|Budget Amount *help
¥2,100,000 (Direct Cost : ¥2,100,000)
Fiscal Year 1993 : ¥400,000 (Direct Cost : ¥400,000)
Fiscal Year 1992 : ¥1,700,000 (Direct Cost : ¥1,700,000)
Several years ago, we established an analysis method for phospholipids in the gastric mucosa using high performance liquid chromatography (HPLC). Subsequent improvements of the method led to an quantitative analysis of phospholipids in a little tissue obtained by endoscopic biopsy. Thus, we clarified the distribution of phospholipids in the human gastric mucosa under physiological condition. Furthermore, we investigated changes in the content of phospholipids in the mucosa to reveal the relation between the background gastric mucosa and the contents of phospholipids.
In this research, we performed the endoscopic observation of the gastric mucosa upon 106 gastric disease patients including 20 cases of superficial gastritis, 30 cases of duodenal ulcer or gastroduodenal ulcer, 51 cases of gastric ulcer and 5 cases of gastric cancer. We obtained fresh tissue specimens from endoscopic biopsy of the gastric mucosa. Then, we measured phospholipids in the biopsy specimen using HLPC to investiga
te the relation between the lesion of the gastric mucosa and the quantity and distribution of phospholipids.
The value of the total phospholipids was higher in the fundic mucosa than in the pyloric mucosa, in gastritis, duodenal ulcer, gastric ulcer and gastric cancer (P<0.001). In terms of the disease, the value of the total phospholipids tended to be low in gastric ulcer and gastric cancer, compared with superficial gastritis and duodenal ulcer. This result reflects that atrophic change of the background gastric mucosa is less in superficial gastritis and duodenal ulcer, possessing fair cytoprotection, and the features of both diseases resemble each other.
In terms of the components of phospholipid, values of phosphatidylethanolamine (PE) and phosphatidylcholoine (PC) were higher than those of the others, indicating that PE and PC are closely related with cytoprotection of the gastric mucosa. Furthermore, in all the diseases the values of PE and PC were significantly higher in the fundic mucosa than in the pyloric mucosa. This fact shows that cytoprotective capacity of the mucosa is higher in the fundic gland area that is the site of hydrochloric acid secretion, compared with the pyloric gland area. In contrast, the values of phosphatidylinositol (PI) and phosphatidylseline (PS) were low in all the diseases, suggesting that these are not significant in cytoprotection of the gastric mucosa.
In patients without a H2 blocker, with healing course of ulcer, total phospholipids tended to increase in the pyloric mucosa and the fundic mucosa, but not in patients taking a H2 blocker, indicating that there is not the active strengthening of cytoprotective capacity of the mucosa by the administration of a H2 blocker.
Phospholipids in the gastric mucosa distribute much on the surface of the mucosa to form strong hydrophobic barrier there, physically taking part in the defense mechanism. Meanwhile, biochemically, phospholipids become the material of the synthesis of prostaglandin to control cytoprotection of the gastric mucosa by mucin production and improvement of microcirculation. Less