Gastric Acid Backdiffusion and Neural Alarm System
The pathophysiological concept that gastroduodenal ulcer is caused by aggressive factors including acid, pepsin, and Helicobacter pylori is met by the current medical treatment involving proton pump inhibitors and antibiotics. Since the time when prostaglandins were discovered to be protective factors, with their deficiency being responsible for the mucosal lesions caused by nonsteroidal anti-inflammatory drugs, attention has also been paid to the defensive forces of the gastroduodenal mucosa. However, the possibility that nociceptive neurons participate in gastric mucosal protection from injury was not thought of until recently. This article summarizes the experimental evidence for afferent neurons being a neural emergency system (Holzer 1998) that alarms protective mechanisms in the stomach in the face of pending acid injury. There is good reason to postulate that a malfunction of this alarm system is an etiological factor in certain forms of gastroduodenal ulcer disease.
KeywordsGastric Mucosal Blood Flow Gastric Blood Flow Celiac Ganglion Gastric Mucosal Barrier Coeliac Ganglion
Unable to display preview. Download preview PDF.
- Esplugues JV, Whittle BJR (1990) Morphine potentiation of ethanol-induced gastric mucosal damage in the rat. Role of local sensory afferent neurons. Gastroenterology 98:82–89.Google Scholar
- Li D-S, Raybouid HE, Quintero E, Guth PH (1991) Role of calcitonin gene-related peptide in gastric hyperemic response to intragastric capsaicin. Am J Physiol 261-.G657–G661.Google Scholar
- Morales MA, Holmberg K, Xu ZQ, Cozzari C, Hartman BK, Emson P, Goldstein M, Elfvin LG, Hökfelt T (1995) Localization of choline acetyltransferase in rat peripheral sympathetic neurons and its coexistence with nitric oxide synthase and neuropeptides. Proc Natl Acad Sci USA 92:11819–11823.PubMedCrossRefGoogle Scholar
- Sternini C (1992) Enteric and visceral afferent CGRP neurons. Targets of innervation and differential expression patterns. Ann NY Acad Sci 657:170–186.Google Scholar
- Wood J (1993) Capsaicin in the study of pain. Academic Press, London.Google Scholar