Effects of Hypochlorhydria and Hypergastrinemia on Structure and Function of Gastrointestinal Cells. A Review and Analysis

Overview

Journal Dig Dis Sci

Specialty Gastroenterology

Date 1995 Feb 1

PMID 7859584

Citations 8

Authors

J W Freston

K Borch

S J Brand

E Carlsson

W Creutzfeldt

R Hakanson

L OLBE

E Solcia

J H Walsh

M M Wolfe

Affiliations

Soon will be listed here.

Abstract

Since hypochlorhydria can induce hypergastrinemia, and gastrin has a trophic effect on some gastrointestinal cells, states that cause elevated plasma gastrin levels are of interest in terms of effects on cell growth and function. This article reviews the relationship between gastric mucosal cells during periods of acid stimulation and inhibition and analyses the effects of hypochlorhydria and hypergastrinemia on gastric and colonic cells and tumors. Hypochlorhydria releases the inhibitory effect of antral gastrin cells, inducing them to release gastrin in the presence of peptides or amino acids in the gastric lumen or in response to antral distension. Gastrin stimulates the oxyntic mucosa, which may lead to hyperplasia of enterochromaffin-like cells, resulting in enterochromaffin-like carcinoid tumors in aged rats and, rarely, in patients with chronic atrophic gastritis or gastrinomas. In addition to hypergastrinemia, other factors appear to be required for the progression of enterochromaffin-like hyperplasia to carcinoids; genetic factors may be involved. Gastrin elevations due to antisecretory drug therapy are indirectly proportional to the degree of acid inhibition and are reversible upon cessation of therapy. The gastrin levels during omeprazole therapy are similar to those caused by gastric vagotomy. Available evidence does not support a relationship between hypergastrinemia and the occurrence or growth of gastric carcinoma or colonic tumors.

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References

Chen M, Lee A, Soll A . Mitogenic response of canine fundic epithelial cells in short-term culture to transforming growth factor alpha and insulinlike growth factor I. J Clin Invest. 1991; 87(5):1716-23. PMC: 295275. DOI: 10.1172/JCI115189. View

Tatsuta M, Itoh T, Okuda S, Taniguchi H, Tamura H . Effect of prolonged administration of gastrin on experimental carcinogenesis in rat stomach induced by N-methyl-N' -nitro-N-nitrosoguanidine. Cancer Res. 1977; 37(6):1808-10. View

Lamers C, Jansen J . Role of gastrin and cholecystokinin in tumours of the gastrointestinal tract. Eur J Cancer Clin Oncol. 1988; 24(2):267-73. DOI: 10.1016/0277-5379(88)90264-7. View

Smith J, Wood J, Solomon T . Elevated gastrin levels in patients with colon cancer or adenomatous polyps. Dig Dis Sci. 1989; 34(2):171-4. DOI: 10.1007/BF01536047. View

KARNES W, Berlin R, Maxwell V, Sytnik B, Root J, Walsh J . Prolonged inhibition of acid secretion causes hypergastrinaemia without altering pH inhibition of gastrin release in humans. Aliment Pharmacol Ther. 1990; 4(5):443-56. DOI: 10.1111/j.1365-2036.1990.tb00491.x. View

Tahara E, Haizuka S . Effect of gastro-entero-pancreatic endocrine hormones on the histogenesis of gastric cancer in rats induced by N-methyl-N'-nitro-N-nitrosoguanidine; with special reference to development of scirrhous gastric cancer. Gan. 1975; 66(4):421-6. View

Tatsuta M, Yamamura H, Ichii M, Taniguchi H . Effect of prolonged administration of gastrin on experimental carcinogenesis in rat colon induced by intrarectal instillation of N-methyl-N'-nitro-N-nitrosoguanidine. Cancer Res. 1983; 43(5):2258-60. View

Borch K . Atrophic gastritis and gastric carcinoid tumours. Ann Med. 1989; 21(4):291-7. DOI: 10.3109/07853898909149210. View

Hakanson R, Bottcher G, Ekblad E, Panula P, Simonsson M, Dohlsten M . Histamine in endocrine cells in the stomach. A survey of several species using a panel of histamine antibodies. Histochemistry. 1986; 86(1):5-17. DOI: 10.1007/BF00492340. View

10.

Befrits R, Uvnas-Moberg K, Johansson C . Interactions between antral peptides and prostaglandin biosynthesis in gastric acid regulation in man. Digestion. 1990; 45(1):9-18. DOI: 10.1159/000200219. View

11.

Inomoto Y, Kinoshita Y, Nakamura A, Arima N, Yamashita Y, Nakata H . Characterization of gastrin/CCK receptors on gastric carcinoid tumor membrane of Mastomys natalensis. Regul Pept. 1993; 43(3):149-58. DOI: 10.1016/0167-0115(93)90149-3. View

12.

Havu N, Maaroos H, Sipponen P . Argyrophil cell hyperplasia associated with chronic corpus gastritis in gastric ulcer disease. Scand J Gastroenterol Suppl. 1991; 186:90-4. DOI: 10.3109/00365529109103993. View

13.

Soll A, Toomey M, Culp D, Shanahan F, BEAVEN M . Modulation of histamine release from canine fundic mucosal mast cells. Am J Physiol. 1988; 254(1 Pt 1):G40-8. DOI: 10.1152/ajpgi.1988.254.1.G40. View

14.

Caygill C, Hill M, KIRKHAM J, Northfield T . Mortality from gastric cancer following gastric surgery for peptic ulcer. Lancet. 1986; 1(8487):929-31. DOI: 10.1016/s0140-6736(86)91041-x. View

15.

Hakanson R, Bottcher G, Sundler F, Vallgren S . Activation and hyperplasia of gastrin and enterochromaffin-like cells in the stomach. Digestion. 1986; 35 Suppl 1:23-41. DOI: 10.1159/000199380. View

16.

Mitchell C, Jewell D, Lewin M, McLaughlin J, Moorhead J . Gastric function and histology in chronic renal failure. J Clin Pathol. 1979; 32(3):208-13. PMC: 1145623. DOI: 10.1136/jcp.32.3.208. View

17.

Borch K . Epidemiologic, clinicopathologic, and economic aspects of gastroscopic screening of patients with pernicious anemia. Scand J Gastroenterol. 1986; 21(1):21-30. DOI: 10.3109/00365528609034616. View

18.

Brunner G, Lamberts R, Creutzfeldt W . Efficacy and safety of omeprazole in the long-term treatment of peptic ulcer and reflux oesophagitis resistant to ranitidine. Digestion. 1990; 47 Suppl 1:64-8; discussion 76. DOI: 10.1159/000200520. View

19.

Solcia E, Bordi C, Creutzfeldt W, DAYAL Y, Dayan A, Falkmer S . Histopathological classification of nonantral gastric endocrine growths in man. Digestion. 1988; 41(4):185-200. DOI: 10.1159/000199786. View

20.

Soll A, Amirian D, Thomas L, Reedy T, Elashoff J . Gastrin receptors on isolated canine parietal cells. J Clin Invest. 1984; 73(5):1434-47. PMC: 425167. DOI: 10.1172/JCI111348. View