Laudanno O M, Cesolari J A, Esnarriaga J, Rista L, Piombo G, Maglione C, Aramberry L J, Sambrano J S, Godoy A, Rocaspana A
Cátedras de Patología Médica III e Histología y Embriología, Facultad de Ciencias Médicas, Rosario, U.N.R.
Acta Gastroenterol Latinoam. 2000;30(1):27-33.
Five experimental models were carried out in different groups of Wistar rats (n = 15) in order to study selective (cyclo-oxygenase) COX-2 non-steroid antiinflammatory inhibitors, such as celecoxib and rofecoxib, as follows: 1) Dose-dependent oral celecoxib and rofecoxib for 5 days, and 24 hours after oral indomethacin. 2) Same as 1, but subcutaneously. 3) Gastric ulcer induced by means of glacial acetic acid. 4) Duodenal ulcer induced by means of cysteamine. 5) Stress due to being kept under restraint and immersion in water at 15 degrees C for 6 hours. Celecoxib and rofecoxib, either orally or subcutaneously, did not produce necrotic injuries in healthy gastrointestinal mucosa (0%), showing normal histology. On the other hand, the injuries previously induced by indomethacin worsened (90%, p < 0.001). Total necrosis of small intestine as well as increased ulcer and perforation of gastric and duodenal ulcers induced by acetic acid and cysteamine were observed. There was also worsening of gastric necrotic area with stress (60-90%, p < 0.05). Celecoxib and rofecoxib showed neutrophilia (5,000/mm3) similar to that presented by indomethacin, but there was no leukocyte infiltration in the gastric mucosa; thus we can consider it a COX-2 selective NSAID (non-steroidal anti-inflammatory drug).
Dose-dependent administration of celecoxib and rofecoxib as COX-2 inhibitors and non-COX-1 inhibitors, respectively, did not produce toxic injuries on healthy gastrointestinal mucosa, thus providing a broad therapeutic spectre. On the other hand, when administered in presence of altered gastrointestinal mucosa, they worsened and complicated gastric ulcers, and also induced necrosis in the small intestine, thereby restricting their clinical use.
为了研究选择性(环氧化酶)COX - 2非甾体抗炎药,如塞来昔布和罗非昔布,在不同组的Wistar大鼠(n = 15)中进行了五种实验模型,如下:1)口服塞来昔布和罗非昔布5天,口服吲哚美辛24小时后。2)与1相同,但为皮下给药。3)用冰醋酸诱导胃溃疡。4)用半胱胺诱导十二指肠溃疡。5)通过束缚并浸入15摄氏度水中6小时造成应激。塞来昔布和罗非昔布,无论是口服还是皮下给药,均未在健康胃肠道黏膜产生坏死性损伤(0%),组织学表现正常。另一方面,先前由吲哚美辛诱导的损伤加重(90%,p < 0.001)。观察到小肠全层坏死以及由乙酸和半胱胺诱导的胃溃疡和十二指肠溃疡的溃疡及穿孔增加。应激时胃坏死面积也增大(60 - 90%,p < 0.05)。塞来昔布和罗非昔布显示出与吲哚美辛相似的中性粒细胞增多(5,000/mm³),但胃黏膜无白细胞浸润;因此我们可将其视为COX - 2选择性非甾体抗炎药(NSAID)。
分别作为COX - 2抑制剂和非COX - 1抑制剂的塞来昔布和罗非昔布的剂量依赖性给药,未对健康胃肠道黏膜产生毒性损伤,从而提供了广泛的治疗范围。另一方面,当在胃肠道黏膜改变的情况下给药时,它们使胃溃疡加重并复杂化,还诱导小肠坏死,从而限制了它们的临床应用。