COX-1, COX-2 and the topical effect in NSAID-induced enteropathy.

Abstract:

:The side effects of NSAIDs are equally evident in the stomach and the small bowel. The latter is increasingly seen as being clinically significant, contributing substantially to the iron-deficiency anaemia that is so common in patients with rheumatoid arthritis. Furthermore, NSAID-enteropathy may be associated with life-threatening events. The pathogenesis of NSAID-enteropathy is uncertain but inhibition of COX-1 is believed to be of pivotal importance. However there is increasing evidence that COX-2 inhibition and the topical effect may have a synergistic detrimental action. We examined the role of COX-1, COX-2 and the so called topical effect of acidic NSAIDs. We found that COX-1 or COX-2 inhibition and the topical effect alone do not damage the GI tract. Dual inhibition of COX-1 and COX-2 results in intestinal inflammation similar to that caused by Indomethacin. The topical effect may act synergistically in this damage. The conventional view that the mechanism of gastrointestinal damage is principally caused by COX-1 inhibition needs to be revised in view of recent studies using selective inhibitors of the COX enzymes and COX knockout animals.

journal_name

Inflammopharmacology

journal_title

Inflammopharmacology

authors

Hotz-Behofsits CM,Walley MJ,Simpson R,Bjarnason IT

doi

10.1163/156856003322699546

subject

Has Abstract

pub_date

2003-01-01 00:00:00

pages

363-70

issue

4

eissn

0925-4692

issn

1568-5608

journal_volume

11

pub_type

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