Improved method for mapping gastric intestinal metaplasia using selective histochemical morphometry

A gastrectomy specimen containing two tubular adenomas from a 67-year-old woman was mapped by an improved method using selective histochemical staining. The specimen was divided into 83 blocks measuring 4.0 cm x 0.5 cm. Sections from the blocks were stained with alcian blue (pH 2.5) to detect mucin. Alcian blue-stained fields were easily identified and measured with the aid of a MOP 30 interactive digital image analyzer. The total area of gastric mucosa analyzed in the 83 sections measured 3,270.9 sq mm while the area occupied by alcian blue-stained goblet cells measured 755.9 sq mm (23.1% of the total area). Intestinal metaplasia was present in 46 of 83 blocks. Both the mean size of alcian blue-positive fields per section as well as the number of alcian blue-positive fields per section were significantly larger in the antral zone I and the intermediate zone II than in the fundal zones III, IV and V. The highest proportion of gastric mucosa with intestinal metaplasia was not found around the two gastric adenomas, but elsewhere. There was no significant difference in the proportion of intestinal metaplasia between the greater and lesser curvatures, further challenging the belief that intestinal metaplasia is always greatest along the lesser curvature. The method described will permit future studies of the possible association between intestinal metaplasia and dysplasias and adenocarcinomas of the stomach.     

The Cardiogastric Gland and Alimentary Tract of Caenolestid Marsupials

The stomach of the South American marsupial family Caenolestidae has a gland on its lesser curvature around the cardia. This cardiogastric gland is bi-lobed, typically 11times5 mm and bears a distinctive, highly folded mucosa which forms sac-like invaginations. These open into the stomach lumen via 40–60 slit-like orifices. The gland mucosa contains unbranched gastric glands which are considerably longer than those of other gastric glands present elsewhere in the stomach. The cells within the cardiogastric gland show intense eosinophilic staining properties, with the parietal cells being larger than those found in other regions of the stomach, as well as being arranged in clusters. Argentaffin cells are not present in the stomach mucosa. The gross morphology of the stomach and intestine is similar to that found in small carnivorous marsupials.     

Apoptosis in Helicobacter pylori gastritis is related to cagA status

BACKGROUND: Helicobacter pylori infection increases gastric epithelial cell apoptosis; however, the influence of cagA status is still controversial. We aimed to investigate if cagA status is related to apoptosis in H. pylori gastritis at different anatomic sites of the gastric mucosa. MATERIALS AND METHODS: We studied by immunohistochemistry (streptavidin-biotin method) pro-apoptotic (Bax and Bak) and antiapoptotic (Bcl-2 and Bcl-x) proteins expression, scored from 0 to 4, in gastric biopsies, at the antrum (lesser and greater curvatures), incisura, and corpus (greater curvature) from 50 patients with H. pylori gastritis (22 males, 28 females, median age 40 years) and eight non-infected patients (6 males, median age 39.6 years). H. pylori and cagA status were determined by polymerase chain reaction. RESULTS: Apoptotic proteins were expressed in a granular pattern, in the cytoplasm of foveolar cells; Bax and Bak expression was higher than Bcl-2 and Bcl-x in most cases and was significantly higher in patients infected by cagA-positive strains than in those infected by cagA-negative strains (p = .001). Bak expression was higher at the lesser curvature (antrum and incisura) than in the other regions (p = .002) and was correlated with atrophy. Anti-apoptotic proteins were significantly more expressed at the antral lesser curvature than in the other regions of the stomach (Bcl-2: p = .02; Bcl-x: p < .001). CONCLUSIONS: Infection with cagA-positive strains is significantly associated with overexpression of pro-apoptotic proteins in the gastric mucosa, mainly at the antral lesser curvature, which may have a role on atrophy development. Anti-apoptotic proteins were also overexpressed at the lesser curvature, which may occur to keep epithelial cell turnover or might be related to malignant transformation.     

Arterial supply to the stomach of indigenous dog (Canis familiaris) in Bangladesh.

Arterial supply to the stomach of dogs indigenous to Bangladesh was investigated by using latex. The hepatic, left gastric and splenic arteries sent their major branches to the stomach. The cranial and caudal branches of the left gastric artery supplied the lesser curvature of the stomach. The right gastric, and right and left gastroepiploic arteries also sent their branches to both the lesser and greater curvatures. Six or seven short gastric arteries from the splenic artery supplied the greater curvature. Anastomoses between the left and right gastric, between the left and right gastroepiploic, and between short gastric arteries and left gastric arteries were observed.     

Quantitative determination of prostaglandin levels in human gastric mucosa--analysis by microcolumn high performance liquid chromatography with laser induced fluorescence detection

This study was designed to analyze PGs in human gastric mucosa using biopsy specimens at femtomole level by the combination of microcolumn HPLC and He/Cd laser induced fluorescence detection. Biopsy specimens were taken along the greater curvature at the corpus of the stomach, in which no gastric disease was revealed by endoscopic examination. PGs extracted from human gastric mucosa were derivatized with ADAM, and ADAM-derivatized PGs were injected into the column for analysis. The mobile phase of acetonitrile-water (73:27) containing 0.01% of phosphoric acid was used at a constant pressure of 20 kgf/cm2. Using this system, PGs in few mg of human gastric mucosa obtained by biopsy were well separated and detected; i.e., 1653 +/- 254 (femtomole/mg tissue), 279 +/- 56, 729 +/- 153, 831 +/- 199 for 6-keto-PGF1 alpha, PGF2 alpha, PGE2, and PGD2, respectively. In conclusion, the microcolumn HPLC system with laser induced fluorescence detection is a reliable method for determining individual PGs in human gastric mucosa. In addition, PGI2 is the predominant PG in human gastric mucosa and probably plays an important role in gastric function.     

Morphometric studies of parietal cells in cats before and after lesser-curvature seromyotomy

A modified, highly selective vagotomy-seromyotomy of the lesser curvature of the stomach was performed on five groups of cats. The horseradish peroxidase (HRP) tract-tracing method was used to detect the regeneration or reinnervation of vagal nerve branches. Morphological changes to the parietal cells and to the gastric mucosa were also examined by light and electron microscopy. Following surgery, the cats were sacrificed at the fourth, eighth, twelfth, sixteenth and the twentieth week. At the sixteenth week, partial regeneration of vagal nerve branches was found. Between the fourth and the twelfth week there was a significant increase in the number of parietal cells per 0.1 mm-wide of mucosa column and in the volume fraction of the mucosa made up of parietal cells. Of the four types of parietal cells, "stimulated", "partially stimulated", "returning" and "resting", the resting type was predominant after seromyotomy, especially between the fourth and the twelfth week. Based on the above observation, we concluded that the modified lesser-curvature seromyotomy depresses the function and responsiveness of the parietal cells despite an increase in their number and in their volume fraction.     

Movement of Na+ and Cl- across the isolated fetal rat stomach

Unidirectional and net isotopic fluxes of Na+ and Cl- were determined at steady state across isolated stomach of rat fetuses on days 19 and 21. On day 19, when parietal cells are not yet functional, net absorptions of Na+ and Cl- (respectively: 3.8 +/- 1.1 and 5.2 +/- 1.7 mu eq X h-1 X cm-2) were observed. By contrast, active secretion of Cl- (-2.1 +/- 1.8 mu eq X h-1 X cm-2) associated with decreased absorption of Na+ (45%) was noted on day 21, and both Na+ and Cl- net movements accounted for the short-circuit current, as observed on adult gastric mucosa. These results show that Na+ active absorption precedes Cl- secretion in fetal rat at the time of parietal cells differenciation.     

Somatostatin cells in the gastric mucosa of small ruminants. Immunohistochemical study

The distribution of somatostatin cells was investigated immunohistochemically in the epithelium of the abomasal mucous membrane of sheep and goats. Tissue samples were taken from different areas at the lesser and greater curvature of the glandular stomach. More somatostatin cells per 0.5 mm2 were found in sheep than in goats, predominantly in the pyloric gland region. In the pyloric area of both species the mucosa in the greater curvature contained more immunoreactive cells than the one in the lesser curvature. A few somatostatin cells with basal cytoplasmic processes of the 'open type' were observed over the entire abomasal mucosa.     

Immunoreactive-FSH in human normal gastric mucosa

Using indirect immuno-peroxidase staining technique, localization of immunoreactive follicle-stimulating hormone (IR-FSH) is demonstrated in the cytoplasm of the epithelial cells of normal human stomach. In view of their triangular shape and central nucleus and their predominance in the intermediate glands of the gastric mucosa, these cells are identified as parietal cells. The stromal tissue is devoid of staining reaction.     

mGluR1 in the fundic glands of rat stomach

l-glutamate not only confers cognitive discrimination for umami taste in the oral cavity, but also conveys sensory information to vagal afferent fibers in the gastric mucosa. We used RT-PCR, western blotting, and immunohistochemistry to demonstrate that mGluR1 is located in glandular stomach. Double staining revealed that mGluR1 is found at the apical membrane of chief cells and possibly in parietal cells. Moreover, a diet with 1% l-glutamate induced changes in the expression of pepsinogen C mRNA in stomach mucosa. These data suggest that mGluR1 is involved in the gastric phase regulation of protein digestion.     

Compositional changes of the muscular layers of the stomach with aging

To elucidate compositional changes of the stomach with aging, the authors investigated age-related changes of the elements and relationships among the elements in the muscular layers of the pylorus, cardia, lesser curvature, and greater curvature by inductively coupled plasma-atomic emission spectrometry. After ordinary dissection by medical students, the pylori, cardias, lesser curvatures, and greater curvatures were removed from the subjects, consisting of 19 men and 1 woman, ranging in age from 65 to 95 yr. The muscular layers were isolated and the element contents were determined.The calcium content increased progressively with aging in the muscular layers of the pylorus, cardia, and lesser curvature, whereas it tended to increase in the muscular layer of the greater curvature with aging. Regarding sulfur, the content increased significantly in the muscular layer of the pylorus with aging, but not significantly in the muscular layers of the cardia, lesser curvature, and greater curvature with aging.Regarding the relationships among the elements, significant direct correlations were found among calcium, phosphorus, sulfur, and magnesium in both the muscular layers of the pylori and cardias, with some exceptions.     

Neurochemically distinct myenteric neurone populations containing calbindin have specific distribution patterns around the circumference of the gastric corpus

We recently described calbindin immunoreactivity in the myenteric plexus of the guinea-pig stomach. To study the neurochemical coding of calbindin D28 k (CALB)-containing myenteric neurones, the presence of calretinin (CALRET), choline acetyltransferase (ChAT), enkephalin (ENK), neuropeptide Y, serotonin (5-HT), somatostatin (SOM) and substance P(SP) was investigated immunohistochemically in colchicine-treated preparations. Nitric oxide synthase-containing neurones were detected by NADPH-diaphorase histochemistry. In addition, we investigated the neurone distribution patterns around the gastric corpus. Most CALB neurones were ChAT positive. ChAT/CALB neurones were either CALRET (ca 75%) or 5-HT positive and most contained in addition SP and/or ENK. All 5-HT neurones contained CALB. CALB labelled on average 2.3, 4.8 and 7.5 neurones per ganglion at the lesser curvature, in the central region and the greater curvature, respectively, which indicated a preferential localisation at the greater curvature. Compared to the total number of myenteric neurones, the proportion of CALB neurones increased significantly from the lesser curvature (6%) towards the greater curvature (18%). This shift, although observed for most ChAT/CALB-positive populations, was most prominent for the ChAT/CALB/CALRET/SP/ENK-encoded neurones. SOM-positive and ChAT-only encoded neurones were preferentially located at the lesser curvature. The remaining ten neurochemically defined populations did not exhibit an uneven distribution. The colocalisation of CALB with CALRET or 5-HT is specific for myenteric neurones in the stomach and represents one significant difference to the neurochemical code of CALB neurones in the guinea-pig intestine. The functional significance of the unevenness of neurone distribution along the circumference of the gastric corpus remains to be studied.     

Immunofluorescence detection of gastric H+/K+-ATPase and its alterations as related to acid secretion

Parietal cells in the rat oxyntic mucosa were analyzed by the immunofluorescence pattern of the proton pump. The adult rats were grouped into fasting (C), gastrin-treated (G), and ranitidine-treated (R) groups, gastric pH was measured, and the stomach was processed for immunohistochemistry. The fluorescence of parietal cells showed a reticular, diffuse, or mixed pattern in cytoplasm. Quantitatively, 53% of the total cells showed the reticular pattern in group G (pH 1.9), 44% in group C (pH 2.0), and 0% in group R (pH 6.7). On the other hand, 7.0% of the total cells showed the diffuse pattern in group G, 11.9% in group C, and 56.2% in group R. The results indicated that the staining pattern depended on the activity of acid secretion. In addition, the proportion of parietal cells showing the reticular pattern decreased in the following order, the superficial, middle, and deep third of the mucosa, and the diffuse pattern showed the opposite trend. This suggests that the acid secretion is more active in parietal cells in the superficial part of the mucosa. The double staining with proton pump-specific and cytochrome oxidase-specific antibodies revealed the close relation between reticular fluorescence and mitochondria.     

Impaired gastric acid secretion in mice with a targeted disruption of the NHE4 Na+/H+ exchanger

The NHE4 Na+/H+ exchanger is abundantly expressed on the basolateral membrane of gastric parietal cells. To test the hypothesis that it is required for normal acid secretion, NHE4-null mutant (NHE4-/-) mice were prepared by targeted disruption of the NHE4 (Slc9a4) gene. NHE4-/- mice survived and appeared outwardly normal. Analysis of stomach contents revealed that NHE4-/- mice were hypochlorhydric. The reduction in acid secretion was similar in 18-day-old, 9-week-old, and 6-month-old mice, indicating that the hypochlorhydria phenotype did not progress over time, as was observed in mice lacking the NHE2 Na+/H+ exchanger. Histological abnormalities were observed in the gastric mucosa of 9-week-old NHE4-/- mice, including sharply reduced numbers of parietal cells, a loss of mature chief cells, increased numbers of mucous and undifferentiated cells, and an increase in the number of necrotic and apoptotic cells. NHE4-/- parietal cells exhibited limited development of canalicular membranes and a virtual absence of tubulovesicles, and some of the microvilli had centrally bundled actin. We conclude that NHE4, which may normally be coupled with the AE2 Cl-/HCO3- exchanger, is important for normal levels of gastric acid secretion, gastric epithelial cell differentiation, and development of secretory canalicular and tubulovesicular membranes.     

Localization of (3H)histamine and (3H)prostaglandin E2 receptors in isolated cells of rat gastric mucosa

Isolated cells of rat gastric mucosa were obtained by treatment of rat stomach with pronase. Two fractions were isolated, one of which was rich (up to 90%) and the second one poor (to 25%) of parietal cells. Using specific antagonists and agonists of H1- and H2-receptors of histamine (diphenhydramine, metiamide, cimetidine, impromidine, dimaprit) the H2-receptors of histamine were shown to be localized in parietal cells. A preferential binding of (3H)prostaglandin E2 by the receptor proteins of plasma membranes of non-parietal (presumably mucoid) cells was found. The data obtained indicate that rat gastric mucosa contains receptors of histamine and PGE2 which differ in their intracellular localization and strictly selectively bind (3H)histamine and (3H)PGE2. It is assumed that the starting point in the mechanism of action of these intercellular regulators on gastric secretion is probably the process of their specific recognition by the protein receptors localized in functionally different cells.     

Prostaglandin E2 output by isolated rat gastric parietal cells and non-parietal epithelial cells

Prostaglandins have acid antisecretory and cytoprotective effects in gastric mucosa when given exogenously. This study's purpose was to isolate preparations of parietal and non-parietal cells from rat stomachs and to compare prostaglandin output by these cells. Gastric epithelial cells were isolated from rat stomachs using pronase. Cells from different incubation times were collected separately and enriched by discontinuous Percoll gradient. Cell types were identified by hematoxylin and eosin stain, succinic dehydrogenase activity (parietal cells), periodic acid Schiff staining (mucous cells), Bowie staining (chief cells) and electron microscopy. Prostaglandin E2 activity was measured by radio-immunoassay. Parietal cells were purified to over 90% while the non-parietal preparation contained 67% chief cells and over 31% mucous cells. By electron-microscopy, cell integrity was seen to be maintained. The parietal cell enriched fraction contained two and one-half times the amount of prostaglandin E2 that the non-parietal chief cell enriched fraction did, p less than 0.01. These results raise the question as to whether output of PGE2 by parietal cells could play a role in modulating gastric acid secretion directly by parietal cells as well as in protecting the deeper layers of gastric mucosa against damaging agents in-vivo.     

Neuronal nitric oxide synthase: expression in rat parietal cells

Nitric oxide synthases (NOS) are enzymes that catalyze the generation of nitric oxide (NO) from L-arginine and require nicotinamide adenine dinucleotide phosphate (NADPH) as a cofactor. At least three isoforms of NOS have been identified: neuronal NOS (nNOS or NOS I), inducible NOS (iNOS or NOS II), and endothelial NOS (eNOS or NOS II). Recent studies implicate NO in the regulation of gastric acid secretion. The aim of the present study was to localize the cellular distribution and characterize the isoform of NOS present in oxyntic mucosa. Oxyntic mucosal segments from rat stomach were stained by the NADPH-diaphorase reaction and with isoform-specific NOS antibodies. The expression of NOS in isolated, highly enriched (>98%) rat parietal cells was examined by immunohistochemistry, Western blot analysis, and RT-PCR. In oxyntic mucosa, histochemical staining revealed NADPH-diaphorase and nNOS immunoreactivity in cells in the midportion of the glands, which were identified as parietal cells in hematoxylin and eosin-stained step sections. In isolated parietal cells, decisive evidence for nNOS expression was obtained by specific immunohistochemistry, Western blotting, and RT-PCR. Cloning and sequence analysis of the PCR product confirmed it to be nNOS (100% identity). Expression of nNOS in parietal cells suggests that endogenous NO, acting as an intracellular signaling molecule, may participate in the regulation of gastric acid secretion.     

Chronic injury as a major factor in susceptibility to gastric cancer

The etiology of gastric cancer is still unclear. The lesser curvature of stomach is more susceptible to chronic injury due to the anatomical characteristics. Many previous studies demonstrated that the lesser curvature is the most frequent tumor site in gastric cancer. And, precancerous gastric lesions, such as atrophic and intestinal metaplasia were also typically located in the lesser curvature. The lesser curvature is the first part of the stomach to be infected with Helicobacter pylori (H. pylori) infection which was associated with precancerous gastric lesions and gastric cancer. So, chronic injury of the stomach may lead to gastric cancer have hypothesized.