774 Renin-Angiotensin System and Risk of Peptic Ulcer and Ulcer Bleeding Induced by Low Dose Aspirin

Shiotani, Akiko; Sugihara, Takashi; Nishi, Ryuji; Uebayashi, Chie; Nomura, Maki; Yamanaka, Yoshiaki; Ishii, Manabu; Tarumi, Ken-ichi; Kamada, Takenobu; Haruma, Ken

doi:10.1016/s0016-5085(10)60495-7

Cited by 1 publication

(1 citation statement)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Recently, novel pathways, independent of COX inhibition, have been identified for some NSAIDs. Patients treated with angiotensin-1 receptor blockers or angiotensin-converting enzyme inhibitors and lowdose aspirin have a reduced risk of peptic ulcers or ulcer bleeding [15]. In vitro, exposure of gastric epithelial cells to different concentrations of NSAIDs resulted in altered cell membrane permeability with profound and rapid changes in cell morphology and cell size on confocal microscopy, suggesting that cytotoxicity and biological actions of NSAIDs are mediated by the cell membrane and not dependent on COX [13 ].…”

Section: Mechanisms Of Nsaid-induced Gastrointestinal Toxicitiesmentioning

confidence: 99%

NSAID-induced gastrointestinal and cardiovascular injury

Chan²

2010

Current Opinion in Gastroenterology

View full text Add to dashboard Cite

NSAIDs can induce peptic ulcers via epithelial cell membrane disruption and the renin angiotensin system, independent of the cyclooxygenase (COX) pathways, whereas mast cells and bile acid sensors may have a protective effect on NSAID-induced gastrointestinal damage. Patients with arthritis treated with a COX-2 inhibitor are less likely to develop upper and lower gastrointestinal complications than those who are treated with diclofenac plus a proton pump inhibitor (PPI). PPI therapy is recommended in patients receiving dual antiplatelet treatment but observational studies show that clopidogrel users taking PPIs have an increased risk of cardiovascular events. Until further reliable controlled data are available, this potential, but currently unproven, clinical interaction can be minimized by widely separating the dosing of clopidogrel and PPI. Histamine-2 antagonists may be an alternative to PPI for the prevention of peptic ulcers in patients taking low-dose aspirin.

show abstract

Section: Mechanisms Of Nsaid-induced Gastrointestinal Toxicitiesmentioning

confidence: 99%

NSAID-induced gastrointestinal and cardiovascular injury

Chan²

2010

Current Opinion in Gastroenterology

View full text Add to dashboard Cite

show abstract

774 Renin-Angiotensin System and Risk of Peptic Ulcer and Ulcer Bleeding Induced by Low Dose Aspirin

Cited by 1 publication

References 0 publications

NSAID-induced gastrointestinal and cardiovascular injury

NSAID-induced gastrointestinal and cardiovascular injury

Contact Info

Product

Resources

About