Role of mucosal blood flow: a conceptional review in gastric mucosal injury and protection.

The present article overviews the role of gastric mucosal blood flow (MBF) in gastric mucosal injury and protection. The MBF maintains the structure and function of the stomach and, thereby, is closely associated with the pathogenesis and the healing of gastrointestinal lesions. Gastric blood flow was regulated and modified by systemic and also local metabolic factors, such as prostaglandin, leukotrienes and other endogenous chemical mediators, in the mucosa. In the present article, we review the role of endothelin (ET) and nitric oxide (NO) in the development of gastric mucosal injury and protection via mucosal microcirculation. Endothelin-1 was increased under various stressful conditions and caused microcirculatory disturbances resulting in mucosal injury. Inhibitors of NO aggravated mucosal injury induced by ethanol, which produced mucosal congestion. Thus, regionally disturbed gastric circulation is closely associated with the pathogenesis of ethanol- and non-steroidal anti-inflammatory drug-induced gastric lesions. The endothelium-derived vasoactive substances ET and NO regulate gastric mucosal microcirculation and an imbalance of endothelium-derived factors may play an important pathophysiological role in the development of gastric lesions.