Effects of misoprostol on gastric pepsin secretion and human mucosal cell loss in man.

The present study determined the effect of an orally administered prostaglandin E1 analogue, misoprostol (200, 400 and 800 micrograms) on pepsin secretion and the recovery of DNA (mucosal cell loss) in human gastric juice. Effects on basal pepsin secretion, and pepsin and DNA following secretory stimulation with pentagastrin, were measured over a period of 150 minutes. At the higher dosages, compared with placebo, misoprostol significantly reduced pepsin output and concentration. Gastric juice DNA was also significantly increased during the initial 45 minutes of the study. Considering the dose-response effects observed, the misoprostol action most likely represents a direct effect on the chief cell. The effect on DNA could be the result of multiple factors, including stimulation of synthesis and/or cell migration. The antiulcer effect of prostaglandins is known to consist of both an acid antisecretory and mucosal protective component. Inhibition of pepsin and stimulation of cell turnover may also play a role in this effect.