Faculty of Medicine, Department of Pharmacology, Ataturk University, Erzurum, Turkey.
Inflammation. 2010 Aug;33(4):224-34. doi: 10.1007/s10753-009-9176-5.
Indomethacin is an indol derivative, non-steroidal, anti-inflammatory drug with anti-inflammatory, analgesic, and antipyretic effects. Indomethacin became the first-choice drug to produce an experimental ulcer model as a result of having a higher ulcerogenic potential than other non-steroidal anti-inflammatory drugs (NSAIDs). There have been several conflicting reports about the ulcerogenic mechanism of indomethacin; the mechanism is still unclear. It has been suggested that indomethacin induces gastric damage via inhibiting the release of protective factors like cyclooxygenase-1 (COX-1), prostaglandin E2 (PGE2), bicarbonate, and mucus; increasing aggressive factors like acid; and increasing oxidant parameters while decreasing antioxidant parameters. Classic antiulcer drugs are known to produce antiulcer effects by activating against indomethacin (increasing PGE2, mucus, and bicarbonate production; inhibiting acid secretion; decreasing oxidant parameters; and increasing antioxidants). However, some antiulcer drugs have been shown to inhibit indomethacin-induced ulcers without affecting acid and mucus secretion or oxidant parameters, as well as to inhibit the production of protective factors like COX-1, PGE2, and bicarbonate, and to reduce antioxidant parameters. In order to resolve the contradictions in the abovementioned data, this review hypothesized a relationship between indomethacin-induced ulcers and alpha 2 adrenergic receptors. It is suggested that blockage of alpha 2 adrenergic receptors may be responsible for the increase in the aggressive factors induced by indomethacin, and stimulation of alpha 2 adrenergic receptors may be responsible for the increase of protective factors induced by antiulcer drugs.
吲哚美辛是一种吲哚衍生物,属于非甾体抗炎药,具有抗炎、镇痛和解热作用。由于吲哚美辛比其他非甾体抗炎药(NSAIDs)具有更高的溃疡形成潜力,因此成为产生实验性溃疡模型的首选药物。关于吲哚美辛的溃疡形成机制存在一些相互矛盾的报道;其机制尚不清楚。有人认为,吲哚美辛通过抑制环氧化酶-1(COX-1)、前列腺素 E2(PGE2)、碳酸氢盐和黏液等保护因子的释放,增加酸等侵袭性因子,并增加氧化应激参数,同时降低抗氧化参数,导致胃损伤。已知经典的抗溃疡药物通过激活针对吲哚美辛的作用(增加 PGE2、黏液和碳酸氢盐的产生;抑制胃酸分泌;减少氧化应激参数;增加抗氧化剂)来产生抗溃疡作用。然而,一些抗溃疡药物已被证明可抑制吲哚美辛诱导的溃疡,而不影响酸和黏液分泌或氧化应激参数,以及抑制 COX-1、PGE2 和碳酸氢盐等保护因子的产生,并降低抗氧化参数。为了解决上述数据中的矛盾,本综述提出了吲哚美辛诱导的溃疡与α2 肾上腺素能受体之间的关系假设。有人认为,α2 肾上腺素能受体的阻断可能是吲哚美辛诱导的侵袭性因子增加的原因,而抗溃疡药物刺激α2 肾上腺素能受体可能是其诱导保护因子增加的原因。
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