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Detection of Pepsinogen in the Neonatal Lung and Stomach by Immunohistochemistry

Elabiad, Mohamad T.*; Zhang, Jie

Journal of Pediatric Gastroenterology and Nutrition: October 2011 - Volume 53 - Issue 4 - p 401–403
doi: 10.1097/MPG.0b013e31821a4b78
Original Articles: Gastroenterology

Objective: Evaluate the hypothesis that the same pepsinogen C molecule produced in the stomach is also produced by the lung.

Patients and Methods: Pulmonary and gastric tissues collected postmortem were immunohistochemically stained for pepsinogen C and pepsinogen A.

Results: Sixteen patients with diverse causes of death were evaluated. Gestational age at birth ranged between 21 and 37 weeks. Pepsinogen A was detected in 12 of the 13 stomach sections, mainly in the chief cells, but not in any lung sections. Pepsinogen C was detected in all stomach sections in chief and mucus cells and in 9 of the 16 lung sections, mainly in type II pneumocytes. Pepsinogen C was not detected in the 3 lung cases with a gestational age <23 weeks.

Conclusions: The same pepsinogen C molecule is produced in the stomach and in the lung. These findings potentially affect previous study results that used an enzymatic pepsin detection assay to evaluate for and associate gastroesophageal reflux disease with other morbidities.

*Department of Pediatrics

Department of Pathology, University of Tennessee Health Science Center, Memphis, TN.

Address correspondence and reprint requests to Mohamad T. Elabiad, MD, College of Medicine, Department of Pediatrics, Division of Neonatology, 853 Jefferson Ave, 2nd Floor, Memphis, TN 38163 (e-mail:

Received 26 October, 2010

Accepted 14 March, 2011

The authors report no conflicts of interest.

Copyright 2011 by ESPGHAN and NASPGHAN