Gastric acid secretion is under nervous and hormonal control. Gastrin, the major circulating stimulus of acid secretion, probably does not stimulate the parietal cells directly but acts to mobilize histamine from the ECL cells in the oxyntic mucosa. Histamine stimulates the parietal cells to secrete HCl. The gastrin-ECL cell pathway has been investigated extensively in situ (gastric submucosal microdialysis), in vitro (isolated ECL cells) and in vivo (intact animals). Gastrin acts on CCK2 receptors to control the synthesis of ECL-cell histamine, accelerating the expression of the histamine-forming enzyme histidine decarboxylase (HDC) at both the transcription and the translation/posttranslation levels. Depletion of histamine by alpha-fluoromethylhistidine (an irreversible inhibitor of HDC) prevents gastrin-induced but not histamine-induced gastric acid secretion. Acute CCK2 receptor blockade inhibits gastrin-evoked but not histamine-induced acid secretion. Studies both in vivo/in situ and in vitro have suggested that while acetylcholine seems capable of activating parietal cells, it does not affect histamine secretion from ECL cells. Unlike acetylcholine, the neuropeptides pituitary adenylate cyclase-activating peptide and vasoactive intestinal peptide mobilize ECL-cell histamine. Whether vagally stimulated acid secretion reflects an effect of the enteric nervous system on the ECL cells (neuropeptides) and/or a direct one on the parietal cells needs to be further investigated.