Abstract
Novel Therapeutic Options for Prevention and Treatment of Peptic Ulcer Disease
Highlights
Peptic ulcer diseases comprise heterogeneous disorders, which manifest as a break in the lining of the gastrointestinal mucosa bathed by acid and pepsin
Topical damage caused by non-steroidal anti-inflammatory drugs (NSAIDs) includes the accumulation of ionized NSAIDs in the gastric epithelial cell called ‘ion trapping’ effect, the reduction of the hydrophobicity of the gastric mucosal surface and uncoupling of oxidative phosphorylation [4,5,6]
Only a combination of antimicrobials can be used in vivo to eradicate H. pylori and none of the antimicrobials is effective enough to eliminate H. pylori when given as monotherapy [8]
Summary
Peptic ulcer diseases comprise heterogeneous disorders, which manifest as a break in the lining of the gastrointestinal mucosa bathed by acid and pepsin. Additional strategies for the prevention of NSAID-induced upper digestive damage include the ongoing clinical development of pharmaceutical products containing fixed combinations of NSAID with a gastro protective drug, such as naproxen/omeprazole, naproxen/lansoprazole, naproxen/esomeprazole and ibuprofen/ famotidine [25] Both vitamins C and E seem to play a role in the preservation of gastric mucosal integrity; vitamin C is actively secreted into the gastric lumen of healthy subjects and its concentrations are decreased in patients with gastroduodenal diseases such as peptic ulcer disease and gastric malignancy [27]. The enzyme Urease plays an important role in the infection capabilities of H. pylori It allows this pathogen to survive, grow, and multiply at the low pH of the stomach, spreading infection to the inner layers of gastro duodenal mucosa, resulting in gastritis and peptic ulceration, which in some cases leads to gastric cancer [48]. Such reasons being that the prevalence of peptic ulcer disease in Western countries is low (limited access to volunteer participants for clinical trials), the high costs of performing such studies on a large scale in developing countries where there is high prevalence of infection is high and there is inadequate facilities to carry out these clinical trials studies in these countries
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