title: Reactive increase in gastric mucus secretion is an adaptive defense mechanism against low-dose aspirin-induced gastropathy.
abstract: BACKGROUND
  Gastric mucus is considered to play an essential role in gastric mucosal defense mechanisms, especially when irritants are present in the stomach.
  
  
  OBJECTIVE
  To investigate the relationship between low-dose aspirin-induced gastropathy and gastric secretory function, especially gastric mucus secretion, in healthy volunteers.
  
  
  METHODS
  Thirty male, asymptomatic, Helicobacter pylori pylori-negative healthy volunteers were asked to take 100 mg of enteric-coated aspirin (Bayaspirin) once a day for 10 days. Endoscopic examination was performed before and 3 and 10 days after drug administration. The extent of endoscopically assessed gastric mucosal injury was semi-quantitatively evaluated according to the modified Lanza score. The pentagastrin-stimulated gastric juice was collected for 10 min during the endoscopic examination and subjected to analysis for gastric acid (mEq/10 min) or mucus (mg hexose/10 min) output.
  
  
  RESULTS
  Overall, the 10-day aspirin treatment significantly increased gastric mucus secretion from 0.8 (interquartile range 1.7) to 1.6 (1.6) mg hexose/10 min (P < 0.05), with a concomitant and significant decrease in the gastric acid/mucus ratio from 4.3 (5.2) to 2.9 (4.7) (P < 0.01). Subsequent analysis of two subgroups of volunteers categorized according to their endoscopic status ("severe gastropathy" vs. "modest gastropathy") revealed that changes in gastric secretory parameters occurred exclusively in those subjects without severe gastric injury; there was no alteration in these parameters in subjects with severe gastric injury.
  
  
  CONCLUSIONS
  The results of this study suggest that the reactive increase in gastric mucus secretion is an adaptive defense mechanism against low-dose aspirin-induced gastropathy. In some individuals, such a response may be insufficient to prevent the development of severe mucosal injury and even ulcers and their complications.
authors: Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aobaku, Sendai, Miyagi, 980-8574, Japan. kiijima@med.tohoku.ac.jp
authors: K
authors: K
authors: Iijima
authors: T
authors: T
authors: Iwabuchi
authors: N
authors: N
authors: Ara
authors: T
authors: T
authors: Koike
authors: H
authors: H
authors: Shinkai
authors: Y
authors: Y
authors: Kamata
authors: T
authors: T
authors: Ichikawa
authors: K
authors: K
authors: Ishihara
authors: T
authors: T
authors: Shimosegawa
mesh_terms: D000328:Adult; D001241:Aspirin / Q000633:toxicity*; D004305:Dose-Response Relationship, Drug; D005753:Gastric Mucosa / Q000378:metabolism*; D005765:Gastrointestinal Agents / Q000494:pharmacology; D006801:Humans; D008297:Male; D009093:Mucus / Q000378:metabolism*; D010418:Pentagastrin / Q000494:pharmacology; D013270:Stomach / Q000187:drug effects; D013272:Stomach Diseases / Q000139:chemically induced*; D055815:Young Adult
chemical_list: D005765:Gastrointestinal Agents; D010418:Pentagastrin; D001241:Aspirin
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