Abstract

Gastroduodenal mucus is present as a water insoluble gel adherent to the mucosal surface and as a viscous mobile solution in the lumen. The protective properties of the mucus against acid (with bicarbonate), pepsin (diffusion barrier) and mechanical damage depend on the quality (structure) and quantity (thickness) of the adherent mucus gel layer. Adherent mucus is a viscoelastic gel which is 95% (v/v) water. It is permeable to ions and smaller molecules (Mr c. 1000), but is impermeable to large proteins (Mr c. 17,000) including pepsins. However, mucus is solubilized rapidly by pepsin, more slowly (greater than or equal to 1 h) by thiol agents, and is unchanged following exposure to bile, acid and ethanol (less than 40%). Glycoprotein macromolecules (Mr greater than or equal to 2 X 10(6] are the structural components of the mucus gel and have a polymeric structure of glycoprotein subunits (Mr c. 5 X 10(5), for gastric mucus) joined by disulphide bridges between their protein cores. This glycoprotein polymerization, which is essential for gel formation and hence function, is the site of action of proteolytic enzymes and thiol agents. The glycoprotein polymeric structure is deficient in antral mucus from patients with peptic ulcer disease. In vivo, adherent mucus forms a thin but continuous cover of variable thickness (50-450 micron in man, about two-fold less in rat) over the gastroduodenal mucosa. Pepsin in gastric juice will rapidly dissolve this mucus cover and can be active up to luminal pH values of 5.(ABSTRACT TRUNCATED AT 250 WORDS)

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