Prostaglandin Protection of the Human Gastric Mucosa against Alcohol-Induced Injury

Abstract

We studied whether pretreatment with prostaglandin (16.16-dimethyl (dm) prostaglandin Ei) may protect the human gastric mucosa against alcohol-induced injury. Healthy volunteers received (via an endoscope) intragastric pretreatment with either: A) placebo or B) 16.16dm prostaglandin E:. 1 ug/kg. and 15 min later 40 ml 60% alcohol was sprayed directly on gastric mucosa. Studies: 1) endoscopic appearance of the gastric mucosa was evaluated and scored (scale 0-5) by two investigators. 2) gastric mucosal potential difference (PD) was continuously recorded, and 3) mucosal biopsies were obtained at 30 min after alcohol for histologic examination. Alcohol instillation in subjects pretreated with placebo (group A) produced within 30 min prominent endoscopic hemorrhagic lesions (grade 4.8 ± 0.2). Histologic examination showed exfoliation of the surface epithelium, extensive edema of lamina propria. and deep hemorrhagic necrotic lesions in 86% ± 10 of specimens. These morphologic changes coincided with a sudden drop in gastric PD of 42 mV. Prostaglandin pretreatment (group B) significantly reduced alcohol-induced endoscopically visible lesions (grade 3.1 ± 0.2, P < 0.01 vs group A). Histologically, prostaglandins reduced deep hemorrhagic erosions (4.5-fold reduction) and subepithelial hemorrhages, but did not prevent exfoliation of the surface epithelium and gastric PD drop. Thus. prostaglandin administration to human volunteers effectively reduced alcohol injury to the gastric mucosa.

Key Words:

• Alcohol
• endoscopic picture
• gastric mucosa
• histology
• potential difference
• protection by prostaglandin