| Histopathology of the gastric oxyntic mucosa in two different patient groups during long-term treatment with omeprazole. | |
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MedLine Citation:
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PMID: 12811309 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: Hypochlorhydria, hypergastrinaemia, inflammation and Helicobacter pylori infection, dose and duration of omeprazole treatment may separately, or in combination, influence the proliferation of enterochromaffin-like (ECL) cells and parietal cell changes in gastric mucosa. To assess the effects of these variables comparisons were carried out in patients with the acid related Zollinger-Ellison syndrome (ZES) versus patients with progressive systemic sclerosis (PSS) and gastro-oesophageal reflux disease. METHODS: Twenty-five patients with PSS and 16 patients with ZES were included and received continuous omeprazole treatment for a mean of 7.5 and 9 years. The patients were investigated every 6-12 months with endoscopy, biopsies and histology, and plasma gastrin measurements. PSS patients were titrated by 24 h pH-metry to oesophageal pH>4, and all ZES patients were titrated to a basal acid output of zero H+. RESULTS: Changes towards diffuse and linear ECL cell hyperplasia were observed in 41% of the PSS patients. Micronodular hyperplasia and neoplasia were not seen. In the ZES patients changes towards linear and micronodular hyperplasia were observed in all patients. Two patients developed ECL cell carcinoids; one of these had MEN-1 syndrome. Also parietal cell changes were more pronounced in the ZES group than in the PSS group. CONCLUSIONS: In patients without intrinsic acid hypersecretion and hypergastrinaemia significant proliferation of ECL cells is not an issue irrespective of gastric mucosal inflammation, omeprazole dose, duration of treatment and acid inhibition. The level of gastrin secretion and high plasma gastrin appear to accelerate ECL cell proliferation and parietal cell changes possibly influenced by chronic gastritis and H. pylori infection. |
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Authors:
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Esther Hage; Lene Hendel; Jens Gustafsen; Jakob Hendel |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: European journal of gastroenterology & hepatology Volume: 15 ISSN: 0954-691X ISO Abbreviation: Eur J Gastroenterol Hepatol Publication Date: 2003 Jul |
Date Detail:
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Created Date: 2003-06-17 Completed Date: 2003-10-06 Revised Date: 2009-10-16 |
Medline Journal Info:
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Nlm Unique ID: 9000874 Medline TA: Eur J Gastroenterol Hepatol Country: England |
Other Details:
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Languages: eng Pagination: 781-9 Citation Subset: IM |
Affiliation:
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Department of Pathology, Rigshospitalet, Copenhagen University Hospital, Denmark. hage@rh.dk |
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| MeSH Terms | |
Descriptor/Qualifier:
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Achlorhydria
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blood Aged Aged, 80 and over Anti-Ulcer Agents / therapeutic use* Cell Division Drug Administration Schedule Female Follow-Up Studies Gastric Mucosa / drug effects, pathology* Gastrins / blood Gastritis / pathology Humans Male Middle Aged Neurosecretory Systems / pathology Omeprazole / therapeutic use* Parietal Cells, Gastric / pathology Scleroderma, Systemic / blood, drug therapy, pathology* Zollinger-Ellison Syndrome / blood, drug therapy, pathology* |
| Chemical | |
Reg. No./Substance:
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0/Anti-Ulcer Agents; 0/Gastrins; 73590-58-6/Omeprazole |
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