PEPTIC ULCER DISEASE

Non Steroidal Anti-

Arachidonic Acid

COX-1 AND COX-2

Decreased Prostaglandin synthesis

Increased HCl secretion

Decreased Mucus secretion
Decreased Bicarbonate secretion P

Decreased Blood flow

Decreased Epithelial cell proliferation

Decrease Somatostain
Mucosal Damage Increase Gastrin and Histamine
Increase Ach from parasympathetic Vagus H. Pylori
Nerve
Increase Acid secretion P

CagA and VacA (+)

Infected Host

Chemotactic Proteases and Adhesins

CagA disrupts Urease Flagella
Factors Phospholipases

ZO-1 to induce SHP-2 to c-Met to

paracellular induce increase
leakage of Cytoskeletal motility in the
bacteria change stomach

Breakdown of Conversion of
glycoprotein Attachment of Urea to Increase mobility
Further within gstric and
lipid complex of bacteria into Ammonia for a
Epithelial Injury duodenal mucosa
mucus gel epithelial cell suitable
environment

Mucosal Damage Mucosal Damage to ULCERATION

the submucosa