Effects of the synthetic PGE1 derivative misoprostol on basal, stimulated and nocturnal acid secretion in duodenal ulcer cases. Mechanism of action.
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.
Buzás
G
G
Simleu Silvaniei Hospital, Department of Gastroenterology, Romania.
Puscas
I
I
Persa
F
F
Reznicek
A
A
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
D000897:Anti-Ulcer Agents; D016595:Misoprostol; D006632:Histamine; D002256:Carbonic Anhydrases; D000527:Alprostadil