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THE CHARACTERISTIC OF THE MUCOSA OF THE STOMACH IN NORM, AT THE ATROPHIC GASTRITIS AND AGEING

1.1. Functional morphology and regulation of cellular updating in a stomach mucosa

Structurally and functionally the stomach mucosa can be parted on two basic types: oxyntic, located in the field of a body and a greater cul-de-sac, and a mucosa of cardial and antral departments.

In the field of a body and a greater cul-de-sac the great bulk of the glands developing the basic components of a gastric juice is concentrated. These glands, besides mucous cells, contain the main things and obkladochnye (parietal) glandulotsity. On a share of the parietal cells producing a hydrochloric acid, 12 %, the main cells of 40 % developing a pepsinogen - mucous cells - 43 %, endocrine - 4 % [Helander II.F are necessary., et al. 1986].

In a mucosa of antral and cardial departments there are mucous glands. The structure of these two departments located at an input in a stomach and at an exit from it, has much in common. The cardial department occupies rather narrow circular strip in an initial part of a stomach. The sizes of a mucosa of antral department are very changeable and almost never coincide with anatomic borders, being displaced, especially on small curvature is far for their limits. Both in cardial and in antral glands there are separate parietal cells, the main cells here do not find. In the slime formed in an epithelium of glands, the considerable quantity neutral glikoproteinov, a lysozyme, Prostaglandinums forming a protective barrier, protecting a mucosa from samoperivarivanija [Uspensky Century M, 1986 contains; Aruin L. I, from co-workers., 1998].

In norm infiltration of a mucosa of a stomach is very insignificant. In modern classification of chronic gastritises it is underlined, that in a normal mucosa of a stomach there is no even a minimum infiltration, and at its presence it is necessary to diagnose already a gastritis [Stolte M et al. 1989]. However this demand can be vypolnimo only at studying of a fundal mucosa of a stomach. As to antral department individual plazmo - and lymphocytes here meet in everyone bioptate [Aruin L.I. from co-workers., 1982; 1998].

In these various on a structure and functions departments of a mucosa of a stomach different populations of endocrine cells prevail also.

Now in a stomach 10 types of endocrine cells [Sjolund K, et al are allocated., 1983]. The majority of endocrine cells, as a rule, settles down one by one or nests from several cells which occupy a basal part of an epithelium. Last years they have been found out and in own plate of a mucosa of a stomach [by Aruin L.I., from co-workers., 1986].

As the basic distinctive sign apudotsitov presence at their cytoplasma of numerous specific secretory granules which are a place of definitive formation and storage peptidnyh hormones and biogenic amines serves. Under the form, the sizes and an internal structure of granules in some cases it is possible to judge type of the hormone synthesised apudotsitom, however precisely to define a functional hormonal profile of a cell it is possible only after immunotsitohimicheskogo the analysis of a cosecreted product [for Jaglov V.V., 1989; Osadchuk M. A from co-workers., 1996].

Most often meeting and studied endokrinotsitami in a stomach are EU - ECL - G - N - D-cages.

In a body and greater cul-de-sac mucosa endocrine cells look as the discrete elements scattered in an epithelium of glands of a stomach, very rare in gastric fossas and in a superficial epithelium.

The majority of them concern cells of "the closed type" thanks to what they do not depend on influence of physical and chemical stimulus of a contained stomach.

They are involved in parakrinnye reguljatornye mechanisms by means of the cytoplasmatic processes, allowing them to reach remote targets - cells or capillaries, and operate as mediators, receiving stimulus from nervous fibers and blood vessels, providing with that trophic and secretory processes in an oxyntic zone [Bordi S et al., 2000].

The antral department of a stomach is area of the richest io to the maintenance of endocrine cells, the majority from which belongs to "open" type, their apical cytoplasmatic processes

With microvillis are informed with a lumen of glands and contain numerous pinotsitotichsskie blisters for reaction to changes of physical and chemical structure of a contained stomach [Bordi S et al., 2000]. The average quantity apudotsitov in antral department on 0,1 мм2 the mucosa areas in norm makes 87,8± 44 [Osadchuk M. A and co-workers., 1996].

Endocrine cells are closely interconnected with peptidergicheskimi neurones and nervous fibers of independent nervous system, forming neuroendocrinal complexes. To known nejrotransmitteram these nerves Acetylcholinum, Noradrenalinum, adrenaline, scale-aminomasljannaja acid, a serotonin, nucleotides - transmitters peptidnoj the nature which meet and in endocrine cells of APUD-system carry.

The basic hormones of a stomach and their function

Gastrinum

Gastrinum is synthesised in G-cells in the form of the precursor of whom under the influence of specific proteolytic enzymes it is formed Г-34 (big Gastrinum with 34 amino-acid rests), and then Г-17 (small Gastrinum) being forms circulating in blood. Are described as Minigastrinum (Г-13) and Pentagastrinum (Г-5), differing on the biological properties and distribution. Pentagastrinum - trailer oligopeptid Г-34 or Г-17 - possesses very high biological activity.

Gastrinum action is carried out by by its linkage with a receptor to holetsistokininu-2, localised on parietal and ECL-cages [Koh T J., et al. 2000]. In regulation of gastric secretion Gastrinum plays one of the basic roles. It is a stimulator obkladochnyh cells, providing, thus, regulation kislotoobrazovanija.

Physiological functions of Gastrinum are very various and are not limited to its action only on parietal cells and activation of development of a hydrochloric acid. Gastrinum stimulates also function of the main cells, enlarging pepsinogen formation, and causes a hyperplasia

ECL-cells with formation intensifying in them of Histaminum.

Last years it is established, that Gastrinum possesses also trophic action. The basic trophic effect of Gastrinum is referred on a stomach mucosa, as a result of rising of a proliferation of cells of a glandular epithelium and is possible stvolovyh cells, and also stimulation of production of the epidermal factor of growth. Gastrinum also participates in a differentiation parietal and ECL-cages, raises an expression of genes assotsiirovannyh with synthesis and deposition of Histaminum of EU-cells. To a lesser degree it is the trophic factor for an intestine mucosa [Osadchuk M. A from co-workers., 1996; Rajhlin N.T. from co-workers., 1993; Dockray G.J., 1999; Khomeriki S.G., 1986].

Gastrinum is capable as to stimulate an egestion of water, sodium and a potassium brunnerovskimi with glands of a duodenum, pancreatic

Gland, liver and kidneys, causes reduction of a smooth musculation of an intestine, a cholic bubble, a uterus, stimulates a lipolysis, insulin and calcitonin synthesis [with Rajhlin N.T., 1983].

Somatostatin

Synthesis somatostatina is carried out in D-cells, and also in some thin nervous fibers intermuscular and podslizistogo plexuses. Somatostatin is the antagonist of a somatotropic hormone, it is established, that it has universal inhibiting an effect on synthesis and liberation of some peptidnyh hormones, including insulin, a glucagon and Gastrinum. Remission somatostatina is stimulated with low value pH in a stomach lumen. Suppression of its secretion is shown at pigs after introduction of a weak solution of alkali in a stomach [to Osadchuk M. A from co-workers., 1996].

Serotonin

It is established, that about 90 % of an endogenous serotonin contains in a gastroenteric tract where it, basically, is synthesised and collects in enterohromaffinnyh cells and is the basic source ekstrapinealnogo melatonina [Helander H.F., 1986].

This biogenic amine possesses the expressed vasoactive action, takes part in regulation of a motility of a gastroenteric tract and slime secretion. The serotonin is mitogennym the agent and can regulate proliferative activity of epithelial and lymphoid cells.

Melatonin

The most important physiological effects melatonina are: the control of circadian and seasonal rhythms, regulation of many biological processes, inhibiting action on a pigmental metabolism, antigonadotrophic effects, sedative and hallucinogenic action

On the central nervous system, suppression of a cellular proliferation and antitumoral action under the relation to many experimental tumours. Melatonin stimulates anabolic processes in tissues and is one of the strongest endogenous absorbants of free radicals [Kvetnaja T.V., 2003].

Vasoactive intestinalnyj a peptide (VIV)

In a stomach mucosa the basic part ViP-immunoreaktivnyh of fibers forms a dense network in glands of a body and antral department, immunohistochemically TWISTED is found out as in Dj-cages. On pharmacological action VIP carry to number of neuropeptids with expressed vazodilatatsionnym and spasmolytic action, he participates in the mechanism retseptivnoj relaxations of a proximal part of a stomach in reply to entering in it of nutrition [Osadchuk M. A from co-workers., 1996].

Bombesin

Bombesin is localised in thin nervous fibers podslizistogo plexuses, with the greatest concentration in antral department of a stomach, where its basic function-stimulation of emission of Gastrinum by G-cells [Osadchuk M. A from co-workers., 1996].

nejrotenzin

The greatest concentration nejrotenzina find out in an ileal intestine, in a stomach it is developed by N-cages and its concentration here is minimum. On visible nejrotenzin it can be released in a blood flow, operating as the "classical" hormone, and has hypotensive an effect.

It also stimulates reduction of a musculation of a gastroenteric tract, suppresses the secretion of a hydrochloric acid caused by Pentagastrinum

[Osadchuk M. A from co-workers., 1996].

Endorphines and enkefalipy

Enkephalins are widely presented in a gastroenteric tract where they basically concentrates in antral department of a stomach and proximal department of a duodenum. By means of immunohistochemical methods of research enkefalinopodobnaja reactance is taped in endocrine cells of a mucosa zheludochno - an intestinal tract, in bodies of neurones of an intermuscular plexus, in thin nervous fibers podslizistoj covers of antral department of a stomach and a muscular cover [by Osadchuk M. A from co-workers., 1996]. Enkephalins can strengthen a muscle tone and accelerate nutrition transit on zheludochno - to an intestinal tract, and endorphines are capable to suppress basal and stimulirovannuju secretion somatostatina [Kvetnoy et al., 2001].

Substance R

Substance R contains in fibers and cells podslizistogo and an intermuscular plexus, EU-cages which settle down mainly in a mucosa piloricheskogo stomach department. Substance R renders strong spazmogennoe action on all departments of a digestive tube [to Osadchuk M. A from co-workers., 1996].

Galanin

As believe, galanin operates on a motility and secretion zheludochno - kishechnoju a tract by means of stimulation of allocation of others nejropeitidov, it suppresses gastric secretion for the account of inhibition of secretion of Histaminum [Pham T, 2002].

As the spectrum of biological effects peptidnyh hormones and biogenic amines is extremely wide and includes their influence on the major links of mechanisms of ageing (such as refljatsija proliferative activity, an apoptosis, a cellular differentiation, mobility of cells,

The metabolism of free radicals and many other things), importance of researches of changes of cellular biology of diffusive neuroendocrinal system during ageing becomes obvious.

Cellular updating of cells of a mucosa of a stomach occurs in the generative zone localised in cervical department of glands and an isthmus where are stvolovye cells [Goodlad R.A. et al., 1995]. After division, cells from a zone generative move to a functional zone. In process of migration epitheliocytes are differentiated and get all structural signs of mature cells. The cells which have finished the life cycle, are exposed to an apoptosis - to the mechanism of the programmed  destruction

[Novikov V. S, 1996]. Coordination of parities of a proliferation and an apoptosis of cells - result of difficult interaction of numerous activating and overwhelming stimulus which are necessary for maintenance of normal structure of a tissue. At a pathology these signals cause activation or on the contrary suppression of the genes participating in regulation of cellular updating that Aruin L.I. from co-workers leads to balance disturbance between a neoplasm and an apoptosis of cells [., 1989; Novikov V. S, 1996]. Studying of patterns of a cellular proliferation and an apoptosis helps to understand, what disturbances lead to pathological conditions of a mucosa of a stomach - hyperplasias, atrophies, metaplasias, dysplasias, and also to development of tumours [to Kogan E.A., 2002].

One of ways of definition of a proliferation is revealing of a nuclear antigen of proliferating cells - PCNA. This protein contains in a kernel and is not bound to a histone, being auxiliary fiber for DNA-polymerase. It is necessary for synthesis and DNA "repair". Expression PCNA occurs mainly in kernels of proliferating cells, however its detection also is possible in cells from the broken

DNA structure as he participates in its restoration [McCormick D., 1992).

Ways of an estimation of an apoptosis it is known much, however now more and more attention its regulations are given to not so much apoptosis, how many. At an estimation of cellular updating, it is much more important to know, what cells are protected from an apoptosis, they are in what site of an epithelium, and what of them, on the contrary, express the genes coding fibers, stimulating an apoptosis. One of such genes (fibers) of regulators of an apoptosis is р53. It is taped in kernels of the transformed cells, and also in very small amounts is present at normal cells [Smith M et al., 1996; Carson D. et al. 1995). DNA damage conducts to accumulation in a cell of an albuminous product of a gene р53 which can stop cell fission and induce an apoptosis. Fiber р53 is the factor of a transcription regulating activity of some genes. It is supposed, that response to fiber formation р53 depends on degree of disturbance cellular genoma. At moderate disturbance genoma there is a stopping of cellular division, DNA reparation is carried out, and the cell continues the existence.

For the function description р53 quite often use tropes, it name «the watchman genoma», «an emergency brake of a proliferation». The gene mutation р53 conducts to development of malignant tumours [Kogan E.A., 2002].

It is taped р53 also as well as PCNA in tissue specimens by methods immunogistohimii by means of monoclonal Serums.

1.2

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A source: ANTSIFEROV Roman Vladimirovich. CLINICO-MORPHOLOGICAL FEATURES of the CURRENT of the ATROPHIC GASTRITIS At PERSONS of the SENIOR AGE GROUPS. The DISSERTATION on competition of a scientific degree of the candidate of medical sciences. St.-Petersburg - 2007. 2007

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  13. 1.3 Age changes of a mucosa of a stomach
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