Cited by 55Gastrointestinal motility and disordersHeme Oxygenase-1 and Carbon MonoxideCongenital gastrointestinal and neural anomalies

Macrophages in diabetic gastroparesis – the missing link?

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Neshatian, L., Gibbons, S. J., Farrugia, G.·2015·Neurogastroenterology & Motility

Abstract

Background: Diabetic gastroparesis results in significant morbidity for patients and major economic burden for society. Treatment options for diabetic gastroparesis are currently directed at symptom control rather than the underlying disease and are limited. The pathophysiology of diabetic gastroparesis includes damage to intrinsic and extrinsic neurons, smooth muscle, and interstitial cells of C ajal ( ICC ). Oxidative damage in diabetes appears to be one of the primary insults involved in the pathogenesis of several complications of diabetes, including gastroparesis. Recent studies have highlighted the potential role of macrophages as key cellular elements in the pathogenesis of diabetic gastroparesis. Macrophages are important for both homeostasis and defense against a variety of pathogens. Heme oxygenase 1 ( HO 1), an enzyme expressed in a subset of macrophages has emerged as a major protective mechanism against oxidative stress. Activation of macrophages with high levels of HO 1 expression protects against development of delayed gastric emptying in animal models of diabetes, while activation of macrophages that do not express HO 1 are linked to neuromuscular cell injury. Targeting macrophages and HO 1 may therefore be a therapeutic option in diabetic gastroparesis. Purpose: This report briefly reviews the pathophysiology of diabetic gastroparesis with a focus on oxidative damage and how activation and polarization of different subtypes of macrophages in the muscularis propria determines development of delay in gastric emptying or protects against its development.

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  • In diabetes, insulin and IGF-1 deficiency causes muscle atrophy and reduced SCF production, leading to ICC depletion and impaired neuromuscular transmission.

    “In diabetes, insulin and IGF-1 deficiency causes muscle atrophy and reduced SCF production, leading to ICC depletion and impaired neuromuscular transmission [52–60].”

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Authors
Neshatian, L., Gibbons, S. J., & Farrugia, G.
Affiliations
Mayo Clinic (US)
Corresponding author
Farrugia, G.
Venue
Neurogastroenterology & Motility
Publisher
Wiley
Published
2014-08-28
Volume
27
Issue
1
Pages
7-18
ISSN
  • 1350-1925 (ISSN-L)
  • 1365-2982
OpenAlex
W1974169016
Cited by
55
References
10
Citations by year
2026: 3 · 2025: 6 · 2024: 5 · 2023: 2 · 2022: 4 · 2021: 6 · 2020: 6 · 2019: 4 · 2018: 5 · 2017: 5 · 2016: 7 · 2015: 1 · 2014: 1
FWCI
0.76
Type
journal article
Language
en
Open access
Locations
  • Neurogastroenterology & Motility (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institutes of Health (DK57061, DK68055, DK74008, DK76169)
Topics
  • Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Heme Oxygenase-1 and Carbon Monoxide
  • Health Sciences › Medicine › Surgery › Congenital gastrointestinal and neural anomalies
Keywords
diabetic gastroparesis, macrophages, heme oxygenase-1, oxidative stress, macrophage polarization, delayed gastric emptying, muscularis propria, interstitial cells of Cajal, diabetic neuropathy, macrophage-targeted therapy
MeSH terms
Animals, Diabetic Neuropathies, Heme Oxygenase (Decyclizing), Humans, Macrophages, Oxidative Stress, Gastroparesis, Gastrointestinal Tract, Diabetes Complications, Mice, Rats, Interstitial Cells of Cajal

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