Ulcers, duodenal pathogenesis

Takeuchi, K., Nishiwaki, H., Niida, H., Ueshima, K. and Okabe, S. (1991b). Duodenal ulcers induced by diethyl-dithiocarbamate, a superoxide dismutase inhibitor, in the rat role of antioxidative system in the pathogenesis. Jpn. J. Pharmacol. 57, 299-310. 

The pathogenesis of duodenal ulcers (DU) and gastric ulcers (GU) is multifactorial and most likely reflects a combination of pathophysiologic abnormalities and environmental and genetic factors. 

Recent data in our laboratories indicated the possible involvement of central and peripheral dopamine binding sites in the pathogenesis of duodenal ulceration. Structure activity studies with duodenal ulcerogens implicated dopamine as a putative mediator and/or modulator in duodenal ulceration. Using the cysteamine- or propionitrile-induced duodenal ulcer model in rats, we found that dopamine agonists (e.g., bromocriptine, lergotrile,... 

Circunstantial evidence directly implicating dopamine in the pathogenesis of duodenal ulcer in man is the unusual incidence of peptic ulcer disease in dopamine-deficient disorders. From purely descriptive clinical and epidemiologic studies we know that patients with Parkinson s disease, before the introduction of dopamine therapy, had an excess of ulcer disease (72). One report even comments on the curiosity that after initiation of L-DOPA administration the ulcer symptoms have virtually disappeared (72 ). On the other hand, less clearly, schizophrenia which is associated with dopamine excess and/or receptor hyperactivity is accompanied by virtual lack, or decreased prevalence, of peptic ulcer (73-76). Schizophrenia associated with ulcer disease has been viewed as a reportable curiosity in medical literature (75). At present, possibly because of the widespread therapeutic application of neuroleptics, the lack of peptic ulcer disease in schizophrenics is less striking than in the past. On the other hand, we recently observed in our autopsy series perforated duodenal ulcers in two schizophrenic patients who had been on large doses of haloperidol therapy (Szabo, unpublished observation). Thus, even in man, dopamine may indeed be implicated in the pathogenesis of duodenal ulcer disease. 

Peptide ulcer disease (PUD) is a group of upper Gl tract disorders that result from the erosive action of acid and pepsin. Duodenal ulcer (DU) and gastric ulcer (GU) are the mou common forms, although PUD may occur in the esophagus or small intestine. Factors involved in the pathogenesis and... 

Shiotani A, Graham D, Pathogenesis and therapy of gastric and duodenal ulcer disease. Med Clin N Am 2002 86 1447-66. 

FIGURE 33-2. The natural history of Helicobacter pylori infection in the pathogenesis of gastric ulcer and duodenal ulcer, mucosa-associated lymphoid tissue (MALT) lymphoma, and gastric cancer. 

Malfertheiner P, Bode G (1993) Helicobacter pylori and the pathogenesis of duodenal ulcer disease. Europ J Gastroenterol Hepatol 5 (Suppl) 51 -58... 

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