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胃酸是导致非甾体抗炎药诱导的大鼠溃疡发病机制的关键调节剂。

Gastric acid is the key modulator in the pathogenesis of non-steroidal anti-inflammatory drug-induced ulceration in rats.

机构信息

Division of Gastroenterology, Department of Medicine, State University of New York, Upstate Medical University, Syracuse, New York 13210, USA.

出版信息

Clin Exp Pharmacol Physiol. 2010 Jul;37(7):654-61. doi: 10.1111/j.1440-1681.2010.05357.x. Epub 2010 Jan 17.


DOI:10.1111/j.1440-1681.2010.05357.x
PMID:20082628
Abstract
  1. In the present study, we investigated the role of gastric acid (GA) secretion on non-steroidal anti-inflammatory drug (NSAID)-induced ulcerogenesis in vivo. Rats were administered single oral doses of selective cyclo-oxygenase (COX)-1 (SC-560; 2.5 mg/kg), COX-2 (DFU; 25 mg/kg) or non-selective COX (indomethacin; 25 mg/kg) inhibitors. Three groups (basal, histamine-stimulated and histamine with lansoprazole) were pylorus ligated 2 h after inhibitor administration and killed 2 h later. Another group without pylorus ligation received only inhibitors and was killed after 18 h. 2. At 4 h, indomethacin increased the ulcer index (UI) and myeloperoxidase (MPO) activity in basal and histamine-stimulated states, whereas SC-560 only increased MPO activity. Histamine-stimulated, but not basal, GA was further enhanced by indomethacin and SC-560 via increased proton pump expression. Lansoprazole (10 mg/kg) reduced the UI, MPO activity and GA to basal levels with SC-560 and DFU and to near basal with indomethacin. Indomethacin and SC-560 significantly inhibited prostaglandin (PG) E(2), without significantly affecting COX-1 and COX-2 expression. Although DFU inhibited PGE(2) by one-third, it did not affect COX expression. 3. At 18 h, indomethacin significantly increased the UI and MPO activity, whereas PGE(2) synthesis was less inhibited, indicating a return to control levels. In contrast, PGE(2) synthesis was higher than control with SC-560. Furthermore, COX-2 expression was significantly elevated with indomethacin and SC-560, explaining the source of augmented PGE(2) synthesis. Proton pump expression remained elevated, comparable with 4 h levels, with indomethacin and SC-560. However, DFU had no significant effect on the aforementioned parameters. 4. The data suggest that NSAID-induced ulcerogenesis is dependent on the amount of GA secretion derived from increased proton pump expression and requires inhibition of both COX-1 and COX-2.
摘要
  1. 在本研究中,我们研究了胃酸(GA)分泌在体内非甾体抗炎药(NSAID)诱导的溃疡形成中的作用。大鼠单次口服给予选择性环氧化酶(COX)-1(SC-560;2.5mg/kg)、COX-2(DFU;25mg/kg)或非选择性 COX(吲哚美辛;25mg/kg)抑制剂。抑制剂给药后 2 小时结扎幽门,并在 2 小时后处死三组(基础、组胺刺激和组胺加兰索拉唑)。另一组未结扎幽门,仅给予抑制剂,18 小时后处死。
  2. 4 小时时,吲哚美辛增加了基础和组胺刺激状态下的溃疡指数(UI)和髓过氧化物酶(MPO)活性,而 SC-560 仅增加了 MPO 活性。组胺刺激,但不是基础状态,GA 进一步通过增加质子泵表达被吲哚美辛和 SC-560 增强。兰索拉唑(10mg/kg)降低了 UI、MPO 活性和 GA,使 SC-560 和 DFU 恢复到基础水平,使吲哚美辛接近基础水平。吲哚美辛和 SC-560 显著抑制前列腺素(PG)E(2),但对 COX-1 和 COX-2 表达无显著影响。虽然 DFU 抑制了 PGE(2)的三分之一,但对 COX 表达没有影响。
  3. 18 小时时,吲哚美辛显著增加了 UI 和 MPO 活性,而 PGE(2)合成抑制较少,表明恢复到对照水平。相比之下,SC-560 导致 PGE(2)合成高于对照水平。此外,吲哚美辛和 SC-560 显著上调 COX-2 表达,解释了增强 PGE(2)合成的来源。质子泵表达仍然升高,与吲哚美辛和 SC-560 的 4 小时水平相当。然而,DFU 对上述参数没有显著影响。
  4. 数据表明,NSAID 诱导的溃疡形成依赖于源自增加的质子泵表达的 GA 分泌量,并需要抑制 COX-1 和 COX-2。

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[9]
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[10]
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引用本文的文献

[1]
Effect of omeprazole dose, nonsteroidal anti-inflammatory agents, and smoking on repair mechanisms in acute peptic ulcer bleeding.

Dig Dis Sci. 2014-11

[2]
Potential immunological consequences of pharmacological suppression of gastric acid production in patients with multiple sclerosis.

BMC Med. 2012-6-7

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