Document Detail

Histopathology of the gastric oxyntic mucosa in two different patient groups during long-term treatment with omeprazole.
MedLine Citation:
PMID:  12811309     Owner:  NLM     Status:  MEDLINE    
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.
Esther Hage; Lene Hendel; Jens Gustafsen; Jakob Hendel
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of gastroenterology & hepatology     Volume:  15     ISSN:  0954-691X     ISO Abbreviation:  Eur J Gastroenterol Hepatol     Publication Date:  2003 Jul 
Date Detail:
Created Date:  2003-06-17     Completed Date:  2003-10-06     Revised Date:  2009-10-16    
Medline Journal Info:
Nlm Unique ID:  9000874     Medline TA:  Eur J Gastroenterol Hepatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  781-9     Citation Subset:  IM    
Department of Pathology, Rigshospitalet, Copenhagen University Hospital, Denmark.
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MeSH Terms
Achlorhydria / blood
Aged, 80 and over
Anti-Ulcer Agents / therapeutic use*
Cell Division
Drug Administration Schedule
Follow-Up Studies
Gastric Mucosa / drug effects,  pathology*
Gastrins / blood
Gastritis / pathology
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*
Reg. No./Substance:
0/Anti-Ulcer Agents; 0/Gastrins; 73590-58-6/Omeprazole

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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