GASTRODUODENAL MUCOSAL DEFENSE

Although there are now clear associations between ulcer disease and in fection with Helicobacter pylori or use of nonsteroidal anti-inflammat ory drugs (NSAIDs), it remains unclear how these factors affect the ab ility of the gastroduodenal mucosa to resist injury tie, mucosal defen se). Progress has been made in understanding the factors that regulate mucus and bicarbonate secretion in the upper gastrointestinal tract, and the influence of antiulcer drugs leg, lansoprazole, omeprazole) on these factors. The discovery of two isoforms of the enzyme responsibl e for prostaglandin synthesis has resulted in a reappraisal of the rol e of this class of mediators in mucosal defense, and an evaluation of the theory that selective inhibitors of the inducible form of this enz yme will be ''GI safe.'' The most active area of research in mucosal d efense over the past year was concerned with factors influencing mucos al repair. A number of growth factors have been identified as playing key roles in the ulcer healing process. Moreover, the role of these fa ctors in improving the quality of ulcer healing has been carefully exa mined.