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Pepsinogens, proteolytic enzymes produced by peptic cells of the stomach and discharged into the gastric lumen as well as into the blood have been divided into two groups: PG-I, originating from chief cells, and PG-II, mainly from antrum peptic cells. Both total serum pepsinogen (s-Pg) and PG-I have been separately reported as being significantly increased in gastric (GU) and duodenal ulcer (DU) patients and related to maximal acid output. In order to ascertain the relationship between s-Pg measured by means of the colorimetric Uete method, and PG-I determined by RIA method, these were assayed in 72 control subjects, 35 GU and 95 DU patients. s-Pg was found to be significantly increased both in GU and DU patients in comparison with control subjects. Likewise PG-I was significantly enhanced in GU and DU patients as compared with controls. A significant direct correlation between s-Pg and PG-I was found in all the subjects studied (r = 0.732).

Serum alkaline phosphatase (AP) electrophoretic phenotype and the level of its activity inhibited by l-phenylalanine 5 mM (the stereospecific inhibitor of the intestinal AP isoenzyme) were investigated in 312 subjects (132 healthy controls, 89 patients with duodenal ulcer, 31 with gastric ulcer and 60 family members of the duodenal ulcer patients) in correlation with the ABO blood group system and secretory status. In the control subjects, those with A(II) blood group showed a predominance of the p degrees electrophoretic phenotype while phenotypes p+ and p++ were more frequent in the controls with O(I) and B(III) blood groups and in the secretory ones. In the patients with duodenal ulcer and their family members the frequency of phenotypes p+ and p+ was significantly higher than in the controls. The same distribution of frequencies was observed for the level of AP activity inhibited by l-phenylalanine. The results obtained are discussed in the light of a possible genetic linkage.

No microbial growth in platings of the gastric juice of patients with gastric ulcer and chronic anacidic gastritis was observed. It means that the absence of hydrochloric acid in the gastric juice does not deprive it of any antimicrobial action. The possible role of lysozyme in providing sterility of the proximal part of the gastro-intestinal tract was studied. Eighty patients with chronic diseases of the digestive organs were observed. It was noted that the levels of lysozyme in the gastric juice was high and markedly exceeded the maximum concentrations required for lysis of organisms most resistant to it. The maximum concentration was determined at pH of the gastric juice equal to 7.0-7.5 (265 gamma/ml+/-28). No lysozyme in the content of the duodenum and jejunal juice was found in most cases. Its presence in the above parts of the gastro-intestinal tract was mainly associated with microbial growth. The maximum concentration of lysozyme (40 gamma/ml) in the jejunal juice was observed in a female patient with chronic enterocolitis and significant microbial proliferation in the thin colon (more than 10(4) microbial bodies per 1 ml of the juice). Such parallelism between the presence of lysozyme in the gastric juice and microbial proliferation in it may be considered as a protective-adoptive reaction of the host.

The gamma-glutamyl-transferase activity, the total glutathione content, the GSH-peroxidase activity, and the GSH S-transferase activity using an aryl substrate were estimated in the S9 fraction of gastric biopsy specimens taken from patients with normal stomach morphology (n = 24), acute gastritis (n = 15), chronic-atrophic gastritis (n = 10), gastric ulcer (n = 9), and carcinoma of the stomach (n = 12). The total glutathione content of normal gastric mucosal specimens was significantly higher than that of human liver biopsy specimens, whereas the GSH-peroxidase and the GSH S-aryltransferase activities were much lower than those found in the liver. Specimens of gastric ulcer had significantly lower enzyme activities of GSH-peroxidase and GSH-aryltransferase, whereas gastric cancer tissue had significantly lower concentrations of total glutathione. The intraindividual comparison of tumorous and non-tumorous tissue showed a consistent decrease of total glutathione as well as of GSH-aryltransferase activity in carcinomatous tissue.

The role of pepsin proteolytic activity in the Exalto-Mann-Williamson ulcer has previously not been established. Our studies show that a potent inhibitor of pepsin activity, when administered orally to E-M-W dogs, reduced both the incidence and severity of jejunal ulceration. These results indicate that pepsin may play a major role in the development of ulceration in this model.

Biosynthesis of pyrimidine nucleotides was intensified in proliferating tissues. Age-dependent alterations in activities of thymidine kinase and thymidine phosphorylase were found in healthy persons of 17-70 years old. Distinct increase in activity of thymidine kinase was observed in patients with gastric ulcer but the activity was decreased with ageing. Alterations in the ratio between anabolic and catabolic reactions involving thymidine were studied also in patients with gastric tumor depending on age.

Luminescence analysis of gastric biopsy specimens reflecting the state of cell respiration of the mucous membrane of the stomach (MMS) was used for endoscopic investigation of 271 patients with gastric ulcer (GU). A degree of decrease of the patients' own luminescence (DDPL) in an ordinary course of GU with a favorable outcome of cicatrization (108 patients) did not exceed 25% at the ulcer edge and 10% in the periulcerative zone. Prognosis of malignant transformation of ulcer and the development of callous gastric ulcer was based on the detection of a sharp decrease in the level of luminescence at the ulcer edge. A conclusion was made of a high prognostic value of luminescence endoscopy in GU.

Acid proteolytic zymogens contained in biopsy specimens obtained from the area surrounding peptic ulcers of the stomach were analyzed by means of agar gel electrophoresis and compared with histopathological findings. It was demonstrated that the specimens obtained from the base of ulcer contained only slow moving protease (SMP) while mucosa located near the margin of ulcer showed the pyloric mucosal type of electrophoretic pattern and increase in distance between the margin of ulcer and the site of biopsy changed the electrophoretic pattern of specimens to the fundic mucosal type. The electrophoretic findings of acid proteolytic zymogens were found to be correlated closely to histological findings, and these changes were found to distribute in a patchy form around the ulcer. It was also found that endoscopically healed scared was covered with regenerated epithelium containing parietal and chief cells of which the electrophoretic pattern of acid proteolytic zymogens was of a fundic mucosal type.

In duodenal ulcer alkaline phosphatase activity was the highest in mucosa of pyloric region of curvature ventriculi minor and it decreased distinctly in the tissues removed from pylorus. In cases of gastric ulcer, the enzymatic activity was high throughout the curvatura ventriculi minor reaching the maximal value at the ulcerous zone. Alkaline phosphatase from gastric mucosa resembled the enzyme from intestine in its inhibition patterns with 1-phenylalanine and in inactivation properties at 56 degrees within 15 min; but, as distinct from the latter, the enzyme was more stable at 65 degrees within 5 min, maintaining 50% of the initial activity.

The antiulcer effect of two medicinal forms (oil solution, liniment) of dibunol in rats with different models of the stomach and duodenum ulcers was studied. The therapeutic activity of dibunol was evaluated by determining the index of ulcer formation as well as during the morphological and histochemical studies. The two medicinal forms of dibunol possessed equal antiulcer activity by all studied criteria. One should note a characteristic property of dibunol--its ability to produce pronounced epithelialization of ulceroerosive and ulceronecrotic lesions of the mucosa without rough scarring.

We examined the pathophysiological roles of the urea-urease-ammonia system in gastric ulcer disease using rats. Exposure of the stomach to ammonia (0.01-1.0%) decreased the transmucosal potential difference (PD) and histological injury in a concentration-dependent manner. Exposure of the stomach for 20 min to urea (0.025-0.2%) together with urease (100 IU) produced a decrease in PD and microscopic injury similarly, and the lesion was closely associated with the amount of ammonia produced. Urea and urease alone had no effect on the gastric mucosa. These results suggested the pathophysiological importance of urea, urease and ammonia in gastric ulcer disease.

Fundic mucosal pepsinogens reveal six major bands of protease activity on gel electrophoresis and four minor bands. Antral mucosa shows two major bands of activity; the four rapidly moving bands found in fundic mucosa are found in lesser activity in the antral mucosa. Duodenal mucosa shows only one slowly moving band of protease activity. There is a significant difference in the pepsinogen pattern when the uninvolved fundic mucosa of gastric ulcer patients is compared with that of cancer patients.A satisfactory method is described for separating the pepsinogens on column chromatography.