Mechanisms for rapid re-epithelialization of the gastric mucosal surface.

Abstract

Defects in the mucosal surface of the stomach are generally thought to be re-epithelialized by cells generated from proliferating stem cells in the neck region of the gastric glands. Regeneration by mitotic proliferation, however, would require at least 1-2 days for the migration and differentiation of the surface mucous cells (13, 21). It seems reasonable that there be a more rapid process of re-epithelialization to repair superficial defects incurred in daily living, especially because the gastric mucosal surface can be and is damaged by many common foods and drugs. The early recognition that the stomach could repair itself rapidly was by Grant (6). who in 1945 reported that the damage of the superficial third of the mucosa of cat stomachs exposed to 60% ethanol was repaired within 4 hr. In this early study the process was interpreted to be regeneration, but the cellular mechanism was not otherwise clarified. Morris & Wallace ( 15) recently proposed t�at the reestablishment of rat gastric mucosal epithelial continuity after ethanol injury occurred by migration of underlying epithelial cells from the gastric pits. In 1982, we described the cellular process of reconstitution in in vitro amphibian gastric mucosa mounted in an Ussing chamber, a process in which reestablishment of epithelial continuity occurred following destruction of the surface layer with hypertonic NaCl (22). More recently, gastric mucosal restitution has been identified in the in vitro guinea