TY - JOUR
T1 - Intestinal mucosal damage caused by non-steroidal anti-inflammatory drugs
T2 - Role of bile salts
AU - Petruzzelli, Michele
AU - Vacca, Michele
AU - Moschetta, Antonio
AU - Cinzia Sasso, Rosa
AU - Palasciano, Giuseppe
AU - van Erpecum, Karel J.
AU - Portincasa, Piero
PY - 2007/5
Y1 - 2007/5
N2 - The strong analgesic, anti-inflammatory effects of non-steroidal anti-inflammatory drugs (NSAIDs) are hampered by high occurrence of gastrointestinal side effects. Therapeutic actions of NSAIDs result from cyclooxygenase (COX) enzymes inhibition with reduced synthesis of prostaglandins, major modulators of inflammation. Since prostaglandins also regulate key events in gut homeostasis -mucosal secretion, blood flow, epithelial regeneration - COX inhibition has been accepted as the reason for NSAID gastrointestinal toxicity. Several findings challenge this theory: first, intestinal damage by NSAIDs occurs also in COX-1 knockout mice, demonstrating that topical (non-prostaglandin mediated) mechanisms are involved; second, no correlation is found in vivo between the extent of intestinal injury and the degree of inhibition of prostaglandin synthesis; third, bile flow interruption in animal models completely prevents intestinal damage by parenterally administered NSAIDs. What is in bile that could play a role in NSAID toxicity? This timely review will critically discuss the role of bile salts in NSAID-dependent gut damage.
AB - The strong analgesic, anti-inflammatory effects of non-steroidal anti-inflammatory drugs (NSAIDs) are hampered by high occurrence of gastrointestinal side effects. Therapeutic actions of NSAIDs result from cyclooxygenase (COX) enzymes inhibition with reduced synthesis of prostaglandins, major modulators of inflammation. Since prostaglandins also regulate key events in gut homeostasis -mucosal secretion, blood flow, epithelial regeneration - COX inhibition has been accepted as the reason for NSAID gastrointestinal toxicity. Several findings challenge this theory: first, intestinal damage by NSAIDs occurs also in COX-1 knockout mice, demonstrating that topical (non-prostaglandin mediated) mechanisms are involved; second, no correlation is found in vivo between the extent of intestinal injury and the degree of inhibition of prostaglandin synthesis; third, bile flow interruption in animal models completely prevents intestinal damage by parenterally administered NSAIDs. What is in bile that could play a role in NSAID toxicity? This timely review will critically discuss the role of bile salts in NSAID-dependent gut damage.
KW - Bile salts
KW - Cyclooxygenase (COX)
KW - Farnesoid X Receptor
KW - Intestinal toxicity
KW - Non-steroidal anti-inflammatory drugs (NSAIDs)
KW - Phospholipids
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U2 - 10.1016/j.clinbiochem.2007.01.015
DO - 10.1016/j.clinbiochem.2007.01.015
M3 - Review article
C2 - 17321514
AN - SCOPUS:34247098498
SN - 0009-9120
VL - 40
SP - 503
EP - 510
JO - Clinical Biochemistry
JF - Clinical Biochemistry
IS - 8
ER -