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Keynote webinar | Spotlight on medication adherence

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Current Gastroenterology Reports
Published in: Current Gastroenterology Reports 6/2015

01-06-2015 | Stomach and Duodenum (J Pisegna, Section Editor)

Protective Factors of the Gastric and Duodenal Mucosa: An Overview

Authors: Harathi Yandrapu, Jerzy Sarosiek

Published in: Current Gastroenterology Reports | Issue 6/2015

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Abstract

The structural and functional integrity of the gastric and duodenal mucosa represents equilibrium between aggressive factors and protective mechanisms. Mucus-buffers-phospholipid layer as pre-epithelial barrier, enhanced by prostaglandins and epidermal growth factor, remains a vanguard of mucosal protection. It maintains a neutral pH at the surface epithelial luminal interface, facing luminal pH dropping to 1.0, i.e., hydrogen ion concentration gradient equal 1,000,000. The surface epithelial cells, elaborating mucins, buffers, phospholipids, prostaglandins, trefoil peptides, peptide growth factor and their receptors, heat shock proteins, cathelicidins, and β-defensins form the second line of defense. Endothelium exerts mucosal protection through production of potent vasodilators like nitric oxide and prostacyclins and through release of angiogenic growth factors, securing adequate blood flow and representing the third and an ultimate line of mucosal protection. This microcirculation is instrumental for supply of oxygen, nitric oxide, hydrogen sulfide and removal of ad hoc generated toxic substances as well as for continuous mucosal cell renewal from progenitor cells, secured by growth factors accompanied by survivin preventing early apoptosis.
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Metadata
Title
Protective Factors of the Gastric and Duodenal Mucosa: An Overview
Authors
Harathi Yandrapu
Jerzy Sarosiek
Publication date
01-06-2015
Publisher
Springer US
Published in
Current Gastroenterology Reports / Issue 6/2015
Print ISSN: 1522-8037
Electronic ISSN: 1534-312X
DOI
https://doi.org/10.1007/s11894-015-0452-2
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WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

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