Long-term omeprazole therapy in peptic ulcer disease: Gastrin, endocrine cell growth, and gastritis

doi:10.1016/0016-5085(93)90344-C

Gastroenterology

Volume 104, Issue 5, May 1993, Pages 1356-1370

https://doi.org/10.1016/0016-5085(93)90344-C Get rights and content

Abstract

Background: The effects of chronic drug-induced hypergastrinemia on the exocrine and endocrine stomach are still incompletely understood. Chronic hypergastrinemia in rats and humans is associated with gastric argyrophil cell hyperplasia. Methods: Seventy-four patients with chronic ranitidine-resistant ulcerations were treated chronically with omeprazole (median observation period 48 [6–84] months). Results: Median fasting serum gastrin levels increased from a pretreatment value of 74–145 pg/mL after 3 months. No further increase was observed thereafter. The finding of atrophic gastritis increased from 1.8% to 20.8% after 5 years. A doubling of the mean argyrophil cell volume density (0.36% vs. 0.74% after 5 years; P < 0.01%) was paralleled by a decrease in the normal endocrine cell growth pattern from 64.3% to 33.3% and an increase in micronodular hyperplasia (8.9% vs. 16.7%). These changes correlated with the severity of corpus gastritis and seemed to be more disease- than drug-related. No statistically significant changes were observed in the antral G- and D-cell volume densities under therapy. Conclusions: Long-term omeprazole therapy in humans results in moderate hypergastrinemia and a significant argyrophil cell hyperplasia, which are correlated to the grade of corpus gastritis. Because hypergastrinemia and gastritis are closely related, it is difficult to quantitatively assess their respective role in this process.

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: Supported by grants from the German Research Society (grant La 434/2-2) and AB Hässle, subsidiary of AB Astra, Sweden.

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Long-term omeprazole therapy in peptic ulcer disease: Gastrin, endocrine cell growth, and gastritis

Abstract

The mechanism of action of omeprazole—a survey of its inhibitory actions in vitro

Scand J Gastroenterol

A comparison of two different doses of omeprazole versus ranitidine in treatment of duodenal ulcers

J Clin Gastroenterol

Effect of omeprazole and ranitidine on ulcer healing and relapse rates in patients with benign gastric ulcer

New Engl J Med

Omeprazole. An updated review of its pharmacology and therapeutic use in acid-related disorders

Drugs

Omeprazole in peptic ulcers resistant to histamine H2-receptor antagonists

Aliment Pharmacol Ther

Healing and relapse of severe peptic esophagitis after treatment with omeprazole

Gastroenterol

Enterochromaffin-like cell carcinoids of gastric mucosa in rats after life-long inhibition of gastric acid secretion

Digestion

Endocrine cell proliferation and carcinoid development: a review of new aspects of hypergastrinaemic atrophic gastritis

Digestion

Gastric endocrine cell hyperplasia and carcinoid tumors in pernicious anemia

Gastroenterology

Argyrophil cell hyperplasia of fundic mucosa in patients with chronic atrophic gastritis

Digestion

Diffuse enterochromaffin-like (ECL) cell hyperplasia and multiple gastric carcinoids: a complication of pernicious anemia

Gut

Gastric argyrophil carcinoidosis in patients with Zollinger-Ellison syndrome due to type I multiple endocrine neoplasia

Am J Surg Pathol

Gastrin and the trophic control of gastric mucosa

Scand J Gastroenterol

Enterochromaffin-like cell carcinoids in the rat gastric mucosa following long-term administration of ranitidine

Digestion

Trophic effects of continuous infusion of (Leu15)-gastrin-17 in the rat

Gastroenterology

Partial gastric corpectomy results in hypergastrinemia and development of gastric enterochromaffinlike-cell carcinoids in the rat

Gastroenterology

Plasma gastrin and gastric enterochromaffinlike cell activation and proliferation

Gastroenterology

Fasting levels of serum gastrin in different functional and morphologic states of the antrofundal mucosa

Scand J Gastroenterol

Morphology and pathogenesis of endocrine hyperplasias, precarcinoid lesions, and carcinoids arising in chronic atrophic gastritis

Scand J Gastroenterol

Evolution of fundic argyrophil cell hyperplasia in nonantral atrophic gastritis

Gastroenterology

Serum gastrin and argyrophil cell hyperplasia relationships in fundic atrophic gastritis

Gastric carcinoids and related endocrine growths

Digestion

Qualitative studies of gastric endocrine cells in patients treated long-term with omeprazole

Scand J Gastroenterol

Argyrophil cell hyperplasia associated with chronic corpus gastritis in gastric ulcer disease

Scand J Gastroenterol

Long-term omeprazole treatment in man: effects on gastric endocrine cell populations

Digestion

Therapy with omeprazole in patients with peptic ulcerations resistant to extended high-dose ranitidine treatment

Digestion

Influence of feeding and sham feeding upon serum gastrin and gastric acid secretion in control subjects and duodenal ulcer patients

Scand J Gastroenterol

The histological diagnosis of chronic gastritis in fibre-optic gastroscope biopsy specimens

J Clin Pathol

Helicobacter colonization and histopathological profile of chronic gastritis in patients with or without dyspepsia, mucosal erosion and peptic ulcer: a morphological approach to the study of ulcerogenesis in man

Virch Arch A Pathol Anat

The Sydney System: a new classification of gastritis

A silver nitrate stain for A2-cells in human pancreatic islets

Acta Soc Med Upsal

Omeprazole in peptic ulcers resistant to histamine H₂-receptor antagonists

Trophic effects of continuous infusion of (Leu¹⁵)-gastrin-17 in the rat

A silver nitrate stain for A₂-cells in human pancreatic islets