Selective cyclooxygenase-2 inhibitor induces gastric mucosal damage in adrenalectomized rats

We investigated gastric ulcerogenic properties of the selective COX-2 inhibitor in adrenalectomized rats. SC-560 (selective COX-1 inhibitor) or celecoxib (selective COX-2 inhibitor) was given to sham-operated and adrenalectomized rats, with or without corticosterone replacement 11 days after the surgery, and gastric lesions were estimated 8 h later. Neither SC-560 nor celecoxib alone induced any gross damage in the gastric mucosa in sham-operated rats. In adrenalectomized rats, however, celecoxib did provoke gross damage that was prevented by corticosterone pellets. Mucosal PGE₂ content was increased 3-fold after adrenalectomy, and this response was prevented by both celecoxib and corticosterone pellets. The COX-2 mRNA was up-regulated in the stomach of adrenalectomized rats, but this expression was suppressed by corticosterone replacement. These results support our hypothesis that adrenalectomy increases gastric mucosal PGE₂ due to COX-2 expression, and the selective COX-2 inhibitor produces gastric lesions by inhibiting the additional PGE₂ production in adrenalectomized rats.     

Influence of proton pump inhibitors on dexamethasone-induced gastric mucosal damage in rats

The present study was designed to compare the curative role of proton pump inhibitors, omeprazole, rabeprazole and lansoprazole against dexamethasone-induced ulcer model. Dexamethasone (5 mg/kg/day) was used as an ulcerogen. Dexamethasone suspended in 1% CMC in water was given orally to all rats. Omeprazole (20 mg/kg), rabeprazole (20 mg/kg), and lansoprazole (20 mg/kg) were administered by oral route 30 minutes prior to dexamethasone for ulcer protective studies, gastric secretion and mucosal studies. Effects of proton pump inhibitors were determined by the evaluation of various biochemical parameters such as estimation of myeloperoxidase, cortisol, alkaline phosphatase, malondialdehyde, endogenous anti-oxidants like superoxide dismutase, catalase and reduced glutathione. In dexamethasone induced ulcer model, omeprazole showed significant decrease in malondialdehyde, myeloperoxidase, alkaline phosphatase level and increase in superoxide dismutase, catalase and reduced glutathione level as compared to rabeprazole and lansoprazole. Omeprazole showed significant reduction in cortisol content where as rabeprazole and lansoprazole did not show significant changes as compared to control. The result indicates that omeprazole is the most effective and selective proton pump inhibitor in dexamethasone induced ulcer model as compared to rabeprazole and lansoprazole.     

Gastric damage induced by subchronic administration of preferential cyclooxygenase-1 and cyclooxygenase-2 inhibitors in rats

Nonsteroidal anti-inflammatory drugs (NSAIDs) are well known to induce gastrointestinal damage including bleeding, ulceration and perforation in humans and animals. The aim of this study was to compare the effects of two oxicams, preferential cyclooxygenase (COX)-1 or COX-2 inhibitors, on both gastric mucosa and some biological parameters (hematological, hepatic and renal) after subchronic administration (14 and 28 days) in rats. Neutrophil infiltration was also assessed. Equipotent doses of meloxicam (3.75 and 7.5 mg/kg) and piroxicam (5 and 10 mg/kg) were administered. Both drugs dose-dependently caused multiple gastric erosions and hemorrhage in rats after 14 and 28 days of administration. Treatment with meloxicam led to a higher gastric damage than with piroxicam on day 14 although these results were not significant. The levels of myeloperoxidase activity (as an index of neutrophil infiltration) were not changed compared with control after drug treatment. All the hematological parameters obtained after drugs administration for 14 and 28 days were in the range of normal values, and a significant increase in platelet levels could be observed in the group treated with 5 mg/kg of piroxicam for 14 days. Aspartate aminotransferase (AST or GOT) increased significantly after 14 days, but after 28 days the values returned to normality. Creatinine and urea did not undergo significant changes except for the piroxicam 14-day 5 mg/kg group, in which uremia increased significantly over normal values. In conclusion, our results show that meloxicam, a preferential COX-2 inhibitor, causes rates of gastric lesion comparable to those seen with traditional NSAIDs, without inducing important changes in biological parameters.     

质子泵抑制剂的胃黏膜保护作用与环氧化酶-2表达

目的　探讨质子泵抑制剂 (PPIs)的胃黏膜保护作用与环氧化酶 2 (COX 2 )表达的关系。方法　♂SD大鼠ig给予雷巴拉唑、奥美拉唑或兰索拉唑 5 0mg·kg-1·d-1,对照组ig给予质量分数为 0 5 %羧基纤维素 5ml·kg-1·d-1,连续 2wk。Westernblot和免疫组化检测胃黏膜COX 2表达。酶免疫方法测定胃黏膜中前列腺素E2 (PGE2 )水平 ,评价兰索拉唑和特异性COX 2抑制剂NS 3 98对乙醇所致大鼠胃黏膜损伤的影响。结果　 3种PPI均增加大鼠胃黏膜COX 2的表达。兰索拉唑呈剂量依赖性地增加胃黏膜中PGE2 含量 ,有效地减轻乙醇对胃黏膜的损伤作用。NS 3 98有效地阻断了兰索拉唑诱导的PGE2 合成及胃黏膜保护作用。结论　PPIs通过诱导胃黏膜COX 2表达 ,增加PGE2 合成而发挥胃黏膜保护作用     

Interaction of inducible nitric oxide synthase and cyclooxygenase-2 inhibitors in formalin-induced nociception in mice

Studies with inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 inhibitor were conducted to assess their synergistic antinociceptive effect and possible therapeutic advantage. The antinociceptive interaction of rofecoxib, a selective cyclooxygenase-2 inhibitor, with aminoguanidine hydrochloride, a selective iNOS inhibitor, was examined in the formalin-induced paw-licking model in mice. Analysis of variance (ANOVA) and the isobolographic method were used to identify the nature of the antinociceptive interaction. Different doses of rofecoxib (1, 3, 10 and 30 mg/kg) and aminoguanidine hydrochloride (10, 30, 100 and 300 mg/kg) alone were administered orally to adult male albino mice (20-30 g). Only high doses of rofecoxib (10 and 30 mg/kg) and aminoguanidine hydrochloride (100 and 300 mg/kg) showed a statistically significant antinociceptive effect. Combination of a subthreshold dose of rofecoxib (1 mg/kg) with increasing doses of aminoguanidine hydrochloride (30, 100 and 300 mg/kg) resulted in potentiated antinociception (P<0.05). Combined therapy with a subthreshold dose of aminoguanidine hydrochloride (30 mg/kg) with increasing doses of rofecoxib (1, 3, 10 and 30 mg/kg) also resulted in significant antinociception (P<0.05). These results suggest that rofecoxib and aminoguanidine hydrochloride act synergistically in their antinociceptive action in mice. A possible mechanism of interaction is that nitric oxide (NO) stimulates the activity of cyclooxygenase-2 by combining with its heme component. Furthermore, the present results suggest that combination therapy with rofecoxib and aminoguanidine hydrochloride may provide an alternative for the clinical control of pain.     

Calcium and ethanol-induced gastric mucosal damage in rats

The effects of graded doses of ethanol on stomach mucosal damage and calcium levels were studied in rats. The influence of verapamil and/or calcium chloride on these changes was also investigated. Orally administered ethanol (20, 50 or 80% v/v) markedly decreased gastric glandular tissue calcium and it concentration dependently produced mucosal lesions. Pretreatment with verapamil (2.5 or 5 mg/kg, i.p.) dose dependently lessened glandular wall calcium levels and worsened ethanol-induced mucosal damage. Calcium chloride (50 mg/kg, i.p.) significantly prevented ethanol-induced gastric calcium depletion; it also dose dependently antagonized the damaging effect of ethanol as well as the lesion-intensifying action of verapamil. The findings that verapamil potentiated, whereas calcium chloride prevented, ethanol-induced glandular mucosal damage and tissue calcium changes indeed suggest that altered gastric cell calcium levels could be closely related to the mucosal lesions produced by ethanol in rats.     

Chronic gastric ulcer healing in rats subjected to selective and non-selective cyclooxygenase-2 inhibitors

The influence of different nonsteroidal anti-inflammatory drugs (NSAIDs) and of a proton pump inhibitor on the healing parameters of a chronic gastric ulcer was evaluated. Wistar rats were used after the induction of a chronic acetic acid ulcer. The animals were treated orally for 8 and 15 days, twice daily, with the conventional NSAID, piroxicam (0.35 mg/kg), the non-narcotic analgesic, metamizol (33 mg/kg), the selective cyclooxygenase-2 inhibitor, celecoxib (1.8 mg/kg) and the proton pump inhibitor, omeprazole (0.35 mg/kg). Macroscopic ulcer index, myeloperoxidase activity and prostaglandin E(2) content (both biochemical parameters were evaluated in ulcerated and in intact tissue) as well as histological and immunohistochemical evaluations were carried out at 8 and 15 days. Omeprazole accelerated ulcer healing at 8 and 15 days (P<0.05), while celecoxib delayed healing significantly at 15 days (P<0.01). At 8 days, the prostaglandin E2 content decreased with all NSAIDs at the ulcer site as well as in intact tissue. The same happened at 15 days except for celecoxib, which only diminished prostaglandins in intact mucosa. Immunohistochemistry showed differences in the location of cyclooxygenase-2 and -1. The highest cyclooxygenase-2 expression was found with piroxicam and the lowest expression was with celecoxib. CONCLUSIONS: Down-regulation of cyclooxygenase-2 expression as well as a possible involvement of the chemical structure of celecoxib, a 1,5-dirarylpirazole with a sulphonamide moiety, may account for the delay in ulcer healing.     

Inhibition of gastric mucosal damage by methylglyoxal pretreatment in rats.

The effect of methylglyoxal pretreatment on gastric mucosal injuries caused by 80% ethanol, 25% NaCl and 0.2 M NaOH, was investigated in rats. The effects caused by pylorous ligation accumulated gastric acid secretions and ethanol-induced changes in gastric mucus secretions, levels of proteins, nucleic acid, malondialdehyde (MDA) and non-protein sulfhydryl groups were also investigated. Methylglyoxal pretreatment at oral doses of 50, 100 and 200 mg/kg body weight was found to provide a dose-dependent protection against the ulcerogenic effects of different necrotizing agents used. With the same dose regimen methylglyoxal offered significant protection against ethanol-induced damage on the parameters evaluated for histopathology. Furthermore, the pretreatment afforded a dose-dependent inhibition of pylorous ligated accumulation of gastric acid secretions and ethanol-induced depletion of stomach wall mucus, proteins, nucleic acids, NP-SH contents and an increase in the MDA levels in gastric tissue. The protective effect of methylglyoxal against ethanol-induced damage to the gastric wall mucosa may be mediated through its effect on mucous production, proteins, nucleic acids, NP-SH groups and its free-radical scavenging property under the influence of polyamines stimulated by ornithine decarboxylase activity (ODC).     

Effect of caffeine on ibuprofen-induced gastric mucosal damage in rats.

During investigations on the effect of caffeine on ibuprofen-induced gastric mucosal lesions in rats, we have found that caffeine (p.o.) inhibits the development of ibuprofen-induced gastric lesions in a dose-dependent manner (ED50 18.4 mg kg(-1)). To investigate this protective effect of caffeine, we have studied the effect of caffeine on HCl-ethanol-induced gastric mucosal lesions with or without indomethacin pretreatment. Caffeine inhibited the development of HCl-ethanol-induced gastric lesions with and without indomethacin pretreatment. These results indicate that caffeine did not act as a mild irritant but, on the contrary, had protective effects. We measured the gastric mucosal prostaglandin E2 (PGE2) concentrations and gastric mucosal blood flow, as representative protective factors for gastric mucosa. Caffeine did not affect the gastric mucosal PGE2 concentrations 4h after administration of ibuprofen. However, topical administration of caffeine resulted in an increase in gastric mucosal blood flow, as measured by laser Doppler flowmetry. We investigated the gastric acid secretion and gastric mucosal myeloperoxidase activity as representative aggressive factors for gastric mucosa. When caffeine was administered intraduodenally in pylorus-ligated rats, gastric acid secretion decreased in a dose-dependent manner, with an ED50 of 44.9 mg kg(-1). Caffeine decreased ibuprofen-induced gastric myeloperoxidase activity in a dose-dependent manner, with an ED50 of 9.1 mg kg(-1). These findings indicate that caffeine, at least in rats, may inhibit the development of acute gastric mucosal injury. The mechanisms underlying the protective actions of caffeine are unclear, but may be related in part to an increase in gastric mucosal blood flow and suppression of neutrophil activation.     

环氧化酶-2抑制剂与抗癌药对Caco-2细胞抑制的相互作用

目的:探讨环氧化酶-2(COX-2)抑制剂与细胞毒抗癌药对人结肠腺癌细胞Caco-2抑制的相互作用.方法:用MTT法测定尼美舒利和塞来昔布与细胞周期非特异性药物CDDP和细胞周期特异性药物5-Fu并用时Caco-2细胞的抑制作用.结果:塞来昔布1mg/L～10mg/L与CDDP 1mg/L合用或塞来昔布1mg/L～5mg/L与5-Fu 0.5mg/L合用,对Caco-2细胞的抑制有相加作用.更高浓度(15mg/L～20mg/L)的塞来昔布与CDDP 1mg/L合用或塞来昔布10mg/L～20mg/L与5-Fu 0.5mg/L合用,引起拮抗作用.尼美舒利1mg/L～20mg/L与CDDP 1mg/L合用,对Caco-2细胞的抑制呈拮抗作用,而与5-Fu 1mr/L合用,对Caco-2细胞的抑制呈相加作用.结论:低浓度的塞来昔布和CDDP合用,呈相加作用,但当塞来昔布的浓度增大时,就转为拮抗.尼美舒利和CDDP合用时,无论浓度高低,都呈拮抗作用.     

Role of neutrophils in acrylonitrile-induced gastric mucosal damage

Acrylonitrile (ACN) is a widely used intermediate in the manufacture of plastics, acrylic ?bers, synthetic rubbers and resins that are used in a variety of products including food containers and medical devices. ACN is a possible human carcinogen and a documented animal carcinogen, with the stomach being an important target of its toxicity. ACN has been previously reported to require metabolic activation to reactive intermediates and finally to cyanide (CN⁻). The current study aimed at exploring the potential role of neutrophils in ACN-induced gastric damage in rats. Experimental neutropenia was attained by injecting rats with methotrexate. This significantly ameliorated gastric mucosal injury induced by ACN. This is evidenced by protection against the increase in gastric ulcer index, myeloperoxidase (MPO) activity and CN⁻ level. Also, neutropenia guarded against the decrease in prostaglandin E2 (PGE2), induction of oxidative stress and reduction of total nitrites and alleviated histopathological alterations in rat stomachs. These data indicate that neutrophil infiltration is, at least partly, involved in ACN-induced gastric damage in rats.     

Vascular mediation of gastric mucosal damage and cytoprotection

This review addresses questions surrounding the role of the mucosal circulation in damage and protection against chemical injury to the stomach. The modern history of the topic is briefly summarized, and widely used methods are appraised critically. The role of the circulation is examined in mucosal injury and in cytoprotection, and a new conceptual model is described which involves the vasculature and inflammatory mediators.     

选择性环氧化酶-2抑制剂的研究与安全性

近年研究发现,环氧化酶有两种同工酶,即COX-1和COX-2。COX-1对机体功能具有生理性保护作用,而COX-2主要参与炎症等病理反应的调节。非甾体类药物的抗炎镇痛等作用源于对COX-2的抑制,而胃肠道等不良反应的发生则与COX-1被抑制密切相关。本文介绍了COX-1与COX-2的主要特点;目前已上市的几种选择性COX-2抑制剂及其在治疗肿瘤、老年性痴呆、动脉粥样硬化等方面的前景;以及增加心血管不良事件等方面研究进展。     

Dexamethasone impairs the gastric mucosal integrity in rats treated with a cyclooxygenase-1 but not with a cyclooxygenase-2 inhibitor

In rats, neither the cyclooxygenase-1 inhibitor SC-560 nor the cyclooxygenase-2 inhibitor rofecoxib damages the gastric mucosa. Coadministration of dexamethasone induced injury in SC-560- but not in rofecoxib-treated rats. High levels of cyclooxygenase-1 protein occurred in the gastric mucosa of control rats, with no change after administration of SC-560. In contrast, the gastric cyclooxygenase-2 protein levels were low in control rats, but increased in a time-dependent manner after administration of SC-560. Dexamethasone prevented the increase in cyclooxygenase-2 protein levels. Our findings show that inhibition of cyclooxygenase-1 upregulates cyclooxygenase-2. When the upregulation is prevented by dexamethasone, gastric damage develops, suggesting that induction of cyclooxygenase-2 represents a compensatory mechanism that counteracts the injurious effect of cyclooxygenase-1 inhibition.     

Cholinoceptor blockers protect against ethanol-induced gastric mucosal damage in rats.

The role of the cholinergic nervous system in ethanol-induced gastric mucosal damage has been examined in rats. Oral administration of 50 or 80% ethanol produced haemorrhagic lesions which were reduced by atropine pretreatment (0.65, 2.5, 5 or 10 mg/kg injected i.p.); there was lesser protection against the higher dose of ethanol. Pirenzepine (a specific M1 receptor antagonist) pretreatment (0.1, 0.2, 1 or 2 mg/kg, injected s.c.) also protected against ethanol-induced gastric injury to a similar extent; it also increased the amount of adherent mucus on the glandular mucosa. This action may, therefore, account for the protective action of the ganglion blocker. It is concluded that ethanol may stimulate the stomach wall ganglionic nicotinic receptors to activate the postganglionic fibres and subsequently the muscarinic receptors which would then trigger off some of the ulcerogenic mechanisms in the stomach. However, ethanol could also produce gastric damage via the non-cholinergic mechanisms; this action becomes more prominent in gastric injury produced by high doses of ethanol.     

Sodium salicylate enhances the expression of cyclooxygenase-2 in endotoxin-stimulated human mononuclear cells.

The effects of salicylate on the expression of cyclooxygenases, and on prostaglandin E(2) biosynthesis were examined in human peripheral blood mononuclear cells. Peripheral blood mononuclear cells were incubated in the presence of endotoxin, which induced expression of cyclooxygenase-2 protein, and caused a time-dependent increase of immunoreactive prostaglandin E(2) in the supernatant. The cycooxygenase-2 selective inhibitor N-(2-cyclohexyloxy-4-nitrophenyl)methanesulfonamide (NS-398, 1 microM) suppressed the endotoxin-induced increase of prostaglandin E(2), without significantly affecting the expression of cyclooxygenase-1 or cyclooxygenase-2. In peripheral blood mononuclear cells exposed to endotoxin (18 h), 1.0 and 3.0 mM sodium salicylate reduced the prostaglandin E(2) concentration of the supernatant, and, at the same time, stimulated cyclooxygenase-2 expression. After a subsequent 2 h incubation of peripheral blood mononuclear cells in drug-free medium, prostaglandin E(2) concentrations in samples that had been exposed to endotoxin together with 1.0 or 3.0 mM salicylate were significantly higher than in samples exposed to endotoxin alone. These results show that salicylate can enhance the expression of cyclooxygenase-2 in endotoxin-exposed peripheral blood mononuclear cells and at the same time reduce prostaglandin E(2) formation. After washout and removal of salicylate-induced cyclooxygenase inhibition, increased cyclooxygenase-2 expression resulted in enhanced prostaglandin E(2) formation. It seems possible that under certain conditions salicylate-induced stimulation of cyclooxygenase-2 expression may contribute to its clinical pharmacological profile.     

Interaction of salicylate and corticosteroids in man.

Corticosteroids have been reported to decrease the plasma concentrations of salicylate when salicylates have been administered chronically at high doses. In the present study, two single, oral doses of sodium salicylate, 10 mg kg-1 were administered to six adult subjects with a variety of inflammatory conditions both before and during treatment with daily oral doses of prednisone (12-60 mg). Concomitant prednisone therapy did not increase the whole body clearance of single doses of salicylate in these subjects (0.0275 +/- 0.08 l kg-1 h-1 before prednisone; 0.0247 +/- 0.03 l kg-1 h-1 during prednisone therapy; P greater than 0.05). These results indicate that corticosteroids do not alter the clearance of single doses of salicylate in man.     

Cimetidine decreases aspirin-induced gastric mucosal damage in humans

Aspirin induces gastric mucosal damage in animals and humans. The purpose of this study was to examine whether cimetidine protects the human gastric mucosa from acute aspirin-induced damage. Eight healthy subjects were studied on 4 separate days. Cimetidine, 400 mg, or placebo was given orally 1 hour before initial endoscopy. The stomach was isolated and atropine given to suppress basal acid secretion. Each study consisted of four 15 min periods during which an acidic test solution was instilled into the stomach. During the second period only, either aspirin (1300 mg, 36 mmol) or control for aspirin (36 mmol HCl) was added to the test solution. Ion fluxes and gastric mucosal potential difference were measured, and endoscopy performed following each test. After placebo, aspirin significantly altered hydrogen ion flux and potential difference versus basal and control. Cimetidine decreased the damaging effect of aspirin. Endoscopic scores increased after aspirin plus placebo, whereas they remained unchanged after aspirin plus cimetidine. Therefore, cimetidine decreased aspirin-induced gastric mucosal damage in humans. As gastric acidity was identical during all studies, the effect of cimetidine was independent of gastric acid secretion.     

环氧酶-2抑制剂的选择性及安全性

目的：了解环氧酶-2抑制剂的作用特点及其临床的用药安全性。方法：综合国内外一些文献资料,阐述环氧酶-2抑制剂的作用方式,作用特点及分类方法,并通过总结临床研究及药物流行病学的研究报道,对临床用药安全性作了初步评价。结果：环氧酶-2抑制剂通过对环氧酶-2的选择性抑制作用,而起到抗炎镇痛作用。而对环氧酶-1的抑制作用较少或甚少,与传统的非甾类抗炎药相比,减少了胃肠道等的毒副作用。提高了用的安全性。结论：环氧酶-2抑制剂特别是高选择性（特异性）抑制剂,由于安全有效,可望成为继传统非甾类抗炎药后的新一代抗炎镇痛药物。     

Gastroduodenal safety of cyclooxygenase-2 inhibitors

Cyclooxygenase-1 (COX-1) derived eicosanoids promote gastroprotective mucosal defenses and induce platelet aggregation. By sparing COX-1, COX-2 specific inhibitors provide effective anti-inflammatory and analgesic activity while substantially reducing the risk of peptic ulcer disease and GI bleeding compared to dual COX inhibitors (traditional NSAIDs). Clinical studies of the COX-2-selective inhibitors have demonstrated efficacy equivalent to nonselective NSAIDs with significantly lower rates of GI toxicity. The incidence of endoscopic ulcers in some studies with coxibs has approximated placebo. However, as the detection of endoscopic lesions is not always correlated with symptomatic ulcers and ulcer complications, outcome studies of GI safety were performed. The results of large outcome studies have evaluated rofecoxib and celecoxib in over 39,000 patients with osteoarthritis or rheumatoid arthritis. Results of these studies showed that patients taking a supratherapeutic dose of rofecoxib or celecoxib had significantly lower rates of GI-related adverse events than those taking a nonselective NSAID. The GI safety of coxibs for patients using low dose aspirin concomitantly with a coxib appears to be reduced, particularly with regard to ulcer complications. Such data provide support for the COX-2 hypothesis and demonstrate that coxibs provide effective treatment of pain and inflammation with a reduced risk of gastropathy.