Chapter 23
Gastric Secretions
M. Michael Wolfe,
Robert C. Lowe,
M. Michael Wolfe
MetroHealth Medical Center and Case Western Reserve University School of Medicine, Cleveland, OH, USA
Search for more papers by this authorRobert C. Lowe
Boston University School of Medicine, Boston, MA, USA
Search for more papers by this authorM. Michael Wolfe,
Robert C. Lowe,
M. Michael Wolfe
MetroHealth Medical Center and Case Western Reserve University School of Medicine, Cleveland, OH, USA
Search for more papers by this authorRobert C. Lowe
Boston University School of Medicine, Boston, MA, USA
Search for more papers by this authorBook Editor(s):Daniel K. Podolsky MD,
Michael Camilleri MD,
J. Gregory Fitz MD FAASLD,
Anthony N. Kalloo MD,
Fergus Shanahan MD,
Timothy C. Wang MD,
Daniel K. Podolsky MD
President, University of Texas Southwestern Medical Center, Professor of Internal Medicine, Department of Internal Medicine, University of Texas Southwestern Medical School, Dallas, TX, USA
Search for more papers by this authorMichael Camilleri MD
Executive Dean for Development, Atherton and Winifred W. Bean Professor, Professor of Medicine, Physiology and Pharmacology, Distinguished Investigator, Mayo Clinic, Rochester, MN, USA
Search for more papers by this authorJ. Gregory Fitz MD FAASLD
Executive Vice President for Academic Aff airs and Provost, University of Texas Southwestern Medical Center, Dean, Professor of Internal Medicine, Department of Internal Medicine, University of Texas Southwestern Medical School, Dallas, TX, USA
Search for more papers by this authorAnthony N. Kalloo MD
Professor of Medicine, Johns Hopkins University School of Medicine, Director, Division of Gastroenterology & Hepatology, Johns Hopkins Hospital, Baltimore, MD, USA
Search for more papers by this authorFergus Shanahan MD
Professor and Chair, Department of Medicine, Director, Alimentary Pharmabiotic Centre, University College Cork, National University of Ireland, Cork, Ireland
Search for more papers by this authorTimothy C. Wang MD
Chief, Division of Digestive and Liver Diseases, Silberberg Professor of Medicine, Department of Medicine and Irving Cancer Research Center, Columbia University Medical Center, New York, NY, USA
Search for more papers by this authorSummary
The stomach is innervated by both parasympathetic and sympathetic neurons of the autonomic nervous system. Vagal stimulation, broadly, increases the secretory and motor function of the stomach. This chapter discusses the effect of vagal stimulation on gastric secretion. The important role of the nervous system in regulating gastric acid secretion has long been recognized, with prior studies demonstrating that the vagus was the sole responsible gastrocephalic neural link. Vagal stimulation of the parietal cell appears to involve several mechanisms. The parietal cell possesses several different receptors for stimulatory and inhibitory ligands on its basolateral membrane. Autocrine or paracrine signaling by sonic hedgehog (Shh) is required for full functional differentiation of the parietal cell, as well as gastric acid secretion. The H+/K+ adenosine triphosphatase (H+, K+-ATPase) enzyme of the gastric parietal cell is generally regarded as the most critical component of the ion transport system mediating acid secretion.
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