NSAID-induced small intestinal damage--roles of various pathogenic factors

Digestion
Koji Takeuchi, Hiroshi Satoh

Abstract

NSAID-induced enteropathy has been the focus of recent basic and clinical research subsequent to the development of the capsule endoscope and double-balloon endoscope. We review the possible pathogenic mechanisms underlying NSAID-induced enteropathy and discuss the role of the inhibition of COX-1/COX-2 and the influences of food as well as various prophylactic treatments on these lesions. Studies were performed in experimental animals. Multiple factors, such as intestinal hypermotility, decreased mucus secretion, enterobacteria, and upregulation of iNOS/NO expression, are involved in the pathogenesis of NSAID-induced enteropathy, in addition to the decreased production of PGs due to the inhibition of COX. Enterobacterial invasion is the most important pathogenic event, and intestinal hypermotility, which was associated with this event, is essential for the development of these lesions. NSAIDs also upregulate the expression of COX-2, and the inhibition of both COX-1 and COX-2 is required for the intestinal ulcerogenic properties of NSAIDs to manifest. NSAID-induced enteropathy is prevented by PGE2, atropine, ampicillin, and aminoguanidine as well as soluble dietary fiber, and exacerbated by antisecretory drugs such as proton pum...Continue Reading

Citations

Apr 17, 2016·Translational Research : the Journal of Laboratory and Clinical Medicine·Devendra Pratap SinghManish Nivsarkar
Feb 28, 2016·Digestive Diseases and Sciences·Hiroshi Satoh, Tetsuro Urushidani
Jun 30, 2016·Biomedical Chromatography : BMC·Mónika KuzmaPál Perjési
Oct 12, 2019·International Journal of Molecular Sciences·Noriaki NagaiTadatoshi Tanino
Nov 14, 2019·Current Gastroenterology Reports·Carmelo Scarpignato, Ingvar Bjarnason
Aug 30, 2019·Circulation. Genomic and Precision Medicine·Sony Tuteja, Jane F Ferguson
Dec 23, 2019·Journal of Gastroenterology·Toshio WatanabeFrancis K L Chan
Aug 28, 2020·Frontiers in Pharmacology·Damian Maseda, Emanuela Ricciotti
Oct 20, 2020·Frontiers in Immunology·Ah-Mee ParkIkuo Tsunoda
Jan 7, 2021·Clinical Journal of Gastroenterology·Takeshi Okamoto, Katsuyuki Fukuda
Jun 10, 2021·Chinese Journal of Integrative Medicine·Lin DuJie Zhang
May 18, 2021·Clinical Journal of Gastroenterology·Karim OsmanDaniel Maselli

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