Absence of a gastrin inhibitory factor in the IgG fraction of serum from patients with pernicious anaemia

Article Abstract:

Gastrin, a peptide hormone secreted by the stomach, is an important stimulator of gastric acid secretion. In patients chronically treated with gastric acid-suppressing drugs such as omeprazole or antihistamines, the levels of gastrin are dramatically increased (known as hypergastrinemia). These increased levels cause a proliferation of a certain type of cell in the stomach lining which may develop into carcinoid tumors. In patients with Addisonian pernicious anemia (APA; a type of anemia characterized by deficient gastric acid secretion), gastrin levels are also increased. Some have proposed using patients with APA as a model to study the effects of long-term hypergastrinemia. But this may not be a suitable model, because it has been reported that APA patients may produce a novel antibody (an immunoglobulin G antibody) directed against the gastrin receptor (the structure in the wall of gastric cells to which gastrin must bind to have its physiological effect). This antibody is reported to antagonize gastrin-stimulated gastric acid secretion, and may exert a similar effect on the incipient gastric tumor cells, preventing their development. In order to investigate whether such an antibody is in fact produced in APA patients, a study was carried out in which blood was taken from 15 patients suffering from the disease, and the fraction which would contain the antibody was isolated. When the ability of this fraction to displace radioactively labeled gastrin from rat pancreatic carcinoma cells (which would indicate the presence of gastrin antibodies) was studied, it was found that there was no displacement. Similarly, intravenous and intragastric administration to anesthetized rats of the fraction containing the presumptive antibody failed to have any effect on gastrin-stimulated acid secretion. These findings are thought to indicate that the existence of gastric antibodies in the blood of APA patients is questionable. (Consumer Summary produced by Reliance Medical Information, Inc.)

Measurement, Physiological aspects, Immunoglobulin G, Hormone antagonists, Gastrin, Pernicious anemia

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Helicobacter pylori infection in healthy people: a dynamic process?

Article Abstract:

Infection of the gastric mucosa (the inner lining of the stomach) with the microorganism Helicobacter pylori is associated with a wide range of inflammatory gastrointestinal conditions, including antral gastritis (inflammation of the stomach), gastric ulcer, duodenal ulcer, and nonulcer dyspepsia (painful digestion). An extremely high percentage of patients with these conditions can be shown to have H. pylori infestation; however, the high percentage of healthy individuals (up to 50 percent) who have anti-H. pylori antibodies clouds the role of this microbe in the etiology of inflammatory gastrointestinal conditions. It is not known whether the presence of antibodies reflects active colonization of the organism in the gastric mucosa of these healthy patients, or simply a prior exposure to H. pylori that was successfully overcome. To further clarify this issue, 100 healthy volunteers were tested for the presence of H. pylori antibodies by means of a specific enzyme-linked immunosorbent assay (ELISA); the same group of volunteers was tested for active H. pylori infection with the 13C-urea breath test (a biochemical assay which makes use of a metabolic pathway unique to H. pylori to quantify the presence and extent of infestation). Almost half of the subjects had high levels of anti-H. pylori antibodies; only 24 percent had active H. pylori infection. This suggests that a considerable number (over 25 percent in this sample) have been infected with H. pylori at one time, and have successfully overcome the infection. The inability of some individuals to eliminate H. pylori may be an important factor in the development of ulcerative conditions. (Consumer Summary produced by Reliance Medical Information, Inc.)

Helicobacter pylori, Gastrointestinal diseases, Peptic ulcer

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