallized by the description in 1973 of Type A (Autoimmune) and Type B (later, Bacterial) gastritis. Clarification was enhanced by identification in Type A gastritis of the autoantigen of the parietal cell antibody, by the alpha and beta subunits of gastric H+/K+ ATPase, and by the highly informative experimental murine model of postneonatal thymectomy autoimmune gastritis, and in Type B of the causative role of gastric infection with Helicobacter pylori (H. pylori). A denouement will require a full understanding of (1) the origin and pathogenetic contribution of antibody to intrinsic factor; (2) the connection, if any, between H. pylori infection and Type A autoimmune gastritis; and (3) the genetic contributions to gastritis, whether due to autoimmunity or to H. pylori infection.

Authors+Show Affiliations

Department of Biochemistry and Molecular Biology, Monash University, Clayton, Victoria, Australia. Senga.Whittingham@med.monash.edu.auNo affiliation info available

Pub Type(s)

Historical Article
Journal Article
Review

Language

eng

PubMed ID

15763987

Citation

Whittingham, Senga, and Ian R. Mackay. "Autoimmune Gastritis: Historical Antecedents, Outstanding Discoveries, and Unresolved Problems." International Reviews of Immunology, vol. 24, no. 1-2, 2005, pp. 1-29.
Whittingham S, Mackay IR. Autoimmune gastritis: historical antecedents, outstanding discoveries, and unresolved problems. Int Rev Immunol. 2005;24(1-2):1-29.
Whittingham, S., & Mackay, I. R. (2005). Autoimmune gastritis: historical antecedents, outstanding discoveries, and unresolved problems. International Reviews of Immunology, 24(1-2), 1-29.
Whittingham S, Mackay IR. Autoimmune Gastritis: Historical Antecedents, Outstanding Discoveries, and Unresolved Problems. Int Rev Immunol. 2005 Jan-Apr;24(1-2):1-29. PubMed PMID: 15763987.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Autoimmune gastritis: historical antecedents, outstanding discoveries, and unresolved problems. AU - Whittingham,Senga, AU - Mackay,Ian R, PY - 2005/3/15/pubmed PY - 2005/5/6/medline PY - 2005/3/15/entrez SP - 1 EP - 29 JF - International reviews of immunology JO - Int Rev Immunol VL - 24 IS - 1-2 N2 - The earliest recorded history of autoimmune gastritis can be traced to 1849 in London, when Thomas Addison described "a very remarkable form of anemia" later called pernicious (fatal) anemia (PA). This was followed by the recognition of a gastric mucosal defect suspected to have a nutritional basis, the discovery of the megaloblast that characterized the anemia, the insufficiency of a dietary extrinsic factor characterized as vitamin B12 (cobalamin), and a gastric-secreted intrinsic factor. Treatment with vitamin B12 proved curative. The link between PA and gastritis and atrophy was first confirmed histologically after immediate fixation of the stomach postmortem and later, in the 1940s, by peroral tube biopsy. The causes of gastritis remained enigmatic until the era of autoimmunity, when autoantibodies were detected first to gastric intrinsic factor and then to gastric parietal cells. Hints of a dichotomy in pathogenesis of gastritis were crystallized by the description in 1973 of Type A (Autoimmune) and Type B (later, Bacterial) gastritis. Clarification was enhanced by identification in Type A gastritis of the autoantigen of the parietal cell antibody, by the alpha and beta subunits of gastric H+/K+ ATPase, and by the highly informative experimental murine model of postneonatal thymectomy autoimmune gastritis, and in Type B of the causative role of gastric infection with Helicobacter pylori (H. pylori). A denouement will require a full understanding of (1) the origin and pathogenetic contribution of antibody to intrinsic factor; (2) the connection, if any, between H. pylori infection and Type A autoimmune gastritis; and (3) the genetic contributions to gastritis, whether due to autoimmunity or to H. pylori infection. SN - 0883-0185 UR - https://www.unboundmedicine.com/medline/citation/15763987/Autoimmune_gastritis:_historical_antecedents_outstanding_discoveries_and_unresolved_problems_ L2 - https://www.tandfonline.com/doi/full/10.1080/08830180590884413 DB - PRIME DP - Unbound Medicine ER -