Objective:
To investigates the nitric oxide donating properties of furoxan moiety and validates its role in
the gastroprotective effect of rabeprazole against indomethacin induced gastric mucosal
Methods:
The study was performed between April and July 2010 in the Department of Pharmacology
/ College of Medicine /Baghdad University .The study was conducted on 72 adult male albino
rats, divided into 6 groups, the first served as a control received the vehicle , the second
received indomethacin orally of 60mg/kg. The third and fourth groups were pretreated orally
30 minute prior indomethacin with either rabeprazole or omeprazole. In order to study the
possible role of nitric oxide (NO) in their gastroprotective effect ; intraperitoneal N -
Arginine Methyl Ester (L-NAME) a nitric oxide synthase inhibitor was given 30 minutes
prior to rabeprazole and omeprazole administration followed by indomethacin and this served
as fifth and sixth group respectively .
The rats were then sacrificed after 4 hours and their stomachs were isolated and submitted to
macroscopical assessment and for the measurement of the gastric prostaglandin E2 (PGE2),
Results:
Rabeprazole and omeprazole produced significant gastroprotective effects. Their protective
effects were associated with marked decrease in MPO activity. However, the protective effect
of furoxan containing rabeprazole was significantly better than that of in omeprazole .On the
other hand, L-NAME pretreatment decreased the effects of rabeprazole while L-NAME
pretreatment don't decrease the protective effects of omeprazole. Conclusions:
The prophylactic use of rabeprazole and omeprazole in this study prevented
indomethacin induced gastropathy. However,
significantly better than that of in omeprazole which indicates the important role of NO in the
* MSc. Pharm.Al-Sadir general hospital**FICMS,Al-Sadir general hospital
Introduction:
It was reported that incorporated of nitric
oxide-releasing properties into a NSAIDs may
minimize or protect against NSAIDs induced
mg/kg was used for the induction of gastric
gastropathy.(1)(2) .Nitric oxide (NO) is a crucial
damage at a concentration of 15mg/ml.
mediator of gastrointestinal (GI) mucosal
Indomethacin was dissolved in a vehicle of
defense(3) , exerting many of the same actions as
c arb ox y me th yl c e llu lo s e (C M C ).
addition it is capable of inhibiting neutrophil
degranulation (5) , and has a number of effects
concentrations were adjusted to 10mg/ml.
in the GI tract that could counteract the loss of
saline (PH 7.2) at a concentration of 32.5
mucosa (6) , increases blood flow to the gastric
m g / m l f o r i n t r a p e r i t o n e a l
mucosa and maintain its integrity and defense
administration according to the method of
(7) , promoting repair and removal of toxins (8) ,
decreases interaction of neutrophils with the
gastric microcirculation (1) , and may promote
groups the first group served as a control
newer proton pump inhibitor (PPI) provides
reliable control of gastric acid secretion with
more potent antisecretory activity than that of
.The third and fourth groups were pretreated
orally 30 minutes prior indomethacin with
lansoprazole (10) .In addition to , rabeprazole
contains a furoxan moiety (11 , 12 ) that has the
omeprazole .In order to study the role of NO
ability to release NO and reduces histamine
in the protective effect, intraperitoneal L-
secretion (1) .In addition , early reports showing
that furoxan moiety can mimic some of the
minutes before rabeprazole and omeprazole
physiological actions of NO (13) . In this study
the gastroprotective role of two different PPIs
respectively . At the end of each experiment
( 4 h o u r s f o l l o w i n g in d o m e t h a c i n
administration) the rats were sacrificed and
gastropathy was investigated and their effects
were opened along the greater curvature and
Methods:
This study was conducted on 72 adult male
stomach then quickly divided into two parts
albino-Wister rats weighing (200-250 g) ,
divided into 6 groups, each group carried out
with 12 rats per treatment. The study was
initiated after seeking approval from the ethical
Assessment of gastric mucosal damage:
and scientific committee in the Department of
Gastric damage score was calculated by the
Pharmacology / College of Medicine /Baghdad
University on April 2010 . Rats were starved
for at least 24 hours before indomethacinadministration. During starvation , rats were
Biological assays:
kept in cages provided with a wide wire - mesh
floor to avoid coprophagy but allowed free
each in specific buffer and stored in freeze
until evaluation of biological parameters:
m e a n s o f g a s t r i c d a m a g e s c o r e ,
A :prostaglandin E2 assay: The samples
used for assay of PGE2 were kept in sodium
phosphate buffer (10 mmol/l ; pH 7.4).At the
Scheffe test. All statistical tests were two-
tailed with a p value of < 0.05 deemed
with scissors, placed in a shaking water bath
Results: Gastric MPO activity assay : The
indomethacin administration compared with
a normal gastric mucosa in control group.
kept in phosphate buffer saline (50 mmol/l ;
Indomethacin caused a significant (p< 0.05)
tissue was homogenized in 2 ml of PBS (50
indomethacin caused significant suppression
(p<0.05) of gastric PGE2 mean (57.92 +
then centrifuged at 2000 x g for 5 min. at 4 C.
1.56ng/g) versus (222.08 + 2.92ng/g) in the
MPO activity of supernatant was determined
control group as shown in figure (2). Also
by adding 0.1 ml of the supernatant to 2.9 ml
there was significant increased (p<0.05) in
of 50 mm phosphate buffer containing 0.167
control group as shown in figure (3 ).
Rabeprazole pretreated group: rabeprazole
measured spectrophotometrically. One unit
pretreatment caused significant reduction
of MPO activity was defined as that which
(p< 0.05) of GDS , mean (0.52+ 0.03mm )
would convert 1 Mmol of H2O2 to water in 1
figure ( 1 ) . Gastric PGE2 level was not
mean ( 64.17+ 2.2 Statistical analysis:
ng/g) versus (57.92 + 1.56ng/g) in the
using SPSS version 11 (SPSS, Inc, Chicago,
figure ( 2 ) .By evaluating the effect of
activity mean ( 6.27+ 0.28 u/mg ) compared
descriptive statistics. One way ANOVA test
was used for comparison between groups of
treated group as shown in figure ( 3 ) . When
control, indomethacin, rabeprazole with and
rabeprazole in order to validate any role of
N O ,L-N AM E pr et re at me n t c a us e s
significant decrease in the gastroprotective
failed to decrease the cytoprotective effect
of omeprazole; where it is shown that there
pretreated group: Omeprazole pretreatment
is no significant effect on GDS as shown in
also demonstrate significant gastroprotective
cytoprotective action between rabeprazole
and omeprazole ; reveals that rabeprazole
was more effective in prevent ulcerogenic
treated group as shown in figure (1).This effect
action of indomethacin , where rabeprazole
was correlated with the inability of omeprazole
to up regulates gastric PGE2 level mean (
59.58+ 1.44 ng/g ) versus (57.92 + 1.56ng/g)
in the indomethacin treated group as shown in
shown in figure (1), and its suppression of
MPO activity was significantly greater than
that of in omeprazole as shown in figure (3)
significant change in gastric MPO activity
mean (10.46+ 0.34 u/mg) compared to (35.08+0.83u/mg)) in the indomethacin treated groupas shown in figure (3) . Fig(1) : The effect of rabeprazole versus omeprazole pretreatment on the gastric damage score induced by indomethacin. The results are expressed as the mean +
* P < 0.05 when compared with indomethacin group. † P < 0.05 when compared with omeprazole pretreated group. Fig.(2) : The effect of rabeprazole versus omeprazole pretreatment on the gastric PGE2 levels inhibited by indomethacin. The results are expressed as the mean + Fig.(3) : The effect of rabeprazole versus omeprazole pretreatment on the increased gastric MPO activity induced by indomethacin .The results are expressed as the mean +
* P < 0.01 when compared with indomethacin group. † < 0.01 when compared with omeprazole pretreated group.
Fig(4) : The effect of L-NAME pretreatment on the cytoprotective effect of rabeprazole and omeprazole on the gastric damage score induced by indomethacin . The results are expressed as the mean +
* P < 0.05 when compared with rabeprazole pretreated group without L-NAME. Discussion:
significant decrease in the extent of the
gastric damage caused by indomethacin.
did not seem to be related to gastric PGs
continue NSAIDs use (18) . This therapeutic
effect of PPIs is generally attributed to their
study were not able to alter the gastric PGE2
level which was significantly suppressed by
through inhibition of the gastric H,K-ATPase (19
However ,in this study the significant reduction
in the gastric damage score obtained could not
inhibition of MPO activity, a specific marker
be explained on this bases alone . This is
because in present study only one single dose
infiltration in tissues and adherence to the
vascular endothelium, which are the early
events of gastric damage associated with the
secretion requires several doses of PPIs (18 .)
Moreover the time allowed of PPIs to produce
its effects on acid secretion in this study was
of the cytoprotective effects of omeprazole
relatively short (4.5 hrs) , where more than 5
hrs are needed before any significant increment
in the gastric acid PH could be detected (20)
omeprazole is similar to that of rabeprazole
rabeprazole in this study was significantly
5. Carmelo Scarpignato and Richard H Hunt
omeprazole in their extent of protection the
the end or the end of the beginning ?.
gastric mucosa in this experiment could be
current opinion in pharmacology .2008 ; 8:
moiety that has the ability to release NO , a
6. Brown JF , Keates AC , Hanson PJ ,
mediator that involved in the cytoprotection
gastric mucosal cells . Am J Physiol.1993 ;
mechanisms of rabeprazole , this is because
7.Full Young Chang , Chih Yen Chen , Ching
significantly decrease the protective effects
pretreatment did not seem to decrease the
endothelin-1 and nitric oxide activity in
gastric damage score and therefore any role
Helicobacter Pylori eradication. World
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Aalykke C , Hansen JM , et al.Use of single
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contrast bioavailability of rabeprazole does
9. Ma L ,Wallace JL .Endothelial nitric oxide
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