Gastric Ulcerogenic and Healing Impairment Actions of Alendronate, A Nitrogen- Containing Bisphosphonate - Prophylactic Effects of Rebamipide

Author(s): Koji Takeuchi, Shinichi Kato, Kikuko Amagase.

Journal Name: Current Pharmaceutical Design

Volume 17 , Issue 16 , 2011

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Abstract:

Alendronate, a nitrogen containing bisphosphonate (BPP), when given p.o., decreases the transmucosal potential difference by direct irritating action, resulting in non-hemorrhagic lesions in both the corpus and antrum of fasted rats, and after re-feeding produces large ulcers in the antrum with increased vascular permeability and submucosal edema. The pathogenesis of these ulcers may be explained by the impairment of the mucosal anti-oxidative system and does not involve acid digestion as well as a deficiency of prostaglandins (PGs). Alendronate, although does not affect cyclooxygenase/ PGE2 production in the ulcerated mucosa, but impairs the healing of gastric ulcers in rats, and this effect may be related to the down-regulation of vascular endothelial growth factor and basic fibroblast growth factor (bFGF), the important growth factors for the vascularization/granulation as well as the suppression of the stimulatory action of epidermal growth factor on the epithelial proliferation/migration. Rebamipide, a mucosal protective and antiulcer drug, does not affect the direct irritating action of alendronate in the gastric mucosa but prevents the alendronate-induced antral ulceration, probably due to anti-oxidative and anti-inflammatory actions. In addition, this agent also antagonizes the healing impairment action of alendronate by counteracting the down-regulation of bFGF expression in the ulcerated mucosa. It is assumed that rebamipide is a promising drug that can be used as a prophylactic against the adverse effects of BPPs in the stomach.

Keywords: Bisphosphonate, alendronate, gastric ulcerogenic action, healing impairment action, rebamipide, edema, pathogenesis, fibroblast, vascularization, prophylactic, antiresorptive, esophagitis, triphosphate, malondialdehyde, propionic acid, indomethacin, exfoliation

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Article Details

VOLUME: 17
ISSUE: 16
Year: 2011
Page: [1602 - 1611]
Pages: 10
DOI: 10.2174/138161211796196927
Price: $58

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