Modlin I M, Kumar R R, Soroka C J, Ahlman H, Nilsson O, Goldenring J R
Department of Surgery, Yale University School of Medicine, New Haven, Connecticut 06510.
Dig Dis Sci. 1994 Jul;39(7):1446-53. doi: 10.1007/BF02088047.
Profound and sustained inhibition of gastric acid secretion has been associated with development of carcinoid tumors of the fundic enterochromaffin-like (ECL) cells in rodents. While ECL cell hyperplasia has been recognized in humans, the development of carcinoid tumors is rare and often confined to patients under treatment for gastrinoma related to the multiple endocrine neoplasia type I (MEN1) syndrome. The Mastomys was utilized as a model for the rapid induction of ECLomas by insurmountable acid secretory blockade induced by the pharmacologically irreversible H2-receptor antagonist, loxtidine. Loxtidine-induced ECL cell hyperplasia and neoplasia were compared in the absence of presence of cyproheptadine (0.5 mg/kg), an H1-receptor antagonist. Loxtidine administration resulted in a significant increase in ECL cell hyperplasia and neoplasia as well as an increase in ECL cell number, mucosal thickness, plasma gastrin levels, and stomach weight. Cyproheptadine ameliorated loxtidine-induced ECL cell hyperplasia and neoplasia and significantly decreased loxtidine-stimulated increases in ECL cell number. Nevertheless, cyproheptadine failed to alter the loxtidine-induced increase in plasma gastrin, stomach weight or mucosal height. The results indicate that cyproheptadine, an H1-receptor antagonist, inhibits loxtidine-induced ECL cell hyperplasia independent of any effects on serum gastrin.
胃酸分泌受到深度且持续的抑制与啮齿动物胃底肠嗜铬样(ECL)细胞类癌肿瘤的发生有关。虽然人类已认识到ECL细胞增生,但类癌肿瘤的发生较为罕见,且通常局限于患有与I型多发性内分泌肿瘤综合征(MEN1)相关的胃泌素瘤的正在接受治疗的患者。将非洲巨鼠用作模型,以研究由药理学上不可逆的H2受体拮抗剂洛替丁诱导的不可克服的胃酸分泌阻断对ECL瘤的快速诱导作用。在存在或不存在H1受体拮抗剂赛庚啶(0.5mg/kg)的情况下,比较了洛替丁诱导的ECL细胞增生和肿瘤形成情况。给予洛替丁导致ECL细胞增生和肿瘤形成显著增加,以及ECL细胞数量、黏膜厚度、血浆胃泌素水平和胃重量增加。赛庚啶改善了洛替丁诱导的ECL细胞增生和肿瘤形成,并显著降低了洛替丁刺激引起的ECL细胞数量增加。然而,赛庚啶未能改变洛替丁诱导的血浆胃泌素、胃重量或黏膜高度增加。结果表明,H1受体拮抗剂赛庚啶抑制洛替丁诱导的ECL细胞增生,且与对血清胃泌素的任何影响无关。