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Gut. Oct 1998; 43(4): 465–469.
PMCID: PMC1727283

Age and Helicobacter pylori decrease gastric mucosal surface hydrophobicity independently


Background—Gastric mucosal surface hydrophobicity (GMSH) is an essential component of the mucosal defence system that is decreased by Helicobacter pylori and non-steroidal anti-inflammatory drugs (NSAIDs). Gastric ulcers occur predominantly in elderly subjects, and may thus reflect diminished mucosal resistance.
Aims—To investigate whether aging decreases GMSH.
Patients—One hundred and twenty patients without peptic ulcer disease were divided into three age groups: I (41 years or below); II (41-64 years); and III (65 years or above).
Methods—Biopsy specimens were taken from the antrum, corpus, and cardia for histology (Sydney system), urease testing for H pylori, and for contact angle measurement of GMSH with a goniometer. The presence of specific H pylori antibodies was checked by immunoblotting.
Results—Fifty two patients (43%) were infected, and 68 were uninfected with H pylori. GMSH at all biopsy sites was lower in H pylori infected subjects (p=0.0001), but also decreased with age independently of infection status (p=0.0001). The most notable decrease in GMSH occurred between age groups I and II in those with, and between age groups II and III in those without, H pylori infection. GMSH was greater in antral than in corpus mucosa in both infected (p=0.0001) and uninfected patients (p=0.0003).
Conclusions—A physiological decrease in GMSH with aging may contribute to the risk of ulcer development in the elderly, and may act synergistically with H pylori and/or NSAIDs on gastric mucosal defence.

Keywords: gastric mucosal defence; surface hydrophobicity; aging; Helicobacter pylori

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Selected References

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  • al-Assi MT, Genta RM, Karttunen TJ, Graham DY. Ulcer site and complications: relation to Helicobacter pylori infection and NSAID use. Endoscopy. 1996 Feb;28(2):229–233. [PubMed]
  • el-Omar EM, Penman ID, Ardill JE, Chittajallu RS, Howie C, McColl KE. Helicobacter pylori infection and abnormalities of acid secretion in patients with duodenal ulcer disease. Gastroenterology. 1995 Sep;109(3):681–691. [PubMed]
  • Ruiz B, Correa P, Fontham ET, Ramakrishnan T. Antral atrophy, Helicobacter pylori colonization, and gastric pH. Am J Clin Pathol. 1996 Jan;105(1):96–101. [PubMed]
  • Lichtenberger LM, Graziani LA, Dial EJ, Butler BD, Hills BA. Role of surface-active phospholipids in gastric cytoprotection. Science. 1983 Mar 18;219(4590):1327–1329. [PubMed]
  • Kao YC, Lichtenberger LM. Localization of phospholipid-rich zones in rat gastric mucosa: possible origin of a protective hydrophobic luminal lining. J Histochem Cytochem. 1987 Nov;35(11):1285–1298. [PubMed]
  • Hills BA, Butler BD, Lichtenberger LM. Gastric mucosal barrier: hydrophobic lining to the lumen of the stomach. Am J Physiol. 1983 May;244(5):G561–G568. [PubMed]
  • Spychal RT, Marrero JM, Saverymuttu SH, Northfield TC. Measurement of the surface hydrophobicity of human gastrointestinal mucosa. Gastroenterology. 1989 Jul;97(1):104–111. [PubMed]
  • Spychal RT, Goggin PM, Marrero JM, Saverymuttu SH, Yu CW, Corbishley CM, Maxwell JD, Northfield TC. Surface hydrophobicity of gastric mucosa in peptic ulcer disease. Relationship to gastritis and Campylobacter pylori infection. Gastroenterology. 1990 May;98(5 Pt 1):1250–1254. [PubMed]
  • Goddard PJ, Hills BA, Lichtenberger LM. Does aspirin damage canine gastric mucosa by reducing its surface hydrophobicity? Am J Physiol. 1987 Mar;252(3 Pt 1):G421–G430. [PubMed]
  • Mendall MA, Goggin PM, Molineaux N, Levy J, Toosy T, Strachan D, Northfield TC. Childhood living conditions and Helicobacter pylori seropositivity in adult life. Lancet. 1992 Apr 11;339(8798):896–897. [PubMed]
  • Cullen DJ, Collins BJ, Christiansen KJ, Epis J, Warren JR, Surveyor I, Cullen KJ. When is Helicobacter pylori infection acquired? Gut. 1993 Dec;34(12):1681–1682. [PMC free article] [PubMed]
  • Kurata JH. Ulcer epidemiology: an overview and proposed research framework. Gastroenterology. 1989 Feb;96(2 Pt 2 Suppl):569–580. [PubMed]
  • Sipponen P, Seppälä K, Aärynen M, Helske T, Kettunen P. Chronic gastritis and gastroduodenal ulcer: a case control study on risk of coexisting duodenal or gastric ulcer in patients with gastritis. Gut. 1989 Jul;30(7):922–929. [PMC free article] [PubMed]
  • Lindell G, Celebioglu F, Von Holstein CS, Graffner H. On the natural history of peptic ulcer. Scand J Gastroenterol. 1994 Nov;29(11):979–982. [PubMed]
  • Gabriel SE, Jaakkimainen L, Bombardier C. Risk for serious gastrointestinal complications related to use of nonsteroidal anti-inflammatory drugs. A meta-analysis. Ann Intern Med. 1991 Nov 15;115(10):787–796. [PubMed]
  • Schubert TT, Bologna SD, Nensey Y, Schubert AB, Mascha EJ, Ma CK. Ulcer risk factors: interactions between Helicobacter pylori infection, nonsteroidal use, and age. Am J Med. 1993 Apr;94(4):413–418. [PubMed]
  • Dixon MF, Genta RM, Yardley JH, Correa P. Classification and grading of gastritis. The updated Sydney System. International Workshop on the Histopathology of Gastritis, Houston 1994. Am J Surg Pathol. 1996 Oct;20(10):1161–1181. [PubMed]
  • Malfertheiner P, Enrique Domínguez-Muñoz J, Heckenmüller H, Neubrand M, Fischer HP, Sauerbruch T. Modified rapid urease test for detection of Helicobacter pylori infection. Eur J Gastroenterol Hepatol. 1996 Jan;8(1):53–56. [PubMed]
  • Goggin PM, Marrero JM, Spychal RT, Jackson PA, Corbishley CM, Northfield TC. Surface hydrophobicity of gastric mucosa in Helicobacter pylori infection: effect of clearance and eradication. Gastroenterology. 1992 Nov;103(5):1486–1490. [PubMed]
  • Asante M, Ahmed H, Patel P, Davis T, Finlayson C, Mendall M, Northfield T. Gastric mucosal hydrophobicity in duodenal ulceration: role of Helicobacter pylori infection density and mucus lipids. Gastroenterology. 1997 Aug;113(2):449–454. [PubMed]
  • Mack DR, Neumann AW, Policova Z, Sherman PM. Surface hydrophobicity properties of rabbit stomach in vitro. Pediatr Res. 1994 Feb;35(2):209–213. [PubMed]
  • Mauch F, Bode G, Ditschuneit H, Malfertheiner P. Demonstration of a phospholipid-rich zone in the human gastric epithelium damaged by Helicobacter pylori. Gastroenterology. 1993 Dec;105(6):1698–1704. [PubMed]
  • Dial EJ, Lichtenberger LM. A role for milk phospholipids in protection against gastric acid. Studies in adult and suckling rats. Gastroenterology. 1984 Aug;87(2):379–385. [PubMed]
  • Dial EJ, Lichtenberger LM. Milk protection against experimental ulcerogenesis in rats. Dig Dis Sci. 1987 Oct;32(10):1145–1150. [PubMed]
  • Kiviluoto T, Paimela H, Mustonen H, Kivilaakso E. Exogenous surface-active phospholipid protects Necturus gastric mucosa against luminal acid and barrier-breaking agents. Gastroenterology. 1991 Jan;100(1):38–46. [PubMed]
  • Scheiman JM, Kraus ER, Bonnville LA, Weinhold PA, Boland CR. Synthesis and prostaglandin E2-induced secretion of surfactant phospholipid by isolated gastric mucous cells. Gastroenterology. 1991 May;100(5 Pt 1):1232–1240. [PubMed]
  • Bernhard W, Schulte H, Piller M, Sewing KF. Synthesis and release of phosphatidylcholine by isolated porcine gastric mucous cells in primary culture. Eur J Clin Invest. 1996 Sep;26(9):797–802. [PubMed]
  • Lichtenberger LM, Richards JE, Hills BA. Effect of 16,16-dimethyl prostaglandin E2 on the surface hydrophobicity of aspirin-treated canine gastric mucosa. Gastroenterology. 1985 Jan;88(1 Pt 2):308–314. [PubMed]
  • Dial EJ, Lichtenberger LM. Surface hydrophobicity of the gastric mucosa in the developing rat. Effects of corticosteroids, thyroxine, and prostaglandin E2. Gastroenterology. 1988 Jan;94(1):57–61. [PubMed]
  • Goddard PJ, Kao YC, Lichtenberger LM. Luminal surface hydrophobicity of canine gastric mucosa is dependent on a surface mucous gel. Gastroenterology. 1990 Feb;98(2):361–370. [PubMed]
  • Hawkey CJ. Synthesis of prostaglandin E2, thromboxane B2 and prostaglandin catabolism in gastritis and gastric ulcer. Gut. 1986 Dec;27(12):1484–1492. [PMC free article] [PubMed]
  • Goto H, Sugiyama S, Ohara A, Hoshino H, Hamajima E, Kanamori S, Tsukamoto Y, Ozawa T. Age-associated decreases in prostaglandin contents in human gastric mucosa. Biochem Biophys Res Commun. 1992 Aug 14;186(3):1443–1448. [PubMed]
  • Uchida M, Kawano O, Misaki N, Saitoh K, Irino O. Healing of acetic acid-induced gastric ulcer and gastric mucosal PGI2 level in rats. Dig Dis Sci. 1990 Jan;35(1):80–85. [PubMed]
  • Lee M, Feldman M. Age-related reductions in gastric mucosal prostaglandin levels increase susceptibility to aspirin-induced injury in rats. Gastroenterology. 1994 Dec;107(6):1746–1750. [PubMed]
  • Majumdar AP, Jasti S, Hatfield JS, Tureaud J, Fligiel SE. Morphological and biochemical changes in gastric mucosa of aging rats. Dig Dis Sci. 1990 Nov;35(11):1364–1370. [PubMed]
  • Farinati F, Formentini S, Della Libera G, Valiante F, Fanton MC, Di Mario F, Vianello F, Pilotto A, Naccarato R. Changes in parietal and mucous cell mass in the gastric mucosa of normal subjects with age: a morphometric study. Gerontology. 1993;39(3):146–151. [PubMed]
  • Majumdar AP, Fligiel SE, Jaszewski R. Gastric mucosal injury and repair: effect of aging. Histol Histopathol. 1997 Apr;12(2):491–501. [PubMed]
  • Hackelsberger A, Günther T, Schultze V, Labenz J, Roessner A, Malfertheiner P. Prevalence and pattern of Helicobacter pylori gastritis in the gastric cardia. Am J Gastroenterol. 1997 Dec;92(12):2220–2224. [PubMed]
  • Hogben CA, Kent TH, Woodward PA, Sill AJ. Quantitative histology of the gastric mucosa: man, dog, cat, guinea pig, and frog. Gastroenterology. 1974 Dec;67(6):1143–1154. [PubMed]

Figures and Tables

Figure 1
Means of contact angles as a function of H pylori status and biopsy site.
Figure 2
(A) Mean contact angles (SD) at the three biopsy sites in patients without H pylori infection as a function of age. Group I (n=31), Group II (n=23), Group III (n=14). (B) Mean contact angles (SD) at the three biopsy sites in patients with H pylori infection ...
Figure 3
Contact angle values as a measure of GMSH in antral mucosa according to age and H pylori infection.

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