Wang NN, Ding L. Letter to the Editor: Unresolved questions regarding Anwei decoction’s role in chronic atrophic gastritis. World J Gastroenterol 2026; 32(32): 117070 [DOI: 10.3748/wjg.117070]
Corresponding Author of This Article
Lei Ding, MD, PhD, Professor, Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, No. 10 Tieyilu, Yangfangdian, Haidian District, Beijing 100038, China. dinglei1005@126.com
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Biology
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letter
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Wang NN, Ding L. Letter to the Editor: Unresolved questions regarding Anwei decoction’s role in chronic atrophic gastritis. World J Gastroenterol 2026; 32(32): 117070 [DOI: 10.3748/wjg.117070]
World J Gastroenterol. Aug 28, 2026; 32(32): 117070 Published online Aug 28, 2026. doi: 10.3748/wjg.117070
Letter to the Editor: Unresolved questions regarding Anwei decoction’s role in chronic atrophic gastritis
Nan-Nan Wang, Lei Ding
Nan-Nan Wang, Lei Ding, Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
Author contributions: Wang NN drafted the manuscript; Ding L revised the manuscript for important intellectual content; and all authors thoroughly reviewed and endorsed the final manuscript.
AI contribution statement: We utilized a Large Language Model to assist in drafting and refining the linguistic expression of the manuscript. The linguistic framework and initial drafting of the text were assisted by AI. However, the scientific content, critical analysis, and specific arguments - including the critique of the NLRP3/caspase-1 pathway, the limitations of the MNNG-induced model, and the discussion on microbiome causality - were entirely conceptualized and directed by the authors. As clinical researchers in the field of gastrointestinal oncology, our primary goal was to ensure that our scientific concerns regarding the study by Qin et al were communicated clearly and accurately in English. We take full responsibility for the content of the manuscript and confirm that the AI tool did not substitute for the authors’ original thinking or scientific judgment.
Supported by the National Natural Science Foundation of China, No. 82471761.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Lei Ding, MD, PhD, Professor, Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, No. 10 Tieyilu, Yangfangdian, Haidian District, Beijing 100038, China. dinglei1005@126.com
Received: December 8, 2025 Revised: January 28, 2026 Accepted: March 2, 2026 Published online: August 28, 2026 Processing time: 238 Days and 10.4 Hours
Abstract
In this article, we comment on a recent study published in the World Journal of Gastroenterology by Qin et al that evaluated the therapeutic effects of Anwei decoction in a rat model of chronic atrophic gastritis. The authors report improvements in gastric inflammation, glandular atrophy, and intestinal metaplasia, alongside extensive serum compound profiling. While these findings are encouraging, we highlight specific methodological limitations that warrant further clarification. First, attributing efficacy primarily to the nucleotide-binding oligomerization domain-like receptor protein 3/caspase-1/interleukin-1β pathway may overlook the multifactorial nature of chronic atrophic gastritis. Second, reliance on the N-methyl-N’-nitro-N-nitrosoguanidine-induced model limits extrapolation to other etiologies, particularly Helicobacter pylori-associated or autoimmune gastritis. Finally, the biological relevance of the mass-spectrometry - identified serum compounds remains uncertain without functional assays and pharmacokinetic validation. This article highlights priorities for future research on the microbiome, pharmacology, and long-term clinical outcomes to strengthen the translational value of Anwei decoction.
Core Tip: While Anwei decoction shows promise in a rat chronic atrophic gastritis model, key questions regarding its mechanism beyond nucleotide-binding oligomerization domain-like receptor protein 3 inhibition, efficacy across distinct etiologies, the causal role of microbiome shifts, the pharmacokinetics of active components, and long-term anti-cancer effects remain unanswered. Addressing these gaps through rigorous model validation and functional assays is crucial for the clinical translation of this traditional Chinese medicine formulation.
