Leite A Z A, Sipahi A M, Damião A O M C, Garcez A T, Buchpiguel C A, Lopasso F P, Lordello M L L, Agostinho C L O, Laudanna A A
Laboratório de Investigação Médica, Departamento de Gastroenterologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
Braz J Med Biol Res. 2004 Mar;37(3):333-6. doi: 10.1590/s0100-879x2004000300007. Epub 2004 Mar 3.
The pathogenesis of nonsteroidal anti-inflammatory drug (NSAID) enteropathy is a complex process involving the uncoupling of mitochondrial oxidative phosphorylation and inhibition of cyclooxygenase (COX). Rofecoxib, a selective inhibitor of COX-2, has shown less gastric damage, but the same beneficial effect is not clear in the case of the small bowel. Fifty-seven male Wistar rats (250-350 g) were divided into three groups (N=19 each) to evaluate the effect of this NSAID on the rat intestine. The groups received 2.5 mg/kg rofecoxib, 7.5 mg/kg indomethacin or water with 5% DMSO (control) given as a single dose by gavage 24 h before the beginning of the experiment. A macroscopic score was used to quantify intestinal lesions and intestinal permeability was measured using [51Cr]-ethylenediaminetetraacetic acid ([51Cr]-EDTA). The extent of intestinal lesion, indicated by a macroscopic score, was significantly lower when rofecoxib was administered compared to indomethacin (rofecoxib=0.0 vs indomethacin=63.6 +/- 25.9; P<0.05) and did not differ from control. The intestinal permeability to [51Cr]-EDTA was significantly increased after indomethacin (control=1.82 +/- 0.4 vs indomethacin=9.12 +/- 0.8%; P<0.0001), but not after rofecoxib, whose effect did not differ significantly from control (control=1.82 +/- 0.4 vs rofecoxib=2.17 +/- 0.4%; ns), but was significantly different from indomethacin (indomethacin=9.12 +/- 0.8 vs rofecoxib=2.17 +/- 0.4%; P<0.001). In conclusion, the present data show that rofecoxib is safer than indomethacin in rats because it does not induce macroscopic intestinal damage or increased intestinal permeability.
非甾体抗炎药(NSAID)肠病的发病机制是一个复杂的过程,涉及线粒体氧化磷酸化解偶联和环氧化酶(COX)抑制。罗非昔布是一种COX-2选择性抑制剂,已显示出较少的胃损伤,但在小肠方面,其相同的有益效果尚不清楚。将57只雄性Wistar大鼠(250 - 350克)分为三组(每组N = 19只),以评估这种NSAID对大鼠肠道的影响。在实验开始前24小时,通过灌胃分别给予各组2.5毫克/千克罗非昔布、7.5毫克/千克吲哚美辛或含5%二甲亚砜的水(对照组),作为单剂量给药。使用宏观评分来量化肠道病变,并使用[51Cr] - 乙二胺四乙酸([51Cr] - EDTA)测量肠道通透性。与吲哚美辛相比,给予罗非昔布时,由宏观评分表示的肠道病变程度显著更低(罗非昔布 = 0.0,吲哚美辛 = 63.6 ± 25.9;P < 0.05),且与对照组无差异。吲哚美辛给药后,肠道对[51Cr] - EDTA的通透性显著增加(对照组 = 1.82 ± 0.4,吲哚美辛 = 9.12 ± 0.8%;P < 0.0001),但罗非昔布给药后未增加,其效果与对照组无显著差异(对照组 = 1.82 ± 0.4,罗非昔布 = 2.17 ± 0.4%;无显著性差异),但与吲哚美辛有显著差异(吲哚美辛 = 9.12 ± 0.8,罗非昔布 = 2.17 ± 0.4%;P < 0.001)。总之,目前的数据表明,在大鼠中罗非昔布比吲哚美辛更安全,因为它不会引起宏观肠道损伤或肠道通透性增加。