Gastric cytoprotection: a critical appraisal of the concept, methodology, implications, mechanisms and future research prospects

Abstract

Gastric cytoprotection is the property of certain substances, particularly prostaglandins, when used in non-antisecretory doses, to protect the gastric mucosa from becoming inflamed and necrotic on being exposed to noxious agents. An association between alterations in endogenous prostaglandins and gastric mucosal damage induced by a number of drugs has also been observed. The process of adaptive cytoprotection in which mild irritants protect the gastric mucosa against the damaging effects of various necrotizing agents has been shown to be prostaglandin mediated. However, the exact mechanisms underlying this cytoprotective activity have still not been elucidated although a number of hypotheses have been proposed. Recently, thromboxanes, leukotrienes and endogenous sulfhydryls have also been suggested to be involved in the pathogenesis of gastric mucosal damage induced by various necrotizing agents. This review attempts to provide an up-to-date appraisal of the concept, methodology, mechanisms and implications of this phenomenon and suggests that prostaglandins and endogenous sulfhydryls may play a significant role in the pathogenesis of gastric ulceration and may serve an important function in maintaining normal gastric mucosal integrity.

Effect of amitriptyline on gastric ulceration

“…In another experiment, amitriptyline significantly decreased gastric volume, total acidity and protein content in animals treated with alcohol after pyloric ligation. According to some workers, LTD 4 increases gastric protein content and decreases the transgastric potential [19]. Ethanol is also known to exert similar effects in rats, where it increases the total acidity as well as peptic activity [13].…”

The effects of antidepressants on gastric ulcer

“…Amitiptilinin soğuk stresle indüklenen ülseri de inhibe etmesinin açıklaması ilacın hem merkezi hem de periferde etki etmesinden kaynaklanıyor olabilir [36]. Amitriptilinin pilor bölgesi bağlanmış ratlardaki mide salgısı üzerindeki etkileri ilacın önemli ölçüde toplam asit ve protein içeriğini azaltmasından kaynaklanıyor olabilir [37]. Başka bir deneyde amitriptilin mide hacmini azaltmıştır, pilor ligasyonundan sonra alkol ile beraber hasta hayvanlarda toplam asit ve protein içeriği azalmıştır [38].…”

Effect of Ethanol Extract of Seed of Mucuna Pruriens on Gastric Ulcers

“…The nature and action of newer anti-ulcer drugs also mark a departure from the classical approach of seeking the anticholinergic-antisecretory types of drugs for the treatment of ulcers. These drugs have been shown either to directly promote the healing of ulcers or to possess H 2 -antihistaminic activity, more selective antimuscarinic effects, inhibitory effect on gastric proton pump hydrogen-potassium ATPase, cytoprotective 3 or adaptive cytoprotective effects. Peptic ulcer is a condition associated with a number of factors involving autonomic nervous system, which occurs due to excessive acid secretion in the stomach.…”