Evaluation of the relationship between lesions in the gastroduodenal region and cyclooxygenase expression in clinically normal dogs.

OBJECTIVE: To determine whether clinically normal dogs have lesions in the pylorus and duodenum and to examine the expression of cyclooxygenase (COX) isoforms in the pylorus and duodenum of these dogs. ANIMALS: 27 clinically normal dogs. PROCEDURES: Physical examination was performed on clinically normal dogs from animal shelters and research projects; the dogs were then euthanized. After the dogs were euthanized, the pylorus and duodenum were photographed and scored for gross appearance of lesions. Samples were obtained for histologic evaluation and determination of COX expression via western blot analyses. Tissues from the pylorus and duodenum were categorized as normal, inflamed, or eroded on the basis of histologic analysis. Each histologic category of tissue was then evaluated to determine the correlation with gross appearance and COX expression. RESULTS: Of the 27 dogs, 5 had unremarkable histologic findings in the pylorus and duodenum. Inflammation was found in the pylorus of 10 dogs and in the duodenum of 5 dogs. Epithelial erosion was detected in the pylorus of 1 dog and in the duodenum of 3 dogs. Gross appearance was not significantly correlated with histologic appearance. Expression of COX-1 was not upregulated by inflammation, whereas COX-2 expression was increased by inflammation or erosion. CONCLUSIONS AND CLINICAL RELEVANCE: Dogs that appear to be clinically normal may have underlying gastroduodenal lesions associated with upregulation of COX-2. Because of the inability to determine this during routine physical examination, practitioners should be aware of this potential situation when prescribing COX inhibitors.

[The role of E2 and F2alpha prostaglandins in development of erosive-ulcerative lesions of the gastroduodenal region].

THE PURPOSE OF THE STUDY: To study role of E2 and F2alpha prostaglandins in development of erosive-ulcerative lesions of gastrointestinal tract. MATERIALS AND METHODS: were examined patients with mucosal erosive-ulcerative and inflammatory lesions of gastrointestinal tract, as well as patients with osteoarthritis who received selective and non selective NSAIDs. Determination of E2 and F2alpha endogenous PG group was investigated with help of immunefuoration method with help of R&D Systems, Inc. Control group was 15 healthy patients. RESULTS: in presented work you can find that there is relationship between degree of reduction of PG level and severity of gastrointestinal mucosal lesion area. The lowest values of PGE2 and PG F2alpha observed in patients with gastric ulcer disease, especially during exacerbation. Patients with low PG synthesis in body increases likelihood of gastropathy as to reception of non-selective COX inhibitors, and at receiving selective COX-2 inhibitors.

Loss of carbamoyl phosphate synthetase I in small-intestinal adenocarcinoma.

Carbamoyl phosphate synthetase I (CPS1), normally found in hepatocytes and small-intestine (SI) enterocytes, is the antigen of Hep Par 1 antibody. Expression of CPS1 in invasive SI adenocarcinoma seems to be lost. We retrospectively collected 36 total specimens, which included 31 SI adenomas and 21 adenocarcinomas. We used 34 cases of duodenitis as a control group. Immunohistochemical and Western blot analyses were performed to determine CPS1 expression. The normal SI mucosa, all 34 cases of duodenitis, and all 29 adenomas with low-grade dysplasia demonstrated diffuse Hep Par 1 expression. Of the 21 invasive adenocarcinomas, 15 lost antigen expression (71%). These data are statistically significant (P < .05). Western blot analysis confirmed the immunohistochemical findings, with strong CPS1 expression within the normal mucosa and adenoma and complete loss in the invasive tumor. The differential expression of Hep Par 1 in dysplastic vs malignant tumors of the SI may be diagnostically useful in difficult cases.

[A procedure for determination of acid mannosidase activities in biological fluids].

A procedure has been developed for simultaneous determination of the activities of alpha-D- and beta-D-mannosidase in the biological fluids from the quantity of free 4-nitrophenol. The latter is released via enzymatic degradation of substrates of 4-nitrophenyl-alpha-D-mannose and 4-nitrophenyl-beta-D-mannose in individual incubation tests.

[The role of the hormones-cyclases system in the pathogenesis of erosive gastric and duodenal affections]. / Rol' sistemy "gormony-tsiklazy" v patogeneze érozivnogo porazheniia zheludka i dvenadtsatiperstnoi kishki.

As a result of a complex survey of 120 patients with erosive gastroduodenal affections, significant abnormalities of the aggressive-protective balance of the mucous coat of the stomach were discovered. In addition to affections of local protection factors, the change of the hormonal status characterized by hypercortisolemia, hyperinsulinemia, hypergastrinemia and increased level of such cyclic nucleotides as cAMP and cGMP was revealed. The dependence of the mucus-producing function, lysozyme activity and acid production on the level of blood hormones was discovered. Alternate dependencies of cortisol, insulin and gastrin levels on cAMP and cGMP levels as well as alternate impact of cAMP and cGMP on acid-producing gastric cells were established.

Faecal elastase 1 concentration is a marker of duodenal enteropathy.

BACKGROUND: Measurement of faecal elastase (FE1) is used widely to screen for pancreatic exocrine insufficiency (PI). FE1 does not allow differentiation of primary from secondary PI. AIMS: To investigate the relation between duodenal morphology and FE1 in children with secondary PI resulting from primary gastrointestinal diseases. METHODS: A group of 51 children underwent small intestinal biopsy and FE1 measurement. Villus to crypt ratio (VCR) and inflammation within the lamina propria of duodenal mucosal biopsy specimens were scored and compared with FE1 values. RESULTS: In 51 children from nine diagnostic categories, a highly significant correlation between FE1 and both duodenal morphology and inflammation was found. CONCLUSION: Small bowel enteropathy is associated with low FE1 concentrations, indicative of secondary exocrine pancreatic insufficiency.

Serum cholinesterase activity in children with gastroduodenitis or peptic ulcer disease.

Serum cholinesterase /ChE/ investigation in children with gastroduodenitis or peptic ulcer disease indicate its low activity, specially in children with peptic ulcer disease. These investigation can be index of parasympathetic tonus in digestive tract disease.

[The ultrastructural, histomorphological and histoenzymological changes in the gastric mucosa in different forms of chronic gastroduodenitis]. / Ul'trastrukturnye, gistomorfologicheskie i gistoénzimologicheskie izmeneniia slizistoi obolochki zheludka pri razlichnykh formakh khronicheskogo gastroduodenita.

Investigations designed to study gastric mucosa (GM) in patients with chronic primary gastroduodenitis with the aid of electron microscopy showed the abnormal changes in the cellular, subcellular membranes and capillaries to be of the same type as they are in peptic ulcer (PU) though poorly manifest. Changes in GM under chronic atrophic gastroduodenitis (ChGD) suggested involutive changes while in chronic secondary gastroduodenitis (ChSGD) it was generally not different from the mucosa ultrastructure in healthy subjects except for changes in surface epithelium. Based on the histoenzymologic studies it has been ascertained that in ChPGD there occurs a rise in lysosomal enzymes similar to that encountered in PU, reflecting the intensity of catabolic processes, decrease in the activity of enzymes of the capillary wall and mitochondria respiratory chain against the background of compensatory enhancement of the activity of the glycolytic enzyme lactate dehydrogenase. In ChAGD the activity of all the enzymes was low, while in ChSGD it did not differ significantly from that in healthy subjects.

[Characteristics of enzymatic function of the stomach in gastroduodenal diseases in children with regard to gastric carcinogenesis]. / Osobennosti fermentativnoi funktsii zheludka pri gastroduodenal'noi patologii u detei v aspekte gastrokantserogeneza.

The paper deals with a description of the biochemical properties of the isoforms of pepsinogen pepsin of gastric mucosa and blood serum in children suffering from duodenal ulcerative disease as well as in atrophic and subtrophic lesions of gastric mucosa. Atrophic gastritis was found to involve an inhibited biosynthesis of the Ist fraction of pepsinogen while ulcerative-erosive lesions of the gastro-duodenal area--an increased level of the 3rd isoform of pepsinogen.

Measurement of tryptase in endoscopic gastroduodenal biopsies: distribution and relationship with ulcer disease.

Tryptase, a serine endoprotease, was determined in mucosal biopsies from fundus, corpus, antrum and corpus-fundus of the stomach and from the duodenum in 15 controls, 66 patients with duodenal ulcer, 22 with gastric ulcer and 9 with duodenitis. Intra- and inter-assay coefficients of variation ranged from 3.3% to 8.0% and from 3.5% to 8.6%, respectively. In controls, the highest values for tryptase were found in the fundus and progressively decreased in the corpus, antrum and duodenum. Analysis of variance of data from repeated measurements, performed in six subjects having multiple determinations, achieved statistical significance (F = 16.85, P less than 0.001). Data from the corpus-fundus area documented a significant difference among patient groups (F = 2.70, P less than 0.05). Patients with an active gastric ulcer had higher mean values when compared to controls and to patients with healed gastric ulcer. A similar trend was found in patients with active duodenal ulcer. Furthermore, corpus-fundus tryptase evaluated longitudinally in three patients with an active ulcer (point A) and after healing (point B), showed significant decrease from point A to point B. By contrast it remained elevated or showed only minor decrease in two patients with a persistent active ulcer.

[Determination of fecal alpha-amylase activity in the diagnosis of chronic duodenitis]. / Opredelenie aktivnosti al'fa-amilazy kala dlia diagnostiki khronicheskikh duodenitov.

Amylasorrhea has been detected in 92-97 percent of 190 patients suffering from chronic duodenitis, 40 of these children and 50 ones with concomitant imbalance of colonic microflora, during acutely or moderately manifest catarrhal and erosive mucosal abnormalities. This condition was somewhat more marked in the children and in the patients with colonic microflora imbalance, but less acute than in acute intestinal dysfunctions such as dysentery. A characteristic feature of duodenitis-associated amylasorrhea is the predominance of a thermolabile pancreatic fraction of amylase (a small-intestinal component of amylase); in cases with concomitant colonic microflora imbalance the share of thermostable intestinal fraction (amylase large-intestinal component) grows reaching its maximum in dysentery. In chronic duodenitis amylasorrhea is regularly detectable over the course of many years; whereas in dysentery it is more manifest though not lasting. Transient impaired membranous digestion involving a reduction of the intestinal surface to adsorb pancreatic amylase appears to be responsible for duodenitis associated amylase thin-intestinal component.

Loss of alkaline phosphatase activity in duodenal mucosa: a marker for precursors of gastric metaplasia?

Biopsy specimens from duodenal mucosa in 34 patients with upper gastrointestinal symptoms and endoscopically abnormal mucosa (including duodenitis, active duodenal ulcer, and healed duodenal ulcer) and in 9 patients with histologically normal mucosa were examined histologically for gastric metaplasia and endogenous alkaline phosphatase (AP) activity. Using haematoxylin and eosin (H&E) and periodic acid-Schiff (PAS), we found gastric metaplasia in 91.2 per cent (31 out of 34) of patients with altered duodenal mucosa and in 33.3 per cent (3 out of 9) of patients with histologically normal, non-inflamed duodenal mucosa (P less than 0.001). To characterize gastric metaplasia further, histochemical methods for AP activity were applied to duodenal mucosa specimens. No AP activity was detected in complete metaplastic cells, but focal or diffuse loss of AP activity was frequently shown in otherwise normal appearing enterocytes next to metaplastic cell groups. Focal loss of AP activity was also detected in seven out of nine healthy controls (= 77.8 per cent) which appeared normal when stained with H&E. Our results suggest that the loss of AP activity in enterocytes may be an early marker of developing gastric metaplasia or at least a morphological manifestation of cell damage.

Effects of milk, prostaglandin, and antacid on experimentally induced duodenitis in the rat. Use of myeloperoxidase as an index of inflammation.

Ulcerogenesis of the duodenal mucosa frequently involves an inflammatory reaction with infiltration of leukocytes. Measurement of neutrophil myeloperoxidase activity might thus be a sensitive indicator of damage, before visible lesions occur. To test this possibility, a rat model for duodenal injury was used where fasted animals were treated with indomethacin and histamine-diHCl. Twenty-four hours after indomethacin treatment, duodenal tissues were collected for histochemical staining and biochemical assay for myeloperoxidase activity. Indomethacin- and histamine-challenged rats had significantly elevated myeloperoxidase activity compared to unchallenged controls (P less than 0.05) for both histochemistry and biochemistry. There was also a significant correlation between these two parameters (r = 0.68, P less than 0.001). The duodenal injury model then was used to test the effectiveness of known gastric protective agents. Results indicated that milk and buttermilk did not aggravate or protect against duodenal injury, while antacid and prostaglandin did significantly protect against inflammation (P less than 0.02). We concluded that measurement of myeloperoxidase activity is a sensitive and potentially useful estimate of duodenal injury that can be valuable in assessing ulcerogenesis and healing.

Low activities of disaccharidases associated with inflamed duodenal bulb mucosa.

In order to establish whether an enzymatic method (a "functional" test) could be used instead of the histological picture as an indicator of damage to enterocytes of duodenal mucosa, biopsies were taken from 39 patients with upper gastrointestinal symptoms suggestive of peptic ulcer disease, but without active ulcers at endoscopy. Eleven patients with a normal appearance of the duodenal bulb mucosa and twenty-eight patients with various degrees of endoscopic inflammation ("bulbitis") were evaluated. The histological degree of duodenitis was assessed, and the activities of maltase, invertase, trehalase and lactase in the biopsy specimens were measured. Disaccharidase activities were inversely proportional to severity in both endoscopic and histological scoring of degree of inflammation. Low disaccharidase activities were also present in patients with endoscopic inflammation of the duodenal bulb, but without histological duodenitis. Focal and especially widespread gastric metaplasia was, in itself, significantly associated with low disaccharidase activities. The correlation between endoscopic and histologic scoring of inflammation of duodenal mucosa was not significant as assessed by kappa statistics. A previous history of peptic ulcer disease was significantly more common in patients with, than in those without, endoscopic inflammation of the duodenal bulb.

[The effect of histamine H2 receptor blockaders on the proteolytic activity in patients with ulcers]. / Vliianie blokatorov H2-retseptorov gistamina na proteoliticheskuiu aktivnost' u bol'nykh iazvennoi bolezn'iu.

Fifty-three patients with duodenal ulcer and chronic duodenitis and 8 normal subjects were examined for the proteolytic activity parameters in the duodenal cavity and in withdrawn duodenal contents. In 13 duodenal ulcer patients these parameters were examined before and after therapy with histadyl (histamine H2-receptor blocker). The findings evidence that intraduodenal proteolytic activity is lower in peptic ulcer than in health, whereas the digestion of protein substrate preincubated in the duodenal cavity and put into acid solution (pH 1.68) is active in the patients and absent in normal subjects. This latter parameter reduces in peptic ulcer patients under the effect of histadyl therapy.

[Diagnosis of Campylobacter infection in patients with diseases of the stomach and duodenum]. / Diagnostika kampilobakternoi infektsii u bo'lnykh s zabolevaniiami zheludka i dvenadtsatiperstnoi kishki.

The method of C. pylori diagnosis proposed by the authors proved more informative that histological detection of the infection. The technique employs evaluation of urease activity in gastric contents. Upon comparison of the two diagnostic modalities in 30 patients with chronic gastroduodenitis and peptic ulcer there was no definite correlation in their results. It was noted that C. pylori invasion produced negligible characteristic symptoms in gastroduodenal affections.

Distribution of carbonic anhydrase I in gastric and duodenal tissue sections.

Forty-four sections of normal and abnormal gastric and duodenal tissue were examined by an immunoperoxidase technique for the demonstration of carbonic anhydrase I. The presence of the enzyme in normal gastric parietal and surface epithelial cells was confirmed. The enzyme was also demonstrated in normal and metaplastic intestinal absorptive cells, and in gastric adenocarcinoma of the usual and superficial types. The enzyme was normally absent in antral and Brunner's glands, normal and metaplastic goblet cells, and signet ring tumor cells. Gastritis and duodenitis were associated with a decrease in the staining intensity of the enzyme in surface epithelial cells, suggesting a possible decreased enzyme activity, which may enhance the risk for peptic ulceration in susceptible persons.

[Biochemical diagnosis of duodenitis]. / Zum Problem einer biochemischen Duodenitis-Diagnostik.

The activities of enteropeptidase, alanine aminopeptidase, sucrase, and leucine aminopeptidase were determined in mucosa biopsies taken from three defined places of the duodenum and in duodenal juice. We examined 23 adults with a histological proven normal mucosa and 10 patients suffering from duodenitis grade I. Using multivariate evaluation of all the four enzyme activities of the three mucosa sites, we could differentiate duodenitis from normal mucosa with an efficiency of 88%.

Variation of disaccharidase activities in duodenal biopsy specimens.

Multiple biopsy specimens were taken from the duodenal cap and/or from the descending part of the duodenum in patients admitted for routine upper endoscopy, to determine the degree of variation in disaccharidase activity. Four specimens were taken from each site and assayed in pairs. The mean coefficients of variation (CV) of enzymatic activities between duplicate measurements in the same pair of specimens were less than 3.5% and between two pairs of biopsies about 30%. The large variation in disaccharidase activity between assays performed on simultaneously biopsied specimens from the same area of the bulb and the descending part of the duodenum in the same individual implies that single values for enzyme activity must be interpreted with caution.