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In biopsies that contained oxyntic gastric mucosa, changes suggestive of PPI use, such as parietal cell hyperplasia and dilated fundic glands, were seen on microscopic examination.
GHRL is a potent growth hormone secretagogue, which is mainly produced by endocrine cells of the gastric oxyntic mucosa and linked to many physiological and pathophysiological aspects, such as bone metabolism, in addition to growth.
Ghrelin, one of the hormones playing a role in the pathogenesis of IBS, is a 28-amino acid lipopeptide hormone produced in the enteroendocrine X/A-like cells of the gastric oxyntic gland mucosa (6).
Ghrelin is mainly produced and secreted by A-like cells within the oxyntic glands of the stomach (Shi et al., 2017), and the acylation is essential for ghrelin's activity through the GHSR (Nishi et al., 2011).
In brief, inflammation, mucous metaplasia, oxyntic gland atrophy, and pseudopyloric metaplasia in the gastric corpus were scored as increasing and extension of leukocyte, foci replacing of parietal cells, loss of chief/parietal cells, and site of foci replacing.
Caption: Figure 5: Partial gastrectomy specimen with ganglioneuromatous proliferation extending from the submucosa into the lamina propria splaying oxyntic mucosal glands.
Wong et al., "Lgr5-expressing chief cells drive epithelial regeneration and cancer in the oxyntic stomach," Nature Cell Biology, vol.
Ghrelin is a peptide hormone mainly secreted in the oxyntic mucosa of the stomach and is the ligand for the growth hormone secretagogue receptor (GHS-R); which is the other endocrine pathway that stimulates the secretion of GH by the pituitary gland in addition to the GH-releasing hormone (Dimaraki & Jaffe, 2006).
The production of this peptide occurs mostly in the endocrine cells of the oxyntic gastric mucosa, responsible for about 80% of its serum levels (10).
Yakubov et al., "Identification and characterization of nesfatin-1 immunoreactivity in endocrine cell types of the rat gastric oxyntic mucosa," Endocrinology, vol.
The hematoxylin and eosin stain of the biopsy showed small intestinal and gastric oxyntic mucosa with dark brown clumpy pigment within histiocytes of the lamina propria (Figure 2).
Nesfatin-1 is also expressed in extrahypothalamic tissues such as gastrointestinal tissue (gastric oxyntic mucosa, pancreatic beta cells, and liver), skeletal muscle, and adipose tissue [25-28].