Korean J Gastroenterol.  1997 May;29(5):591-600.

Oxyntic Gland Area and Density of Parietal Cells and Its Relationship to Acid Output in Helicobacter pylori Infected Duodenal Ulcer Patients

• Chung IS
• Park DH
• Choi SW
• Yang YS
• Choi MK
• Kim SS
• Chae HS
• Kim SW
• Choi JY

Abstract

BACKGROUND/AIMS: Convincing evidence now exists that Helicobacter pylori (H. pylori) has a pathogenic role in the development of active chronic gastritis and duodenal ulcer (DU). Unlike H. pylori-induced gastritis, the pathophysiology of H. pylori-induced DU is not clearly defined. It has been known that the patients with DU disease tend to secrete acid more than the controls do. To secrete acid more, the density of parietal cells should be increased and/or the oxyntic gland area of gastric mucosa should be well preserved. The present study aims to identify which of the two mechanisms is more relevant to hyperacidity in H. pylori-infected DU patients.
METHODS
we examined the acid output (basal and pentagastrin-stimulated), the oxyntic area by Congo red chromoscopy, and the number of parietal cells per unit area of the oxyntic gland in H. pylori-infected 20 DU patients and 20 non-ulcer subjects.
RESULTS
Basal acid output of DU patients was about 5-fold higher than that of controls (32.3 +/- 17.9 vs. 6.1 +/- 5.6 mmol/hr, P<0.001). The maximal acid output and peak acid output of DU patients were also approximately 3-fold higher than those of controls, respectively (59.7 +/- 29.8 vs. 18.8 +/- 18.9 mmol/hr, P=0.001; 73.9 +/- 40.1 vs. 23.7 +/- 20.6 mmol/hr, P=0.001). Fasting serum gastrin concentration was not significantly different between DU patients and controls. There was a significant difference in the width of oxyntic area between DU patients and controls (P<0.001). Eighty five percent of oxyntic area in DU patients was closed type, whereas 85 % of controls was open type. In DU patients, although the parietal cell density seemed to be higher than that of controls (579 +/- 197 vs. 477 +/- 204/mm ), the difference was not statistically significant. Peak acid output was well correlated with width of oxyntic area(r=0.568, P=0.002).
CONCLUSIONS
H. pylori-infected duodenal ulcer patients have hyperacidity owing to rather well-preserved oxyntic area than density of parietal cells.

Keyword

Acid output; Oxyntic gland area; Parietal cell density; Helicobacter pylori; Duodenal ulcer

MeSH Terms

Cell Count
Congo Red
Duodenal Ulcer*
Fasting
Gastric Mucosa
Gastrins
Gastritis
Helicobacter pylori*
Helicobacter*
Humans
Rabeprazole*
Congo Red
Gastrins