Kuroda Masaaki, Yoshida Norimasa, Ichikawa Hiroshi, Takagi Tomohisa, Okuda Toshimitsu, Naito Yuji, Okanoue Takeshi, Yoshikawa Toshikazu
Inflammation and Immunology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Int J Mol Med. 2006 Jan;17(1):89-93.
The spread of capsule endoscopy has led to a focus on small intestinal injury induced by non-steroidal anti-inflammatory drugs (NSAIDs). However, it has been proposed that proton pump inhibitors (PPI), a strong anti-secretary agent, have anti-inflammatory action beyond acid suppression. Therefore, we evaluated the biological effects of lansoprazole, a PPI used in the clinical area, in the setting of experimental rat non-steroidal anti-inflammatory drug-induced enteritis. The animals were given indomethacin subcutaneously and the intestinal mucosa was examined 24 h later. Lansoprazole was given subcutaneously just after following indomethacin injection. Single administration of indomethacin at 10 mg/kg provoked severe hemorrhagic lesions in the small intestine, mostly the jejunum and ileum. The levels of thiobarbituric acid-reactive substances (TBARS), the myeloperoxidase (MPO) activity and the content of cytokine-induced neutrophil chemoattractant-1 (CINC-1) in the intestinal mucosa significantly increased in indomethacin-treated groups compared with the sham-operated groups. The development of intestinal lesions in response to indomethacin was dose-dependently prevented by lansoprazole at a dose of 5 mg/kg together with significant suppression of the increased level of TBARS, MPO activities and CINC-1 in the small bowel. Furthermore, the increased CINC-1 mRNA expression after administration of indomethacin was also inhibited by treatment with lansoprazole. These results suggest that lansoprazole administered exogenously prevented the small intestine against indomethacin-induced damage, the action being dependent on its anti-inflammatory and anti-oxidative responses. This evidence supports the theory that PPI have an expanding role beyond acid suppression.
胶囊内镜的普及使得人们将重点放在了非甾体抗炎药(NSAIDs)引起的小肠损伤上。然而,有人提出质子泵抑制剂(PPI)作为一种强效的抗分泌剂,除了抑制胃酸外还具有抗炎作用。因此,我们评估了临床使用的PPI兰索拉唑在实验性大鼠非甾体抗炎药诱导的肠炎模型中的生物学效应。给动物皮下注射吲哚美辛,24小时后检查肠黏膜。在注射吲哚美辛后立即皮下注射兰索拉唑。以10mg/kg的剂量单次注射吲哚美辛会在小肠,主要是空肠和回肠引发严重的出血性病变。与假手术组相比,吲哚美辛处理组的肠黏膜中硫代巴比妥酸反应性物质(TBARS)水平、髓过氧化物酶(MPO)活性以及细胞因子诱导的中性粒细胞趋化因子-1(CINC-1)含量显著增加。兰索拉唑以5mg/kg的剂量可剂量依赖性地预防吲哚美辛引起的肠道病变,同时显著抑制小肠中TBARS水平、MPO活性和CINC-1的升高。此外,兰索拉唑治疗还可抑制吲哚美辛给药后CINC-1 mRNA表达的增加。这些结果表明,外源性给予兰索拉唑可保护小肠免受吲哚美辛诱导的损伤,其作用依赖于其抗炎和抗氧化反应。这一证据支持了PPI除抑制胃酸外还具有更广泛作用的理论。