Non-steroidal anti-inflammatory drugs and gastric DNA synthesis

In vitro incubation of endoscopic gastric antral biopsy specimens with tritiated thymidine, with confirmatory autoradiography, was used to assess gastric epithelial cell turnover in man and to investigate the effects of chronic administration of non-steroidal anti-inflammatory drugs (NSAIDs). In the absence of NSAID administration, macroscopic erosions and ulceration in the antrum were associated with enhanced gastric epithelial cell proliferation. In patients taking NSAIDs erosions occurred without a compensatory increase in epithelial cell DNA synthesis. The failure to respond to injury by enhancing epithelial cell proliferation is likely to be an important factor in NSAID-induced gastric damage and supports a role for prostaglandins in enhancing mucosal repair by increasing epithelial cell generation.