Koizumi Shigeto, Odashima Masaru, Otaka Michiro, Jin Mario, Linden Joel, Watanabe Sumio, Ohnishi Hirohide
Department of Gastroenterology, Akita University School of Medicine, Akita, Japan.
J Gastroenterol. 2009;44(5):419-25. doi: 10.1007/s00535-009-0028-8. Epub 2009 Apr 1.
Nonsteroidal anti-inflammatory drugs (NSAIDs) such as indomethacin induce gastric mucosal lesions in part by the activation of inflammatory cells and the production of proinflammatory cytokines. The activation of adenosine A(2A) receptors inhibits inflammation by increasing cyclic AMP in leukocytes and reducing both the production of various proinflammatory cytokines and neutrophil chemotaxis. The aim of present study was to determine whether administration of an orally active adenosine A(2A) receptor agonist (4-[3-[6-amino-9-(5-cyclopropylcarbamoyl-3,4-dihydroxy-tetrahydro-furan-2-yl)-9H-purin-2-yl]-prop-2-ynyl]-piperidine-1-carboxylic acid methyl ester; ATL-313) ameliorated indomethacin-induced gastric mucosal lesions in rats.
Gastric lesions were produced by oral gavage of indomethacin (30 mg/kg). ATL-313 (1-10 microg/kg) was given orally just before the indomethacin administration.
The ulcer index induced by indomethacin was significantly (>50%) reduced by pretreatment with ATL-313 and this effect was blocked completely by the addition of equimolar ZM241385, a selective A(2A) receptor antagonist. The gastric content of myeloperoxidase (MPO) and proinflammatory cytokines was significantly reduced by 10 microg/kg ATL-313, but gastric mucosal prostaglandin 2 (PGE2) was not affected.
We conclude that ATL-313 does not inhibit the mucosal damaging effect of indomethacin, but it does block secondary injury due to stomach inflammation. A(2A) agonists may represent a class of new therapeutic drugs for NSAID-induced gastric ulcers.
非甾体抗炎药(NSAIDs)如吲哚美辛部分通过激活炎症细胞和产生促炎细胞因子来诱导胃黏膜损伤。腺苷A(2A)受体的激活通过增加白细胞中的环磷酸腺苷(cAMP)以及减少各种促炎细胞因子的产生和中性粒细胞趋化性来抑制炎症。本研究的目的是确定口服活性腺苷A(2A)受体激动剂(4-[3-[6-氨基-9-(5-环丙基氨基甲酰基-3,4-二羟基-四氢呋喃-2-基)-9H-嘌呤-2-基]-丙-2-炔基]-哌啶-1-羧酸甲酯;ATL-313)是否能改善吲哚美辛诱导的大鼠胃黏膜损伤。
通过口服灌胃给予吲哚美辛(30 mg/kg)来产生胃损伤。在给予吲哚美辛之前立即口服给予ATL-313(1 - 10 μg/kg)。
用ATL-313预处理可使吲哚美辛诱导的溃疡指数显著降低(>50%),并且这种作用被加入等摩尔的选择性A(2A)受体拮抗剂ZM241385完全阻断。10 μg/kg的ATL-313可使胃内容物中的髓过氧化物酶(MPO)和促炎细胞因子显著减少,但胃黏膜前列腺素E2(PGE2)不受影响。
我们得出结论,ATL-313并不抑制吲哚美辛的黏膜损伤作用,但它确实能阻断因胃炎症引起的继发性损伤。A(2A)激动剂可能代表一类用于NSAID诱导的胃溃疡的新型治疗药物。