Reduced gastric mucosal vascularity in patients with chronic gastritis

Objectives/design Chronic inflammation is increasingly being linked to isch aemia, but the mechanism is poorly understood, and little is known about it s effect on local gastric endothelial microvessels. We aimed at studying th e number and surface area of gastric mucosal endothelial microstructures in the presence or absence of chronic gastritis. Methods Immunohistochemical assessments were carried out on gastric antral and body biopsies taken from patients with chronic gastritis and others wit h normal histology. The primary antibody (QB-END/10) was raised against CD3 4 antigen within the endothelial cell membranes, A computer attached to a m icroscope was used to count the number and measure the surface area of muco sal endothelial entities. Results In patients with Helicobacter pylori gastritis (n =19), the median number of endothelial microstructures per section was 43 in the antrum and 86 in the gastric body, compared with 205 (P = 0.00004) and 165 (P = 0.002) , respectively, in subjects with normal gastric histology (n = 11). The med ian surface area of the endothelial microstructures was also reduced in pat ients with gastritis, The normal gastric antrum had more endothelial entiti es than the normal body (median of 205 vs 165; P = 0.007). Conclusions Within the normal stomach, the antrum is more richly vasculariz ed than the gastric body. However, active chronic gastritis is associated w ith reduction in both the number and surface area of mucosal endothelial mi crostructures, with the reduction being more marked in the antrum. This is different from acute inflammation, and is relevant to our understanding of the natural history of mucosal defence, particularly the greater susceptibi lity of the gastric antrum to ulceration, compared with the gastric body. E ur J Gastroenterol Hepatol 10: 1001-1005 (C) 1998 Lippincott Williams & Wil kins.