The Gastric Mucosal Barrier: A Dynamic, Multifactorial System

  • Andrew Garner
  • Paul H. Rowe
  • Jeffrey B. Matthews
Part of the Hans Selye Symposia on Neuroendocrinology and Stress book series (HSSN, volume 2)

Abstract

The mucosal lining of the upper gastrointestinal tract possesses two distinct properties; the ability to withstand autolysis by endogenous secretions, and the ability to rapidly repair superficial damage induced by exogenous irritants. Resistance of the gastric mucosa to autodigestion has been recognized for more than 200 years1. However, major advances in understanding the mechanisms involved in acid disposal and recovery from acute injury in the stomach have taken place over the past 10 years2,3.

Keywords

Permeability Migration Urea Aspirin Acidity 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    J. Hunter, On the digestion of the stomach after death, Phil Trans Roy Soc. 62:447 (1772).CrossRefGoogle Scholar
  2. 2.
    A. Garner, and P.E. O’Brien, “Mechanisms of Injury, Protection and Repair of the Upper Gastrointestinal Tract”, John Wiley & Sons, Chichester, U.K. (1991).Google Scholar
  3. 3.
    A. Allen, G. Flemstrom, A. Garner, and E. Kivilaakso, Gastroduodenal mucosal protection, Physiol Rev. 73:823 (1993).PubMedGoogle Scholar
  4. 4.
    F. Hollander, The two-component mucus barrier, Arch Intern Med. 93:107 (1954).CrossRefGoogle Scholar
  5. 5.
    H.W. Davenport, The gastric mucosal barrier, Digestion. 5:162 (1972).PubMedCrossRefGoogle Scholar
  6. 6.
    A. Garner, A. Allen, J. Gutknecht, A. Yanaka, P.J. Goddard, W. Silen, E.R. Lacy, P. Bauerfiend,M. Starlinger, and J.L. Wallace, Mechanisms of gastric mucosal defence, Eur J Gastroenterol Hepatol. 2:165 (1990).Google Scholar
  7. 7.
    A. Allen, Gastrointestinal mucus, in: “Handbook of Physiology, The Gastrointestinal System:Salivary, Gastric and Hepatobiliary Secretions,” J.G. Forte, ed., Am Physiol Soc. Bethesda (1989).Google Scholar
  8. 8.
    B.A. Hills, B.D. Butler, and L.M. Lichtenberger, Gastric mucosal barrier: hydrophobic lining to the lumen of the stomach, Am J Physiol. 244:G561 (1983).PubMedGoogle Scholar
  9. 9.
    G. Flemstrom, and A. Garner, Gastroduodenal bicarbonate transport: characteristics and proposed role in acidity regulation and mucosal protection, Am J Physiol. 242:G183 (1982).PubMedGoogle Scholar
  10. 10.
    J.L. Wallace, Gastric resistance to acid: is the “mucus-bicarbonate barrier” functionally redundant?,Am J Physiol. 256:G31 (1989).PubMedGoogle Scholar
  11. 11.
    L.A. Sellers, A. Allen, and M.K. Bennett, Formation of a fibrin-based gelatinous coat over repairing rat gastric epithelium after acute ethanol damage: interaction with adherent mucus, Gut. 28:835 (1987).PubMedCrossRefGoogle Scholar
  12. 12.
    J.L. Wallace, G.W. McKnight, The mucoid cap over superficial gastric damage in the rat,Gastroenterology. 99:295 (1990).PubMedGoogle Scholar
  13. 13.
    G. Flemstrom, Active alkalinization by amphibian gastric fundic mucosa in vitro, Am J Physiol.233:E1 (1977).PubMedGoogle Scholar
  14. 14.
    A. Allen, and A. Garner, Gastric mucus and bicarbonate secretion and their possible role in mucosa protection, Gut. 21:249 (1980).PubMedCrossRefGoogle Scholar
  15. 15.
    E.M. Quigley, and L.A. Turnberg, pH of the microclimate lining human gastric and duodenal mucosa in vivo: studies in control subjects and in duodenal ulcer patients, Gastroenterology. 92:1876 (1987).PubMedGoogle Scholar
  16. 16.
    J.M. Wilkes, A. Garner, and T.J. Peters, Mechanisms of acid disposal and acid-stimulated alkaline secretion by gastroduodenal mucosa, Dig Dis Sci. 33:361 (1988).PubMedCrossRefGoogle Scholar
  17. 17.
    R. Schiessel, A. Merhav, J.B. Matthews, L.A. Fleischer, A. Barzilai, and W. Silen, The role of nutrient bicarbonate in protection of amphibian gastric mucosa, Am J Physiol. 239:G536 (1980).PubMedGoogle Scholar
  18. 18.
    E. Kivilaakso, High plasma bicarbonate protects gastric mucosa against acute ulceration in the rat,Gastroenterology. 81:921 (1981).PubMedGoogle Scholar
  19. 19.
    E. Kivilaakso, and W. Silen, Pathogenesis of experimental gastric mucosal injury, New Engl J Med.301:364 (1979).PubMedCrossRefGoogle Scholar
  20. 20.
    T.E. Machen, A.M. Paradiso, Regulation of intracellular pH in the stomach, Ann Rev Physiol. 49:19 (1987).CrossRefGoogle Scholar
  21. 21.
    B.J. Gannon, J. Browning, and P.E. O’Brien, The microvascular architecture of the glandular mucosa of the rat, J Anal. 133:667 (1982).Google Scholar
  22. 22.
    K. Takeuchi, A. Merhav, W. Silen, Mechanism of luminal alkalinization by bullfrog fundic mucosa,Am J Physiol 243.G377 (1982).PubMedGoogle Scholar
  23. 23.
    M. Starlinger, and R. Schiessel, Bicarbonate delivery to the gastroduodenal mucosa by the blood: its importance for mucosal integrity, Gut. 29:647 (1988).PubMedCrossRefGoogle Scholar
  24. 24.
    S. Szabo, J.S. Trier, A. Brown, and J. Schnoor, Early vascular injury and increased vascular permeability in gastric mucosal injury caused by ethanol in the rat, Gastroenterology. 88:228 (1985).PubMedGoogle Scholar
  25. 25.
    E. Kivilaakso, A. Barzilai, R. Schiessel, R. Cross, and W. Silen, Ulceration of amphibian gastric mucosa, Gastroenterology. 71:31 (1979).Google Scholar
  26. 26.
    M. Lipkin, P. Sherlock, and B. Bell, Cell proliferation kinetics in the gastrointestinal tract of man:II cell renewal in the stomach, ileum, colon and rectum, Gastroenterology. 45:721 (1963).PubMedGoogle Scholar
  27. 27.
    T.K. Hunt, The principles of wound healing, in: “Mechanisms of Peptic Ulcer Health,” F. Halter,A. Garner, and G.N.J. Tytgat, eds., Kluwer, Dortrecht (1991).Google Scholar
  28. 28.
    W. Silen, and S. Ito, Mechanisms for rapid reepithelialization of the gastric mucosal surface, Ann Rev Physiol. 47:217 (1985).CrossRefGoogle Scholar
  29. 29.
    E.R. Lacy, Gastric mucosal defence after superficial injury, Clin Invest Med. 10:189 (1987).PubMedGoogle Scholar
  30. 30.
    J. Critchlow, D. Magee, S. Ito, K. Takeuchi, and W. Silen, Requirements for restitution of the surface epithelium of frog stomach after mucosal injury, Gastroenterology. 88:237 (1985).PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1995

Authors and Affiliations

  • Andrew Garner
  • Paul H. Rowe
  • Jeffrey B. Matthews

There are no affiliations available

Personalised recommendations