Future Trends in the Management of Peptic Ulcer Disease

Therapy for Unhealed Gastrocutaneous Fistulas in Rats as a Model for Analogous Healing of Persistent Skin Wounds and Persistent Gastric Ulcers: Stable Gastric Pentadecapeptide BPC 157, Atropine, Ranitidine, and Omeprazole

“…Immediately after the sacrifice at postoperative days 1, 2, 3, 7, 14, and 21, the skin and stomach defects were assessed as described before [2,3,[5][6][7][8][9][15][16][17][18]. Briefly, a precise caliper was used to verify the final size of the defect and the largest diameter of the skin or stomach defect was assessed (mm), photographed, and further verified using the program ISSA (VAMSTEC Software Company, Zagreb, Croatia), and the tissue processed for further microscopic analysis.…”

“…Of note, with the fistulas therapy defined in this way, we also challenge the wound [5]/growth factors (for a review see, e.g., [6,17]) theory of the analogous nonhealing of wounds and persistent gastric ulcers. As an anti-ulcer peptide [8][9][10][11][12][13][14][15][16], BPC 157 is stable in human gastric juice [18], safe in trials for inflammatory bowel disease (PL 14736, Pliva) [19][20][21], and has also been shown to improve wound healing [22][23][24][25][26][27][28].…”

“…Namely, the healing capacity of the standard antiulcer agents for cutaneous wounds based on their beneficial effect on gastric ulcers remains largely undetermined. Their healing capacity for cutaneous wounds is still an enigma, despite the common belief and theory [5] that standard drugs that have been reported to promote the healing of gastric ulcers [5,6] should equally affect cutaneous wounds. In fact, the discordant effects of standard anti-ulcer agents on skin wound healing recently cast doubt on whether they could also be used as a therapy for skin healing [29].…”

“…Also, we focused on unhealed gastrocutaneous fistulas to resolve whether standard drugs that promote healing of gastric ulcers (for a review see, e.g., [5,6]) may at the same time exhibit an equal effect on cutaneous wounds, under corticosteroid aggravation [7]. We will also demonstrate why peptides such as stable gastric pentadecapeptide BPC 157 [8][9][10][11][12][13][14][15][16] can have a greater healing effect.…”

Intracellular Signalling and Regulation of Gastric Acid Secretion

“…The development of specific histamine H2 receptor antagonists such as cimetidine and ranitidine has led to a revolution in the treatment of peptic ulcer disease. These drugs can heal approximately 80% of duodenal and gastric ulcers in 4-6 weeks, and can also be used as maintenance therapy to prevent relapse (Misiewicz, 1988). Virtually all of the characterization of the histamine H2 receptor on parietal cells has involved measurement of cellular responses such as increased oxygen consumption or aminopyrine accumulation.…”