Di Simone Massimo P, Baldi Fabio, Vasina Valentina, Scorrano Fabrizio, Bacci Maria Laura, Ferrieri Antonella, Poggioli Gilberto
Department of General Surgery and Transplants, University of Bologna, Bologna.
Clin Exp Gastroenterol. 2012;5:103-7. doi: 10.2147/CEG.S31404. Epub 2012 Jun 11.
The aim of the present study was to assess the potential barrier effect of Esoxx(®), a new nonprescription medication under development for the relief of gastroesophageal reflux symptoms. Esoxx is based on a mixture of hyaluronic acid and chondroitin sulfate in a bioadhesive suspension of Lutrol(®) F 127 polymer (poloxamer 407) which facilitates the product adhesion on the esophageal mucosa. The mucosal damage was induced by 15 to 90 minutes of perfusion with an acidic solution (HCl, pH 1.47) with or without pepsin (2000 U/mL, acidified to pH 2; Sigma-Aldrich). Mucosal esophageal specimens were histologically evaluated and Evans blue dye solution was used to assess the permeability of the swine mucosa after the chemical injury. The results show that: (1) esophageal mucosal damage is related to the perfusion time and to the presence of pepsin, (2) mucosal damage is associated with an increased permeability, documented by an evident Evans blue staining, (3) perfusion with Esoxx is able to reduce the permeability of the injured mucosa, even after saline washing of the swine esophagus. These preliminary results support further clinical studies of Esoxx in the topical treatment of gastroesophageal reflux symptoms.
本研究的目的是评估Esoxx（®）的潜在屏障作用，Esoxx是一种正在研发的用于缓解胃食管反流症状的新型非处方药。Esoxx基于透明质酸和硫酸软骨素的混合物，悬浮于Lutrol（®）F 127聚合物（泊洛沙姆407）的生物粘附性混悬液中，这有助于产品粘附于食管黏膜。通过用酸性溶液（盐酸，pH 1.47）灌注15至90分钟来诱导黏膜损伤，灌注时可添加或不添加胃蛋白酶（2000 U/mL，酸化至pH 2；西格玛奥德里奇公司）。对食管黏膜标本进行组织学评估，并使用伊文思蓝染料溶液评估化学损伤后猪黏膜的通透性。结果表明：（1）食管黏膜损伤与灌注时间及胃蛋白酶的存在有关；（2）黏膜损伤与通透性增加相关，伊文思蓝染色明显可证明这一点；（3）即使在对猪食管进行盐水冲洗后，用Esoxx灌注仍能降低受损黏膜的通透性。这些初步结果支持对Esoxx在胃食管反流症状局部治疗方面进行进一步的临床研究。
