Systematic Analysis of Monoterpenes: Advances and Challenges in the Treatment of Peptic Ulcer Diseases

Abstract

Peptic ulcer disease (PUD) is a multifactorial and complex disease caused by an imbalance of protective and aggressive factors (endogenous and exogenous). Despite advances in recent years, it is still responsible for substantial mortality and triggering clinical problems. Over the last decades, the understanding of PUD has changed a lot with the discovery of Helicobacter pylori infection. However, this disease continues to be a challenge due to side-effects, incidence of relapse from use of various anti-ulcer medicines, and the rapid appearance of antimicrobial resistance with current H. pylori therapies. Consequently, there is the need to identify more effective and safe anti-ulcer agents. The search for new therapies with natural products is a viable alternative and has been encouraged. The literature reports the importance of monoterpenes based on the extensive pharmacological action of this class, including wound healing and anti-ulcerogenic agents. In the present study, 20 monoterpenes with anti-ulcerogenic properties were evaluated by assessing recent in vitro and in vivo studies. Here, we review the anti-ulcer effects of monoterpenes against ulcerogenic factors such as ethanol, nonsteroidal anti-inflammatory drugs (NSAIDs), and Helicobacter pylori, highlighting challenges in the field.Biomolecules 2020, 10, 265 2 of 18 PUD results from an imbalance in mucosal defensive factors, such as mucus secretion, bicarbonate efflux, endogenous antioxidant, cell regeneration, continuous synthesis and release of prostaglandin E 2 (PGE 2 ), nitric oxide (NO), and sulfhydryl compounds (SH); and aggressive agents such as smoking, alcohol consumption, dietary factors, stress, prolonged and excessive intake of nonsteroidal anti-inflammatory drugs (NSAIDs), and Helicobacter pylori (H. pylori) infection, among others [6][7][8][9]. For a long time, it was believed that the main factor implicated in the development and progression of peptic ulceration was an hypersecretory acidic environment and together with dietary factors and/or stress was thought to cause most of PUD. But the discovery of H. pylori infection and the widespread use of NSAIDs in the second half of the 20 th century changed this perception. In recent years, peptic ulcer has been found to have multiple causes-H. pylori infection, NSAIDs, smoking, alcohol consumption, stress, lifestyle, and genetic predispositions are determined as major risk factors for the development of PUD [2]. PathophysiologyUnder normal conditions, gastric and duodenal mucosa integrity is maintained by the mucus-bicarbonate barrier, the neutral pH, and continuous epithelial cell renewal [10,11]. PGE 2 stimulates cell proliferation, mucus, and bicarbonate production, promoting a crucial function in mucosa preservation. Another vital factor in gastric homeostasis is adequate blood flow. The NO and PGs are responsible for the maintenance of proper perfusion to the gastric mucosa, assuring the delivery of oxygen and nutrients, as well as removing toxic metabolites, preventing damages to the ti...

Hypothermic Effect of Acute Citral Treatment during LPS-induced Systemic Inflammation in Obese Mice: Reduction of Serum TNF-α and Leptin Levels

“…To minimize the deleterious effects of SI, therapeutic agents such as nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used in current therapy; however, the clinical use of NSAIDs is limited due to the gastrointestinal toxicity induced by these compounds [ 16 , 17 , 18 ]. Therefore, there is a great challenge of finding new therapeutic options for NSAIDs with lesser adverse effects in patients.…”

The metabolomic analysis of five Mentha species: cytotoxicity, anti-Helicobacter assessment, and the development of polymeric micelles for enhancing the anti-Helicobacter activity

“… 51 Additionally, monoterpenes have been proved to have gastroprotective and possible anti- Helicobacter effects. 52 Meanwhile, M. piperita , which showed the best cytotoxic activity, was distinguished by its phenolic acid as well as its flavonoid contents in addition to the presence of salvadoside, a lignan glycoside previously identified in Salvadora persica ; 53 these epoxy carotenoids represent lipophilic-active compounds of xanthophylls in foods and play a great role in cancer prevention, 54,55 including violaxanthin, previously identified in Mentha species, 48 and the main constituent in Dunaliella tertiolecta , which demonstrated a powerful antiproliferative effect against breast cell carcinoma 56 in addition to antheraxanthin.…”

Therapeutic strategies of Moringa oleifera Lam. (Moringaceae) for stomach and forestomach ulceration induced by HCl/EtOH in rat model

“…protects stomach against ulcers mediated by ethanol in mice, suppressing neutrophils accumulation myeloperoxidase activity and decreasing the levels of pro-inflammatory cytokines (TNF-α, interleukin-6 (IL-6), IL-1β), improving gastric mucus and NO ( Serafim et al, 2020 ). Interestingly, the main factor implicated in the development and progression of peptic ulceration was an hypersecretory acidic environment and together with dietary factors and/or stress was thought to cause most of peptic ulcer disease ( Périco et al, 2020 ). The mucus and the bicarbonate are the first line of defense against acid because they cover the entire stomach mucosa and protects against the colonization of bacteria and mechanical forces of proteolytic digestion ( Caldas et al, 2014 ).…”