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Effects of hypochlorhydria and hypergastrinemia on structure and function of gastrointestinal cells

A review and analysis

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Abstract

Since hypochlorhydria can induce hypergastrinemia, and gastrin has a trophic effect on some gastrointestinal cells, states that cause elevated plasma gastrin levels are of interest in terms of effects on cell growth and function. This article reviews the relationship between gastric mucosal cells during periods of acid stimulation and inhibition and analyses the effects of hypochlorhydria and hypergastrinemia on gastric and colonic cells and tumors. Hypochlorhydria releases the inhibitory effect of antral gastrin cells, inducing them to release gastrin in the presence of peptides or amino acids in the gastric lumen or in response to antral distension. Gastrin stimulates the oxyntic mucosa, which may lead to hyperplasia of enterochromaffin-like cells, resulting in enterochromaffin-like carcinoid tumors in aged rats and, rarely, in patients with chronic atrophic gastritis or gastrinomas. In addition to hypergastrinemia, other factors appear to be required for the progression of enterochromaffin-like hyperplasia to carcinoids; genetic factors may be involved. Gastrin elevations due to antisecretory drug therapy are indirectly proportional to the degree of acid inhibition and are reversible upon cessation of therapy. The gastrin levels during omeprazole therapy are similar to those caused by gastric vagotomy. Available evidence does not support a relationship between hypergastrinemia and the occurrence or growth of gastric carcinoma or colonic tumors.

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Authors and Affiliations

  1. Department of Medicine, University of Connecticut Health Center, Farmington, Connecticut, USA

    James W. Freston MD, PhD, Kurt Borch MD, Stephen J. Brand MD, Enar Carlsson PhD, W. Creutzfeldt MD, Rolf Håkanson MD, Lars Olbe MD, PhD, Enrico Solcia MD, John H. Walsh MD & M. Michael Wolfe MD

  2. Department of Surgery, University Hospital of Linköping, Linköping, Sweden

    James W. Freston MD, PhD, Kurt Borch MD, Stephen J. Brand MD, Enar Carlsson PhD, W. Creutzfeldt MD, Rolf Håkanson MD, Lars Olbe MD, PhD, Enrico Solcia MD, John H. Walsh MD & M. Michael Wolfe MD

  3. Gastrointestinal Unit, Massachusetts General Hospital, Boston, Massachusetts, USA

    James W. Freston MD, PhD, Kurt Borch MD, Stephen J. Brand MD, Enar Carlsson PhD, W. Creutzfeldt MD, Rolf Håkanson MD, Lars Olbe MD, PhD, Enrico Solcia MD, John H. Walsh MD & M. Michael Wolfe MD

  4. Astra Hässle AB, Mölndal, Sweden

    James W. Freston MD, PhD, Kurt Borch MD, Stephen J. Brand MD, Enar Carlsson PhD, W. Creutzfeldt MD, Rolf Håkanson MD, Lars Olbe MD, PhD, Enrico Solcia MD, John H. Walsh MD & M. Michael Wolfe MD

  5. Division of Gastroenterology and Endocrinology, University of Göttingen, Göttingen, Germany

    James W. Freston MD, PhD, Kurt Borch MD, Stephen J. Brand MD, Enar Carlsson PhD, W. Creutzfeldt MD, Rolf Håkanson MD, Lars Olbe MD, PhD, Enrico Solcia MD, John H. Walsh MD & M. Michael Wolfe MD

  6. Department of Pharmacology, University of Lund, Lund, Sweden

    James W. Freston MD, PhD, Kurt Borch MD, Stephen J. Brand MD, Enar Carlsson PhD, W. Creutzfeldt MD, Rolf Håkanson MD, Lars Olbe MD, PhD, Enrico Solcia MD, John H. Walsh MD & M. Michael Wolfe MD

  7. Department of Surgery II, Sahlgrenska Hospital, Göteborg, Sweden

    James W. Freston MD, PhD, Kurt Borch MD, Stephen J. Brand MD, Enar Carlsson PhD, W. Creutzfeldt MD, Rolf Håkanson MD, Lars Olbe MD, PhD, Enrico Solcia MD, John H. Walsh MD & M. Michael Wolfe MD

  8. Department of Human Pathology, University of Pavia, Pavia, Italy

    James W. Freston MD, PhD, Kurt Borch MD, Stephen J. Brand MD, Enar Carlsson PhD, W. Creutzfeldt MD, Rolf Håkanson MD, Lars Olbe MD, PhD, Enrico Solcia MD, John H. Walsh MD & M. Michael Wolfe MD

  9. UCLA Medical School, VA Wadsworth, Los Angeles, California, USA

    James W. Freston MD, PhD, Kurt Borch MD, Stephen J. Brand MD, Enar Carlsson PhD, W. Creutzfeldt MD, Rolf Håkanson MD, Lars Olbe MD, PhD, Enrico Solcia MD, John H. Walsh MD & M. Michael Wolfe MD

  10. Gastroenterology Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA

    James W. Freston MD, PhD, Kurt Borch MD, Stephen J. Brand MD, Enar Carlsson PhD, W. Creutzfeldt MD, Rolf Håkanson MD, Lars Olbe MD, PhD, Enrico Solcia MD, John H. Walsh MD & M. Michael Wolfe MD

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  1. James W. Freston MD, PhD
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  2. Kurt Borch MD
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  5. W. Creutzfeldt MD
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  8. Enrico Solcia MD
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Freston, J.W., Borch, K., Brand, S.J. et al. Effects of hypochlorhydria and hypergastrinemia on structure and function of gastrointestinal cells. Digest Dis Sci 40 (Suppl 2), 50S–62S (1995). https://doi.org/10.1007/BF02214871

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