Publication: Duodenal and gastric cell regenerating epithelia on margins of human duodenal ulcer and presence of H. pylori - An electron microscopic study
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Date
1997
Authors
Ogata, T.
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Publisher
Murcia : F. Hernández
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DOI
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info:eu-repo/semantics/article
Description
Abstract
Specimens from 22 cases of human duodenal
ulcers obtained at surgery were studied by transmission
and scanning electron microscopy. Observations were
focused on the ulcer margins which always showed
some evidence of healing by simple cuboidal epithelial
cells migrating on the ulcer base. Two types of
regenerating epithelia (RE) were found: the intestinal
and the gastric cell types. The intestinal type RE
originating from intestinal epithelium of the surrounding
epithelium of the ulcer edge was composed of immature
enterocytes, which differentiated into absorptive and
goblet cells, and formed presumptive crypts and villi.
The gastric type RE grew from adjacent metaplastic
gastric mucosa at the edge of the ulcer and consisted of
immature cells, which developed into mucous cells.
Some ulcers had RE of both intestinal cell and gastric
cell origin. In most margins, the RE was of only one cell
type, but in others both intestinal and gastric type cells
were present. In more developed regions both types
formed presumptive glands. The basa1 lamina was
frequently missing near the leading edge. This
corresponded to degeneration and necrosis of RE,
especially in areas of severe inflammatory foci.
Helicobacter (H.) pylori colonization on gastric
metaplastic epithelium was observed in about one third
of the ulcer cases. In the surrounding epithelium of
ulcers colonized with H. pylori there were degenerative
changes, disruption of cell membranes, and massive cell
exfoliation resulting in denuded lamina propria. Some gastric type RE was also colonized with H. pylori. No
infection was found on intestinal epithelia. These
findings suggest that H. pylori may be important in the
development of duodenal ulcers as well as in the
prevention or delay of ulcer healing.
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