Duodenal inflammation: an emerging target for functional dyspepsia?

Area of Science:

• Gastroenterology
• Immunology
• Pharmacology

Background:

• Functional dyspepsia (FD) is a common gastrointestinal disorder with limited effective therapies.
• Duodenal inflammation and the eosinophil-mast cell axis are implicated in FD pathogenesis.
• Current treatments like prokinetics and neuromodulators have limited efficacy and side effects.

Purpose of the Study:

• To review recent advances in FD pathophysiology and treatment.
• To identify potential therapeutic targets and research gaps in FD management.
• To explore the role of inflammation and the gut microbiome in FD.

Main Methods:

• A narrative review of the literature.
• Electronic literature search conducted in PubMed up to December 31, 2019.

Main Results:

• Compelling evidence supports duodenal inflammation and the eosinophil-mast cell axis in FD.
• Proton pump inhibitors may exert therapeutic effects via anti-inflammatory actions, independent of acid suppression.
• Existing and novel anti-inflammatory drugs warrant investigation for FD.

Conclusions:

• Targeting duodenal inflammation and the eosinophil-mast cell axis is crucial for FD treatment.
• Further research into probiotics, antibiotics, and treatments for impaired permeability and dysbiosis is needed.
• Future FD therapies may focus on modulating the gut microbiome and immune activation.