Sucralfate pp 25-34 | Cite as

Ulcer Healing by Strengthening of Mucosal Defense

An Alternative Approach to Inhibition of Acid Secretion
  • A. Tarnawski


Peptic ulcer is a defect in the gastric wall involving the entire mucosal thickness and penetrating through the muscularis mucosae. Involvement of the muscularis mucosae is crucial for distinguishing ulcers from erosions where necrosis is confined only to the mucosa. 1,2


Duodenal Ulcer Granulation Tissue Ulcer Healing Ulcer Margin Surface Epithelial Cell 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Cotran RS, Robbins SL, Kumar V (eds): Healing and repair, in Robbins Pathologic Basis of Disease. Philadelphia, WB Saunders, 1989, pp 71–86. The basic morphology of the peptic ulceration is presented.Google Scholar
  2. 2.
    Tarnawski A, Hollander D, Stachura J, et al: Vascular and microvascular changes—Key factors in the development of acetic acid-induced gastric ulcers in rats. J Clin Gastroenterol 12(suppl 1):S148–S157, 1990. This paper presents a sequential analysis of the development of acetic acid-induced gastric ulcers in rats. It demonstrates the important role of vascular and microvascular factors in ulcer formation.PubMedCrossRefGoogle Scholar
  3. 3.
    Richardson CT: Pathogenic factors in peptic ulcer disease. Am J Med 79(2C):1–7, 1985. Summary of the pathogenetic factors playing a role in peptic ulcer disease.PubMedCrossRefGoogle Scholar
  4. 4.
    Tarnawski A, Erickson RA: Sucralfate—24 years later: Current concepts of its protective and therapeutic actions. Eur J Gastroenterol Hepatol 3(11):795–810, 1991. Review of the current knowledge of pharmacologic and therapeutic actions of sucralfate. Also, the general principles of gastric mucosal defense and injury, as well as ulcer healing are presented.Google Scholar
  5. 5.
    Allen A, Hunter AC, Mall A: Mucus secretion, in Hollander D, Tarnawski A (eds): Gastric Cytoprotection. New York, Plenum Press, 1989, pp 75–90. Review of the role of mucus in gastric mucosal defense.Google Scholar
  6. 6.
    Shorrock CH, Rees WDW: Bicarbonate secretion and alkaline microclimate, in Hollander D, Tarnawski A (eds): Gastric Cytoprotection New York, Plenum Press, 1989, pp 91–108. Review of bicarbonate’s role in gastric mucosal defense.Google Scholar
  7. 7.
    Eastwood GJ: Epithelial cell renewal in cytoprotection, in Hollander D, Tarnawski A (eds): Gastric Cytoprotection. New York, Plenum Press, 1989, pp 109–124. An excellent chapter discussing epithelial cell renewal and its role in mucosal protection.Google Scholar
  8. 8.
    Szabo S, Folkman J, Morales RE, et al: Vascular factors in mucosal injury, protection and ulcer healing, in Garner A, O#x2019;Brien PE (eds): Mechanisms of Injury, Protection and Repair of the Upper Gastrointestinal Tract. New York, John Wiley & Sons, 1991, pp 447–454. An excellent chapter discussing the role of vascular factors in injury, protection, and healing of gastroduodenal mucosa.Google Scholar
  9. 9.
    Wilson DE: Cytoprotective therapy: Prostaglandins in cytoprotection, in Hollander D, Tarnawski A (eds): Gastric Cytoprotection. New York, Plenum Press, 1989, pp 169–186. An excellent review of the role of prostaglandins in mucosal defense and ulcer healing.Google Scholar
  10. 10.
    Piasecki C: Evidence for an infarctive pathogenesis of acute and chronic gastroduodenal ulceration. J Physiol Pharmacol 43:99–112, 1992. A demonstration that ligation of small gastric arteries produces ulcerations.PubMedGoogle Scholar
  11. 11.
    Tarnawski A, Stachura J, Krause WJ, et al: Quality of gastric ulcer healing: A new emerging concept. J Clin Gastroenterol 13(suppl 1):S42–S47, 1991. Experimental basis for hypothesis regarding the quality of ulcer healing (i.e., quality of mucosal restoration) as an important factor in determining ulcer recurrence.PubMedCrossRefGoogle Scholar
  12. 12.
    Tarnawski A, Stachura J, Durbin T, et al: Increased expression of epidermal growth factor receptor during gastric ulcer healing in rats. Gastroenterology 102:695–698, 1992. A study demonstrating increased expression of EGF receptors in the margin of experimental gastric ulcer and in the mucosal scar.PubMedGoogle Scholar
  13. 13.
    Lu S-Y, Tarnawski A, Stachura J, et al: Sequential expression and distribution of fibronectin, laminin and collagen III and IV during experimental gastric ulcer healing. Gastroenterology A116:192, 1992. This study demonstrated increased expression of extracellular matrix components during healing of experimental gastric ulcer.Google Scholar
  14. 14.
    Hunt TK: The principles of wound healing, in Halter A, Garner A, and Tytgat GNT (eds): Mechanisms of Peptic Ulcer Healing, Falk Symposium No. 59. Dordrecht, Kluver Academic Publishers, 1991, pp 1–12. This paper describes general principles of wound healing.Google Scholar
  15. 15.
    Folkman J, Szabo S, Stovroff A, et al: Duodenal ulcer. Discovery of a new mechanism and development of angiogenic therapy that accelerates healing. Ann Surg 214:414–427, 1991. Landmark paper demonstrating that basic EGF accelerates the healing of experimental duodenal ulcer by inducing angiogenesis.PubMedCrossRefGoogle Scholar
  16. 16.
    Wilson DE: Role of prostaglandins in gastroduodenal mucosal protection. J Clin Gastroenterol 13(suppl 1):S65–S71, 1991. This paper reviews the role of prostaglandins in mucosal protection and ulcer healing.PubMedCrossRefGoogle Scholar
  17. 17.
    Tarnawski A, Stachura J, Durbin T, et al: Sucralfate treatment induces increased expression of EGF, TGFα and their common receptor in the gastric mucosa. A key to the ulcer healing and trophic action? Gastroenterology 102:A175, 1992. This study showed that chronic administration of sucralfate to rats increases expression of EGF, TGFα and their receptors in the gastric mucosa.Google Scholar
  18. 18.
    Litman A, Hanscom DH: The course of recurrent ulcer. Gastroenterology 61:585–591, 1971. A demonstration that recurrent gastric ulcers recur usually in the same location as the previous ulcers.Google Scholar

Copyright information

© Plenum Press 1995

Authors and Affiliations

  • A. Tarnawski
    • 1
  1. 1.Gastroenterology SectionDVA Medical CenterLong BeachIrvine

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