intrinsic-factor and Gastritis

Gastric exocrine secretion, both acid and non-acid, is required for micronutrients absorption, such as iron, calcium and vitamin B12, drugs absorption, protein digestion. Clinical presentation of a gastric secretion impairment might be then characterized by the presence of both gastrointestinal and non-gastrointestinal specific symptoms (i.e. anemia) or to a non-response to therapies. The main factor that impairs gastric exocrine secretion homeostasis is mucosal chronic inflammation that principally occurs after colonization by Helicobacter pylori (Hp). The extent and distribution of gastritis ultimately determine the clinical outcome linked to differences in gastric acid secretion status, the involvement of gastric body leading to a decrease in gastric exocrine secretion with possible progression to mucosal atrophy towards cancer. A correct clinical strategy in the management of Hp infected patients should be then to early identify body involvement, a diagnosis generally missed in that body biopsies are not routinely performed. The use of gastric serological markers, gastrin and pepsinogens, are helpful in suspecting the presence of mucosal atrophy but their diagnostic accuracy for non-atrophic chronic gastritis topography is not adequate despite a good specificity due to the low sensitivity, of all the available biomarkers. Gastric serology associated to anemia/iron-deficiency screening might nevertheless been helpful in the framing of patients that undergo endoscopy in order to highlight the need of extensive mucosal biopsies sampling.

Topics: Absorption; Anemia; Biomarkers; Biopsy; Gastric Acid; Gastrins; Gastritis; Gastritis, Atrophic; Helicobacter Infections; Helicobacter pylori; Humans; Intrinsic Factor; Micronutrients; Models, Biological; Parietal Cells, Gastric; Pepsinogens; Secretory Rate; Stomach

Patients of chronic gastritis should be investigated with gastric mucosal biopsy, parietal cell antibody, intrinsic factor antibody, Helicobacter pylori antibody, urea breath test or faecal antigen test for Helicobacter pylori, to accurately classify them. The results of these tests will indicate Helicobacter pylori infection (present or past), the role of hereditary factor (intrinsic factor antibody present or absent) and the success or failure of Helicobacter pylori eradication treatment.

Topics: Biopsy; Chronic Disease; Gastric Mucosa; Gastritis; Helicobacter Infections; Helicobacter pylori; Humans; Intrinsic Factor; Parietal Cells, Gastric

Human autoimmune gastritis is an organ-specific autoimmune disease of the stomach. It is characterized by the development of disease-specific autoantibodies and a pathology that specifically targets specialized cells within the gastric environment. The autoantigens associated with this disease have been defined as the gastric H+/K+ ATPase and intrinsic factor. The development of experimental disease models has been pivotal in our contemporary understanding of autoimmunity. Here we review mouse models of autoimmune gastritis and their relevance to human autoimmune gastritis associated with pernicious anemia. We appraise some historical as well as recent studies of experimental autoimmune gastritis (EAG), highlighting key findings that have formed the basis of our current understanding of the etiology and mechanism(s) associated with autoimmune gastritis. A precise understanding of the pathogenesis of autoimmune gastritis will permit the design of innovative and rational therapeutic strategies to prevent, arrest, ameliorate or reverse the disease.

Topics: Anemia, Pernicious; Animals; Autoimmune Diseases; Disease Models, Animal; Gastritis; H(+)-K(+)-Exchanging ATPase; Intrinsic Factor; Mice; Mice, Inbred C3H; Parietal Cells, Gastric

Topics: Animals; Digestive System; Digestive System Physiological Phenomena; Duodenal Ulcer; Gastric Acid; Gastrins; Gastritis; Histamine; Histamine H2 Antagonists; Humans; Intrinsic Factor; Liver Circulation; Pepsinogens; Receptors, Histamine; Receptors, Histamine H1; Receptors, Histamine H2; Regional Blood Flow; Stomach; Stomach Ulcer; Zollinger-Ellison Syndrome

This monograph on the clinical chemistry of vitamin B12 reviews the literature on daily requirements, methods for measurement, the effects of drugs on vitamin B12 metabolism absorption, pregnancy, clinical conditions associated with vitamin B12 deficiency, errors of metabolism, and reactions to vitamin therapy. Although only very small quantities of vitamin B12 are required to satisfy the daily requirement, a sufficient supply is stored in the liver to meet normal requirements for at least a 3-year period. A number of drugs are known to affect the absorption of vitamin B12, including neomycin, potassium chloride, p-aminosalicylic acid, and colchicine. Significantly reduced serum concentrations of vitamin B12 have been noted in users of oral contraceptives (OCs), although concentrations still remain within the limits of normal. It appears that the vitamin B12 level in OC users reestablishes itself at a different and somewhat lower level. Vitamin B12 binding protein appears to remain unchanged. A vitamin B12 deficiency is unusual in pregnant women who consume a normal, varied diet. On the other hand, lactating women whose diets are low in animal protein and dairy products may have problems providing enough vitamin B12 to meet their own and their infant's needs; supplementary oral vitamins should be considered.

Topics: Absorption; Adult; Alcoholism; Anemia, Pernicious; Ascorbic Acid; Autoantibodies; Biguanides; Biological Transport; Chemical Phenomena; Chemistry; Chlorpromazine; Contraceptives, Oral; Diet; Female; Gastrectomy; Gastritis; Humans; Intrinsic Factor; Malabsorption Syndromes; Male; Metabolism, Inborn Errors; Middle Aged; Neoplasms; Nervous System Diseases; Nitrous Oxide; Nutritional Requirements; Pancreatic Diseases; Parasitic Diseases; Pregnancy; Pregnancy Complications; Transcobalamins; Vitamin B 12; Vitamin B 12 Deficiency

Development of histamine H2-receptor antagonists has enhanced the understanding of histamine physiology and pharmacology. The effect of H2-receptor antagonists on gastrointestinal physiology has been studied extensively. These compounds inhibit gastric acid secretion in response to all known secretagogues and, in contrast to anticholinergic drugs, markedly inhibit food-stimulated acid secretion in duodenal ulcer patients. The relative roles of H2-receptor antagonists, anticholinergic drugs and antacids in the treatment of duodenal ulcer remain to be defined. Cimetidine currently is under investigation for the treatment of duodenal ulcer, gastric ulcer, reflux esophagitis, gastrointestinal bleeding and hypersecretory states. Although the long-term safety of cimetidine has not been established, in short-term clinical trials there have been no significant subjective or objective side-effects. Assuming that toxic effects do not develop, H2-receptor antagonists should improve the treatment of acid-peptic disease.

Topics: Cimetidine; Cyclic AMP; Duodenal Ulcer; Esophagitis, Peptic; Gastric Juice; Gastrins; Gastritis; Gastrointestinal Hemorrhage; Histamine; Histamine H2 Antagonists; Humans; Intrinsic Factor; Metiamide; Pepsin A; Stomach Ulcer

Topics: Adrenal Cortex Hormones; Anemia, Pernicious; Animals; Antigen-Antibody Complex; Antigens; Autoantibodies; Autoimmune Diseases; Chronic Disease; Dogs; Female; Gastric Mucosa; Gastrins; Gastritis; Guinea Pigs; Haplorhini; Humans; Immunity, Cellular; Intrinsic Factor; Male; Rabbits; Rats; Vitamin B 12 Deficiency

Topics: Adrenal Cortex Hormones; Adult; Anemia, Pernicious; Atrophy; Autoantibodies; Autoimmune Diseases; Binding Sites, Antibody; Child; Gastric Juice; Gastric Mucosa; Gastrins; Gastritis; Humans; Immunity, Cellular; Immunoglobulin A; Immunoglobulin G; Intrinsic Factor; Vitamin B 12

Topics: Anemia, Pernicious; Autoantibodies; Autoimmune Diseases; Celiac Disease; Colitis, Ulcerative; Crohn Disease; Fluorescent Antibody Technique; Gastritis; Gastrointestinal Diseases; Glutens; Humans; Hypersensitivity; Immunoglobulin G; Intrinsic Factor; Vitamin B 12

Topics: Adolescent; Anemia; Animals; Biological Transport; Blind Loop Syndrome; Calcium; Gastric Mucosa; Gastritis; Guinea Pigs; Humans; Hydrogen-Ion Concentration; Ileum; Intestinal Absorption; Intestinal Diseases, Parasitic; Intestinal Mucosa; Intrinsic Factor; Male; Pancreatic Diseases; Radiation Effects; Rats; Thalassemia; Trypsin; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia, Pernicious; Autoantibodies; Chronic Disease; Diagnosis, Differential; Gastric Juice; Gastric Mucosa; Gastrins; Gastritis; Humans; Intrinsic Factor; Schilling Test

Topics: Adrenal Cortex Hormones; Anemia, Pernicious; Animals; Antibodies; Autoantibodies; Biopsy; Chronic Disease; Gastric Juice; Gastric Mucosa; Gastrins; Gastritis; Humans; Intrinsic Factor; Schilling Test; Stomach; Stomach Neoplasms; Stomach Ulcer; Vitamin B 12

Topics: Anemia, Pernicious; Antibodies; Atrophy; Autoimmune Diseases; Capillaries; Chronic Disease; Dyspepsia; Gastrectomy; Gastric Juice; Gastric Mucosa; Gastrins; Gastritis; Humans; Hypertrophy; Intrinsic Factor; Metaplasia; Mitosis; Pentagastrin; Pepsin A; Peptic Ulcer; Pyloric Antrum; Radiography; Stomach; Stomach Neoplasms; Thyroid Diseases; Vagotomy

Topics: Anemia, Macrocytic; Anemia, Pernicious; Antigens; Autoantibodies; Biopsy; Chronic Disease; Cytoplasm; Digestive System; Female; Fluorescent Antibody Technique; Gastric Juice; Gastric Mucosa; Gastritis; Humans; Immunologic Deficiency Syndromes; Intrinsic Factor; Lipoproteins; Microsomes; Schilling Test; Stomach; Vitamin B 12

Topics: Adolescent; Adrenal Cortex Hormones; Adult; Aged; Anemia, Pernicious; Blind Loop Syndrome; Chronic Disease; Female; Gastritis; Humans; Intrinsic Factor; Male; Middle Aged; Stomach

Topics: Acetylcholine; Achlorhydria; Adenoma; Anemia, Pernicious; Atrophy; Duodenal Ulcer; Endocrine System Diseases; Gastrectomy; Gastric Juice; Gastric Mucins; Gastric Mucosa; Gastrins; Gastritis; Humans; Hyperplasia; Intrinsic Factor; Stomach Ulcer; Vagus Nerve; Zollinger-Ellison Syndrome

Topics: Anemia, Hypochromic; Anemia, Pernicious; Animals; Burns, Chemical; Celiac Disease; Diagnosis, Differential; Gastric Juice; Gastritis; Humans; In Vitro Techniques; Intrinsic Factor; Peptic Ulcer; Stomach Neoplasms; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Antibodies; Autoradiography; Chronic Disease; Depression, Chemical; Duodenal Ulcer; Gastric Juice; Gastric Mucosa; Gastritis; Histamine; Humans; Insulin; Intrinsic Factor; Methods; Protein Binding; Radioisotopes; Stimulation, Chemical; Stomach Neoplasms; Vitamin B 12

Topics: Acute Disease; Anemia, Pernicious; Chronic Disease; Gastric Juice; Gastritis; Humans; Intrinsic Factor; Stomach Neoplasms

Topics: Anemia, Pernicious; Animals; Antibodies; Autoimmune Diseases; Gastric Mucosa; Gastritis; Humans; Intrinsic Factor; Thyroid Diseases

Topics: Age Factors; Anemia, Pernicious; Antibodies; Atrophy; Bethanechol Compounds; Carbachol; Gastric Juice; Gastric Mucosa; Gastrins; Gastritis; Histamine; Humans; Insulin; Intrinsic Factor; Methacholine Compounds; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Anemia, Pernicious; Blood Group Antigens; Duodenal Ulcer; Electrolytes; Gastric Acidity Determination; Gastritis; Humans; Hydrochloric Acid; Intrinsic Factor; L-Lactate Dehydrogenase; Pepsin A; Stomach Neoplasms; Stomach Ulcer; Zollinger-Ellison Syndrome

Patients with autoimmune gastritis (AIG) are reported to have an increased risk of developing gastric cancer (GC). In this study, we assess the characteristics and outcomes of GC patients with AIG in a multicenter case-control study.. Between April 2013 and May 2017, patients with GC, including cancers of the esophagogastric junction (EGJ) Siewert type II and III, were recruited. Patients with histological characteristics of AIG were identified and matched in a 1:2 fashion for age and gender to GC patients with no AIG. Presenting symptoms were documented using a self-administered questionnaire.. Pernicious anemia leads to earlier diagnosis of GC in AIG patients and contributes significantly to a better clinical outcome.

Topics: Aged; Anemia, Pernicious; Autoantibodies; Autoimmune Diseases; Case-Control Studies; Endoscopy, Digestive System; Female; Gastric Mucosa; Gastritis; Humans; Intrinsic Factor; Male; Middle Aged; Parietal Cells, Gastric; Risk Assessment; Risk Factors; Stomach Neoplasms

In the diagnostic work up of autoimmune gastritis several immunological methods are available for the detection of antibodies against Intrinsic Factor (IF) and Parietal Cells (PC). However, there are no recent reports directly comparing all the available assays and methods. The objective of this study was to compare the performance of several commercially available anti-IF and anti-PC antibody assays from different manufacturers in a multi-center multi-cohort setting.. Sera were used from 5 different cohorts consisting of samples from 25 healthy elderly, 20 HCV or HIV positive patients and 150 patients positive for anti-IF or anti-PC antibodies or in whom these antibodies were requested. These cohorts were tested for anti-IF antibodies with 6 different assays (IIF, ELISA, DIA and EliA) and for anti-PC antibodies with 7 different assays (IIF, ELISA, DIA and EliA). Performance was evaluated by calculating the concordance and relative sensitivity and specificity.. Good concordance was found between the assays for both antibody specificities, ranging from 81 to 100% and 91-100% for anti-IF and anti-PC antibodies, respectively. Highest relative sensitivity was found with the (automated) ELISA based methods. However, all assays had a relative sensitivity between 85 and 100% for anti-IF antibodies and between 95 and 100% for anti-PC antibodies. The relative specificity ranged between 76 and 100% for anti-IF antibodies and between 96 and 100% for anti-PC antibodies.. We conclude that most assays perform well and are concordant to each other, despite the methodological differences and the different sources of antigen used. However, the method used affects the sensitivity and specificity. The (automated) ELISA based assays have the highest relative sensitivity and relative specificity. Care should be taken in the interpretation of positive results by IIF and negative results by the Blue Diver when testing for anti-IF antibodies.

Topics: Autoantibodies; Autoimmune Diseases; Biomarkers; Case-Control Studies; Enzyme-Linked Immunosorbent Assay; Fluorescent Antibody Technique, Indirect; Gastritis; Humans; Immunoassay; Intrinsic Factor; Netherlands; Parietal Cells, Gastric; Predictive Value of Tests; Reproducibility of Results; Serologic Tests

Parietal cell antibody is a marker for autoimmune gastritis. With identification of gastric H/K ATPase as its molecular target, ELISAs have been introduced. We compared performance of ELISA with immunofluorescence in a retrospective and prospective sera set and correlated the results with intrinsic factor antibody. In 138 retrospective sera selected for positivity or negativity for intrinsic factor antibody, 87 reacted with gastric H/K ATPase by Euroimm ELISA but only 62 reacted by immunofluorescencence.. Similar results were obtained with Inova ELISA with 78 positives that were also positive by Euroimm ELISA. In 161 prospective sera, 29 sera tested positive by ELISA compared to 24 by immunofluorescence. ELISA positive but immunofluoresnce negative sera are bona fide positives because a representative set of 16 sera reacted with both 95kD α and 60-90kDβ subunits of gastric H/K ATPase. ELISA values rose with age regardless of whether immunofluorescence tests were positive or negative. Of 53 sera containing antibody to intrinsic factor, 46/53 (87%) reacted to gastric H/K ATPase by ELISA. Taken together, the data indicates an enhanced detection rate by ELISA over immunofluorescence and validates it as a robust diagnostic assay for parietal cell antibody. As parietal cell antibody marks asymptomatic autoimmune gastritis that may progress to end stage gastric atrophy and haematological complications, and as autoimmune gastritis is associated with autoimmune thyroiditic and type 1 diabetes mellitus, early detection of parietal cell antibody by a sensitive ELISA will enable early follow-up of at risk subjects.

Topics: Adult; Age Factors; Aged; Aged, 80 and over; Autoantibodies; Autoimmune Diseases; Enzyme-Linked Immunosorbent Assay; Erythrocytes, Abnormal; Female; Fluorescent Antibody Technique; Gastritis; H(+)-K(+)-Exchanging ATPase; Hematologic Diseases; Humans; Intrinsic Factor; Male; Middle Aged; Parietal Cells, Gastric; Retrospective Studies; Vitamin B 12 Deficiency; Young Adult

Ectopic expression of gastric intrinsic factor (IF) has been described in rodent models of chronic gastritis.. The current study undertook to determine if ectopic IF was also present in chronic gastritis in humans and might identify the process of ectopic protein expression as part of the response to chronic injury.. Archived biopsies from mid-body, angularis and prepylorus of 9 patients with and without chronic gastritis and food-cobalamin malabsorption were examined in a blinded fashion by immunocytochemistry as were biopsies from 5 normal subjects. Cells with ectopic IF were further examined with antibodies against pepsin or with Griffonia simplicifolia II (GSII) to identity cells in the mucous neck cell compartment.. Ectopic IF production in non-parietal cells was identified in cells that were H(+),K(+)-ATPase-negative but IF-positive in 7 of the 9 patients (6/9 in the angularis and/or prepylorus biopsies and 1/9 only in the mid-body). These included 5 of the 6 H. pylori-infected patients and all 5 patients with severe food-cobalamin malabsorption. No normal control subjects demonstrated ectopic IF. The cells with ectopic IF were pepsinogen-positive peptic cells and were not GSII-positive. Expression was most extensive in patients and gastric regions with inflammation. In all but one sample, ectopic IF was observed near anatomical mucosal junctions, such as antral/body and prepylorus/duodenum junctions.. These data in humans with and without gastritis are consistent with the hypothesis that local factors influence ectopic gastric IF expression, arising from either the anatomical location, the focal inflammation, or both.

Topics: Adult; Aged; Female; Gastric Mucosa; Gastritis; Humans; Intrinsic Factor; Male; Middle Aged

Helicobacter pylori gastritis may lead to impairment of the production of pepsinogen and acid, which are essential to cobalamin absorption. In turn, cobalamin deficiency leads to hyperhomocysteinaemia, a risk factor for cardio and cerebrovascular diseases.. To evaluate the effect of H pylori eradication on plasma homocysteine levels in elderly patients.. Sixty-two H pylori-positive elderly patients with cobalamin deficiency were prospectively studied.. Homocysteine and cobalamin concentrations were determined before, 6 and 12 months after H pylori eradication.. Corpus atrophy was observed in a few patients; otherwise, in most of them, the degree of corpus gastritis was moderate to severe. The initial homocysteine mean (SD) levels decreased from 41.0 (27.1) to 21.6 (10.1) micromol/l at the 6 month follow-up (p<0.001) and to 13.1 (3.8) micromol/l 12 months after H pylori eradication (p<0.001). Conversely, initial cobalamin mean levels increased from 145.5 (48.7) pmol/l to 209.8 (87.1) pmol/l and to 271.2 (140.8) pmol/l, 6 and 12 months after treatment, respectively (p<0.001 for both). Although the erythrocyte mean corpuscular volume was within reference intervals, it decreased significantly 6 (p = 0.002) and 12 (p<0.001) months after treatment.. The results of the current study demonstrated that the eradication of H pylori in elderly patients with cobalamin deficiency is followed by increasing of cobalamin and decreasing of homocysteine blood levels.

Topics: Aged; Aged, 80 and over; Autoantibodies; Female; Follow-Up Studies; Gastrins; Gastritis; Helicobacter Infections; Helicobacter pylori; Homocysteine; Humans; Intrinsic Factor; Male; Middle Aged; Parietal Cells, Gastric; Pepsinogen A; Prospective Studies; Vitamin B 12 Deficiency

Researchers have developed murine lymphopenic, non-lymphopenic, transgenic, spontaneous and infectious agent based models to induce an experimental autoimmune gastritis (EAG) for the study of human organ-specific autoimmune disease. These models result in a chronic inflammatory mononuclear cell infiltrate in the gastric mucosa, destruction of parietal and zymogenic cells with autoantibodies reactive to the gastric parietal cells and the gastric H+/K+ ATPase (ATP4), arguably hallmarks of a human autoimmune gastritis (AIG). In the case of AIG, it is well documented that, in addition to parietal cell antibodies being detected in up to 90% of patients, up to 70% have intrinsic factor antibodies with the later antibodies considered highly specific to patients with pernicious anemia. This is the first report specifically investigating the occurrence of intrinsic factor antibodies, cobalamin deficiency and pernicious anemia in EAG models. We conclude, in contrast to AIG, that, in the three EAG models examined, intrinsic factor is not selected as a critical autoantigen.

Topics: Anemia, Pernicious; Animals; Autoantibodies; Autoantigens; Autoimmune Diseases; Disease Models, Animal; Enzyme-Linked Immunosorbent Assay; Female; Gastritis; H(+)-K(+)-Exchanging ATPase; Immunoblotting; Intrinsic Factor; Male; Mice; Mice, Inbred BALB C; Mice, Transgenic; Vitamin B 12; Vitamin B 12 Deficiency

The catalytic alpha and glycoprotein beta subunits of the gastric H/K ATPase are major molecular targets in human and mouse autoimmune gastritis. We have previously shown that the H/K ATPase beta subunit is required for the initiation of mouse gastritis and identified a gastritogenic H/K ATPase beta subunit peptide (H/Kbeta253-277). Here we report the generation of MHC class II-restricted TCR transgenic mice using V(alpha)9 and V(beta)8.3 TCR chains with specificity for the gastritogenic H/Kbeta253-277 peptide. We found an 8-fold reduction in CD4(+) T cells in the thymus of the transgenic mice. Despite the reduction in intrathymic CD4(+) T cells, V(beta)8. 3-expressing T cells comprised the majority (>90%) of peripheral spleen and lymph node T cells. These peripheral T cells retained their capacity to proliferate in vitro to the H/Kbeta253-277 peptide. Using the responsive T cells, we have restricted the gastritogenic T cell epitope to H/Kbeta261-274. Despite the capacity of the peripheral T cells to proliferate in vitro to the peptide, the majority ( approximately 80%, 13 of 16) of transgenic mice remained free of gastritis while a minority (20%, three of 16) spontaneously developed an invasive and destructive gastritis. Our results confirm that H/Kbeta261-274 is a gastritogenic peptide. The data also suggest that CD4 T cell tolerance to the gastritogenic peptide in the transgenic mice is maintained by a combination of intrathymic and peripheral tolerance mechanisms.

Topics: Animals; Autoantibodies; Autoimmune Diseases; Autoimmunity; CD4-Positive T-Lymphocytes; Gastric Mucosa; Gastritis; H(+)-K(+)-Exchanging ATPase; Immune Tolerance; Intrinsic Factor; Lymph Nodes; Lymphocyte Activation; Mice; Mice, Inbred BALB C; Mice, Inbred C57BL; Mice, Transgenic; Parietal Cells, Gastric; Peptide Fragments; Receptors, Antigen, T-Cell, alpha-beta; Spleen; Swine; Thymus Gland

Intrinsic factor is produced primarily by chief cells in rat and mouse, but 4 to 11% of isolated rat parietal cells also contain intrinsic factor. To test whether local conditions could alter the distribution of intrinsic factor expression, two rodent models of chronic lymphocytic gastric inflammation were examined. Immunocytochemistry was performed using antiserum against human intrinsic factor and H/K ATPase (a parietal cell marker), counting the percent of intrinsic factor-positive parietal cells. HLA-B27 transgenic rats develop chronic gastritis at age 3 months. Congenic controls expressed intrinsic factor in 8.9 +/- 3.8% (mean +/- SD) of parietal cells; in inflamed areas of transgenic rats 21 +/- 5.2% (P < 0.0001) of parietal cells were positive. In adjacent areas without inflammatory infiltrate 16 +/- 3.6% of parietal cells contained intrinsic factor. C57BL/6 mice inoculated with Helicobacter felis develop gastritis by 4 weeks. After 4 and 8 weeks of infection, intrinsic factor-positive parietal cells increased from 7.8 +/- 2.8% in the congenic controls to 17.6 +/- 4.1% in the inflamed gastric body (P < 0.0001). Isolated rat parietal cells incubated with interleukin-1beta demonstrated a twofold increase in intrinsic factor-positive parietal cells. These studies are consistent with the concept that intrinsic factor expression is both predetermined in chief cells and can be expressed in parietal cells in response to local inflammatory factors. The differences between inflamed and adjacent noninflamed areas in the rat model suggest a tissue gradient of soluble inducer(s), possibly cytokines.

Topics: Animals; Animals, Genetically Modified; Cell Line; Cell Separation; Female; Gastric Mucosa; Gastritis; Helicobacter Infections; HLA-B27 Antigen; Immunohistochemistry; Interleukin-1; Intrinsic Factor; Mice; Mice, Inbred C57BL; Parietal Cells, Gastric; Rats; Rats, Inbred Lew

Experimental autoimmune gastritis (AIG), defined by the appearance of auto antibodies to parietal cells, was induced by neonatal thymectomy in BALB/c nu/+mice 3 days after birth. Vitamin B12 absorption and intrinsic factor in the stomach extract decreased compared with those in AIG-negative control groups. No decrease of the serum A/G ratio in AIG-bearing mice was observed. Although development of anemia, as evaluated by a decrease in hematocrit value, was poor until 12 mo of age and the gastric mucosa was hypertrophic, the AIG resembled human pernicious anemia rather than Ménétrier's disease. Adoptive transfer of spleen cells, but not sera, of AIG-bearing nu/+ into BALB/c nu/nu mice caused AIG in all animals 1 mo later, indicating the involvement of lymphocytes in the induction mechanism of AIG. Cytofluorometric and immunohistochemical analysis of lymphocytes in the gastric mucosa revealed T-cell infiltration at an early stage (1.5-3 mo) followed by B cell infiltration (6 mo). When the fraction enriched with parietal cells, which were intensively stained with sera of AIG-bearing mice and fluorescent antibody to mouse immunoglobulin G, was injected into the foot pads of AIG-bearing nude mice, typical delayed-type hypersensitivity reaction was observed in all animals. This was not seen in the mice injected with the cell fraction enriched with chief cells, although a few of them were stained by the immunofluorescent technique. Thus, the delayed-type hypersensitivity reaction seems to be directly involved in the mechanism of tissue damage.

Topics: Anemia, Pernicious; Animals; Animals, Newborn; Antigen-Antibody Complex; Autoantibodies; Autoimmune Diseases; Disease Models, Animal; Female; Gastric Mucosa; Gastritis; Hypersensitivity, Delayed; Immunization, Passive; Intrinsic Factor; Lymphocytes; Male; Mice; Mice, Inbred BALB C; Mice, Nude; Parietal Cells, Gastric; Thymectomy; Vitamin B 12

The ratio of pepsinogen I to pepsinogen II in the circulation decreases progressively with increasing severity of atrophic gastritis of the fundic gland mucosa. Fasting blood was obtained from 359 free-living and institutionalized elderly people (age range, 60 to 99 years). A pepsinogen I/pepsinogen II ratio less than 2.9, indicating atrophic gastritis, was found in 113 (31.5%) subjects. The prevalence of atrophic gastritis increased significantly with advancing age (P less than .05). Within the atrophic gastritis group, 84 had a pepsinogen I level greater than or equal to 20 micrograms/L, indicating mild to moderate atrophic gastritis, and 29 had a pepsinogen I level less than 20 micrograms/L, indicating severe atrophic gastritis or gastric atrophy. A significant increase in the prevalences of elevated serum gastrin levels (P less than .005), low serum vitamin B12 levels (P less than .005), circulating intrinsic factor antibody (P less than .005), and anemia (P less than .025) was observed with stepwise increases in severity of atrophic gastritis. Subjects with atrophic gastritis exhibited a lower mean serum vitamin B12 level (P less than .05) and a higher mean folate level (P less than .05), but no difference was detected in mean hemoglobin levels or serum levels of iron, ferritin, retinol or alpha-tocopherol. It is concluded that serum pepsinogen I and pepsinogen II levels can be used to determine the prevalence and severity of atrophic gastritis, that atrophic gastritis is common in an elderly population, and that atrophic gastritis is associated with vitamin B12 deficiency and anemia. Further, higher folate levels in atrophic gastritis may be related to an accumulation of 5-methyl tetrahydrofolate in serum due to vitamin B12 deficiency and/or greater folate synthesis by the intestinal flora resulting from bacterial overgrowth secondary to hypo- or achlorhydria.

Topics: Aged; Aged, 80 and over; Aging; Boston; Female; Gastrins; Gastritis; Gastritis, Atrophic; Hemoglobins; Humans; Intrinsic Factor; Male; Middle Aged; Nutritional Status; Pepsinogens; Vitamin B 12 Deficiency

The Authors show and discuss the classification proposed till now for dividing chronic atrophic gastritis into subtypes different in hystological, functional or immunological aspects. In accordance with the more recent reports, the classification into type A, type B and type AB is accepted. Genetical (factor A) and environmental agents (alcohol, smoke, drugs) as well as immunological (parietal and gastrin cell antibodies) and functional abnormalities (duodenogastric reflux), suggested to play a role in the aetiopathogenesis of chronic atrophic gastritis, are also re-examined. Finally, dynamic aspects of chronic atrophic gastritis and its association with anemia and gastric carcinoma are widely reviewed.

Topics: Age Factors; Antibodies; Chronic Disease; Gastritis; Gastritis, Atrophic; Gastroesophageal Reflux; Humans; Intrinsic Factor; Precancerous Conditions; Sex Factors; Smoking; Stomach Neoplasms; Substance-Related Disorders

Topics: Anemia, Pernicious; Antibodies; Binding, Competitive; Gastritis; Humans; Intrinsic Factor; Reagent Kits, Diagnostic; Reference Values; Stomach Neoplasms; Stomach Ulcer

Topics: Adult; Aged; Anemia, Pernicious; Animals; Cell Migration Inhibition; Gastric Mucosa; Gastritis; Gastritis, Atrophic; Humans; Immunity, Cellular; Intrinsic Factor; Leukocytes; Middle Aged; Swine

The leucocyte migration in the presence of gastric antigens was studied in 10 patients with type A gastritis, 38 patients with type B gastritis (28 with atrophic and 10 with superficial gastritis) and 10 healthy controls. A positive leucocyte migration was found in a significant proportion of patients with both types of gastritis, whereas no difference between the two types was observed. These results indicate that cellular immunity is implicated in the aetiology of both types of gastritis, is of greater importance than auto-antibody production and is associated with the severity of the atrophic lesion.

Topics: Animals; Antigens; Autoantibodies; Cell Migration Inhibition; Gastric Mucosa; Gastritis; Gastritis, Atrophic; Humans; Immunity, Cellular; Intrinsic Factor; Leukocytes; Swine

Topics: Anemia, Pernicious; Chronic Disease; Female; Gastric Mucosa; Gastritis; Gastritis, Atrophic; Genetic Markers; Humans; Intrinsic Factor; Male; Pedigree; Stomach Neoplasms

The megaloblastic anaemia observed in patients with chronic atrophic gastritis is usually due to malabsorption of vitamin B12. In some cases, the absence of intrinsic factor supports the diagnosis of pernicious anaemia but other factors, the importance of which varies from case to case, are also involved. They include proliferation of bacteria in the lumen of the gut, intestinal cell abnormalities resulting from lack of vitamin B12 and low hydrochloric acid output with subsequent reduction in the release of vitamin B12 from foodstuffs. With regard to treatment, it would seem justified to combine oral broad-spectrum antibiotics with parenteral administration of vitamin B12.

Topics: Achlorhydria; Aged; Anemia, Megaloblastic; Female; Gastritis; Gastritis, Atrophic; Humans; Intestine, Small; Intrinsic Factor; Malabsorption Syndromes; Male; Middle Aged; Vitamin B 12 Deficiency

A specific gastritis was induced in BALC/c (+/?) mice by thymectomy within 3 days after birth (25 to 45 per cent) or in BALB/c (nu/nu) mice by the injection of spleen cells (10(7)) from neonatally thymectomized mice (70 per cent). Normal peripheral lymphoid cells, irrespective of the sex and dose, were generally ineffective in inducing gastritis in nude mice, while thymus cells were partially effective (30 per cent). The induced gastritis was characterized by a loss of chief and parietal cells and by varying degrees of lymphoid cell infiltration along thickened muscularis mucosa. The fundic mucosa was replaced by mucous necklike immature cells, and there was a rise of pH of the gastric juice. Argyrophilic endocrine cells escaped the inflammation and increased in number. The gastritis induced in nude mice was generally more severe and was often followed by severe macrocytic anemia. Megaloblast-like large immature erythroid cells were numerous in the spleens of affected mice. Antiparietal cell antibodies (IgG) were always demonstrated by an indirect immunofluorescence test in the sera of gastritis-developing mice, but were absent in sera of normal or untreated conventional nude mice. These findings suggest a new animal model of pernicious anemia in man.

Topics: Anemia, Macrocytic; Animals; Animals, Newborn; Autoimmune Diseases; Disease Models, Animal; Female; Gastric Mucosa; Gastritis; Immunoglobulin G; Immunoglobulin M; Intrinsic Factor; Male; Mice; Mice, Nude; Spleen; Thymectomy

A method of assay for the circulating intrinsic factor antibody type I (IFA1) and for the serum vitamin-B12 level by the use of hog intrinsic factor has been developed. The results, the sources of error being taken into consideration, are in agreement with the values obtained by the generally accepted methods of ARDEMAN--CHANARIN for IFA1 and of WIDE--KILLANDER for the serum vitamin-B12 level. Parallel with the increase in the frequency of circulating IFA1, the serum vitamin-B12 level was found to decline in normal individuals as well as in patients with atrophic gastritis or pernicious anaemia. The method is suitable for the assessment of vitamin-B12 deficiency and lends itself to screening of patients tending to pernicious anaemia.

Topics: Adult; Anemia, Pernicious; Animals; Antibodies; Cattle; Female; Gastritis; Humans; Intrinsic Factor; Male; Middle Aged; Swine; Vitamin B 12

Leucocyte migration inhibition test was used for evaluation of cell-mediated immunity in patients with pernicious anaemia (PA) and simple atrophic gastritis (SAG). As antigens microsomal antigen from gastric mucosa of swine foetus and relatively pure hog intrinsic factor (IF) were used. Significant differences were found between PA and SAG with microsomal antigen, but not with IF. It was concluded, that the microsomal antigen might be more active than IF. This observation could contribute to explane the higher incidence of parietal cell antibody than that of IF antibody in PA patients.

Topics: Anemia, Pernicious; Animals; Antigen-Antibody Reactions; Antigens; Cell Migration Inhibition; Fetus; Gastric Mucosa; Gastritis; Humans; Intrinsic Factor; Leukocytes; Microsomes; Swine

Gastric morphology, function, and immunology was studied in 68 patients with pernicious anemia (PA), 183 of their first-degree relatives, and 354 control subjects. The PA relatives and controls were comparable in age and sex distribution. In both groups, mean gastric acid output decreased and mean fasting serum gastrin levels and the prevalence of atrophic gastritis increased with age. The total prevalence of chronic gastritis was similar in the two groups, but severe atrophic gastritis of the body of the stomach (AGB), achlorhydria, parietal cell antibodies, and a raised fasting serum gastrin level were significantly more common in PA relatives than in controls. Of the PA relatives 23 had severe AGB which was indistinguishable from the gastric mucosal lesion found in PA probands and was, as a rule, accompanied by several other characteristics of type A gastritis. These included a normal antrum (78%), slight or absent inflammatory cell infiltration in the gastric mucosa (70%), achlorhydria (91%), high fasting serum gastrin level (83%), parietal cell antibodies (65%), and intrinsic factor antibodies (22%). The mean age and the proportion of subjects with slight and moderate AGB of all AGB subjects was significantly lower in PA relatives than in controls. This suggests an early onset and a rapid progression from mild to severe AGB in PA relatives. Thus, the PA relatives appear to consist of two populations, one with a high and one with little or no proneness to severe AGB. This bimodal distribution suggests the participation of a single major factor, probably genetic, in the pathogenesis of severe AGB in PA relatives.

Topics: Adolescent; Adult; Age Factors; Anemia, Pernicious; Atrophy; Autoantibodies; Consanguinity; Female; Gastric Juice; Gastric Mucosa; Gastrins; Gastritis; Humans; Intestines; Intrinsic Factor; Male; Metaplasia; Middle Aged; Pyloric Antrum; Vitamin B 12

A patient with granulomatous gastritis is described. Two years after the presentation of his gastric disease he developed pernicious anemia. Lack of intrinsic factor production secondary to Crohn's disease of the stomach is felt to be the cause of his Vitamin B12 malabsorption.

Topics: Adult; Anemia, Pernicious; Crohn Disease; Gastritis; Humans; Intrinsic Factor; Male; Vitamin B 12

Topics: Anemia, Macrocytic; Anemia, Megaloblastic; Autoantibodies; Diagnosis, Differential; FIGLU Test; Gastric Juice; Gastritis; History, 18th Century; History, 19th Century; History, 20th Century; Humans; Intrinsic Factor; Prognosis; Vitamin B 12

Three hundred and one first-degree relatives (series) of 73 gastric carcinoma patients and 358 control relatives (controls) of 73 computer-matched probands from a general population were studied by direct-vision gastric biopsy and functional and immunological examinations. The controls were representative of the series with respect to age, sex, birth and dwelling place, and relationship of the relatives. Series and controls behaved similarly as to total prevalence of gastritis, age and sex distribution of gastritis, serum gastrin level, and circulating gastric antibodies. On the other hand, the total prevalence of hyperplastic polyps, atrophic gastritis of the body and antrum, severe atrophic gastritis of the body, intestinal metaplasia, epithelial atypia, and achlorhydria was significantly higher in the series than in the controls. In subjects below 50 years of age the prevalence of severe atrophic gastritis of the body, intestinal metaplasia, and epithelial atypia was also significantly higher in the series. In addition, the mean age of the subjects with atrophic gastritis, intestinal metaplasia, epithelial atypia, and achlorhydria was lower in the series than in controls; however, significant differences were found only in female subjects with epithelial atypia and atrophic gastritis of the body. The results suggest that the prevalence of signs often considered premalignant is significantly higher in carcinoma relatives than in controls and that these signs show a trend to occur at an earlier age in carcinoma relatives. This could explain the significantly higher than expected death rate from gastric carcinoma in close relatives with this disease, found in the present and in other series.

Topics: ABO Blood-Group System; Achlorhydria; Adolescent; Adult; Age Factors; Antibodies; Endoscopy; Epithelium; Female; Gastric Juice; Gastric Mucosa; Gastritis; Humans; Intestines; Intrinsic Factor; Male; Metaplasia; Middle Aged; Stomach Neoplasms

Topics: Achlorhydria; Aged; Anemia, Pernicious; Atrophy; Chronic Disease; Female; Gastritis; Humans; Intestine, Small; Intrinsic Factor; Malabsorption Syndromes; Pepsin A

34 subjects including 5 probands with pernicious anemia, 3 probands with severe atriphic body gastritis and 26 of their first-degree relatives were studied gastroscopically, bioptically, functionally and immunologically. In general, members of the same family revealed a trend to behave similarly with respect to the parameters studied. Signs of A-gastritis (severe atrophy of gastric body glands with a normal or almost normal antrum, achlorhydria, hypergastrinemia and parietal cell antibodies), with intrinsic factor antibodies in the gastric juice and diminished intrinsic factor secretion without anemia were found both in families of probands with atrophic gastritis and pernicious anemia. This suggests a close etiopathogenetic relation of this type of mucosal lesion to overt pernicious anemia. Determination of HCl output and serum gastrin level enabled us to distinguish two differently behaving subgroups in the series, one of them with characteristics of overt adult pernicious anemia. Very low intrinsic factor secretion was found almost exclusively in connection with the presence of intrinsic factor antibodies in the gastric juice and always with severe atrophy of gastric body glands.

Topics: Anemia, Pernicious; Autoantibodies; Gastric Juice; Gastrins; Gastritis; Gastroscopy; Humans; Intrinsic Factor

261 subjects with a normal body mucosa or with superficial gastritis used as controls for an atrophic gastritis series have been followed up for 23--27 years. Of them, 41 died during the earlier and 63 during the present follow-up period. In all, 141 subjects were reexamined in 1976--1977 and 16 answered a questionnaire. None of the subjects had gastric carcinoma or an adenomatous polyp. One patient diagnosed and reported earlier had died of gastric carcinoma during the present period of observation. Of the subjects with normal body mucosa 58% had developed superficial and 14% atrophic gastritis. Of those with superficial body gastritis 42% had developed atrophic gastritis and 18% showed an improvement of the gastritic changes. It should be noted, however, that earlier examinations were performed with blind biopsy and the present with direct vision gastroscopic biopsy. The state of the antral and body mucosa was similar in 53%, antral changes dominated in 33% and the changes in the body in 14%. Intestinal metaplasia was found in 36%, atypical epithelium in 6%, parietal cell antibodies in 0.5% and intrinsic factor antibodies in 0.5%. The fasting serum gastrin level was above 100 ng/ml in 10%. Only 2 cases fulfilled the morphological, functional and immunological criteria of type A gastritis. The present controls differed from the atrophic gastritis series in that the topography of gastritis was different and in that the incidence of metaplasia, atypia, gastric antibodies and high serum gastrin levels was markedly lower.

Topics: Antibodies; Atrophy; Biopsy; Female; Follow-Up Studies; Gastric Mucosa; Gastritis; Gastroscopy; Humans; Intestines; Intrinsic Factor; Male; Metaplasia; Middle Aged; Pyloric Antrum; Stomach Neoplasms; Time Factors

Twenty-one patients (4 females and 17 males) were re-examined 20 years after partial gastrectomy for benign peptic ulcer. Different stages of morphological change in the gastric stump mucosa were compared with haematological parameters as well as with gastric acid and IF secretions. Biopsy specimens were taken by the direct vision technique. Haematological values including also serum vitamin B12, folate and Schilling test were determined. Gastric acid and IF secretions were lower in all patients with "selective parietal cell atrophy" in the gastric mucosa compared with those of other patients. Serum B12 and Schilling test values showed the same tendency. The present study indicates that it is possible to determine the gastric function dependent on parietal cells according to morphological criteria.

Topics: Atrophy; Female; Gastrectomy; Gastric Juice; Gastric Mucosa; Gastritis; Hemoglobins; Humans; Intrinsic Factor; Male; Postgastrectomy Syndromes; Schilling Test; Vitamin B 12

Mucosal biopsies from multiple sites in the stomachs of 21 patients with pernicious anaemia have been examined. The histological changes almost always involved the entire gastric mucosa, including that of the pyloric antrum. Metaplastic changes were almost universal and consisted of intestinal metaplasia in the body and antrum and pyloric metaplasia in the body. The severity of the pyloric metaplasia was such as to make the distinction between body and antrum on biopsy impossible. No relationship was found between serum gastrin activity and the histological appearances of the gastric antrum or body.

Topics: Adult; Aged; Anemia, Pernicious; Antibodies; Atrophy; Female; Gastric Mucosa; Gastrins; Gastritis; Humans; Hyperplasia; Intrinsic Factor; Male; Metaplasia; Middle Aged; Pyloric Antrum

Topics: Achlorhydria; Anemia, Pernicious; Atrophy; Fasting; Gastrins; Gastritis; Humans; Intrinsic Factor; Radioimmunoassay

A method is described for the isolation of parietal cells from the gastric mucosa of the guinea pig by enzymatic digestion with collagenase. A suspension was obtained that contained 70-80% parietal cells. About 80% of the cells were viable immediately after incubation, but viability dropped sharply after one hour. Parietal cells were identified by their morphology on light and electron microscopy, by their uptake of neutral red, by immunofluorescent staining and by carbonic anhydrase activity. Antibodies to four distinct parietal-cell antigens were obtained from rabbits immunized with the isolated parietal cells or fractions thereof. These antibodies were directed against the microsomal fraction of the parietal-cell cytoplasm, the plasma and nuclear membranes, the soluble proteins, and Castle's intrinsic factor. The antibody against the microsomal fraction, though reacting in the same way as the antibody to parietal cell canaliculi found in the serum of patients with pernicious anaemia, showed greater species specificity.

Topics: Anemia, Pernicious; Animals; Antibodies; Antigen-Antibody Reactions; Antigens; Anura; Cell Membrane; Cell Separation; Cell Survival; Chronic Disease; Cytotoxicity Tests, Immunologic; Fluorescent Antibody Technique; Gastric Mucosa; Gastritis; Guinea Pigs; Humans; Immunization; Intrinsic Factor; Mice; Microscopy, Electron; Microsomes; Rabbits; Rana catesbeiana; Rats; Staining and Labeling; Time Factors

Addisonian pernicious anemia (PA) usually develops after age 50. These PA patients are immunocompetent and usually manifest gastric autoimmunity. The prevalence of PA is increased about 10-fold with multiple myeloma and 250-fold in adults with primary immunoglobulin deficiency. Atrophic gastritis develops at an unusually early age with primary immunoglobulin deficiency but not with myeloma. Family history with myeloma is often relevant to PA. Atrophic gastritis develops in both syndromes without gastrict autoantibody production.

Topics: Aging; Anemia, Pernicious; Antibodies; Binding, Competitive; Child, Preschool; Fluorescent Antibody Technique; Gastric Juice; Gastric Mucosa; Gastritis; Hemagglutination Tests; Humans; Hypersensitivity, Delayed; Immunodiffusion; Immunoglobulins; Infant; Intestinal Secretions; Intrinsic Factor; Multiple Myeloma; Radioimmunoassay; Thyroid Gland; Vitamin B 12; Vitamin B 12 Deficiency

Cellular immunity to hog intrinsic factor was detected by a modified agarose-leukocyte migration test in 18 patients with pernicious amemia. Lymphocytes from 17 out of 18 patients with pernicious anemia gave positive responses to a concentrate of hog intrinsic factor; the intrinsic factor present in 1 mg. of this concentrate bound 128 ng. of vatamin B12. Six patients with atrophic gastritis, 7 with regional enteritis, and 9 out of 10 healthy adults did not respond to this preparation. No correlation existed between the presence of serum autoantibodies to intrinsic factor and in vitro lymphocyte responsiveness to intrinsic factor. The results demonstrate that cellular immunity to intrinsic factor concentrates is present in the majority of patients with pernicious anemia.

Topics: Adult; Aged; Anemia, Pernicious; Antibodies; Cell Migration Inhibition; Crohn Disease; Female; Fluorescent Antibody Technique; Gastritis; Humans; Immunity, Cellular; Intrinsic Factor; Lymphocytes; Male; Middle Aged

One hundred fifty alcoholic men and women and 150 age and sex-matched nonalcoholic controls (after exclusion of pernicious anemia and cancer of the stomach) were evaluated for the presence of parietal cell antibodies (PCA). Blocking and binding intrinsic factor antibodies (IFA) were determined in the PCA positive sera. The prevalence and age and sex distribution of PCA in the alcoholics and nonalcoholics was identical. In alcoholics above the age of 60 years, the incidence of PCA, although higher than in those of the younger age group was similar to that in the nonalcoholics of the same age group (in men 6.3 percent and 7.3 percent and in women 7.5 percent and 10.0 percent respectively). Antral gastritis of moderate or severe degree was the frequent lesion in alcoholics. This form of gastritis was not associated with any significant increase in the incidence of PCA. No patients with sera positive for IFA were detected among the 22 PCA positive patients. There is no evidence for humoral derangement of the gastric autoimmunity in chronic alcoholics.

Topics: Adult; Age Factors; Aged; Alcoholism; Antibodies; Autoantibodies; Biopsy; Female; Gastric Mucosa; Gastritis; Humans; Intrinsic Factor; Male; Middle Aged

The role of autoimmune processes in the pathogenesis of atrophic gastritis, be it with or without pernicious anemia, is described on the basis of literature data. Various findings in cases of atrophic gastritis favor such a role, e.g. histological findings, the high incidence of autoantibodies against gastric mucosa, a high specificity of gastric antigens in cellular immune reactions, the concomitant occurrence of other auto-immune diseases, the favorable effect of immunosuppressive therapy. On an experimental basis transfer of autoimmune gastritis by lymphocytes from the ductus thoracicus lymph of sick animals to non-immunized animals does support this hypothesis.

Topics: Anemia, Pernicious; Animals; Autoantibodies; Chronic Disease; Dogs; Gastric Mucosa; Gastritis; Humans; Immunization, Passive; Immunosuppression Therapy; Intrinsic Factor; Lymphocytes

Topics: Anemia, Pernicious; Animals; Antibodies; Antibody Formation; Autoimmune Diseases; B-Lymphocytes; Cell Migration Inhibition; Female; Fluorescent Antibody Technique; Gastric Juice; Gastritis; Humans; Immunity, Cellular; Intrinsic Factor; Lymphocyte Activation; Male; Swine; T-Lymphocytes

Topics: Achlorhydria; Adult; Aged; Anemia, Pernicious; Atrophy; Autoantibodies; Autoimmune Diseases; Female; Follow-Up Studies; Gastritis; Humans; Intrinsic Factor; Malabsorption Syndromes; Male; Middle Aged; Schilling Test; Time Factors; Vitamin B 12

Evidence of cell-mediated immunity to gastric intrinsic factor was present in 86% of patients with pernicious anaemia and in at least 13% of patients with hyperthyroidism, 21% of patients with atrophic gastritis, and four out of nine (46%) patients with hypogammaglobulinaemia. Controls gave negative results. The four patients with hypogammaglobulinaemia and cell-mediated immunity to intrinsic factor had evidence of impaired gastric function.

Topics: Agammaglobulinemia; Anemia, Pernicious; Antibodies; Autoimmune Diseases; Cell Migration Inhibition; Diabetes Mellitus; Female; Gastritis; Hematocrit; Humans; Hyperthyroidism; Hypothyroidism; Immunity, Cellular; Intestinal Absorption; Intrinsic Factor; Leukocytes; Lymphocyte Activation; Male; Vitamin B 12

Topics: Aged; Antibodies; Atrophy; Biopsy; Female; Follow-Up Studies; Gastric Mucosa; Gastrins; Gastritis; Humans; Intestinal Polyps; Intrinsic Factor; Male; Metaplasia; Middle Aged; Pyloric Antrum; Stomach; Stomach Diseases; Stomach Neoplasms

Topics: Anemia, Pernicious; Animals; Antibody Formation; Antigen-Antibody Complex; Autoantibodies; Autoimmune Diseases; Chromatography, Gel; Cytotoxicity Tests, Immunologic; Gastritis; Humans; Immunity, Cellular; Immunologic Deficiency Syndromes; Intrinsic Factor; Lymphocytes; Mice; Stomach

Topics: Acute Disease; Age Factors; Animals; Antibodies; Chronic Disease; Gastric Mucosa; Gastritis; Gastroscopy; Humans; Immune System Diseases; Immunity, Cellular; Intrinsic Factor

Topics: Addison Disease; Adolescent; Adult; Antibodies, Anti-Idiotypic; Autoimmune Diseases; Candidiasis; Diabetes Mellitus; Female; Follicle Stimulating Hormone; Gastritis; Humans; Hypoparathyroidism; Hypopituitarism; Intrinsic Factor; Luteinizing Hormone; Myxedema; Ovarian Diseases; Syndrome; Thyroiditis, Autoimmune

The administration of prednisolone did not affect absorption of vitamin B(12) and gastric secretion of intrinsic factor in nine subjects with normal gastric mucosa, or in five with chronic superficial gastritis. No gastric morphological changes were observed in either group. In contrast, four of seven patients with pernicious anaemia showed improvement in absorption of vitamin B(12) during prednisolone administration for periods of two to 10 months. No consistent changes in gastric mucosal morphology were noted. An additional five patients were studied intensively during one month of prednisolone administration. In three, absorption of vitamin B(12) was restored to within the normal range between eight and 13 days after the commencement of the drug. The improvement was not paralleled by enhancement of secretion of intrinsic factor or other vitamin B(12) binders. Suppression of intrinsic factor antibodies in serum and gastric juice did not occur consistently in those patients showing a functional response.

Topics: Anemia, Pernicious; Antibodies; Binding Sites; Cobalt Isotopes; Complement Fixation Tests; Female; Fluorescent Antibody Technique; Gastric Juice; Gastric Mucosa; Gastritis; Humans; Intestinal Absorption; Intrinsic Factor; Male; Prednisolone; Stomach; Vitamin B 12

Topics: Anemia, Pernicious; Antigen-Antibody Reactions; Autoantibodies; Chronic Disease; Gastric Mucosa; Gastritis; Humans; Immunity, Cellular; Immunoglobulins; Immunologic Deficiency Syndromes; Intrinsic Factor

Topics: Adult; Anemia, Pernicious; Antibody Formation; Antigens; Binding Sites, Antibody; Female; Gastritis; Humans; Immunity, Cellular; Intrinsic Factor; Male

Topics: Adolescent; Adult; Anemia, Pernicious; Carbachol; Cobalt Radioisotopes; Coffee; Diagnosis, Differential; Fasting; Female; Gastric Acidity Determination; Gastric Juice; Gastritis; Histamine; Humans; Intestinal Absorption; Intrinsic Factor; Male; Middle Aged; Schilling Test; Vitamin B 12

Topics: Anemia, Pernicious; Antigens; Atrophy; Cell Migration Inhibition; Gastric Mucosa; Gastritis; Humans; Intrinsic Factor; Leukocytes; Microsomes; Mitochondria; Mitochondria, Liver; Organ Specificity; Stomach

Topics: Adult; Aged; Anemia, Pernicious; Autoantibodies; Charcoal; Female; Gastric Juice; Gastritis; Humans; Intrinsic Factor; Male; Middle Aged; Radioimmunoassay; Stomach

Topics: Anemia; Anemia, Hypochromic; Anemia, Pernicious; Anemia, Sideroblastic; Blind Loop Syndrome; Crohn Disease; Diverticulitis; Folic Acid Deficiency; Gastritis; Gastrointestinal Diseases; Gastrointestinal Hemorrhage; Gastrointestinal Neoplasms; Humans; Intrinsic Factor; Malabsorption Syndromes; Vitamin B 12 Deficiency; Whipple Disease

Topics: Adult; Aged; Anemia, Pernicious; Antigens; Autoantibodies; Cell Migration Inhibition; Female; Gastritis; Humans; Immunity, Cellular; Intrinsic Factor; Male; Middle Aged; Stomach

Topics: Achlorhydria; Atrophy; Autoantibodies; Biopsy; Duodenal Ulcer; Duodenum; Follow-Up Studies; Gastrectomy; Gastric Mucosa; Gastritis; Humans; Intrinsic Factor; Iron; Postoperative Complications; Stomach

Topics: Adult; Aged; Chronic Disease; Electrophoresis, Starch Gel; Endopeptidases; Enzyme Precursors; Gastric Acidity Determination; Gastric Juice; Gastritis; Histamine; Humans; Intestinal Diseases; Intrinsic Factor; Metaplasia; Middle Aged; Peptide Hydrolases; Spectrophotometry

Topics: Achlorhydria; Anemia, Pernicious; Antibodies; Biopsy; Cobalt Isotopes; Complement Fixation Tests; Deficiency Diseases; Fats; Feces; Female; Folic Acid; Gastric Juice; Gastric Mucosa; Gastritis; Humans; India; Intestinal Absorption; Intrinsic Factor; Malabsorption Syndromes; Male; Middle Aged; Vitamin B 12; Xylose

Topics: Adult; Aged; Anemia, Pernicious; Beta-Globulins; Biopsy; Female; Fluorescent Antibody Technique; Gastric Mucosa; Gastritis; Haptoglobins; Humans; Immunodiffusion; Immunoglobulin A; Immunoglobulin G; Immunoglobulin M; Intrinsic Factor; Male; Middle Aged; Radioimmunoassay; Schilling Test; Vitiligo

Topics: Adult; Aged; Anemia, Pernicious; Autoantibodies; Cobalt Isotopes; Female; Gastric Juice; Gastritis; Humans; Immunodiffusion; Immunoglobulin A; Immunoglobulin G; Immunoglobulin M; Immunoglobulins; Intrinsic Factor; Lymphocytes; Male; Middle Aged; Radioisotope Dilution Technique; Schilling Test; Vitamin B 12

Topics: Antigen-Antibody Reactions; Antigens; Autoantibodies; Autoimmune Diseases; Chronic Disease; Complement Fixation Tests; Fluorescent Antibody Technique; Gastritis; Humans; Intrinsic Factor; Stomach

Topics: Duodenal Ulcer; False Negative Reactions; False Positive Reactions; Gastric Acidity Determination; Gastric Juice; Gastric Mucosa; Gastritis; Histamine; Humans; Intrinsic Factor; Peptides; Stomach; Stomach Neoplasms; Stomach Ulcer; Time Factors; Vagotomy; Vagus Nerve; Zollinger-Ellison Syndrome

The prevalence of circulating antibodies to gastric intrinsic factor and parietal cells was examined in 60 patients with histologically proven gastric carcinoma and was found not to differ from the prevalence of these antibodies in control subjects of similar age and sex distribution.Amongst the 60 patients with gastric carcinoma seven were thought to have actual or potential pernicious anaemia. The absence of an increased prevalence of antigastric antibodies in gastric carcinoma indicates that gastritis itself, whether autoimmune or not, is the likely common denominator underlying the predisposition to gastric carcinoma in both pernicious anaemia and chronic atrophic gastritis.

Topics: Adolescent; Adult; Anemia, Pernicious; Autoantibodies; Autoimmune Diseases; Child; Female; Gastritis; Humans; Intrinsic Factor; Male; Middle Aged; Precancerous Conditions; Stomach; Stomach Neoplasms; Vitamin B 12

Topics: Anemia, Pernicious; Animals; Autoantibodies; Child; Cricetinae; Cytoplasm; Female; Gastric Mucosa; Gastritis; Humans; Intrinsic Factor; Male; Radioimmunoassay

Topics: Anemia, Pernicious; Fetus; Gastritis; Gestational Age; Humans; Intrinsic Factor; Pylorus; Radioimmunoassay; Stomach

Topics: Adolescent; Adult; Age Factors; Aged; Alcohol Drinking; Antibodies; Biopsy; Blood Group Antigens; Coffee; Feeding Behavior; Female; Finland; Gastric Mucosa; Gastritis; Humans; Intrinsic Factor; Male; Middle Aged; Pedigree; Sex Factors; Smoking; Vitamin B 12

Topics: Adolescent; Adult; Agammaglobulinemia; Anemia, Pernicious; Biopsy; Child; Child, Preschool; Female; gamma-Globulins; Gastric Acidity Determination; Gastric Juice; Gastric Mucosa; Gastritis; Humans; Hydrogen-Ion Concentration; Immunoglobulin G; Immunoglobulin M; Immunoglobulins; Infant; Intrinsic Factor; Male; Saliva; Stomach Diseases

Topics: Adult; Aged; Anemia, Pernicious; Antibodies; Autoimmune Diseases; Cell Movement; Female; Follow-Up Studies; Gastric Juice; Gastritis; Graves Disease; Humans; Hyperthyroidism; Intestinal Absorption; Intrinsic Factor; Leukocytes; Male; Middle Aged; Myxedema; Thyroid Diseases; Thyroiditis, Autoimmune; Vitamin B 12

Topics: Anemia, Pernicious; Animals; Body Weight; Disease Models, Animal; Fluorescent Antibody Technique; Gastric Acidity Determination; Gastric Juice; Gastric Mucosa; Gastritis; Guinea Pigs; Humans; Immunoelectrophoresis; Immunoglobulin G; Intestinal Mucosa; Intrinsic Factor; Rats; Sodium Chloride; Solutions; Time Factors

Topics: Adult; Antibodies; Biopsy; Diabetes Mellitus; Duodenal Ulcer; Fluorescent Antibody Technique; Gastritis; Gastrointestinal Diseases; Humans; Intrinsic Factor; Middle Aged; Stomach; Stomach Neoplasms; Stomach Ulcer

Topics: Anemia, Pernicious; Antibodies; Antibody Specificity; Antigen-Antibody Reactions; Atrophy; Autoimmune Diseases; Biopsy; Chronic Disease; Complement Fixation Tests; Fluorescent Antibody Technique; Gastric Mucosa; Gastritis; Humans; Immune Tolerance; Intrinsic Factor; Stomach Ulcer

Topics: Anemia, Pernicious; Animals; Chromatography, Gel; Chromatography, Ion Exchange; Chromium Isotopes; Electrophoresis; Feces; Gastrectomy; Gastric Juice; Gastritis; Guinea Pigs; Humans; Hydrogen-Ion Concentration; Intestinal Absorption; Intestinal Mucosa; Intrinsic Factor; Liver; Postoperative Complications; Swine; Vitamin B 12

Topics: Anemia, Pernicious; Antibodies; Cell Movement; Gastric Juice; Gastric Mucosa; Gastritis; Humans; Intrinsic Factor; Leukocytes

Topics: Achlorhydria; Adolescent; Adult; Aged; Anemia, Pernicious; Biopsy; Chronic Disease; Female; Gastric Juice; Gastric Mucosa; Gastritis; Histamine; Humans; Intrinsic Factor; Male; Middle Aged; Stomach

Topics: Anemia, Pernicious; Antibody Formation; Autoimmune Diseases; Complement Fixation Tests; Gastritis; Humans; Immunity, Cellular; Intestinal Mucosa; Intrinsic Factor

Topics: Anemia, Pernicious; Atrophy; Autoantibodies; Gastritis; Humans; Intestinal Mucosa; Intrinsic Factor; Stomach

Topics: Achlorhydria; Adult; Agammaglobulinemia; Anemia, Pernicious; Antibodies; Arthritis, Rheumatoid; Atrophy; Autoimmune Diseases; Colitis, Ulcerative; Diarrhea; Female; Fluorescent Antibody Technique; gamma-Globulins; Gastric Mucosa; Gastritis; Giardiasis; Humans; Hypersensitivity; Hypersensitivity, Delayed; Infections; Intrinsic Factor; Male; Middle Aged; Vitamin B 12

Topics: Anemia, Pernicious; Animals; Autoantibodies; Complement Fixation Tests; Fluorescent Antibody Technique; Gastric Juice; Gastric Mucosa; Gastritis; Goats; Humans; Intrinsic Factor; Rabbits; Stomach; Swine

Topics: Adult; Age Factors; Aged; Anemia, Pernicious; Antibodies, Antinuclear; Autoantibodies; Autoimmune Diseases; Female; Fluorescent Antibody Technique; Gastritis; Humans; Intrinsic Factor; Male; Middle Aged; Sex Factors; Stomach; Thyroid Diseases; Thyroid Gland; Wales

Topics: Adult; Aged; Anemia, Pernicious; Antigen-Antibody Reactions; Atrophy; Biopsy; Complement System Proteins; Female; Fluorescent Antibody Technique; Gastric Mucosa; Gastritis; Humans; Intrinsic Factor; Male; Middle Aged; Vitamin B 12

Topics: Aged; Autoantibodies; Biopsy; Chronic Disease; Fluorescent Antibody Technique; Gastric Mucosa; Gastritis; Humans; Intrinsic Factor; Male; Thyroid Gland

Topics: Adolescent; Adult; Aged; Anemia, Pernicious; Atrophy; Autoantibodies; Female; Finland; Gastric Mucosa; Gastritis; Humans; Intrinsic Factor; Male; Mass Screening; Middle Aged; Rural Population; Sampling Studies

Topics: Anemia, Pernicious; Antibody Formation; Chromatography, Gel; Cobalt Isotopes; Female; Gastritis; Humans; Intrinsic Factor; Male; Methods; Vitamin B 12

Topics: Adult; Anemia, Pernicious; Asian People; Atrophy; Autoantibodies; Female; Gastritis; Hong Kong; Humans; Hyperthyroidism; Intestinal Absorption; Intrinsic Factor; Male; Middle Aged; Stomach; Vitamin B 12

Topics: Anemia, Pernicious; Antibodies; Cobalt Isotopes; Gastritis; Humans; Intrinsic Factor; Stomach Neoplasms; Vitamin B 12

Topics: Adolescent; Adult; Aged; Anemia, Pernicious; Female; gamma-Globulins; Gastric Mucosa; Gastritis; Humans; Immunoelectrophoresis; Intrinsic Factor; Male; Methods; Middle Aged

Topics: Achlorhydria; Anemia, Pernicious; Gastric Juice; Gastrins; Gastritis; Histamine; Humans; Intrinsic Factor; Radioimmunoassay; Schilling Test; Vitamin B 12

Topics: Adult; Aged; Anemia, Pernicious; Autoantibodies; Autoimmune Diseases; Diabetes Complications; Diabetes Mellitus; Female; Fluorescent Antibody Technique; Gastric Mucosa; Gastritis; Humans; Insulin; Intestinal Absorption; Intrinsic Factor; Male; Middle Aged; Schilling Test; Vitamin B 12

Topics: Anemia, Pernicious; Autoantibodies; Biopsy; Complement Fixation Tests; Fluorescent Antibody Technique; Gastric Juice; Gastric Mucosa; Gastritis; Humans; Intrinsic Factor; Microsomes; Vitamin B 12

Topics: Anemia, Pernicious; Antibodies; Atrophy; Complement System Proteins; Diagnosis, Differential; Fluorescent Antibody Technique; gamma-Globulins; Gastric Mucosa; Gastritis; Humans; Intestinal Diseases; Intrinsic Factor; Metaplasia; Postgastrectomy Syndromes; Stomach Neoplasms

Topics: Anemia, Pernicious; Antibodies; Antigen-Antibody Reactions; Autoantibodies; Fluorescent Antibody Technique; Gastric Mucosa; Gastritis; Humans; Hyperthyroidism; Hypothyroidism; Intrinsic Factor; Lupus Erythematosus, Systemic

Topics: Achlorhydria; Anemia, Pernicious; Autoimmune Diseases; Gastritis; History, 19th Century; History, 20th Century; Intrinsic Factor; Prednisolone; Thyroid Diseases; Thyroiditis, Autoimmune; Vitamin B 12

Topics: Achlorhydria; Aged; Anemia, Pernicious; Animals; Antigen-Antibody Reactions; Atrophy; Biopsy; Diabetes Mellitus; Female; Fluorescent Antibody Technique; Gastric Juice; Gastric Mucosa; Gastritis; Humans; Immune Sera; Intrinsic Factor; Male; Middle Aged; Prednisolone; Rats; Regeneration; Reticulocytes; Schilling Test; Stomach; Stomach Diseases; Thyroiditis, Autoimmune; Vitamin B 12

Topics: Age Factors; Aged; Antibodies; Arthritis, Rheumatoid; Autoimmune Diseases; Complement Fixation Tests; Female; Fluorescent Antibody Technique; Gastric Mucosa; Gastritis; Hematocrit; Hemoglobins; Humans; Intestinal Absorption; Intrinsic Factor; Male; Middle Aged; Schilling Test; Stomach; Vitamin B 12

Topics: Aged; Anemia, Pernicious; Autoantibodies; Body Height; Body Weight; Female; Fluorescent Antibody Technique; Gastric Acidity Determination; Gastric Juice; Gastric Mucosa; Gastritis; Histamine; Humans; Intrinsic Factor; Iron; Ischemia; Male; Middle Aged; Peptic Ulcer; Polycythemia Vera; Stomach Ulcer; Vitamin B 12

Topics: Anemia, Pernicious; Atrophy; Autoantibodies; Chronic Disease; Fluorescent Antibody Technique; Gastritis; Humans; Intrinsic Factor

Topics: Adult; Aged; Anemia, Pernicious; Antibodies, Antinuclear; Antigen-Antibody Reactions; Atrophy; Autoantibodies; Female; Gastric Juice; Gastric Mucosa; Gastritis; Humans; Intestinal Absorption; Intrinsic Factor; Male; Middle Aged; Stomach Diseases; Vitamin B 12

Topics: Adult; Anemia, Pernicious; Female; Gastritis; Humans; Hyperthyroidism; India; Intrinsic Factor; Thyroid Function Tests; Vitamin B 12

Topics: Female; Gastric Acidity Determination; Gastric Mucosa; Gastritis; Humans; Intrinsic Factor; Male; Pylorus; Vagotomy

Topics: Adult; Anemia, Hypochromic; Anemia, Pernicious; Antigen-Antibody Reactions; Australia; Autoantibodies; Blood Donors; Complement Fixation Tests; Diabetes Mellitus; Female; Gastric Mucosa; Gastritis; Humans; Hyperthyroidism; India; Intrinsic Factor; Male; Middle Aged; North America; United Kingdom

Topics: Achlorhydria; Adult; Anemia, Pernicious; Diagnosis, Differential; Gastric Juice; Gastritis; Histamine; Humans; Intrinsic Factor; Schilling Test; Vitamin B 12

Topics: Anemia, Pernicious; Antibodies; Autoantibodies; Autoimmune Diseases; Female; Gastric Juice; Gastritis; Humans; Intrinsic Factor; Male; Microscopy, Fluorescence; Prednisone; Saliva; Vitamin B 12

Topics: Anemia, Pernicious; Autoantibodies; Fluorescent Antibody Technique; Gastric Mucosa; Gastritis; Humans; Intestinal Absorption; Intrinsic Factor; Postgastrectomy Syndromes; Vitamin B 12

Topics: Aged; Antibodies; Atrophy; Biopsy; Fluorescent Antibody Technique; Gastric Juice; Gastric Mucosa; Gastritis; Histamine; Humans; Intrinsic Factor; Iron; Male; Middle Aged; Schilling Test; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Chromatography; Clinical Enzyme Tests; Enzyme Precursors; Gastric Acidity Determination; Gastric Juice; Gastritis; Humans; Intrinsic Factor; Peptide Hydrolases; Secretory Rate; Stomach Neoplasms; Stomach Ulcer

Topics: Adult; Anemia, Pernicious; Female; Gastric Acidity Determination; Gastric Juice; Gastric Mucosa; Gastritis; Hexoses; Humans; Intestinal Absorption; Intrinsic Factor; Male; Middle Aged; Pepsin A; Secretory Rate; Vitamin B 12

Topics: Anemia, Pernicious; Autoantibodies; Fluorescent Antibody Technique; Gastritis; Humans; Intrinsic Factor; Stomach; Stomach Diseases

Topics: Anemia, Pernicious; Autoantibodies; Biopsy; Fluorescent Antibody Technique; Gastric Mucosa; Gastritis; Humans; In Vitro Techniques; Intrinsic Factor; Schilling Test

Topics: Atrophy; Gastric Acidity Determination; Gastritis; Histamine; Humans; Intrinsic Factor; Urine; Vitamin B 12

Topics: Achlorhydria; Adolescent; Adult; Anemia, Pernicious; Antibodies; Biopsy; Blood; Child; Child, Preschool; Female; Gastric Juice; Gastritis; Humans; Hydrochloric Acid; In Vitro Techniques; Infant; Intrinsic Factor; Male; Stomach Diseases; Vitamin B 12

Topics: Adult; Aged; Anemia, Pernicious; Duodenal Ulcer; Female; Gastric Acidity Determination; Gastric Juice; Gastritis; Histamine; Humans; Intrinsic Factor; Male; Middle Aged; Secretory Rate

Topics: Allergy and Immunology; Anemia, Pernicious; Antibodies; Autoimmune Diseases; Complement Fixation Tests; Fluorescent Antibody Technique; Gastric Mucosa; Gastritis; Gastritis, Atrophic; Hemagglutination; Humans; Intrinsic Factor; Thyroglobulin; Thyroid Gland; Tissue Extracts

Topics: Anemia, Pernicious; Antibodies; Biopsy; Diagnosis; Gastric Acidity Determination; Gastric Juice; Gastric Mucosa; Gastrins; Gastritis; Histamine; Humans; Immunochemistry; Intestinal Absorption; Intrinsic Factor; Pharmacology; Vitamin B 12

Topics: Adult; Aged; Anemia, Pernicious; Antibodies; Cobalt Isotopes; Gastric Acidity Determination; Gastritis; Histamine; Humans; Immunoassay; Intrinsic Factor; Middle Aged; Stomach Diseases; Stomach Neoplasms; Stomach Ulcer; Vitamin B 12

Topics: Anemia, Pernicious; Autoantibodies; Autoimmune Diseases; Complement Fixation Tests; Electrophoresis; Fluorescent Antibody Technique; Gastritis; Humans; Intrinsic Factor

Topics: Adolescent; Adult; Biopsy; Gastric Juice; Gastric Mucosa; Gastritis; Humans; India; Intrinsic Factor; Male; Middle Aged; Sprue, Tropical

Topics: Anemia, Pernicious; Biomedical Research; Corrinoids; Diagnosis, Differential; Gastritis; Humans; Intrinsic Factor; Research; Stomach Neoplasms; Vitamin B 12

Topics: Anemia, Pernicious; Animals; Cestoda; Cestode Infections; Corrinoids; Erythrocyte Count; Gastritis; Humans; Intrinsic Factor; Physiology; Schilling Test; Vitamin B 12

Topics: Aging; Gastric Acidity Determination; Gastric Juice; Gastric Mucosa; Gastritis; Humans; Intrinsic Factor; Schilling Test; Urine; Vitamin B 12

Topics: Achlorhydria; Anemia; Anemia, Pernicious; Blood; Carbachol; Gastric Juice; Gastritis; Gastritis, Atrophic; Geriatrics; Histamine; Humans; Hydrochloric Acid; Intrinsic Factor; Pathology; Pharmacology; Vitamin B 12

Topics: Achlorhydria; Anemia; Anemia, Pernicious; Atrophy; Chemical Phenomena; Chemistry; Erythropoiesis; Gastric Juice; Gastric Mucosa; Gastritis; Gastrointestinal Hormones; Humans; Intrinsic Factor; Metabolism; Peptic Ulcer; Pharmacology; Physiology; Vitamin B 12

Topics: Atrophy; Duodenal Ulcer; Gastritis; Gastritis, Atrophic; Humans; Intrinsic Factor; Polyps; Stomach Diseases; Stomach Neoplasms; Stomach Ulcer; Vitamin B 12

Topics: Achlorhydria; Gastric Juice; Gastritis; Gastritis, Atrophic; Intrinsic Factor