Approaches to gastrointestinal cytoprotection: from isolated cells, via animal experiments to healthy human subjects and patients with different gastrointestinal disorders.

摘要

Our clinical observations proved that the the duodenal ulcer in patients healed without any inhibition of gastric acid secretion (1965), and the healing rates of atropine vs cimetidine vs Carbenoxolone were equal and superior to that of placebo in randomized, prospective and multiclinical study of DU patients (1978). The phenomenon of gastric cytoprotection was defined by Andre Robert in rats (1979). The essential point of this phenomenon is that the prostaglandins prevent the chemical-induced gastric mucosal damage without affecting gastric acid secretion, this being originally suggested as a reaction specific to prostaglandins. Since then gastrointestinal cytoprotection has been shown with various agents (anticholinergic agents, H(2)RA, growth factors, body protecting compound, BPC) and retinoids in animals; the latter differing from the actions of vitamin A. In examining the various components of gastrointestinal cytoprotection , different studies have performed in isolated cells, stable cell lines, animal experiments, healthy human subjects, in patients chronic gastric and duodenal ulcers, and with different gastrointestinal disorders. Our attention has focused on the effects of cytoprotective agents on cellular viability, mitochondrial and DNA damage, oxygen free radicals, natural antioxidant systems, mucosal biochemistry, vascular events, gastrointestinal mucosal protection as well as in their prevention of different human diseases. This paper gives an overview on the different approaches for the exploring gastrointestinal cytoprotection (at the level of isolated cells, animal experiments, healthy human beings and patients with different gastrointestinal disorders). It has been indicated that the gastric cytoprotection exists in animals, human healthy subjects, patients with different gastrointestinal disorders. The our human observation in patients with duodenal ulcer healed without any changes of gastric acid secretion, there were no significant differences between the cimetidine vs. atropine (as antisecterory agents) or vs. Carbenoxolone vs. retinoid (as cytoprotective compounds) treatment. Also we indicated the presence of intact vagal nerve basically necessary for development of gastrointestinal cytoprotection and for capsaicin-sensitive vagal nerve induced mucosal protection (1982).