Histochemical changes in gastric mucosubstances in patients with acute and chronic ulcer disease

The several types of epithelial cells in human gastric mucosa produce different mucosubstances. The surface epithelium largely forms a neutral mucosubstance except that in about two-thirds of the specimens the deep foveolar cells produce a slight to moderate amount of a mucosubstance apparently containing sulfate esters and carboxyl groups. Mucous neck cells often exhibit a neutral mucosubstance but in about onehalf of the stomachs reveal a slight to moderate reactivity indicative of sulfated mucosubstance. Chief cells contain a sulfated mucosubstance with unique histochemical properties. Mast cells vary widely in prevalence but those in the gastric mucosa appear depleted of stored mucosubstances when compared with those in the gastric submucosa or the esophagus. The sulfated mucosubstance normally abundant in human as in canine chief cells appears consistently depleted in patients with stress ulcer or hemorrhagic gastritis. In addition, mucus often appears depleted in the surface epithelium and interstitial edema is present in the superficial mucosa of these patients. These findings appear consistent with the view that biosynthetic activity in chief cells and surface epithelial cells is impaired perhaps secondary to shock-induced circulatory changes in gastric mucosa of patients with stress ulcer or hemorrhagic gastritis.