Burman P, Mårdh S, Lööf L, Naesdal J, Karlsson F A
Department of Internal Medicine, Uppsala University, Sweden.
Gut. 1991 Jun;32(6):620-3. doi: 10.1136/gut.32.6.620.
The possible presence of parietal cell stimulating antibodies was examined in sera from 57 patients with relapsing ulcer disease. The sera were obtained at the time of symptomatic relapse and all patients had ulcers confirmed by endoscopy. A sensitive assay based on adenosine 3':5' cyclic monophosphate (cAMP) production in isolated porcine gastric mucosal cells was used as a measure. cAMP production increased up to four hours of incubation and was histamine responsive; an approximately 20-fold increase was found with histamine 10(-4) mol/l. Sera from both patients and healthy control subjects showed some inhibitory effect on basal cAMP production compared with incubation in medium only, whereas immunoglobulin preparations had a weaker non-specific effect. No stimulation was found when the patients' sera and immunoglobulins (up to a concentration of 6 mg/ml) were examined. These results suggest that gastric acid hypersecretion in duodenal ulcer disease is not an effect of histamine receptor stimulating antibodies. The data thus argue against a recent hypothesis that severe chronic ulcer disease in some patients has an autoimmune origin.
对57例复发性溃疡病患者的血清进行了壁细胞刺激抗体存在可能性的检测。血清于症状复发时采集,所有患者均经内镜检查证实有溃疡。采用一种基于分离的猪胃黏膜细胞中3':5'-环磷酸腺苷(cAMP)生成的敏感检测方法作为衡量指标。cAMP生成在孵育4小时内增加且对组胺有反应;在10(-4) mol/l组胺作用下发现增加约20倍。与仅在培养基中孵育相比,患者和健康对照受试者的血清对基础cAMP生成均显示出一定抑制作用,而免疫球蛋白制剂的非特异性作用较弱。检查患者血清和免疫球蛋白(浓度高达6 mg/ml)时未发现刺激作用。这些结果表明十二指肠溃疡病中的胃酸分泌过多并非组胺受体刺激抗体的作用。因此,这些数据与最近关于某些患者严重慢性溃疡病有自身免疫起源的假说相悖。