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Eicosanoid synthesis in duodenal ulcer disease: decrease in leukotriene C4 by colloidal bismuth subcitrate.

A Ahmed¹, P R Salmon, C R Cairns

¹Department of Surgery, University College and Middlesex Hospital Medical School, London.

|February 1, 1992

Summary

This summary is machine-generated.

Treatment with colloidal bismuth subcitrate healed duodenal ulcers and reduced the production of inflammatory leukotriene C4 (LTC4) in the duodenal mucosa. This indicates a decreased capacity for generating proinflammatory mediators after ulcer healing.

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Area of Science:

Gastroenterology
Immunology
Pharmacology

Background:

Duodenal ulcer disease is associated with altered mucosal eicosanoid production.
Prostaglandin E2 (PGE2) and leukotriene C4 (LTC4) are key inflammatory mediators.
Colloidal bismuth subcitrate is a treatment for duodenal ulcers.

Purpose of the Study:

To investigate the effect of colloidal bismuth subcitrate on PGE2 and LTC4 release from duodenal and antral mucosa in patients with duodenal ulcers.
To assess changes in eicosanoid synthesis after successful ulcer healing.

Main Methods:

Radioimmunoassay measurement of PGE2 and LTC4 from mucosal biopsy specimens.
In vitro incubation of tissue with and without calcium ionophore A23187.
Gastroscopic and histological examination for ulcer healing and mucosal status.

Main Results:

Basal PGE2 release was higher from antral than duodenal mucosa; basal LTC4 release was lower from antral mucosa.
Ionophore stimulation significantly increased LTC4 generation in duodenal ulcer patients compared to controls.
Colloidal bismuth subcitrate treatment reduced basal and ionophore-stimulated LTC4 production in duodenal mucosa, with no change in PGE2 synthesis.

Conclusions:

Therapeutic healing of duodenal ulcers with colloidal bismuth subcitrate is associated with a significantly reduced capacity of the duodenal mucosa to generate proinflammatory leukotrienes.
This suggests a normalization of mucosal inflammatory mediator production following successful treatment and healing.