Spectrum of Interstitial Cell of Cajal Deficits in Chronic Gastroduodenal Disorders: Systematic Review and Meta-Analysis

作者：Chris Varghese, Pankaj J. Pasricha, Thomas L. Abell, Henry P. Parkman, Christopher N. Andrews, Dániel Keszthelyi, Armen A. Gharibans, Gianrico Farrugia, Gregory O’Grady · 发表于：The American Journal of Gastroenterology · 年份：2025 · DOI：10.14309/ajg.0000000000003646 · 被引用次数：14 · 研究领域：Gastrointestinal motility and disorders、Pain Mechanisms and Treatments、Gastroesophageal reflux and treatments

INTRODUCTION: Chronic neurogastroduodenal disorders are heterogeneous and thought to lie on a spectrum of disease encompassing both sensory and neuromuscular pathologies. Abnormalities of interstitial cells of Cajal (ICC), a subset of which generate pacemaker signals and subsequently motility, have been implicated in their pathophysiology. We systematically reviewed the literature to pool ICC deficits observed in chronic neurogastroduodenal disorders. METHODS: Studies quantifying gastric ICC from the corpus or antrum, in adult patients with gastroparesis, functional dyspepsia (FD), or chronic nausea and vomiting syndromes (CNVS) were analyzed (PROSPERO: CRD42024613226). MEDLINE, Embase and CENTRAL databases were searched systematically. Random effects meta-analyses were used to compare ICC counts by disorder group with subgroup analysis by quantification methodology. RESULTS: Overall, 2,158 studies were screened and 22 included. Comparative studies (n = 12) showed patients with chronic neurogastroduodenal disorders (n = 167 with gastroparesis, n = 19 with FD ± CNVS) had lower ICC counts than nondiabetic controls (n = 130); standardized mean difference -1.58, 95% confidence interval -2.09 to -1.07, P < 0.0001, with more severe deficits in gastroparesis compared to FD ± CNVS (standardized mean difference [SMD] -0.44, P = 0.048). A spectrum of ICC deficits was evident in a subgroup of studies using gold-standard methods with c-KIT antibody and 4',6-diamidino-2-phenylindole-stain...