Endoscopic characteristics and <i>Helicobacter pylori</i> infection in NSAID‐associated gastric ulcer

Kamada, Takenobu; Hata, Jiro; Kusunoki, Hiroaki; Sugiu, Kuniaki; Tanimoto, Takuya; Mihara, Mitsuhiro; Hamada, Hiroshige; Kido, Soichiro; Qiu, Dongmei; Haruma, Ken

doi:10.1111/j.1440-1746.2005.04219.x

Cited by 26 publications

(16 citation statements)

References 19 publications

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“…Currently, it is not known whether the differential impact of COX inhibitors on OATP2A1 function may contribute to the gastrointestinal side effects of COX inhibitors. NSAID-induced gastroduodenal complications are most frequent in the antrum, followed by the corpus (Kamada et al, 2006), and our results indicate that OATP2A1 expression levels follow the same order. It is known that the blockade of cyclooxygenases by COX inhibitors is a major cause for NSAID-induced gastrointestinal ulcerations.…”

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confidence: 58%

Influence of Cyclooxygenase Inhibitors on the Function of the Prostaglandin Transporter Organic Anion-Transporting Polypeptide 2A1 Expressed in Human Gastroduodenal Mucosa

Mandery¹,

Bujok²,

Schmidt³

et al. 2009

J Pharmacol Exp Ther

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The human organic anion-transporting polypeptide 2A1 (OATP2A1) is a prostaglandin transporter expressed in several tissues and plays an important role for local distribution of prostaglandins, which contribute to the integrity of gastric mucosa. Blockade of prostaglandin pathways by cyclooxygenase (COX) inhibitors has been associated with serious side effects such as gastrointestinal ulceration and bleeding. However, little is known regarding OATP2A1 expression in the upper gastrointestinal tract and the potential impact of cyclooxygenase inhibitors on OATP2A1 function. We first investigated the expression of OATP2A1 mRNA and protein in human gastroduodenal mucosa using human biopsy specimens obtained from antrum, corpus, and duodenum. The results indicate that OATP2A1 is expressed in the neck region and deep pyloric glands of antrum and in parietal cells of gastric corpus. Second, we examined various COX inhibitors for their effects on OATP2A1 transporter activity. Using HEK293 cells expressing OATP2A1, we found that diclofenac and lumiracoxib are potent inhibitors of OATP2A1-mediated transport of prostaglandin (PG) E 2 with IC 50 values of 6.2 Ϯ 1.2 and 3.1 Ϯ 1.2 M. In contrast, indomethacin, ketoprofen, and naproxen led to significant stimulation of OATP2A1-mediated PGE 2 transport by 162.7 Ϯ 13.9, 77.2 Ϯ 3.6, and 32.3 Ϯ 4.9%, respectively. Taken together, our results suggest that various clinically used COX inhibitors have differential impact on the function of the prostaglandin transporter OATP2A1 in human stomach and that these effects may contribute to differences in the gastrointestinal side effects of COX inhibitors.

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confidence: 58%

Influence of Cyclooxygenase Inhibitors on the Function of the Prostaglandin Transporter Organic Anion-Transporting Polypeptide 2A1 Expressed in Human Gastroduodenal Mucosa

Mandery¹,

Bujok²,

Schmidt³

et al. 2009

J Pharmacol Exp Ther

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“…In consideration of the mean age of patients (68.2± 8.3 years), we had an impression that the positivity rate was low. According to a recent study (9), the H. pylori infection rate in patients with non-NSAID-induced ulcer whom we encounter in routine medical practice is !90% in contrast to a rate of 50% in patients with NSAID-induced ulcer. NSAID-induced ulcer is considered to develop preferentially in patients without H. pylori infection.…”

Section: Discussionmentioning

confidence: 99%

Gastric Mucosal Damage Evaluated by Transnasal Endoscopy and QOL Assessments in Ischemic Heart Disease Patients Receiving Low-dose Aspirin

et al. 2011

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Objective Transnasal endoscopy was conducted to examine gastric mucosal damage in Japanese patients with ischemic heart disease who were receiving low-dose aspirin for preventing the onset or recurrence of cardiovascular disease. Patients and Methods An endoscopist assessed gastric mucosal damage. Furthermore, the MOS 36-Item Short-Form Health Survey (SF-36 ) and the Gastrointestinal Symptom-Rating Scale (GSRS) were used to assess the outcomes of their quality of life (QOL) and the possible presence of gastric cancer and H. pylori infection. Results Seventy-five patients were studied; and 24 (32.0%) and 16 (21.3%) of them concurrently received antithrombotic drugs other than aspirin and antiulcer drugs, respectively. Regarding gastric mucosal damage, 15 (20.0%) and 8 (10.7%) of the patients were endoscopically diagnosed with ulcer and hemorrhagic gastritis, respectively. Furthermore, 5 patients (6.7%) were found to have esophageal or gastric cancer. The positivity rate of Helicobacter pylori (H. pylori) was 45.3%. Patients receiving low-dose aspirin showed a decreased QOL. Consequently, no significant differences were found among the groups. Regarding endoscopic findings, no differences were found in the scores of both SF-36 and GSRS with respect to the presence or absence of gastric ulcer, hemorrhagic gastritis, and H. pylori infection. Conclusion Transnasal endoscopy was possible to perform during the oral intake of low-dose aspirin without causing any hemorrhagic complications. Many patients with gastric mucosal lesions showed no subjective symptom, and patients receiving aspirin were strongly recommended to undergo regular transnasal endoscopy, regardless of the presence or absence of symptoms.

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“…An Italian study of symptomatic elderly chronic users of low-dose aspirin found that the prevalence of peptic ulcers was significantly higher (36.6% versus 15.8%) among H. pylori-positive subjects than the H. pylori-negative subjects (17). However, in another study in Japan, the prevalence of (H. pylori) infection was found to be significantly lower in patients considered to have NSAID-associated gastric ulcer than in age-matched non-NSAID-associated gastric ulcer patients (48% versus 96%) (18). Our findings possibly reflect the differences in the prevalence or severity of H. pylori gastritis between different countries.…”

Section: Discussionmentioning

confidence: 80%

Relationship between continuous use of low-dose enteric-coated aspirin and gastrointestinal injuries in patients with gastrointestinal hemorrhage

Mousavi

Salehimarzijarani²,

Dadvar³

et al. 2013

Turk J Gastroenterol

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Amaç: Gastrointestinal bozukluklar, düflük doz enterik-kapl› formu kullan›lsa bile aspirin tedavisinin hayati yan etkilerindendir. Bu çal›flman›n amac›, gastrointestinal kanamal› hastalarda düflük doz enterik-kapl› aspirine ba¤l› üst ve alt endoskopik bulgula Background/aims: Gastrointestinal disorders are important side effects of aspirin therapy, even if the low-dose enteric-coated form is administered. The aim of the current study was to present the upper and lower endoscopic features of patients with gastrointestinal hemorrhage using low-dose enteric-coated aspirin. Materials and Methods: This prospective study was conducted among 633 consecutive patients with gastrointestinal hemorrhage who admitted to our tertiary referral hospital for endoscopy assessment. Patients were divided into two groups as low-dose aspirin users (n=168) and non-aspirin users (n=495). Aspirin users included tho-

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Endoscopic characteristics and Helicobacter pylori infection in NSAID‐associated gastric ulcer

Abstract: In contrast to non-NSAID-associated gastric ulcers, NSAID-associated gastric ulcers frequently occur in the antrum with bleeding. The rate of H. pylori infection in NSAID-associated gastric ulcers is significantly lower than that in non-NSAID-associated gastric ulcers.

Cited by 26 publications

References 19 publications

Influence of Cyclooxygenase Inhibitors on the Function of the Prostaglandin Transporter Organic Anion-Transporting Polypeptide 2A1 Expressed in Human Gastroduodenal Mucosa

Influence of Cyclooxygenase Inhibitors on the Function of the Prostaglandin Transporter Organic Anion-Transporting Polypeptide 2A1 Expressed in Human Gastroduodenal Mucosa

Gastric Mucosal Damage Evaluated by Transnasal Endoscopy and QOL Assessments in Ischemic Heart Disease Patients Receiving Low-dose Aspirin

Relationship between continuous use of low-dose enteric-coated aspirin and gastrointestinal injuries in patients with gastrointestinal hemorrhage

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