Gastric morphology in ulcer patients receiving misoprostol.

The effects of misoprostol on human gastric antral mucosa were investigated in patients with established diagnoses of either gastric or duodenal ulcer. All patients had pretreatment biopsy. After starting treatment with misoprostol, antral biopsies were taken at four and eight weeks and were fixed in formaldehyde. Following fixation and routine tissue processing, the slides were stained with hematoxylin and eosin. A pathologist from the laboratory preparing the slides reviewed the slides and prepared surgical pathology reports. An identical slide of each biopsy was sent to pathologists at G.D. Searle and Company who were unaware of the diagnoses and who issued an independent descriptive report. Representative cases are presented for discussion. Misoprostol was administered at doses of 100 or 200 micrograms for four or eight weeks. No cellular or mucosal changes were observed. Both groups of pathologists were unable to recognize any dose-related or structural alterations. No special studies were performed on these tissues due to their fixation and sample size. Infiltration of the mucosa by chronic inflammatory cells with a variable number of granulocytes was the most common finding. There were a few cases of goblet cell metaplasia and mild hyperplasia both before and after treatment. By the application of histochemical and immunohistochemical staining methods it is hoped that the constituents in mucus and specialized cells can be identified.