Critical Reappraisal of Mucosal Repair Mechanisms

The repair of the mucosal surface of the stomach is a complex process involving a number of different cell systems. These include mucosal enterocytes, matrix proteins, and cells responsible for angiogenesis. The regulation of each of these systems is as yet poorly defined and the interaction between the different components remains to be characterized. The signal system involved in recognition of damage initiates a cascade of events which broadly comprise cell migration, cell proliferation, lineage determination, matrix reconfiguration, and angiogenesis. Critical regulators of this process include the trefoil peptides, specific adhesion molecules, and the modulators of cell lineage. The utility of specific pharmacotherapeutic probes, whether responsible for surface protection, growth factor delivery, acid inhibition, or growth factor amplification, remains to be rigorously defined. The repair of the mucosal defect is critical in establishing the functional integrity of the gastric luminal surface. In order to facilitate rapid and long-lasting repair of mucosal injury, a precise understanding of the specific biological events participant in the repair process is required. At this time, there is only a paucity of such information available.