Role of energy metabolism in drug‐induced acute gastric mucosal injuries in humans

Abstract

In the NSAID group, the ATP levels and the total adenine nucleotide (TAN) levels in both the antrum and corpus were significantly lower than in the control group. In the steroid group, no significant differences were observed in either the ATP or TAN levels. The NSAID decreased energy metabolism in the entire stomach while the steroid had a negligible effect on energy metabolism.

Membrane‐bound, ATP‐dependent energy systems and tissue hypoxia in human gastric mucosa

“…We have interpreted our biochemical studies, which have been ongoing since 1967, 16 in a different way to Sasahara et al , 9 who present their findings in this issue of the Journal. When we analysed the changes in gastric mucosal ATP, ADP and Mg + ‐Na + ‐K + ‐ATPase activity in connection with gastric H + secretion, we indicated that the gastric mucosal ATP level decreased at 4 h and that it returned to normal 7 h after pyloric ligation (while gastric ulceration appeared in 7–24 h), proving that intact oxidative phosphorylation occurred in 4–7 h. Gastric H + increased gradually and peaked 7 h after pyloric ligation.…”

“…The decrease in human gastric mucosal ATP produced by NSAID treatment, compared with the effect of prednisolone, provides new data in patients with Helicobacter infection. 9 Surprisingly, in patients treated with NSAID, only gastric mucosal ATP decreased, without any changes in gastric mucosal ADP or AMP, while no changes were found in the levels of adenosine compounds treated with prednisolone. The questions to be answered are why ATP is decreased in human gastric mucosa (without any changes in the other adenosine compounds and increase of lactate) after NSAID treatment; and why aren’t changes in the other adenosine compounds found in NSAID‐treated patients after ATP breakdown?…”

“…However, the presence of tissue hypoxia in injured gastrointestinal mucosa can not be proved directly, either experimentally (under conditions other than those used by Menguy et al ) or in patients with genuine gastrointestinal ulcers. 6–15 …”

“…Of course, there are well regulated extra‐ and intercellular feedback mechanisms operating between the two ATP‐dependent energy systems in the gastric mucosa. 6–15 …”

“… 10–12 There were no measurements or arguments to suggest the impaired oxidative phosphorylation in the gastric mucosa of the above‐mentioned paper. 9 …”