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Topic:Pathogenesis

Pathogenesis in horses refers to the biological mechanisms that lead to the development and progression of diseases within equine species. This process involves a complex interaction between the horse's immune system, genetic predispositions, environmental factors, and infectious agents such as bacteria, viruses, or parasites. Understanding pathogenesis is essential for identifying how diseases manifest and progress in horses, which can inform diagnostic and therapeutic strategies. Research in this area often focuses on specific diseases, examining factors such as pathogen entry, immune response, tissue damage, and recovery processes. This page compiles peer-reviewed research studies and scholarly articles that explore the mechanisms, contributing factors, and implications of pathogenesis in equine health.
Development of septic polysynovitis and uveitis in foals experimentally infected with Rhodococcus equi.
PloS one    February 7, 2018   Volume 13, Issue 2 e0192655 doi: 10.1371/journal.pone.0192655
Huber L, Giguère S, Berghaus LJ, Hanafi A, Vitosh-Sillman S, Czerwinski SL.Rhodococcus equi is one of the most important causes of disease in foals. Infection is typically characterized by pyogranulomatous pneumonia although extrapulmonary infections occur occasionally. Uveitis and polysynovitis have been reported in foals naturally infected with R. equi and are thought to be the result of an immune-mediated process. However, the pathogenesis of these conditions is poorly understood. The objectives of this study were to document the occurrence of uveitis and polysynovitis after experimental infection with R. equi and to determine if these disorders are the direct res...
Bronchoalveolar lavage fluid neutrophilia is associated with the severity of pulmonary lesions during equine asthma exacerbations.
Equine veterinary journal    February 7, 2018   Volume 50, Issue 5 609-615 doi: 10.1111/evj.12806
Bullone M, Joubert P, Gagné A, Lavoie JP, Hélie P.The severe form of equine asthma is associated with pathological changes of the peripheral airways and pulmonary parenchyma that are only partly described. Also, the relationship between these structural alterations and the percentage of neutrophils found within the airway lumen, assessed by bronchoalveolar lavage fluid (BALF) cytology, remains ill-defined. Objective: To examine the histological lesions associated with equine asthma during disease exacerbation and remission, and their relationship with lung function and BALF neutrophilia. Methods: Observational retrospective study. Methods: Pe...
Identification of a staphylococcal complement inhibitor with broad host specificity in equid Staphylococcus aureus strains.
The Journal of biological chemistry    February 5, 2018   Volume 293, Issue 12 4468-4477 doi: 10.1074/jbc.RA117.000599
de Jong NWM, Vrieling M, Garcia BL, Koop G, Brettmann M, Aerts PC, Ruyken M, van Strijp JAG, Holmes M, Harrison EM, Geisbrecht BV, Rooijakkers SHM.Staphylococcus aureus is a versatile pathogen capable of causing a broad range of diseases in many different hosts. S. aureus can adapt to its host through modification of its genome (e.g. by acquisition and exchange of mobile genetic elements that encode host-specific virulence factors). Recently, the prophage φSaeq1 was discovered in S. aureus strains from six different clonal lineages almost exclusively isolated from equids. Within this phage, we discovered a novel variant of staphylococcal complement inhibitor (SCIN), a secreted protein that interferes with activation of the human complem...
Advanced nutritional and stem cells approaches to prevent equine metabolic syndrome.
Research in veterinary science    January 31, 2018   Volume 118 115-125 doi: 10.1016/j.rvsc.2018.01.015
Marycz K, Michalak I, Kornicka K.Horses metabolic disorders have become an important problem of modern veterinary medicine. Pathological obesity, insulin resistance and predisposition toward laminitis are associated with Equine Metabolic Syndrome (EMS). Based on pathogenesis of EMS, dietary and cell therapy management may significantly reduce development of this disorder. Special attention has been paid to the diet supplementation with highly bioavailable minerals and mesenchymal stem cells (MSC) which increase insulin sensitivity. In nutrition, there is a great interests in natural algae enriched via biosorption process with...
Increased sclerostin associated with stress fracture of the third metacarpal bone in the Thoroughbred racehorse.
Bone & joint research    January 25, 2018   Volume 7, Issue 1 94-102 doi: 10.1302/2046-3758.71.BJR-2016-0202.R4
Hopper N, Singer E, Henson F.The exact aetiology and pathogenesis of microdamage-induced long bone fractures remain unknown. These fractures are likely to be the result of inadequate bone remodelling in response to damage. This study aims to identify an association of osteocyte apoptosis, the presence of osteocytic osteolysis, and any alterations in sclerostin expression with a fracture of the third metacarpal (Mc-III) bone of Thoroughbred racehorses. Methods: A total of 30 Mc-III bones were obtained; ten bones were fractured during racing, ten were from the contralateral limb, and ten were from control horses. Each Mc-II...
Phylogenetic Analysis and Characterization of a Sporadic Isolate of Equine Influenza A H3N8 from an Unvaccinated Horse in 2015.
Viruses    January 11, 2018   Volume 10, Issue 1 31 doi: 10.3390/v10010031
Sreenivasan CC, Jandhyala SS, Luo S, Hause BM, Thomas M, Knudsen DEB, Leslie-Steen P, Clement T, Reedy SE, Chambers TM, Christopher-Hennings J....Equine influenza, caused by the H3N8 subtype, is a highly contagious respiratory disease affecting equid populations worldwide and has led to serious epidemics and transboundary pandemics. This study describes the phylogenetic characterization and replication kinetics of recently-isolated H3N8 virus from a nasal swab obtained from a sporadic case of natural infection in an unvaccinated horse from Montana, USA. The nasal swab tested positive for equine influenza by Real-Time Quantitative Reverse Transcription Polymerase Chain Reaction (RT-PCR). Further, the whole genome sequencing of the virus ...
Differential Expression of Serum MicroRNAs Supports CD4⁺ T Cell Differentiation into Th2/Th17 Cells in Severe Equine Asthma.
Genes    December 12, 2017   Volume 8, Issue 12 383 doi: 10.3390/genes8120383
Pacholewska A, Kraft MF, Gerber V, Jagannathan V.MicroRNAs (miRNAs) regulate post-transcriptional gene expression and may be exported from cells via exosomes or in partnership with RNA-binding proteins. MiRNAs in body fluids can act in a hormone-like manner and play important roles in disease initiation and progression. Hence, miRNAs are promising candidates as biomarkers. To identify serum miRNA biomarkers in the equine model of asthma we investigated small RNA derived from the serum of 34 control and 37 asthmatic horses. These samples were used for next generation sequencing, novel miRNA identification and differential miRNA expression ana...
Comparative Genomic Sequencing and Pathogenic Properties of Equine Herpesvirus 1 KyA and RacL11.
Frontiers in veterinary science    December 11, 2017   Volume 4 211 doi: 10.3389/fvets.2017.00211
Shakya AK, O'Callaghan DJ, Kim SK.Equine herpesvirus 1 (EHV-1) is a major pathogen affecting equines worldwide. The virus causes respiratory disease, abortion, and, in some cases, neurological disease. EHV-1 Kentucky A (KyA) is attenuated in the mouse and equine, whereas wild-type pathogenic strain RacL11 induces severe inflammatory infiltration of the lung, causing infected mice to succumb. The complete DNA sequencing of the KyA genome revealed that genes UL17 (ORF17), US6 (ORF73; gI), US7 (ORF74; gE), and US8 (ORF75; 10 K) are deleted as compared to the RacL11 and Ab4 genomes. In-frame deletions in the US1 (ORF68), US4 (OR...
Equine renal hemangiosarcoma: clinical presentation, pathologic features, and pSTAT3 expression. Hughes K, Scott VHL, Blanck M, Barnett TP, Spanner Kristiansen J, Foote AK.Hemangiosarcoma is an uncommon tumor in horses. We characterized 3 cases of equine renal hemangiosarcoma, focusing on clinical and pathologic features, and describe occurrence of the epithelioid variant of hemangiosarcoma in one of these cases. Nuclear expression of phosphorylated STAT3 (pSTAT3) was assessed to analyze potential inappropriate STAT3 activation as a component of tumor pathogenesis. Clinical signs in the 3 horses included insidious weight loss, followed in one case by serosanguineous nasal discharge and terminal epistaxis, and nonspecific signs of abdominal pain. Two of the heman...
Access to a main alphaherpesvirus receptor, located basolaterally in the respiratory epithelium, is masked by intercellular junctions.
Scientific reports    November 30, 2017   Volume 7, Issue 1 16656 doi: 10.1038/s41598-017-16804-5
Van Cleemput J, Poelaert KCK, Laval K, Maes R, Hussey GS, Van den Broeck W, Nauwynck HJ.The respiratory epithelium of humans and animals is frequently exposed to alphaherpesviruses, originating from either external exposure or reactivation from latency. To date, the polarity of alphaherpesvirus infection in the respiratory epithelium and the role of respiratory epithelial integrity herein has not been studied. Equine herpesvirus type 1 (EHV1), a well-known member of the alphaherpesvirus family, was used to infect equine respiratory mucosal explants and primary equine respiratory epithelial cells (EREC), grown at the air-liquid interface. EHV1 binding to and infection of mucosal e...
Reproductive effects of arteriviruses: equine arteritis virus and porcine reproductive and respiratory syndrome virus infections.
Current opinion in virology    November 21, 2017   Volume 27 57-70 doi: 10.1016/j.coviro.2017.11.005
Balasuriya UB, Carossino M.Equine arteritis virus (EAV) and porcine reproductive and respiratory syndrome virus (PRRSV) are the most economically important members of the family Arteriviridae. EAV and PRRSV cause reproductive and respiratory disease in equids and swine, respectively and constitute a significant economic burden to equine and swine industries around the world. Furthermore, they both cause abortion in pregnant animals and establish persistent infection in their natural hosts, which fosters viral shedding in semen leading to sexual transmission. The primary focus of this article is to provide an update on t...
Is Sclerostin Glycoprotein a Suitable Biomarker for Equine Osteochondrosis?
Journal of equine veterinary science    November 13, 2017   Volume 64 27-33 doi: 10.1016/j.jevs.2017.11.003
Mendoza L, Franck T, Lejeune JP, Caudron I, Detilleux J, Deliège B, Serteyn D.Osteochondrosis (OC) disease appears to be multifactorial in origin, including skeletal growth rates, nutrition, endocrinological factors, exercise, biomechanics, and other environmental factors. Endocrinological and metabolic factors seem to have an important role in the pathogeny of OC like the Wnt signaling pathway. One of the regulators in the Wnt signaling pathway is the sclerostin glycoprotein. The aim of this study was to investigate the sclerostin blood concentration according to the evolution of the disease, the environment, and the age but also its use as a possible biomarker for OC ...
Streptococcus equi subsp. zooepidemicus Invades and Survives in Epithelial Cells.
Frontiers in cellular and infection microbiology    November 6, 2017   Volume 7 465 doi: 10.3389/fcimb.2017.00465
Skive B, Rohde M, Molinari G, Braunstein TH, Bojesen AM. subsp. () is an opportunistic pathogen of several species including humans. is found on mucus membranes of healthy horses, but can cause acute and chronic endometritis. Recently was found able to reside in the endometrium for prolonged periods of time. Thus, we hypothesized that an intracellular phase may be part of the pathogenesis and investigated if was able to invade and survive inside epithelial cells. HEp-2 and HeLa cell lines were co-cultured with two strains (1-4a and S31A1) both originating from the uterus of mares suffering from endometritis. Cells were fixed at different time...
The Contribution of Adipose Tissue-Derived Mesenchymal Stem Cells and Platelet-Rich Plasma to the Treatment of Chronic Equine Laminitis: A Proof of Concept.
International journal of molecular sciences    October 11, 2017   Volume 18, Issue 10 doi: 10.3390/ijms18102122
Angelone M, Conti V, Biacca C, Battaglia B, Pecorari L, Piana F, Gnudi G, Leonardi F, Ramoni R, Basini G, Dotti S, Renzi S, Ferrari M, Grolli S.Laminitis, a highly debilitating disease of the foot in ungulates, is characterized by pathological changes of the complex lamellar structures that maintain the appendicular skeleton within the hoof. Laminitis is a multifactorial disease that involves perturbation of the vascular, hematological, and inflammatory homeostasis of the foot. Interestingly, the pathogenesis of the disease resembles what is observed in metabolic syndromes and sepsis-induced organ failure in humans and animals. We hypothesized that local administration of mesenchymal stem cells (MSCs) and platelet-rich plasma (PRP) mi...
Longitudinal analysis of allergen-specific IgE and IgG subclasses as potential predictors of insect bite hypersensitivity following first exposure to Culicoides in Icelandic horses.
Veterinary dermatology    October 5, 2017   Volume 29, Issue 1 51-e22 doi: 10.1111/vde.12493
Ziegler A, Hamza E, Jonsdottir S, Rhyner C, Wagner B, Schüpbach G, Svansson V, Torsteinsdottir S, Marti E.Insect bite hypersensitivity (IBH) is an allergic dermatitis of horses caused by bites of Culicoides spp. IBH does not occur in Iceland because of the absence of Culicoides, but the prevalence is high in horses imported from Iceland to environments where Culicoides are present. Objective: Test, in a longitudinal study before and after Culicoides exposure, whether a primary sensitizing Culicoides allergen can be identified and if an increase of allergen-specific immunoglobulin (Ig)E or IgG subclasses precedes clinical signs of IBH. Methods: Thirty two horses imported from Iceland to Europe; 16 ...
Complications of intravenous catheterization in horses.
Schweizer Archiv fur Tierheilkunde    September 28, 2017   Volume 159, Issue 9 477-485 doi: 10.17236/sat00126
Schoster A.Intravenous catheterization is a necessity for continuous administration of intravenous fluids and for intermittent intravenous access to avoid discomfort and potential complications of repeated needle insertions into the vein. Intravenous catheterization is commonly performed and well tolerated in horses, but catheter associated complications have been reported. The most commonly reported complication is thrombophlebitis, but others such as venous air embolism, exsanguination and catheter fragmentation may also occur. This article aims to review clinical signs, pathogenesis, diagnosis, therap...
The integration of a macrophage-adapted live vaccine strain of equine infectious anaemia virus (EIAV) in the horse genome.
The Journal of general virology    September 9, 2017   Volume 98, Issue 10 2596-2606 doi: 10.1099/jgv.0.000918
Liu Q, Wang XF, Du C, Lin YZ, Ma J, Wang YH, Zhou JH, Wang X.Integration is an important feature of retroviruses and retrovirus-based therapeutic transfection vectors. The non-primate lentivirus equine infectious anaemia virus (EIAV) primarily targets macrophages/monocytes . Investigation of the integration features of EIAV strains, which are adapted to donkey monocyte-derived macrophages (MDMs), is of great interest. In this study, we analysed the integration features of EIAV in equine MDMs during infection. Our previously published integration sites (IS) for EIAV in fetal equine dermal (FED) cells were also analysed in parallel as references. Sequenc...
Proteome Dynamics in Biobanked Horse Peripheral Blood Derived Lymphocytes (PBL) with Induced Autoimmune Uveitis.
Proteomics    August 29, 2017   Volume 17, Issue 19 doi: 10.1002/pmic.201700013
Hauck SM, Lepper MF, Hertl M, Sekundo W, Deeg CA.Equine recurrent uveitis is the only spontaneous model for recurrent autoimmune uveitis in humans, where T cells target retinal proteins. Differences between normal and autoaggressive lymphocytes were identified in this study by analyzing peripheral blood derived lymphocytes (PBL) proteomes from the same case with interphotoreceptor retinoid binding protein induced uveitis sampled before (Day 0), during (Day 15), and after uveitic attack (Day 23). Relative protein abundances of PBL were investigated in a quantitative, label-free differential proteome analysis in cells that were kept frozen for...
Development of an elisa for the diagnosis of reactive IgE antibodies anti-therapeutic horse sera.
Toxicon : official journal of the International Society on Toxinology    August 12, 2017   Volume 138 37-42 doi: 10.1016/j.toxicon.2017.08.012
De-Simone SG, Souza ALA, Aguiar AS, Melgarejo AR, Provance DW.Hypersensitive diseases that involve IgE reactivity are important concern of public, especially those encompassing the potential pathogenesis from the administration of horse serum-based therapeutics such as antivenoms. A method for the definitive diagnosis of reactive IgE is important for identifying allergic patients to control severe collateral effects during planned and emergency application of immunotherapies when the allergy source cannot be avoided for treatment. To date, no tests have been developed to accompany the wide range of antivenoms produced from horse sera. The aim of this was...
Genomic Dissection of an Icelandic Epidemic of Respiratory Disease in Horses and Associated Zoonotic Cases.
mBio    August 1, 2017   Volume 8, Issue 4 e00826-17 doi: 10.1128/mBio.00826-17
Björnsdóttir S, Harris SR, Svansson V, Gunnarsson E, Sigurðardóttir ÓG, Gammeljord K, Steward KF, Newton JR, Robinson C, Charbonneau ARL....Iceland is free of the major infectious diseases of horses. However, in 2010 an epidemic of respiratory disease of unknown cause spread through the country's native horse population of 77,000. Microbiological investigations ruled out known viral agents but identified the opportunistic pathogen subsp. () in diseased animals. We sequenced the genomes of 257 isolates of to differentiate epidemic from endemic strains. We found that although multiple endemic clones of were present, one particular clone, sequence type 209 (ST209), was likely to have been responsible for the epidemic. Concurrent ...
Investigation of the Fim1 putative pilus locus of Streptococcus equi subspecies equi.
Microbiology (Reading, England)    July 28, 2017   Volume 163, Issue 8 1217-1228 doi: 10.1099/mic.0.000506
Steward KF, Robinson C, Maskell DJ, Nenci C, Waller AS.The Gram-positive bacterium subspecies () is the causative agent of strangles, among the most frequently diagnosed infectious diseases of horses worldwide. Genome analysis of strain 4047 (4047) identified a putative operon, Fim1, with similarity to the pilus loci of other Gram-positive bacteria. The Fim1 locus was present in all strains of and its close relative subspecies () that have been studied to date. In this study we provide evidence that the putative structural pilus proteins, SEQ_0936 and CNE, are produced on the cell surface during growth and infection. Although the proteins ...
Differential Expression of Tubulin Acetylase and Deacetylase Between the Damaged Central and Peripheral Branch of Dorsal Root Ganglion Neurons.
Medical science monitor : international medical journal of experimental and clinical research    July 28, 2017   Volume 23 3673-3678 doi: 10.12659/msm.902829
Fu Z, Shi J.BACKGROUND The differences between the peripheral and central branches of the dorsal root ganglion (DRG) have not been fully elucidated. This study aimed to explore the expression of tubulin post-translational modifications (acetylation and deacetylation) between damaged peripheral and central branches of DRG neurons. MATERIAL AND METHODS Fifty Sprague-Dawley rats were randomly assigned to five groups with 10 rats in each group. These five groups consisted of spinal nerve ligation (SNL) at 24 hour and 48 hour, and cauda equina compression (CEC) at 24 hour and 48 hour, and a sham group. SNL inj...
Changes in concentrations of haemostatic and inflammatory biomarkers in synovial fluid after intra-articular injection of lipopolysaccharide in horses.
BMC veterinary research    June 19, 2017   Volume 13, Issue 1 182 doi: 10.1186/s12917-017-1089-1
Andreassen SM, Vinther AML, Nielsen SS, Andersen PH, Tnibar A, Kristensen AT, Jacobsen S.Septic arthritis is a common and potentially devastating disease characterized by severe intra-articular (IA) inflammation and fibrin deposition. Research into equine joint pathologies has focused on inflammation, but recent research in humans suggests that both haemostatic and inflammatory pathways are activated in the joint compartment in arthritic conditions. The aim of this study was to characterize the IA haemostatic and inflammatory responses in horses with experimental lipopolysaccharide (LPS)-induced joint inflammation. Inflammation was induced by IA injection of LPS into one antebrach...
Function of bacteriophage G7C esterase tailspike in host cell adsorption.
Molecular microbiology    June 19, 2017   Volume 105, Issue 3 385-398 doi: 10.1111/mmi.13710
Prokhorov NS, Riccio C, Zdorovenko EL, Shneider MM, Browning C, Knirel YA, Leiman PG, Letarov AV.Bacteriophages recognize and bind to their hosts with the help of receptor-binding proteins (RBPs) that emanate from the phage particle in the form of fibers or tailspikes. RBPs show a great variability in their shapes, sizes, and location on the particle. Some RBPs are known to depolymerize surface polysaccharides of the host while others show no enzymatic activity. Here we report that both RBPs of podovirus G7C - tailspikes gp63.1 and gp66 - are essential for infection of its natural host bacterium E. coli 4s that populates the equine intestinal tract. We characterize the structure and funct...
Acquired equine polyneuropathy of Nordic horses: A conspicuous inclusion body schwannopathy.
Neuromuscular disorders : NMD    June 16, 2017   Volume 27, Issue 10 931-941 doi: 10.1016/j.nmd.2017.06.005
Hanche-Olsen S, Matiasek K, Molín J, Rosati M, Hahn C, Hultin Jäderlund K, Gröndahl G.Acquired equine polyneuropathy (AEP), formerly also known as Scandinavian knuckling syndrome, is one of the most prevalent polyneuropathies in equids in Norway and Sweden, with more than 400 cases registered since first observations in 1995. Despite geographical clustering and an association to forage feeding, its aetiology remains unknown. Clinically AEP is characterized by knuckling due to dysfunction of metatarsophalangeal extensor muscles. This neuropathological study aimed to gain further insights in the pathobiology of AEP and its underlying aetiopathogenesis. We thereby confirmed that a...
Virulence markers associated with Trueperella pyogenes infections in livestock and companion animals.
Letters in applied microbiology    June 1, 2017   Volume 65, Issue 2 125-132 doi: 10.1111/lam.12757
Risseti RM, Zastempowska E, Twarużek M, Lassa H, Pantoja JCF, de Vargas APC, Guerra ST, Bolaños CAD, de Paula CL, Alves AC, Colhado BS....Trueperella pyogenes is an opportunistic pathogen that causes diverse pyogenic infections in livestock. The genes that encode the exotoxin pyolysin (plo) and other putative factors that promote adhesion of pathogen to host cells (fimbriae fimA, fimC, fimE, fimG, neuraminidases nanH, nanP, and collagen-binding protein cbpA) have been associated with virulence, particularly in mastitis and uterus infections of dairy cows. However, the role of these virulence markers in the pathogenicity of the agent in domestic animals infections still is incompletely understood. The genes plo, fimA, fimC, fimE,...
Osteochondritis Dissecans Development.
The Veterinary clinics of North America. Equine practice    May 25, 2017   Volume 33, Issue 2 367-378 doi: 10.1016/j.cveq.2017.03.009
Semevolos SA.This article reviews current knowledge of osteochondritis dissecans (OCD) development in horses, including normal cartilage development, early osteochondrosis pathogenesis, and factors that result in healing or advancement to OCD fragments. Discussion includes current theories, detection, and therapeutic options.
Modulatory role of regulatory T cells in a murine model of severe equine asthma.
BMC veterinary research    April 28, 2017   Volume 13, Issue 1 117 doi: 10.1186/s12917-017-1037-0
Henríquez C, Morán G, Carrasco C, Sarmiento J, Barría M, Folch H, Uberti B.It is accepted that T regulatory cells (Treg) control different types of immune responses. In connection with this role, we have recently described an important increase in CD4+, CD25, Foxp3+ lymphocytes in the airway system of horses coursing with an exacerbation of severe equine asthma (EA). To explore the potential role of this population in the resolution of EA inflammation, we used a murine experimental model in which airway neutrophilic inflammation, which is similar to that observed in EA, is induced in mice by continual exposure to Aspergillus fumigatus contaminated hay. This model has...
Development and application of a quantitative PCR assay to study equine herpesvirus 5 invasion and replication in equine tissues in vitro and in vivo.
Journal of virological methods    April 25, 2017   Volume 248 44-53 doi: 10.1016/j.jviromet.2017.04.015
Zarski LM, High EA, Nelli RK, Bolin SR, Williams KJ, Hussey G.Equine herpesvirus 5 (EHV-5) infection is associated with pulmonary fibrosis in horses, but further studies on EHV-5 persistence in equine cells are needed to fully understand viral and host contributions to disease pathogenesis. Our aim was to develop a quantitative PCR (qPCR) assay to measure EHV-5 viral copy number in equine cell cultures, blood lymphocytes, and nasal swabs of horses. Furthermore, we used a recently developed equine primary respiratory cell culture system to study EHV-5 pathogenesis at the respiratory tract. PCR primers and a probe were designed to target gene E11 of the EH...
Therapeutics for Equine Gastric Ulcer Syndrome.
The Veterinary clinics of North America. Equine practice    March 23, 2017   Volume 33, Issue 1 141-162 doi: 10.1016/j.cveq.2016.11.004
Zavoshti FR, Andrews FM.Equine gastric ulcer syndrome (EGUS) is an umbrella term used to describe ulcers in the nonglandular squamous and glandular mucosa, terminal esophagus, and proximal duodenum. Gastric ulcers in the squamous and glandular regions occur more often than esophageal or duodenal ulcers and likely have a different pathogenesis. At present, omeprazole is accepted globally as the best pharmacologic therapy for both regions of the stomach; however, the addition of coating agents and synthetic prostaglandins could add to its effectiveness in treatment of EGUS. Dietary and environmental management are nece...
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