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The aim of the present study was to investigate responses from the gastric mucosa of rats during long-term H. pylori infection. Twenty-four Sprague-Dawley rats were inoculated with a mouse-adapted strain of human H. pylori (vacA+, cagA+), 16 uninfected rats served as controls. Three to six rats from each group were killed two weeks or two, six, or 12 months later. At sacrifice, blood was sampled and the gastric mucosa was taken for bacterial culture, histology, immunocytochemistry and in situ hybridization. H. pylori colonized the antrum in 23/24 inoculated rats; with time the density of bacteria increased. The inflammation in the antral mucosa was mild to moderate and was dominated by infiltration of lymphocytes and macrophages. Serum H. pylori-specific IgG2a was significantly increased in the infected rats. The frequency of epithelial cell apoptosis was significantly increased in the early months of infection. The mucosal expression of trefoil peptide mRNA remained unchanged. We conclude that after one year of H. pylori infection in rats, the mucosal responses were rather mild, indicating that the animals may adapt to the infection by mechanisms which remain to be identified.

We investigated if hypergastrinemia exerted any influence on the proliferation of gastroduodenal epithelium during the healing of ulcers in rats. A mucosal ulcer was induced in the corpus region of the stomach in three groups of rats, which were then given vehicle, omeprazole (400 mumol/kg/day), or gastrin-17 (60 nmol/kg/day) for three or six days. A fourth group of unoperated rats served as controls. One hour before killing, [3H]thymidine was injected. The ulcer margin and corresponding control tissues were excised and processed for light microscopic determination of epithelial labeling index (LI), mitotic index, and apoptotic index. LI was also determined in other parts of the gastroduodenal mucosa. Three and six days after the ulcer operation, the LI in the vehicle-treated ulcer rats was significantly increased in the ulcer margin and in the duodenum, in comparison with the intact controls. In the ulcer margin, the mitotic index was significantly increased, in parallel with the LI; the apoptotic index remained at the control level. The LI in the ulcer margin was increased further after administration of omeprazole or gastrin-17, which elevated the plasma gastrin levels by 5-15 times. It is concluded that hypergastrinemia may increase cell proliferation in the ulcer margin, which may accelerate the rate of healing.

The effect of inhibition of acid secretion on parietal cell morphology and the concentration of H,K-ATPase alpha-subunit protein was determined by electron microscopy and western blotting. Omeprazole or famotidine alone or in combination were used. Control animals showed a morphological stimulation index (0 = resting, 1.0 = fully stimulated) of 0.60; omeprazole treatment (1 mg/kg, twice a day) resulted a stimulation index of 0.63, famotidine injection (20 mg/kg twice a day) an index of 0.11, famotidine infusion (0.2 mg/hr) for five days an index of 0.38, and the combination of omeprazole and famotidine injection twice a day gave an index of 0.02. No change in the frequency of degenerating or damaged parietal cells was observed in any of the groups. In control animals, the number of lysosomes was 0.9/cell, with famotidine 1.8 and with omeprazole 5.6/cell. H/K-ATPase levels fell by about 25% with omeprazole and rose by about 23% with famotidine.

This review examines recent concepts of gastric mucosal cell biology in relation to acid inhibition. Powerful acid-inhibitory drugs have been associated with the production of enterochromaffin-like (ECL) cell proliferation and the induction of ECL-cell carcinoids in rats. The ECL-cell lineage and its renewal is discussed, and the factors that regulate ECL-cell proliferation are reviewed. Current methods in use for assessing genotoxicity in gastric mucosa are scrutinized; the much discussed claim that antisecretory drugs induce unscheduled DNA synthesis is examined, and the methodology that is the basis for these claims is found defective and wanting. The nature of ECL-cell proliferation in rats receiving lifelong treatment with H2-receptor antagonists or acid pump inhibitors is explored, and their relationship to ECL-cell proliferation and ECL-cell carcinoids discussed. It is concluded that aged rats are very prone to developing endocrine proliferations, and this may be related to the multiple endocrine neoplasia syndrome found in humans. There is no evidence at present that long-term antisecretory therapy causes significant ECL-cell proliferation in humans.