Early ultrastructural changes in rat duodenal mucosa associated with cysteamine-induced ulcer

Cellular pathology of experimental colitis induced by trinitrobenzenesulphonic acid (TNBS): protective effects of recombinant human interleukin-11

The objective of this study was to elucidate colonic mucosal ultrastructural effects of trinitrobenzene-sulphonic acid (TNBS) with and without co-administration of recombinant human interleukin-11 (rhIL-11). Using a standard colitis model (ir alcoholic TNBS), rats were sacrificed at 3~14 days after TNBS. Co-administration of rhIL-11 (100, 300 or 1000 mug/kg sc) was given for protection, and controls received saline or alcohol ir, or rhIL-11 sc alone. Transmission electron microscopy revealed that early TNBS-induced cytopathology was primarily in absorptive cells, changes which occurred prior to goblet cell damage. Progressive cellular changes included vacuolization and increased multivesicular bodies in cell apices, disconfiguration of microvilli, enlarged Golgi apparatuses, enlargement of basal inter-cellular spaces, and eventual desquamation of epithelium and apical bursting.Organelle damage preceded surface changes and resembled ultrastructural changes reported for human ulcerative colitis. The principal effect of rhIL-11 was apparent massive release of mucus from goblet cells, filling the colonic crypts, and suggesting a mode of its protection.

Endogenous zinc concentrations in cysteamine-induced duodenal ulcers in the rat

Exogenously administered zinc compounds have been shown to possess anti-ulcer activity against a wide variety of ulcerogenic agents, both in laboratory animal models and in human peptic ulcer disease. However, a strong possibility exists that endogenous zinc may also play an important role during noxious events by various mechanisms. Therefore, the aim of this study was to focus on the changes of endogenous zinc serum and tissue concentrations in cysteamine-induced duodenal lesions. We used atomic absorption spectrophotometry to determine the tissue and serum concentrations of zinc in normal (control) rats and those with cysteamine-induced duodenal ulcers. The results obtained in this study indicated that the onset, development and spontaneous healing of ulcer lesions were associated with certain shifts in zinc serum and tissue concentrations. Prior to ulcer formation, a significant increase was noted in serum zinc values. With the onset of duodenal lesions, zinc serum concentrations significantly decreased, while there was a significant increase in duodenal tissue concentrations when compared to healthy control animals. Zinc tissue concentrations decreased and returned to starting values by the end of the first week of spontaneous healing. This decrease in zinc tissue concentration corresponded to the healing rate of the duodenal ulcers. Serum zinc concentrations also returned to starting values within the first week period. These observations indicate and confirm that zinc could play an important role in duodenal ulcer disease and represent a natural defense system in the body.

From peptic ulcer disease to NSAID gastropathy. An evolving nosology

Nonsteroidal anti-inflammatory drug (NSAID)-induced gastropathy is an important clinical entity, most commonly encountered in elderly female patients. The expanding use of NSAIDs in the elderly population has led to an increased incidence of NSAID-induced gastropathy. The risk of gastric bleeding in these patients is 7-fold higher than in the younger population. Long term NSAID therapy in the elderly is apparently associated with failure of normal gastric mucosal adaptation. Silent unidentified gastric lesions are likely to be common with long term NSAID therapy, as symptomatology does not parallel pathological progression. This gastropathy, in contrast to peptic ulcer disease, is responsive to prostaglandins and other cytoprotective agents. A new generation of prostaglandin-sparing NSAIDs (e.g. nabumetone), in addition to the older nonacetylated salicylates, may represent less gastrotoxic alternatives. Therefore, these agents may substantially reduce the risk of NSAID-induced gastropathy. The debate continues as to whether to use NSAIDs, and under which circumstances. More importantly, the cost-benefit implications and justification for concomitant therapy with gastroprotective agents cloud the picture. Currently, there is a definite consensus that NSAIDs should not be casually used on a chronic basis, especially in patients at risk for serious gastropathy complications. In all cases, where possible, gastric prostaglandin-sparing NSAIDs or nonacetylated salicylates should be used in lowest effective dosages. In special circumstances, gastroprotective co-therapy can be considered. NSAID therapy probably should not be used or continued in elderly patients with a history of bleeding ulcers or recent major gastric ulcer activity.

Role of accumulated gastric content in the pathogenesis of cysteamine- and mepirizole-induced duodenal ulcers in the rat

Subcutaneous administration of cysteamine and mepirizole (at ulcerogenic and non- or weakly ulcerogenic doses) to fasted rats induced villous damage to the duodenum within 4 h. Only the damage induced by ulcerogenic doses progressed to macroscopically visible ulcers 10-12 h later. A considerable increase in gastric content was observed for more than 6-8 h after administration of the ulcerogenic dose of agents, but normal contents were noted 12 h later. The intraduodenal pH remained low for up to 16-20 h when ulcerogenic doses were given, but returned to control levels within 8-12 h when non-ulcerogenic doses were given. Histamine similarly caused villous damage to the duodenum, yet there was no progression to an ulcer. Accumulation of gastric contents and a lower intraduodenal pH with histamine persisted for only 2 h and 1 h, respectively. We conclude that prolonged accumulation of gastric contents for up to 8 h together with a decreased lower intraduodenal pH for 16-20 h are necessary for the developmental progression of villous damage to well-defined ulcers in the presence of ulcerogens.

Gastric leiomyomas in the Japanese newt, Cynops pyrrhogaster; ultrastructural observations

Nineteen of 700 outwardly healthy captive adult Japanese newts, Cynops pyrrhogaster, had nodular neoplasms protruding on the gastric serosal surface. These tumours were characterized as sharply circumscribed leiomyomas of the muscularis externa with occasional submucosal involvement. Ultrastructural analysis of tumour myocytes revealed irregular-shaped, well-differentiated cells with cytoplasmic processes, and reduced quantities of intracellular myofibrils. They were surrounded by enlarged intercellular spaces filled with disorganized and increased amounts of collagen. Vacuolation was seen both in tumour myocytes and in mucous epithelial cells. Virus-like particles were observed in nuclei of some tumour myocytes. Interstitial cells with laminated-type granules were seen amongst tumour cells. These relatively benign leiomyomas shared some morphologic features with human gastric leiomyomas. Their cause and prognosis remain unknown.

Effect of duodenal ulcerogens cysteamine, mepirizole, and MPTP on duodenal myoelectric activity in rats

Increased gastric acid secretion, enhanced acid delivery to the duodenum, and reduced alkaline secretion in the proximal duodenum are relatively well-established pathophysiologic abnormalities in duodenal ulcer. Impaired duodenal motility, however, may also contribute to duodenal ulceration by altering the distribution of acid and alkaline secretions along the upper digestive tract. We tested the hypothesis that the duodenal ulcerogens cysteamine, MPTP, and mepirizole modify duodenal motility in the rat and that motility changes might be a common and early alteration in experimental duodenal ulceration. All three duodenal ulcerogens rapidly produced extensive changes in duodenal myoelectric activity and reduced the frequency of myoelectric slow waves. Cysteamine induced marked hypermotility for at least 6 hr; MPTP rapidly decreased motility and fragmented the myoelectric migrating pattern. Mepirizole induced biphasic changes: an early hypermotility phase of about 30 min was followed by profound hypomotility. These results indicate that marked alterations of duodenal motility are common during experimental duodenal ulceration. In light of the differential effect of the ulcerogens on duodenal motility, it remains to be determined how these changes influence acid neutralization in the proximal duodenum. Nevertheless, our results suggest that all three duodenal ulcerogens, which are different in structure, alter duodenal motility.

Aetiology of ulcers

It seems that duodenal and gastric ulcers are caused by environmental ulcerogens, which are probably infectious or chemical. The reasons for individual susceptibility to these ulcerogens have not been defined and, indeed, it is not yet certain that the effects are not essentially random. Abnormalities of function of the mucosae of the upper alimentary tract do not appear to be necessary or sufficient for the production of ulcers. The two principal clinical aspects of ulcer disease--the tendency to form chronic mucosal wounds and the tendency of the wounds to recur during many years--point to, but cannot yet be explained in terms of, failure of the processes involved in wound repair. More specifically, it is not known whether there is interference with the processes involved in normal mucosal repair or whether there is failure of the repair processes. When these problems are closer to solution, it will perhaps be possible to assess how environmental factors influence ulcerogenesis.