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Hipergastrinemia: un nuevo mecanismo.

P H Deprez¹, P Ghosh, R A Goodlad

¹Department of Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London, UK.

Lancet (London, England)

|August 17, 1991

Resumen

Los pacientes con anemia perniciosa tienen altos niveles de gastrina debido a la falta de ácido estomacal. La neutralización del ácido estomacal en ratas y pacientes redujo significativamente los niveles de gastrina, revelando ácido.

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Área de la Ciencia:

Gastroenterología y Gastroenterología.
Endocrinología Endocrinología.
Fisiología Fisiología Fisiología.

Sus antecedentes:

La anemia perniciosa se caracteriza por la falta de producción de ácido gástrico.
Los niveles elevados de la hormona gastrina (hipergastrinemia) se observan a menudo en pacientes con anemia perniciosa.
El mecanismo preciso que vincula la deficiencia de ácido gástrico con la hipergastrinemia requiere una mayor aclaración.

Objetivo del estudio:

Investigar la relación causal entre la ausencia de ácido gástrico y el desarrollo de hipergastrinemia.
Para determinar si el propio ácido gástrico, o su ausencia, influye directamente en los niveles de gastrina.

Principales métodos:

El jugo gástrico de pacientes con anemia perniciosa (que carecen de ácido) se perfuso en ratas.
El amortiguador de bicarbonato y el jugo gástrico de un paciente con úlcera duodenal (ácido) se utilizaron como controles en ratas.
El lavado gástrico a pH neutro se realizó en pacientes con anemia perniciosa para evaluar los cambios en los niveles de gastrina.

Principales resultados:

La perfusión de jugo gástrico ácido de pacientes con anemia perniciosa en ratas causó un aumento significativo en los niveles plasmáticos de gastrina.
Las perfusiones de control con el tampón de bicarbonato o el jugo gástrico del paciente con úlcera duodenal no alteraron significativamente los niveles de gastrina en ratas.
El lavado gástrico en pacientes con anemia perniciosa condujo a una reducción significativa en las concentraciones plasmáticas de gastrina.

Conclusiones:

La ausencia de ácido gástrico es un conductor principal de la hipergastrinemia en la anemia perniciosa.
Los niveles de gastrina son sensibles al ambiente ácido dentro del estómago.
Restaurar un pH neutro en el estómago puede reducir efectivamente los niveles elevados de gastrina.