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World J Gastroenterol. Jun 7, 2015; 21(21): 6499-6517
Published online Jun 7, 2015. doi: 10.3748/wjg.v21.i21.6499
Role of dietary polyphenols in the management of peptic ulcer
Mohammad Hosein Farzaei, Mohammad Abdollahi, Roja Rahimi
Mohammad Hosein Farzaei, Mohammad Abdollahi, Faculty of Pharmacy and Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran 1417614411, Iran
Mohammad Hosein Farzaei, Roja Rahimi, Department of Traditional Pharmacy, School of Traditional Medicine, Tehran University of Medical Sciences, Tehran 1114733114, Iran
Mohammad Hosein Farzaei, Faculty of Pharmacy, Kermanshah University of Medical Sciences, Kermanshah 6734667149, Iran
Author contributions: Farzaei MH contributed to study design, data collection, and drafting the manuscript; Abdollahi M contributed to study design, editing the manuscript, and English language editing; Rahimi R reviewed data collection and supervised the entire study.
Supported by National Elites Foundation of Iran (partly).
Conflict-of-interest: The authors have no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Roja Rahimi, PhD, Department of Traditional Pharmacy, School of Traditional Medicine, Tehran University of Medical Sciences, Amir Abad, Keshavarz Boulevard, Tehran 1114733114, Iran. rojarahimi@gmail.com
Telephone: +98-215-5693523 Fax: +98-215-5693523
Received: November 26, 2014
Peer-review started: November 26, 2014
First decision: February 10, 2015
Revised: February 22, 2015
Accepted: April 3, 2015
Article in press: April 3, 2015
Published online: June 7, 2015
Processing time: 197 Days and 9.7 Hours
Abstract

Peptic ulcer disease is a multifactorial and complex disease involving gastric and duodenal ulcers. Despite medical advances, the management of peptic ulcer and its complications remains a challenge, with high morbidity and death rates for the disease. An accumulating body of evidence suggests that, among a broad reach of natural molecules, dietary polyphenols with multiple biological mechanisms of action play a pivotal part in the management of gastric and duodenal ulcers. The current review confirmed that dietary polyphenols possess protective and therapeutic potential in peptic ulcer mediated by: improving cytoprotection, re-epithelialization, neovascularization, and angiogenesis; up-regulating tissue growth factors and prostaglandins; down-regulating anti-angiogenic factors; enhancing endothelial nitric oxide synthase-derived NO; suppressing oxidative mucosal damage; amplifying antioxidant performance, antacid, and anti-secretory activity; increasing endogenous mucosal defensive agents; and blocking Helicobacter pylori colonization associated gastric morphological changes and gastroduodenal inflammation and ulceration. In addition, anti-inflammatory activity due to down-regulation of proinflammatory cytokines and cellular and intercellular adhesion agents, suppressing leukocyte-endothelium interaction, inhibiting nuclear signaling pathways of inflammatory process, and modulating intracellular transduction and transcription pathways have key roles in the anti-ulcer action of dietary polyphenols. In conclusion, administration of a significant amount of dietary polyphenols in the human diet or as part of dietary supplementation along with conventional treatment can result in perfect security and treatment of peptic ulcer. Further well-designed preclinical and clinical tests are recommended in order to recognize higher levels of evidence for the confirmation of bioefficacy and safety of dietary polyphenols in the management of peptic ulcer.

Keywords: Anti-inflammatory; Dietary supplement; Helicobacter pylori; Inflammatory cytokines; Natural medicine; Non-steroidal anti-inflammatory drugs; Peptic ulcer; Polyphenols; Ulcer healing

Core tip: Polyphenols ubiquitously present in vegetables and fruits are progressively viewed as natural dietary ingredients vital for a balanced diet. An accumulating body of evidence indicates that dietary polyphenols with multiple biological mechanisms of action play a pivotal part in the management of gastric and duodenal ulcers. Administration of a sufficient amount of dietary polyphenols in the human diet or as part of dietary supplementation along with conventional treatment can result in perfect prevention and treatment of peptic ulcer.