Kinetics of gastric epithelial cells in duodenal ulcer: local environmental factors controlling the proliferation and differentiation of gastric epithelial cells.

The Pathophysiology of peptic ulcer disease is based on heterogenous abnormalities of gastric epithelial cell function. Based on clinical observations, we proposed the hypothesis that duodenal ulcer can occur with normal acid secretion, but that recurrence of duodenal ulcer may be caused by genetic and environmental factors that promote altered kinetics in gastric cells; i.e., the formation of new cells, the migration of cells, and changes in their life span of cells. The factors controlling these processes include feeding, the action of endocrine and gut hormones, the action of the autonomic nervous system, the microcirculation, and growth factors. In this review, to prove our hypothesis, we have summarized the clinical and experimental approaches to reveal the environmental factors that control the proliferation and differentiation of gastric epithelial cells.