Clinical consequences of controversies in gastric physiology

Abstract

Studies on the regulation of gastric acid secretion started more than 100 years ago at an early phase of experimental physiology. In nearly the whole last century there were disputes about the interpretation of the findings: the interaction between the three principle gastric acid secretagogues acetylcholine, gastrin and histamine, the cell producing the relevant histamine which turned out to be the ECL cell, the ability of the ECL cell to divide and thus develop into tumours, the classification of gastric carcinomas and the mechanism for Helicobacter pylori carcinogenesis. The elucidation of the central role of the ECL cell and thus its main regulator, gastrin, solve all these controversies, and gives a solid base for handling upper gastrointestinal diseases.

Keywords:

• ECL cell
• gastric cancer
• gastrin
• Helicobacter pylori
• tumour classification

Acknowledgements

This review is based upon 40 years of work at St. Olavs Hospital and Faculty of Medicine, University of Science and Technology, Trondheim, Norway. The ‘Cancer Foundation at St. Olavs Hospital’ has been the principal financial supporter of the work upon which this review has been based. I am also indebted to my twenty PhD candidates who have contributed to the different aspects finally leading to a complete concept.

Disclosure statement

No potential conflict of interest was reported by the author(s).