Published online Oct 21, 2019. doi: 10.3748/wjg.v25.i39.5926
Peer-review started: April 28, 2019
First decision: July 22, 2019
Revised: August 16, 2019
Accepted: September 13, 2019
Article in press: September 13, 2019
Published online: October 21, 2019
Processing time: 176 Days and 14.8 Hours
Proton pump inhibitors are often used to prevent gastro-intestinal lesions induced by nonsteroidal anti-inflammatory drugs. However, they are not always effective against both gastric and duodenal lesions and their use is not devoid of side effects.
To explore the mechanisms mediating the clinical efficacy of STW 5 in gastro-duodenal lesions induced by nonsteroidal anti-inflammatory drugs (NSAIDs), exemplified here by diclofenac, in a comparison to omeprazole.
Gastro-duodenal lesions were induced in rats by oral administration of diclofenac (5 mg/kg) for 6 successive days. One group was given concurrently STW 5 (5 mL/kg) while another was given omeprazole (20 mg/kg). A day later, animals were sacrificed, stomach and duodenum excised and divided into 2 segments: One for histological examination and one for measuring inflammatory mediators (tumor necrosis factor α, interleukins-1β and 10), oxidative stress enzyme (heme oxygenase-1) and apoptosis regulator (B-cell lymphoma 2).
Diclofenac caused overt histological damage in both tissues, associated with parallel changes in all parameters measured. STW 5 and omeprazole effectively prevented these changes, but STW 5 superseded omeprazole in protecting against histological damage, particularly in the duodenum.
The findings support the therapeutic usefulness of STW 5 and its superiority over omeprazole as adjuvant therapy to NSAIDs to protect against their possible gastro-duodenal side effects.
Core tip: The herbal preparation STW 5, clinically used in functional dyspepsia and irritable bowel syndrome, was compared to omeprazole in protecting against diclofenac- induced gastro-duodenal lesions in rats. Both drugs were effective in preventing changes in the level of inflammatory mediators (tumor necrosis factor α, interleukins-1β and 10), in the level of the oxidative stress enzyme, heme oxygenase-1, and the apoptotic regulator (B-cell lymphoma 2) in both stomach and duodenum. However, STW 5 was more effective than omeprazole in protecting against the histological damage. The results emphasize the potential usefulness of STW 5 and its superiority over omeprazole in protecting against gastro-duodenal lesions induced by nonsteroidal anti-inflammatory drugs.