GROWTH MARKERS IN THE HUMAN GASTRIC-MUCOSA DURING ADAPTATION TO CONTINUED ASPIRIN ADMINISTRATION

The mechanism of gastric mucosal adaptation to continued aspirin (ASA) administration is unknown. We have investigated growth and proliferat ion markers in healthy subjects under prolonged ASA treatment. In eigh t healthy volunteers, ASA treatment (2 g/day) was continued for 14 day s. Endoscopy was performed before medication; at days 3, 7, and 14 of ASA treatment; and at days 16 and 18 (2 and 4 days, respectively, afte r medication was ceased). Gastric biopsies from oxyntic and antral muc osa were studied by histology and by histochemistry for proliferating cell nuclear antigen (PCNA), epidermal growth factor (EGF), transformi ng growth factor-alpha (TGF-alpha), and epidermal growth factor recept or (EGFr). ASA treatment did not change the expression of EGF and EGFr significantly. The PCNA index showed local inconsistent variations. H owever, increased TGF-alpha expression after ASA was noted, particular ly in hyperplastic surface epithelium. Edema and teleangiectases were common in gastric mucosa after ASA. An increasing incidence of foveola r hyperplasia was also noted in the antral mucosa. Healthy subjects on prolonged ASA treatment gradually develop parameters of chronic react ive gastritis accompanied by increased TGF-alpha expression in gastric surface epithelial cells, especially in hyperplastic areas.