Konturek S J
Department of Physiology, Jagiellonian University Medical College, Krakow, Poland.
J Physiol Pharmacol. 2003 Dec;54 Suppl 3:43-68.
Gastric acid and pepsin secretions result from the interplay of neurohormonal factors with stimulatory and inhibitory actions on oxyntic glands. At the turn of XIX century, the notion of nervism or entire neural control of digestive functions, developed by Pavlov prevailed. However, in the second part of XX century, hormonal control has been thought to play a major role in the mechanism of gastric secretion, especially gastrin, which was isolated and synthesized in 1964 by Gregory. Polish traces in gastroenterological history started with the discovery of histamine, a non-nervous and non-gastrin compound in oxyntic mucosa by L. Popielski in 1916, who found that this amine is the most potent and direct stimulant of gastric acid secretion. This histamine concept was supported by leading American gastroenterologists such as A.C. Ivy, championed later by C.F. Code, and clinically applied for testing gastric secretion by K. Kowalewski. Recently, it received a strong support from pharmacological research when J. Black designed H(2)-receptors antagonists, which were first discovered by M.I. Grossman and S.J. Konturek to inhibit not only histamine-, but also meal- and vagally-induced gastric acid secretion, thus reinforcing the notion of the crucial significance of histamine in the control of gastric secretion as the final common chemostimulator. In conclusion, Polish traces appear to be substantial in gastric history due: 1) to discovery by Popielski that histamine is a major, direct stimulus of gastric secretion; 2) to clinical application of this agent by Kowalewski in testing maximal gastric secretory activity; and 3) to clinical use of histamine H(2)-antagonists in control of gastric acid secretion and treatment of peptic ulcers.
胃酸和胃蛋白酶的分泌是神经激素因素对胃腺产生刺激和抑制作用相互作用的结果。在19世纪末20世纪初，由巴甫洛夫提出的神经论或消化功能完全由神经控制的观念盛行。然而，在20世纪后半叶，人们认为激素控制在胃分泌机制中起主要作用，尤其是胃泌素，它于1964年由格雷戈里分离并合成。波兰在胃肠病学史上的踪迹始于1916年L. 波皮尔斯基在胃黏膜中发现组胺，这是一种非神经、非胃泌素的化合物，他发现这种胺是胃酸分泌最有效、最直接的刺激物。这一组胺概念得到了美国顶尖胃肠病学家如A.C. 艾维的支持，后来由C.F. 科德倡导，并由K. 科瓦列夫斯基临床应用于检测胃分泌。最近，当J. 布莱克设计出H(2)受体拮抗剂时，药理学研究为其提供了有力支持，M.I. 格罗斯曼和S.J. 孔图雷克首次发现这些拮抗剂不仅能抑制组胺诱导的胃酸分泌，还能抑制食物和迷走神经诱导的胃酸分泌，从而强化了组胺作为最终共同化学刺激物在控制胃分泌中至关重要的观念。总之，波兰在胃分泌研究史上的踪迹似乎相当重要，原因如下：1）波皮尔斯基发现组胺是胃酸分泌的主要直接刺激物；2）科瓦列夫斯基将该物质临床应用于检测最大胃分泌活性；3）组胺H(2)拮抗剂在控制胃酸分泌和治疗消化性溃疡方面的临床应用。
