Alterations in the cytological composition of the juxta-scar villous mucosa after ulcer therapy with sucralfate or cimetidine.
A comparative light-microscopic morphometric analysis of non-metaplastic mucosa obtained from the pretreatment juxta-duodenal ulcer (DU) villous mucosa of 10 patients and from the first part of the duodenum of 5 normal volunteers revealed a significant increase (P less than 0.01) in the number of goblet cells (GCs) per 100 microns of villous mucosa (GC/100 microns). Such an increase was thought to represent a mucoprotective response by the mucosa to the corrosive lumenal factors that may cause or maintain ulceration. A similar morphometric analysis was performed on the endoscopically healed juxta-scar villous mucosa of 11 patients successfully treated for 6 weeks with sucralfate (5 patients) or cimetidine (6 patients). After treatment with cimetidine, GC/100 microns was reduced to near-normal levels, whereas after sucralfate therapy it was significantly raised (P less than 0.05). The difference in GC/100 microns after treatment with either sucralfate or cimetidine was significant at the P less than 0.02 level. The apparent drug-mediated difference in the cytological composition of the healed mucosa was thought to be a function of the pharmacodynamic mechanisms of action of the two drugs in promoting DU healing. It is proposed that the retention of GC hyperplasia after curative therapy with sucralfate may predisposed patients so treated to extended periods of remission.
Gregory
M A
MA
Electron Microscope Unit, University of Natal, Durban.
Pettengell
K E
KE
Spitaels
J M
JM
Simjee
A E
AE
D002927:Cimetidine / Q000627:therapeutic use*; D004381:Duodenal Ulcer / Q000188:drug therapy / Q000473:pathology*; D004386:Duodenum / Q000473:pathology; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology*; D008679:Metaplasia; D013392:Sucralfate / Q000627:therapeutic use*
D013392:Sucralfate; D002927:Cimetidine