Sucralfate Prevents Experimental Peptic Esophagitis in Rabbits

摘要

Sucralfate was tested in a rabbit model for the ability to prevent experimental esophagitis. Esophagitis was assessed by gross appearance and microscopic examination by an uninformed observer. In addition, the permeability of the esophagus to a number of probe molecules was measured. Animals were exposed for one hour to either acid alone (HCl at pH 2), acid plus pepsin (0.8 mg/ml) or acid plus taurocholic acid (5mM), as well as the same injurious agents with the addition of one gram of sucralfate. At the completion of this hour, the perfusate was removed and all animals were once again perfused for one hour with HCl at pH2 while mucosal permeability was assessed by measuring erythritol, glucose, potassium and sodium fluxes. The animals were then sacrificed. Sucralfate significantly diminished esophagitis and the attendant mucosal permeability changes induced by pepsin. Several in vitro tests suggested that the clear sucrose sulfate solution, like the sucralfate gel, probably acts through a topical protectant effect, rather than through pepsin inactivation. While the degree of esophagitis induced by the bile acid was significantly less than that observed with pepsin, the mucosal permeability changes were comparable, Sucralfate did not significantly reduce all the flux rates of erythritol, glucose, potassium and sodium after exposure to taurocholic acid. In conclusion, the binding of sucralfate to pepsin substrates in tissue results in this agent being a potent agent for preventing experimental peptic esophagitis.