Interaction between Helicobacter pylori infection, nonsteroidal anti-inflammatory drugs and/or low-dose aspirin use: Old question new insights

Table 1 Mechanisms of upper gastrointestinal injury with Helicobacter pylori infection, low dose aspirin and non steroidal anti-inflammatory drugs

Mechanism	LDA	NSAID	H. pylori
Prostaglandin/effect on COX enzyme	Selective and irreversible inhibition of COX-1	Inhibition of both isoforms of COX enzyme (COX-1 and 2)	Increase/up regulation COX-2
Gastric pH	Decrease	Decrease	Decrease or increase or no effect
PMN mediated gastric mucosa injury	Increase	Increase	Increase
Gastric mucosal flow	Decrease	Decrease	Increase
Gastric adaptation to LDA and NSAIDs			Reduce

Adapted from reference [5]. LDA: Low dose aspirin; NSAID: Non steroidal anti-inflammatory drugs; H. pylori: Helicobacter pylori; PMN: Polimorphonuclear cells; COX: Cicloxigenase.