Gastric Cytoprotection
Kluwer Academic / Plenum Publishers (Verlag)
978-0-306-43266-8 (ISBN)
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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.
I. Cytoprotection for the Clinician.- 1 Cytoprotection: Historical Perspective.- 1. Introduction.- 2. Antiulcer Effect without Acid Inhibition.- 3. Direct Cytoprotection.- 4. Differences among Prostaglandins.- 5. Clinical Studies on Cytoprotection.- 6. Adaptive Cytoprotection.- 7. Functional Cytoprotection.- 8. Intestinal Cytoprotection.- 9. Conclusions.- Annotated Bibliography.- 2 Acid Hypersecretion: Important Factor or Innocent Bystander?.- 1. Introduction.- 2. Information Interpreted as Indicating a Connection between Gastric Juice and Duodenal Ulceration.- 2.1. Animal Studies.- 2.2. Human Studies.- 2.3. Response to Treatment.- 2.4. Relationship between Acid and Pepsin in Gastric Juice.- 3. Analysis of the Evidence for the Role of Gastric Secretion in Ulcerogenesis.- 3.1. Animal Studies.- 3.2. Human Studies.- 3.3. Response to Treatment.- 3.4. Relationship between Acid and Pepsin.- 3.5. Heterogeneity.- 3.6. Mucosal Injury.- 4. Association and Causation.- 4.1. Strength of Association.- 4.2. Consistency of Observed Association.- 4.3. Specificity of Association.- 4.4. Temporality.- 4.5. Plausibility and Coherence.- 4.6. Bias.- 4.7. Summary: Relationship between Putative Cause and Disease.- 5. Alternative Etiologic Bases for Duodenal Ulceration.- Annotated Bibliography.- 3 Pathomorphology of Gastric Mucosal Injury.- 1. Functional Morphology of the Gastric Mucosa.- 2. General Consideration of Cell Injury.- 3. Pathogenesis of Reversible and Irreversible Cell Injuries.- 3.1. Ischemia.- 3.2. FreeRadicals.- 3.3. Cellular Signaling System.- 3.4. Cytoskeleton.- 3.5. Calcium as Ultimate Cell Killer.- 4. Gastric Mucosal Injury.- 4.1. Acutelnjury.- 4.2. Chronic Mucosal Injury - Acetic Acid-Induced Ulcers.- 4.3. Stress-Induced Ulcers.- 4.4. Endogenous Prostaglandins, Thromboxanes, Leukotrienes, and Platelet Activating Factor.- 5. Pathogenesis of Gastric Mucosal Injury.- 6. Relevance to Human Pathology.- Annotated Bibliography.- II Defensive Mechanisms of the Stomach.- 4 Mechanisms of Mucosal Protection.- 1. Introduction.- 2. Anatomical Features of Gastroprotection.- 2.1. Cell and Organelle Membrane Permeability.- 2.2. Cell Migration (Restitution) and Division (Regeneration).- 2.3. Microcirculation.- 2.4. Muscle Tone.- 3. Biochemical Processes Relevant to Protection.- 3.1. Mucus and Bicarbonate Secretion.- 3.2. Hydrophobicity of Phospholipids.- 3.3. AcidSecretion.- 3.4. Fluid Flux.- 3.5. Free Radical Scavenging.- 3.6. Release and Action of Enzymes.- 3.7. Release and Action of Vasoactive Substances.- 4. Mechanisms of Action of Major Groups of Protective Agents.- 4.1. Major Chemical Groups.- 4.2. Individual Drugs.- 5. Summary.- Annotated Bibliography.- 5 Mucus Secretion.- 1. The Nature of the Gastroduodenal Mucus Barrier.- 2. Structure of Mucus and Its Mucin Components.- 3. Mucus and Protection against the Endogenous Aggressors.- 3.1. Acid.- 3.2. Pepsin.- 4. Impairment of the Mucus Barrier in Peptic Ulcer Disease.- 5. Mucus and Protection against Exogenous Damaging Agents.- 6. Mucus Secretion, Cytoprotection, Prostaglandins, and Other Antiulcer Agents.- Annotated Bibliography.- 6 Bicarbonate Secretion and the Alkaline Microclimate.- 1. Introduction.- 2. Bicarbonate Secretion.- 2.1. Historical Background.- 2.2. Measurement of Bicarbonate Secretion.- 2.3. Significance of Bicarbonate Secretion.- 2.4. Mechanisms of Bicarbonate Secretion.- 3. Regulation of Gastroduodenal Bicarbonate Secretion.- 4. Effects of Damaging and Protective Agents on the Alkaline Microclimate.- 4.1. Damaging Agents.- 4.2. Protective Agents.- 5. Importance of the Alkaline Microclimate in the Pathogenesis and Treatment of Peptic Ulcer Disease.- Annotated Bibliography.- 7 Epithelial Cell Renewal.- 1. Introduction.- 2. Epithelial Renewal in the Normal Gastrointestinal Tract.- 2.1. Process of Epithelial Renewal.- 2.2. Epithelial Renewal within the Esophagus, Stomach, and Duodenum.- 2.3. Regulation of Epithelial Renewal.- 2.4. Restitution of the Epithelium.- 3. Methods of Studying Epithelial Renewal.- 3.1. Light Microscopy.- 3.2. Radioactive Labeling of Newly Synthesized DNA with Tritiated Thymidine.- 3.3. Measurement of Substances Involved in Cell Growth.- 4. Epithelial Renewal in Disorders of the Esophagus, Stomach, and Duodenum.- 4.1. Esophagus.- 4.2. Stomach and Duodenum.- 5. Relevance of Abnormalities in Epithelial Renewal to Carcinogenesis.- 6. Conclusions: Relevance of Abnormalities in Epithelial Cell Renewal to Cytoprotection.- Annotated Bibliography.- 8 Gastric Blood Flow and Mucosal Defense.- 1. Introduction.- 2. The Gastric Vasculature.- 2.1. General Anatomical Design.- 2.2. Functional Implications.- 3. Physiological Regulation of Mucosal Blood Flow.- 3.1. Basal Flow.- 3.2. Stimulated Flow.- 4. Blood Flow and the Gastric Mucosal Barrier.- 4.1. The Mucosal Barrier.- 4.2. Nonvascular Barrier Components.- 4.3. Role of Blood Flow in Barrier Function.- 4.4. Mucosal Mast Cells.- 5. Blood Flow in Mucosal Pathophysiology.- 5.1. Acid-Dependent Lesions and Blood Flow.- 5.2. Acid-Independent Mucosal Lesions.- 5.3. The Mucosal Homeostat System: A Unifying Hypothesis.- 6. Summary and Conclusions.- Annotated Bibliography.- III. Cytoprotective Therapy.- 9 Cytoprotective Therapy: Prostaglandins.- 1. Introduction.- 2. Evidence for a Role of Prostaglandin in Cytoprotection.- 2.1. Experimental Models.- 2.2. Effects of Modifiers of Arachidonic Acid Metabolism on Mucosal Integrity.- 2.3. Effects of Exogenous Prostaglandins on Mucosal Defense Mechanisms.- 2.4. Postulated Prostaglandin-Related Defects in Duodenal Ulcer Disease.- 3. Therapeutic Effects of Prostaglandins on Acute and Chronic Mucosal Injury in Humans.- 3.1. Aspirin and NSAID-Related Injury.- 3.2. Ethanol-Related Injury.- 3.3. Peptic Ulcer Disease.- 4. Summary.- 5. Future Directions.- Annotated Bibliography.- 10 The Role of Nutrient Essential Fatty Acids in Gastric Mucosal Protection.- 1. Introduction.- 2. Dietary Precursors of Prostanoid Synthesis.- 3. Protective Activity of Dietary Essential Fatty Acids against Acute Injury.- 4. Advantages of Dietary Essential Fatty Acids over Synthetic Prostaglandins.- 5. Mucosal Protective Effect of Chronic Feeding of Dietary Essential Fatty Acids.- 6. Effect of Dietary Essential Fatty Acids on Human Gastric Mucosa.- 7. Dietary Essential Fatty Acids and the Epidemiology of Peptic Ulcer Disease.- 8. Conclusions and Future Directions.- Annotated Bibliography.- 11 Gastroprotection by Nonprostaglandin Substances.- 1. Introduction.- 2. Gastroprotection by Suppression of Release or Action of PAF, Tx, or LT in the Gastric Mucosa.- 3. Endogenous Nonprostaglandin Gastroprotective Substances: Sulfhydryls, EGF, Gastrin, Somatostatin.- 4. Antiulcer Drugs with Gastroprotective Activity: Antacids, Carbenoxolone, Solon, Sucralfate, and Colloidal Bismuth.- 5. Other Nonprostaglandin Gastroprotective Substances: Sulfhydryls, Meciadanol, Certain Inorganic Compounds, Papavarine.- 6. Concluding Remarks.- Annotated Bibliography.
| Zusatzinfo | biography |
|---|---|
| Verlagsort | Dordrecht |
| Sprache | englisch |
| Gewicht | 510 g |
| Themenwelt | Medizinische Fachgebiete ► Innere Medizin ► Gastroenterologie |
| ISBN-10 | 0-306-43266-8 / 0306432668 |
| ISBN-13 | 978-0-306-43266-8 / 9780306432668 |
| Zustand | Neuware |
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