Yoshida Masashi, Wakabayashi Go, Ishikawa Hideki, Kameyama Kaori, Shimazu Motohide, Tanabe Minoru, Kawachi Shigeyuki, Kumai Koichiro, Kubota Tetsuro, Otani Yoshihide, Saikawa Yoshiro, Sano Katsuko, Kitajima Masaki
Department of Surgery, Keio University School of Medicine, Tokyo, Japan.
Clin Hemorheol Microcirc. 2003;29(3-4):301-12.
A possible defensive mechanism in the basal region of the gastric mucosa was hypothesized in the present study. In vivo microscopy was performed to observe the basal region after thermal injury to the back skin of rats. A donor of nitric oxide, 3-morpholinosydnonimine hydrochloride (SIN-1), or a serine protease inhibitor, camostat mesilate, was administered. Anti-vascular endothelial growth factor (VEGF) neutralizing antibody was administered 5 hours after thermal injury (anti-VEGF group). Post-capillary venules could be observed in the basal region of the gastric mucosa (PV-BGM). The PV-BGM was dilated 5 hours after thermal injury, and it was reduced by the administration of SIN-1 or pre-treatment with camostat mesilate. In the control group, the erosions did not reach the basal region of the gastric mucosa. Most of the erosions healed within 72 hours. Delayed healing was observed in the anti-VEGF group. In this group, exudation and congestion in the basal region were observed at 24 hours, and ulcer formation was observed at 72 hours after thermal injury. It is thus hypothesized that blood flow of the PV-BGM increases when superficial mucosal circulation is disturbed. The PV-BGM can contribute to defensive mechanisms in the basal region of gastric mucosa. The abnormal healing process may disturb the defensive mechanism at the base of the gastric mucosa, thereby resulting in ulcer formation.
本研究假设胃黏膜基底部可能存在一种防御机制。对大鼠背部皮肤进行热损伤后,采用体内显微镜观察胃黏膜基底部。给予一氧化氮供体盐酸3 - 吗啉代辛二亚胺(SIN - 1)或丝氨酸蛋白酶抑制剂甲磺酸卡莫司他。热损伤5小时后给予抗血管内皮生长因子(VEGF)中和抗体(抗VEGF组)。可在胃黏膜基底部观察到毛细血管后微静脉(PV - BGM)。热损伤5小时后PV - BGM扩张,给予SIN - 1或甲磺酸卡莫司他预处理可使其缩小。在对照组中,糜烂未累及胃黏膜基底部。大多数糜烂在72小时内愈合。抗VEGF组观察到愈合延迟。在该组中,热损伤24小时时在基底部观察到渗出和充血,72小时时观察到溃疡形成。因此推测,当浅表黏膜循环受到干扰时,PV - BGM的血流增加。PV - BGM有助于胃黏膜基底部的防御机制。异常的愈合过程可能会干扰胃黏膜底部的防御机制,从而导致溃疡形成。