[Hemolysis-inducing substances in gastric secretion, incidence-rate of lysolecithin]

Samples of gastric contents from 152 patients with pyloric reflex were taken during gastroscopy after an overnight fast and examined for hemolytic activity. Hemolysis was induced by 97 specimens (64%). The hemolysis test was positive in 45% of patients with a histologically normal gastric mucosa, in 76% of patients suffering from chronic atrophic gastritis with intestinal metaplasia, in 83% with gastric erosions and in 67% with gastric ulcer. No lysolecithin was found in 9 of the 97 positive specimens. The other aspirates contained widely differing values up to 320 mg/100 ml. The average quantities of lysolecithin in gastric contents varied in the different patient groups from 20 to 60 mg/100 ml. These values are much higher than the mean value of 0.9 mg/100 ml quantified in patients without pyloric reflex during an earlier investigation. It is now widely accepted that pyloric reflex promotes gastritis. Furthermore, it has been shown on several occasions that bile constituents exert a damaging effect on the gastric mucosa barrier. The same is true of lysolecithin, which promotes (for example) acute cholecystitis under experimental conditions. These findings, together with the results of our investigation, seem to afford evidence that lysolecithins may exert a pathogenic influence in the development of different gastric lesions.