title: The role of nonsteroidal antiinflammatory drugs and cyclooxygenase-2 inhibitors on experimental colitis.
abstract: The nonsteroidal anti-inflammatory drugs (NSAIDs) have been widely used in the management of pain and inflammation. Unfortunately, they are associated with dose-dependent gastrointestinal (GI) adverse events ranging from dyspepsia to symptomatic and complicated ulcers. The mechanism of NSAID action is attributed to the cyclooxygenase (COX) inhibition. New anti-inflammatory drugs have been synthesized, such as selective COX-2 inhibitors, however, these drugs may present side effects, such as modification of the epithelial barrier. Inflammatory bowel disease (IBD) is a common chronic gastrointestinal disorder characterized by alternating periods of remission and active intestinal inflammation. A possible association between the use of NSAIDs and the relapse of IBD has been repeatedly suggested. For this reason, many studies are conducted with the use of COX-2 in experimental models. The objective of this review is to describe the role of NSAIDs and COX-2 inhibitors in different experimental models of colitis. We reviewed controlled trials, original articles, case reports and reviews. The role of selective inhibition of COX-2 in the inflammatory process and the course of experimental and human colitis is controversially discussed. In conclusion, the relative role of COX-2 selective inhibitors on human and experimental colitis remains to be explored. Thus, the use of COX-2 inhibitors in IBD should be considered with caution.
authors.affiliation: Department of Pathology, Federal University of São Paulo, UNIFESP, SP, Brazil.
authors.forename: Ana Paula Ribeiro
authors.initials: AP
authors.lastname: Paiotti
authors.forename: Patrícia
authors.initials: P
authors.lastname: Marchi
authors.forename: Sender Jankiel
authors.initials: SJ
authors.lastname: Miszputen
authors.forename: Celina Tizuko Fujiyama
authors.initials: CT
authors.lastname: Oshima
authors.forename: Marcello
authors.initials: M
authors.lastname: Franco
authors.forename: Daniel Araki
authors.initials: DA
authors.lastname: Ribeiro
mesh_terms: D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000494:pharmacology*; D002908:Chronic Disease; D002986:Clinical Trials as Topic; D003092:Colitis / Q000139:chemically induced* / Q000201:enzymology / Q000473:pathology; D052246:Cyclooxygenase 2 Inhibitors / Q000009:adverse effects / Q000494:pharmacology*; D006801:Humans; D007527:Isoenzymes / Q000378:metabolism; D011451:Prostaglandin-Endoperoxide Synthases / Q000378:metabolism; D011453:Prostaglandins / Q000502:physiology
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D052246:Cyclooxygenase 2 Inhibitors; D007527:Isoenzymes; D011453:Prostaglandins; D011451:Prostaglandin-Endoperoxide Synthases