Etiological and pathogenetic characteristics of chronic atrophic gastritis

Nowadays, there is a steady increase in the prevalence of chronic atrophic gastritis (CAG). The CAG etiology is complex and associated with many factors, which can act synergistically. Despite significant advances in the understanding of CAG, no specific treatment strategies for this disease have been developed. It drives scientists around the world to attach special attention to studying its pathophysiology and developing effective approaches to diagnosis and treatment in terms of cancer prevention. Today active work is underway to find new diagnostic biomarkers for early detection of atrophy, including the use of proteomic and metabolomic analysis. Due to the complexities of the pathogenesis of atrophic changes of gastric mucosa and the difficulties in treating this disease, it is necessary to consider personalized approaches to the treatment of such patients. The main objectives of the CAG therapy are to relieve dyspeptic symptoms, if any, and to prevent the risks of developing gastric cancer. The latest consensus documents contain recommendations on lifestyle modification, timely diagnosis and subsequent eradication of H. pylori infection, as well as the use of cytoprotective drugs to reduce the mucosal damage progression in CAG. Rebamipide neutralizes lipid peroxidation, increases mucosal blood flow and accelerates epithelial barrier restitution, which allows to recommend this drug for the treatment of CAG. Rebamipide can potentially prevent CAG by improving the mucous membrane state in chronic gastritis of any etiology, for which reason the cyclic and continuous therapy with rebamipide is currently considered as an effective strategy for the treatment of CAG and the prevention of gastric cancer.