Multiple pathways controlling acid secretion.

A simple balance exists between factors that promote ulcer disease (e.g., acid and pepsin secretion) and factors that protect the stomach from ulcer disease (e.g., mucosal defense mechanisms). These factors are regulated and control the integrity of the gastric mucosa. Some of the newest discoveries in the area of regulation of acid secretion are related to the cellular localization of physiologically relevant receptors for acid secretagogues and acid inhibitors. The ability to isolate and culture histamine-containing ECL cells and somatostatin-containing "D" cells, and the ability to clone genes encoding for specific receptors has greatly enhanced our understanding of the physiological role and the regulation of various cell types within the gastric mucosa.