Role of surface-active phospholipids in gastric cytoprotection

Participation of phosphoinositides in gastric mucosal protection by colloidal bismuth subcitrate against ethanol-induced injury

The mechanism of gastric mucosal protection by an antiulcer agent, colloidal bismuth subcitrate (CBS), against ethanol-induced injury was investigated using in vivo and in vitro systems. The experiments in vivo were conducted with groups of rats with and without indomethacin pretreatment, and the animals received either a dose of CBS (100 mg/kg) or a vehicle (saline), followed 30 min later by ethanol. In the in vitro studies, gastric mucosa segments were cultured in the presence of CBS, ethanol, or both. The results of in vivo experiments revealed that in the absence of CBS, ethanol caused extensive gastric hemorrhagic lesions which were significantly reduced following CBS pretreatment and this effect of CBS was not prevented by indomethacin. The data obtained with gastric mucosal culture established that in comparison to the controls, ethanol caused a 27% decrease in mucin synthesis, while mucin synthesis in the presence of CBS increased by 48%. The increase in mucin synthesis evoked by CBS was accompanied by the enhanced metabolism of mucosal phosphoinositides, as reflected by a decrease in PI (15%) and PIP2 (30%), and an increase in IP1 (26%) and IP3 (67%). In contrast, ethanol, which exhibited detrimental effect on mucin synthesis, caused a decrease in PIP (35%), IP2 (47%) and IP3 (38%), and an increase in PIP2 (80%), and IP1 (51%). However, when the mucosal culture was carried out in the presence of both CBS and ethanol, the detrimental changes evoked by ethanol on mucin synthesis were prevented, and the phosphoinositide and inositide phosphate distribution patterns were quite similar to those in the mucosa cultured in the presence of CBS only.(ABSTRACT TRUNCATED AT 250 WORDS)

Morphological effects of aspirin and prostaglandin on the canine gastric mucosal surface. Analysis with a phospholipid-selective cytochemical stain

An iodoplatinate technique that selectively stains phospholipid was used to evaluate morphologically the effects of aspirin and 16,16-dimethyl prostaglandin E2 on canine gastric mucosa in an in vitro Ussing chamber system. The association between these morphological alterations and the changes in mucosal surface hydrophobicity as determined by contact angle analysis was also investigated. Prostaglandin (1 microgram/ml) did not alter aspirin-induced cell injury, although it reduced (45%) the detachment of damaged cells from the lamina propria. Mucus release appeared to be stimulated independently both by aspirin and prostaglandin treatment and by the blotting and drying procedure routinely performed before contact angle analysis. When an extracellular mucus gel coat was present, it contained numerous iodoplatinate-reactive vesicles and myelinated or lamellated structures. Iodoplatinate-reactive substances also appeared at the luminal surface of the mucus gel as a filamentous band. This band of reactivity was frequently seen after simultaneous treatment with prostaglandin and aspirin but only sporadically observed after aspirin treatment alone. The hydrophobic nature of the canine gastric mucosa under the above experimental conditions correlated well (r = 0.743, p less than 0.005) with the percentage of mucosal surface covered by this filamentous band, and less so with the density of iodoplatinate-reactive structures within the mucus gel. We conclude that phospholipid structures in the mucus gel may account for the hydrophobic nature of the gastric mucosal surface and the ability of damaging and "cytoprotective" agents to influence both surface wettability and barrier integrity.

Prostaglandins in the gut and their relationship to non-steroidal anti-inflammatory drugs

Prostaglandins are long-chain, saturated, oxygenated fatty acids. Relatively large quantities of prostaglandins have been found in gut mucosa, suggesting that these substances play an important role in gastrointestinal physiology. Non-steroidal anti-inflammatory drugs (NSAIDs) cause damage to the gastric, intestinal, and colonic mucosa in experimental animals and in humans. Prostaglandins protect the gastric mucosa against injury induced by NSAIDs, and this property has been labelled cytoprotection. The mechanisms of cytoprotection have been extensively evaluated and are probably multifactorial, including effects on the gastric mucosal barrier, gastric blood flow, mucus, bicarbonate, and fluid section, ionic transport, cyclic AMP, and surface-active phospholipids. Prostaglandins may also prevent NSAID-induced injury in the small intestine and colon. The mechanisms responsible for prostaglandin protection in the lower gut against injurious agents are unknown. Further studies of the role of prostaglandins in the gut and their relationship to the effects of NSAIDs are needed. The results of these investigations may lead to a better understanding of the importance of prostaglandins in the physiology of the gastrointestinal tract, and may provide information regarding actions of NSAIDs on the functional integrity of the gastric, intestinal, and colonic mucosa.

Arachidonic acid metabolism in isolated gastric mucous and parietal cells

Arachidonic acid metabolism was studied in isolated gastric mucous and parietal cells. During a 90 min incubation, mucous cells incorporated [1-14C]arachidonic acid (4.5 mumol/l) into triacylglycerols (500 pmol/mg protein), phosphatidylcholine (520), phosphatidylethanolamine (290) and phosphatidylinositol (100). 230 pmol/mg protein was recovered as 14CO2 and 130 pmol/mg protein in the form of unidentified water-soluble metabolites. The incorporation rates were linearly related with arachidonic acid concentration up to 10 mumol/l. Neither equimolar concentrations of oleic acid, palmitic acid and linoleic acid nor prostaglandin E2 (1 mumol/l) or indomethacin (10 mumol/l) affected incorporation. During prolonged incubation incorporated arachidonic acid was transferred from triacylglycerols and phosphatidylcholine to phosphatidylethanolamine. Upon subcellular fractionation most of the incorporated arachidonic acid was found in the microsomal fraction. Compared with mucous cells, parietal cells incorporated arachidonic acid less quickly into phospholipids, but utilized it more efficiently for energy metabolism. In conclusion gastric cells show a highly dynamic metabolism of arachidonic acid which is qualitatively similar but quantitatively different between cell types.

Effect of prostaglandin F3 alpha on gastric mucosal injury by ethanol in rats: comparison with prostaglandin F2 alpha

In humans eicosapentaenoic acid can be converted to 3-series prostaglandins (PGF3 alpha, PGI3, and PGE3). Whether 3-series prostaglandins can protect the gastric mucosa from injury as effectively as their 2-series analogs is unknown. Therefore, we compared the protective effects of PGF3 alpha and PGF2 alpha against gross and microscopic gastric mucosal injury in rats. Animals received a subcutaneous injection of either PGF3 alpha or PGF2 alpha in doses ranging from 0 (vehicle) to 16.8 mumol/kg and 30 min later they received intragastric administration of 1 ml of absolute ethanol. Whether mucosal injury was assessed 60 min or 5 min after ethanol, PGF3 alpha was significantly less protective against ethanol-induced damage than PGF2 alpha. These findings indicate that the presence of a third double bond in the prostaglandin F molecule between carbons 17 and 18 markedly reduces the protective effects of this prostaglandin on the gastric mucosa.

Mechanisms of nonsteroidal anti-inflammatory drug-induced gastric damage

The effects of nonsteroidal anti-inflammatory drugs (NSAIDs) on the gastric mucosa are well documented. The complex mechanisms of gastric damage, however, are not fully understood. This review examines current knowledge about the normal function of the gastric mucosal barrier; the role of prostaglandins in cytoprotection and repair; the mechanisms by which aspirin and other weak organic acids are absorbed by the stomach; and the subsequent cascade of events--including ion trapping and back diffusion of hydrogen ions--that leads to gastric erosion and bleeding. A hypothesis describing NSAIDs' dual insult on the stomach is advanced.

Effects of 15(S)-15-methyl prostaglandin E2 methyl ester on phospholipid metabolism in rat gastric mucosa

The effects of 15(S)-15-methyl prostaglandin E2 (PGE2) methyl ester on gastric mucosal metabolism of phospholipids in intact rats and rats injured by intragastric instillation of acidified taurocholic acid were examined by using radioisotope-labeled precursors. The incorporation of palmitic, oleic and arachidonic acids into phosphatidylcholine (PC) and phosphatidylethanolamine (PE) was reduced by treatment with 15(S)-15-methyl PGE2 methyl ester in the intact rats, but the incorporation of glycerol was unaffected or affected only slightly. Instillation of acidified taurocholic acid resulted in decreased incorporation of palmitic acid and glycerol into PC and PE, whereas pretreatment with 15(S)-15-methyl PGE2 methyl ester caused the incorporations of these precursors to be maintained after acidified taurocholic acid treatment. These results suggest that 15(S)-15-methyl PGE2 methyl ester may reduce the incorporation of fatty acids into PC and PE by inhibition of the deacylation-reacylation cycle either directly or indirectly, whereas acidified taurocholic acid decreases de novo synthesis of PC and PE, and probably also the reacylation of fatty acid into phospholipids. Pretreatment with 15(S)-15-methyl PGE2 methyl ester protected the PC- and PE-synthesizing activity against the injury induced by acidified taurocholic acid, and this effect may be involved in the prevention of mucosal damage.

Delayed healing of acetic acid-induced gastric ulcers in rats by indomethacin

We examined the mechanism by which repeated administration of indomethacin significantly delays the natural healing of experimental gastric ulcers induced in rats. Gastric ulcers were produced 5 days after injecting 20% acetic acid (0.03 ml) into the submucosal layer of the gastric wall of the antral-oxyntic border. The natural healing of the acetic acid-induced ulcers was extensively delayed by administering indomethacin (1 mg/kg) subcutaneously once daily for 2 or 4 wk. Subcutaneous administration of natural prostaglandin E2 (1 or 3 mg/kg) twice daily for 2 and 4 wk, together with indomethacin, significantly prevented the delay of ulcer healing. Prostaglandin E2 (3 mg/kg) administered twice daily for 2 wk also significantly accelerated the natural healing of the ulcers. A single administration of prostaglandin E2 (1 or 3 mg/kg) significantly reduced histamine-stimulated gastric acid secretion for 4 h in acute fistula rats with 1- or 2-wk-old ulcers, treated with or without daily indomethacin (1 mg/kg). Endogenous prostaglandin E2 levels in the gastric mucosa of normal rats were significantly reduced for at least 12 h after a single or repeated administration of indomethacin (1 mg/kg) for 2 or 4 wk. Gastric mucosal prostaglandin E2 levels in rats with ulcers (5 days after acetic acid injection) were also markedly reduced by indomethacin. This reduction significantly reverted toward control levels after administration of exogenous prostaglandin E2 (3 mg/kg). These results suggest that endogenous prostaglandin E2 plays an important role in the healing process of gastric ulcers.

Disturbances in the balance between aggressive and protective factors in the gastric and duodenal mucosa

A brief description is made of agents that may damage the gastric and duodenal mucosa, and of the more important protective factors. The main protective mechanisms are the same in the two organs, but their relative contributions are different. Some bacteria are able to live on the gastric mucosa by utilizing mucosal defence mechanisms to protect themselves against acid and pepsin. Some drugs may damage the mucosa by interfering with the protective mechanisms. The non-steroidal anti-inflammatory drugs (NSAIDs) reduce the mucosal synthesis of prostaglandins, which are important protective factors.

Biological significance of phospholipids in the rat stomach--from the viewpoint of electron microscopy

The structures of gastric phospholipids (PLs) were further confirmed by employing an improved fixative and fixation method. PLs were detected on the free surface of superficial mucous epithelial cells and epithelial cells of the foveolar crypts. PLs were also detected inside superficial mucous cells and epithelial cells of the foveolar crypts. The gastric PLs were secreted through a merocrine-like mechanism. Apocrine-like secretion of PLs was also observed in some electron microscopic images. PLs were observed in the intercellular and intracellular secretory canaliculi of parietal cells and also in the rest of the parietal cytoplasm. The above findings indicated the localization of PLs on the surface of the gastric lumen and in the gastric mucosa, and suggested that, similar to gastric glycoproteins, gastric PLs play an important role in the gastric mucous barrier and mucosal barrier.

Effects of gastric distension and prostaglandin on acid ethanol-induced mucosal lesions in the rat

The effects of gastric distension on the morphology of acidified ethanol (AE) -induced mucosal lesions and on the protective action of 16,16-dm PGE2 were investigated in rats. AE (50% ethanol in 150 mM HCl) was given by gavage in the intact stomach or through a fistula prepared in the forestomach in the pylorus-ligated stomach. AE produced elongated bands of hemorrhagic necrosis within 1 hr in the former, while in the pylorus-ligated stomach the shape of lesions varied depending upon the volume of irritant. One milliliter produced bandlike lesions, whereas 2 ml or more induced widespread lesions; such volumes were observed to remove the mucosal folds. 16,16-dm PGE2 (0.3-10 micrograms/kg, subcutaneous) dose dependently reduced bandlike lesions in the intact stomach, but had no or little effect on non-band-like lesions in the pylorus-ligated stomach. This agent (10 micrograms/kg) had a slight effect on the reduction of PD caused by 10-min exposure of the stomach to AE (2 ml) in the intact stomach, while such effects were not apparent in the pylorus-ligated stomach. Oral gentian violet (2 ml, 0.3% w/v) produced bandlike staining of the mucosa in intact rats, but the effect was blocked by pyloric ligation. 16,16-dm PGE2 also significantly prevented the localized staining pattern seen in intact rats.(ABSTRACT TRUNCATED AT 250 WORDS)

Surface hydrophobicity and water transport of the toad urinary bladder: effects of vasopressin

The present study investigated whether the hydrophobic properties (wettability) of the luminal surface of the toad urinary bladder might play a role in modulating water transport across this epithelium. In the absence of vasopressin (ADH), water transport across the tissue was low, while luminal surface hydrophobicity (water contact angle) was relatively high. Following stimulation by ADH, water transport increased and surface hydrophobicity decreased. The addition of indomethacin to inhibit ADH-induced prostaglandin synthesis did not reduce these actions of ADH. In an attempt to alter water transport in this tissue, a liposomal suspension of surface-active phospholipids was administered to the luminal surface. This addition had no detectable influence on the low basal rates of water transport, but blocked the ADH-induced stimulation of water transport. We suggest that surface-active phospholipids on the toad bladder luminal membrane may contribute to the hydrophobic characteristics of this tissue. ADH may act to decrease surface hydrophobicity, facilitating the movement of water molecules across an otherwise impermeable epithelium. This surface alteration may be associated with the appearance of water channels in the apical membrane.

Encapsulation of indomethacin in liposomes provides protection against both gastric and intestinal ulceration when orally administered to rats

Encapsulation of indomethacin into egg phosphatidylcholine (EPC) monophasic vesicles (MPV) or into stable plurilamellar vesicles (SPLV) before oral administration to rats substantially reduced or eliminated the gastric and intestinal ulceration normally associated with ingestion of this drug. Ulcers were assessed by the 4-hour single-dose gastric ulceration model and the 4- or 14-day repeated-dose intestinal ulceration model, using microscopic/planimetric quantitation. Oral dosages of up to 10 mg/kg of indomethacin in polyethylene glycol-400 resulted in substantial gastric ulceration, but not when given in methylcellulose suspension or as EPCMPV. Severe intestinal ulcers resulted following oral administration of indomethacin in either vehicle at daily 3-4-mg/kg doses, but did not result from EPCMPV formulations, whether dosed for 4 days or 14 days. Oral administration of pH-sensitive indomethacin liposomes constructed from cholesterol hemisuccinate resulted in loss of the protective action. Indomethacin-MPV showed both comparable bioactivity and comparable blood levels of the drug when contrasted with free drug in vehicles. Biodistribution studies demonstrated that when delivered from liposomes, drug and phospholipid are rapidly cleared through the stomach but then are differentially absorbed. Empty EPCMPV given by mouth also offered some protection against ulcers induced by systemic (subcutaneous) introduction of indomethacin, although better protective action was noted when the drug was first liposome-encapsulated and then given orally. The application of liposomes to the development of nonsteroidal antiinflammatory drugs that have minimal gastrointestinal side effects is discussed.

Effects of taurocholic acid/HCl alone or after pretreatment with geranylgeranylacetone on phospholipid metabolism in rat gastric mucosa

Changes in phospholipid metabolism in gastric mucosa caused by instillation of taurocholic acid (TCA)/HCl (80 mM/300 mM) into the stomach of rats and the effects of pretreatment with an antiulcer agent, geranylgeranylacetone (GGA), were studied after intravenous injection of radioisotope-labeled precursors. The instillation of TCA/HCl rapidly reduced the incorporation of labeled fatty acids and glycerol into phosphatidylcholine and phosphatidylethanolamine, indicating the inhibition of de novo synthesis of phospholipids. These changes were restored by 120-150 min after the TCA/HCl treatment. Pretreatment with GGA enhanced the incorporation of precursors into phosphatidylcholine immediately after the instillation of TCA/HCl. Experiments in which the mucosal lipids were labeled with fatty acids prior to the instillation of TCA/HCl showed that the degradation of cellular lipids and release of the products into the gastric lumen were induced by TCA/HCl and that these changes were not prevented by GGA. Since GGA almost completely inhibited the gastric lesions induced by TCA/HCl, the enhancement of synthesis of mucosal phosphatidylcholine induced by GGA may be involved in the prevention of gastric damage. The incorporation of labeled fatty acids into free fatty acid fraction and diacylglycerol was increased quickly by the TCA/HCl treatment, suggesting early damage to the blood vessels of the gastric mucosa; these changes were inhibited significantly by GGA.

Gastric mucosal protection by OPC-12759, a novel antiulcer compound, in the rat

OPC-12759, 2-(4-chlorobenzoylamino)-3-[2(1H)-quinolinon-4-yl]-propionic acid, was studied for its efficacy to prevent the gastric mucosal damage induced by several necrotizing agents. Experiments were also performed to elucidate the mechanism of this mucosal protective activity. OPC-12759 dose dependently prevented the formation of mucosal necrosis induced by absolute ethanol, 0.2 N NaOH or 0.6 N HCl. PGE2 was also shown to prevent the gastric mucosal erosion induced by necrotizing agents. The mucosal protective effect of OPC-12759 was completely counteracted by pretreatment with indomethacin while that of PGE2 was not. In addition, OPC-12759 given alone increased the generation of gastric mucosal PGE2-like activity. OPC-12759 dose dependently reduced the volume, acid output and pepsin output of the gastric juice in pylorus-ligated rats. The inhibitory effect of OPC-12759 but not of cimetidine or atropine on gastric secretion was also abolished by concurrent administration of indomethacin. These findings suggest that the mucosal protective effect and antisecretory effect of OPC-12759 presumably result from enhancement of the generation of endogenous PGs.

Milk protection against experimental ulcerogenesis in rats

The antiulcer activity in pasteurized/homogenized bovine milk and a lipid extract of this milk was tested in an attempt to isolate and identify the active component. Using 0.6 N HCl as a damaging agent in pylorus-ligated rats, the protective property of milk appeared to be related to its phospholipid content and not its protein constituents. With intact (non-pylorus-ligated) rats, milk had demonstrable protective activity against 0.6 N HCl, as well as 100% ethanol and 160 mM taurocholic acid. The increasing phospholipid concentrations in skim, whole, and buttermilk paralleled their antiulcer efficacy. A lipid extract of whole milk showed significant protection against 0.6 N HCl when given alone or following indomethacin treatment. Measurements of the contact angle (hydrophobicity) of the gastric surface showed that it was maintained near control levels in the presence of 0.6 N HCl, if rats were first pretreated with milk. These results are consistent with the possibility that surface-active lipids in dairy milk, such as phospholipids, may account for a significant portion of milk's antiulcer activity by maintaining the hydrophobicity of the luminal surface of the gastric mucosa in the presence of a damaging agent.

Mucosal coating agents and other nonantisecretory agents. Are they cytoprotective?

Gastric cytoprotection is protection against gross and histological gastric mucosal injury by a mechanism other than inhibition of neutralization of gastric acid secretion. Animal studies have shown that a variety of agents afford such a protective effect. With some of these agents, a similar protective effect has been shown in man. This protective effect must be distinguished from an action that enhances healing of an already established mucosal lesion as an ulcer. It is yet to be established that the cytoprotective effect of an agent enhances ulcer healing. Agents other than prostaglandins that have been shown to possess such a cytoprotective effect in animals are reviewed. Some, such as sucralfate, act via stimulation of endogenous prostaglandin synthesis, while others, such as DeNol, neomycin, and meciadanol, do not. Investigation of the mechanism through which these agents enhance gastric mucosal defense is a fertile field for investigation.

Protective effect of exogenous phospholipid on aspirin-induced gastric mucosal injury

The protective effects of exogenous phospholipid on aspirin-induced gastric mucosal injury were examined in a canine chamber model which provided two separate segments of mucosa supplied by a single vascular pedicle. In each dog, one segment was treated with a suspension of surface-active phospholipid, similar in composition to that normally present in the gastric mucosa, whereas the other segment served as the control. Pretreatment of the test segments significantly prevented aspirin-induced disruption of the mucosal barrier as evidenced by an increase in potential difference and a decrease in acid back-diffusion and sodium ion and potassium ion flux. These findings were associated with a marked reduction in the degree of mucosal injury. Our results support the recent hypothesis that surface-active phospholipid plays an important role in gastric mucosal defense against the damaging effects to luminal acid.

Prostaglandins in clinical treatment of gastroduodenal mucosal lesions: a review

E-type prostaglandins inhibit gastric acid secretion and stimulate gastroduodenal bicarbonate and mucus secretion as well as the formation of hydrophobic surfactant-like phospholipids in the gastric epithelial cells. Furthermore, E-type prostaglandins have trophic effects on the gastro-duodenal mucosa. These effects may partly explain the unique protective effects of E-type prostaglandins against experimental damage of gastroduodenal mucosal lesions in animals and humans. E-type prostaglandins have been used in clinical trials on peptic ulcers, on upper gastrointestinal bleeding, and on mucosal lesions induced by non-steroid anti-inflammatory drugs. In nearly all trials natural prostaglandin E2 as well as the synthetic prostaglandin analogues arbaprostil, misoprostol, enprostil, rioprostil, trimoprostil, and rosaprostol accelerated the healing of peptic ulcers compared with placebo. The PGE analogues must be given in gastric acid antisecretory dosage to reach healing rates similar to those of cimetidine. The drugs seem to be safe, and diarrhoea--the main adverse effect--occurs rarely. Future studies are necessary to identify the place of prostaglandins among other drugs used in peptic ulcer treatment. In the treatment of acute upper gastrointestinal bleeding, arbaprostil was not more effective than placebo in spite of several case reports suggesting that prostaglandin E analogues would be helpful in these situations. E-type prostaglandins were effective in preventing gastroduodenal mucosal lesions caused by non-steroid anti-inflammatory drugs, but the long-term efficacy of prostaglandins has to be established in studies on patients under continuous anti-inflammatory treatment.

Gastroduodenal mucosal defence mechanisms and the action of non-steroidal anti-inflammatory agents

This review summarises gastroduodenal protective mechanisms, the actions of non-steroidal anti-inflammatory (NSAI) agents on mucus and HCO3 secretions, and the basis of gastric mucosal injury induced by acetylsalicylic and salicylic acids (ASA and SA). Resistance to autodigestion by acid and pepsin present in gastric juice is multifactorial involving pre-epithelial (mucus-bicarbonate barrier) and post-epithelial (blood flow, acid-base balance) factors in addition to properties of the surface cell layer per se. The latter includes mucosal re-epithelialisation, a property which appears particularly important with respect to recovery from acute injury. A range of NSAI agents (ASA, fenclofenac, ibuprofen and indomethacin) inhibit gastric HCO3 transport in isolated mucosal preparations. Inhibition of duodenal HCO3 transport has been demonstrated in response to indomethacin in vitro and in vivo. These effects on secretion can be antagonised by exogenous prostaglandins of the E series. The layer of secreted mucus gel overlying the epithelial surface is not affected by NSAI drugs in the short term. However a number of these agents have been shown to inhibit glycoprotein biosynthesis by the epithelial cells. Thus loss of this protective coat could be anticipated during chronic drug exposure since erosion of adherent mucus by luminal shear and proteolysis would not be compensated by continued secretion. Detailed analysis of the gastric mucosal injury induced by salicylates both in vitro and in vivo reveals that much of the damage previously attributed to ASA is in fact due to the metabolic product SA. In this respect it is concluded that mucosal injury caused by ASA is due to a combination of two factors.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of acid on the basal lamina of the rat stomach and duodenum

Rapid restitution of the gastric and intestinal epithelium after acute injury involves emigration of cells from the gastric glands and basal half of the intestinal villi. An intact basal lamina is prerequisite to the restitution process. The present study was performed to determine the effects of acid on the rat gastric and duodenal basal lamina. The basal lamina was denuded in vitro by ultrasonic vibration. The tissue was then immersed in 0.2 M mannitol (control) or in HCl (5-50 mM) for 10 min. Samples of the tissues were examined by transmission and scanning electron microscopy. Some samples were stained with ruthenium red to demonstrate glycosaminoglycans. The lower concentrations of acid (5 and 10 mM) had little or no effect on the structure of the basal lamina. However, exposure to 20 and 50 mM HCl caused extensive damage to the basal lamina and exposed the underlying connective tissue matrix of the lamina propria. Ruthenium red staining demonstrated differences in size and location of glycosaminoglycans within the basal laminae of stomach and intestine. Exposure to acid at concentrations of 20 or 50 mM caused total loss of ruthenium red staining in both intestinal and gastric basal laminae. Exposure to 10 mM acid resulted in loss of the outermost (luminal) layer of anionic sites from the gastric basal lamina. These studies demonstrate that brief exposure to acid, in concentrations which are necessary for the formation of hemorrhagic erosions in the stomach, caused damage to the basal lamina. This damage may impair epithelial restitution and thus account, in part, for the role of acid in ulcerogenesis.

Gastric antisecretory, gastric and duodenal anti-ulcer and cytoprotective properties of Ro 22-6923, a synthetic trimethyl prostanoid in rats

Ro 22-6923, a synthetic trimethyl prostanoid, has been studied for its ability to inhibit gastric secretion and to protect the gastroduodenal mucosa against the injuries caused by pyloric ligation, hypothermic restraint stress, nonsteroidal anti-inflammatory drugs (NSAIDs), reserpine, dimaprit, cysteamine and the cytodestructing agents--80% ethanol, 0.6 M HCl, 0.2 M NaOH, 25% NaCl, aspirin 30 mg in 0.35 M HCl and 100 mM sodium taurocholate in 0.2 M HCl. The results of this study demonstrate that Ro 22-6923 has both prophylactic and curative effects on various experimental models. It produces a dose dependent inhibition of the gastric mucosal damage induced by pyloric ligation, hypothermic restraint stress, NSAIDs, reserpine, dimaprit and cytodestructing agents and that of duodenal ulcers induced by cysteamine. It also produces a dose dependent healing of the acetic acid induced chronic gastric ulcers. These observations suggest that Ro 22-6923 exerts its anti-ulcer effects by its antisecretory, gastric mucosal resistance increasing and cytoprotective activities and that it may be a useful therapeutic agent for the treatment of peptic ulcer disease in humans.

Effect of teprenone on the content of phospholipids in gastric secretion in man

The phospholipid content of basal and pentagastrin-stimulated gastric secretion was measured in 9 healthy volunteers. One week oral administration of teprenone did not alter the gastric acid and pepsin secretion. The phospholipid content was increased by teprenone. Changes in subclasses of phospholipids in gastric mucus by teprenone treatment, namely, increased phosphatidylcholine and decreased lysophosphatidylcholine, were observed.

Cytoprotective effects of NC-1300 and omeprazole on Hcl . ethanol-induced gastric lesions in rats

NC-1300 (10-100 mg/kg), given p.o. at 0.5, 6, 12 or 24 hr before HCl . ethanol, dose-dependently protected the rat gastric mucosa. This protection was observed even when the gastric contents had been removed before application of HCl . ethanol. NC-1300 (30 mg/kg), given i.p., was without effect on lesion formation in a dose which potently inhibited gastric acid secretion in pylorus-ligated rats. pretreatment with indomethacin (5 mg/kg, s.c.) resulted in no reduction in the protection by NC-1300, excluding the possible participation of endogenous prostaglandins in the protective mechanism. N-ethylmaleimide pretreatment (10 mg/kg, s.c.) slightly reduced the protective activity of NC-1300, suggesting the partial participation of endogenous sulfhydryl compounds in the NC-1300 protection. NC-1300 sulfide and mercaptobenzimidazole (compounds obtained after mixing NC-1300 with acidic solution) also dose-dependently protected against HCl . ethanol-induced lesions when given p.o. at 0.5 hr before HCl . ethanol. The protection was significant but was considerably reduced in contrast to NC-1300 when the compounds were given 12 hr beforehand. NC-1300 sulfone had no effect on lesion formation. Omeprazole (10, 30 mg/kg), given p.o., also dose-dependently inhibited HCl . ethanol-induced lesions. However, the duration of protection was shorter than that seen with NC-1300, i.e., the effect disappeared 12 hr later. Thus, NC-1300 has a potent and long-lasting activity on HCl . ethanol-induced gastric lesions. The mechanism by which this occurs remains unknown.

Cytoprotective effect of 16,16' dimethyl prostaglandin E2 (dm PGE2) on streptozotocin-induced biochemical alterations of Golgi-rich membrane fraction in comparison with morphology of rat liver Golgi apparatus in situ

In 10-11 days after single, intraperitoneal injection of streptozotocin we found a lower (although not statistically significant) yield of Golgi-rich membrane fraction in comparison with control. In these rats similar to control specific activity of galactosyltransferase in nM Gal transferred per h and mg of protein, and statistically significant lower total activity of this enzyme expressed in nM Gal transferred per h and per total liver (t = 2.9666, 0.01 less than p less than 0.05) were found. Organization of Golgi apparatus in situ showed alterations that indicated suppression of secretory activity. Within the dm PGE2 protected animal group the obtained data equal control data.

Aluminium hydroxide inhibits acetylsalicylic acid-induced gastric erosions in cats with Heidenhain-pouch

The effect of Al(OH)3 was investigated on the gastric bleeding induced by acetylsalicylic acid + HCl. Cats provided with Heidenhain pouches were used. The pouch had vascular connections to the main stomach. Instillation of acidified acetylsalicylic acid into the pouch caused a marked increase in its blood content indicating the development of hemorrhagic mucosal damages. The blood loss was totally abolished by administration of Al(OH)3 into the main stomach. We, therefore, conclude that Al(OH)3 induced an enhanced release of PGE2 into the submucosa. PGE2 reached the pouch via connecting vessels originated from the main stomach. The results indicate that certain antacids induce the release of prostaglandins not only into the gastric lumen but also in the submucosa.

Physiology and pharmacology of prostaglandins

Prostaglandins (PGs) are products of polyunsaturated acid metabolism, particularly arachidonic acid (AA) released from membrane phospholipids by the action of phospholipase A2 in response to a variety of physical, chemical, and neurohormonal factors. AA is rapidly metabolized to oxygenated products by two distinct enzymatic pathways: cyclooxygenase and lipoxygenase. The intermediate cyclooxygenase products are converted to primary PGs, while the lipoxygenase products are converted to leukotrienes. The generation of various cyclooxygenase products varies from tissue to tissue. Aspirin and related antiinflammatory drugs reduce tissue biosynthesis of all cyclooxygenase products; their therapeutic effects and side effects parallel the inhibition of cyclooxygenase. Exogenous PGs exhibit a broad spectrum of effects. PGs of the E series and PGI2 are generated by the endothelium and the vessel wall to maintain the microcirculation and to counteract the vasoconstrictive and proaggregatory actions of thromboxane A2 (TXA2). Exogenous PGs of the E and I series are potent vasodilators in various vascular beds, and result in decreased systemic blood pressure and reflex stimulation of heart rate. PGEs and PGI2 increase renal blood flow and provoke diuresis and natriuresis, partly by modulating the renin-angiotensin-aldosterone system. PGFs contract the bronchial and gut muscle, while PGEs and PGI2 have opposite effects. PGEs and PGFs, but not PGI2, cause a strong contraction of the uterine muscle, hence their undesirable uterotonic effects. PGEs relax bronchial muscle, whereas PGFs cause bronchoconstriction; their imbalance may contribute to the high bronchial tone in bronchial asthma. PGs of the E and I series and TXA2 are generated by the gastrointestinal mucosa and released into the lumen upon neural or hormonal stimulation; they probably participate in the maintenance of mucosal integrity and microcirculation. Exogenous PGs of the E and I series inhibit gastric acid secretion and stimulate alkaline secretion while increasing mucosal blood flow. All PGs, including those noninhibitory for acid secretion, are cytoprotective against various ulcerogens and necrotizing agents. The classic PGs constitute only a small fraction of biologically active products of AA metabolism, and recent studies on the lipoxygenase products emphasize their biological activity and involvement in a variety of pathological conditions.

Prostaglandins and the gastrointestinal mucosa: are they important in its function, disease, or treatment?

In 1971 interest in the role of prostaglandins in the gastrointestinal tract was stimulated by the publication of two hypotheses--that aspirin damaged the gastric mucosa by inhibiting prostaglandin synthesis (1) and that cholera toxin caused diarrhea by stimulating it (2). Subsequent research into the gastrointestinal actions of prostaglandins has been considerable and now impinges on clinical practice. This paper reviews the involvement of prostaglandins and related compounds in mucosal protection, in ulcer healing, in diarrhea, and in gastrointestinal inflammation, with particular reference to the growing body of human data.

The gastric mucosal barrier. Component control

The 'gastric mucosal barrier' is a descriptive term for the ability of the gastric epithelium to hold a large (10(5)) H+ concentration gradient from lumen to mucosa under physiological conditions. Compounds which classically have been used to describe the functional integrity of the 'barrier', in addition to very low H+ diffusion from lumen to mucosa, include low diffusion of Na+ and K+ from mucosa to lumen and maintenance of a lumen-negative transmucosal potential difference (PD). Na+ appearance in the luminal fluid is a function of active transport and diffusion. Fixed charges within diffusion channels with pK values greater than or equal to 9, may contribute to maintenance of H+ gradients. Luminal application of aspirin, bile salts, and ethanol increases net cationic flux and reduces PD. When acidified, these luminal agents produce histological and visible damage, yet damage can be produced by parenteral agents without concomitant change in these components. Although no anatomical 'barrier' has been described, it has been suggested that the gel mucus and epithelial phospholipids are constituents. Exogenous administration of a variety of prostanoids attenuate the change in cationic flux and PD produced by those agents in both animals and humans. The role of endogenous prostaglandins in barrier integrity has been questioned since it has been shown that salicylic acid produces permeability changes which are equal to aspirin, yet the former does not inhibit cyclooxygenase while the latter does. The gastric mucosal barrier is physiologically important because, by whatever mechanism, H+ back-diffusion is kept to a minimum under physiological conditions.

Improvement of the gastric tolerance of non-steroidal anti-inflammatory drugs by polyene phosphatidylcholine (Phospholipon 100)

The effect of co-administration with polyene phosphatidylcholine (Phospholipon 100) on the oral gastrotoxicity of various non-steroidal anti-inflammatory drugs (NSAIDs) was studied in the rat. The highly unsaturated phospholipid reduced gastric mucosal lesions measured 3.5 h after oral administration of aspirin, indomethacin, phenylbutazone, diclofenac, piroxicam and sudoxicam to rats which had received a 3 day bread diet followed by 24 h fasting. The extent of reduction of gastrotoxicity varied amongst the individual NSAIDs. Phospholipon 100 also reduced gastric lesions induced by 3 day oral piroxicam and diclofenac administration. A trend towards reduction of oral diclofenac gastrotoxicity was observed following intravenous Phospholipon 100 administration. Phospholipon 100 H (100% saturated phosphatidylcholine) was less effective than Phospholipon 100 in improving acute gastric tolerance to oral phenylbutazone, diclofenac and piroxicam. Administration of the NSAID-Phospholipon 100 combination produced little change in the anti-inflammatory activities of diclofenac on carrageenan paw oedema and diclofenac and piroxicam on adjuvant arthritis in the rat. Combination with Phospholipon 100 offers a novel means for reducing the gastric side-effects of NSAID therapy.

Gastric mucosal protection by spizofurone

The protective effect of spizofurone (AG-629) on the rat gastric mucosa was studied in the presence of various stimuli. Spizofurone given orally markedly inhibited gastric lesions induced by ethanol (ED50 = 6.5 mg/kg). Spizofurone inhibited ethanol-induced gastric lesions even when administered intraperitoneally (i.p.), but the onset of action after oral administration was shorter. Spizofurone given orally or i.p. in a dose range of 25-200 mg/kg inhibited indomethacin-induced gastric antral ulcers in re-fed rats. Furthermore, spizofurone potentiated the inhibitory effect of prostaglandin E2 on indomethacin-induced gastric antral ulcers. Spizofurone given i.p. prevented a decrease in potential difference and the formation of gastric lesions induced by intragastric instillation of 30 mM aspirin in 0.1 N HCl. Spizofurone given i.p. inhibited the increase in net fluxes of H+ and Na+ caused by intragastric instillation of 15% ethanol in 0.1 N HCl. These findings indicate that spizofurone, like prostaglandin E2, exerts gastric mucosal protection and even potentiates the anti-ulcer effect of prostaglandin E2. The gastric mucosal protection by spizofurone is ascribed in part to preservation of the mucosal barrier.

A quantitative method for assessing the extent of experimental gastric erosions and ulcers

Evaluation of acute gastric erosions and ulcers induced by chemicals such as ethanol or aspirin is difficult because these lesions are predominantly multiple and irregularly shaped. A commercially available, relatively inexpensive microprocessor-linked planimeter (Micro-Plan II) with a stereomicroscope was used to measure the area of gastric mucosa damaged following intragastric administration of various doses of ethanol or aspirin. An enlarged image of rat glandular stomach was projected from the stereomicroscope onto a planimeter on which the perimeter of the entire glandular stomach and each lesion was traced with an electronic cursor. An attached printer recorded the area of stomach assessed, the number of lesions, the surface area of each lesion and the total area of mucosal damage. The technique was compared with semiquantitative methods used previously to assess experimentally induced gastric mucosal damage. The quantitative morphometric method was sufficiently sensitive to demonstrate a dose-response effect of ethanol and aspirin. The stereomicroscope--planimeter combination provides a sensitive method to quantitate either a few small, or numerous large, regularly or irregularly shaped hemorrhagic and nonhemorrhagic gastric mucosal lesions.

Cytoprotection by prostaglandin occurs in spite of penetration of absolute ethanol into the gastric mucosa

Several prostaglandins are cytoprotective for the stomach; they prevent mucosal necrosis and hemorrhages produced by noxious agents, such as absolute ethanol. One possible mechanism of cytoprotection would be that the prostaglandin may prevent penetration of the necrotizing agent into the gastric mucosa. To test this hypothesis, 2 ml of 100% ethanol containing tracer amounts of 14C at carbon 1 was given orally to rats, after ligating the pylorus. [14C]Ethanol was measured in the gastric mucosa and in plasma from 2.5 to 60 min after ethanol administration. 16,16-Dimethyl prostaglandin E2 was given orally at a cytoprotective dose (10 micrograms/kg) 15 min before 100% ethanol. The level of [14C]ethanol (disintegrations per minute per gram of tissue) in the gastric mucosa of 16,16-dimethyl prostaglandin E2-treated animals were not different from those of control animals. The plasma levels were slightly lower during the first 10 min, but the area under the curve for the entire 60 min was the same in both groups. We conclude that (a) 16,16-dimethyl prostaglandin E2 does not prevent entry of ethanol into the gastric mucosa; (b) 16,16-dimethyl prostaglandin E2 protects the cells located deep in the gastric mucosa from necrosis, in spite of the fact that these cells are in contact with as much ethanol as cells of untreated animals; (c) gastric cytoprotection is probably due to a defense mechanism at the cellular level. These findings minimize the importance of luminal factors, such as an increase in mucus or bicarbonate, in the mechanism of cytoprotection.

Effect of 16,16-dimethyl prostaglandin E2 on the surface hydrophobicity of aspirin-treated canine gastric mucosa

The canine gastric mucosa has a uniquely hydrophobic or nonwettable surface that is rapidly disrupted by damaging agents such as aspirin. In this study we investigated the effects of acidified aspirin on the wettability of the luminal surface of gastric mucosae mounted in Ussing chambers in the presence of varying concentrations of 16,16-dimethyl prostaglandin E2. It was determined that surface hydrophobicity of the stomach, as measured by contact angle measurements, could be reduced by 50% with an aspirin concentration of 5 mM in the mucosal bath and that this change could be completely and significantly reversed by the addition of 16,16-dimethyl prostaglandin E2 (1 microgram/ml) to the nutrient compartment. 16,16-Dimethyl prostaglandin E2 at this dose was less effective in restoring the surface hydrophobicity in response to a higher concentration of aspirin (20 mM) that abolished the nonwettable property of the tissue. The reduced surface hydrophobicity in the presence of 5 mM aspirin could be increased in a dose response relationship to the nutrient 16,16-dimethyl prostaglandin E2 concentration, with an effect being seen at doses as low as 1 ng/ml. These results support the concept that prostaglandins may protect the stomach by the maintenance of a nonwettable hydrophobic lining between damaging agents in the lumen and the gastric epithelium.

Failure of exogenous prostaglandin to afford complete protection against acetaminophen-induced hepatotoxicity in the rat

The protective effect of 16, 16-dimethylprostaglandin E2 (dm-PGE2) against acetaminophen-induced hepatotoxicity was determined in the rat. The dm-PGE2 was administered at two dose levels both before and after acetaminophen administration. The hepatotoxicity was evaluated by a rise in serum transaminases 24 h after acetaminophen administration and by histological examination of liver preparations. The urinary acetaminophen and its metabolites were determined by high-pressure liquid chromatography. The results suggest that exogenous dm-PGE2 administration had a modest protection against acetaminophen-induced hepatotoxicity, in contrast to its well established cytoprotective effect against many noxious agents in the gastrointestinal tract. Prostaglandin treatment had little effect on acetaminophen metabolites excretion in the urine, suggesting that it did not affect the cytochrome P-450-dependent mixed-function oxidase drug-metabolizing enzyme system. The livers from dm-PGE2-acetaminophen-treated rats showed less advanced necrosis compared to those from saline-acetaminophen-treated rats. Whereas only 2 of 13 rats died in the prostaglandin-treated group, 4 of 13 rats died in the saline-treated group.

Interfacial properties of hydrophilic surfaces of phospholipid films as determined by the method of contact angles. Comparison with cell surfaces

Hydrophilic films of phospholipids were deposited onto plastic substrates (surface-treated for cell cultures) and shown to adhere sufficiently for measuring their interfacial properties by the method of contact angles. Both by absolute magnitude and by their dependence on temperature, the interfacial properties of these phospholipid films were indistinguishable from those determined for black lipid bilayer membranes with a different method by other authors. According to both their vesicular micromorphology and water permeability, the surface films can be interpreted to consist essentially of multibilayer vesicles with the hydrophilic groups facing outward. Treatment of these films with cell-culture medium containing calf serum results in changes of interfacial properties that are very similar to those effected on virus-transformed 3T3 cells (earlier work). These interfacial effects may be attributed essentially to serum proteins (such as albumin) adsorbing to phospholipid or cellular surfaces. The interfacial properties of nontransformed 3T3 cells are much less affected by serum treatment (earlier work), which correlates closely with their higher serum requirement for proliferation. Comparison of these results with those on the interfacial effects of serum on phospholipid films suggests that at least part of the proliferation-stimulating effect of serum is mediated by changes of interfacial properties of cell membranes upon adsorption of serum proteins such as albumin. Treatment of phospholipid films with concanavalin A, an inhibitor of cell proliferation, does not result in effects on their interfacial properties correlating with those on cellular membranes. This confirms previous suggestions that the latter depends on specific binding of concanavalin A to specific carbohydrates on the cell membrane.

Maternal recognition of pregnancy in cattle

Nature and potential functions of chemical signals involved in the process of pregnancy recognition in cattle are discussed. The array of prostaglandins, steroid metabolites, and proteins produced by the conceptus and endometrium are described and collated with histological and physiological responses of the uterus and ovary that lead toward maintenance of the corpus luteum. Advances during the last 10 yr partially have identified the conceptus-endometrial-ovarian signal sequence that is associated with maternal recognition of pregnancy in cattle. Final evaluation of the control system should permit investigators to improve embryo survival and augment further the impact of embryo manipulation to improve genetic merit of the cattle population.

Proton nuclear magnetic resonance spectroscopy of isolated rabbit fundic glands

1H-nuclear magnetic resonance spectroscopy (NMR) was adapted to isolated rabbit fundic glands and identification made of compounds responsible for several observed spectral resonances. A minimum gland concentration of 0.5 mg dry weight or 5 mg wet weight per 0.5 ml was needed for adequate signal-to-noise ratio. At physiological temperature and pH, the glands demonstrated reproducible spectra, stability for accumulation times greater than 30 min and responsiveness to histamine stimulation, as measured by oxygen consumption and aminopyrine uptake. The relatively anaerobic conditions favored use of proton compared to phosphorus NMR, since 1H-NMR allowed significantly shorter spectral accumulation times and therefore did not compromise glandular viability to the same extent as 31P-NMR. The most conspicuous resonance in the gland spectrum was assigned to the -N+(CH3)3 protons of choline and related compounds. In membrane-free lysates, several components of the signal were resolvable and assigned to choline, phosphatidylcholine, phosphocholine and L-alpha-glycerophosphocholine. Thin-layer chromatography verified that phosphatidylcholine and phosphatidylethanolamine were the major phospholipids present in gland lipid. Presumably, they represent the source of the surface-active phospholipids present in gastric juice, which may play a role in gastric cytoprotection.

A functional model for extracellular gastric mucus in the rat

There is no morphologically detectable, continuous layer of extracellular mucus over the undamaged gastric mucosa of the rat. Instead, the mucosa is only partially covered by an interconnected network of mucous strands and sheets. This mucus is strongly acidic (sulphated) and is released by epithelial cells which line the isthmic and lower foveolar regions of the gastric glands of the fundus. A thick layer of gelatinous mucus is, however, released within 5 min after topical application of ulcerogenic agents. This mucus is released as a result of exfoliation and disintegration of interfoveolar surface epithelial cells. The released mucous glycoprotein is neutral or weakly acidic and is readily distinguished from the fibrous mucus produced by the epithelial cells which line the upper regions of the gastric glands. The preexisting network of acidic, fibrous mucus is retained at the luminal surface of the mucous cap which is produced over sites of damage. The layer of fibrous mucus is reinforced during the development of mucosal damage by accelerated release of mucous strands from the gastric glands. We propose that the fibrous mucus acts as an external, restraining layer to maintain the locally released, gelatinous mucus over sites of damage during a period in which epithelial continuity is restored by emigration of cells from the gastric glands.