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Evidence that H. pylori eradication is not always associated with peptic ulcer healing

1995; Elsevier BV; Volume: 108; Issue: 4 Linguagem: Inglês

10.1016/0016-5085(95)22849-7

1528-0012

Stefano Angeletti, Renato Caviglia, Adriana Marcheggiano, G. D’Ambra, Massimo Marignani, M. Paoletti, C. Iannoni, Bruno Annibale, G. Delle Fave,

Microbial Metabolites in Food Biotechnology

Epidermal growth factor (EGF) enhances healing of gastric ulcers.Repeated treatment with indomethacin (IM) significantly delays the healing of experimental gaetric ulcers induced in rate.Those ulcers with delayed healing become chronic, persisting for up to 12 wk after cessation of IM treatment nearly at the same ulcer size.We examined the effect of rhEGF on healing of "unhealed ulcer" as well as on spontaneous healing of ulcers and gastric acid secretion.[Methods] Acetic acid ulcers were induced by submucosal injection of 20% acetic acid (0.03 ml) into the gastric wall of male Donryu rate (260-280 g)."Unhealed ulcers" were induced by repeated administration of IM (1 mg/kg) s.c.twice daily (9:30 am, 0:30 pro) for 4 wk after ulceration.rhEGF (10, 30 or 100 /,g/kg) was given s.c.twice daily (9:00 am, 9:00 pln) for 2 wk after the end of IM treatment.Effect of the agent on spontaneous healing was examined by giving it for 2 wk after ulceration.After the end of each experiment, gastric secretory condition in rhEGFtreated animals was analyzed by pylorus ligation method (4 h).rhEGF was given additionally lh before ligation.Ulcerated area (ram ~) and the wet weight (g) of the stomach were determined.The length of regenerated mucosa and ruptured muscularis mucosa and the thickness of ulcer base were determined.[Resul~] After IM treatment, the ulcerated area was around 20 ram2, with the depth of 2-3 mm.Even 4 wk after cessation of IM treatment, the ulcerated area was about 16 ram2.rhEGF significantly diminished the size of ulcers when given at > 30 × 2 ~,/kg/day after IM treatment.The healing rate was 39% or 49% at 30 or 100 × 2 pg/kg/day.The length of regenerated gastric mucosa and the thickness of ulcer base were increased in a dose-related manner.Length of the ruptured muscularis mucosa was shortened.The stomach weight was significantly increased in a dose-related manner.However, the agent, even at 100 × 2 ~g/kg/day, had no effect on spontaneous healing of gastric ulcers.At that time, the stomach weight was increased significantly in a dose-related manner (1.784:[:0.032g at 100 pg/kg vs 1.398:L0.032g in the controls), rhEGF treatment significantly increased the gastric volume (12.3 ml at 100 /Jg/kg/day vs. 6.3 ml in the controls), without affecting the acidity.[Conclusion] rhEGF significantly reduced the ulcer size of "unhealed ulcers", presumably due to the enhanced proliferation of surface mucoan cells and the contraction of granulation tissue.The role of increased gastric juice volume remains unclear.