Abstract
The morphology of esophagitis, both in the presence and absence of acid, was studied by light microscopy and transmission and scanning electron microscopy. For this purpose the rabbit esophagus was isolatedin situ and perfused with agents known to cause esophageal mucosal damage (HCl, pepsin, taurocholate, and deoxycholate). In addition, changes in the permeability of the plasma membrane of the esophageal epithelial cells were assessed by staining the esophageal epithelium with trypan blue and antinuclear antibodies. The results indicate that HCl alone causes relatively few changes in the esophageal epithelium. However, when combined with pepsin or taurocholate, severe ulcerative changes were caused within an hour. Deoxycholate, which is formed in the upper gastrointestinal tract under nonacidic conditions, also causes severe damage. Further, it was shown that the esophagitis caused by pepsin and bile salts are clearly morphologically different. Bile salts affect primarily the cell membrane and intracellular organelles, while pepsin seems to affect the intercellular substance causing the epithelial cells to be shed. In contrast, the presence or absence of acidper se does not seem to influence the nature of the epithelial damage, since the lesions caused by the two bile salts (deoxycholate vs taurocholate + HCl) were morphologically similar.
Similar content being viewed by others
References
Salo J, Kivilaakso E: Role of luminal H+ in the pathogenesis of experimental esophagitis. Surgery 92:61–68, 1982
Salo JA, Kivilaakso E: Role of bile salts and trypsin in the pathogenesis of experimental alkaline esophagitis. Surgery 1983 (in press)
Drasar BS, Shiner M, McLeon GM: Studies on the intestinal flora. I. The bacterial flora of the gastrointestinal tract in healthy and achlorhydric persons. Gastroenterology 56:71–79, 1969
Bradley EL III, Isaacs J, Hersch T, Davidson ED, Milligan W: Nutritional consequences of total gastrectomy. Ann Surg 182:415–429, 1975
Grankvist K, Lennmark A, Täljedal I-B: Trypan blue as a marker of plasma membrane permeability in alloxan-treated mouse islet cells. J Endocrinol Invest 2:180, 1979
Laurila P, Virtanen I, Wartiovaara J, Stenmark S: Fluorescent antibodies and lectins stain intracellular structure in fixed cells treated with nonionic detergents. J Histochem Cytochem 26:251, 1978
Carney CN, Orlando RC, Powell DW, Dotson MM: Morphologic alterations in early acid-induced epithelial injury of the rabbit esophagus. Lab Invest 45:198–208, 1981
Hopwood D, Milne G, Logan KR: Electron microscopic changes in human oesophageal epithelium in oesophagitis. J Pathol 129:161–167, 1979
Ismail-Beige F, Horton PF, Pope CE II: Histological consequences of gastroesophageal reflux in man. Gastroenterology 58:163–174, 1970
Johnson LF, DeMeester TR, Haggit RC: Esophageal epithelial response to gastroesophageal reflux. A quantitative study. Am J Dig Dis 23:498–509, 1978
Welch RW, Luckmann K, Eicks P, Drake ST, Bannyan G, Owensby L: Lower esophageal sphincter pressure in histologic esophagitis. Dig Dis Sci 25:420–426, 1980
Seefeld U, Krejs GJ, Siebenmann RE, Blum AL: Esophageal histology in gastroesophageal reflux. Morphologic findings in suction biopsies. Am J Dig Dis 22:956–964, 1977
Weinstein WM, Bogoch ER, Bowes KL: The normal human esophageal mucosa: A histological reappraisal. Gastroenterology 68:40–44, 1975
Ismail-Beige F, Pope CE II: Distribution of the histological changes of gastroesophageal reflux in the distal esophagus of man. Gastroenterology 66:1109–1113, 1974
Dilly PN, Mallison CN: Ultrastructural characteristics of the oesophageal mucosa in man. Gut 16:841–842, 1975
Hopwood D, Bateson MC, Milne G, Bouchier IAD: Effects of bile acids and hydrogen ion on the fine structure of oesophageal epithelium. Gut 22:306–311, 1981
Bateson MC, Hopwood D, Milne G, Bouchier IAD: Oesophageal epithelial ultrastructure after incubation with gastrointestinal fluids and their components. Pathology 133:33–51, 1981
Hedman K, Kurkinen M, Alitalo K, Vaheri A, Johansson S, Höök M: Isolation of the pericullar matrix of human fibroblast cultures. J Cell Biol 81:83–91, 1979
Lehto V-P, Vartio T, Virtanen I: Persistance of a 140 000 mV surface glycoprotein in cell-free matrices of cultured human fibroblasts. FEBS Lett 124:289–292, 1981
Duane WC, Wiegan DM: Mechanism by which bile salt disrupts the gastric mucosal barrier in the dog. J Clin Invest 66:1044–1049, 1980
Reaching M: A digestion technique for the reduction of background staining in the immunoperoxidase method. J Clin Pathol 30:88–90, 1976
Author information
Authors and Affiliations
Additional information
This work is supported by grants from the Sigrid Jusélius Foundation, Helsinki, and Finnish Medical Society Duodecim, Helsinki, Finland.
Rights and permissions
About this article
Cite this article
Salo, J.A., Lehto, V.P. & Kivilaakso, E. Morphological alterations in experimental esophagitis. Digest Dis Sci 28, 440–448 (1983). https://doi.org/10.1007/BF02430533
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02430533