Parietal cell
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Parietal cells (also called oxyntic cells) are cells located in the stomach epithelium.
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Acid production
Parietal cells produce gastric acid (hydrochloric acid) after activation of adenylate cyclase. Parietal cells contain an extensive secretory network (called canaliculi) from which the HCl is secreted into the stomach. Active transport, facilitated by the enzyme K+/H+ ATPase, is used since the concentration of hydrogen ions in the cells is about 3 million times greater. Hydrochloric acid is formed in the following manner:
- Hydrogen ions are formed from the dissociation of water molecules. The enzyme carbonic anhydrase converts one molecule of carbon dioxide and one molecule of water into a bicarbonate ion (HCO3-) and a hydrogen ion (H+</sub>).
- The bicarbonate ion (HCO3-) is released into the blood and a chloride ion (Cl-) enters the cell.
- Potassium (K+) and chloride (Cl-) ions are secreted into the canaliculi.
- Hydrogen ions are pumped out of the cell into the canaliculi in exchange for a potassium ion, via the H+/K+ ATPase.
The resulting highly acidic environment causes proteins from food to unfold (or denature) and this exposes the protein's peptide bonds. Enzymes such as pepsin and trypsin help digestion by breaking the bonds linking amino acids, a process known as proteolysis.
Parietal cells secrete acid in response to three types of stimuli: -
- parasympathetic activity via the Vagus nerve
- H2 histamine receptors
- gastrin
Upon stimulation, adenylate cyclase is activated within the parietal cells. This increases intracellular cyclic AMP, which leads to activation of protein kinase A. Protein kinase A phosphorylates proteins involved in the transport of H+/K+ ATPase from the cytoplasm to the cell membrane. This causes resorption of K+ ions and secretion of H+ ions. The pH of the secreted fluid can fall 'by' 0.8
Intrinsic factor
Parietal cells also produce intrinsic factor. Intrinsic factor is required for the absorption of vitamin B12 in the diet.
Diseases of parietal cells
- Peptic ulcers can result from over-acidity in the stomach. Antacids can be used to enhance the natural tolerance of the gastric lining. Antimuscarinic drugs such as pirenzepine or H2 antihistamines can reduce acid secretion. Proton pump inhibitors are more potent at reducing gastric acid production since that is the final common pathway of all stimulation of acid production.
- In pernicious anemia, autoantibodies directed against parietal cells or intrinsic factor cause a reduction in vitamin B12 absorption. It can be treated with injections of replacement vitamin B12 (hydroxocobalamin or cyanocobalamin).
- Achlorhydria is another autoimmune disease of the parietal cells. The damaged parietal cells are unable to produce the required amount of gastric acid. This leads to an increase in gastric pH, impaired digestion of food and increased risk of gastroenteritis.
References
Review of Medical Physiology, William F. Ganong, 20th Edition, 2001, McGraw-Hill, ISBN 0-07-112064-5 pp467-470