Is there a role for dietary essential fatty acids in gastroduodenal mucosal protection?

A great deal is known about methods to diminish intragastric acid concentration, but far less is known about the ability of the gastroduodenal mucosa to resist injury or accelerate its healing. One group of compounds that plays a key role in the endogenous ability of the mucosa to protect itself against injury and perhaps to accelerate healing is the prostaglandins (PGs). The gastroduodenal mucosa synthesizes PGs from fatty acids precursors--predominantly linoleic and arachidonic. PGE1 or PGE2 have been shown to possess cytoprotective activity in the stomach and duodenum. In laboratory animals, linoleic acid feeding increased PG synthesis and diminished injury. When presented in a detergent solubilized form, arachidonic acid can also provide acute protection against injury by alcohol, bile acids, and aspirin. Arachidonic acid can also promote angiogenic response and thereby, perhaps, accelerate the healing process. Epidemiological evidence points toward a parallel between the decrease in peptic ulcer disease virulence and incidence and the total ingestion of linoleic acid by the population in the U.S. and the United Kingdom. Therefore, dietary essential fatty acids may play a key role in mucosal defense and restitution, and perhaps in the diminished incidence and virulence of peptic ulcer disease in the Western world.