Skip to main content
Annals of Surgery logoLink to Annals of Surgery
. 1988 Mar;207(3):327–334. doi: 10.1097/00000658-198803000-00018

Gastric mucosal blood flow in misoprostol pretreated aspirin-induced ulceration.

T J Gana 1, B R MacPherson 1, J Koo 1
PMCID: PMC1493410  PMID: 3125802

Abstract

To determine whether topical misoprostol (a synthetic PGE analog) pretreatment will increase or prevent a decrease in gastric mucosal blood flow (GMBF) during topical aspirin administration, we studied focal GMBF simultaneously by hydrogen gas clearance in a split canine gastric chamber model with one side as control. In the test chamber, immediately after topical misoprostol, there was a transient and significant increase (18%) in GMBF (55.71 +/- 7.80 to 65.84 +/- 6.12 mL/min/100 g; p less than 0.05). After 15 minutes, GMBF returned to premisoprostol levels and then showed a graded drop throughout the aspirin and postaspirin periods. No grossly visible mucosal lesions were observed. In the control chamber, mucosal lesions were observed 45 minutes after aspirin administration accompanied by a graded drop in GMBF throughout the experiments. Misoprostol neither produced a sustained increase in GMBF nor prevented the subsequent reduction in GMBF induced by aspirin. Therefore, maintenance of GMBF may not be important in cytoprotection by misoprostol. The sustained nonparietal secretion induced by this synthetic PGE1 analog may be important in gastric cytoprotection.

Full text

PDF
327

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Allen A., Garner A. Mucus and bicarbonate secretion in the stomach and their possible role in mucosal protection. Gut. 1980 Mar;21(3):249–262. doi: 10.1136/gut.21.3.249. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Ashley S. W., Cheung L. Y. Measurements of gastric mucosal blood flow by hydrogen gas clearance. Am J Physiol. 1984 Oct;247(4 Pt 1):G339–G345. doi: 10.1152/ajpgi.1984.247.4.G339. [DOI] [PubMed] [Google Scholar]
  3. Barzilai A., Schiessel R., Kivilaakso E., Matthews J. B., Fleischer L. A., Bartzokis G., Silen W. Effect of 16-16-dimethyl-prostaglandin E2 on ulceration of isolated amphibian gastric mucosa. Gastroenterology. 1980 Jun;78(6):1508–1512. [PubMed] [Google Scholar]
  4. Bolton J. P., Cohen M. M. Effect of 16,16-dimethyl prostaglandin E2 on the gastric mucosal barrier. Gut. 1979 Jun;20(6):513–517. doi: 10.1136/gut.20.6.513. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Bolton J. P., Cohen M. M. Stimulation of non-parietal cell secretion in canine Heidenhain pouches by 16,16-dimethyl prostaglandin E2. Digestion. 1978 Jul-Aug;17(4):291–299. doi: 10.1159/000198122. [DOI] [PubMed] [Google Scholar]
  6. Chaudhury T. K., Jacobson E. D. Prostaglandin cytoprotection of gastric mucosa. Gastroenterology. 1978 Jan;74(1):58–63. [PubMed] [Google Scholar]
  7. Cheung L. Y., Lowry S. F. Effects of intra-arterial infusion of prostaglandin E1 on gastric secretion and blood flow. Surgery. 1978 Jun;83(6):699–704. [PubMed] [Google Scholar]
  8. Cheung L. Y., Lowry S. F., Perry J., Larson K. Topical effects of 16,16 dimethyl prostaglandin E2 on gastric acid secretion and mucosal permeability to hydrogen ions in dogs. Gut. 1978 Sep;19(9):775–778. doi: 10.1136/gut.19.9.775. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Cohen M. M., Clark L., Armstrong L., D'Souza J. Reduction of aspirin-induced fecal blood loss with low-dose misoprostol tablets in man. Dig Dis Sci. 1985 Jul;30(7):605–611. doi: 10.1007/BF01308407. [DOI] [PubMed] [Google Scholar]
  10. Colton D. G., Callison D. A., Dajani E. Z. Effects of a prostaglandin E1 derivative, SC-29333, and aspirin on gastric ionic fluxes and potential difference in dogs. J Pharmacol Exp Ther. 1979 Aug;210(2):283–288. [PubMed] [Google Scholar]
  11. Colton D. G., Driskill D. R., Phillips E. L., Poy P., Dajani E. Z. Effect of SC-29333, an inhibitor of gastric secretion, on canine gastric mucosal blood flow and serum gastrin levels. Arch Int Pharmacodyn Ther. 1978 Nov;236(1):86–95. [PubMed] [Google Scholar]
  12. Dajani E. Z., Callison D. A., Bertermann R. E. Effects of E prostaglandins on canine gastric potential difference. Am J Dig Dis. 1978 May;23(5):436–442. doi: 10.1007/BF01072927. [DOI] [PubMed] [Google Scholar]
  13. Dajani E. Z., Driskill D. R., Bianchi R. G., Collins P. W., Pappo R. SC-29333: a potent inhibitor of canin gastric secretion. Am J Dig Dis. 1976 Dec;21(12):1049–1057. doi: 10.1007/BF01071862. [DOI] [PubMed] [Google Scholar]
  14. Davenport H. W. Salicylate damage to the gastric mucosal barrier. N Engl J Med. 1967 Jun 8;276(23):1307–1312. doi: 10.1056/NEJM196706082762308. [DOI] [PubMed] [Google Scholar]
  15. Ducharme D. W., Weeks J. R., Montgomery R. G. Studies on the mechanism of the hypertensive effect of prostaglandin F2-alpha. J Pharmacol Exp Ther. 1968 Mar;160(1):1–10. [PubMed] [Google Scholar]
  16. Gana T. J., Huhlewych R., Koo J. Focal gastric mucosal blood flow by laser-Doppler and hydrogen gas clearance: a comparative study. J Surg Res. 1987 Oct;43(4):337–343. doi: 10.1016/0022-4804(87)90090-4. [DOI] [PubMed] [Google Scholar]
  17. Gana T. J., Huhlewych R., Koo J. Focal gastric mucosal blood flow in aspirin-induced ulceration. Ann Surg. 1987 Apr;205(4):399–403. doi: 10.1097/00000658-198704000-00010. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Gaskill H. V., 3rd, Sirinek K. R., Levine B. A. Prostacyclin-mediated gastric cytoprotection is dependent on mucosal blood flow. Surgery. 1982 Aug;92(2):220–225. [PubMed] [Google Scholar]
  19. Hawkey C. J., Rampton D. S. Prostaglandins and the gastrointestinal mucosa: are they important in its function, disease, or treatment? Gastroenterology. 1985 Nov;89(5):1162–1188. doi: 10.1016/0016-5085(85)90225-2. [DOI] [PubMed] [Google Scholar]
  20. Hunt J. N., Smith J. L., Jiang C. L., Kessler L. Effect of synthetic prostaglandin E1 analog on aspirin-induced gastric bleeding and secretion. Dig Dis Sci. 1983 Oct;28(10):897–902. doi: 10.1007/BF01317040. [DOI] [PubMed] [Google Scholar]
  21. Inatomi N., Maki Y. Effect of prostaglandins on mucosal blood flow and aspirin-induced damage in the canine stomach. Jpn J Pharmacol. 1983 Dec;33(6):1263–1270. doi: 10.1254/jjp.33.1263. [DOI] [PubMed] [Google Scholar]
  22. Konturek S. J., Robert A. Cytoprotection of canine gastric mucosa by prostacyclin: possible mediation by increased mucosal blood flow. Digestion. 1982;25(3):155–163. doi: 10.1159/000198824. [DOI] [PubMed] [Google Scholar]
  23. Lacy E. R., Ito S. Rapid epithelial restitution of the rat gastric mucosa after ethanol injury. Lab Invest. 1984 Nov;51(5):573–583. [PubMed] [Google Scholar]
  24. Larsen K. R., Jensen N. F., Davis E. K., Jensen J. C., Moody F. G. The cytoprotective effects of (+/-)-15-deoxy-16-alpha, beta-hydroxy-16-methyl PGE1 methyl ester (sc-29333) versus aspirin-shock gastric ulcerogenesis in the dog. Prostaglandins. 1981;21 (Suppl):119–124. doi: 10.1016/0090-6980(81)90127-1. [DOI] [PubMed] [Google Scholar]
  25. Leung F. W., Guth P. H., Scremin O. U., Golanska E. M., Kauffman G. L., Jr Regional gastric mucosal blood flow measurements by hydrogen gas clearance in the anesthetized rat and rabbit. Gastroenterology. 1984 Jul;87(1):28–36. [PubMed] [Google Scholar]
  26. Lev R., Siegel H. I., Glass G. B. Effects of salicylates on the canine stomach: a morphological and histochemical study. Gastroenterology. 1972 May;62(5):970–980. [PubMed] [Google Scholar]
  27. MOODY F. G., DURBIN R. P. EFFECTS OF GLYCINE AND OTHER INSTILLATES ON CONCENTRATION OF GASTRIC ACID. Am J Physiol. 1965 Jul;209:122–126. doi: 10.1152/ajplegacy.1965.209.1.122. [DOI] [PubMed] [Google Scholar]
  28. Miller T. A. Protective effects of prostaglandins against gastric mucosal damage: current knowledge and proposed mechanisms. Am J Physiol. 1983 Nov;245(5 Pt 1):G601–G623. doi: 10.1152/ajpgi.1983.245.5.G601. [DOI] [PubMed] [Google Scholar]
  29. Moody F. G., Zalewsky C. A., Larsen K. R. Cytoprotection of the gastric epithelium. World J Surg. 1981 Mar;5(2):153–163. doi: 10.1007/BF01658278. [DOI] [PubMed] [Google Scholar]
  30. Murakami M., Moriga M., Miyake T., Uchino H. Contact electrode method in hydrogen gas clearance technique: a new method for determination of regional gastric mucosal blood flow in animals and humans. Gastroenterology. 1982 Mar;82(3):457–467. [PubMed] [Google Scholar]
  31. Nakano J., McCurdy J. R. Hemodynamic effects of prostaglandins E1, A1 and F2-alpha in dogs. Proc Soc Exp Biol Med. 1968 May;128(1):39–42. doi: 10.3181/00379727-128-32937. [DOI] [PubMed] [Google Scholar]
  32. O'Brien P. E., Carter D. C. Effect of gastric secretory inhibitors on the gastric mucosal barrier. Gut. 1975 Jun;16(6):437–442. doi: 10.1136/gut.16.6.437. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Robert A. An intestinal disease produced experimentally by a prostaglandin deficiency. Gastroenterology. 1975 Oct;69(4):1045–1047. [PubMed] [Google Scholar]
  34. Robert A. Antisecretory, antiulcer, cytoprotective and diarrheogenic properties of prostaglandins. Adv Prostaglandin Thromboxane Res. 1976;2:507–520. [PubMed] [Google Scholar]
  35. Robert A. Cytoprotection by prostaglandins. Gastroenterology. 1979 Oct;77(4 Pt 1):761–767. [PubMed] [Google Scholar]
  36. Sato N., Kawano S., Fukuda M., Tsuji S., Kamada T. Misoprostol-induced changes in gastric mucosal hemodynamics. A double-blind parallel study in human volunteers. Am J Med. 1987 Jul 27;83(1A):15–21. doi: 10.1016/0002-9343(87)90573-0. [DOI] [PubMed] [Google Scholar]
  37. Silverstein F. E., Kimmey M. B., Saunders D. R., Surawicz C. M., Willson R. A., Silverman B. A. Gastric protection by misoprostol against 1,300 mg of aspirin. An endoscopic dose-response study. Am J Med. 1987 Jul 27;83(1A):32–36. doi: 10.1016/0002-9343(87)90576-6. [DOI] [PubMed] [Google Scholar]
  38. Terano A., Mach T., Stachura J., Tarnawski A., Ivey K. J. Effect of 16,16 dimethyl prostaglandin E2 on aspirin induced damage to rat gastric epithelial cells in tissue culture. Gut. 1984 Jan;25(1):19–25. doi: 10.1136/gut.25.1.19. [DOI] [PMC free article] [PubMed] [Google Scholar]
  39. Terano A., Ota S., Mach T., Hiraishi H., Stachura J., Tarnawski A., Ivey K. J. Prostaglandin protects against taurocholate-induced damage to rat gastric mucosal cell culture. Gastroenterology. 1987 Mar;92(3):669–677. doi: 10.1016/0016-5085(87)90016-3. [DOI] [PubMed] [Google Scholar]
  40. Walus K. M., Fondacaro J. D., Jacobson E. D. Hemodynamic and metabolic changes during stimulation of ileal motility. Dig Dis Sci. 1981 Dec;26(12):1069–1077. doi: 10.1007/BF01295970. [DOI] [PubMed] [Google Scholar]
  41. Whittle B. J. Mechanisms underlying gastric mucosal damage induced by indomethacin and bile-salts, and the actions of prostaglandins. Br J Pharmacol. 1977 Jul;60(3):455–460. doi: 10.1111/j.1476-5381.1977.tb07522.x. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES