Elliott S N, McKnight W, Cirino G, Wallace J L
Intestinal Disease Research Unit, University of Calgary, Alberta, Canada.
Gastroenterology. 1995 Aug;109(2):524-30. doi: 10.1016/0016-5085(95)90341-0.
BACKGROUND & AIMS: Nonsteroidal anti-inflammatory drugs (NSAIDs) have well-characterized inhibitory effects on gastric ulcer healing. A new class of gastrointestinal-sparing, nitric oxide-releasing NSAID derivatives has been recently described. This study was performed to determine if one of these compounds (nitrofenac) would influence healing of a preexisting ulcer.
Seven days after induction of gastric ulcer with serosal acetic acid, daily oral treatment with antiinflammatory doses of diclofenac, nitrofenac, or vehicle was started. After 7 days of treatment, the ulcer area was measured. The effects of misoprostol and two drugs that show in vitro selectivity for inhibiting cyclooxygenase 2 (nabumetone and L745,337) were also assessed.
Diclofenac, nabumetone, and L745,337 had no effect on ulcer healing when compared with vehicle. Only diclofenac significantly decreased hematocrit and weight gain. On the other hand, nitrofenac significantly accelerated healing. Glyceryl trinitrate also significantly and dose dependently accelerated healing. Nitrofenac suppressed cyclooxygenase 1 activity to a similar extent as diclofenac.
These results show that an NO-releasing NSAID derivative and an NO donor could accelerate ulcer healing, whereas a standard NSAID, misoprostol, and two inhibitors of cyclooxygenase 2 had no effect. In addition to sparing the gastrointestinal tract, NO-releasing NSAIDs, despite suppressing cyclooxygenase activity, are capable of accelerating tissue repair.
非甾体抗炎药(NSAIDs)对胃溃疡愈合具有明确的抑制作用。最近已描述了一类新型的具有胃肠道保护作用的、释放一氧化氮的NSAID衍生物。本研究旨在确定这些化合物之一(硝芬酸)是否会影响已存在溃疡的愈合。
在用浆膜下醋酸诱导胃溃疡7天后,开始每日口服给予抗炎剂量的双氯芬酸、硝芬酸或赋形剂。治疗7天后,测量溃疡面积。还评估了米索前列醇以及两种在体外对抑制环氧化酶2具有选择性的药物(萘丁美酮和L745,337)的作用。
与赋形剂相比,双氯芬酸、萘丁美酮和L745,337对溃疡愈合无影响。仅双氯芬酸显著降低了血细胞比容和体重增加。另一方面,硝芬酸显著加速了愈合。硝酸甘油也显著且剂量依赖性地加速了愈合。硝芬酸对环氧化酶1活性的抑制程度与双氯芬酸相似。
这些结果表明,一种释放一氧化氮的NSAID衍生物和一种一氧化氮供体可加速溃疡愈合,而标准NSAID、米索前列醇和两种环氧化酶2抑制剂则无此作用。除了保护胃肠道外,释放一氧化氮的NSAIDs尽管抑制环氧化酶活性,但仍能够加速组织修复。