1. © 2003 Science Press Internet Services FISIOLOGÍA DIGESTIVA (BCM II) Clase 6: Mecanismos de defensa de la mucosa gastroduodenal Dr. Michel Baró Aliste

2. © 2003 Science Press Internet Services Factores Protectores Factores agresores Hidrofobicidad de la mucosa Capa de mucus Producción local de bicarbonato Tight junctions Prostaglandina E2 Flujo sanguíneo epitelial Recambio epitelial Inmunoglobulina A Epidermal Growth factor Transf. Growth factor alfa Acidez luminal, pepsina Substancias tóxicas (OH, AINES) Tabaco Helicobacter pylori Isquemia Balance entre factores agresores y protectores gástricos

3. © 2003 Science Press Internet Services Papel de la capa de mucus en la protección de la mucosa gástrica

4. © 2003 Science Press Internet Services Hydrophobicity of a surface

5. © 2003 Science Press Internet Services Endoscopic biopsies of nonulcerated mucosa

6. © 2003 Science Press Internet Services 41 patients with chronic gastritis were examined

7. © 2003 Science Press Internet Services Endoscopic biopsies in 5 patients with Helicobacter pylori (a) Reducción del mucus contiguo a H. pylori

8. © 2003 Science Press Internet Services Endoscopic biopsies in 5 patients with Helicobacter pylori (b) Material surfactante residual adherido a pared bacteriana (tinción de iodoplatino, selectiva para fosfolípidos)

9. © 2003 Science Press Internet Services Continuous mucus gel adherent to gastric mucosa (a)

10. © 2003 Science Press Internet Services Pig gastric mucin was prepared (a) HCl + trypan blue pH = 7

11. © 2003 Science Press Internet Services Pig gastric mucin was prepared (b) HCl + trypan blue pH = 5

12. © 2003 Science Press Internet Services Pig gastric mucin was prepared (c) HCl + trypan blue pH = 4

13. © 2003 Science Press Internet Services Pig gastric mucin was prepared (d) HCl + trypan blue pH = 2

14. © 2003 Science Press Internet Services HCl injected through a column of mucin solution (a) HCl + Agua

15. © 2003 Science Press Internet Services HCl injected through a column of mucin solution (b) HCl + mucina

16. © 2003 Science Press Internet Services Study of movement of acid formed in the gastric crypts across the mucus layer. (a) Estómago de rata estimulado con pentagastrina Gel mucoso teñido con rojo congo (oscuro con pH<3) Foco en epitelio

17. © 2003 Science Press Internet Services Study of movement of acid formed in the gastric crypts across the mucus layer. (b) Foco más superficial

18. © 2003 Science Press Internet Services Study of movement of acid formed in the gastric crypts across the mucus layer. (c) Foco en la superficie luminal

19. © 2003 Science Press Internet Services Mucin assessed by enzyme-linked immunosorbent assay (a) Producción de mucus en estómago de rata mediada por aumento del GMPc

20. © 2003 Science Press Internet Services Mucin assessed by enzyme-linked immunosorbent assay (b)

21. © 2003 Science Press Internet Services Papel del la secreción de bicarbonato en la protección de la mucosa gastroduodenal

22. © 2003 Science Press Internet Services Proximal duodenal bicarbonate output was measured (a)

23. © 2003 Science Press Internet Services Distal duodenal bicarbonate output was measured (b)

24. © 2003 Science Press Internet Services Proximal duodenal mucosal bicarbonate secretion was assessed (a) acetazolamida Papel de la anhidrasa carbónica en la secreción proximal de bicarbonato Basal y mediada por PGE2

25. © 2003 Science Press Internet Services Distal duodenal mucosal bicarbonate secretion was assessed (b)

26. © 2003 Science Press Internet Services Adaptación de la célula mucosa epitelial a los cambios de pH luminal

27. © 2003 Science Press Internet Services Intracellular pH of surface mucous cells of rat stomach (a)

28. © 2003 Science Press Internet Services Intracellular pH of surface mucous cells of rat stomach (b)

29. © 2003 Science Press Internet Services Rol protector del glutatión frente al daño inducido por aumento del calcio intracelular

30. © 2003 Science Press Internet Services Gastric mucosal damage induced by 80% ethanol (a)

31. © 2003 Science Press Internet Services Gastric mucosal damage induced by 80% ethanol (b)

32. © 2003 Science Press Internet Services Papel de circulación capilar en la protección de la mucosa

33. © 2003 Science Press Internet Services Vascular casts of human oxyntic mucosa

34. © 2003 Science Press Internet Services Gastric mucosal blood flow monitored by laser Doppler flowmetry (a) Papel de la prostaglandina en la regulación del flujo capilar de la mucosa

35. © 2003 Science Press Internet Services Gastric mucosal blood flow monitored by laser Doppler flowmetry (b) Pretratamiento con indometacina

36. © 2003 Science Press Internet Services Gastric mucosal injury induced in anesthetized rats (a) Daño inducido por etanol 30% Rol del óxido nítrico N Omega-nitro-L-arginine (L-NNA) (inhibidor del NO), L-Arg (dador de NO)

37. © 2003 Science Press Internet Services Gastric mucosal injury induced in anesthetized rats (b)

38. © 2003 Science Press Internet Services Chronic normovolemic anemia was induced (a) Flujo sanguíneo de la mucosa gástrica

39. © 2003 Science Press Internet Services Chronic normovolemic anemia was induced (b) Etanol 100%

40. © 2003 Science Press Internet Services Intragastric perfusion of capsaicin (a)

41. © 2003 Science Press Internet Services Intragastric perfusion of capsaicin (b) Capsaicina + 25% etanol

42. © 2003 Science Press Internet Services Afferent nerve-mediated gastric mucosal hyperemia (a)

43. © 2003 Science Press Internet Services Afferent nerve-mediated gastric mucosal hyperemia (b)

44. © 2003 Science Press Internet Services Gastric ulcers induced by application of acetic acid (a)

45. © 2003 Science Press Internet Services Gastric ulcers induced by application of acetic acid (b)

46. © 2003 Science Press Internet Services Gastric ulcers induced by application of acetic acid (c)

47. © 2003 Science Press Internet Services Gastric ulcers induced by application of acetic acid (d)

48. © 2003 Science Press Internet Services