title: Effects of the synthetic PGE1 derivative misoprostol on basal, stimulated and nocturnal acid secretion in duodenal ulcer cases. Mechanism of action.
abstract: We studied the antisecretory effect of the synthetic PGE1 derivative misoprostol. Basal, histamine-stimulated and nocturnal acid secretion were determined on separate days in 3 groups of endoscopically confirmed duodenal ulcer patients. Misoprostol or placebo were given in random order in doses of 200, 400 and 800 mcg. H+ concentration, acid output and pH of gastric content were determined. Additionally, the effect of misoprostol on purified and gastric mucosa carbonic anhydrase was determined according to Maren's micromethod. Misoprostol reduced dose-dependently basal acid secretion (by 54% after 200 mcg, by 82% after 400 mcg and, respectively, by 94% after 800 mcg) as well as stimulated secretion which was reduced after the same doses by 22% (p less than 0.05), 48% and 64% (p less than 0.001), respectively. Nocturnal secretion was significantly reduced for a period of 4 h, with a consecutive rise of gastric pH. In vitro, misoprostol inhibited dose-dependently purified and gastric mucosa carbonic anhydrase basal activity. In conclusion, misoprostol inhibits basal, nocturnal and histamine-stimulated secretion in duodenal ulcer patients, an effect which could be mediated by inhibition of carbonic anhydrase.
authors.affiliation: Simleu Silvaniei Hospital, Department of Gastroenterology, Romania.
authors.forename: G
authors.initials: G
authors.lastname: Buzás
authors.forename: I
authors.initials: I
authors.lastname: Puscas
authors.forename: F
authors.initials: F
authors.lastname: Persa
authors.forename: A
authors.initials: A
authors.lastname: Reznicek
mesh_terms: D000328:Adult; D000527:Alprostadil / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D002256:Carbonic Anhydrases / Q000378:metabolism; D002940:Circadian Rhythm / Q000187:drug effects; D004381:Duodenal Ulcer / Q000188:drug therapy*; D005744:Gastric Acid / Q000378:metabolism*; D006632:Histamine; D006801:Humans; D016595:Misoprostol; D011897:Random Allocation
chemical_list: D000897:Anti-Ulcer Agents; D016595:Misoprostol; D006632:Histamine; D002256:Carbonic Anhydrases; D000527:Alprostadil