NSAID-induced enteropathy: the current state of the problem

Svistunov, Andrey; Осадчук, М А; Kireeva, N V; Hudarova, Anastasiya A.; Ачкасов, Е. Е.

doi:10.26442/terarkh201890895-100

Cited by 6 publications

(8 citation statements)

References 53 publications

(76 reference statements)

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“…The GI tract side effects of NSAIDs are mainly manifested in NSAIDs-induced gastropathy, and NSAID enteropathy ( Sinha et al., 2013 ; Svistunov et al., 2018 ). The incidence of NSAIDs-related gastric and duodenal injuries is 9–22% ( Cann, 1990 ).…”

Section: Nsaid Enteropathy: a Neglected Diseasementioning

confidence: 99%

Gut Microbiota in NSAID Enteropathy: New Insights From Inside

Wang

Tang

Hou

et al. 2021

Front. Cell. Infect. Microbiol.

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As a class of the commonly used drugs in clinical practice, non-steroidal anti-inflammatory drugs (NSAIDs) can cause a series of adverse events including gastrointestinal injuries. Besides upper gastrointestinal injuries, NSAID enteropathy also attracts attention with the introduction of capsule endoscopy and double balloon enteroscopy. However, the pathogenesis of NSAID enteropathy remains to be entirely clarified. Growing evidence from basic and clinical studies presents that gut microbiota is a critical factor in NSAID enteropathy progress. We have reviewed the recent data about the interplay between gut microbiota dysbiosis and NSAID enteropathy. The chronic medication of NSAIDs could change the composition of the intestinal bacteria and aggravate bile acids cytotoxicity. Meanwhile, NSAIDs impair the intestinal barrier by inhibiting cyclooxygenase and destroying mitochondria. Subsequently, intestinal bacteria translocate into the mucosa, and then lipopolysaccharide released from gut microbiota combines to Toll-like receptor 4 and induce excessive production of nitric oxide and pro-inflammatory cytokines. Intestinal injuries present in the condition of intestinal inflammation and oxidative stress. In this paper, we also have reviewed the possible strategies of regulating gut microbiota for the management of NSAID enteropathy, including antibiotics, probiotics, prebiotics, mucosal protective agents, and fecal microbiota transplant, and we emphasized the adverse effects of proton pump inhibitors on NSAID enteropathy. Therefore, this review will provide new insights into a better understanding of gut microbiota in NSAID enteropathy.

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Section: Nsaid Enteropathy: a Neglected Diseasementioning

confidence: 99%

Gut Microbiota in NSAID Enteropathy: New Insights From Inside

Wang

Tang

Hou

et al. 2021

Front. Cell. Infect. Microbiol.

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“…На этом фоне другое повреждение ЖКТ -НПВП-энтеропатия -вызывает все более серьезную озабоченность [4], в первую очередь из-за появления доказательств более высокой, чем ранее предполагалось, частоты данного побочного эффекта, благодаря появившейся возможности визуализации слизистой оболочки ЖКТ (капсульная и баллонная эндоскопия) [5] и из-за отсутствия эффективных мер ее профилактики. НПВП-гастропатия характеризуется нарушением проницаемости кишечной стенки с экссудацией белка и диапедезом эритроцитов (приводящих к железодефицитной анемии и гипоальбуминемии), нарушением процессов переваривания и всасывания пищи, а также повреждением слизистой оболочки тонкой кишки с развитием эрозий, язв и их осложнений -кровотечения, перфорации, появления циркулярных стриктур, нарушения кишечной проходимости [6]. У 50-70% пациентов, длительно получающих НПВП, развивается повреждение слизистой оболочки тонкой кишки [7], иногда с такими последствиями, как перфорация и кровотечение [8].…”

Section: ââåäåíèåunclassified

“…Интраорганные воспалительные процессы и фиброз вызывают формирование патогномоничных для НПВП-энтеропатии рубцовых циркулярных сужений, так называемых «диафрагмоподобных (клапаноподобных) стриктур» («болезнь диафрагм»). Клапаноподобные стриктуры (диафрагмы) представляют собой множественные тонкие (от 2 до 4 мм) концентрические выступы слизистой оболочки тонкой и толстой кишки, которые суживают просвет кишки [6].…”

Section: ен кареваunclassified

“…Подавляющее большинство эпизодов серьезных осложнений, связанных с приемом НПВП, возникает у лиц, имеющих определенные факторы риска [31]. Риск развития патологии тонкой кишки возрастает у пациентов пожилого возраста, на фоне приема глюкокортикостероидов (способствуют развитию бактериальной транслокации и замедляют темпы регенерации поврежденных эпителиоцитов) и антикоагулянтов, при наличии дивертикулов, а также хронических воспалительных заболеваний кишечника (целиакия, болезнь Уиппла, неспецифический язвенный колит, болезнь Крона) [6].…”

Section: êëèíè÷åñêàÿ êàðòèíà íïâï-ýíòåðîïàòèèunclassified

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NSAID enteropathy

Карева

2020

Terapevticheskii arkhiv

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Nonsteroidal anti-inflammatory drugs (NSAIDs) are one of the most commonly used drugs in the world, and their side effects are very high. First of all, these are NSAID gastropathy, but in the long term, 5070% of NSAIDs cause damage to the small intestine (NSAID enteropathy), sometimes with serious consequences. To date, no drugs have been proposed with proven effectiveness to prevent this side effect. Apparently, this is not due to the fully clarified mechanism of pathogenesis. The most promising is the hypothesis of the participation of individual representatives of microflora in the development of enteropathy. Therefore, modulating the intestinal flora with the help of probiotics can be the basic therapeutic strategy for the prevention and treatment of such damage.

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“…Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most widely prescribed medications for treatment of inflammatory and pain-related conditions [1][2][3]. However, these drugs can elicit detrimental effects at level of the digestive tract [4,5], including the occurrence of small bowel mucosal injury [6][7][8][9]. The pathophysiology of this so called NSAID enteropathy remains partly undetermined, even though a variety of factors, involved in the maintenance of intestinal mucosal integrity, have been called into play [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Role of proteinase-activated receptors 1 and 2 in nonsteroidal anti-inflammatory drug enteropathy

et al. 2020

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NSAID-induced enteropathy: the current state of the problem

Cited by 6 publications

References 53 publications

Gut Microbiota in NSAID Enteropathy: New Insights From Inside

Gut Microbiota in NSAID Enteropathy: New Insights From Inside

NSAID enteropathy

Role of proteinase-activated receptors 1 and 2 in nonsteroidal anti-inflammatory drug enteropathy

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