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Acid suppression and gastric mucosal cell biology

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Abstract

This review examines recent concepts of gastric mucosal cell biology in relation to acid inhibition. Powerful acid-inhibitory drugs have been associated with the production of enterochromaffin-like (ECL) cell proliferation and the induction of ECL cell carcinoids in rats. The ECL cell lineage and its renewal is discussed, and the factors that regulate ECL-cell proliferation are reviewed. Current methods in use for assessing genotoxicity in gastric mucosa are scrutinized; the much discussed claim that antisecretory drugs induce unscheduled DNA synthesis is examined, and the methodology that is the basis for these claims is found defective and wanting. The nature of ECL cell proliferation in rats receiving lifelong treatment with H2-receptor antagonists or acid pump inhibitors is explored, and their relationship to ECL cell proliferation and ECL cell carcinoids discussed. It is concluded that aged rats are very prone to developing endocrine proliferations, and this may be related to the multiple endocrine neoplasia syndrome found in humans. There is no evidence at present that long-term antisecretory therapy causes significant ECL cell proliferation in humans.

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Authors and Affiliations

  1. Astra Hässle AB, Mölndal, Sweden

    G. Delle Fave, H. Helander, S. Holt, I. M. Modlin, R. Powers, E. Solcia, A. Soll, Y. Tielemans & N. A. Wright

  2. Division of Digestive Diseases, Richland Medical Park, Columbia, South Carolina, USA

    G. Delle Fave, H. Helander, S. Holt, I. M. Modlin, R. Powers, E. Solcia, A. Soll, Y. Tielemans & N. A. Wright

  3. Department of Surgery, School of Medicine, New Haven, Connecticut, USA

    G. Delle Fave, H. Helander, S. Holt, I. M. Modlin, R. Powers, E. Solcia, A. Soll, Y. Tielemans & N. A. Wright

  4. Department of Human Pathology, University of Pavia, Pavia, Italy

    G. Delle Fave, H. Helander, S. Holt, I. M. Modlin, R. Powers, E. Solcia, A. Soll, Y. Tielemans & N. A. Wright

  5. UCLA School of Medicine, Los Angeles, California, USA

    G. Delle Fave, H. Helander, S. Holt, I. M. Modlin, R. Powers, E. Solcia, A. Soll, Y. Tielemans & N. A. Wright

  6. Cancer Research Unit, Eaculty of Medicine, University of Brussels, Brussels, Belgium

    G. Delle Fave, H. Helander, S. Holt, I. M. Modlin, R. Powers, E. Solcia, A. Soll, Y. Tielemans & N. A. Wright

  7. Department of Histopathology, Royal Postgraduate Medical School, Hammersmith Hospital, London, UK

    G. Delle Fave, H. Helander, S. Holt, I. M. Modlin, R. Powers, E. Solcia, A. Soll, Y. Tielemans & N. A. Wright

  8. ICRF Laboratories, Lincoln's Inn Fields, London, UK

    G. Delle Fave, H. Helander, S. Holt, I. M. Modlin, R. Powers, E. Solcia, A. Soll, Y. Tielemans & N. A. Wright

  9. I Cattedra di Gastroenterologia, II Clinica Medica, Viala del Policlinico, 00161, Rome, Italy

    G. Delle Fave, H. Helander, S. Holt, I. M. Modlin, R. Powers, E. Solcia, A. Soll, Y. Tielemans & N. A. Wright

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  1. G. Delle Fave
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  2. H. Helander
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  3. S. Holt
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  6. E. Solcia
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  7. A. Soll
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This paper was previously published in Dig Dis Sci 39(9): 1843–1852 (1994).

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Fave, G.D., Helander, H., Holt, S. et al. Acid suppression and gastric mucosal cell biology. Digest Dis Sci 40 (Suppl 2), 121S–131S (1995). https://doi.org/10.1007/BF02214875

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