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This study was undertaken to differentiate between the morphological changes produced in chambered rat gastric mucosae by 40% ethanol and by 50 mM HCl. 40% ethanol produced both focal mucosal hyperemia and widespread exfoliation of the surface epithelium. Massive release of mucus accompanied both events. In the absence of acid the released mucus was stabilized by a network of fibrin, and epithelial continuity was re-established over non-hyperemic regions by migration of epithelial (and parietal) cells from the gastric pits. Hemorrhagic erosions occurred only in the presence of acid, but were limited to the hyperemic regions. Acid had the following effects: (1) platelet thrombi were destroyed, thus promoting hemorrhage; (2) destruction of the fibrin network by acid caused dissipation of the adherent mucous coat; (3) vulnerable cells which had previously shown only ischemic damage were irreversibly damaged by acid; (4) exposed basal lamina was destroyed, thus removing the substratum necessary for orderly epithelial re-establishment.

Rapid restitution of the gastric and intestinal epithelium after acute injury involves emigration of cells from the gastric glands and basal half of the intestinal villi. An intact basal lamina is prerequisite to the restitution process. The present study was performed to determine the effects of acid on the rat gastric and duodenal basal lamina. The basal lamina was denuded in vitro by ultrasonic vibration. The tissue was then immersed in 0.2 M mannitol (control) or in HCl (5-50 mM) for 10 min. Samples of the tissues were examined by transmission and scanning electron microscopy. Some samples were stained with ruthenium red to demonstrate glycosaminoglycans. The lower concentrations of acid (5 and 10 mM) had little or no effect on the structure of the basal lamina. However, exposure to 20 and 50 mM HCl caused extensive damage to the basal lamina and exposed the underlying connective tissue matrix of the lamina propria. Ruthenium red staining demonstrated differences in size and location of glycosaminoglycans within the basal laminae of stomach and intestine. Exposure to acid at concentrations of 20 or 50 mM caused total loss of ruthenium red staining in both intestinal and gastric basal laminae. Exposure to 10 mM acid resulted in loss of the outermost (luminal) layer of anionic sites from the gastric basal lamina. These studies demonstrate that brief exposure to acid, in concentrations which are necessary for the formation of hemorrhagic erosions in the stomach, caused damage to the basal lamina. This damage may impair epithelial restitution and thus account, in part, for the role of acid in ulcerogenesis.