[NSAIDs caused gastric mucosal injury: with a special reference to COX-2].
Nonsteroidal antiinflammatory drugs (NSAIDs) have been shown to cause mucosal injury in the gastrointestinal tract as a side effect, occasionally turning out to be severe complications such as bleeding and perforation. So far NSAIDs-caused mucosal injury was attributed to their inhibitory effects on the activity of cyclooxygenase-1 (COX-1) which is expressed and shown to play a crucial role for the mucosal protection via producing prostaglandin E2 in the stomach. However, a recent progress of the understanding about COX physiology has revealed that NSAIDs cause gastric mucosal injury by inhibiting not only COX-1 but also COX-2 in the stomach. COX-1 inhibition alone has been demonstrated not to cause gastric mucosal injury. In addition, a selective COX-2 inhibitor which is demonstrated to have much less harmful effect in the stomach is now widely used as a safer NSAID in USA. Moreover, a selective COX-2 inhibitor is recently considered to have an inhibitory effect on growth of a certain type of cancers, thereby being in the spotlight as a chemopreventive agent.
Sakamoto
Choitsu
C
Department of Internal Medicine III, Nippon Medical School, Tokyo, Japan.
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D051546:Cyclooxygenase 2; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors / Q000627:therapeutic use*; D005753:Gastric Mucosa / Q000187:drug effects*; D006801:Humans; D007527:Isoenzymes / Q000378:metabolism / Q000502:physiology*; D008565:Membrane Proteins; D011451:Prostaglandin-Endoperoxide Synthases / Q000378:metabolism / Q000502:physiology*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors; D007527:Isoenzymes; D008565:Membrane Proteins; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; D011451:Prostaglandin-Endoperoxide Synthases