摘要
InthiseditorialwecommentonthearticlebyFukushiKetalpublishedintherecentissueoftheWorldJournalofGastroenterology2018;24(34):3908-3918.Wefocusspecificallyonthemechanismsoftheanti-thromboticactionofaspirin,gastricmucosalinjuryandaging-relatedincreasedsusceptibilityofgastricmucosatoinjury.Aspiriniswidelyusednotonlyforthemanagementofacuteandchronicpainandarthritis,butalsoimportantlyfortheprimaryandsecondarypreventionofcardiovasculareventssuchasmyocardialinfarctsandstrokes.Clinicaltrialshaveconsistentlyshownthatantiplatelettherapywithlongterm,lowdoseaspirin(LDA)-75to325mgdaily,dramaticallyreducestheriskofnon-fatalmyocardialinfarcts,strokeandmortalityinpatientswithestablishedarterialdiseases.However,suchtreatmentconsiderablyincreasestheriskofgastrointestinal(GI)ulcerationsandseriousbleedingby>2-4fold,especiallyinagingindividuals.ThisriskisfurtherincreasedinpatientsusingLDAtogetherwithotherantiplateletagents,othernonsteroidalanti-inflammatoryagents(NSAIDs)and/oralcohol,orinpatientswithHelicobacterpylori(H.pylori)infection.Previousstudiesbyourgroupandothershavedemonstratedprominentstructuralandfunctionalabnormalitiesingastricmucosaofagingindividuals(whichwerefertoasaginggastricmucosaor“aginggastropathy”)comparedtothegastricmucosaofyoungerindividuals.Aginggastricmucosahasimpairedmucosaldefense,increasedsusceptibilitytoinjurybyavarietyofnoxiousagentssuchasaspirin,otherNSAIDsandethanol,anddelayedandimpairedhealingofinjury.Themechanismunderlyingtheseabnormalitiesofaginggastricmucosaincludereducedmucosalbloodflowcausinghypoxia,upregulationofPTEN,activationofproapoptoticcaspase-3andcaspase-9,andreducedsurvivin(anti-apoptosisprotein),importin-α(nucleartransportprotein),vascularendothelialgrowthfactor,andnervegrowthfactor.Thedecisionregardinginitiationofalong-termLDAtherapyshould
出版日期
2018年12月22日（中国Betway体育网页登陆平台首次上网日期，不代表论文的发表时间）
