Meddings J B, Kirk D, Olson M E
Gastrointestinal Research Group, University of Calgary, Alberta, Canada.
Am J Vet Res. 1995 Aug;56(8):977-81.
Nonsteroidal anti-inflammatory drugs (NSAID) are widely used for treatment of people and animals. Their use is limited by frequent side effects commonly involving the gastrointestinal tract, most important of which is development of ulcerating lesions principally in the stomach. Unfortunately, presence of such lesions is often unsuspected because clinical signs may be overlooked until a complication develops. We reported that such damage can be detected by measuring the increase in gastric permeability that is a hallmark of this condition. Sucrose is a novel probe molecule for determination of site-specific gastric permeability. As a disaccharide, it is large enough to be effectively excluded by the intact gastric epithelium, and because it is rapidly digested within the small intestine, absorption of the intact molecule implies damage proximal to this site. Recently, we found that increased sucrose permeability is useful in predicting presence of endoscopically relevant gastric damage in people. We extended these results to the detection of NSAID-induced gastropathy in dogs. Dogs treated with aspirin developed NSAID-induced gastropathy (including gastric ulceration), and the degree of endoscopically detectable damage correlated well with sucrose permeability. Furthermore, healing of these lesions could also be monitored by sequential measurements of sucrose permeability. Sucrose permeability decreased more rapidly than the disappearance of gastric ulcers, suggesting that this technique is more sensitive to generalized mucosal damage than is the presence of discrete, endoscopically visible ulceration. This was confirmed by creating artificial ulcers in the antrum and observing that sucrose permeability was not increased in the setting.(ABSTRACT TRUNCATED AT 250 WORDS)
非甾体抗炎药(NSAID)广泛用于人和动物的治疗。其使用受到常见副作用的限制,这些副作用通常涉及胃肠道,其中最重要的是主要在胃中形成溃疡性病变。不幸的是,此类病变的存在往往未被察觉,因为在并发症出现之前临床症状可能会被忽视。我们报告称,通过测量胃通透性的增加可以检测到这种损伤,而胃通透性增加是这种情况的一个标志。蔗糖是一种用于测定胃特定部位通透性的新型探针分子。作为一种二糖,它足够大,能够被完整的胃上皮有效地排除在外,并且由于它在小肠内迅速被消化,完整分子的吸收意味着该部位近端存在损伤。最近,我们发现蔗糖通透性增加有助于预测人类内镜相关胃损伤的存在。我们将这些结果扩展到犬类非甾体抗炎药诱导的胃病检测中。用阿司匹林治疗的犬类出现了非甾体抗炎药诱导的胃病(包括胃溃疡),内镜可检测到的损伤程度与蔗糖通透性密切相关。此外,这些病变的愈合情况也可以通过连续测量蔗糖通透性来监测。蔗糖通透性下降的速度比胃溃疡消失的速度更快,这表明该技术对广泛性黏膜损伤比离散的、内镜可见的溃疡存在更敏感。通过在胃窦部制造人工溃疡并观察到蔗糖通透性没有增加,这一点得到了证实。(摘要截选至250字)