Mucosal defense and repair. Role of prostaglandins in the stomach and duodenum.
When considering the diseases of the stomach and duodenum, peptic ulcer disease has been the one of greatest clinical impact. Although there are several components that contribute mechanistically to ulcer disease, it is recognized that gastroduodenal mucosal prostaglandins play a central pathogenic role, especially in ulcers related to the use of NSAIDs. As a result of understanding the mechanisms of NSAID-induced ulceration, the crucial function that gastroduodenal mucosal prostaglandins have in mucosal defense and repair is appreciated. It now is held widely that mucosal prostaglandin deficiency increases susceptibility to ulcer formation and that exogenous administration of supplemental prostaglandins reduces ulcer risk. This article reviews the role that mucosal prostaglandins play in defense of the gastric and duodenal mucosa against injury and ulceration.
Cryer
B
B
Medical Service, Dallas Veterans Affairs Medical Center, Department of Medicine, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA. bcryer@utsouthwestern.edu
D000367:Age Factors; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D051545:Cyclooxygenase 1; D051546:Cyclooxygenase 2; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors / Q000378:metabolism; D004381:Duodenal Ulcer / Q000209:etiology / Q000503:physiopathology* / Q000517:prevention & control; D005753:Gastric Mucosa / Q000502:physiology; D016481:Helicobacter Infections / Q000150:complications; D006801:Humans; D007413:Intestinal Mucosa / Q000502:physiology; D007527:Isoenzymes / Q000037:antagonists & inhibitors; D008565:Membrane Proteins; D016595:Misoprostol / Q000627:therapeutic use; D011451:Prostaglandin-Endoperoxide Synthases; D011453:Prostaglandins / Q000502:physiology* / Q000627:therapeutic use; D013276:Stomach Ulcer / Q000209:etiology / Q000503:physiopathology* / Q000517:prevention & control
D000894:Anti-Inflammatory Agents, Non-Steroidal; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors; D007527:Isoenzymes; D008565:Membrane Proteins; D011453:Prostaglandins; D016595:Misoprostol; D051545:Cyclooxygenase 1; D051546:Cyclooxygenase 2; C496511:PTGS1 protein, human; C496540:PTGS2 protein, human; D011451:Prostaglandin-Endoperoxide Synthases