Luminal Acid Research Articles

Postnatal development of carbonic anhydrase IV expression in rabbit kidney.

Carbonic anhydrase (CA) IV activity facilitates renal acidification by catalyzing the dehydration of luminal carbonic acid. CA IV has been localized to the proximal tubules and medullary collecting ducts. Maturation of CA IV expression has been considered to be important in the development of renal acid excretion. The purpose of the present study was to determine the maturational expression of CA IV in rabbit kidney. A guinea pig polyclonal antibody to purified rabbit lung microsomal membrane CA IV was generated. Immunoblotting of membrane proteins after peptide-N-glycosidase F treatment revealed two N-glycosylation sites and reduction in size from approximately 52 to 35 kDa; there appeared to be heavier glycosylation in the medulla. In membrane and total proteins from the kidney cortex, CA IV was 15-30% of the adult level during the first 2 wk of life but increased to mature levels by 5 wk of age. The maturational pattern in the cortex was confirmed by measuring SDS-resistant CA hydratase activity. In the medulla, both membrane and total proteins were generally less than one-fourth of the adult level of CA IV during the first 2 wk of life before reaching mature levels by 5 wk of age. Immunohistochemistry showed staining in proximal tubules (apical > basolateral), with maximal label in the S2 segment. CA IV also appeared on the apical membranes of a minority cell type of the cortical collecting duct, presumably the alpha-intercalated cell. Several labeled cells also appeared to be the process of being extruded from medullary collecting ducts of 1- to 2-wk rabbits. The antibody did not reliably detect medullary CA IV expression in sections from mature rabbits. These studies indicate that there is a substantial postnatal increase in expression of CA IV in the maturing kidney in both the cortex and medulla. The disappearance of intercalated cells in the maturing rabbit medullary collecting duct may be part of a normal renal developmental program as previously reported [J. Kim, J.-H. Cha, C. C. Tisher, and K. M. Madsen. Am. J. Physiol. 270 (Renal Fluid Electrolyte Physiol. 39): F575-F592, 1996]. It is likely that the maturation of CA IV expression contributes to the increase in renal acidification observed early in postnatal life.

Effects of extracellular pH on restitution and proliferation of rabbit oesophageal epithelial cells.

Exposure to luminal acid induces mucosal damage in the oesophagus. The extent and degree of interaction of acid with wound repair mechanisms of the oesophagus have not been explored. Rabbit oesophageal cells were isolated, cultured and exposed to different extracellular pHs for several periods of time. Cell mortality was studied in both isolated and primary cultures of these cells by cell flow cytometry using fluorochrome propidium iodide and LDH release. Subconfluent cell cultures were used to study proliferative responses determined by [3H]-thymidine incorporation into DNA. Restitution was studied in confluent monolayers wounded by mechanical denudation. Isolated cells were resistant to acid when exposed to pH > 2 for 15 min. Cell proliferation increased with small pH decreases (7-6.5) if the period of exposure was less than 6 h, but was inhibited with lower pHs and/or longer periods of acid exposure. However, restitution was gradually inhibited with further pH decreases (6.5-3) and time of acid exposure (0.5-24 h). The wound repair activities of oesophageal epithelial cells are deeply affected by even small decreases in pH. These findings may help to explain the need for profound acid inhibition in acid-related reflux oesophagitis.

Release and endogenous actions of the gastrin/cholecystokinin (CCK) family in the chicken

The regulation of cholecystokinin (CCK) and gastrin release in the chicken and their endogenous actions are summarized. Both dietary protein and amino acids stimulated CCK releases. Among dietary fat sources, medium-chain triacylglycerol (MCT) was a potent stimulator of CCK release compared with long-chain triacylglycerol (LCT). However, it is difficult to explain that endogenous CCK released by those stimulators has an important role in the avian gastrointestinal physiology. Luminal acids may be an important regulator in pancreatic enzyme and fluid secretion. Gastrin (a regulator of luminal acid secretion) release was stimulated by food components, strongly by MCT, but not by LCT, and weakly by some amino acids, and was inhibited by luminal acids. Luminal acids controlled food passage from the crop. In conclusion, gastrointestinal physiology may be directly regulated by luminal acid rather than by the gastrin/CCK family in the chicken.

Barrier function of gastric mucus.

A viscoelastic mucus gel layer covers the gastric mucosa in a continuous sheet. The functions of the mucus gel have been one of the least studied aspects of gastric barrier function. Although the role of gastric mucus in providing physical protection against ingested particles, and preventing contact between digestive enzymes such as pepsin and the underlying mucosa is generally accepted, the barrier role function of gastric mucus with regard to luminal acid is still conjectural. The modest proton diffusion barrier that mucus provides is negligible in relation to the overall barrier properties of the gastric mucosa; nevertheless, stabilization of unstirred layers and damping of rapid shifts in luminal pH are potentially important functions. Associative studies have suggested a possible role of a hydrophobic barrier in strengthening the barrier functions of mucus. One of the most actively investigated areas of mucus function in recent times has been the mechanism by which secreted acid traverses the gel. Although compelling and complementary data obtained in vivo and in vitro have been consistent with secretion of acid under pressure, creating temporary viscous fingers through the gel, recent evidence obtained with in vivo confocal microscopy suggests that secreted acid diffuses through the gel. Since Helicobacter pylori exists solely in the juxtamucosal portion of the gastric mucus gel, detailed knowledge concerning the pH microenvironment in which the organism thrives is important in understanding the pathophysiology of peptic ulcer disease and related conditions.

Carbon dioxide mediates duodenal mucosal alkaline secretion in response to luminal acidity in the anesthetized rat

Background & Aims: Acid exposure of the duodenum elicits various functional responses, e.g., an increased mucosal alkaline secretion. Despite low pH in luminal contents, the mucosal secretion of bicarbonate-rich fluid results in pH neutrality at the surface epithelium. It follows that it is probably not luminal pH that triggers the secretory response. The present study was undertaken to investigate if CO 2 could serve as an intermediate messenger between luminal acid and the mucosal secretory response. Methods: Experiments were performed on chloralose-anesthetized rats. The duodenal mucosal alkaline secretion was measured by in situ pH-stat titration. Results: Exposure of the duodenal mucosa to CO 2, administered either as a pregassed solution (pH 4, P CO 2 700 mm Hg) or as an acidified bicarbonate solution (pH 6.4, P CO 2 240 mm Hg), raised the alkaline output by approximately 65%. This response was blocked by the nitric oxide synthase inhibitor N G-nitro- L-arginine methyl ester (0.3 mmol/L intraluminally) but not by indomethacin (5 mg/kg intravenously). Conclusions: Exposure of the duodenal mucosa to solutions with high concentrations of CO 2 increases the mucosal alkaline secretion despite an almost neutral pH. Data indicate that the L-arginine/NO pathway is involved in the mediation of this response. GASTROENTEROLOGY 1998;115:680-685

Pentagastrin gastroprotection against acid is related to H2 receptor activation but not acid secretion

Background—Pentagastrin enhances gastric mucosal defence mechanisms against acid and protects the gastric mucosa from experimental injury.Aims—To investigate whether this gastroprotection is mediated by histamine receptors or occurs as a secondary...

Increased susceptibility of gastric mucosa to ulcerogenic stimulation in diabetic rats--role of capsaicin-sensitive sensory neurons.

1. We examined the gastric mucosal blood flow (GMBF) and ulcerogenic responses following barrier disruption induced by sodium taurocholate (TC) in diabetic rats and investigated the role of capsaicin-sensitive sensory neurons in these responses. 2. Animals were injected streptozotocin (STZ: 70 mg kg(-1), i.p.) and used after 5, 10 and 15 weeks of diabetes with blood glucose levels of > 350 mg dl(-1). The stomach was mounted on an ex-vivo chamber under urethane anaesthesia and exposed to 20 mM TC plus 50 mM HCl for 30 min in the presence of omeprazole. Gastric transmucosal potential difference (PD), GMBF, and luminal acid loss (H+ back-diffusion) were measured before and after exposure to 20 mM TC, and the mucosa was examined for lesions 90 min after TC treatment. 3. Mucosal application of TC caused PD reduction in all groups; the degree of PD reduction was similar between normal and diabetic rats, although basal PD values were lower in diabetic rats. In normal rats, TC treatment caused luminal acid loss, followed by an increase of GMBF, resulting in minimal damage in the mucosa. 4. The increased GMBF responses associated with H+ back-diffusion were mitigated in STZ-treated rats, depending on the duration of diabetes, and severe haemorrhagic lesions occurred in the stomach after 10 weeks of diabetes. 5. Intragastric application of capsaicin increased GMBF in normal rats, but such responses were mitigated in STZ diabetic rats. The amount of CGRP released in the isolated stomach in response to capsaicin was significantly lower in diabetic rats when compared to controls. 6. The deleterious influences on GMBF and mucosal ulcerogenic responses in STZ-diabetic rats were partially but significantly antagonized by daily insulin (4 units rat(-1)) treatment. 7. These results suggest that the gastric mucosa of diabetic rats is more vulnerable to acid injury following barrier disruption, and this change is insulin-sensitive and may be partly accounted for by the impairment of GMBF response associated with acid back-diffusion and mediated by capsaicin-sensitive sensory neurons.

Sensitivity to 5-hydroxytryptamine in different afferent subpopulations within mesenteric nerves supplying the rat jejunum.

1. This study was performed to elucidate the type of afferents that mediate the multiple actions of 5-hydroxytryptamine (5-HT) on mesenteric nerve discharge. Electrophysiological recordings were made from mesenteric afferents innervating the mid-jejunum of the urethane-anaesthetized rat. The discharge of single nerves within the whole nerve recording was monitored using waveform discrimination software. 2. Afferents responded to 5-HT in one of two ways: a short latency, transient excitation mediated by 5-HT3 receptors, or a delayed onset, more prolonged effect that was 5-HT2A receptor mediated. Afferents showing the 5-HT3-mediated response did not respond to luminal distension but were sensitive to intraluminal hydrochloric acid (150 mM) in twenty-eight of twenty-nine experiments. In eight experiments, the 5-HT3-mediated response was reversibly abolished by a 2 min exposure to intraluminal application of local anaesthetic (2 % Xylocaine). 3. Mechanosensitive afferents which responded to distension (< 10 cmH2O) did not show a 5-HT3-mediated response (P = 0.92, n = 14), and maintained this mechanosensitivity after luminal anaesthesia. Mechanosensitive afferents did show a secondary response to 5-HT that was significantly attenuated by atropine (100-200 microg kg-1), whereas hexamethonium (8 mg kg-1) had no effect. 4. In animals whose vagal afferent contribution to their mesenteric nerves had been eliminated by chronic truncal vagotomy, the 5-HT3-mediated response was absent in thirty-six of thirty-six nerve bundles. In contrast, mechanosensitivity to distension and the secondary response to 5-HT could still be evoked. 5. These results suggest that 5-HT stimulates mesenteric afferents by a direct action on 5-HT3 receptors that are present on vagal mucosal afferent terminals. The mucosal afferent response to luminal acid, however, was unaffected by treatment with granisetron (0.5 mg kg-1) indicating that endogenous 5-HT from enterochromaffin cells is not essential for transduction of this luminal signal. In contrast, mechanosensitivity in non-vagal afferents was modulated by 5-HT following an intestinal motor response which was influenced by cholinergic tone.

Mediation by 5_hydroxytryptamine of the femoral vasoconstriction induced by acid challenge of the rat gastric mucosa.

1. Gastric mucosal barrier disruption in the presence of luminal acid causes femoral vasoconstriction via a pathway that appears to be stimulated by messengers generated in the injured gastric mucosa. This study was undertaken to analyse the gastric factors that are responsible for the femoral vasoconstrictor response. 2. Gastric mucosal barrier disruption in the presence of luminal acid was induced by perfusing the stomach of urethane-anaesthetized rats with ethanol (15 %) in 0.01-0.15 M HCl. Blood flow in the left gastric and right femoral artery was estimated by the ultrasonic transit time shift technique. 3. Gastric perfusion of ethanol in HCl caused loss of H+ ions from the gastric lumen, decreased the HCO3- concentration in hepatic portal vein blood, induced macroscopic histological damage to the gastric mucosa, dilated the left gastric artery and constricted the femoral artery. These responses were related to the HCl concentration in the ethanol-containing perfusion medium. 4. The femoral vasoconstriction was also seen when, instead of ethanol, taurocholate (20 mM) was used to disrupt the gastric mucosal barrier in the presence of 0.15 M HCl. 5. The femoral vasoconstriction evoked by gastric perfusion of ethanol in HCl was left unaltered by pharmacological blockade of gastrin and histamine receptors. In contrast, the 5-hydroxytryptamine 5-HT1/2 receptor antagonist methiothepin, but not the 5-HT2A receptor antagonist ketanserin or the 5-HT3 receptor antagonist granisetron, inhibited the ability of both 5-hydroxytryptamine and gastric acid back-diffusion to constrict the femoral artery. 6. Gastric acid back-diffusion caused release of 5-hydroxytryptamine into the gastric lumen, which was related to the HCl concentration in the ethanol-containing perfusion medium. 7. These data show that femoral vasoconstriction evoked by gastric mucosal barrier disruption depends on back-diffusion of acid into the mucosa. The acid-induced damage results in release of 5-hydroxytryptamine from the gastric mucosa, and the pathway leading to constriction of the femoral artery involves 5-hydroxytryptamine acting via 5-HT1/2 receptors as a messenger molecule.

Nitric oxide is involved in the gastric mucosal vasodilation induced by pentagastrin or luminal acid but not in the vasodilation after tactile stimulation of the mucosa

Nitric oxide is involved in the gastric mucosal vasodilation induced by pentagastrin or luminal acid but not in the vasodilation after tactile stimulation of the mucosa

Regulation of intestinal Cl- and HCO3-secretion by uroguanylin.

Uroguanylin is an intestinal peptide hormone that may regulate epithelial ion transport by activating a receptor guanylyl cyclase on the luminal surface of the intestine. In this study, we examined the action of uroguanylin on anion transport in different segments of freshly excised mouse intestine, using voltage-clamped Ussing chambers. Uroguanylin induced larger increases in short-circuit current (Isc) in proximal duodenum and cecum compared with jejunum, ileum, and distal colon. The acidification of the lumen of the proximal duodenum (pH 5.0-5.5) enhanced the stimulatory action of uroguanylin. In physiological Ringer solution, a significant fraction of the Isc stimulated by uroguanylin was insensitive to bumetanide and dependent on HCO3- in the bathing medium. Experiments using pH-stat titration revealed that uroguanylin stimulates serosal-to-luminal HCO3- secretion (Js-->lHCO3-) together with a larger increase in Isc. Both Js-->lHCO3- and Isc were significantly augmented when luminal pH was reduced to pH 5.15. Uroguanylin also stimulated the Js-->lHCO3- and Isc across the cecum, but luminal acidity caused a generalized decrease in the bioelectric responsiveness to agonist stimulation. In cystic fibrosis transmembrane conductance regulator (CFTR) knockout mice, the duodenal Isc response to uroguanylin was markedly reduced, but not eliminated, despite having a similar density of functional receptors. It was concluded that uroguanylin is most effective in acidic regions of the small intestine, where it stimulates both HCO3- and Cl-secretion primarily via a CFTR-dependent mechanisms.

Cellular mechanism of adaptive cytoprotection to luminal acid in rat duodenal mucosa

Possibly or probably drug-related adverse event reported by > 3% of patients in any treatment group was diarrhea. There were no reports of gastric ulcer hemorrhage. Conclusions: Lansoprazole 15 mg daily and 30 mg daily were significantly better than ranitidine 150 mg twice daily in healing NSAID-induced GU in patients continuing to take NSAIDs. All regimens were well-tolerated. This research was funded by TAP Holdings Inc., Deerfield, IL.

Luminal hypertonicity and the susceptibility of rabbit esophagus to acid injury

The esophagus is regularly exposed to hypertonic luminal environments, some of which have the capacity to increase epithelial permeability. The present experiments were designed to determine what impact such environments have on epithelial resistance to injury by acid. Rabbit esophageal epithelium mounted in Ussing chambers was exposed to luminal acid while monitoring electrical resistance (R), a marker of epithelial permeability, and morphology was assessed in tissues luminally pretreated with either urea (1 M), mannitol (1 M), or normal Ringer. Hypertonic mannitol, which had little effect on R, was associated with a minor increase in susceptibility to acid injury, pH 1.6. In contrast, hypertonic urea lowered R and was associated with marked injury upon exposure to acid. This susceptibility to acid injury occurred within 15 minutes of exposure and converted a non-damaging concentration of acid (pH 2.0) to a damaging one. Moreover, urea's effects were abolished if it was removed from the bath allowing R to return to baseline before acidification. We conclude that hypertonic luminal environments that impair epithelial barrier function predispose the esophagus to acid injury. Such findings may provide insight into additional mechanisms contributing to the development of heartburn following meals.

Cyclo-oxygenase isozymes in mucosal ulcergenic and functional responses following barrier disruption in rat stomachs.

1. We examined the effects of selective and nonselective cyclo-oxygenase (COX) inhibitors on various functional changes in the rat stomach induced by topical application of taurocholate (TC) and investigated the preferential role of COX isozymes in these responses. 2. Rat stomachs mounted in ex vivo chambers were perfused with 50 mM HCl and transmucosal potential difference (p.d.), mucosal blood flow (GMBF), luminal acid loss and luminal levels of prostaglandin E2 (PGE2) were measured before, during and after exposure to 20 mM TC. 3. Mucosal application of TC in control rats caused a reduction in p.d., followed by an increase of luminal acid loss and GMBF, and produced only minimal damage in the mucosa 2 h later. Pretreatment with indomethacin (10 mg kg[-1], s.c.), a nonselective COX-1 and COX-2 inhibitor, attenuated the gastric hyperaemic response caused by TC without affecting p.d. and acid loss, resulting in haemorrhagic lesions in the mucosa. In contrast, selective COX-2 inhibitors, such as NS-398 and nimesulide (10 mg kg[-1], s.c.), had no effect on any of the responses induced by TC and did not cause gross damage in the mucosa. 4. Luminal PGE2 levels were markedly increased during and after exposure to TC and this response was significantly inhibited by indomethacin but not by either NS-398 or nimesulide. The expression of COX-1-mRNA was consistently detected in the gastric mucosa before and after TC treatment, while a faint expression of COX-2-mRNA was detected only 2 h after TC treatment. 5. Both NS-398 and nimesulide significantly suppressed carrageenan-induced rat paw oedema, similar to indomethacin. 6. These results confirmed a mediator role for prostaglandins in the gastric hyperaemic response following TC-induced barrier disruption, and suggest that COX-1 but not COX-2 is a key enzyme in maintaining 'housekeeping' functions in the gastric mucosa under both normal and adverse conditions.

Luminal acid increases apical cell membrane resistance in isolated Necturus antral mucosa

BACKGROUND & AIMS: The gastric mucosa must have efficient protective mechanisms to maintain physiological intracellular pH. The aim of this study was to investigate the effect of low luminal pH on apical membrane permeability. METHODS: Chambered Necturus antral mucosa was perfused with Ringer's/95% O2-5% CO2 at pH 7.25. The mucosal side was exposed to pH 4.0-2.0 with four microelectrodes placed in surface cells. Two-dimensional cable analysis was used to measure apical, basolateral, and shunt resistances. In some experiments, liquid sensor pH or Na(+)-selective microelectrodes were used. RESULTS: Luminal acidification hyperpolarized apical cell membrane potential and increased apical cell membrane resistance from 21.3 +/- 2.6 (pH 7.25) to 38.0 +/- 2.3 k omega.cm2 (pH 3.0; n = 8). The increase in apical cell membrane resistance was preceded by transient intracellular acidosis from 7.32 +/- 0.07 (pH 4.0) to 7.23 +/- 0.06 (pH 3.0; n = 6). Similar intracellular acidosis (provoked by NH4+ prepulse) failed to cause the effects observed with luminal acid. The increase in apical cell membrane resistance caused by luminal acid was eliminated when N- methyl-D-glucamine+, but not Na+, was substituted for all cations in the luminal solution. CONCLUSIONS: Luminal acidification (pH 3.0-2.0) closes apical amiloride-blockable Na+ channels. Protons are probably able to pass and even block these channels, but their effect in closing the channels does not occur intracellularly. (Gastroenterology 1997 Sep;113(3):875-83)

Butyrate Activates the WAF1/Cip1 Gene Promoter through Sp1 Sites in a p53-negative Human Colon Cancer Cell Line

Butyrate is a well known colonic luminal short chain fatty acid, which arrests cell growth and induces differentiation in various cell types. We examined the effect of butyrate on the expression of WAF1/Cip1, a potent inhibitor of cyclin-dependent kinases, and its relation to growth arrest in a p53-mutated human colon cancer cell line WiDr. Five millimolar butyrate completely inhibited the growth of WiDr and caused G1-phase arrest. WAF1/Cip1 mRNA was rapidly induced within 3 h by treatment with 5.0 mM butyrate, and drastic WAF1/Cip1 protein induction was detected. Using several mutant WAF1/Cip1 promoter fragments, we found that the butyrate-responsive elements are two Sp1 sites at -82 and -69 relative to the transcription start site. We also found that a TATA element at -46 and two overlapping consensus Sp1 sites at -60 and -55 are essential for the basal promoter activity of WAF1/Cip1. These findings suggest that butyrate arrests the growth of WiDr by activating the WAF1/Cip1 promoter through specific Sp1 sites in a p53-independent fashion.

Deranged hydrophobic barrier of the rat gastroduodenal mucosa after parenteral nonsteroidal anti-inflammatory drugs

BACKGROUND & AIMS: Parenteral administration of nonsteroidal anti- inflammatory drugs (NSAIDs) may cause gastrointestinal mucosal lesions. The aim of this study was to investigate whether parenteral NSAIDs alter surface hydrophobicity of the gastroduodenal mucosa. METHODS: Conscious rats received indomethacin or diclofenac subcutaneously at different doses (0.5-10 mg/kg). Surface hydrophobicity of gastric and duodenal mucosa was determined by contact angle measurement at various time points; mucosal prostaglandin synthesis and mucus phospholipid content were measured. Also, the effects of NSAIDs were studied in bile duct-ligated rats. RESULTS: A single 1-2-mg/kg dose significantly decreased hydrophobicity in the stomach and duodenum. The decrease was associated with a reduction in mucus phosphatidylcholine. In the duodenum, mucosal prostaglandin synthesis was restored 24 hours after NSAID dosing, but hydrophobicity was still decreased. There was no adaptation to long-term treatment. In bile duct-ligated rats, NSAIDs did not decrease gastric or duodenal hydrophobicity. Moreover, oral administration of bile from rats pretreated with parenteral NSAIDs significantly decreased mucosal hydrophobicity in untreated rats. CONCLUSIONS: Low-dose NSAIDs by parenteral route impair the physicochemical barrier against luminal acidity and render the mucosa susceptible to injury. Excretion of NSAIDs in bile seems to play a key role in this effect. (Gastroenterology 1997 Jun;112(6):1931-9)

Human spasmolytic polypeptide decreases proton permeation through gastric mucus in vivo and in vitro.

Exogenously administered trefoil peptides are gastroprotective in rat injury models. We hypothesized that trefoil-associated gastroprotection occurred by decreasing the rate of proton permeation through mucus. Gastric surface cell intracellular pH and mucus gel thickness were measured by in vivo microscopy. Gastric mucosal blood flow was measured by laser-Doppler flowmetry. The effect of human spasmolytic peptide (hSP) on H+ diffusion through 5% purified porcine mucin was measured using an Ussing chamber. Buffering action of mucin was measured by titration. In vivo, gastric mucosal blood flow and mucus gel thickness were not affected by any of the treatments. Topical hSP, but not intravenous hSP, decreased initial acidification rate and elevated the intracellular pH of gastric surface cells during luminal acid challenge. In in vitro studies, hSP dose dependently decreased the diffusion coefficient of H+ through 5% porcine mucin solution. hSP had no significant effect on the buffering action of mucin solutions. These data support our hypothesis that hSP interacts with gastric mucin in a manner that inhibits proton permeation through the mucus gel layer.

Cytoprotective effect of bismuth subsalicylate in indomethacin-treated rats is associated with enhanced mucus bismuth concentration.

Bismuth compounds prevent gastric injury from the short-term administration of nonsteroidal anti-inflammatory drugs. We studied the mechanisms underlying the gastroprotective actions of bismuth subsalicylate against indomethacin-induced injury in rats. An in vivo microscopic technique was used in which acid output, surface cell intracellular pH (pHi), gastric mucus gell thickness and mucosal blood flow were measured simultaneously. Concentrations of bismuth in mucus were measured by atomic absorption. Indomethacin (60 mg/kg) significantly thinned the mucus gel layer and augmented the decrease of pHi during luminal acid superfusion, consistent with a weakened gastric mucosal barrier to acid. Bismuth subsalicylate partially reversed this effect of indomethacin on pHi, consistent with gastroprotection. Neither a prostaglandin-inhibiting but non-injurious dose of indomethacin (5 mg/kg), bismuth subsalicylate, or their combination affected mucus gel thickness or pHi homeostasis. In separate experiments, indomethacin (60 mg/kg) significantly increased gastric mucus bismuth concentration in rats given bismuth subsalicylate. Bismuth accumulation in the gastric mucus during the evolution of mucosal injury may play an important role in the gastroprotective effect of bismuth subsalicylate against indomethacin injury.

Analysis of pathogenic elements involved in gastric lesions induced by non‐steroidal anti‐inflammatory drugs in rats

Pathogenesis of gastric damage induced by non-steroidal anti-inflammatory drugs (NSAID) involves multiple elements, such as deficiency of prostaglandins (PG), gastric hypermotility, neutrophil activation and luminal acid. The present study was performed to examine the effects of these elements, either alone or in combination, on the rat gastric mucosa and investigate which element is most closely associated with the gastric ulcerogenic response to NSAID. The following treatments were used to express various pathogenic elements: (i) a low dose of indomethacin (IM) to cause PG deficiency; (ii) 2-deoxy-D-glucose (2DG) to induce gastric hypermotility and acid secretion; (iii) histamine to induce acid hypersecretion; and (iv) n-formyl-Met-Leu-Phe (fMLP) to elicit neutrophil activation. When rats fasted for 18 h were subjected to each treatment alone, only 2DG caused slight macroscopic damage in the gastric mucosa within 4 h. Indomethacin showed over 90% inhibition of mucosal PG generation and fMLP increased myeloperoxidase activity four-fold greater than normal values, yet either of these treatments alone did not cause any damage in the stomach. However, the combination of IM with 2DG or His provoked severe lesions in the stomach or the duodenum, respectively, while fMLP did not modify or potentiate the mucosal ulcerogenic response to other treatments. We conclude that among various pathogenic elements only gastric hypermotility is sufficient, by itself, to induce mild damage in the mucosa, that PG deficiency may be critical in the increase of mucosal susceptibility to injury and that neutrophil activation alone is not ulcerogenic in the gastric mucosa nor does it potentiate the ulcerogenic effect of other elements. Luminal acid may be a prerequisite for later extension of damage to severe lesions.