Gastric Cytoprotection

1. Front Matter

   Pages i-xv

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2. Cytoprotection for the Clinician

   1. Front Matter

      Pages 1-1

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   2. Cytoprotection Historical Perspective

      • André Robert

      Pages 3-12

   3. Acid Hypersecretion Important Factor or Innocent Bystander?

      • James Penston, Kenneth G. Wormsley

      Pages 13-31

   4. Pathomorphology of Gastric Mucosal Injury

      • Jerzy Stachura

      Pages 33-45

3. Defensive Mechanisms of the Stomach

   1. Front Matter

      Pages 47-47

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   2. Mechanisms of Mucosal Protection

      • Sandor Szabo

      Pages 49-73

   3. Mucus Secretion

      • Adrian Allen, Andrew C. Hunter, Anwar H. Mall

      Pages 75-90

   4. Bicarbonate Secretion and the Alkaline Microclimate

      • Christopher J. Shorrock, Wynne D. W. Rees

      Pages 91-108

   5. Epithelial Cell Renewal

      • Gregory L. Eastwood

      Pages 109-123

   6. Gastric Blood Flow and Mucosal Defense

      • Peter J. Oates

      Pages 125-165

4. Cytoprotective Therapy

   1. Front Matter

      Pages 167-167

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   2. Cytoprotective Therapy Prostaglandins

      • Donald E. Wilson

      Pages 169-186

   3. The Role of Nutrient Essential Fatty Acids in Gastric Mucosal Protection

      • Daniel Hollander, Andrzej Tarnawski

      Pages 187-195

   4. Gastroprotection by Nonprostaglandin Substances

      • Stanislaw J. Konturek, Jan W. Konturek

      Pages 197-214

5. Back Matter

   Pages 215-220

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Gastric secretions contain hydrogen ions at a concentration that is more than one million times higher than their intracellular concentration. This phenomenal gradient as well as the demonstrated ability of gastric juice to digest tissues has motivated clinicians and investigators alike to emphasize acid secretion and acid ablation in studying the pathogenesis and therapy of peptic ulcer disease. Conse­ quently, over the past 150 years, we have made considerable progress in under­ standing the mechanisms and regulation of acid secretion by the stomach. Not surprisingly, therapy for both peptic disease and mucosal injury has also been predominantly directed at either neutralizing acid or suppressing its production. During the past 10 years, attention has been focused on factors other than acid in the genesis and therapy of ulcer disease. Work done worldwide demon­ strated that acid hypersecretion is not a common event in peptic ulcer disease. Therefore, we began realizing that factors other than acid secretion may be important in the genesis of ulcer disease or in gastroduodenal mucosal damage. In addition, new physiological information has established that the gas­ troduodenal mucosa is normally protected by a complex series of events includ­ ing mucus and bicarbonate secretion, cell renewal, surface mucosal restitution, and preservation of the microvasculature and mucosal proliferative zone.

• attention
• cell
• gastrointestinal tract
• muscle
• pathogenesis
• pathophysiology
• physiology
• production
• regulation
• stomach
• stress
• therapy
• tissue
• treatment
• hepatology

• Division of Gastroenterology Department of Medicine, University of California-Irvine, Irvine, USA

  Daniel Hollander, Andrzej S. Tarnawski

• Veterans Administration Medical Center, Long Beach, USA

  Andrzej S. Tarnawski

Policies and ethics