Search

Objective: Suffering a stroke might lead to permanent cognitive and/or physical impairment. It has been shown that these impairments could have an impact on an individual's fitness to drive. In Sweden, as in many other countries, there are regulations on driving cessation post-stroke. Information on driving cessation should be given to all patients and noted in the journal. The present study sought to determine physician's compliance to driving regulations post-stroke as well as follow-up and gender aspects., Method: A retrospective study of medical records on stroke patients was carried out. The study covered all of the medical records on stroke incidents (n = 342) during a year at a typical medium to large-sized hospital in Sweden., Results: A journal entry on driving cessation post-stroke was missing in 81% of the medical records. Only 2% of the patients were scheduled for a follow-up meeting specifically concerning fitness to drive. Significantly more men than women had an entry on driving in the journal., Conclusions: We conclude that the Swedish regulations on driving cessation post-stroke were not followed at the participating hospital. It is crucial that all stroke patients receive information on driving cessation because their condition might affect fitness to drive. Analysis of follow-up records showed that there was no consistent method for assessment of a patient's fitness to drive. There was also a gender difference in the material, which warrants further investigation.

According to the literature, landscape (panoramas, heritage objects e.g. landmarks) affects people in various ways. Data are primarily developed by asking people (interviews, photo sessions, focus groups) about their preferences, but to a lesser degree by measuring how the body reacts to such objects. Personal experience while driving a car through a landscape is even more rare. In this paper we study how different types of objects in the landscape affect drivers during their drive. A high-fidelity moving-base driving simulator was used to measure choice of speed and lateral position in combination with stress (heart rate measure) and eye tracking. The data were supplemented with questionnaires. Eighteen test drivers (8 men and 10 women) with a mean age of 37 were recruited. The test drivers were exposed to different new and old types of landscape objects such as 19th century church, wind turbine, 17th century milestone and bus stop, placed at different distances from the road driven. The findings are in some respect contradictory, but it was concluded that that 33% of the test drivers felt stressed during the drive. All test drivers said that they had felt calm at times during the drive but the reason for this was only to a minor degree connected with old and modern objects. The open landscape was experienced as conducive to acceleration. Most objects were, to a small degree, experienced (subjective data) as having a speed-reducing effect, much in line with the simulator data (objective data). Objects close to the road affected the drivers' choice of' lateral position. No significant differences could be observed concerning the test drivers' gaze between old or modern objects, but a significant difference was observed between the test drivers' gaze between road stretches with faraway objects and stretches without objects. No meaningful, significant differences were found for the drivers' stress levels as measured by heart rate., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Background: The purpose of the present study was to gain insight into Alzheimer's disease (AD) patients' perception of the world through the study of a few aspects of awareness. The aspects in focus of the study were disease awareness, metacognition, managing of everyday life, and as a complement, the agreement (calibration) between patients and their spouses on the studied aspects was considered., Method: A mixed-method evaluation design was used involving 15 AD patients, their spouses, and 15 elderly healthy control subjects. The study comprised both a semistructured interview (AD patients and spouse) and a neuropsychological assessment (AD patients and control subjects)., Results: The patients were aware of their disease and able to report on their illness. Despite this awareness, they were unable to realize and manage the practical and cognitive implications of their impairment. The results also indicate that patients and spouses were not well calibrated regarding thoughts about the disease and problems in handling the cognitive deterioration., Conclusions: The findings of our study have relevance to patients' well being and how they manage everyday life. An open dialogue on these issues between spouses and in the care for AD patients would hopefully enhance quality of life for all parties involved.

Central coherence refers to the ability to interpret details of information into a whole. To date, the concept of central coherence is mainly used in research of autism, Asperger's syndrome and recently in the research on eating disorders. The main purpose of the present study was to examine central coherence in patients with Alzheimer's disease. Nine Alzheimer's disease patients and ten age- and gender-matched control subjects, who differed significantly in neurological assessment, were shown a picture of a fire. Compared to control subjects, the Alzheimer's disease patients described the picture in a fragmented way by mentioning details and separate objects without perceiving the context of the fire. In conclusion, patients with Alzheimer's disease are at the weak end of central coherence, and hence suffer from a fragmented view of their surroundings. The findings have important clinical implications for the understanding of patients with Alzheimer's diseaseand also for the possibility of caregivers to meet the Alzheimer's disease individual in an appropriate way in the everyday care.

Introduction: The present study explored the nature of the semantic deterioration normally displayed in the course of Alzheimer's disease (AD). The aim was to disentangle the extent to which semantic memory problems in patients with AD are best characterized as loss of semantic knowledge rather than difficulties in accessing semantic knowledge., Method: A longitudinal approach was applied. The same semantic tests as well as same items were used across three test occasions a year apart. Twelve Alzheimer patients and 20 matched control subjects, out of a total of 25 cases in each group, remained at the final test occasion., Results and Conclusions: Alzheimer patients were impaired in all the semantic tasks as compared to the matched comparison group. A progressing deterioration was evident during the study period. Our findings suggest that semantic impairment is mainly due to loss of information rather than problems in accessing semantic information., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Objective: The study examines how drivers experience a conventional W-beam guardrail (metal crash barrier) along both sides of narrow versus wider roads (single carriageway with 2 lanes) in terms of stress, feelings, and driving patterns and whether subjective experience concurs with the actual driving patterns captured by the quantitative data., Methods: The study used different methods to capture data, including the VTI Driving Simulator III (speed and lateral vehicle position) in conjunction with electrocardiogram (ECG) data on heart rate variability (HRV) and questionnaires (oral during driving and written after driving). Eighteen participants--8 men and 10 women--were recruited for the simulator study and the simulator road section was 10 km long., Results: Driving speeds increased slightly on the wider road and on the road with a crash barrier, and the lateral driving position was nearer to the road center on the narrower road and on the road with a crash barrier. The HRV data did not indicate that participants experienced greater stress due to road width or due to the presence of a crash barrier. Participant experience captured in the oral questionnaires suggested that road width did not affect driver stress or driving patterns; however, the written questionnaire results supported the simulator data, indicating that a wider road led to increased speed. None of the participants felt that crash barriers made them feel calmer., Conclusions: We believe that there is a possibility that the increased speed on roads with crash barriers may be explained by drivers' sense of increased security. This study demonstrates that an experimental design including experience-based data captured using both a simulator and questionnaires is productive. It also demonstrates that driving simulators can be used to study road features such as crash barriers. It seems more than likely that features such as street lamps, signs, and landscape objects could be tested in this way.

The most common types of benign gastric polyps are fundic gland polyps, hyperplastic polyps, and adenomas. The aim of this study was to determine on which morphological and functional background benign gastric polyps develop. The study includes 85 consecutive patients with gastric polyps and sex- and age-matched controls without polyps selected at random from a general population sample. The type of polyp was hyperplastic in 52 (61%), fundic gland in 18 (21%), adenoma in 10 (12%), carcinoid in 2 (2%), hamartoma in 2 (2%), and inflammatory fibroid in 1 (1%) of the cases. Routine biopsies from the gastric corpus and antrum were examined for presence of gastritis and H. pylori. Blood samples were analyzed for H. pylori antibodies, H+,K+-ATPase antibodies, gastrin, and pepsinogen I. Patients with hyperplastic polyps had increased P-gastrin concentrations and S-H+,K+-ATPase antibody titers and decreased S-pepsinogen I concentrations with a high prevalence of atrophic corpus gastritis or pangastritis. A similar pattern was observed among patients with adenomas, whereas patients with fundic gland polyps had normal serology and a lower prevalence of gastritis and H. pylori infection than controls. In conclusion, hyperplastic polyps and adenomas are generally associated with atrophic gastritis. Patients with fundic gland polyps seem to have a sounder mucosa than controls. Whereas the risk of malignant gastric neoplasia is increased in patients with hyperplastic polyps or adenomas, this does not seem to be the case in patients with fundic gland polyps.

The excluded stomach after Roux-en-Y gastric bypass (RYGBP) cannot be readily examined by endoscopy for obvious anatomic reasons. Thus it is difficult to monitor possible changes in the gastric mucosa. However, the type and severity of gastritis can now be assessed by a combination of serologic tests: pepsinogen I and antibodies to Helicobacter pylori and H,K-ATPase. Morbidly obese patients were examined before and 1 to 4 years after surgery. A group of 34 patients (mean age 39 years, BMI 44 kg/m(2)) underwent RYGBP; another group of 30 patients (mean age 42 years, BMI 44 kg/m(2)) had simple gastric restriction and served as control subjects. All patients, except one in the control group, had normal titers of pepsinogen I before surgery. One year after RYGBP, pepsinogen I levels were significantly reduced, as compared to the control group (P<0.0001), and remained low throughout the study. The control group had stable pepsinogen I levels. In both groups, few patients had increased titers of H. pylori or H,K-ATPase antibodies, but these abnormalities remained unchanged. Low pepsinogen I levels, similar to those we observed in our RYGBP patients, have been linked to chronic atrophic gastritis. However, the absence of food stimulation in the excluded stomach could also be a reason for the low pepsinogen I levels.

The prevalence of dementia disorders, cobalamin and/or folate deficiency as well as gastritis increases with age. To investigate whether there is an association between these conditions, plasma homocysteine (Hcy), serum methylmalonic acid, serum cobalamin and blood folate concentrations were measured. Gastritis was indirectly diagnosed by measuring serum antibodies against H,K-ATPase, HELICOBACTER PYLORI and intrinsic factor, using enzyme-linked immunosorbent assays. The studied groups consisted of 47 patients with Alzheimer's disease (AD), 9 with AD pathology in combination with additive vascular lesions, 59 with vascular dementia, 8 who were cognitively impaired, and 101 control cases. Plasma Hcy concentrations were significantly elevated in the dementia groups, with the highest levels in patients with vascular pathology. We conclude that hyperhomocysteinemia is a common finding in patients with dementia disorders of different etiologies. The markers for gastritis did not contribute to an elucidation of a possible connection between this condition, dementia disorders, or cobalamin/folate deficiency., (Copyright 2003 S. Karger AG, Basel)

Background: Gastrin exerts trophic effects on the gastric mucosa by mechanisms not yet completely elucidated. Our aim was to localize the cholecystokinin-2 (CCK2) receptor in epithelial cells of foetal and adult rat stomachs in order to determine the cell types that are directly affected by gastrin., Methods: Gastric tissue was subjected to indirect double immunofluorescence staining with antiserum against the C-terminal decapeptide of the CCK2 receptor and antibodies against 5' bromo-2-deoxyuridine, which had been injected into the rats I h before they were killed, the acid pump H,K-ATPase, the membrane-cytoskeletal linker ezrin, pepsin/pepsinogen or histidine decarboxylase., Results: Undifferentiated foetal gastric epithelial cells expressed CCK2 receptors, whereas stem cells of adult gastric glands did not exhibit immunoreactivity. However, other epithelial cells in the progenitor zone of adult gastric glands did express CCK2 receptors. Some of these cells were faintly stained for H,K-ATPase; pepsin/pepsinogen was also detected in this region. Parietal cells in the isthmus/pit region of the glands contained ezrin, and some showed weak immunoreactivity for the CCK2 receptor. As expected, enterochromaffin-like cells also expressed CCK2 receptors., Conclusion: Our findings are consistent with the hypothesis that a CCK2 receptor mediates direct effects of gastrin on gastric epithelial cells during both stomach organogenesis and adult life.

Background: Gastroscopy and examination of biopsy is normally required for diagnosis of gastritis. This is costly and inconvenient for the patient, and there is a need for a simple pregastroscopic screening method to reduce the endoscopy workload. Our aim was to develop a serological screening test for gastritis., Methods: Sera from subjects examined with gastroscopy and biopsy were analyzed for H,K-ATPase antibodies, Helicobacter pylori antibodies and pepsinogen I. The diagnoses were normal gastric mucosa (n=50), duodenal ulcer (n=53) and atrophic corpus gastritis, with (n=50) or without pernicious anemia (n=46)., Results: An evaluation scheme was constructed to optimize the diagnostic agreement between serology and gastric mucosal morphology. The sensitivity to detect gastritis was 98% (146/149) (95% CI 94-100%) and the specificity 84% (42/50) (95% CI 71-93%). Additional sera from 483 subjects from the general population were analyzed. There was a good agreement between serology and gastric mucosal morphology., Conclusions: Assays of multiple serum analytes are useful for the initial screening of gastritis. They are complementary to upper gastroscopy by identification of subjects with a normal gastric mucosa, those who qualify for eradication of H. pylori, and those who have developed atrophy and are at risk of developing malignancy and, therefore, require gastroscopic examination.

Since the discovery of Na/K-ATPase, evidence has accumulated to suggest that 1 mol of ATP hydrolysis occurs via the Na(+)-occluded ADP-sensitive phosphoenzyme, the K(+)-sensitive phosphoenzyme and the K(+)-occluded enzyme accompanying active transport of 3Na(+) and 2K(+) according the Post-Albers scheme. However, some controversial issues have arisen concerning whether the functional unit of the enzyme is an alpha beta-protomer or a much higher oligomer, which would be related to the mechanism of transport, either sequential or simultaneous. Detailed studies of oligomer interaction and the reactivity of the enzyme and a comparison of the extent of phosphorylation with ligand-binding capacities in the presence or absence of ATP hydrolysis and others strongly suggest that the functional unit of the enzyme in the membrane is a tetraprotomer, (alpha beta)(4). They also suggest that each reaction intermediate of the Post-Albers scheme, respectively, reflects half of the site property of the intermediate and that another half binds ATP. These data may be useful not only to answer the long-standing question of whether the mechanism functions in the presence of both Na(+) and K(+) but also contribute to a better understanding of the mechanism of P-type pump ATPase in general.

A simple and reproducible method for isolating oxyntic glands from the rat gastric mucosa was developed. The mucosa was incubated with pronase and EGTA, and then treated mechanically to release glands that were separated from single cells by sedimentation. Parietal cells were identified by immunostaining using a monoclonal antibody against H,K-ATPase. The glandular cells appeared morphologically intact. By careful control of the conditions of gland isolation, long glandular structures comprising hundreds of cells surrounding the lumen were obtained. Intraperitoneal injection of Br-deoxyuridine in the rat 1.5 h before the isolation procedure resulted in glands with a labeling of cells in their neck region. The glands were viable, as demonstrated by their ability to respond to various hormones. Histamine dose-dependently stimulated the acid formation which was measured as the accumulation of [14C]aminopyrine. At 100 microM histamine the accumulation was increased 5-10-fold. At 100 nM, pentagastrin potentiated the histamine stimulated accumulation by approximately 40% but pentagastrin alone did not stimulate. The oxyntic glands obtained by the present procedure appear useful for studies on cell physiology, including regulation of acid secretion, cellular interactions, and possibly also differentiation and proliferation mechanisms since long glandular fragments that contained the proliferative zone could be isolated.

Some benign and malignant diseases develop on the background of chronic gastritis or duodenitis. The present study was performed in order to determine the magnitude of these background changes with relations to symptomatology and life style in the general population. Examinations were performed in 501 volunteers (age 35-85 years). Fifty percent had gastritis; this was associated with H. pylori in 87%. H. pylori-negative gastritis was associated with regular use of NSAIDs [odds ratio 3.8 (1.6-9.9)]. Duodenitis, observed in 32%, was associated with H. pylori infection [odds ratio 2.3 (1.3-4.6)], previous cholecystectomy [odds ratio 3.6 (1.1-16.1)], and regular use of NSAIDs [odds ratio 3.0 (1.4-7.1)]. Neither gastritis nor duodenitis was associated with smoking or alcohol consumption. The rate of digestive symptoms did not differ between subjects with and without uncomplicated gastritis or duodenitis. In conclusion, half of this adult population had gastritis strongly associated with H. pylori infection. Gastritis without H. pylori infection was frequently associated with regular NSAID intake. One third had duodenitis, which was associated with H. pylori infection as well as with regular use of NSAIDs and previous cholecystectomy. Digestive symptoms were not overrepresented in uncomplicated gastritis or duodenitis.

Isolated gastric glands and isolated cells prepared from rabbit and rat were studied to analyse the influence of cholecystokinin octapeptide (CCK 8) on histamine stimulated parietal cell acid formation as assessed by [14C]aminopyrine sequestered in acid tissue compartments. In rabbit gastric glands, CCK 8 evoked 32+/-6% (P<0. 01) inhibition of histamine stimulated acid formation, whereas in glands prepared from rat no inhibition was recorded. Instead, CCK 8 seemed to induce a variable increase of the histamine stimulation in rat gastric glands as the aminopyrine accumulation was increased by 110+/-46% (P<0.1). Further studies on cell preparations derived from rabbit gastric mucosa revealed dual properties of CCK 8, eliciting either inhibition or stimulation of the parietal cell depending on the presence of endocrine cells. The results show that paracrine communication may be effective in glandular preparations, but seems to vary depending on species.

Colonization of the human stomach by Helicobacter pylori is associated with the development of gastritis, duodenal ulcer, mucosa-associated lymphoid tissue (MALT) lymphoma, and gastric cancer. H. pylori-antigen-binding single-chain variable fragments (ScFv) were derived from murine hybridomas producing monoclonal antibodies and expressed as a g3p-fusion protein on a filamentous M13 phage. The recombinant ScFv-phage reacted specifically with a 30-kDa monomeric protein of a H. pylori surface antigen preparation and by means of immunofluorescence microscopy the phage was shown to bind to both the spiral and coccoid forms of the bacterium. In vitro, the recombinant phage exhibited a bacteriocidal effect and inhibited specifically the growth of all the six strains of H. pylori tested. When H. pylori was pretreated with the phage 10 min before oral inoculation of mice, the colonization of the mouse stomachs by the bacterium was significantly reduced (P<0.01). The results suggest that genetic engineering may be used to generate therapy-effective phages.

At gestational day 16 the epithelium of the rat stomach consists of a stratified layer of undifferentiated cells, and two days later glandular structures appear. The present study was carried out to identify extracellular matrix proteins that could be involved in the epithelial cell proliferation and differentiation processes that occur in the fetal rat stomach during this period. For comparative purposes the expression of the same components in the adult gastric mucosa was examined. Pregnant Sprague-Dawley rats received an intraperitoneal injection of 5-bromo-2'-deoxyuridine to label proliferating cells. One, 3.5, or 6 h post-injection the stomachs were excised and immediately frozen. The specimens were sectioned and stained with hematoxylin and eosin or for 5-bromo-2'-deoxyuridine, cytokeratin no. 8, H,K-ATPase, and the extracellular matrix proteins fibronectin, laminin, and collagens type I and IV. A stratified layer of proliferating cells was observed in the epithelium of the fetal stomachs, while in adult stomachs proliferating cells were detected in the isthmus/neck region of the glands. Cytokeratin, an epithelial cell marker, was sparse at gestational day 16 but abundant both at gestational day 18 and in the isthmus/neck region of gastric glands of the adult stomach. The parietal cell marker H,K-ATPase could not be detected in the fetal stomachs during this period. Fibronectin was observed in the stroma of both fetal and adult stomachs. Collagen type I could only be detected in the stroma close to the oesophagus at gestational day 16. Two days later, collagen type I was abundant in the lamina propria, the submucosa and in the serosa of the fetal stomachs. In adult tissue collagen type I was detected in the surface epithelium, the submucosa and in the serosa of the stomach. Collagen type IV and laminin were expressed in the lamina propria, the basement membranes around blood vessels, muscle cells, and nerve bundles, as well as in the serosa of both 16- and 18-day-old fetal and adult rat stomachs. In conclusion, a high cell proliferation rate was observed in the epithelium at both gestational days 16 and 18. The increased expression of cytokeratin observed during this period indicates that the epithelial character of the embryonic cells becomes more distinct, while the remarkable change in the expression of collagen type I might reflect an important role of collagen type I in the development of the gastric epithelium.

In vivo reversible phosphorylation of Tyr-7 and Tyr-10 of the pig stomach H/K-ATPase alpha-chain was initially demonstrated in mammals, rat, rabbit, and pig, in the presence of vanadate + H(2)O(2). In vitro phosphorylation has also been unequivocally demonstrated via the use of protease inhibitors during membrane H/K-ATPase preparation. An amphoretic detergent permitted each intrinsic kinase to phosphorylate each fusion protein containing the requisite Tyr residues, along with a reduction in alpha-chain phosphorylation. These and other data suggest that some important enzyme systems are present in the apical membrane and that they are in sufficient proximity to participate in the reversible phosphorylation of the amino terminal soluble domain of the alpha-chain with an unknown physiological function in the membrane embedded H/K-ATPase.

The aim of the present study was to correlate molecular evidence of the presence of Helicobacter pylori in gastric biopsy samples, based on analysis of 16S rDNA, vacuolating toxin (vacA), urease A (ureA) and cagA genes, with the clinical, histological and serological findings in patients with H. pylori-associated gastritis. Fresh biopsy samples were collected from the gastric antrum and corpus of 22 asymptomatic volunteers with or without H. pylori-associated gastritis. Total DNA was extracted from the biopsy material and subjected to 16S rDNA PCR amplification, Southern blotting and 16S rDNA sequence analysis of the PCR products. The vacA, ureA and cagA genes were characterised by PCR amplification and Southern blot analysis. Based on partial 16S rDNA sequence analysis, DNA belonging to the genus Helicobacter was detected in gastric biopsy samples from 20 of 22 subjects, including seven of nine histologically and serologically normal controls. Six of 20 partial 16S rDNA sequences revealed variations within variable regions V3 and V4 that deviated from those of the H. pylori type strain ATCC 4350T and, therefore, possibly represented other species of Helicobacter. VacA genes identical with those of the type strain were found predominantly in the subjects with H. pylori gastritis, and all the patients except one were found to be cagA-positive. There was no evidence of false positive PCR reactions. In conclusion, the PCR-based molecular typing methods used here were apparently too sensitive when applied to the detection of H. pylori in human gastric tissues. The lack of quantitative analysis makes them inappropriate as clinical tools for the diagnosis of H. pylori-associated gastritis, despite the fact that they provide a qualitative and sensitive tool for the detection and characterisation of H. pylori in the gastrointestinal tract.

Our aim was to investigate whether there are changes in permeability to sucrose in asymptomatic Helicobacter pylori gastritis. Nineteen asymptomatic subjects with Helicobacter pylori-associated gastritis with no or mild mucosal atrophy and 19 age- and sex-matched normal controls were studied by peroral load of sucrose (100 g). The fraction of the given oral dose of sucrose excreted in urine was increased in subjects with Helicobacter pylori gastritis (median 0.08% versus 0.04% in controls). Sucrose excretion was not related to atrophy, intestinal metaplasia, or inflammation in the gastric mucosa. However, sucrose permeability was related to the degree of inflammatory (neutrophil) activity, since moderate activity was associated with higher sucrose excretion than mild activity (median 0.13% vs 0.07%). Asymptomatic Helicobacter pylori gastritis was associated with an increased sucrose permeability, which could be a sign of gastric mucosal leakage. This could have implications for the diseases and complications associated with Helicobacter pylori infection.

Previously H,K ATPase preparations from pig stomach were shown to contain intrinsic protein kinase activities which phosphorylated specific tyrosine and serine residues in the N-terminal of the alpha-chain of H,K ATPase (Togawa et al. 1996). In the present investigation, pig H,K ATPase-containing membrane preparations were compared with rat preparations. In contrast to results obtained with the alpha-subunit of H,K ATPase from pig, phosphorylation was not observed in the rat enzyme. Addition of rat preparations to the pig preparations resulted in decreased phosphorylation in pig preparations. To follow the phosphorylation of membrane proteins in vivo, 32P-loaded gastric cells prepared from rat were stimulated with several secretagogues. Proteins with molecular weights of about 120 and 80 kDa were markedly phosphorylated upon stimulation, but the alpha-subunit of H,K ATPase was not. These results suggest that phosphorylation of tyrosine or serine residues of H,K ATPase found in pig H,K ATPase preparations may not be involved in the acid secretion pathway.

Helicobacter pylori is the major cause of gastritis. The aim of this investigation was to develop a specific antibody, which recognizes both coccoid and spiral forms of Helicobacter pylori and to test this antibody on gastric biopsy sections known to harbour coccoid bacteria. Murine monoclonal antibodies against glycine-acid extracts of five strains of Helicobacter pylori were raised. Immunofluorescence and immunoelectron microscopy showed that one antibody of the IgG1 subclass was specific for both the spiral and coccoid forms. It reacted with a 28 kDa protein that was present in all the five strains tested. Using this antibody in an indirect immunofluorescence assay of formalin-fixed antral and corpus biopsy specimens from Helicobacter pylori-associated gastritis patients showed that nine of the nine antral and five of six corpus specimens harboured the coccoid form of Helicobacter pylori. This technique thus provides a rapid and specific detection of both the spiral and coccoid forms.

The current understanding of the mechanisms controlling the proliferation and differentiation of the stem cells of the gastric oxyntic glands is limited. The aim of the present study was to develop a method for investigating proliferation and differentiation of undifferentiated cells from fetal rat stomach. Outgrowth of cells was initiated from explants of 16-day-old fetal rat stomachs. At this stage of the fetal development the gastric epithelial cells are undifferentiated. The explants were cultured in DMEM/F-12 medium supplemented with fetal calf serum only, or fetal calf serum combined with either hydrocortisone or pentagastrin. Morphological characterization by means of light microscopy, dye staining and immunostaining was used to identify the growing cells. Both hydrocortisone and pentagastrin accelerated the differentiation towards H,K-ATPase-positive cells, mucus-producing cells and other epithelial cells. H,K-ATPase-positive cells, which were identified by immunostaining with a monoclonal antibody reacting with the alpha-subunit of the H,K-ATPase, grew on top of the confluent layer of epithelioid and fibroblastoid cells. With this method in vitro investigations of the mechanisms of proliferation and differentiation of gastric mucosal cells are possible. Although by different mechanisms, both hydrocortisone and pentagastrin appear to play a regulatory role in these processes.

When pig stomach membrane H+,K(+)-ATPase preparations were incubated with [gamma-32P]ATP, Mg2+ and Ca2+, reversible phosphorylation of specific Tyr and Ser residues in the N-terminal alpha-chain of H+,K(+)-ATPase occurred without any detectable phosphorylation in other regions of the alpha-chain. Mild tosylphenylalanyl chloromethyl ketone trypsin treatment followed by reverse-phase column chromatography yielded three radioactive peptide peaks. The first peak contained both Tyr10(32P) and Tyr7(32P) and the second peak contained Tyr10(32P). The third peak contained Ser27(32P) which was also obtained after trypsin treatment of partially purified H+,K(+)-ATPase preparations phosphorylated with protein kinase-C + Ca2+ or protein kinase-A. This is the first demonstration of Ca2(+)-dependent phosphorylation of the alpha-chain of H+,K(+)-ATPase by protein kinases.

Isolated rat parietal cells were used to investigate the role of intracellular Ca2+ in the action of cAMP-dependent secretagogues and cross talk between cAMP- and Ca2+ -dependent stimulatory pathways. Aminopyrine accumulation (an index of acid produced and trapped by the parietal cells), cytosolic free Ca2+, morphological transformation and cell viability were used to investigate parietal cell function and stimulation. The increase of cytosolic free Ca2+ promoted by gastrin, or carbachol, was abolished by the intracellular Ca2+ chelator 1,2-bis(2-aminophenoxy)ethane-N,N,N',N'-tetraacetic acid (BAPTA, 10 microM). Also, the morphological transformations induced by dibutyryladenosine 3':5'-cyclic monophosphate (DBcAMP), gastrin, and Sp-adenosine-cyclic-3', 5'-monophosphothioate (Sp-cAMPS) were completely abolished by BAPTA (10 microM). In aminopyrine accumulation the action of 1 mM DBcAMP was dose-dependently reduced by BAPTA. The Ca2+ ionophore A23187 alone, in the range of 1 pM to 1 microM, had no effect but it dose-dependently potentiated the action of 1 mM DBcAMP in aminopyrine accumulation. The inhibitory actions of BAPTA on DBcAMP- and histamine-stimulated aminopyrine accumulation were dose-dependently reversed by A23187. Histamine-stimulated protein kinase activity and viability parameters as cellular lactate dehydrogenase (LDH) and trypan blue exclusion were not changed by BAPTA. These results indicated that in isolated parietal cells: (1) the action of cAMP-dependent secretagogues in aminopyrine accumulation and morphological transformation are dependent on cytosolic free Ca2+; (2) Ca2+ -induced morphological transformation is essential for aminopyrine accumulation; (3) a threshold level of one second messenger is required for stimulation of aminopyrine accumulation by the other second messenger.

The role of endogenous adenosine 3',5'-cyclic monophosphate (cAMP) in the mechanisms of action of gastrin and carbachol on aminopyrine accumulation in isolated pig and rat parietal cells was investigated. In pig cells, pentagastrin (100 nM) alone stimulated aminopyrine accumulation, an action significantly reduced by the protein kinase A inhibitor Rp-adenosine 3',5'-cyclic monophosphothioate (Rp-cAMP[S]; 100 microM). In rat cells, gastrin-17 (100 nM) was incapable of stimulating aminopyrine accumulation, but it potentiated the action of histamine (100 microM). Carbachol (10 microM) stimulated aminopyrine accumulation and potentiated the action of histamine, and its action was potentiated in a dose-dependent manner by Sp-adenosine 3',5'-cyclic monophosphothioate (Sp-cAMP[S]; a cAMP analogue) in both species. The effect of carbachol was dose dependently reduced by Rp-cAMP[S]. The basal cAMP in pig parietal cells was 3.5-fold higher than that in rat parietal cells. Histamine (100 microM) and 3-isobutyl-1-methylxanthine (IBMX; 100 microM) only slightly elevated the cAMP content (1.2- to 2.9-fold the basal level) in both pig and rat parietal cells. Their combination, however, increased the cAMP level by 8- to 38-fold, but it did not increase aminopyrine accumulation above that elicited by histamine alone. Gastrin did not alter the cAMP levels in parietal cells of either of the two species. Both gastrin and carbachol increased cytosolic free Ca2+ in enriched pig and rat parietal cells.(ABSTRACT TRUNCATED AT 250 WORDS)

Background: Helicobacter pylori is a major cause of gastritis, and the parietal cell H,K-adenosine triphosphatase (ATPase) is a major autoantigen in autoimmune atrophic corpus gastritis, which may eventually lead to pernicious anemia and/or neuropathy. Whether the bacterium induces the autoimmune response is unknown., Methods: By means of enzyme-linked immunosorbent assay the occurrence of antibodies against porcine H,K-ATPase and H. pylori was determined in sera from 30 patients with pernicious anemia., Results: All sera scored positive against H,K-ATPase, and 25 (83%) scored positive against H. pylori. The titers of antibodies against both antigen preparations inversely correlated with the duration of disease. A possible common epitope in the antigen preparations was tested with a competition assay. There was no indication of a common epitope in either human or porcine H,K-ATPase and H. pylori., Conclusions: There was a positive correlation and a high incidence of antibodies against H,K-ATPase and H. pylori in sera from patients with pernicious anemia. These antibodies recognized different epitopes.

Background: Sera from patients with atrophic corpus gastritis with pernicious anemia frequently contain parietal cell autoantibodies. We have previously demonstrated that the human H,K-adenosine triphosphatase (H,K-ATPase) alpha-subunit constitutes a major autoantigen. The present study investigates whether the human H,K-ATPase beta-subunit is an autoantigen, too,, Methods: The gene of the human beta-subunit was expressed in insect cells by a baculovirus expression system. The reactivity of sera from 42 patients towards the recombinant glycoprotein was analyzed by means of an enzyme-linked immunosorbent assay., Results: Thirty-nine of the 42 sera (93%) scored positive. Autoantibody binding in 41 sera (98%) was eliminated when unglycosylated beta-subunit was used as antigen, and antibody binding in the last serum was decreased by 30%., Conclusions: The results indicate that the beta-subunit is indeed a major autoantigen and that carbohydrates are involved in binding of the autoantibodies.

Four cDNA fragments encoding different portions of the alpha-subunit of human H,K-adenosine triphosphatase (ATPase) were amplified by means of the polymerase chain reaction technique, ligated into the plasmid pGEX-2T, and expressed as glutathione S-transferase fusion proteins in Escherichia coli. The fragments A (residues 163-313), Ba (residues 360-797), Bb (residues 526-797), and C (residues 822-1031) together encompass 77% of the alpha-subunit and cover most of its cytosolic part. The reactivities of autoantibodies in the sera from patients with pernicious anaemia with the recombinant fusion proteins were analysed by immunoblotting. One autoantigenic epitope was found in the NH2-terminal part of the Ba fragment--that is, between residues 360 and 525. No epitope was detected in the other fragments. The Ba fragment was cleaved off from the glutathione S-transferase fusion protein by the action of thrombin and was then further purified. By means of enzyme-linked immunosorbent assay, 28 of 42 sera (67%) from patients with pernicious anaemia were positive against the purified Ba fragment. The present results provide a final proof that the human H,K-ATPase alpha-subunit is a major autoantigen in the parietal cell and that the major epitope is located between residues 360 to 525 on the cytosolic side of the secretory membrane.

A preparation of pig kidney Na+,K(+)-ATPase showed changes in fluorescence energy transfer between probes bound to the alpha-subunit. Excitation (305 nm) of an N-(p-(2-benzimidazolyl)phenyl)maleimide (BIPM) probe, which was covalently bound to Cys-964, and excitation (470 nm) of a fluorescein 5'-isothiocyanate (FITC) probe at Lys-501 gave different FITC fluorescence intensity changes at 520 nm in BIPM-FITC doubly labeled enzyme accompanying formation of reaction intermediates. Addition of acetyl phosphate to a Na(+)-bound enzyme (NaE1) to accumulate acetate-sensitive phosphoenzyme (E1P) induced a faster and greater FITC fluorescence decrease when excited at 470 nm than at 305 nm. An oligomycin-sensitive transition of E1P to K(+)-sensitive phosphoenzyme (E2P) was also accompanied by a larger FITC fluorescence decrease when excited at 470 nm. The addition of K+ to [32P]E2P to form a K(+)-bound enzyme (KE2) induced a rapid dephosphorylation (140/s) with both a slow rate of FITC fluorescence increase and a larger fluorescence increase when excited at 470 nm. The addition of Na+ to KE2 induced both a slow increase of FITC fluorescence and a larger fluorescence increase when excited at 470 nm. The data suggest that fluorescence energy transfer from the BIPM to the FITC probe accompanies the processes of migration of Na+ and K+ in the pump molecules. The dynamic fluorescence changes after phosphorylation and dephosphorylation seem to reflect changes in the binding state or the process of migration of these ions.

The mechanism of action of gastrin on pig parietal cells was investigated. The aminopyrine accumulation technique was used to estimate acid production in gastric mucosal cells, containing 10-20% parietal cells, and in enriched parietal cells, containing 65-95% parietal cells. The gastrin analogue pentagastrin stimulated aminopyrine accumulation in a dose-dependent fashion irrespective of the proportion of non-parietal cells present. The apparent EC50 for pentagastrin was 5 nM and the maximally effective concentration was 100 nM. The histamine H2-receptor antagonist ranitidine did not affect the action of pentagastrin. The stimulatory effects of various doses of histamine on aminopyrine accumulation in highly enriched parietal cells were potentiated by the inclusion of 100 nM pentagastrin in the incubation medium. In another series of experiments using mucosal cells, the action of effective doses of pentagastrin were potentiated by the phosphodiesterase inhibitor isobutylmethyl xanthine (IBMX), which alone elicited an aminopyrine accumulation equal to 50% of that obtained by 100 microM histamine. When ranitidine (100 microM) was included, the action of IBMX was almost completely abolished. However, the dose-response curve for pentagastrin in the presence of ranitidine plus IBMX was similar to that obtained in the absence of IBMX. Dibutyryl-cAMP (DBcAMP, 1 mM) in the presence of ranitidine (100 microM) also potentiated the action of all effective doses of pentagastrin on mucosal cells. The protein kinase A inhibitor Rp-cAMPS, present at 500 microM in the incubation medium, significantly reduced the action of each effective concentration of pentagastrin on aminopyrine accumulation in enriched parietal cells. These results in pig parietal cells were interpreted as indicative of: (i) an action of gastrin exerted directly on the parietal cells; (ii) elevation of intracellular cAMP having a permissive role in the action of gastrin on aminopyrine accumulation.

In isolated rat parietal cells, a potentiating effect by gastrin of the stimulatory action of histamine and dibutyryl-cAMP (DBcAMP) on aminopyrine accumulation, an index of the acid formed and trapped by the cells, was recently reported by us (1991, Am. J. Physiol. 261, G621-G627). In the present study, this mechanism of action of gastrin was further investigated. Enriched parietal cells (approximately 65% parietal cells) were incubated under different conditions and processed for electron microscopy. Morphometric analysis of the micrographs revealed that pentagastrin (100 nM) was as efficient as histamine (100 microM) in inducing the formation of vacuolar/canalicular spaces in the parietal cells. In the presence of the histamine H2-receptor antagonist ranitidine, histamine was ineffective but pentagastrin and gastrin-17 (G17) maintained their capacity to induce the morphological transformations. By stimulation with pentagastrin plus histamine, the vacuolar/canalicular volume was 2-fold higher than by stimulation separately with each one of the secretagogues. G-17 (100 nM) alone was ineffective but potentiated the maximal [14C]aminopyrine accumulation obtained with 100 microM histamine in mucosal cells (approximately 25-35% parietal cells). Ranitidine blocked both histamine-and histamine plus G-17-stimulated aminopyrine accumulation. G-17 potentiated also the stimulation by 1 mM dibutyryl-cyclic AMP but this was not inhibited by ranitidine. Pentagastrin (100 nM) increased the basal [14C]glucose oxidation in mucosal cells by 30%. This increase was not blocked by ranitidine which, however, abolished the histamine-stimulated glucose oxidation. Incubation of the cells with pentagastrin plus histamine resulted in a glucose oxidation which equaled the sum of the values obtained by each one of the agents. These results indicate that gastrin, acting directly on the parietal cells, potentiates the action of histamine on aminopyrine accumulation by increasing the vacuolar/canalicular spaces, a process that is reflected in the metabolic activity of the cells. Thus a major effect of gastrin at the parietal cell level appears to be the induction of a morphology which is characteristic of stimulated cells rather than a direct activation of ion-transport mechanisms.

The effects of gastrin on cytosolic free Ca2+ ([Ca2+]i) in single, isolated rat gastric parietal cells were investigated using the fluorescent probe Fura-2 and digital image analysis. [Ca2+]i was increased by gastrin (100 nM) in approximately 30% of the parietal cells, which were identified by using either the fluorescent probe acridine orange or a parietal cell-specific monoclonal antibody. In the dominant pattern observed, [Ca2+]i was elevated 50-150% and returned within 1-2 min to a value 30-60% over the basal, which was sustained until withdrawal of the stimulant or addition of the gastrin inhibitor L-365,260 (1 microM). The second, but not the first phase, was abolished in the absence of extracellular Ca2+. The results indicate the existence of functional gastrin receptors in a subpopulation of rat parietal cells.

Two-dimensional crystallization of membrane-bound H,K-ATPase (EC 3.6.1.36) in vesicle preparations from parietal cells of hog gastric mucosa was induced by an imidazole buffer containing Mg2+ and VO3- ions. A continuous reorganization of the protein molecules started within a few hours by the formation of linear arrays. At later stages confluent two-dimensional crystals were formed. Electron microscopy and image processing showed that these were of a single tetragonal type. The asymmetric unit consisted of one pear-shaped protein domain corresponding to a H,K-ATPase protomer. Through stain-deficient contact regions four adjacent protein units were connected forming a tetrameric structure.

Two mice DBA/1 were each immunized with a single injection of one million enriched parietal cells in the hind foot pads. Monoclonal antibodies to be used as research tools in studies on regulatory mechanisms in gastric parietal cells were obtained after fusion of mouse myeloma cells (SP2) with cells from the popliteal lymph nodes of the mice. Twelve hybridomas produced antibodies reactive with structures only present in parietal cells as assessed by immunohistochemistry of oxyntic mucosa sections. Three hybridomas were subcloned and the antibodies produced by them, designated as PC4, PC8, and PC117, were characterized. In an enzyme-linked immunosorbent assay, all antibodies reacted with H,K-ATPase-containing vesicles. The antibody PC8 recognized a 94 kDa protein after immunoblotting of H,K-ATPase-containing vesicles and all antibodies precipitated a 94 kDa protein from [125I]H,K-ATPase-containing vesicles. The antibodies PC4 and PC117 recognized extracellular structures with a polarized distribution in viable, purified parietal cells. The results suggest that the structure recognized by all three antibodies is the alpha-subunit of the H,K-ATPase. The antibodies produced by another hybridoma, PC43, recognized a structure present in parietal and surface epithelial cells of the oxyntic mucosa. In an enzyme-linked immunosorbent assay, they reacted with a high-activity carbonic anhydrase which had been affinity-purified from pig oxyntic mucosa and they recognized a 30 kDa protein after immunoblotting. Thus, monoclonal antibodies against both intracellular and extracellular parietal cell structures were obtained after immunization with a small number of parietal cells.

A continuous flow method was developed for determining the stoichiometry of the gastric proton pump H,K-ATPase in its hydrolysis of ATP, translocation of H+ and the K+ congener 86Rb+. H,K-ATPase-containing vesicles which had been isolated from pig gastric mucosa were incubated at 37 degrees C for 2 h in 150 mM 86RbCl, 0.5 mM EGTA and 3 mM Mes-buffer adjusted to pH 6.1 with Tris, and then applied to a 0.45 micron pore size filter. The immobilized vesicles were superfused with 0.15 mM Mes/Tris buffer, pH 6.1, containing 150 mM choline-Cl and 0.2 mM MgCl2. After the medium was changed to one containing 0.1 mM ATP, the amounts and rates of H+ uptake, 86Rb+ efflux, and ATP hydrolysis were measured in fractions collected after the filter. The initial ratio of transported Rb+ to hydrolysed ATP gave values of 0.96 +/- 0.26 (mean +/- SD, n = 28). The initial ratio of ATP-dependent Rb+ efflux to H+ uptake gave values of 0.92 +/- 0.28 (mean +/- SD, n = 28). The MgATPase activity was measured in vesicles which had been incubated with choline-Cl instead of RbCl. In the initial fractions used for calculation of the stoichiometry, the MgATPase activity was 15.8% +/- 8.7 (mean +/- S.D.) of the maximal ATPase activity obtained with Rb(+)-loaded vesicles. The MgATPase may be an intrinsic activity of the H,K-ATPase. However, whether corrections were made for the MgATPase or not, it had only marginal effects on the calculations of the stoichiometry of the pump.(ABSTRACT TRUNCATED AT 250 WORDS)

A full-length cDNA clone encoding the human gastric H,K-ATPase (EC 3.6.1.36)beta-subunit was isolated from a human gastric mucosal lambda gt10 library using oligonucleotide probes which were based on the cDNA sequence from rat and rabbit H,K-ATPase beta-subunits. The insert was 1407 bp in length and encoded a polypeptide of 291 amino acids with a MW = 33,367 Da. It exhibited 84.2%, 85.6% and 81.3% identity to the H,K-ATPase beta-subunits of rabbit, pig and rat, respectively.

Rat gastric mucosal cells, containing 25-35% parietal cells, were obtained by a modified isolation procedure involving protease, ethylene glycol-bis(beta-aminoethyl ether)-N,N,N',N'-tetraacetic acid, and mechanical treatments. Parietal cell responsiveness to secretagogues was assessed by the accumulation of the weak base [14C]aminopyrine in intracellular acidic compartments. Histamine, without phosphodiesterase inhibitors, dose dependently stimulated aminopyrine accumulation with an effective concentration producing 50% of maximal response of 13 microM and a maximal effective dose of 100 microM. Pentagastrin and rat gastrin-17 alone were ineffective but potentiated dose dependently the action of 100 microM histamine. The mean potentiating effect varied from 32 to 70% for 100 nM pentagastrin and from 36 to 95% for 100 nM rat gastrin-17. Pentagastrin (100 nM) also potentiated the effect of 1 mM dibutyryladenosine 3',5'-cyclic monophosphate (cAMP) by 44%, but it did not increase further the stimulation by carbachol. The potentiating effect of pentagastrin on histamine- and dibutyryl cAMP-stimulated aminopyrine accumulation was also observed after enrichment of parietal cells to 65-85%. The endogenous histamine was insufficient to stimulate acid production. Therefore gastrin appears to have a direct action also in rat parietal cells.

The occurrence of autoantibodies against intrinsic factor, H,K-ATPase, and pepsinogen was analysed by means of enzyme-linked immunosorbent assay in three groups of sera. Group 1 comprised sera from 14 rheumatoid arthritis patients with normal acid secretion; group 2, sera from 18 rheumatoid arthritis patients with reduced acid secretion; and group 3, sera from 11 patients with pernicious anaemia or achylia. Groups 1 and 2 were rheumatoid factor-positive, and group 3 was negative. Intrinsic factor autoantibodies were low in groups 1 and 2. In group 3, 9 of the 11 sera (82%) scored positive. The highest titres of H,K-ATPase and pepsinogen autoantibodies were found in groups 2 and 3. Only one serum in group 1 scored positive against H,K-ATPase, and two against pepsinogen, whereas corresponding values were 11 (61%) and 7 (39%) in group 2, and 10 (91%) and 6 (55%) in group 3. Autoantibodies against H,K-ATPase from a pool of patient sera recognized both the alpha- and beta-subunits of the enzyme. The present results support the hypothesis of an autoimmune disease overlap between non-organ-specific rheumatoid arthritis and organ-specific pernicious anaemia.

The possible presence of parietal cell stimulating antibodies was examined in sera from 57 patients with relapsing ulcer disease. The sera were obtained at the time of symptomatic relapse and all patients had ulcers confirmed by endoscopy. A sensitive assay based on adenosine 3':5' cyclic monophosphate (cAMP) production in isolated porcine gastric mucosal cells was used as a measure. cAMP production increased up to four hours of incubation and was histamine responsive; an approximately 20-fold increase was found with histamine 10(-4) mol/l. Sera from both patients and healthy control subjects showed some inhibitory effect on basal cAMP production compared with incubation in medium only, whereas immunoglobulin preparations had a weaker non-specific effect. No stimulation was found when the patients' sera and immunoglobulins (up to a concentration of 6 mg/ml) were examined. These results suggest that gastric acid hypersecretion in duodenal ulcer disease is not an effect of histamine receptor stimulating antibodies. The data thus argue against a recent hypothesis that severe chronic ulcer disease in some patients has an autoimmune origin.

A continuous-flow method was developed for determining the stoichiometry of the gastric proton pump H,K-ATPase (EC 3.6.1.36) in its hydrolysis of ATP and translocation of H+ and the K+ congener 86Rb+. H,K-ATPase-containing vesicles which had been isolated from pig gastric mucosa were incubated at 37 degrees C for 2 h in 150 mM 86RbCl, 0.5 mM ethylenebis(oxyethylenenitrilo)tetra-acetic acid and 3 mM 2-(N-morpholino)ethane sulphonic acid (Mes) adjusted to pH 6.1 with Tris, and then applied onto a 0.45 micron pore size cellulose acetate filter. The immobilized vesicles were superfused with 0.15 mM Mes/Tris buffer, pH 6.1, containing 150 mM choline chloride and 0.2 mM MgCl2. After changing to a medium containing 0.1 mM ATP, the amounts and rates of H+ uptake, 86Rb+ efflux and ATP hydrolysis were measured. The initial ratio of Rb+ transported to ATP hydrolysed gave values of 0.96 +/- 0.26 (mean +/- SD, n = 28). The initial ratio of ATP-dependent Rb+ efflux to H+ uptake gave values of 0.92 +/- 0.28 (mean +/- SD, n = 28). The Mg-ATPase activity was measured in vesicles which had been incubated with choline chloride instead of RbCl. This activity was 15.8 +/- 8.7% (mean +/- SD) of the total ATPase activity in the initial fractions used for calculation of the stoichiometry. It is argued that this Mg-ATPase may be an intrinsic activity of the H,K-ATPase and that the relation between these activities is dependent on the amount of K+ (or Rb+) present in the assay.(ABSTRACT TRUNCATED AT 250 WORDS)

A membrane fraction containing H,K-ATPase (EC 3.6.1.36) was prepared from pig gastric mucosa and found to contain phospholipase A2 (EC 3.1.1.4) and lysophospholipase (EC 3.1.1.5) activities. Washing the membranes decreased their protein content by 25%. Recovery profiles of H,K-ATPase, phospholipase A2 and lysophospholipase were similar for membranes washed either with water or with 0.15 or 1.5 M KCl. Nearly identical distribution profiles were obtained for the three enzyme activities after centrifugation of washed vesicle membranes on a linear sucrose gradient. The phospholipase A2 activity was stimulated by calcium and increased further in the presence of calmodulin. The amount of cellular radioactively labelled lysophosphatidylcholine was doubled upon cholinergic stimulation of isolated parietal cells prelabelled with [3H]glycerol or 32Pi. The liberated lyso[32P]phosphatidylcholine had its acyl chain in the sn-1 position, which implies an activation of a phospholipase A2. These findings indicate that secretagogues which increase the cytosolic Ca2+ concentration, i.e. acetylcholine, histamine and gastrin, may activate a phospholipase A2 in the parietal cell.

Fusion of pig gastric H,K-ATPase- and phospholipase A2-containing vesicles in vitro was studied by electron microscopy and by monitoring the change in fluorescence of octadecyl rhodamine B-labelled vesicles. Ca2+ stimulated fusion of the vesicles, and the fusion rate showed a positive correlation with the activity of the phospholipase A2. Both the Ca2(+)-stimulated fusion rate and the Ca2(+)-dependent phospholipase A2 activity were further enhanced by the presence of calmodulin. The present results supported our previous findings (Olaisson et al. 1990) and further indicate that the phospholipase A2 associated with the H,K-ATPase-containing membranes might play a central role in membrane fusion processes in the stimulated parietal cell.

Mucosal cells were prepared by enzymatic digestion of porcine gastric mucosa with pronase and collagenase. The resulting cell suspension contained 10-15% parietal cells, which responded to histamine stimulation by an up to 20-fold increase in [14C]aminopyrine accumulation over control levels. Cholecystokinin-8 (CCK-8) evoked a more moderate stimulation of [14C]aminopyrine accumulation, whereas somatostatin inhibited histamine-stimulated accumulation. Parietal cells were enriched by elutriation and isopycnic centrifugation on density gradients of Percoll. A fraction with 60% parietal cells bound approximately three times more iodinated CCK-8 than a fraction containing 70% non-parietal cells. Binding of [125I]BH-CCK-8 to preparations containing 30-60% parietal cells was specifically inhibited to about 50% by 10(-9) M unlabelled CCK-8 but not by bombesin. Cell fractions containing about 30% parietal cells also bound [125I]somatostatin. Unlabelled somatostatin at 10(-9) M inhibited tracer binding by about 50%, while CCK-8 did not affect somatostatin binding to such a preparation. The results suggest the existence of specific receptors for CCK and somatostatin on porcine parietal cells exerting a regulatory influence on acid secretion.

The occurrence of auto-antibodies in patients with the autoimmune disease pernicious anaemia and in patients with active duodenal ulcers was investigated. In order to characterize antigenic structures, various cellular and subcellular fractions were prepared from pig gastric mucosa and from a homogenate of duodenal mucosa. By means of an enzyme-linked immunosorbent assay and immunoblotting, both the H+,K(+)-ATPase and pepsinogen/pepsin were shown to constitute the major antigens. All of the seven pernicious-anaemia sera that were tested contained auto-antibodies against both antigens, and the epitopes of the H+,K(+)-ATPase were shown to be localized on its cytoplasmic face. In 75% (18/24) of the sera from patients with duodenal ulcers, auto-antibodies were detected when using purified antigens. Six sera reacted with H+,K(+)-ATPase and twelve reacted with pepsinogen, one reacted with both antigens, and four sera reacted with the duodenal mucosal antigen. The occurrence of auto-antibodies indicates that there is a mucosal lesion and that immunological factors may be involved in the pathogenesis of the disease in some patients.

Antibodies to a membrane-bound antigen, localized to the canalicular structures of the parietal cell, are found in most sera of patients with chronic atrophic gastritis and pernicious anemia. In the present study immunoglobulins containing parietal cell antibodies were found to inhibit the activity of H+,K+-adenosine triphosphatase (EC 3.6.1.36) in a tubulovesicular membrane preparation from porcine gastric mucosa. The degree of inhibition correlated to the titer of parietal cell antibodies as assessed by an enzyme-linked immunosorbent assay. The specificity of the enzymatic inhibition was confirmed by the lack of effect of parietal cell antibodies on membrane-bound esterase. A possible interaction of parietal cell antibodies with gastrin binding at the receptor level was investigated in a radioreceptor assay employing 125I-gastrin 1 and gastric mucosal cell suspension from the guinea pig. No blocking capacity was found with immunoglobulins from patients with pernicious anemia as compared with immunoglobulins from healthy controls. The results thus demonstrate a direct inhibitory effect of parietal cell antibodies on the acid producing H+,K+-adenosine triphosphatase of the parietal cell, but also a lack of interaction with the gastrin receptor, and indicate that in the development of hypo/achylia H+,K+-adenosine triphosphatase autoantibodies could have a major pathogenic role.

Disulphonic stilbenes are effective inhibitors of an anion exchanger which is present in the plasma membranes of many cells (Cabantchik et al. 1978). In the present study, the effects of 4,4'-diisothiocyano-2,2'-disulphonic stilbene acid (DIDS) on the transport activity of the hydrochloric acid pump isolated from pig stomach (H,K-ATPase, EC 3.6.1.36) were tested. Half-maximal inhibition of proton transport carried out by the H,K-ATPase in the isolated vesicles was observed at micromolar concentrations of DIDS. The effects of DIDS on the adenosine-trisphosphatase and p-nitrophenyl-phosphatase activities of isolated H,K-ATPase were also studied and compared with those of the kinetically and structurally related Na,K-ATPase (EC 3.6.1.37). Half-maximal inhibition of the enzymatic activities of both enzymes were observed in the micromolar range of DIDS. The lipid bilayer of the gastric vesicle membrane is highly asymmetric and the original cytosolic side is facing the outside of the vesicle. Since DIDS does not readily cross the membrane, it is most likely that DIDS exerts its inhibitory effects by modifying the transport ATPases on their cytosolic sides.

The effect of arachidonic acid and its metabolites on the histamine-stimulated acid production in human isolated parietal cells provenient from endoscopic biopsies was examined. 14C-aminopyrine (14C-AP) accumulation in the parietal cells was used for evaluation of acid production. Histamine dose-dependently increased AP uptake. Histamine stimulation (taken as 100% at 10(-5) M) was significantly inhibited by prostaglandin (PG) E2 to 66 +/- 7% at 10(-8) M, 42 +/- 8% at 10(-6) M, and 13 +/- 10% at 10(-4) M (mean +/- SEM, n = 10). PGF2 alpha, PGD2, and PGI2 showed significant inhibitory effects only at very high concentrations (10(-5)-10(-4) M). Leukotriene (LT) B4 and LTC4 were without effect. The basal acid production (taken as 0%) was lowered significantly by 10(-6) M arachidonic acid to -20 +/- 7.4% (p less than 0.02, n = 10), and the histamine-stimulated (10(-6) M) acid production from 100% to 64 +/- 7.2% (p less than 0.001, n = 10). Aspirin (10(-3) M) increased basal (45 +/- 9.6%, p less than 0.001, n = 10) and histamine-stimulated (10(-6) M) acid production (164 +/- 16.3%, p less than 0.001). It is concluded that PGE2, the major product from arachidonic acid metabolism in the human gastric mucosa, is a significant inhibitor of the histamine-stimulated human parietal cell and may, in humans, play a role as a local physiologic inhibitor of acid secretion.