Serum Progastrin and Its Products, Gastric Acid Secretion and Serum Pepsinogen I in Gastric Cancer

Konturek, Stanisław J.; Konturek, Peter C.; Bielański, Władysław; Karczewska, E; Zuchowicz, Monika; Hartwich, A; Rehfeld, Jens F.; Goetze, Jens P.; Hahn, Eckhart G.

doi:10.1159/000075553

Cited by 16 publications

(16 citation statements)

References 34 publications

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“…This increased risk has also been illustrated in animal models of gastric inhibition [96]. The mechanism for this is believed to be increased gastrin secretion in response to acid inhibition.…”

Section: Controversies In Acid Suppressionmentioning

confidence: 95%

Acid Suppression and Chemoprevention in Barrett’s Oesophagus

Raj¹,

Jankowski²

2004

Dig Dis

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Barrett’s oesophagus is a pre-malignant condition affecting 1% of the population in the West. Even though most patients with Barrett’s will not develop oesophageal cancer, the incidence of adenocarcinoma is 0.45–1%, conferring a 40-fold increased risk compared with the general population. The risk rises to 40–50% within 5 years for those with high grade dysplasia. Currently, the only strategies available to diminish adenocarcinoma rates are surveillance endoscopy, endoscopic thermal or photodynamic ablation or tissue resection. The latter options are reserved for those who already have dysplasia. 10–50% of patients undergoing oesophagectomy for high grade dysplasia have been shown to have adenocarcinoma. Therefore approaches are needed to be that either remove or prevent stimuli propelling patients down the dysplasia-adenocarcinoma pathway. Both gastric acid and bile acids have been reported as potential insults involved in the pathogenesis of Barrett’s oesophagus. This is thought to be mediated by a range of molecules including cyclo-oxygenase-2, c-myc and mitogen-activated protein kinase signalling. Proton pump inhibitors not only suppress acid but also bile reflux, although symptom control is a poor guide as to adequacy of acid suppression. There is some evidence that proton pump inhibitors cause partial regression in Barrett’s oesophagus length, although the data is contradictory. Proton pump inhibitors have also been shown to increase cell differentiation and apoptosis, reduce proliferation and COX-2 levels, with the supposition that this may diminish cancer risk. However this role in decreasing cancer risk has not yet been evaluated. The use of NSAIDS and aspirin, most likely via inhibition of COX-2 and other inflammatory pathways, is associated with a reduction of adenocarcinoma rates. Both PPIs and NSAIDs/Aspirin may therefore be potential chemopreventative agents but further studies are required to appraise their use.

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Section: Controversies In Acid Suppressionmentioning

confidence: 95%

Acid Suppression and Chemoprevention in Barrett’s Oesophagus

Raj¹,

Jankowski²

2004

Dig Dis

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“…Furthermore, in gastric cancer patients the stomach is not highly acidic, which is not the case in peptic ulcer patients. 22,23 In a study of European and American patients, the primary disease in stomal ulcer was duodenal ulcer in 95% of cases, gastric ulcer in 3%, and gastroduodenal ulcer in 2%; 24 in Japan the primary disease was duodenal ulcer in 65.9% of cases, gastric ulcer in 19.1%, and gastroduodenal ulcer in 15%. 25 These fi ndings show that, preoperatively, duodenal ulcer is very frequently the primary disease in stomal ulcer, and that gastric cancer is relatively rare.…”

Section: Stomal Ulcermentioning

confidence: 99%

“…[18][19][20][21][22][23][24][25][26] The involvement of the hepatic branch of the vagus nerve and the hepatic branch which connects with the celiac branch are strongly associated with the development of gallstones, as is delayed gastric evacuation due to the decreased movement of the residual stomach after a gastrectomy. 27 Factors other than a vagotomy that affect gallbladder movement include changes in the secretions of gut hormones, including cholecystokinin (CCK); edema due to surgery; decreased sensitivity of CCK receptors in the gallbladder wall due to disorders of circulation; changes in endogenous opioids in the gallbladder wall; and the length of the postoperative fasting period.…”

Section: Postoperative Cholelithiasismentioning

confidence: 99%

The advantages and disadvantages of a Roux-en-Y reconstruction after a distal gastrectomy for gastric cancer

2009

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In Japan, the Billroth I and Billroth II operations have been used for reconstruction after a distal gastrectomy for gastric cancer. However, a Roux-en-Y reconstruction is increasingly performed to prevent duodenogastric reflux. We herein discuss the indications for Roux-en-Y in gastric surgery and review the literature to determine its advantages and disadvantages. Indications for Roux-en-Y reconstruction after a distal gastrectomy are: (a) When the primary lesion has directly invaded the duodenum or head of the pancreas, the Billroth I operation is likely to result in local recurrence near the anastomosis; (b) in addition, the Billroth I operation is not indicated after a subtotal gastrectomy due to an unacceptable anastomotic tension; reconstruction using a nonphysiological route is therefore preferred. The advantages of Roux-en-Y reconstruction after a distal gastrectomy include a reduction of reflux gastritis and esophagitis, a decreased probability of gastric cancer recurrence, and a reduction in the incidence of surgical complications such as ruptured suture lines. The disadvantages of Roux-en-Y reconstruction include the possible development of stomal ulcer, an increased probability of cholelithiasis, increased difficulty with an endoscopic approach to the ampulla of Vater, and the possibility of Roux stasis syndrome. The principal advantage of a Roux-en-Y reconstruction is that it is less likely than the Billroth I operation to result in duodenogastric reflux. Roux-en-Y reconstruction or Billroth I operation can only be selected after considering their respective advantages and disadvantages.

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“…Thus, stimulation with exogenous CCK has been proven useful in diagnostic tests of gallbladder and pancreatic diseases (Rehfeld, 2004). In another way, Konturek et al (2003a) concluded by suggesting that determination of high serum progastrin, amidated gastrins and IL-8 combined with low serum pepsinogen I may be useful biomarkers of gastric cancer (often associated with an H. pylori infection) with acute pangastritis followed by chronic active gastritis, gastric atrophy, intestinal metaplasia and displasia. In addition to standard markers such as pepsinogen, gastrin and IL-8, reactive oxygen species were recently confirmed as biomarkers in patients with gastric inflammation (Naito et al 2005).…”

Section: Molecular Forms: Roles and Therapymentioning

confidence: 99%

Gastrin, cholecystokinin and gastrointestinal tract functions in mammals

et al. 2006

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The aim of the present review is to synthesise and summarise our recent knowledge on the involvement of cholecystokinin (CCK) and gastrin peptides and their receptors in the control of digestive functions and more generally their role in the field of nutrition in mammals. First, we examined the release of these peptides from the gut, focusing on their molecular forms, the factors regulating their release and the signalling pathways mediating their effects. Second, general physiological effects of CCK and gastrin peptides are described with regard to their specific receptors and the role of CCK on vagal mucosal afferent nerve activities. Local effects of CCK and gastrin in the gut are also reported, including gut development, gastrointestinal motility and control of pancreatic functions through vagal afferent pathways, including NO. Third, some examples of the intervention of the CCK and gastrin peptides are exposed in diseases, taking into account intervention of the classical receptor subtypes (CCK 1 and CCK 2 receptors) and their heterodimerisation as well as CCK-C receptor subtype. Finally, applications and future challenges are suggested in the nutritional field (performances) and in therapy with regards to the molecular forms or in relation with the type of receptor as well as new techniques to be utilised in detection or in therapy of disease. In conclusion, the present review underlines recent developments in this field: CCK and gastrin peptides and their receptors are the key factor of nutritional aspects; a better understanding of the mechanisms involved may increase the efficiency of the nutritional functions and the treatment of abnormalities under pathological conditions.

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Serum Progastrin and Its Products, Gastric Acid Secretion and Serum Pepsinogen I in Gastric Cancer

Cited by 16 publications

References 34 publications

Acid Suppression and Chemoprevention in Barrett’s Oesophagus

Acid Suppression and Chemoprevention in Barrett’s Oesophagus

The advantages and disadvantages of a Roux-en-Y reconstruction after a distal gastrectomy for gastric cancer

Gastrin, cholecystokinin and gastrointestinal tract functions in mammals

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