The Gastric Epithelium: Slow Starter in the Stem Cell/Lineage Specification Stakes?
538 - 539
Cell Mol Gastroenterol Hepatol
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Stem cell dynamics and lineage specification form the basis of the understanding of the generation of metaplastic and neoplastic states in the gut. Although our knowledge in the intestine has raced ahead, the stomach lags behind. Here, we highlight some of the problems. There has been a veritable explosion in our knowledge of stem cell identity, dynamics, and lineage specification in the small intestine, and, to a lesser extent, the colon, particularly in relationship to early neoplasia. In the stomach, progress has been less spectacular: given the importance of the cell and molecular changes within the metaplasia/dysplasia/carcinoma sequence in both gastric and esophageal carcinogenesis, this state of affairs is less than satisfactory. The situation is well illustrated by 3 recent articles in Cellular and Molecular Gastroenterology and Hepatology: the first of these, Stomach Organ and Cell Lineage Differentiation: From Embryogenesis to Adult Homeostasis,1 elegantly surveys the present state of our knowledge. Through a variety of techniques there is now a generally accepted map of lineage relationships in the gastric corpus and antrum, quite different areas in terms of cellular content and specification. It is in our understanding of stem cell identity and dynamics, and the relationship of the contained lineages to these stem cells, that wide gaps in our knowledge exist.