Long-term treatment with anti-secretory drugs: could it affect morphology and cell kinetics of gastric mucosa?
Drugs reducing gastric acid output are widely used and commonly considered free from relevant side effects. However, our knowledge on the consequences of long-term anti-secretory treatment is still lacking. Several observations both, in animal models and in man, indicate that a decreased gastric acid output may lead modifications of several features of epithelial gastric cells. These alterations can be determined by different mechanisms. The drugs can raise plasma levels of gastrin, which possibly cause a proliferative stimulus on fundic mucosa. Moreover, some drugs showed a direct effect on cell proliferation. Finally, hypochlorhydria reduces the antibacterial power of gastric juice. In this environment, bacterial flora can overgrow and synthesize also the N-nitrosocompounds. These observations suggest that prolonged treatments with powerful anti-secretory drugs should be carried out taking into account the hypothetical biological risk on gastric mucosa.
Biasco
G
G
Istituto di Fisiopatologia Medica, Università di Chieti, Italy.
D000818:Animals; D002453:Cell Cycle / Q000187:drug effects; D005753:Gastric Mucosa / Q000187:drug effects* / Q000473:pathology; D006635:Histamine H2 Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008134:Long-Term Care
D006635:Histamine H2 Antagonists