Structural changes of gastric mucosa in patients with intestinal metaplasia and nitrogen oxide hyperproduction
Background. The purpose was to analyze structural changes in gastric mucosa and to assess the role of nitric oxide system in these processes in patients with chronic gastritis and intestinal metaplasia. Materials and methods. Morphological study was conducted in 38 patients with chronic gastritis with atrophy, intestinal metaplasia located in the antrum and diffuse intestinal metaplasia. Concentration of nitric oxide was measured in gastric contents and in the blood of all patients. Results. Morphometric study showed a marked decrease (to (0.12 ± 0.04) %) in the nuclear-cytoplasmic ratio in patients with intestinal metaplasia compared to patients with atrophy, while the ellipticity of the native cell nuclei also decreased with the development of intestinal metaplasia, and in patients without metaplastic changes was equal to (0.76 ± 0.04) %, for cases of antrum-localized intestinal metaplasia — (0.65 ± 0.11) %, and for the diffuse metaplasia — (0.41 ± 0.12) %. It was found that in patients with antrum-localized intestinal metaplasia, the level of nitric oxide in gastric juice increased and was 24–65 % higher than the control values. A possible mechanism of gastric mucosa cell death with apoptosis and necrosis under hyperproduction of nitric oxide is considered. Conclusions. The inhibitory effect of nitric oxide on acidic gastric secretion is realized at the expense of its stimulating effect on the activity of cyclooxygenase and the synthesis of prostaglandins.
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