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Review

The Critical Role of Growth Factors in Gastric Ulcer Healing: The Cellular and Molecular Mechanisms and Potential Clinical Implications

1
Medical Research Service, VA Long Beach Healthcare System Long Beach, 5901 East Seventh Street, Long Beach, CA 90822, USA
2
Division of Gastroenterology, Department of Medicine and Digestive Health Institute, The University of California-Irvine, Irvine, CA 92697, USA
*
Authors to whom correspondence should be addressed.
Academic Editor: Marc Basson
Cells 2021, 10(8), 1964; https://doi.org/10.3390/cells10081964
Received: 28 June 2021 / Revised: 25 July 2021 / Accepted: 29 July 2021 / Published: 2 August 2021
In this article we review the cellular and molecular mechanisms of gastric ulcer healing. A gastric ulcer (GU) is a deep defect in the gastric wall penetrating through the entire mucosa and the muscularis mucosae. GU healing is a regeneration process that encompasses cell dedifferentiation, proliferation, migration, re-epithelialization, formation of granulation tissue, angiogenesis, vasculogenesis, interactions between various cells and the matrix, and tissue remodeling, all resulting in scar formation. All these events are controlled by cytokines and growth factors (e.g., EGF, TGFα, IGF-1, HGF, bFGF, TGFβ, NGF, VEGF, angiopoietins) and transcription factors activated by tissue injury. These growth factors bind to their receptors and trigger cell proliferation, migration, and survival pathways through Ras, MAPK, PI3K/Akt, PLC-γ, and Rho/Rac/actin signaling. The triggers for the activation of these growth factors are tissue injury and hypoxia. EGF, its receptor, IGF-1, HGF, and COX-2 are important for epithelial cell proliferation, migration, re-epithelialization, and gastric gland reconstruction. VEGF, angiopoietins, bFGF, and NGF are crucial for blood vessel regeneration in GU scars. The serum response factor (SRF) is essential for VEGF-induced angiogenesis, re-epithelialization, and blood vessel and muscle restoration. Local therapy with cDNA of human recombinant VEGF165 in combination with angiopoietin1, or with the NGF protein, dramatically accelerates GU healing and improves the quality of mucosal restoration within ulcer scars. The future directions for accelerating and improving healing include local gene and protein therapies with growth factors, their combinations, and the use of stem cells and tissue engineering. View Full-Text
Keywords: gastric ulcer healing; growth factors; signaling pathways; angiogenesis; vasculogenesis; bone marrow derived endothelial progenitor cells gastric ulcer healing; growth factors; signaling pathways; angiogenesis; vasculogenesis; bone marrow derived endothelial progenitor cells
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MDPI and ACS Style

Tarnawski, A.S.; Ahluwalia, A. The Critical Role of Growth Factors in Gastric Ulcer Healing: The Cellular and Molecular Mechanisms and Potential Clinical Implications. Cells 2021, 10, 1964. https://doi.org/10.3390/cells10081964

AMA Style

Tarnawski AS, Ahluwalia A. The Critical Role of Growth Factors in Gastric Ulcer Healing: The Cellular and Molecular Mechanisms and Potential Clinical Implications. Cells. 2021; 10(8):1964. https://doi.org/10.3390/cells10081964

Chicago/Turabian Style

Tarnawski, Andrzej S., and Amrita Ahluwalia. 2021. "The Critical Role of Growth Factors in Gastric Ulcer Healing: The Cellular and Molecular Mechanisms and Potential Clinical Implications" Cells 10, no. 8: 1964. https://doi.org/10.3390/cells10081964

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