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Gastroduodenal mucus gel thickness in patients with Helicobacter pylori: a method for assessment of biopsy specimens.

The gastroduodenal mucus layer is considered the primary mucosal protective barrier, especially important in the maintenance of a mucosal pH gradient. Thus, the measurement of the mucus layer thickness in various disease states could advance our understanding of gastroduodenal pathophysiology. We present a novel method for measuring the mucus layer in endoscopic biopsy material and compare layer thickness in Helicobacter pylori (HP)-negative and HP-positive specimens. Endoscopic biopsies were obtained from 17 patients with gastroduodenal mucosa harboring HP and from 15 patients without current HP colonization. The thickness of the mucus layer was measured in fresh specimens by the phase-contrast dark-field microscopy technique. In patients with confirmed HP infection, the thickness of the mucus layer (mean +/- SD) was 0.093 +/- 0.033 mm in duodenal, 0.085 +/- 0.027 mm in antral, and 0.105 +/- 0.033 mm in corporal mucosa. In patients without concomitant HP colonization, the thickness of the mucus gel was 0.162 +/- 0.045 mm, 0.175 +/- 0.067 mm, and 0.161 +/- 0.064 mm in duodenum, antrum, and corpus, respectively. The differences between the means were statistically significant (p less than 0.001 for the duodenal, p less than 0.001 for antral, and p less than 0.01 for corporal mucosa). This study suggests that colonization of the gastroduodenal mucosa by HP impairs the mucus layer covering the surface epithelium. This mucus layer impairment may lead to mucosal injury with subsequent development of inflammation and, possibly, peptic ulcer disease.

Adult↗

A histamine H2 receptor antagonist, roxatidine, stimulates mucus secretion and synthesis by cultured rabbit gastric mucosal cells.

We examined the effects of the known antisecretory and mucosal protective drug, roxatidine, on the secretion and synthesis of mucus by cultured rabbit gastric mucosal cells. The amounts of secreted and synthesized mucus were determined by the [3H] glucosamine labelling method. Exposure of the cells to roxatidine for 8 hr caused increases in the secretion and synthesis of mucus in a dose-related manner. The increase in mucus synthesis was maximally induced 4 hr after the addition of roxatidine, while mucus secretion was maximally enhanced a further 4 hr later. However, other H2 antagonists such as cimetidine, rantidine and famotidine failed to stimulate the secretion and synthesis of gastric mucus. In addition, neither indomethacin nor NG-nitro-L-arginine methyl ester affected the roxatidine-induced increases in mucus secretion and synthesis. We conclude that roxatidine directly acts on gastric mucosal cells, inducing increases in both the secretion and synthesis of mucus, and that an unknown regulatory pathway might be involved in these stimulatory actions of roxatidine.

Animals↗

Survey of gastrointestinal reactions to foods in adults in relation to atopy, presence of mucus in the stools, swelling of joints and arthralgia in patients with gastrointestinal reactions to foods.

BACKGROUND: Food intolerance in adults is mostly associated with vague symptoms and not clearly related to atopy and food allergy. A combination of different pathogenetic mechanisms may be responsible for the symptoms. OBJECTIVE: The aim of this study was to describe patients with a history of food-related gastrointestinal symptoms in relation to the presence of mucus in the stools, joint swelling and arthralgia and to determine whether or not there is an association between the presence of these parameters, atopic disease and the presence of immune complexes in serum. METHODS: Fifty-eight patients consecutively referred to our clinic with food-related gastrointestinal symptoms were investigated. RESULTS: Thirty-five patients (60%) had mucus in their stools, 24 patients (41%) complained about joint swelling and 41 patients (71%) had arthralgia. There were no correlations between these parameters and atopy according to Phadiatope test or skin prick test (SPT). No correlations were found between the occurrence of mucus in the stools, arthralgia and joint swelling. There were significantly higher levels of circulating immune complexes in patients with a history of arthralgia compared with patients with no such history (P < 0.03) and the number of individuals with the presence of such immune complexes was higher among the patients with arthralgia than among the patients without. In general the patients did not relate the exposure to certain foods to symptoms like joint swelling, arthralgia and presence of mucus in the stools. However, there were significant positive correlations between food-related gastrointestinal symptoms in the following instances: chocolate-induced gastrointestinal symptoms and mucus in the stools (P = 0.006), vegetable-induced gastrointestinal symptoms and mucus in the stools (P = 0.002) and meat-induced gastrointestinal symptoms and mucus in the stools (P = 0.003). In a group of individuals without food-related symptoms investigated separately, a very low frequency of mucus in the stools, joint swelling and arthralgia was seen (none, two and three individuals of the 20 subjects, respectively). Of 41 patients with immediate onset of gastrointestinal symptoms, 20 were atopic according to Phadiatope and SPT. Of 11 patients with late onset of symptoms 10 were negative in Phadiatope and SPT (P < 0.05). The most frequently involved foods were fruits, vegetables, milk, fish and meat. CONCLUSION: The results suggest the involvement of different inflammatogenic mechanisms in food-related gastrointestinal symptoms.

Adolescent↗

Human cervical mucus. I. Rheologic characteristics.

The viscoelastic properties of human cervical mucus were subjected to detailed characterization by microrheometry. An introduced to the range of parameters that can be measured and the sensitivity of microroheometry to variations in mucus viscoelasticity was presented, along with an interpretation of results obtained by this approach. Fresh cervical mucus samples were shown to be rheologically heterogeneous, reflecting compositional differences in situ. Mucas viscoelasticity was stable for several hours when samples were stored at ambient temperature in the microrheometer sample holder. Mucus viscoelasticity was strongly dependent upon nondialyzable solids (NDS) concentration. In order to eliminate (NDS) as a variable in comparative studies of mucus, procedures were developed for reconstitution of mucus at identical (NDS) or for normalization of viscoelasticity data derived from fresh samples to 2.5% NDS. The validity of this approach was then examined by applying these procedures to mucus collected during the follicular, ovulatory, and luteal phases of the normal menstrual cycle.

Animals↗

A separating method for quantifying mucus glycoprotein localized in the different layer of rat gastric mucosa.

A method was devised for separating rat gastric mucosa into three layers each containing a different mucin species. The mucus gel (first layer) was removed by stirring the gastric mucosa in a solution of phosphate-buffered saline containing 2% N-acetylcysteine. The surface mucosa (second layer), rich in surface mucus cells, was then separated from the deep mucosa (third layer) containing mucus neck cells, by scraping with forceps. The effectiveness of this method was confirmed by light microscopical observation after GOCTS-PCS (dual staining by the galactose oxidase-cold thionin Schiff method and paradoxical concanavalin A method) and AB-PAS staining (dual staining with alcian blue and the periodic acid Schiff method). The fixed specimen of scraped mucus and cell debris was rich in AB-PAS and GOCTS positive mucus, but was hardly stained by PCS, indicating mucus derived from surface mucus cells to have been efficiently recovered from this preparation. The residual mucosa could be stained by PCS but hardly at all by AB-PAS or GOCTS. The lyophilized powder specimens obtained from the three different layers of rat gastric mucosa were used to extract and quantify mucus glycoprotein (mucin). This was done to examine changes in mucin content in the three layers of gastric mucosa one hour following the oral administration of 20% ethanol or 0.35 N hydrochloric acid, both mild irritants. Mucin content was noted to significantly increase in the first layer but hardly at all in the second layer. In the third layer, it decreased significantly by 0.35 N hydrochloric acid, but changed only slightly by 20% ethanol administration.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Immune rejection of Trichostrongylus colubriformis in sheep; a possible role for intestinal mucus antibody against an L3-specific surface antigen.

Sheep that have been immunized by multiple truncated infections with the parasitic nematode Trichostrongylus colubriformis contain anti-larval activity in their intestinal mucus and high-speed mucus supernatants. This activity induces T. colubriformis L3 to clump in vitro and causes a significant reduction in larval establishment in naive sheep after infusion of larvae and mucus into the intestinal lumen via a duodenal cannula. In this report, we provide evidence that one factor contributing to the anti-larval activity of immune mucus is antibody against a 35-kDa L3-specific cuticular antigen. The anti-larval activity in mucus is > 100 kDa by membrane filtration, is heat labile and sensitive to either protease digestion or reduction with DTT. Immunoblotting showed that mucus and supernatants of ultracentrifuged mucus from immune sheep contained IgG1 and IgA antibodies that recognized predominantly a larval antigen with an estimated molecular weight of 35 kDa on SDS-PAGE. Antibodies eluted from the surface of washed larvae that had been incubated in immune mucus also reacted specifically with the 35 kDa antigen on blots of larval homogenate. Immunofluorescence and immunogold electron microscopy showed that the 35 kDa antigen is present on the epicuticle of L3 and is shed during the moult to L4. The antigen is not present in eggs, L1, L2, L4 or adult worms and is found only in extracts of sheaths and L3 before infection and up to 4 days after infection. We hypothesize that the binding of antibody to the larval surface prevents larvae from establishing at their preferred site, causing them to be eliminated from the intestine. Monoclonal antibody PAB-1 recognizes the 35 kDa T. colubriformis larval antigen and also cross-reacts with antigens of similar molecular weight on blots of L3 extracts of the parasitic nematodes Haemonchus contortus and Ostertagia circumcincta; and with a 22-kDa antigen on blots of L3 extracts from Cooperia curticei and Nematodirus spathiger. This indicates that an antigenically related surface antigen with immunizing potential is present on several nematode species and can be identified by mAb PAB-1. The 35 kDa T. colubriformis larval antigen and related molecules in other nematodes are potential novel targets for stimulating host-protective immunity against nematode infections.

Animals↗

Mucus clearance and lung function in cystic fibrosis with hypertonic saline.

BACKGROUND: Abnormal homeostasis of the volume of airway surface liquid in patients with cystic fibrosis is thought to produce defects in mucus clearance and airway defense. Through osmotic forces, hypertonic saline may increase the volume of airway surface liquid, restore mucus clearance, and improve lung function. METHODS: A total of 24 patients with cystic fibrosis were randomly assigned to receive treatment with inhaled hypertonic saline (5 ml of 7 percent sodium chloride) four times daily with or without pretreatment with amiloride. Mucus clearance and lung function were measured during 14-day baseline and treatment periods. RESULTS: Long-term inhalation of hypertonic saline without pretreatment with amiloride (i.e., with placebo pretreatment) resulted in a sustained (> or =8 hours) increase in 1-hour rates of mucus clearance, as compared with those with amiloride pretreatment (14.0+/-2.0 vs. 7.0+/-1.5 percent, respectively; P=0.02) and increased 24-hour rates of mucus clearance over baseline. Furthermore, inhalation of hypertonic saline with placebo improved the forced expiratory volume in one second (FEV1) between the baseline period and the treatment period (mean difference, 6.62 percent; 95 percent confidence interval, 1.6 to 11.7; P=0.02), whereas hypertonic saline with amiloride did not improve FEV1 (mean difference, 2.9 percent; 95 percent confidence interval, -2.2 to 8.0; P=0.23). Forced vital capacity (FVC), the forced expiratory flow between 25 and 75 percent of FVC (FEF25-75), and respiratory symptoms also significantly improved in patients treated with hypertonic saline and placebo, whereas the residual volume as a proportion of total lung capacity (RV:TLC) did not change in either group. A comparison of the changes in lung function in the two groups showed no significant difference. In vitro data suggested that sustained hydration of airway surfaces was responsible for the sustained improvement in mucus clearance, whereas inhibition of osmotically driven water transport by amiloride accounted for the observed loss of clinical benefit. CONCLUSIONS: In patients with cystic fibrosis, inhalation of hypertonic saline produced a sustained acceleration of mucus clearance and improved lung function. This treatment may protect the lung from insults that reduce mucus clearance and produce lung disease.

Administration, Inhalation↗

Colonic mucin: methods of measuring mucus thickness.

Mucus is a water-insoluble gel secreted by the gastrointestinal tract. It exists as a protective gel layer adherent to the epithelial surface of the stomach, small intestine and colon. The mucus gel is composed of 1-10 % (w/v) mucin glycoprotein in a plasma-like fluid. Since the mucus gel is predominantly water, standard histological techniques dehydrate the mucus, making visualisation of the functional barrier difficult. Specialist techniques have been developed to enable visualisation of the intact mucus layer. A simple histological method using snap-frozen tissue, sectioned with a cryostat and stained with modified periodic acid-Schiffs/Alcian blue in mucus-preserving conditions will be described. A second powerful in vivo animal model is described which enables measurement of mucus secretion over time. The use of these two methods has allowed the characterisation of the normal mucus layer in the colon and the determination of how it is affected by disease and dietary intervention, in particular the effect of dietary fibre, and evidence that fibre deficiency results in colonic mucosal fragility is presented.

Animals↗

Effects of cagA+ and cagA- strains of Helicobacter pylori on the human gastric mucus layer thickness.

BACKGROUND: Infection with cytotoxin-associated gene A (cagA) Helicobacter pylori is associated with severe gastric diseases, with contradictory views being expressed concerning the effect of H. pylori on the gastric mucus thickness. The aim of the present study was to differentiate between the effect of cagA+ and cagA- strains on gastric mucus thickness. METHODS: Ninety-nine patients without peptic ulcers who were not on medication were randomly recruited from consecutive endoscopy clinics: six biopsies (five antral, one body) were obtained from each patient. Cryostat sections (18 microm) were cut and stained using the modified periodic acid-Schiff/Alcian blue technique. Mucus thickness was measured using computer-assisted light microscopy. The H. pylori status was assessed by histology, Campylobacter-like organism (CLO)test and culture, and cagA+ status determined by polymerase chain reaction (PCR). RESULTS: There was no significant difference (P = 0.784) in mean mucus thickness between cagA+ (52.7 +/- 1.2 microm, n = 10), cagA- (46.6 +/- 1.1 microm, n = 18) or H. pylori-negative patients (51.3 +/- 1.1 microm, n = 30). In cagA- patients, mucus thickness was significantly reduced with increased H. pylori colonization density, Spearman (r(s)) = -0.805, P < 0.0001. In contrast, in cagA+ patients there was a weak positive, but not significant, association between mucus thickness and H. pylori colonization density, r(s) = 0.333, P = 0.381. CONCLUSIONS: The human gastric mucus thickness is not affected by infection with cagA+ or cagA- strains of H. pylori compared with uninfected. Although a trend of increased mucus thickness with cagA+ infection was observed.

Adolescent↗

Expression of prostaglandin protective functions in gastric mucosa cells cultured in the presence of ethanol: effects on the synthesis, retention, secretion, and structure of mucus glycoprotein.

The magnitude of prostaglandin [16,16-dimethylprostaglandin E2 (DMPGE2)] protection against ethanol action has been evaluated by studying the intracellular events leading to synthesis, modification, intracellular retention, and secretion of mucus glycoprotein in the rat gastric mucosal cell culture. When metabolic activity of the cultured cells was expressed as the amount of radioactive tracer in purified mucus glycoprotein, it was found that ethanol at low concentration (0.1 M) caused an 8- to 9-fold increase in proline and a 5- to 6-fold increase in palmitic acid incorporation into mucus glycoprotein; however, at 1.5 M ethanol, the synthetic processes ceased to function. In the presence of DMPGE2 (10 ng/ml), a 2-fold increase in proline and a 3-fold increase in palmitic acid incorporation into mucus glycoprotein were observed. A simultaneous addition of DMPGE2 (10 ng/ml) and ethanol (0.1-1.5 M), or pretreatment with DMPGE2 (10 ng/ml) for 20 min followed by the addition of ethanol (0.1-1.5 M), resulted in the stabilization of glycoprotein synthesis and secretion, and in restoration of the function at the level observed with DMPGE2 alone. The addition of 10 ng/ml of DMPGE2 caused a 32% increase in mucus glycoprotein secretion and an 11% increase in the intracellular content of the glycoprotein. The amount of mucus apoprotein precursor rose by 18%, and the fatty acylation of the synthesized peptides was up by 38%. Addition of DMPGE2, together with ethanol, prevented depletion of the intracellular glycoprotein stores. As observed with ethanol alone, the secretion was elevated by 16-27%, whereas the intracellular glycoprotein stores remained similar to those of controls. The synthesis of the mucus apoprotein precursor was highly sensitive to ethanol, and addition of DMPGE2 only partially prevented its inhibitory action. Pretreatment with DMPGE2, however, eliminated ethanol toxicity, and the precursor pool level remained elevated (28-30%) at all concentrations of ethanol tested. The fatty acylation, although positively affected by DMPGE2, decreased steadily with increments of ethanol concentration. The results show that DMPGE2 stabilizes the cellular membrane processes and thus imposes control over mucus glycoprotein synthesis, secretion, and its intracellular retention.

16,16-Dimethylprostaglandin E2↗

Role of endosymbiotic zooxanthellae and coral mucus in the adhesion of the coral-bleaching pathogen Vibrio shiloi to its host.

Vibrio shiloi, the causative agent of bleaching the coral Oculina patagonica in the Mediterranean Sea, adheres to its coral host by a beta-D-galactopyranoside-containing receptor on the coral surface. The receptor is present in the coral mucus, since V. shiloi adhered avidly to mucus-coated ELISA plates. Adhesion was inhibited by methyl-beta-D-galactopyranoside. Removal of the mucus from O. patagonica resulted in a delay in adhesion of V. shiloi to the coral, corresponding to regeneration of the mucus. DCMU inhibited the recovery of adhesion of the bacteria to the mucus-depleted corals, indicating that active photosynthesis by the endosymbiotic zooxanthellae was necessary for the synthesis or secretion of the receptor. Further evidence of the role of the zooxanthellae in producing the receptor came from a study of adhesion of V. shiloi to different species of corals. The bacteria failed to adhere to bleached corals and white (azooxanthellate) O. patagonica cave corals, both of which lacked the algae. In addition, V. shiloi adhered to two Mediterranean corals (Madracis and Cladocora) that contained zooxanthellae and did not adhere to two azooxanthellate Mediterranean corals (Phyllangia and Polycyathus). V. shiloi demonstrated positive chemotaxis towards the mucus of O. patagonica. The data demonstrate that endosymbiotic zooxanthellae contribute to the production of coral mucus and that V. shiloi infects only mucus-containing, zooxanthellate corals.

Animals↗

Growth of Vibrio anguillarum in Salmon Intestinal Mucus.

The physiological changes of Vibrio anguillarum in response to growth in salmon intestinal mucus were investigated. Growth, survival, and changes in protein expression during growth in media supplemented with mucus were compared to growth and starvation in the identical media without mucus. V. anguillarum exhibited a rapid decline in CFU following growth in mucus as the sole carbon source. No such decline was observed in Luria broth with a 2% NaCl concentration, in glucose-minimal broth (3M), or during starvation in a carbon-, nitrogen-, and phosphorus-free salt solution (NSS). The changes in protein expression during growth in mucus were examined by labeling cells with [(sup35)S]methionine and analyzing the labeled proteins by one- and two-dimensional gel electrophoresis and autoradiography. Comparison of [(sup35)S]methionine-labeled proteins from mucus-grown cells with 3M-grown cells and NSS-starved cells revealed four de novo mucus-inducible proteins (Mips). These Mips were localized in the membrane fraction of V. anguillarum. Additionally, at least one other membrane protein was found to have increased expression in response to growth in mucus.

Journal Article↗

Roles of Vibrio fischeri and nonsymbiotic bacteria in the dynamics of mucus secretion during symbiont colonization of the Euprymna scolopes light organ.

During light organ colonization of the squid Euprymna scolopes by Vibrio fischeri, host-derived mucus provides a surface upon which environmental V. fischeri forms a biofilm and aggregates prior to colonization. In this study we defined the temporal and spatial characteristics of this process. Although permanent colonization is specific to certain strains of V. fischeri, confocal microscopy analyses revealed that light organ crypt spaces took up nonspecific bacteria and particles that were less than 2 micro m in diameter during the first hour after hatching. However, within 2 h after inoculation, these cells or particles were not detectable, and further entry by nonspecific bacteria or particles appeared to be blocked. Exposure to environmental gram-negative or -positive bacteria or bacterial peptidoglycan caused the cells of the organ's superficial ciliated epithelium to release dense mucin stores at 1 to 2 h after hatching that were used to form the substrate upon which V. fischeri formed a biofilm and aggregated. Whereas the uncolonized organ surface continued to shed mucus, within 48 h of symbiont colonization mucus shedding ceased and the formation of bacterial aggregations was no longer observed. Eliminating the symbiont from the crypts with antibiotics restored the ability of the ciliated fields to secrete mucus and aggregate bacteria. While colonization by V. fischeri inhibited mucus secretion by the surface epithelium, secretion of host-derived mucus was induced in the crypt spaces. Together, these data indicate that although initiation of mucus secretion from the superficial epithelium is nonspecific, the inhibition of mucus secretion in these cells and the concomitant induction of secretion in the crypt cells are specific to natural colonization by V. fischeri.

Animals↗

Characterization and identification of a porcine small intestine mucus receptor for the K88ab fimbrial adhesin.

The ability of Escherichia coli K-12(K88ab) to adhere to immobilized porcine small intestine mucus was examined. E. coli K-12(K88ab) but not the isogenic E. coli K-12 strain was found to adhere readily to immobilized crude mucus but not to bovine serum albumin. The adhesion of E. coli K-12(K88ab) was inhibited in a specific fashion by anti-K88 antiserum. Adhesion was also inhibited by pretreatment of receptor-containing crude mucus preparations with sodium metaperiodate or proteolytic enzymes. Removal of glycolipids from crude mucus by chloroform-methanol extraction did not affect the ability of E. coli K-12(K88ab) to bind to mucus preparations. Adsorption of crude mucus preparations with K88ab fimbriae but not type 1 fimbriae resulted in the removal of K88-specific receptors. Analysis of the pelleted fimbriae-receptor complex by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, together with gel filtration chromatography of crude mucus preparations, suggest that the K88-specific receptor present in porcine small intestine mucus is a 40- to 42-kDa glycoprotein.

Adhesins, Escherichia coli↗

An Escherichia coli MG1655 lipopolysaccharide deep-rough core mutant grows and survives in mouse cecal mucus but fails to colonize the mouse large intestine.

The ability of E. coli strains to colonize the mouse large intestine has been correlated with their ability to grow in cecal and colonic mucus. In the present study, an E. coli MG1655 strain was mutagenized with a mini-Tn5 Km (kanamycin) transposon, and mutants were tested for the ability to grow on agar plates with mouse cecal mucus as the sole source of carbon and nitrogen. One mutant, designated MD42 (for mucus defective), grew poorly on cecal-mucus agar plates but grew well on Luria agar plates and on glucose minimal-agar plates. Sequencing revealed that the insertion in MD42 was in the waaQ gene, which is involved in lipopolysaccharide (LPS) core biosynthesis. Like "deep-rough" E. coli mutants, MD42 was hypersensitive to sodium dodecyl sulfate (SDS), bile salts, and the hydrophobic antibiotic novobiocin. Furthermore, its LPS core oligosaccharide was truncated, like that of a deep-rough mutant. MD42 initially grew in the large intestines of streptomycin-treated mice but then failed to colonize (<10(2) CFU per g of feces), whereas its parent colonized at levels between 10(7) and 10(8) CFU per g of feces. When mouse cecal mucosal sections were hybridized with an E. coli-specific rRNA probe, MD42 was observed in cecal mucus as clumps 24 h postfeeding, whereas its parent was present almost exclusively as single cells, suggesting that clumping may play a role in preventing MD42 colonization. Surprisingly, MD42 grew nearly as well as its parent during growth in undiluted, highly viscous cecal mucus isolated directly from the mouse cecum and, like its parent, survived well after reaching stationary phase, suggesting that there are no antimicrobials in mucus that prevent MD42 colonization. After mini-mariner transposon mutagenesis, an SDS-resistant suppressor mutant of MD42 was isolated. The mini-mariner insertion was shown to be in the bipA gene, a known regulator of E. coli surface components. When grown in Luria broth, the LPS core of the suppressor mutant remained truncated; however, the LPS core was not truncated when the suppressor mutant was grown in the presence of SDS. Moreover, when the suppressor mutant was grown in the presence of SDS and fed to mice, it colonized the mouse large intestine. Collectively, the data presented here suggest that BipA may play a role in E. coli MG1655 LPS core biosynthesis and that because MD42 forms clumps in intestinal mucus, it is unable to colonize the mouse large intestine.

Animals↗

Demonstration of a pH gradient across the mucus layer on the surface of human gastric mucosa in vitro.

In previous studies we have demonstrated a hydrogen ion concentration gradient across the mucus on rat and rabbit fundic mucosa, in vivo and in vitro respectively, observations which support the possibility of a 'mucus-bicarbonate' protective barrier. In the present studies we have demonstrated a similar gradient across the mucus on human gastric mucosa in vitro. The minimum mean hydrogen ion concentration at the mucus-epithelium interface was 1 . 1 X 10(-4) mM (pH 6 . 96, n = 10) when the luminal concentration was 5 . 6 mM (pH 2 . 25). Aspirin (10 mM) and N-acetyl cysteine (306 mM) (5%) increased the minimum intra-mucus hydrogen ion concentration and the gradient was overwhelmed by a luminal hydrogen ion concentration of 40 mM (pH 1 . 4). These results suggest that a hydrogen ion concentration gradient exists across the mucus on human gastric mucosa and that potential damaging agents may act by compromising one or other of th components of this 'mucus-alkaline', presumed 'mucus-bicarbonate', barrier.

Aspirin↗

Effect of forced expirations on mucus clearance in patients with chronic airflow obstruction: effect of lung recoil pressure.

Spontaneous mucus clearance and the effect of forced expirations and coughing on mucus clearance were investigated in eight patients with chronic airflow obstruction and low elastic recoil pressure (emphysema group: mean FEV1 45% predicted) and in seven patients with chronic airflow obstruction and normal elastic recoil pressure (chronic bronchitis group: mean FEV1 57% predicted). Mucus clearance was measured in a central and a peripheral lung region by a radioactive aerosol tracer technique. Spontaneous mucus clearance from the peripheral lung region was higher in the patients with emphysema than in those with chronic bronchitis. There was no difference in central mucus clearance between the two groups. Mucus clearance from the peripheral lung region increased significantly during forced expirations and coughing in the patients with chronic bronchitis but not in those with emphysema. It is concluded that in patients with chronic airflow obstruction and regular sputum production spontaneous peripheral mucus clearance is greater in those with decreased elastic recoil pressure. Physiotherapy that includes forced expirations and coughing can enhance mucus clearance in such patients when elastic recoil pressure is normal but is unlikely to be effective when elastic recoil pressure is decreased.

Adult↗

Use of the ileal conduit as a model for studying human small intestinal mucus glycoprotein secretion.

To establish a human model system for investigating control of mucus secretion by the small intestine, we have studied the output of mucus glycoprotein in the urine of patients with ileal conduits. A highly specific enzyme-linked immunosorbent assay (ELISA) was used to measure mucus glycoprotein with a sensitivity down to 0.3 ng protein of mucus glycoprotein. The assay detects human ileal mucus glycoprotein in the urine of ileal conduit patients; for an individual subject, the amount hardly varied from day to day, although there were substantial differences between individuals in the amounts secreted. Control urine from persons with normal bladders did not contain any mucus glycoprotein that reacted in the ELISA. The model has many advantages over other experimental systems for studying the rate of mucus glycoprotein secretion from the human ileum and can also be used as a reproducible resource of undegraded mucus glycoprotein.

Amino Acids↗