PARIETAL-CELL SENSITIVITY IN HUMANS - CONTROL AND DUODENAL-ULCER SUBJECTS, SMOKERS AND NONSMOKERS

Objective: To determine (1) the respective contributions, if any, of p arietal cell mass and parietal cell sensitivity to the increased maxim al gastric secretion of patients with duodenal ulcer compared with con trol subjects; (2) the effect of smoking on parietal cell sensitivity, and (3) the mechanism of increased basal secretion in patients with d uodenal ulcer. Design: Measurement of gastric secretion rates in basal circumstances and in response to varying levels of stimulation, inclu ding maximal, in control subjects and in patients with duodenal ulcer. Methods: Gastric secretion studies were performed in 126 control subj ects and 221 patients with duodenal ulcer. Secretion in response to 0. 04 mg/kg/h histamine acid phosphate by intravenous infusion was measur ed in all subjects, in response to histamine at a quarter of that dose rate in 30 control subjects and in 30 patients with duodenal ulcer, a t an eighth of that dose rate in eight controls and 14 patients with d uodenal ulcer, and in basal circumstances in 45 controls and 106 patie nts. Results: There were no differences in parietal cell sensitivity b etween control subjects and patients with duodenal ulcer, or between s mokers and non-smokers. Basal secretion as a proportion of maximal sec retion was the same in duodenal ulcer patients and controls. Conclusio n: Parietal cell sensitivity plays no part in hypersecretion in duoden al ulcer patients compared with controls, or in smokers compared with non-smokers; there is no basal hyperstimulation ('vagal drive') in pat ients with duodenal ulcer.