Do We Need Gastric Acid?

Pohl, Daniel; Fox, Mark; Fried, Michael; Göke, Burkhard; Prinz, Christian; Mönnikes, Hubert; Rogler, Gerhard; Dauer, Marc; Keller, Johannes; Lippl, Florian; Schiefke, Ingolf; Seidler, Ursula; Allescher, H.D.

doi:10.1159/000142726

Cited by 34 publications

(21 citation statements)

References 324 publications

(202 reference statements)

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“…6), which also play a role in activation of the immune system during H. pylori or other bacterial infections (70). A recent report suggests that activation of these receptors by luminal agents induces histamine decarboxylase expression in the gastric corpus mucosa, which may result in increased histamine production and hence acid secretion, perhaps intended to increase the antibacterial effect of acid secretion (19,67).…”

Section: Epithelial Protection Regeneration and Innate Immune Responsementioning

confidence: 99%

Selective gene expression by rat gastric corpus epithelium

Goebel

Stengel

Lambrecht

et al. 2011

Physiological Genomics

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The gastrointestinal (GI) tract is divided into several segments that have distinct functional properties, largely absorptive. The gastric corpus is the only segment thought of as largely secretory. Microarray hybridization of the gastric corpus mucosal epithelial cells was used to compare gene expression with other segments of the columnar GI tract followed by statistical data subtraction to identify genes selectively expressed by the rat gastric corpus mucosa. This provides a means of identifying less obvious specific functions of the corpus in addition to its secretionrelated genes. For example, important properties found by this GI tract comparative transcriptome reflect the energy demand of acid secretion, a role in lipid metabolism, the large variety of resident neuroendocrine cells, responses to damaging agents and transcription factors defining differentiation of its epithelium. In terms of overlap of gastric corpus genes with the rest of the GI tract, the distal small bowel appears to express many of the gastric corpus genes in contrast to proximal small and large bowel. This differential map of gene expression by the gastric corpus epithelium will allow a more detailed description of major properties of the gastric corpus and may lead to the discovery of gastric corpus cell differentiation genes and those mis-regulated in gastric carcinomas.transcriptome; stomach THE FUNCTION OF AN ORGAN DEPENDS on the genes and protein products expressed and their regulation. Much has been learnt by classical physiological or biochemical approaches, but the complexity of biology suggests that many functions may be overlooked by conventional approaches. If a complete and specific gene expression profile were available, a more realistic understanding of a specific organ's capabilities would ensue.The gastric corpus epithelium is the most complicated region of the gastrointestinal (GI) tract in terms of secretion, endocrine function, and differentiation due to its large variety of cell types. In this article, we present the specific transcriptome of the rat gastric corpus mucosa as obtained by whole rat genome microarray hybridization compared with three other mucosal segments of the columnar GI tract (proximal and distal small bowel, and colon). This is followed by statistical data subtraction to identify genes selectively expressed by the rat gastric corpus mucosa, but not by the other segments. Genes identified with this method most likely reflect functional importance in the stomach when considered in the context of relative rather than absolute expression levels. For example, many receptors are expressed at relatively low levels but their increased expression relative to other regions of the GI tract indicates significant function in the gastric secretory epithelium. The success of this method has been previously shown during transcriptomal analysis of purified suspensions of individual cell types, such as parietal and enterochromaffin-like (ECL) cells compared with the primary mucosal digest of the gastric corpus m...

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Section: Epithelial Protection Regeneration and Innate Immune Responsementioning

confidence: 99%

Selective gene expression by rat gastric corpus epithelium

Goebel

Stengel

Lambrecht

et al. 2011

Physiological Genomics

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“…Moreover, gastric secretion might have an effect on the gastric emptying process (5). Current methods to assess gastric secretion are unsatisfactory and often unable to provide new and detailed insights into the pathophysiology of GERD (6).…”

Section: Introductionmentioning

confidence: 99%

Measuring the interaction of meal and gastric secretion: a combined quantitative magnetic resonance imaging and pharmacokinetic modeling approach

Sauter

Curcic

Menne³

et al. 2012

Neurogastroenterology Motil

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BACKGROUND: The stimulation and intragastric accumulation of gastric secretion has been recognized as an important factor in gastroesophageal reflux disease. However, the interaction of gastric secretion and meal emptying has not been fully understood. Current methods to assess gastric secretion are either invasive or unable to provide information on its volume, distribution and dynamics. The aim of this study was to quantify the interaction between meal emptying and meal induced gastric secretion by using quantitative magnetic resonance imaging (MRI) and pharmacokinetic analysis. METHODS: A chocolate test meal was developed which is secretion stimulating and MRI compatible. Meal emptying and gastric secretion were assessed in fourteen healthy volunteers using a validated quantitative MRI technique. A population based pharmacokinetic model was developed and applied to the extracted volume data, assessing the meal emptying rate, rate of secretion and their interaction. KEY RESULTS: The test meal continuously induced gastric secretion in all subjects, which partly accumulated at the meal-air interface, forming a 'secretion layer' in the proximal stomach. Traditional fitting detected a significant correlation between meal emptying rate and rate of secretion. The pharmacokinetic model quantified this interaction and estimated a 2.3 ± 1 fold higher effect of meal on secretion than vice versa. The efficacy of the emptied meal to produce gastric secretion was 61%. CONCLUSIONS 38; INFERENCES: The combined quantitative MRI and pharmacokinetic model approach allows for the quantification of gastric secretion volume and its interaction on meal emptying. The observed secretion layer might explain previous findings postulating the presence of an intragastric 'acid pocket'.

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“…The stomach is functionally characterized by motor and secretory functions, and these two functions are closely interrelated [3,4]. Motor function is generally represented by gastric emptying.…”

Section: Introductionmentioning

confidence: 99%

Effects of Proton Pump Inhibitors on Gastric Emptying: A Systematic Review

2009

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The proton pump inhibitor (PPI) is widely used for the treatment of gastroesophageal reflux disease, peptic ulcer diseases, and functional dyspepsia. The pathogenesis of these acid-related and/or functional upper gastrointestinal disorders is potentially associated with abnormal gastric emptying. To date, variable effects of PPIs on gastric emptying have been reported. Therefore, it is relevant to gather and analyze published information on this topic. A systematic literature search has been performed, showing that the delaying effect of PPIs on gastric emptying of solid meals is consistent, whereas the effect of PPIs on the emptying of liquids is inconsistent. The underlying mechanisms whereby PPIs may affect gastric emptying have been discussed, most of which still remain hypothetic. Gastric emptying of solids involves a process of peptic hydrolysis. PPIs impair the hydrolytic digestion by inhibiting acid-dependent peptic activity, thereby delaying the solid emptying. Gastric emptying of liquids largely depends on volume and energy density of intragastric contents. PPIs variably modify the volume and the energy density by reducing gastric fluid secretion, thereby modifying the liquid emptying in an unpredictable manner. Hypergastrinemia has been considered to delay gastric emptying, but it seems of minor importance in the regulation of gastric emptying during PPI use. The delayed emptying of solids due to PPI therapy may have clinical implications in the management of gastroesophageal reflux disease, functional dyspepsia, as well as diabetes.

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Do We Need Gastric Acid?

Cited by 34 publications

References 324 publications

Selective gene expression by rat gastric corpus epithelium

Selective gene expression by rat gastric corpus epithelium

Measuring the interaction of meal and gastric secretion: a combined quantitative magnetic resonance imaging and pharmacokinetic modeling approach

Effects of Proton Pump Inhibitors on Gastric Emptying: A Systematic Review

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