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THE TWO-COMPONENT MUCOUS BARRIER: Its Activity in Protecting the Gastroduodenal Mucosa Against Peptic Ulceration

THE TWO-COMPONENT MUCOUS BARRIER: Its Activity in Protecting the Gastroduodenal Mucosa Against... Abstract Why DOES the living stomach of a warm-blooded animal not digest itself? This question has intrigued physiologists for almost two centuries, yet it still constitutes one of the major mysteries of our science. To some people, the problem may seem to be purely academic—one that might have fascinated the medieval philosophers, had they had a suitable conception of the process of digestion to start with. In actuality, however, the answer to this question is the key to the etiology of peptic ulceration, because this disease process is essentially just such a process of autodigestion. In the normal person, digestion of the gastrointestinal mucosa by his own gastric juice is evidently prevented by the operation of some protective mechanism, but in the ulcer patient this agent appears to have suffered impairment, at least in isolated areas. Hence, the answer to our question rests entirely on the character and action of this References 1. References 3 and 4. 2. References 8, 9, and 10. 3. References 15 and 16. 4. References 18 and 19. 5. References 8, 9, and 10 6. References 23, 24, and 25. 7. References 9, 26, 27, 28, and 29. 8. References 27, 30, 31, 32, and 33. 9. References 34, 35, and 36. 10. References 15 and 37. 11. References 38 and 39. 12. References 41 and 42. 13. References 18, 39, and 43. 14. References 39, 43, and 44. 15. References 17 and 48. 16. Hunter, J.: On the Digestion of the Stomach After Death , Philosoph. Tr. 62:447, 1772. 17. Virchow, R.: Historische, Kritisches und Positives zur Lehre der Unterleibsaffektionen , Arch. path. Anat. 5:281, 1853.Crossref 18. Pavy, F. W.: On the Immunity Enjoyed by the Stomach from Being Digested by Its Own Secretion During Life , Philosoph. Tr. 153:161, 1863. 19. Pavy, F. W.: A Treatise on the Function of Digestion, Its Disorders and Their Treatment , Ed. 2, London, J. Churchill & Sons, 1869, pp. 70-86. 20. Glover, J.: An Attempt to Prove that Digestion, in Man, Depends on the United Causes of Solution and Fermentation, Dissertation, Philadelphia, Way and Groff, 1800, p. 39. 21. Harley, G.: Contribution to Our Knowledge of Digestion , Brit. & Foreign Med. Chir. Rev. 25:206, 1860. 22. Beaumont, W.: Experiments and Observations on the Gastric Juice and the Physiology of Digestion , facsimile reprint, Boston, 1929 (original publication, Plattsburg, 1833). 23. Schiff, M.: Autodigestion of the Stomach After Death and During Life , Beitr. Physiol. 4:405, 1898. 24. de Klug, F.: Pourquoi les ferments protéolytiques ne digèrent-ils pas l'estomac et l'intestin sur le vivant? Arch. internat. physiol. 5:297, 1907. 25. Whitlow, J. E.: The Protective Role of Gastric Mucus Against the Proteolytic Action of Gastric Secretion, Master's Thesis, Loyola University Medical School, 1920. 26. Bernard, C.: Leçons de physiologie expérimentale appliquée à la médicine , Paris, J. B. Baillière, 1856, Vol. 2. 27. Danilevski, A. J.: Arb. d. XI Kongr. russ. Naturf. u. Aerzte, 1901 28. de Klug,9 p. 303. 29. Gensel, E.: Antipepsin, als Ursach der Nichtselbstverdauung des Magens, inaugurat Dissertation, St. Petersburg, 1903 30. Jahrb. Physiol. (Herman's) 12:212, 1903. 31. Hollander, F.: The Mucus Barrier in the Stomach , in Sandweiss, D. J., editor: Peptic Ulcer: Clinical Aspects, Diagnosis and Management , Philadelphia, W. B. Saunders Company, 1951. 32. Jarno, L.: Über die Antipepsin des Magensaftes , Arch. Verdauungskr. 30:191, 1922. 33. Langenskiöld, F.: Resistance of Living Tissues Against Proteolytic Enzymes , Skandinav. Arch. Physiol. 31:1, 1914. 34. Hollander, F.: Discussion on Gastric Physiology in Relation to Gastric Carcinoma , J. Nat. Cancer Inst. 5:330, 1945. 35. Hollander, F.; Sonnenblick, B. P., and Sober, H. A.: Experimental Impairment of the Gastric Mucous Barrier in Dogs , J. Nat. Cancer Inst. 7:361, 1947. 36. Hollander, F.; Stein, J., and Lauber, F. U.: The Consistency, Opacity, and Columnar Cell Content of Gastric Mucus Secreted Under the Influence of Several Mild Irritants , Gastroenterology 6:576, 1946. 37. Janowitz, H. D.; Hollander, F., and Jackson, C.: Stimulation of Cell-Free Gastric Mucus by the Topical Application of Acetylcholine , Proc. Soc. Exper. Biol. Med. 76:578, 1951. 38. Bucher, R.: Klebekraft und Haftfähigkeit des Magenschleims, ihre Bedeutung für die Therapie des Mageneschwürs , Deutsche Ztschr. Chir. 247:603, 1936. 39. Pavlov, I. P.: The Work of the Digestive Glands , Ed. 2, London, Charles Griffin & Co., Ltd., 1910. 40. Bucher, R.: Das Wesen der Schutzwirkung des Magenschleims , Deutsche Ztschr. Chir. 236:515, 1932. 41. Miller, C. O., and Dunbar, J.: Change in Viscosity of Mucin with pH , Proc. Soc. Exper. Biol. & Med. 30:627, 1933. 42. Janowitz, H. D., and Hollander, F.: Some Properties of Cell-Free Gastric Mucus , Fed. Proc. 10:70, 1951. 43. Schiff, M.: Leçons sur la physiologie de la digestion , Florence and Turin, H. Loescher, 1867, Vol. 2. 44. Komarov, S. A.: The Inactivation of Pepsin and Its Relation to Peptic Ulcer , Rev. Gastroenterol. 9:165, 1942. 45. Pekelharing, C. A.: Mitteilungen über Pepsin , Ztschr. physiol. Chem. (Hoppe-Seyler's) 35:8, 1902. 46. Schmidt, A.: Über die Scheimabsonderung im Magen, Deutsches , Arch. klin. Med. 57:65, 1896. 47. Bradley, H. C.: Inhibition of Pepsin by Mucin , J. Biol. Chem. 100: xx, 1933. 48. Bradley, H. C., and Hodges, M.: The Effect of Mucin and Mucinoids on Peptic Digestion , J. Lab. & Clin. Med. 20:165, 1934. 49. Riefler, F., and Schmid, J.: Magenschleim und Ulcusgenese: II. Mitteilung , Gastroenterologia 74:134, 1948-1949. 50. Zaus, E. A., and Fosdick, L. S.: The Antipeptic Influence of Gastric Mucin , Am. J. Digest. Dis. 1:177, 1934. 51. Florey, H. W., and Harding, H. E.: The Function of Brunner's Glands and of the Pyloric End of the Stomach , J. Path. & Bact. 37:431, 1933. 52. Fogelson, S. J.: The Treatment of Peptic Ulcer with Gastric Mucin: Preliminary Report , J. A. M. A. 96:673, 1931. 53. Mahlo, A., and Mulli: Wie wirkt Muzin im Magen? Deutsche med. Wchnschr. 60:937; 1632, 1934. 54. Hollander, F.: Secretion of Gastric Mucus in Health and Disease , in Bockus, H. L., editor: Postgraduate Gastroenterology , Philadelphia, W. B. Saunders Company, 1950, pp. 39-53. 55. Hollander, F.; Stein, J. J., and Lauber, F. U.: The pH of Gastric Mucous Secretion , Am. J. Physiol. 152:645, 1948. 56. Sober, H. A.; Hollander, F., and Sonnenblick, B. P.: Response of Gastric Mucous Barrier in Pouch Dogs to Repeated Topical Application of Eugenol , Am. J. Physiol. 162:120, 1950. 57. Hollander, F.: Factors Which Reduce Gastric Acidity: A Survey of the Problem , Am. J. Digest. Dis. 5:364, 1938. 58. Hollander, F.: Some Characteristics of Mucus Secretion in the Digestive Tract , Gastroenterology 3:403, 1944. 59. Hollander, F.: The Buffer Power of Native Gastric Mucus, in Abstracts of Communications, XIX International Physiological Congress, Montreal, 1953, p. 476. 60. Sonnenblick, B. P.; Hollander, F., and Sober, H. A.: Variations in Cell Types and Cell Density of Gastric Secretions in Dogs Following Repeated Eugenol Stimulation , Gastroenterology 16:211, 1950. 61. Hollander, F., and Goldfischer, R. L.: Histological Study of the Destruction and Regeneration of the Gastric Mucous Barrier Following Application of Eugenol: Preliminary Report , J. Nat. Cancer Inst. 10:339, 1949. 62. Bèchamp, M.: Microzymas des glands stomacales , Bull. Acad. méd., Paris 11:296, 1882. 63. Grant, R.: Rate of Replacement of the Surface Epithelial Cells of the Gastric Mucosa , Anat. Rec. 91:175, 1945. 64. Bockus, H. L.: Gastro-Enterology , Philadelphia, W. B. Saunders Company, Vol. 1, 1943. 65. Hollander, F.: Experimental Gastric Carcinoma and Mucus Secretion , Gastroenterology 2:286, 1944. 66. Kaufman, J.: Lack of Gastric Mucus (Amyxorrhoea Gastrica) and Its Relation to Hyperacidity and Gastric Ulcer , Am. J. M. Sc. 135:207, 1908. 67. Glass, G. B. J.: Gastric Mucin and Its Constituents: Physico-Chemical Characteristics, Cellular Origin, and Physiological Significance , Gastroenterology 23:636, 1953. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives of Internal Medicine American Medical Association

THE TWO-COMPONENT MUCOUS BARRIER: Its Activity in Protecting the Gastroduodenal Mucosa Against Peptic Ulceration

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References (26)

Publisher
American Medical Association
Copyright
Copyright © 1954 American Medical Association. All Rights Reserved.
ISSN
0888-2479
DOI
10.1001/archinte.1954.00240250117009
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Abstract

Abstract Why DOES the living stomach of a warm-blooded animal not digest itself? This question has intrigued physiologists for almost two centuries, yet it still constitutes one of the major mysteries of our science. To some people, the problem may seem to be purely academic—one that might have fascinated the medieval philosophers, had they had a suitable conception of the process of digestion to start with. In actuality, however, the answer to this question is the key to the etiology of peptic ulceration, because this disease process is essentially just such a process of autodigestion. In the normal person, digestion of the gastrointestinal mucosa by his own gastric juice is evidently prevented by the operation of some protective mechanism, but in the ulcer patient this agent appears to have suffered impairment, at least in isolated areas. Hence, the answer to our question rests entirely on the character and action of this References 1. References 3 and 4. 2. References 8, 9, and 10. 3. References 15 and 16. 4. References 18 and 19. 5. References 8, 9, and 10 6. References 23, 24, and 25. 7. References 9, 26, 27, 28, and 29. 8. References 27, 30, 31, 32, and 33. 9. References 34, 35, and 36. 10. References 15 and 37. 11. References 38 and 39. 12. References 41 and 42. 13. References 18, 39, and 43. 14. References 39, 43, and 44. 15. References 17 and 48. 16. Hunter, J.: On the Digestion of the Stomach After Death , Philosoph. Tr. 62:447, 1772. 17. Virchow, R.: Historische, Kritisches und Positives zur Lehre der Unterleibsaffektionen , Arch. path. Anat. 5:281, 1853.Crossref 18. Pavy, F. W.: On the Immunity Enjoyed by the Stomach from Being Digested by Its Own Secretion During Life , Philosoph. Tr. 153:161, 1863. 19. Pavy, F. W.: A Treatise on the Function of Digestion, Its Disorders and Their Treatment , Ed. 2, London, J. Churchill & Sons, 1869, pp. 70-86. 20. Glover, J.: An Attempt to Prove that Digestion, in Man, Depends on the United Causes of Solution and Fermentation, Dissertation, Philadelphia, Way and Groff, 1800, p. 39. 21. Harley, G.: Contribution to Our Knowledge of Digestion , Brit. & Foreign Med. Chir. Rev. 25:206, 1860. 22. Beaumont, W.: Experiments and Observations on the Gastric Juice and the Physiology of Digestion , facsimile reprint, Boston, 1929 (original publication, Plattsburg, 1833). 23. Schiff, M.: Autodigestion of the Stomach After Death and During Life , Beitr. Physiol. 4:405, 1898. 24. de Klug, F.: Pourquoi les ferments protéolytiques ne digèrent-ils pas l'estomac et l'intestin sur le vivant? Arch. internat. physiol. 5:297, 1907. 25. Whitlow, J. E.: The Protective Role of Gastric Mucus Against the Proteolytic Action of Gastric Secretion, Master's Thesis, Loyola University Medical School, 1920. 26. Bernard, C.: Leçons de physiologie expérimentale appliquée à la médicine , Paris, J. B. Baillière, 1856, Vol. 2. 27. Danilevski, A. J.: Arb. d. XI Kongr. russ. Naturf. u. Aerzte, 1901 28. de Klug,9 p. 303. 29. Gensel, E.: Antipepsin, als Ursach der Nichtselbstverdauung des Magens, inaugurat Dissertation, St. Petersburg, 1903 30. Jahrb. Physiol. (Herman's) 12:212, 1903. 31. Hollander, F.: The Mucus Barrier in the Stomach , in Sandweiss, D. J., editor: Peptic Ulcer: Clinical Aspects, Diagnosis and Management , Philadelphia, W. B. Saunders Company, 1951. 32. Jarno, L.: Über die Antipepsin des Magensaftes , Arch. Verdauungskr. 30:191, 1922. 33. Langenskiöld, F.: Resistance of Living Tissues Against Proteolytic Enzymes , Skandinav. Arch. Physiol. 31:1, 1914. 34. Hollander, F.: Discussion on Gastric Physiology in Relation to Gastric Carcinoma , J. Nat. Cancer Inst. 5:330, 1945. 35. Hollander, F.; Sonnenblick, B. P., and Sober, H. A.: Experimental Impairment of the Gastric Mucous Barrier in Dogs , J. Nat. Cancer Inst. 7:361, 1947. 36. Hollander, F.; Stein, J., and Lauber, F. U.: The Consistency, Opacity, and Columnar Cell Content of Gastric Mucus Secreted Under the Influence of Several Mild Irritants , Gastroenterology 6:576, 1946. 37. Janowitz, H. D.; Hollander, F., and Jackson, C.: Stimulation of Cell-Free Gastric Mucus by the Topical Application of Acetylcholine , Proc. Soc. Exper. Biol. Med. 76:578, 1951. 38. Bucher, R.: Klebekraft und Haftfähigkeit des Magenschleims, ihre Bedeutung für die Therapie des Mageneschwürs , Deutsche Ztschr. Chir. 247:603, 1936. 39. Pavlov, I. P.: The Work of the Digestive Glands , Ed. 2, London, Charles Griffin & Co., Ltd., 1910. 40. Bucher, R.: Das Wesen der Schutzwirkung des Magenschleims , Deutsche Ztschr. Chir. 236:515, 1932. 41. Miller, C. O., and Dunbar, J.: Change in Viscosity of Mucin with pH , Proc. Soc. Exper. Biol. & Med. 30:627, 1933. 42. Janowitz, H. D., and Hollander, F.: Some Properties of Cell-Free Gastric Mucus , Fed. Proc. 10:70, 1951. 43. Schiff, M.: Leçons sur la physiologie de la digestion , Florence and Turin, H. Loescher, 1867, Vol. 2. 44. Komarov, S. A.: The Inactivation of Pepsin and Its Relation to Peptic Ulcer , Rev. Gastroenterol. 9:165, 1942. 45. Pekelharing, C. A.: Mitteilungen über Pepsin , Ztschr. physiol. Chem. (Hoppe-Seyler's) 35:8, 1902. 46. Schmidt, A.: Über die Scheimabsonderung im Magen, Deutsches , Arch. klin. Med. 57:65, 1896. 47. Bradley, H. C.: Inhibition of Pepsin by Mucin , J. Biol. Chem. 100: xx, 1933. 48. Bradley, H. C., and Hodges, M.: The Effect of Mucin and Mucinoids on Peptic Digestion , J. Lab. & Clin. Med. 20:165, 1934. 49. Riefler, F., and Schmid, J.: Magenschleim und Ulcusgenese: II. Mitteilung , Gastroenterologia 74:134, 1948-1949. 50. Zaus, E. A., and Fosdick, L. S.: The Antipeptic Influence of Gastric Mucin , Am. J. Digest. Dis. 1:177, 1934. 51. Florey, H. W., and Harding, H. E.: The Function of Brunner's Glands and of the Pyloric End of the Stomach , J. Path. & Bact. 37:431, 1933. 52. Fogelson, S. J.: The Treatment of Peptic Ulcer with Gastric Mucin: Preliminary Report , J. A. M. A. 96:673, 1931. 53. Mahlo, A., and Mulli: Wie wirkt Muzin im Magen? Deutsche med. Wchnschr. 60:937; 1632, 1934. 54. Hollander, F.: Secretion of Gastric Mucus in Health and Disease , in Bockus, H. L., editor: Postgraduate Gastroenterology , Philadelphia, W. B. Saunders Company, 1950, pp. 39-53. 55. Hollander, F.; Stein, J. J., and Lauber, F. U.: The pH of Gastric Mucous Secretion , Am. J. Physiol. 152:645, 1948. 56. Sober, H. A.; Hollander, F., and Sonnenblick, B. P.: Response of Gastric Mucous Barrier in Pouch Dogs to Repeated Topical Application of Eugenol , Am. J. Physiol. 162:120, 1950. 57. Hollander, F.: Factors Which Reduce Gastric Acidity: A Survey of the Problem , Am. J. Digest. Dis. 5:364, 1938. 58. Hollander, F.: Some Characteristics of Mucus Secretion in the Digestive Tract , Gastroenterology 3:403, 1944. 59. Hollander, F.: The Buffer Power of Native Gastric Mucus, in Abstracts of Communications, XIX International Physiological Congress, Montreal, 1953, p. 476. 60. Sonnenblick, B. P.; Hollander, F., and Sober, H. A.: Variations in Cell Types and Cell Density of Gastric Secretions in Dogs Following Repeated Eugenol Stimulation , Gastroenterology 16:211, 1950. 61. Hollander, F., and Goldfischer, R. L.: Histological Study of the Destruction and Regeneration of the Gastric Mucous Barrier Following Application of Eugenol: Preliminary Report , J. Nat. Cancer Inst. 10:339, 1949. 62. Bèchamp, M.: Microzymas des glands stomacales , Bull. Acad. méd., Paris 11:296, 1882. 63. Grant, R.: Rate of Replacement of the Surface Epithelial Cells of the Gastric Mucosa , Anat. Rec. 91:175, 1945. 64. Bockus, H. L.: Gastro-Enterology , Philadelphia, W. B. Saunders Company, Vol. 1, 1943. 65. Hollander, F.: Experimental Gastric Carcinoma and Mucus Secretion , Gastroenterology 2:286, 1944. 66. Kaufman, J.: Lack of Gastric Mucus (Amyxorrhoea Gastrica) and Its Relation to Hyperacidity and Gastric Ulcer , Am. J. M. Sc. 135:207, 1908. 67. Glass, G. B. J.: Gastric Mucin and Its Constituents: Physico-Chemical Characteristics, Cellular Origin, and Physiological Significance , Gastroenterology 23:636, 1953.

Journal

A.M.A. Archives of Internal Medicine – American Medical Association

Published: Jan 1, 1954

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