Reflux-related gastric mucosal injury is associated with increased mucosal histamine content in humans.
BACKGROUND
Experimental studies in the dog and the rat have shown histamine involvement in reflux-related gastric mucosal injury. However, no definite demonstrations of a link between reflux-related gastric mucosal injury and mast cell mediators exist in humans.


METHODS
The relationships between reflux, gastric mucosal histamine content, and gastric histology were assessed in partially gastrectomized subjects presumptively with high (11 Billroth II subjects) and low reflux levels (9 total biliary diversion subjects), respectively. Findings were compared with those in a control group consisting of 8 endoscopically and histologically proven normal subjects.


RESULTS
Bile acid quantity and concentration in the gastric aspirates were significantly greater in Billroth II subjects than in total biliary diversion subjects. Significantly higher cumulative scores for foveolar hyperplasia, mucosal edema, capillary dilatation and congestion, and smooth muscle fibers in the lamina propria were found in Billroth II subjects than in total biliary diversion subjects. Mucosal histamine content as well as mast cell density and degranulation differed significantly between Billroth II and the other two groups.


CONCLUSIONS
These results represent the first demonstration in humans of an association between mast cell mediators and chemical gastric mucosal injury.
Bechi
P
P
Istituti di Clinica Chirurgica 3, Università di Firenze, Italy.
Amorosi
A
A
Mazzanti
R
R
Dei
R
R
Bianchi
S
S
Mugnai
L
L
Masini
E
E
D000328:Adult; D000368:Aged; D000713:Anastomosis, Roux-en-Y; D001646:Bile / Q000502:physiology*; D001655:Bile Reflux / Q000473:pathology / Q000503:physiopathology*; D005260:Female; D005704:Gallbladder / Q000601:surgery*; D005743:Gastrectomy; D005753:Gastric Mucosa / Q000293:injuries / Q000378:metabolism* / Q000473:pathology*; D006632:Histamine / Q000378:metabolism*; D006640:Histidine Decarboxylase / Q000378:metabolism; D006801:Humans; D008297:Male; D008407:Mast Cells / Q000473:pathology / Q000502:physiology; D008875:Middle Aged
D006632:Histamine; D006640:Histidine Decarboxylase