Gastric ulcerogenic and healing impairment actions of alendronate, a nitrogen-containing bisphosphonate - prophylactic effects of rebamipide.

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/ PGE(2) 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.

• Authors: Koji Takeuchi, Shinichi Kato, Kikuko Amagase
• Journal: Current pharmaceutical design (Curr Pharm Des) Vol. 17 Issue 16 Pg. 1602-11 ( 2011) ISSN: 1873-4286 [Electronic] United Arab Emirates
• PMID: 21548868 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)

Chemical References

• Anti-Ulcer Agents
• Bone Density Conservation Agents
• Quinolones
• rebamipide
• Alanine
• Alendronate

Topics

• Alanine (analogs & derivatives, therapeutic use)
• Alendronate (adverse effects)
• Animals
• Anti-Ulcer Agents (therapeutic use)
• Bone Density Conservation Agents (adverse effects)
• Humans
• Quinolones (therapeutic use)
• Stomach Ulcer (chemically induced, prevention & control)
• Wound Healing (drug effects)