A mucosal barrier of gastric surfactant identified in the human stomach.

Using a special fixation procedure avoiding glutaraldehyde, an oligolamellar lining has been demonstrated by electronmicroscopy on the luminal surface of the human stomach and, with more lamellations, on the epithelial surfaces of oxyntic ducts and parietal cells. These results indicate that, in the human stomach, there is indeed a gastric mucosal barrier consisting of a multi-laminated structure of surface-active phospholipid (SAPL). This gastric surfactant is probably produced in parietal cells and surface mucus cells in which lamellar bodies and some prominent multi-focal lamellated agglomerates of SAPL were prevalent. These findings of a gastric mucosal barrier similar in structure and function to a very thin polyethylene liner are compatible with previous information about the hydrophobicity of the gastric mucosa, the clinical correlation of hydrophobicity with peptic ulceration and the action of barrier breakers (including Helicobacter pylori). It is speculated that the administration of exogenous gastric surfactant in various forms may be effective for inexpensive long-term maintenance of the ulcer patient treated acutely by more conventional means.