Review
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World J Gastroenterol. Jan 28, 2007; 13(4): 493-496
Published online Jan 28, 2007. doi: 10.3748/wjg.v13.i4.493
Physiological and clinical significance of enterochromaffin-like cell activation in the regulation of gastric acid secretion
Guanglin Cui, Helge L Waldum
Guanglin Cui, Laboratory of Gastroenterology, Institute of Clinical Medicine, Faculty of Medicine, University of Tromsø, Tromsø, Norway
Helge L Waldum, Department of Gastroenterology and Hepatology, University Hospital of Trondheim, Norwegian University of Science and Technology, Trondheim, Norway
Author contributions: All authors contributed equally to the work.
Correspondence to: Dr. Guanglin Cui, Laboratory of Gastroenterology, Institute of Clinical Medicine, Faculty of Medicine, University of Tromsø, Tromsø N-9037, Norway. guanglin.cui@fagmed.uit.no
Telephone: +47-7764-4847 Fax: +47-7764-4650
Received: October 17, 2006
Revised: November 15, 2006
Accepted: December 5, 2006
Published online: January 28, 2007
Abstract

Gastric acid plays an important role in digesting food (especially protein), iron absorption, and destroying swallowed micro-organisms. H+ is secreted by the oxyntic parietal cells and its secretion is regulated by endocrine, neurocrine and paracrine mechanisms. Gastrin released from the antral G cell is the principal physiological stimulus of gastric acid secretion. Activation of the enterochromaffin-like (ECL) cell is accepted as the main source of histamine participating in the regulation of acid secretion and is functionally and trophically controlled by gastrin, which is mediated by gastrin/CCK-2 receptors expressed on the ECL cell. However, long-term hypergastrinemia will induce ECL cell hyperplasia and probably carcinoids. Clinically, potent inhibitors of acid secretion have been prescribed widely to patients with acid-related disorders. Long-term potent acid inhibition evokes a marked increase in plasma gastrin levels, leading to enlargement of oxyntic mucosa with ECL cell hyperplasia. Accordingly, the induction of ECL cell hyperplasia and carcinoids remains a topic of considerable concern, especially in long-term use. In addition, the activation of ECL cells also induces another clinical concern, i.e., rebound acid hypersecretion after acid inhibition. Recent experimental and clinical findings indicate that the activation of ECL cells plays a critical role both physiologically and clinically in the regulation of gastric acid secretion.

Keywords: Enterochromaffin-like cell; Gastrin; Gastric acid; Gastric carcinoid; Rebound acid hypersecretion