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A Potential Therapeutic Problem

Marc D. Basson, MD; Karl A. Zucker, MD; Thomas E. Adrian, PhD, MRCPath; Michael J. Zdon, MD; Garth H. Ballantyne, MD; Irvin M. Modlin, MD

Arch Surg. 1988;123(4):431-433.

Abstract
• Prostaglandins inhibit gastric acid secretion and are independently "cytoprotective" for gastric mucosa. They are currently under clinical investigation for the treatment of peptic ulcers. The effects of the prostaglandin E₁ analogue misoprostol on pepsinogen and acid secretion were tested in isolated rabbit gastric glands and enriched parietal cells. Pepsinogen concentrations were measured by iodine 125—labeled albumin digestion and acid secretion indirectly by carbon 14—tagged aminopyrine uptake. Misoprostol inhibited histamine-stimulated acid secretion in parietal cells with 50% inhibition at 10^–9 mol/L and maximally (78% inhibition) at 10⁷ mol/L. In contrast, however, misoprostol strongly stimulated pepsinogen secretion by gastric glands with a halfmaximal effect at 10^–8 mol/L and maximal stimulation of 227% at 10⁶ mol/L. It is possible that this release of pepsin could compromise the action of prostaglandins in promoting ulcer healing.

(Arch Surg 1988;123:431-433)

Author Affiliations
From the Departments of Surgery, Yale University School of Medicine, New Haven, Conn, and the Veterans Administration Medical Center, West Haven, Conn.

Footnotes
Accepted for publication Sept 23, 1987.

Read before the Association of Veterans Administration Surgeons, Portland, Ore, May 6, 1987.

Reprints not available.

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