Melarange R, Gentry C, Durie M, O'Connell C, Blower P R
SmithKline Beecham Pharmaceuticals, Research and Development Technologies, Harlow, Essex, UK.
Dig Dis Sci. 1994 Mar;39(3):601-8. doi: 10.1007/BF02088349.
Many nonsteroidal antiinflammatory drugs have the ability to cause gastrointestinal damage in both animals and man. The aim of the present study was to compare nabumetone, a nonacidic drug, with etodolac on rat gastric mucosal damage and prostanoid synthesis, while concurrently measuring prostanoid production during edema formation in a carrageenan model of paw inflammation. The results showed that both drugs inhibited paw exudate prostaglandin E2 and edema significantly, but they did not inhibit gastric prostanoid production 4 hr after dosing. Gastric damage, however, was observed with etodolac. Additional time-course studies showed that over a 4-hr period, etodolac, unlike nabumetone, markedly inhibited gastric mucosal prostaglandin E2 production, which was associated with gastric erosion formation. Further studies demonstrated that nabumetone did not induce gastrointestinal damage or blood loss when administered to rats in a high antiinflammatory oral dose. In contrast, etodolac produced marked gastrointestinal damage and bleeding, which was evident for up to 48 hr after the dose. It is suggested that nabumetone's favorable gastrointestinal irritancy profile may relate, in part, to its nonacidic nature and to its differential effects on prostanoid production.
许多非甾体抗炎药在动物和人类中均有导致胃肠道损伤的能力。本研究的目的是比较非酸性药物萘丁美酮与依托度酸对大鼠胃黏膜损伤和前列腺素合成的影响,同时在角叉菜胶诱导的爪部炎症模型中测量水肿形成过程中前列腺素的产生。结果显示,两种药物均能显著抑制爪部渗出液中前列腺素E2的产生和水肿,但给药4小时后它们并未抑制胃前列腺素的产生。然而,依托度酸可导致胃损伤。进一步的时间进程研究表明,在4小时内,与萘丁美酮不同,依托度酸显著抑制胃黏膜前列腺素E2的产生,这与胃糜烂的形成有关。进一步研究表明,给大鼠口服高剂量抗炎剂量的萘丁美酮时,不会引起胃肠道损伤或失血。相比之下,依托度酸可导致明显的胃肠道损伤和出血,在给药后长达48小时内都很明显。提示萘丁美酮良好的胃肠道刺激性可能部分与其非酸性性质及其对前列腺素产生的不同影响有关。