Role of surface-active phospholipids in gastric cytoprotection

Biochemical bases in differentiation of a mouse cell line GSM06 to gastric surface cells

A mouse gastric surface cell line GSM06 established from a transgenic mouse harboring temperature-sensitive simian virus 40 large T-antigen gene was subjected to the lipid and glycoprotein analysis. When GSM06 cells were cultured for a long time after formation of a confluent monolayer, they differentiated to resemble foveolar epithelial cells morphologically. Biochemical changes during culture were studied in cells harvested just when a monolayer had formed (day 0), on day 7, and on day 21. Content of total phospholipids, cholesterol, cholesterol sulfate, total sugar and sialic acid increased about 1.5-fold from day 0 to 7 and remained elevated till day 21. The fatty acid composition of phospholipids revealed increased relative levels of oleic acid in phosphatidylcholine and phosphatidylethanolamine, and an increased level of plasmenylethanolamine from day 0 to 7. The level of dolichylphosphate continued to increase in a time-dependent manner. Glycosylation of various proteins, detected with lectins, was enhanced from day 7. In addition, greater resistance to taurodeoxycholate and acetylsalicylic acid was observed on days 7 and 21 than on day 0. Thus, enhanced glycosylation of proteins and an overall increase in the area of cellular membranes were the major changes in GSM06 cells during culture, and they were accompanied by an enhancement of cytoprotective potential.

Econutrition and health maintenance — A new concept to prevent GI inflammation, ulceration and sepsis

The nutritional needs of the gastrointestinal mucosa per se has until today been largely neglected. It is a rather novel finding, that the lower part of the digestive tract is most dependent on luminal nutrition for maintaining its integrity, structure and function. Even the most complete parenteral nutrition (PN) regimen cannot, in the absence of adequate enteral nutrition (EN), fully prevent the development of mucosal atrophy in the lower part of the digestive tract, especially the colon. Nor can PN prevent the downregulation of the colon's many important functions. Increased microbial translocation and a predisposition to sepsis are consequences of inadequate luminal nutrition. Such developments can only be prevented by oral feeding and the local 'manufacturing' of essential nutrients in the colon. Probiotic bacteria are also important, especially with respect to the function of the colonic mucosa, which is the focus of this review.

Milk and egg phospholipids act as protective surfactants against luminal acid in Necturus gastric mucosa

BACKGROUND

Our previous studies indicate that milk phospholipids have anti-ulcer properties in rats and humans, possibly by forming a hydrophobic surfactant layer at the epithelial surface. In the present study we measured intracellular pH and parameters of membrane resistances in gastric epithelium exposed to luminal acid using a microelectrode technique.

METHODS

Chambered isolated Necturus maculosus antral mucosa was exposed to pH 2.3, with or without 20-25 min pre-treatment with milk or egg phospholipids. The pH in surface epithelial cells was measured with double-barrelled liquid sensor pH/PD-microelectrodes.

RESULTS

Pre-treatment with phospholipids (2500-5000 micrograms P/mL) significantly (P < 0.01, n = 14) opposed intracellular acidification. Phospholipids significantly (P < 0.05, n = 14) increased the ratio of apical and basal membrane resistances, suggesting that they primarily affect the apical cell membrane. In contrast, there was no significant change in transmucosal resistance suggesting lack of effect on paracellular shunts in the 'leaky' epithelium.

CONCLUSIONS

Exogenous phospholipids of dietary origin may be used to form a protective layer in the gastric mucosa against irritants.

Gastroprotection by dairy foods against stress-induced ulcerogenesis in rats

We investigated the ability of three dairy foods to prevent stress-induced gastric lesions and bleeding in rats. Skim milk, whole milk, and cream were all significantly gastroprotective with the greatest protection seen with the highest fat dairy food. Pretreatment of rats with cream for up to 2 hr prior to stress maintained a portion of the protective effect. Lipid extracts of cream, but not skim milk or whole milk, were gastroprotective. Surface hydrophobicity of the gastric mucosa was reduced by stress, but was maintained at prestress levels by treatment with milk, cream, or their lipid extracts, although this effect was not sufficient for protection in stressed rats. Alterations in gastric pH or titratable acid could not explain the protective effects of dairy foods or their lipid extracts. Milk was more gastroprotective in stressed rats than another food of equal caloric value. We conclude that both the lipid and nonlipid fractions of dairy foods possess gastroprotective activity against stress-induced ulcerogenesis in rats, a property that may be of therapeutic value for man.

Gastrointestinal surface protection and mucosa reconditioning

BACKGROUND

There is increasing evidence that preservation of the ecology of the gastrointestinal tract and the surface protection system--surfactants, mucus, and fiber--is important for the outcome in postoperative trauma patients, patients after bone marrow and liver transplantation, and patients with HIV or AIDS. Approximately 50% of the nourishment of the small intestine and > 80% of the nourishment of the large intestine comes from the lumen. This is especially deleterious to the large intestine. Within less than a week of intestinal starvation--even in the presence of intense parenteral nutrition--a mucosal atrophy is observed, promoting translocation of potentially pathogenic microorganisms. Enteral nutrition is crucial to the outcome in many of these conditions. If however, such a nutrition is based on simple carbohydrates, peptides, amino acids, or fatty acids, most of the nutrition administered will be absorbed in the upper gastrointestinal tract. Complex fibers and proteins can be regarded as nutrients especially destined to the lower gastrointestinal tract. They are fermented by the probiotic flora, normally colonizing the colonic mucosa, and the necessary nutrients: short-chain fatty acids and amino acids such as arginine and glutamine are produced at the level of the colonic mucosa. Careless antibiotic treatment reduces or eliminates this flora, induces local mucosal starvation, and makes the patients vulnerable to opportunistic infections and microbial intestinal translocation.

METHODS AND RESULTS

In this review the role of the different ingredients of the surface protection system are discussed. A program to recondition the intestines, particularly the colonic mucosa by resupply of species-specific lactobacilli, surfactants, amino acids (especially glutamine), and oat fiber (beta-glucans) is suggested. Extensive experience in animal models and early experience in a patient population are summarized and discussed. Oat has been chosen as a substrate for fermentation because it contains 100 times more of membrane lipids (surfactants) than any other food, has a favorable amino acid pattern (rich in glutamine), and is rich in water-soluble, fermentable-fiber beta-glucans. More than 1000 isolates of human-specific lactobacilli have been studied. Some strains, especially those of plantarum type, have proven effective in colonizing the colonic mucosa, suppressing the potentially pathogenetic flora, and may have other probiotic effects as well.

CONCLUSION

A totally new enteral formula has been designed based on probiotic bacteria and fiber and aimed at colonizing the intestinal mucosa with a local probiotic effect and fermentation of fiber.

Pulmonary surfactant protein A (SP-A) is expressed by epithelial cells of small and large intestine

Surfactant protein A (SP-A) is the most abundant protein associated with phospholipids in pulmonary surfactant. There are several lines of evidence that pulmonary and gastrointestinal epithelium produce closely related surface-active materials, although the presence of SP-A in gastrointestinal tract has so far not been reported. Indirect immunofluorescence experiments using different antibodies raised against rat pulmonary SP-A showed that some jejunal and colonic but not gastric epithelial cells positively stained for SP-A. Analysis of the proteins in cell lysates from rat small intestine and colon studied by Western blot revealed several immuno-reactive bands, including the characteristic triplet of 26-, 32-, and 38-kDa monomeric proteins, less strongly labeled than in lung cells, and higher molecular mass forms of 66 and 120 kDa also present in lung cells. The 66- and 120-kDa bands displayed the expected isoelectric pH of SP-A after two-dimensional electrophoresis. Alkylation induced conversion of the 120-kDa form (almost completely) and the 66-kDa form (partly) into the 26-38-kDa monomeric species. The presence of SP-A mRNA in rat stomach, small intestine, and colon was then searched for by conventional cDNA/reverse transcriptase-polymerase chain reaction. Products of appropriate size (372 base pairs) identical to that of pulmonary tissue were amplified in small intestine and colon but not in stomach or in other tissues used as controls. Cloning and sequencing of rat colon SP-A cDNA revealed the same sequence as the one reported for rat lung SP-A. Furthermore, analysis of the transcriptional initiation site of SP-A gene in colon by anchored-polymerase chain reaction showed that transcription was initiated at the same site in both colon and lung. These data, which demonstrate that small intestine and colon express SP-A constitutively and that this protein is present in some epithelial cells, extend the concept of intestinal surfactant and underline its close relationships to pulmonary surfactant.

Non-steroidal anti-inflammatory drugs (NSAIDs) associate with zwitterionic phospholipids: insight into the mechanism and reversal of NSAID-induced gastrointestinal injury

The molecular basis of the injurious actions of non-steroidal anti-inflammatory drugs (NSAIDs) on the gastrointestinal (GI) tract is only partly understood. In this study we have obtained evidence, employing both in vitro and in vivo systems, that five NSAIDs have the ability to form a chemical association with zwitterionic phospholipids. Since this same class of phospholipids line the luminal aspects of the mucus gel layer to provide it with non-wettable properties, this intermolecular association may be the mechanism by which NSAIDs attenuate the hydrophobic barrier properties of the upper GI tract. Preassociating a number of NSAIDs with exogenous zwitterionic phospholipids prevented this increase in surface wettability of the mucus gel layer and protected rats against the injurious GI side-effects of these drugs, while enhancing their lipid permeability, antipyretic and anti-inflammatory activity.

[Surfactants in the digestive tube]

Epithelia of the gastrointestinal tract both synthesize and secrete surfactant-like materials. Like the pulmonary surfactant, these materials contain not only phospholipids, but also surfactant apoproteins, regarded until recently as specific products of the bronchoalveolar epithelium. Presented here are the various roles, most of them still speculative, of these phospholipids-containing products in the gastro-intestinal tract.

Fatty acid-mediated gastroprotection does not correlate with prostaglandin elevation in rats exposed to various chemical insults

This study involved a comparison of activity of several long-chain fatty acids (arachidonic acid, dihomo-[gamma]-linolenic acid, linoleic acid, and oleic acid) for protection against gastric mucosal damage elicited by taurocholic acid, acidified aspirin, and ethanol in rats. Each damaging agent induced gastric mucosal lesions in the corpus. Mucosal damage was induced by all agents, and all fatty acids protected the gastric mucosa; however, ethanol and arachidonic acid were the most potent damaging and protecting agents, respectively. Maximally protective doses for prevention of taurocholic acid-induced damage by arachidonic, dihomo-[gamma]-linolenic, linoleic, and oleic acids were 50, 200, 100, and 200 mg/kg, respectively; however, 10 mg/kg arachidonic acid reduced lesion length by > 50%, whereas minimally effective doses of the other fatty acids were > or = 50 mg/kg. Similar potency differences were observed for fatty acid protection against acidified aspirin-induced gastric damage. Although all the fatty acids reduced macroscopic damage, histologic studies showed they did not totally eliminate surface mucosal damage. Microscopic analysis showed that treatment with dihomo-[gamma]-linolenic acid or oleic acid attenuated depletion of neutral and acidic glycoproteins from the mucus neck cells of the gastric mucosa in response to exposure to taurocholic acid. Despite having similar gastroprotective activity, arachidonic, dihomo-[gamma]-linolenic, linoleic, and oleic acids had very dissimilar abilities to elevate gastric mucosal E-series prostaglandins. Both arachidonic and dihomo-[gamma]-linolenic acids elevated E-series prostaglandins, but arachidonic acid had 2-5-fold greater gastroprotective potency. Furthermore, oleic and linoleic acids, which had protective potency similar to that dihomo-[gamma]-linolenic acid, did not significantly elevate prostaglandins. These studies failed to demonstrate an absolute correlation between prostaglandin elevation and gastroprotection. The results of this investigation suggest that prostaglandin elevation, although associated with gastroprotection, does not appear to be the sole mechanism for fatty acid-mediated protection of rat gastric mucosa.

Phosphatidylcholines as mediators of adaptive cytoprotection of the rat duodenum

BACKGROUND/AIMS

Surfactant phospholipids impede diffusion of acid through the gastric mucus, but their relevance in the defense of the duodenum against luminal acid is not known.

METHODS

Duodenal resistance to acid was tested in anesthetized rats by instillation of HCl using a tube implanted in the proximal duodenum. The effects of a detergent (Brij 35; Sigma, St. Louis, MO) and a lipid mixture flushed through the luminal surface on duodenal resistance to acid were studied. The lipid content in the mucus and the effects of acid, prostaglandins, and indomethacin on the lipid layer were also analyzed.

RESULTS

Instillation of 100 mumol HCl or 5 micrograms/kg 16,16-dimethyl prostaglandin E2 increased resistance to acid, preventing duodenal lesions induced by 500 mumol HCl. However, 100 mumol HCl or 16,16-dimethyl prostaglandin E2 did not prevent lesions induced by 500 mumol HCl in rats undergoing perfusions with 5% Brij 35. Indomethacin suppressed acid-induced protection. A mixture of tripalmitin and dipalmitoyl-phosphatidylcholine protected against 500 mumol HCl, and the effect was also observed in rats receiving indomethacin. Finally, 100 mumol HCl increased the phosphatidylcholine content in the duodenal mucus but not in rats receiving 5% Brij 35 or indomethacin.

CONCLUSIONS

Surface-active phospholipids are critical for adaptive cytoprotection to acid in the rat duodenum.

Effects of smoking and nicotine on the gastric mucosa: a review of clinical and experimental evidence

Epidemiological and experimental evidence have shown that nicotine has harmful effects on the gastric mucosa. The mechanisms by which cigarette smoking or nicotine adversely affect the gastric mucosa have not been fully elucidated. In this report, clinical and experimental data are reviewed. The effects of nicotine from smoking on gastric aggressive or defensive factors are discussed. Nicotine potentiates gastric aggressive factors and attenuates defensive factors; it also increases acid and pepsin secretions, gastric motility, duodenogastric reflux of bile salts, the risk of Helicobacter pylori infection, levels of free radicals, and platelet-activating factor, endothelin generation, and vasopressin secretion. Additionally, nicotine impairs the therapeutic effect of H2-receptor antagonists and decreases prostaglandin synthesis, gastric mucosal blood flow, mucus secretion, and epidermal growth factor secretion. Although many of the studies provide conflicting results, the bulk of the evidence supports the hypothesis that nicotine is harmful to the gastric mucosa.

Lipids of human gastric mucosa: effect of Helicobacter pylori infection and nonalcoholic cirrhosis

BACKGROUND/AIMS

Gastric mucosa phospholipids play an important protective role against exogenous and endogenous toxic agents. Recently, we described a significant alteration of phospholipid profile in patients with chronic atrophic gastritis without Helicobacter pylori infection. The aim of the present study was to assess the phospholipid composition of gastric biopsy specimens in 41 subjects with chronic gastritis in relation to H. pylori infection (no. 26) and nonalcoholic cirrhosis (no. 18).

METHODS

Phospholipids were extracted from homogenate mucosal samples using Folch's method, purified, and separated by thin-layer chromatography, while bound fatty acids were analyzed by gas liquid chromatography.

RESULTS

The amounts of five gastric phospholipid classes, their rank order, and percent distribution of the principal ones (phosphatidylcholine [PC] 58%, phosphatidylethanolamine [PE] 26%, and phosphatidylinositol 11% vs. values of 49, 19, and 14, respectively, in the earlier study) were confirmed in chronic gastritis without H. pylori infection. H. pylori infection induced a dramatic reduction (about 30%) in the absolute amount of total phospholipids (24.2 micrograms/mg protein versus 35.1 of the H. pylori-negative group; P < 0.01), PC and PE being the most affected (-36% and -26%, respectively), while bound fatty acids remained unchanged. There was no difference in cirrhotic vs. noncirrhotic subjects.

CONCLUSIONS

(1) The development of gastritis is characterized by an alteration of the lipid mucosal pattern that can change with the different etiologies, the most dramatic variations being observed in the presence of H. pylori infection; and (2) cirrhosis does not affect further the alteration in the phospholipid profile of the antral mucosa caused by chronic gastritis.

Phospholipase A2 activity in gastric juice from patients with active and H. pylori-eradicated healed duodenal ulcer

BACKGROUND

Despite the close association between gastric Helicobacter pylori infection and duodenal ulcer, little is known about how this organism may promote mucosal damage. A possibility might be that it produces, or induces the host to release, phospholipases that metabolize the protective layer of phospholipids.

METHODS

Aimed at determination of phospholipase A2 activity and the concentration of choline-containing phospholipids in gastric juice, aspirates were collected during gastroscopy in 38 consecutive referrals with either active (n = 19) or H. pylori-eradicated healed duodenal ulcer (n = 19).

RESULTS

Gastric juice phospholipase A2 activity was 3.1 times higher in active than in healed duodenal ulcers (P = 0.03). Concurrently, the concentration of choline-containing phospholipids in the group with active ulcers was less than half compared with the healed group (P = 0.02).

CONCLUSION

The results indicate that phospholipase A2 activity and the concentration of choline-containing phospholipids in gastric juice are related to H. pylori status and duodenal ulcer disease.

Gastric mucosal defensive factors: the therapeutic strategy

There are several interesting approaches to augmenting defence or repair mechanisms that can be used already or may find a place in therapy for ulcer disease. Factors such as epidermal growth factor and basic fibroblast growth factor show potential. Alternative strategies might be to stimulate mucosal blood flow with agents that release nitric oxide (NO), or to scavenge free radicals in the inflamed or ischaemic mucosa. If such approaches are to find a role in therapy, it is likely that it will be restricted: perhaps for the treatment of refractory ulcers, or for prophylaxis of stress ulceration. This is because most ulcers in future are likely to be healed with tolerable and high efficacy acid-inhibiting drugs then have their recurrence prevented by regimens that eradicate Helicobacter pylori. The most important current indication for concentrating on enhancing mucosal defences is for managing non-steroidal anti-inflammatory drug (NSAID)-induced ulcers. There is no clear advantage in using a defence-enhancing agent (rather than an acid suppressant) to heal an NSAID ulcer if the NSAID can be stopped. The main value of prostaglandins is for prophylaxis of NSAID ulcers in those patients who need ongoing treatment with NSAID. For cost-benefit reasons, prostaglandins should probably be used mainly for those at high risk of NSAID complications, and there has been progress in identifying these. Another interesting approach is aimed at clarifying mechanisms of gastric adaptation to NSAID, so that we might be able to design drugs and dosing regimens to maximize this phenomenon.

Effect of ammonium ion on the hydrophobic and barrier properties of the gastric mucus gel layer: implications on the role of ammonium in H. pylori-induced gastritis

Infection with the bacterium Helicobacter pylori is associated with both the development of gastritis and an attenuation in the hydrophobic properties of the stomach. In order to better understand the effect of ammonium, one of the major products of H. pylori urease on these properties, a series of in vivo and in vitro experiments was performed. In the in vivo studies rats were intragastrically administered NH4Cl alone and in combination with the mucolytic agent, Muco-Mist, in various dosing strategies and concentrations. It was determined that the intragastric administration of four consecutive doses of a NH4Cl/Muco-Mist mixture (20 mmol/L/5%) was capable of converting the stomach from a hydrophobic to hydrophilic state as determined by contact angle analysis. Further, the treated rats became more susceptible to the injurious effect of luminal acid as determined by measuring the haemoglobin concentration of a collected gastric perfusate. In the in vitro studies it was determined that exposure of the hydrophobic surface of a synthetic mucus gel layer to increasing concentrations of NH4Cl (0-20 mmol/L) resulted in a rapid transition to a hydrophilic state and an associated increase in the flux of H+ across its surface. Helicobacter pylori may induce an attenuation in both mucosal hydrophobicity and barrier properties by producing high concentrations of NH4+ in the mucus gel layer. The molecular mechanism of this action may be related to the chemical similarities of NH4+ and choline-based phospholipids which contribute to the stomach's hydrophobic surface.

Demonstration of a phospholipid-rich zone in the human gastric epithelium damaged by Helicobacter pylori

BACKGROUND

Recently, a hydrophobic layer has been shown by the contact angle method in human gastric biopsy specimens. The aim of this study was to show the existence of a phospholipid-rich layer in the human gastric epithelium and to investigate the influence of Helicobacter pylori on these structures.

METHODS

Biopsy specimens from the gastric antrum were obtained during gastroscopy from patients with normal gastric mucosa as well as from patients with H. pylori-positive gastritis for electron microscopical and histological examination. Structures reacting with a phospholipid-selective stain, iodoplatinate were analyzed by electron microscopy and electron-dispersive x-ray microanalysis.

RESULTS

Both methods revealed the morphological existence of a phospholipid-rich zone covering the human gastric epithelial layer. Reaction products could be localized within the cells, at the epithelium closely associated with the surface, and in connection with the mucus. In infected tissue, H. pylori affects iodoplatinate-reactive material within the mucous layer and material covering the epithelium.

CONCLUSIONS

The phospholipid-rich zone in the apical region of surface mucous cells is likely to represent an important factor of the gastric protective system in humans. The destruction of this hydrophobic layer may result in a reduction of hydrophobicity giving access to gastric acid.

Phospholipase activity of Helicobacter pylori and its inhibition by bismuth salts. Biochemical and biophysical studies

In this study we measured phospholipase A (PLA) and C (PLC) activity of media filtrates and French Press lysates of the gastritis-inducing bacteria Helicobacter pylori. We report here that both H. pylori lysates and filtrates contain PLA1, PLA2, and C enzymes, which readily hydrolyze a radiolabeled dipalmitoylphosphatidylcholine (DPPC) and phosphorylcholine substrates, respectively. The specific activity of both PLA and C enzymes were greatest in the 6.5-7.0 and 8.4-8.8 pH ranges, respectively. Colloidal bismuth subcitrate (CBS) induced a dose-dependent inhibition of PLA2 and C activity of both H. pylori lysates and filtrates. This inhibitory effect of CBS on PLA2 was antagonized in a dose-dependent fashion by the addition of CaCl2 to the incubation mixture, suggesting that calcium and bismuth may be competing for the same site on the enzyme. In contrast, the ability of bismuth salts to inhibit PLC activity of H. pylori lysates was not antagonized by CaCl2. Employing a biophysical assay system for surface wettability, it was determined that H. pylori lysates had the capacity to remove a synthetic phospholipid monolayer off a glass in a dose-dependent fashion. This ability of the bacterial lysates to catalyze the transformation of a hydrophobic surface to a wettable state was significantly attenuated in the presence of bismuth salts. Our experimental results are, therefore, consistent with the possibility that H. pylori colonization compromises the stomach's barrier to acid by eroding a phospholipid lining, possibly a monolayer, on the surface of the gastric mucus gel and that this process is blocked in response to bismuth therapy.

Effects of alcohol-induced lipid interdigitation on proton permeability in L-alpha-dipalmitoylphosphatidylcholine vesicles

6-Carboxyfluorescein was employed to examine the effect of alcohol-induced lipid interdigitation on proton permeability in L-alpha-dipalmitoylphosphatidylcholine (DPPC) large unilamellar vesicles. Proton permeability was measured by monitoring the decrease of 6-carboxyfluorescein fluorescence after a pH gradient from 3.5 (outside the vesicle) to 8.0 (inside the vesicle) was established. At 20 degrees C and below 1.2 M ethanol, the fluorescence decrease is best described by a single exponential function. Above 1.2 M ethanol, the intensity decrease is better described by a two-exponential decay law. Using the fitted rate constants and the vesicle radii determined from light-scattering measurements, the proton permeability coefficient, P, in DPPC vesicles was calculated as a function of ethanol concentration. At 20 degrees C, P increases monotonically with increasing ethanol content up to 1.0 M, followed by an abrupt increase at 1.2 M. The vesicle size also exhibits a sudden increase at around 1.2 M ethanol, which has been shown to result from vesicle aggregation rather than vesicle fusion. The abrupt increases in P and in vesicle size occur at the concentration region close to the critical ethanol concentration for the formation of the fully interdigitated gel state of DPPC. At 14 degrees C, the abrupt change in P shifts to 1.9-2.0 M ethanol, completely in accordance with the ethanol-temperature phase diagram of interdigitated DPPC. Effects of methanol and benzyl alcohol on lipid interdigitation have also been examined. At 20 degrees C, DPPC large unilamellar vesicles exhibit a dramatic change in P at 3 M methanol and at 40 mM benzyl alcohol. These concentrations come close to the critical methanol and benzyl alcohol concentrations for the formation of fully interdigitated DPPC structures determined previously by others. It can be concluded that proton permeability increases dramatically as DPPC is transformed from the noninterdigitated gel to the fully interdigitated gel state by high concentrations of alcohol. This marked increase in proton permeability can be attributed to the combined effect of the changes in membrane thickness and surface charge density, due to the ethanol-induced lipid interdigitation. The possible effects of the increased proton permeability caused by ingested ethanol on gastric mucosal membranes are discussed.

Green banana protection of gastric mucosa against experimentally induced injuries in rats. A multicomponent mechanism?

The protective capacities of fresh green (unripe) sweet bananas and of phosphatidylcholine and pectin (banana ingredients) against acute (ethanol- or indomethacin-induced) and chronic (indomethacin-induced) gastric mucosal lesions were evaluated in rats. Banana pulp was mixed with saline and given by gavage, as a pretreatment in a single dose. The identical protocol was used for pectin and phosphatidylcholine solution, and the dosages were adjusted to equal the amount of ingredients in the banana mixture, but higher concentrations were also given. The banana suspension reduced acute lesions, as did pectin and phosphatidylcholine in higher concentrations, but in concentrations as in fresh fruit no protective effects were observed except by pectin against indomethacin injury. In the model of chronic ulcers the banana suspension provided an incomplete and temporary protective effect. We conclude that the protective capacity of fresh green sweet bananas cannot be confined to only one active component. Pectin and phosphatidylcholine may protect gastric mucosa by strengthening the mucous-phospholipid layer, but the mechanism of protection afforded by bananas has to be further elucidated.

Influence of dietary fat on duodenal resistance to acid

Three experimental diets were prepared from a standard formula plus pure oleic, linoleic, or eicosapentaenoic acid (2% by weight). Mucosal resistance to acid was tested in anaesthetised rats fed the experimental diets for at least four weeks (60 rats per diet) by duodenal infusion of HCl (200 to 700 mumol) 30 minutes after pretreatment with either saline or 100 mumol HCl (used as a mild irritant). Rats were killed one hour after the test and the duodenal damage was assessed 'blindly' using a combined macroscopic and histological score. Differences were tested by analysis of covariance of the dose-response curves. Mucosal resistance was similar in the three groups when the acid challenge was given after saline pretreatment. Resistance to acid in all three groups was significantly increased by previous exposure to 100 mumol HCl (p < 0.01). Interestingly, rats fed a linoleic or eicosapentaenoic supplemented diet after pretreatment with HCl developed significantly higher resistance to acid than those fed the diet with oleic acid (p < 0.05). Pretreatment with indomethacin suppressed the difference between diets. In conclusion, dietary polyunsaturated fatty acids enhance duodenal resistance to acid by potentiation of adaptive cytoprotection.

PGE2 protects isolated cells against injury through multiple mechanisms

In order to clarify how PGE2 regulates gastric mucosal integrity, we examined the effects of PGE2 on ethanol-caused injury of isolated gastric chief cells, cultured gastric mucous cells from guinea pigs and Balb/c 3T3 fibroblasts. Pretreatment of these cells with PGE2 reduced ethanol-caused injury of the cells. Furthermore, pretreatment of gastric mucous cells with indomethacin enhanced ethanol-caused injury, suggesting that endogenous PGE2 may be involved in the cell protection. PGE2 stimulated an increase in diacylglycerol (DG) accumulation in chief cells and treatment of chief cells with synthetic DG reduced the injury of the cells. However, DG accumulation was not observed in gastric mucous cells treated with PGE2. Therefore PGE2 may protect the cells from injury through a variety of mechanisms. In addition, PGE2 enhanced the survival of the quiescent fibroblasts cultured in the absence of serum, while PGE2 had no survival enhancing effect on gastric mucous cells. These results suggest that the mechanism by which PGE2 preserves the cell viability may depend on not only cell types used but also how the cells are injured.

Gastric mucosal barrier: evidence for Helicobacter pylori ingesting gastric surfactant and deriving protection from it

Ultrastructural examination by electron microscopy has been undertaken on human oxyntic mucosa from biopsy specimens obtained during diagnostic endoscopy from patients in whom infection by Helicobacter pylori was subsequently confirmed. A novel fixation procedure was used that avoided conventional fixatives based upon glutaraldehyde, which can destroy the hydrophobic lining of surfaces such as gastric mucosa. The resulting electron micrographs show densely osmiophilic inclusions of varying sizes in Helicobacter, some of which can be resolved and identified as lamellar bodies and their partially digested states. This finding indicates that Helicobacter may act as an aggressive agent by ingesting a gastric mucosal barrier of gastric surfactant, exposing the surface to attack by acid while simultaneously rendering it less hydrophobic. There is also evidence that Helicobacter pylori avoid their own digestion by coating themselves with essentially the same barrier of gastric surfactant, probably derived from the host. This is a possible explanation for the apparent absence of these bacteria in the duodenum.

Phospholipid composition of human gastric mucosa: a study of endoscopic biopsy specimens

Gastric mucosal phospholipids, and in particular those of the surface layer, play an important part in mucosal barrier function. This study examined whether the phospholipid composition of the full thickness gastric mucosa is changed in peptic ulcer disease and gastritis. The phospholipid composition of gastric mucosa from endoscopic biopsy specimens in 28 subjects (eight healthy controls, 12 patients with duodenal ulcer, and eight with chronic atrophic gastritis) was studied. In addition, the phospholipid composition of gastric mucosa was compared with that of duodenal mucosa in 10 patients with duodenal ulcer. As expected phosphatidylcholine and phosphatidylethanolamine prevailed in all three groups. Lysolecithin was the smallest component in the duodenal ulcer and chronic atrophic gastritis groups. The phosphatidylethanolamine value was higher in duodenal ulcer and lower in chronic atrophic gastritis compared with the control group. In chronic atrophic gastritis there was an appreciable amount of phosphatidylglycerol that was not present in patients with duodenal ulcer or in the control group. There was no significant difference in phospholipid composition between antral and duodenal sites in duodenal ulcer patients. In conclusion, the phospholipid composition of gastric mucosa changes in human gastrointestinal diseases but its relation to cellular functions needs further study.

Gastroprotective capability of exogenous phosphatidylcholine in experimentally induced chronic gastric ulcers in rats

Phosphatidylcholine (PC) is a main component of the hydrophobic gastric mucosal barrier. Exogenously administered, it prevents acute lesions. We evaluated the gastroprotective capacity of exogenous PC in both acute (ethanol- and indomethacin-induced) and chronic (indomethacin-induced) lesions in rats. Polyunsaturated (PPC) or hydrogenated PC in different concentrations were given intragastrically, before or after the injury factor, in single or repeated doses. Mucosal lesions were significantly reduced by a single dose of PPC, given before or after the injury factor, in both acute models. In the chronic model a single dose of PPC or hydrogenated PC significantly reduced lesions evaluated 6 h after ulcer induction, whereas after 72 h no protective effect was noticed. Repeated doses of PC were ineffective. In conclusion, in acute models exogenous PC reduces lesions in a dose-dependent manner and contributes to the mucosal defense. In chronic models an incomplete and temporary protection might be due to complex pathogenesis that requires activation of all levels in the mucosal defense. Strengthening of only one level was insufficient to restrict injury.

Effect of 16,16-dimethyl prostaglandin E2 on lipidic organelles of rat gastric surface mucous cells

BACKGROUND

We examined the effect of 16,16-dimethyl prostaglandin E2 (dmPGE2) on the subcellular distribution of phospholipids in rat gastric surface mucous cells (SMCs) using the cytochemical stain, iodoplatinate (IP).

METHODS

The volume of a number of subcellular organelles and the density of IP reactivity within these organelles was determined by modified vertical section stereology.

RESULTS

The volume occupied by most of the subcellular organelles was not affected by dmPGE2 treatment, with the exception that the volume fraction of two classes of large infranuclear inclusion bodies (LIIB1 and LIIB2, organelles we have previously shown to contain hydrophobic lipids), were significantly expanded by a factor of 3-4-fold. The distribution of IP reactivity among the various subcellular compartments appeared to undergo a shift in response to dmPGE2 treatment. Once again the major prostanoid effect was seen in the infranuclear inclusion bodies, as the volume density of IP reactivity was increased 2-24-fold in LIIB1 and 9-10-fold in LIIB2 in comparison to control values.

CONCLUSION

dmPGE2 administration to rats induces an increase in the volume and IP reactivity of a family of lipid-containing organelles, which may underlie its ability to increase the hydrophobic surface properties of the stomach.

Effect of ethanol on rat gastric surfactant: a fluorescence polarization study

BACKGROUND

Gastric surfactant is believed to protect gastric mucosa by the hydrophobic properties of its phospholipidic component, which are reflected in the fluorescence polarization of a lipophylic fluorescent probe. The present study aimed to observe the consequences of intragastric administration of 40% ethanol on the physical properties of rat gastric surfactant.

METHODS

Fluorescence polarization studies and lipid composition of gastric mucosal surface scrapings were performed.

RESULTS

Time course experiments indicated that the ulcerogenic action of ethanol occurred along with a fluidization of the surface scrapings followed by secondary rigidification. The fluidizing effect of ethanol was related to modifications of the molecular dynamics of lipid structures. The rigidifying effect of ethanol was a result of an increase in the cholesterol-triglyceride and cholesterol-phospholipid ratios and an increase in the percent composition of phosphatidyl-ethanolamine of surface scrapings.

CONCLUSIONS

The results suggest that alcohol could alter the gastric mucosal barrier by its disorganizing effect on the molecular dynamics of the gastric surfactant. The second rigidifying effect of ethanol could be a part of the damage repair phenomenon.

The mitigating effects of phosphatidylcholines on bile salt- and lysophosphatidylcholine-induced membrane damage

The effects, at pH 7.0, of a series of 0.2 mM phosphatidylcholines (PC), namely dicaproyl-PC (DCPC), didecanoyl-PC (DDPC), dilauroyl-PC (DLaPC), dimyristoyl-PC (DMPC), dipalmitoyl-PC (DPPC), dioleoyl-PC (DOPC) and dilinoleoyl-PC (DLPC) and a series of 0.2 mM fatty acid salts (namely sodium myristate, palmitate, stearate, oleate and linoleate) upon the erythrocyte haemolysis induced by 2 mM sodium taurodeoxycholate (STDC) were determined. The influence of egg PC and dihexadecyl phosphate (DHDP) concentration upon the haemolysis induced by 1.4 mM sodium deoxycholate (SDC), 2 mM STDC and 0.1 mM lysophosphatidylcholine (LPC) were also established. A bile salt:egg PC mole ratio of 0.5 virtually abolished the haemolysis induced by SDC and STDC, whereas the same ratio of LPC:egg PC only reduced haemolysis from 65 to 40% (maximum haemolysis). DHDP had no effect on the haemolytic action of SDC or STDC. The salts of the fatty acids were non-haemolytic, and when mixed with STDC did not affect the level of haemolysis induced by the bile salt. In contrast, DDPC and DLaPC enhanced the haemolysis of STDC and DCPC had no effect, whereas DMPC, DPPC, DSPC, DOPC, DLPC and egg PC all reduced haemolysis. Maximum reduction was determined for DMPC and egg PC. The mixed micelle preparation temperature (either room or 60 degrees C) and temperature of incubation (either 20 degrees C for 30 min or 37 degrees C for 5 min) had only minor effects on the net haemolysis induced by STDC. These findings may be of significance in understanding the aetiology of certain gastrointestinal diseases and in determining whether mixed bile salt micelles have a role as drug penetration enhancers.

Eosinophil cationic protein and phospholipase A2 activity in human gastric juice. With emphasis on Helicobacter pylori status and effects of antacids

To elucidate possible new effects of antacids, gastric juice from 15 volunteers with known Helicobacter pylori status were analysed for eosinophil cationic protein (ECP), phospholipase A2 (PLA2) activity, phosphatidylcholine (PC), and bile acids (BA) before and after administration of one tablet of antacid or placebo in a double blind cross-over design. Geometric mean ECP concentrations were more than 13 times higher in gastric juice from H. pylori-positive (12.9 micrograms/l) than from H. pylori-negative (0.97 micrograms/l) subjects (p = 0.0032). Geometric mean PLA2 activity was 1.31 U/l for the negative subjects and 4.02 U/l for the positive subjects (p = 0.13). There were no differences between positive and negative subjects with regard to either PC or BA concentration. Regardless of H. pylori status, mean PC concentration increased significantly after antacids as compared with placebo (p = 0.024). The effect of antacids did not differ significantly from placebo for ECP, PLA2 activity, or BA concentration. Hence, antacids may not act by binding 'toxic' H. pylori-associated gastric juice components like ECP or PLA2. Increased concentration of PC may indicate an increased protective capacity induced by antacids.

Prostaglandins protect kidneys against ischemic and toxic injury by a cellular effect

The ability of prostaglandins to protect the kidney against ischemic and toxic renal injury was evaluated by in vivo and in vitro models of renal ischemia. The prostaglandin E1 analogue, misoprostol, was found to provide significant protection against ischemia-induced renal dysfunction in rats subjected to 40 minutes of renal artery occlusion. Misoprostol-treated rats had glomerular filtration rates almost threefold greater than control animals, although renal blood flow and renal vascular resistance were not significantly different. Improved tubular function was reflected in a lower fractional excretion of sodium and a higher urine-to-plasma creatinine ratio. Misoprostol also provided similar protection in a model of toxic renal injury produced by mercuric chloride. In an in vitro model employing primary cultures of proximal tubule epithelial cells subjected to hypoxia and reoxygenation, misoprostol limited cell death. Posthypoxic cells had apical membrane disruption and loss of microvilli when examined by transmission electron microscopy. These changes were not seen in misoprostol-treated cells. The "cytoprotective" effect was also produced by prostaglandin E2 and prostacyclin. The ability of prostaglandin E to protect against toxic and ischemic renal injury did not appear to be due to an antioxidant effect because misoprostol did not limit lipid peroxidation in vivo and did not protect against oxidant injury by tert-butyl hydroperoxide in vitro. Although the exact mechanism of prostaglandin protection was not revealed, these studies demonstrate that prostaglandins protect renal tubule epithelial cells from hypoxic injury at the cellular level independent of hemodynamic factors or inflammatory responses. Such a "cytoprotective" effect of prostaglandins may be a generalized phenomenon since it has also been demonstrated in gastrointestinal epithelium.

Effect of sucralfate on components of mucosal barrier produced by cultured canine epithelial cells in vitro

The mucous gel maintains a neutral microclimate at the epithelial cell surface, which may play a role in both the prevention of gastroduodenal injury and the provision of an environment essential for epithelial restitution and regeneration after injury. Enhancement of the components of the mucous barrier by sucralfate may explain its therapeutic efficacy for upper gastrointestinal tract protection, repair, and healing. We studied the effect of sucralfate and its major soluble component, sucrose octasulfate (SOS), on the synthesis and release of gastric mucin and surface active phospholipid, utilizing an isolated canine gastric mucous cells in culture. We correlated these results with the effect of the agents on mucin synthesis and secretion utilizing explants of canine fundus in vitro. Sucralfate and SOS significantly stimulated phospholipid secretion by isolated canine mucous cells in culture (123% and 112% of control, respectively). Indomethacin pretreatment significantly inhibited the effect of sucralfate, but not SOS, on the stimulation of phospholipid release. Administration of either sucralfate or SOS to the isolated canine mucous cells had no effect upon mucin synthesis or secretion using a sensitive immunoassay. Sucralfate and SOS did not stimulate mucin release in the canine explants; sucralfate significantly stimulated the synthesis of mucin, but only to 108% of that observed in untreated explants. No increase in PGE2 release was observed after sucralfate or SOS exposure to the isolated canine mucous cells. Our results suggest sucralfate affects the mucous barrier largely in a qualitative manner. No increase in mucin secretion or major effect on synthesis was noted, although a significant increase in surface active phospholipid release was observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of antiulcer drugs on phosphatidylcholine synthesis in isolated guinea pig gastric glands

To better understand phosphatidylcholine synthesis in the stomach, we isolated guinea pig gastric glands and examined their [3H]choline incorporation into phosphatidylcholine in response to either antiulcer drugs such as geranylgeranylacetone (GGA) and H2-receptor antagonists or agents that cause phosphatidylcholine synthesis in other tissues. [3H]Choline incorporation was stimulated by GGA, palmitate, and 12-O-tetradecanoylphorbol-13-acetate (TPA). Dibutyryl cyclic-AMP had no effect. By contrast with GGA, famotidine, ranitidine, and cimetidine equipotently inhibited [3H]choline incorporation into phosphatidylcholine. GGA, palmitate, and TPA increased phosphatidyl-[3H]choline and decreased phosphoryl-[3H]choline as compared with control in tissues that had been pulsed with [3H]choline. On the other hand, no more decrease in [3H]choline incorporation at chase periods was observed in pulse-labeled glands in response to each H2-receptor antagonist. The particulate fraction of glands that had been incubated with GGA or palmitate had more CTP-phosphocholine cytidylyltransferase activity than that of glands incubated without agents. A decrease in choline kinase activity was not observed in the cytosolic fraction of glands that had been incubated with cimetidine. These results suggest that GGA and palmitate stimulate phosphatidylcholine synthesis by activating cytidylyltransferase, and H2-receptor antagonists may affect phosphatidylcholine synthesis by inhibiting choline uptake in the gastric glands.

Modulation of dihydropyridine-sensitive gastric mucosal calcium channels by GM1-ganglioside

1. A dihydropyridine-sensitive calcium channel complex was solubilized from gastric mucosal cell membranes and purified by affinity chromatography on wheat germ agglutinin. 2. The calcium channel complex labeled with [3H]PN200-110, when reconstituted into phosphatidylcholine vesicles, exhibited active 45Ca2+ uptake into intravesicular space as evidenced by La3+ displacement and osmolarity studies. The channel complex responded in a dose-dependent manner to dihydropyridine calcium antagonist, PN200-110, which at 0.5 microM exerted maximal inhibitory effect of 66% in 45Ca2+ uptake. 3. The uptake of 45Ca2+ into vesicle-reconstituted gastric mucosal calcium channel complex was inhibited by GM1-ganglioside. Maximum inhibitory effect was achieved at 10-15 nM GM1, at which point a 74% decrease in 45Ca2+ uptake occurred. Furthermore, GM1 also inhibited dihydropyridine binding to gastric mucosal membranes, indicating the extracellular orientation of calcium channel domains for GM1. 4. The ability of GM1 to modulate the intracellular calcium levels may be an important feature in gastric mucosal protection by this ganglioside.

Pathogenesis of gastroduodenal injury due to nonsteroidal antiinflammatory drugs: implications for prevention and therapy

Nonsteroidal antiinflammatory drugs (NSAIDs) initiate gastroduodenal ulceration and promote complications such as bleeding and perforation by interfering with the ability of the proximal gastrointestinal tract to maintain its defensive capabilities. Mucosal defense is composed of three critical components: preepithelial, epithelial, and postepithelial. Preepithelial defense is composed of the mucous gel containing mucin, bicarbonate, and surface-active phospholipids. The epithelial component includes the surface cells, their apical tight junctions, and membrane transporters. Postepithelial defense is maintained by mucosal blood flow, which is essential for both defense and repair. NSAIDs interfere with each component of mucosal defense via direct toxic effects along with cyclooxygenase inhibition and depletion of endogenous prostaglandins. Although NSAID injury is dependent on luminal acid, attempts to prevent NSAID injury by acid suppression using H2-receptor antagonists in humans have had limited success, whereas complete inhibition of acid secretion with proton pump inhibition may have promise. Prostaglandins appear most effective for prevention of NSAID injury, sucralfate appears ineffective, and bismuth compounds have not been studied extensively. Recent evidence suggests that NSAID ulcers heal quickly with proton pump inhibitors compared with H2-receptor antagonists in patients who continue NSAID therapy.

Adrenergic and cholinergic regulation of gastric mucus phospholipid secretion

The influence of adrenergic and cholinergic agonists on phospholipid secretion in gastric mucosal cells maintained in the presence of [3H]choline was investigated. The secretion of [3H]choline phospholipids over a 30-min period averaged 1.98% of the total cellular labeled phospholipids in the absence of any mediator and was enhanced by the beta-adrenergic agonist isoproterenol to a greater extent than by the cholinergic agonist pilocarpine. A 2-fold increase in phospholipid secretion was achieved with isoproterenol, whereas pilocarpine produced a 1.3-fold increase. The stimulatory effect of isoproterenol was inhibited by alprenolol, and that of pilocarpine by atropine. The phospholipids secreted in response to isoproterenol showed a 30% decrease in lysophosphatidylcholine, whereas a 2.1-fold enrichment in this phospholipid occurred with pilocarpine. The results demonstrate the involvement of neural mediators in the regulation of phospholipid secretion in gastric mucus.

Surfactant-like material on the chemoreceptorial surface of the frog's taste organ: an ultrastructural and electron spectroscopic imaging study

Tannic acid treatment was used to study the morphology of surfactant-like material (SLM) in the taste organ of Rana esculenta and the relation between this material and the cell types of the organ. On the surface of the taste organ SLM was associated with the apical processes of wing and putative taste cells. In SLM, a biphasic pattern was visible, a portion showed a lamellar periodicity (the repeating period of lamellae approximated 45 A), and a second portion showed an homogeneous electron density. Electron spectroscopic imaging revealed the presence of phosphorus and a large amount of calcium associated with the SLM. The result of our work suggests that SLM has a role in the perireceptorial events in the gustatory transduction by concentrating calcium in specific sites of the chemoreceptorial surface.

Phospholipid- and neutral lipid-containing organelles of rat gastroduodenal mucous cells. Possible origin of the hydrophobic mucosal lining

In this study, an attempt was made to localize the cell types and subcellular organelles that synthesize and secrete surface-active lipids from the rat gastroduodenal mucosa. Two fluorescent hydrophobic probes--Nile Red and 1-anilinonaphthalene-8-sulfonic acid--and a phospholipid-selective cytochemical stain--iodoplatinate--were used for fluorescence and electron microscopic studies, respectively. The results showed the presence of phospholipid and neutral lipid fluorescent hot spots in the mucous cells of both the gastric mucosa and the submucosal Brunner's glands of the duodenum. In contrast, other cell types of the stomach (parietal, chief, and endocrine cells) or the duodenum (goblet cells and villous and crypt enterocytes) were either unreactive or weakly stained with the dyes. Ultrastructurally, two classes of large infranuclear inclusion bodies were observed in these two types of mucous cells. The location and size of these inclusion bodies appeared to be in agreement with the position and size of the large hydrophobic fluorescent hot spots detected at the light microscopic level. The ultrastructural appearance, localization, and histochemical staining pattern of these lipid-containing organelles suggest that they are specific for these cell types and not a general feature of degenerative epithelium undergoing lysosome-induced autolysis. It was concluded that the mucous cells of both the stomach and the Brunner's glands contain a subcellular organelle that stores hydrophobic material constituting both neutral lipids and phospholipids. These lipidic substances may be secreted into the gastroduodenal mucous gel and provide its surface with a nonwettable lining to repel luminal acid.

GM1 ganglioside protection against ethanol-induced gastric mucosal injury

The gastroprotective properties of GM1-ganglioside, an indigenous component of epithelial cell membrane, was investigated. The experiments were conducted with groups of rats with and without indomethacin pretreatment. The animals received intragastrically either a dose of GM1 as emulsion in 5% gum arabic or vehicle alone, followed by ethanol given at various time intervals up to 3 h after the GM1. The animals were sacrificed 30 min after the ethanol dose and their gastric mucosa subjected to macroscopic and histologic assessment, and physicochemical measurements. In the absence of GM1, ethanol caused extensive gastric hemorrhagic lesions which were significantly reduced by pretreatment with GM1 at dose as low as 70 micrograms/100 g body weight. Removal of sialic acid from GM1 led to the loss of gastroprotection. Furthermore, the effect of GM1 was not thwarted by indomethacin. The maximal protection was achieved 1 h following GM1 dose and this protective effect persisted at least 2.5 hr. The results of physicochemical measurements revealed that GM1 was capable of preventing the detrimental effect of indomethacin on the adherent mucus gel dimension, and on its content of sulfo- and sialomucins, protein, and phospholipids. The effects brought by GM1 were also accompanied by a significant (40-60%) increase in mucus gel viscosity, hydrogen ion retardation capacity (35-46%) and hydrophobicity (70-94%). The results indicate that the gastroprotective action of GM1 occurs through the enhancement of the physicochemical characteristics of the mucus layer, and does not appear to be mediated by endogenous prostaglandins.

The inhibitory effect of anti-tumor drugs on phosphatidylcholine synthesis and its reversal by geranylgeranylacetone in the isolated guinea pig gastric glands

To clarify the mechanism by which the administration of anti-tumor drugs, antibiotics or hypoglycemic agents causes gastric mucosal injury, the effects of these drugs on phosphatidylcholine synthesis in isolated guinea pig gastric glands were examined in vitro. Anti-tumor drugs such as tegafur, cyclophosphamide, and mitomycin C decreased [3H]choline incorporation into phosphatidylcholine. Furthermore, tegafur at 0.4 mg/ml decreased [3H]choline incorporation in the glands that had been pulsed with [3H]choline incorporation, suggesting that tegafur exerts its effect by inhibiting late step of phosphatidylcholine synthesis in the stomach. On the other hand, cefaclor and glibenclamide had no effect on [3H]choline incorporation. Geranylgeranylacetone, an anti-ulcer drug partially restored tegafur-induced reduction of [3H]choline incorporation into phosphatidylcholine. These results suggest that the anti-tumor drug-induced gastric mucosal injury may be due to drug-induced decrease in phosphatidylcholine synthesis, which the restoration of phosphatidylcholine synthesis by geranylgeranylacetone may explain its anti-ulcer action on drug-induced gastric mucosal lesions in vivo.

Effects of 16,16-dimethyl prostaglandin E2 on glycoprotein and lipid synthesis of gastric epithelial cells grown in a primary culture

We investigated the biosynthesis of phospholipid, neutral lipids, glycoproteins, and DNA in primary cultures of rat oxyntic mucosal cells. In addition, responses of these biosynthetic pathways to the gastric protective agent 16,16-dimethyl prostaglandin E2 (dmPGE2) were studied. Cultured gastric cells under control conditions synthesized glycoprotein in a linear manner over time. The cells responded to dmPGE2 with an increase in glycoprotein synthesis without an effect on DNA synthesis. Investigations of lipid synthesis showed that phospholipid was produced in a linear fashion by these cells, however, no effect of exogenously administered dmPGE2 on its rate of formation was discernible. In contrast, the incorporation of labeled palmitate into neutral lipids revealed that triglyceride biosynthesis was significantly increased by the addition of dmPGE2 to the culture medium, which could be further enhanced by the administration of the phosphodiesterase inhibitor, isobutyl methyl xanthine. Cyclic nucleotide involvement was further suggested by our finding that triglyceride synthesis in cultured gastric mucous cells could be increased a comparable amount by the addition of both dbcAMP and dbcGMP to the medium. The possible relationship between these biochemical alterations and the gastric protective action of dmPGE2 is discussed.

Exogenous surface-active phospholipid protects Necturus gastric mucosa against luminal acid and barrier-breaking agents

The nature of the protective action of exogenous surface-active phospholipid on gastric mucosa was studied in isolated Necturus antral mucosa by measuring intracellular pH and intraepithelial potentials and resistances with a microelectrode technique. Exposure of the antral mucosa to luminal pH 2 acidified intracellular pH in surface epithelial cells by 0.6-0.3 pH units. A 20-minute pretreatment with exogenous (pulmonary) surfactanlike phospholipid completely abolished this effect. Obviously, phospholipid protected the mucosa against intracellular acidosis by decreasing the apical cell membrane conductance to H+ (and other ions), because it increased apical cell membrane resistance by +108% and total transcellular resistance by +86% but had no significant effects on paracellular or total transepithelial resistances. In mucosas exposed to three barrier-breaking agents, 10 mmol/L acetylsalicylic acid, 20% (vol/vol) ethanol, and 10 mmol/L taurocholate, at acid luminal perfusate (pH 2.0-2.5), a profound intracellular acidification of 0.9-1.3 pH units/15 min occurred. Pretreatment of the tissue with phospholipid significantly opposed intracellular acidification, but the modulatory influences on the changes in intraepithelial potentials or resistances were less conspicuous and mostly insignificant.

Prostaglandin protects isolated guinea pig chief cells against ethanol injury via an increase in diacylglycerol

We studied cellular processes activated by prostaglandins (PG) that are involved in the protection of gastric chief cell injury estimated in terms of dye exclusion test, release of lactate dehydrogenase (LDH), or 51Cr from prelabeled chief cells. Pretreatment of chief cells with 3 x 10(-6) M PGE2 or PGE1 at 37 degrees C and pH 7.4 for 15 min maximally reduced not only ethanol- but also taurocholic acid-caused LDH release from chief cells. PGs equipotently stimulated increases in the accumulation of diacylglycerol and cyclic AMP without elevating intracellular Ca2+ concentrations in gastric chief cells. The rank order of the potency was equal to that of PGs to reduce the injury. Pretreatment of chief cells with synthetic 1-oleoyl-2-acetyl-sn-glycerol (OAG) or 12-o-tetradecanoyl phorbol 13-acetate (TPA) reduced the injury of chief cells, while 4 alpha-phorbol 12,13-didecanoate, an inactive phorbol ester, failed to reduce the injury and 1-(5-isouinolinylsulfonyl)-2-methylpiperazine (H7) blocked the protective action of PGE2. On the other hand, forskolin and dbcAMP had no effect on ethanol-caused LDH release and diacylglycerol formation in chief cells. These results suggest that PGE2 and PGE1 possess the direct protective action against ethanol- or taurocholic acid-caused injury in chief cells, presumably through the activation of the diacylglycerol/protein kinase C signaling pathway.

Phospholipids from rat, human, and canine gastric mucosa. Composition and metabolism of molecular classes of phosphatidylcholine

To validate a recent proposal that a phospholipid lining with a high content of dipalmitoylphosphatidylcholine may protect gastric mucosa against luminal acid, it was decided to study composition and metabolism of phospholipids in the gastric mucosa. Phospholipids were analyzed in rat, human, and dog gastric mucosal surface tissue and in a chloroform/methanol-lavage of rat and canine stomach. Phosphatidylcholine and phosphatidylethanolamine were the main components. Saturated fatty acids were almost exclusively esterified at the sn-1 position of the glycerol moiety of phosphatidylcholine, and unsaturated fatty acids mainly at the sn-2 position. The disaturated class of phosphatidylcholine comprised 2%-6% of total phosphatidylcholine. Precursors of phosphatidylcholine, i.e., [32P]orthophosphate and [methyl-14C]choline, were preferentially incorporated into the disaturated molecular class 0.5-6 hours after IV administration. It can be speculated that disaturated phosphatidylcholine, although quantitatively a minor component, is specifically triggered in mucosal renewal processes.

Acute effects of antacids on gastric juice components in duodenal ulcer patients

In 10 duodenal ulcer patients gastric juice was aspirated every 10 min for 20 min before and 200 min after sham feeding. One antacid tablet or placebo was given 80 min after the sham feeding. Analyses of the aspirates showed that antacids reduced mean hydrogen ion activity and pepsin concentration significantly for 40 and 60 min, respectively, and increased phospholipid concentration for 30 min, compared with placebo. Highest mean pH was 2.52. The percentage of pH readings at or above pH levels of 2, 3, and 4 during the 2 h period following antacid administration was 29, 10, and 2%, respectively. No significant differences between antacid and placebo were found regarding intragastric concentrations of bile acids and prostaglandin E2. When one antacid tablet was administered 80 min after a real meal, the effect on intragastric pH was similarly weak, but lasted slightly longer. Acid neutralization' alone can hardly explain the ulcer-healing effect of low-dose antacids. Antacid-induced increase in intragastric concentration of phospholipids is a new and potentially important observation.

Sterol-dependence of gastric protective activity of unsaturated phospholipids

The major aim of this study was to investigate the gastric protective effect of unsaturated phospholipids and to determine the ability of neutral lipids to enhance this activity. We found that although a liposomal suspension of unsaturated phosphatidylcholine (PC) administered intragastrically failed to protect rats from acid-induced gastric ulcer formation, addition of cholesterol to unsaturated PC induced a dose-dependent protective response with the maximally effective dose, reducing lesion score greater than 70%. This effect also was seen with the plant sterol, beta-sitosterol (reducing lesion score by 81.6 +/- 36%) but was blocked if cholesterol was esterified to fatty acids of varying chain length. Addition of sterols to liposomes of saturated dipalmitoylphosphatidylcholine, in contrast, attenuated the gastric protective action of the saturated PC. It appears that the protective mechanism elicited by sterols and unsaturated PC is not mediated by alterations in gastric emptying rate or prostaglandin biosynthesis, although maintenance of surface hydrophobicity may be involved. These results suggest that the sterol may promote the packing of adjacent unsaturated phospholipid molecules of either the cell membrane or a putative extracellular hydrophobic lining of the gastric epithelium to provide the mucosa with protection against luminal acid.

Enhancement in gastric mucus gel qualities with colloidal bismuth subcitrate administration

The effects of intragastric administration of an antiulcer drug, colloidal bismuth subcitrate, on the content, composition and physical properties of the mucus component of gastric mucosal barrier were investigated. The experiments were conducted with two groups of rats in which one group received twice daily for three consecutive days a dose of 100 mg/kg colloidal bismuth subcitrate, while the control group received saline. The animals were killed 16 h after the last dose, their stomachs dissected and the mucosa subjected to physicochemical measurements. The results revealed that colloidal bismuth subcitrate elicited a 49% increase in mucus gel dimension, while sulfo- and sialomucin content of the gel increased by 64 and 112%, respectively. The changes in mucus with colloidal bismuth subcitrate were accompanied by a 28% increase in H+ retardation capacity, 2.2-fold increase in viscosity, and a 26% increase in the gel hydrophobicity. The mucus elaborated in the presence of colloidal bismuth subcitrate exhibited 16% lower protein content and 68% higher content of carbohydrate than that of the control, displayed similar levels of total lipids and covalently bound fatty acids, but its phospholipid content was 32% higher. Furthermore, the mucus of the colloidal bismuth subcitrate group showed a marked increase in the proportion of the high molecular weight form of mucin. The results suggest that colloidal bismuth subcitrate is capable of the enhancement of mucus gel qualities associated with the maintenance of gastric mucosal integrity.

Gastric protective activity of mixtures of saturated polar and neutral lipids in rats

It has been shown that intragastric treatment of rats with a suspension of dipalmitoylphosphatidylcholine and tripalmitin at a 1:4 ratio (5 mg lipid/mL per rat) provided rats with highly efficaceous and consistent protection against a variety of ulcerogenic agents and conditions. The gastric protective activity of this mixture was of long duration (t 1/2 approximately 9 hours. In an attempt to understand the mechanism of protection, it was determined that the ulcerogen-induced reduction in gastric surface hydrophobicity was reversed in rats pretreated with the mixture. However, the lipid mixture did not affect the gastric emptying rate and maintained its cytoprotective activity in indomethacin-treated rats. These results indicate that the mixture's protective effect was not mediated by alterations in either gastrointestinal motility or the gastric accumulation of lipids or "cytoprotective" metabolites (prostaglandins). The mixture also appreciably reduced gastric lesion score in response to acid if one or both the lipids was substituted for a metabolically inert ether analogue, suggesting that lipid metabolism makes a negligible contribution to the protective response. Electron microscopic observation indicated that the predominent structure in the mixture is a microemulsion in which a dipalmitoylphosphatidylcholine monolayer encapsulates a tripalmitin core. Last, the improved gastric protective activity of the mixture in comparison to dipalmitoylphosphatidylcholine liposomes is discussed regarding marked differences in the physical structure of the two suspensions and the rate at which lipids in these states adsorb to a surface to enhance its hydrophobic properties.