We recently reported that nonsteroidal anti-inflammatory drug (NSAID)-induced gastric lesions involve NSAID-induced apoptosis of gastric mucosal cells, which in turn involves the endoplasmic reticulum stress response, in particular the up-regulation of CCAAT/enhancer-binding protein homologous transcription factor (CHOP). In this study, we have examined the molecular mechanism governing this NSAID-induced apoptosis in primary cultures of gastric mucosal cells. Various NSAIDs showed membrane permeabilization activity that correlated with their apoptosis-inducing activity. Various NSAIDs, particularly celecoxib, also increased intracellular Ca 2؉ levels. This increase was accompanied by K ؉ efflux from cells and was virtually absent when extracellular Ca 2؉ had been depleted. These data indicate that the increase in intracellular Ca 2؉ levels that is observed in the presence of NSAIDs is due to the stimulation of Ca 2؉ influx across the cytoplasmic membrane, which results from their membrane permeabilization activity. An intracellular Ca 2؉ chelator partially inhibited celecoxib-induced release of cytochrome c from mitochondria, reduced the magnitude of the celecoxib-induced decrease in mitochondrial membrane potential and inhibited celecoxib-induced apoptotic cell death. It is therefore likely that an increase in intracellular Ca 2؉ levels is involved in celecoxib-induced mitochondrial dysfunction and the resulting apoptosis. An inhibitor of calpain, a Ca 2؉ -dependent cysteine protease, partially suppressed mitochondrial dysfunction and apoptosis in the presence of celecoxib. Celecoxib-dependent CHOP-induction was partially inhibited by the intracellular Ca 2؉ chelator but not by the calpain inhibitor. These results suggest that Ca 2؉ -stimulated calpain activity and CHOP expression play important roles in celecoxib-induced apoptosis in gastric mucosal cells.
Nonsteroidal anti-inflammatory drugs (NSAIDs)1 account for nearly 5% of all prescribed medications (1). The anti-inflammatory action of NSAIDs is mediated through their inhibitory effect on cyclooxygenase (COX)