Kato S, Fujii T, Nakano K, Naganuma H, Nakagawa H
Department of Pediatrics, Sendai City Hospital, Japan.
J Pediatr Gastroenterol Nutr. 1994 Jul;19(1):91-6. doi: 10.1097/00005176-199407000-00015.
This study was designed to investigate ultrastructural changes in parietal cells during treatment with omeprazole. Endoscopic biopsies were performed in patients treated with omeprazole (n = 2) and cimetidine (n = 4) and in normal controls (n = 3). In the patients who received omeprazole, many parietal cells (90.9 and 66.6%) were in the "stimulated" or "partially stimulated" stage. As reported previously, our results suggest that omeprazole fails to prevent the morphological transition of parietal cells to an actively secreting phase, although it strongly inhibits acid secretion. The altered cells frequently demonstrated more marked dilation of the secretory canaliculi, compared with those of normal controls and cimetidine-treated patients. Vacuolation was found in one patient given omeprazole and one given cimetidine. In the former patient, initial famotidine treatment also led to the vacuolation of parietal cells. However, this change does not seem to imply serious parietal cell degeneration. There were no adverse morphological changes in mitochondria and nuclei in any of the groups. In conclusion, vacuolation is not specific to omeprazole. Moreover, if omeprazole is administered at a pharmacologically effective dosage for a short period of time, it may not have serious effects on the ultrastructure of human parietal cells.
本研究旨在调查奥美拉唑治疗期间壁细胞的超微结构变化。对接受奥美拉唑治疗的患者（n = 2）、西咪替丁治疗的患者（n = 4）以及正常对照者（n = 3）进行了内镜活检。在接受奥美拉唑治疗的患者中，许多壁细胞（90.9%和66.6%）处于“刺激”或“部分刺激”阶段。如先前报道，我们的结果表明，尽管奥美拉唑强烈抑制胃酸分泌，但它未能阻止壁细胞向活跃分泌阶段的形态转变。与正常对照者和西咪替丁治疗的患者相比，发生改变的细胞常常表现出分泌小管更明显的扩张。在1例接受奥美拉唑治疗的患者和1例接受西咪替丁治疗的患者中发现了空泡形成。在前者患者中，初始法莫替丁治疗也导致了壁细胞空泡形成。然而，这种变化似乎并不意味着壁细胞严重退变。所有组的线粒体和细胞核均未出现不良形态学变化。总之，空泡形成并非奥美拉唑所特有。此外，如果短期给予药理学有效剂量的奥美拉唑，它可能不会对人壁细胞的超微结构产生严重影响。
