The Parietal Cell: Mechanism of Acid Secretion
The best-known component of gastric juice is hydrochloric acid, the secretory product of the parietal, or oxyntic cell. It is known that the capacity of the stomach to secrete HCl is almost linearly related to parietal cell numbers.
When stimulated, parietal cells secrete HCl at a concentration of roughly 160 mM (equivalent to a pH of 0.8). The acid is secreted into large cannaliculi, deep invaginations of the plasma membrane which are continuous with the lumen of the stomach.
When acid secretion is stimulated there is a dramatic change in the morphology of the membranes of the parietal cell. Cytoplasmic tubulovesicular membranes which are abundant in the resting cell virtually disappear in concert with a large increase in the cannalicular membrane. It appears that the proton pump as well as potassium and chloride conductance channels initially reside on intracellular membranes and are transported to and fused into the cannalicular membrane just prior to acid secretion.
The epithelium of the stomach is intrinsically resistant to the damaging effects of gastric acid and other insults. Nonetheless, excessive secretion of gastric acid is a major problem in human and, to a lesser extent, animal populations, leading to gastritis, gastric ulcers and peptic acid disease. As a consequence, the parietal cell and the mechanisms it uses to secrete acid have been studied extensively, leading to development of several drugs useful for suppressing acid secretion.
Mechanism of Acid Secretion
The hydrogen ion concentration in parietal cell secretions is roughly 3 million fold higher than in blood, and chloride is secreted against both a concentration and electric gradient. Thus, the ability of the partietal cell to secrete acid is dependent on active transport.
The key player in acid secretion is a H+/K+ ATPase or "proton pump" located in the cannalicular membrane. This ATPase is magnesium-dependent, and not inhibitable by ouabain. The current model for explaining acid secretion is as follows:
These processes are depicted in the animation below.
Control of Acid Secretion
Parietal cells bear receptors for three stimulators of acid secretion, reflecting a triumverate of neural, paracrine and endocrine control:
Histamine from enterochromaffin-like cells may well be the primary modulator, but the magnitude of the stimulus appears to result from a complex additive or multiplicative interaction of signals of each type. For example, the low amounts of histamine released constantly from mast cells in the gastric mucosa only weakly stimulate acid secretion, and similarly for low levels of gastrin or acetylcholine. However, when low levels of each are present, acid secretion is strongly forced. Additionally, pharmacologic antagonists of each of these molecules can block acid secretion.
Histamine's effect on the parietal cell is to activate adenylate cyclase, leading to elevation of intracellular cyclic AMP concentrations and activation of protein kinase A (PKA). One effect of PKA activation is phosphorylation of cytoskeletal proteins involved in transport of the H+/K+ ATPase from cytoplasm to plasma membrane. Binding of acetylcholine and gastrin both result in elevation of intracellular calcium concentrations.
The animation below depicts acid secretion by the parietal cell. Even though many of the actors are unlabeled, you should be able to deduce the identity of all the components you see.
Several additional mediators have been shown to result in gastric acid secretion when infused into animals and people, including calcium, enkephalin and bombesin. Calcium and bombesin both simulate gastrin release, while opiate receptors have been identified on parietal cells. It is unclear whether these molecules have a significant physiologic role in parietal cell function.
A variety of substances are capable of reducing gastric acid secretion when infused intravenously, including prostaglandin E2 and several peptides hormones, including secretin, gastric inhibitory peptide, glucagon and somatostatin. PGE2, secretin and somatostatin may be physiologic regulators. Somatostatin inhibits secretion of gastrin and histamine, and appears to have a direct inhibitory effect on the parietal cell.
References and Reviews
Advanced and Supplemental Topics
|Index of: The Stomach|
Last updated on March 20, 2010
|Author: R. Bowen|
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