Natural products based on Correa's cascade for the treatment of gastric cancer trilogy: Current status and future perspective

Gastric carcinoma (GC) is a malignancy with multifactorial involvement, multicellular regulation, and multistage evolution. The classic Correa's cascade of intestinal GC specifies a trilogy of malignant transformation of the gastric mucosa, in which normal gastric mucosa gradually progresses fr...

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Main Authors: Wenhao Liao, Jing Wang, Yuchen Li
Format: Article
Language:English
Published: Elsevier 2025-02-01
Series:Journal of Pharmaceutical Analysis
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Online Access:http://www.sciencedirect.com/science/article/pii/S2095177924001722
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author Wenhao Liao
Jing Wang
Yuchen Li
author_facet Wenhao Liao
Jing Wang
Yuchen Li
author_sort Wenhao Liao
collection DOAJ
description Gastric carcinoma (GC) is a malignancy with multifactorial involvement, multicellular regulation, and multistage evolution. The classic Correa's cascade of intestinal GC specifies a trilogy of malignant transformation of the gastric mucosa, in which normal gastric mucosa gradually progresses from inactive or chronic active gastritis (Phase I) to gastric precancerous lesions (Phase II) and finally to GC (Phase III). Correa's cascade highlights the evolutionary pattern of GC and the importance of early intervention to prevent malignant transformation of the gastric mucosa. Intervening in early gastric mucosal lesions, i.e., Phase I and II, will be the key strategy to prevent and treat GC. Natural products (NPs) have been an important source for drug development due to abundant sources, tremendous safety, and multiple pharmacodynamic mechanisms. This review is the first to investigate and summarize the multi-step effects and regulatory mechanisms of NPs on the Correa's cascade in gastric carcinogenesis. In phase I, NPs modulate Helicobacter pylori urease activity, motility, adhesion, virulence factors, and drug resistance, thereby inhibiting H. pylori-induced gastric mucosal inflammation and oxidative stress, and facilitating ulcer healing. In Phase II, NPs modulate multiple pathways and mediators regulating gastric mucosal cell cycle, apoptosis, autophagy, and angiogenesis to reverse gastric precancerous lesions. In Phase III, NPs suppress cell proliferation, migration, invasion, angiogenesis, and cancer stem cells, induce apoptosis and autophagy, and enhance chemotherapeutic drug sensitivity for the treatment of GC. In contrast to existing work, we hope to uncover NPs with sequential therapeutic effects on multiple phases of GC development, providing new ideas for gastric cancer prevention, treatment, and drug development.
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spelling doaj-art-d6b71c26306b45f2b80326b2757d6d8f2025-01-31T05:11:14ZengElsevierJournal of Pharmaceutical Analysis2095-17792025-02-01152101075Natural products based on Correa's cascade for the treatment of gastric cancer trilogy: Current status and future perspectiveWenhao Liao0Jing Wang1Yuchen Li2Department of Nephrology, the Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Chongqing Clinical Research Center of Kidney and Urology Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, 400037, China; Corresponding author.Department of Obstetrics and Gynecology, Chongqing Bishan Hospital of Traditional Chinese Medicine, Chongqing, 402760, ChinaDepartment of Laboratory Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China; Corresponding author.Gastric carcinoma (GC) is a malignancy with multifactorial involvement, multicellular regulation, and multistage evolution. The classic Correa's cascade of intestinal GC specifies a trilogy of malignant transformation of the gastric mucosa, in which normal gastric mucosa gradually progresses from inactive or chronic active gastritis (Phase I) to gastric precancerous lesions (Phase II) and finally to GC (Phase III). Correa's cascade highlights the evolutionary pattern of GC and the importance of early intervention to prevent malignant transformation of the gastric mucosa. Intervening in early gastric mucosal lesions, i.e., Phase I and II, will be the key strategy to prevent and treat GC. Natural products (NPs) have been an important source for drug development due to abundant sources, tremendous safety, and multiple pharmacodynamic mechanisms. This review is the first to investigate and summarize the multi-step effects and regulatory mechanisms of NPs on the Correa's cascade in gastric carcinogenesis. In phase I, NPs modulate Helicobacter pylori urease activity, motility, adhesion, virulence factors, and drug resistance, thereby inhibiting H. pylori-induced gastric mucosal inflammation and oxidative stress, and facilitating ulcer healing. In Phase II, NPs modulate multiple pathways and mediators regulating gastric mucosal cell cycle, apoptosis, autophagy, and angiogenesis to reverse gastric precancerous lesions. In Phase III, NPs suppress cell proliferation, migration, invasion, angiogenesis, and cancer stem cells, induce apoptosis and autophagy, and enhance chemotherapeutic drug sensitivity for the treatment of GC. In contrast to existing work, we hope to uncover NPs with sequential therapeutic effects on multiple phases of GC development, providing new ideas for gastric cancer prevention, treatment, and drug development.http://www.sciencedirect.com/science/article/pii/S2095177924001722Atrophic gastritisCorrea's cascadeDysplasiaGastric carcinomaHelicobacter pyloriGastric precancerous lesions
spellingShingle Wenhao Liao
Jing Wang
Yuchen Li
Natural products based on Correa's cascade for the treatment of gastric cancer trilogy: Current status and future perspective
Journal of Pharmaceutical Analysis
Atrophic gastritis
Correa's cascade
Dysplasia
Gastric carcinoma
Helicobacter pylori
Gastric precancerous lesions
title Natural products based on Correa's cascade for the treatment of gastric cancer trilogy: Current status and future perspective
title_full Natural products based on Correa's cascade for the treatment of gastric cancer trilogy: Current status and future perspective
title_fullStr Natural products based on Correa's cascade for the treatment of gastric cancer trilogy: Current status and future perspective
title_full_unstemmed Natural products based on Correa's cascade for the treatment of gastric cancer trilogy: Current status and future perspective
title_short Natural products based on Correa's cascade for the treatment of gastric cancer trilogy: Current status and future perspective
title_sort natural products based on correa s cascade for the treatment of gastric cancer trilogy current status and future perspective
topic Atrophic gastritis
Correa's cascade
Dysplasia
Gastric carcinoma
Helicobacter pylori
Gastric precancerous lesions
url http://www.sciencedirect.com/science/article/pii/S2095177924001722
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AT jingwang naturalproductsbasedoncorreascascadeforthetreatmentofgastriccancertrilogycurrentstatusandfutureperspective
AT yuchenli naturalproductsbasedoncorreascascadeforthetreatmentofgastriccancertrilogycurrentstatusandfutureperspective