Comparison of aloe vera and omeprazole in the treatment of equine gastric ulcer syndrome

Changes in Management Lead to Improvement and Healing of Equine Squamous Gastric Disease

Equine squamous gastric disease (ESGD) is common in horses and poses a serious welfare problem. Several risk factors have been identified and ESGD is routinely treated with omeprazole. Fourteen mares, previously used as embryo recipients and diagnosed with ESGD, were selected. Horses were confined to individual stalls, exercised once daily, and fed ad libitum hay, 1 kg of a low starch compound complementary feed and a mineral supplement. Half of the horses received a compound containing hydrolysed collagen (supplement) and the other half did not (control). At the start of the study, ESGD scores were 3.57 and 3.36 for the supplement and control group, respectively. After 4 weeks, the ESGD grades were significantly reduced in both groups (1.89 and 1.43, respectively, p < 0.01), and healing (ESGD < 2) occurred in 7 out of 14 horses. No treatment effect was observed (p = 0.75), and it was concluded that the change in husbandry overshadowed any potential effect of the compound. Severe ESGD can improve, and even heal, with the provision of a diet of ad libitum forage and a small amount of a compound complementary feed, without the use of omeprazole. A predictable daily routine, with a limited number of dedicated caretakers, may have contributed to the improvement of gastric health.

Kangfuxin solution for treatment of gastric ulcer: Efficacy and impact on serum VEGF and ERK12 levels

BACKGROUND

Kangfuxin solution can improve microcirculation and promote mucous membrane repair, and has a significant effect in ulcer disease. This study applied Kangfuxin solution to the treatment of gastric ulcer and analyzed its effect on the repair of gastric ulcer.

AIM

To investigate the efficacy of Kangfuxin solution combined with conventional Western medicine in the treatment of gastric ulcer complicated by chronic obstructive pulmonary disease and its effect on serum levels of vascular endothelial growth factor (VEGF) and extracellular regulated protein kinases 1/2 (ERK1/2).

METHODS

Prospectively, 48 patients with gastric ulcer treated at our hospital from January 2021 to August 2021 were selected as study subjects and randomly divided into either a control group or an observation group, with 24 cases in each group. Both groups received conventional treatments for gastric ulcer such as acid suppression, gastric mucosa protection, and antibiotics, and the observation group was additionally treated with Kangfuxin solution for 8 wk. The clinical effects, mucosal microvascular morphology, serum levels of ERK1/2 and VEGF, immune-responsive T lymphocyte subsets (CD3+, CD4+, CD4+/CD8+), histological maturation of the regenerated mucosa, gastric fluid pH, and the incidence of adverse effects and recurrence rate were recorded.

RESULTS

The overall clinical efficiency of the observation group was 95.83%, which was higher than that of the control group (66.67%; P < 0.05). The proportion of regular microvascular network was higher in the observation group than in the control group (P < 0.05). Serum levels of VEGF and ERK1/2 were higher in the observation group than in the control group after treatment (P < 0.05). The percentages of CD3⁺ T lymphocyte and CD4⁺ T lymphocyte, and CD4⁺/CD8⁺ ratio were higher in the observation group than in the control group (P < 0.05). The area of collagen fiber deposition, types Ⅰ/Ⅱ collagen ratio, hydroxyproline content, and gastric fluid pH were higher in the observation group than in the control group (P < 0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P > 0.05), and the 3-mo recurrence rate in the observation group was lower than that of the control group (4.17% vs 33.33%, P < 0.05).

CONCLUSION

Kangfuxin solution combined with conventional drugs for the treatment of gastric ulcer complicated by chronic obstructive pulmonary disease can significantly improve clinical efficacy, promote ulcer healing, and reduce the risk of recurrence, without significantly increasing adverse drug reactions.

Prophylactic effects of Glycyrrhiza glabra root extract on phenylbutazone-induced Equine Glandular Gastric Disease (EGGD)

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), like phenylbutazone (PBZ), are prescribed to treat pain and inflammation in the equine. However, experimentally their use has been associated with the development of Equine Glandular Gastric Disease (EGGD). To evaluate the prophylactic effects of Glycyrrhiza glabra root extracts (GGRE) on EGGD induction following oral administration of PBZ, 12 donkeys were used. Animals were divided into three equal groups (A, B and C) in a randomized block design. A: placebo, B: PBZ (4.4 mg/kg PO q 12 h) and C: PBZ plus GGRE (17.6 mg/kg PO q 24h). Gastroscopy and blood sampling for CBC, biochemical tests and antioxidant status were performed days 0 and 7. All but 1 animal had no EGGD lesions on day 0, but on day 7, severe EGGD lesions were seen in group B animals (grade 1/4 (× 1), grade 2/4 (× 2), and grade 3/4 (× 1)). Only mild changes were seen in group C animals, the most severe lesions being grade 1/4 lesions in 2 animals. No change was observed in Group A. Hematology and serum antioxidant status did not change significantly in any group. In group B glucose decreased and ALT and ALP increased, while in group C only ALP increased. In conclusion, GGRE reduced the severity of EGGD caused by PBZ. Further, GGRE prevented PBZ induced hypoglycemia and might reduce the possible hepatic injury of PBZ.

Ginkgolide protects against ethanol-induced gastric ulcer in rats through NLRP3 related pathway

BACKGROUND

Ginkgolide has a protective effect on gastric ulcer gastric mucosa damage, but the exact mechanism involved is still not clear.

AIM

To investigate the molecular mechanism of ginkgolide for protecting against ethanol-induced gastric ulcer by detecting the expression of proteins related to the nod-like receptor thermal protein domain associated protein 3 (NLRP3) pathway.

METHODS

Sixty SD rats were randomly divided into a blank group (group A, rats with no treatment), a model group (group B, rats treated with ethanol), control group (group C, rats treated with ethanol and 20 mg/ mL omeprazole), low-dose ginkgolide group (group D, rats treated with ethanol and 1 mg/mL ginkgolide), medium-dose ginkgolide group (group E, rats treated with ethanol and 2.5 mg/mL ginkgolide), and high-dose ginkgolide group (group F, rats treated with ethanol and 5 mg/mL ginkgolide), with ten rats in each group. Gastric pH, gastrin, pepsin, and ulcer index (UI) of rats in different groups were compared. The contents of NLRP3, caspase-1, IL-18, IL-1β, superoxide dismutase (SOD), malondialdehyde (MDA), and reduced glutathione (GSH) in serum were determined by ELISA. The expression levels of NLRP3, interleukin (IL)-18, IL-1β, caspase-1, and apoptosis associated blotch-like protein (ASC) in gastric tissues were detected by real-time fluorescence quantitative PCR, Western blot (WB), and immunofluorescence assay.

RESULTS

UI, gastrin, total acidity, and total pepsin activity in group B were significantly higher than those in group A (P < 0.01), while UI, total acidity, and total pepsin activity in groups C, E, and F were significantly lower than those in group B (P < 0.01). Serum levels of SOD and GSH in groups C, D, E, and F were significantly higher than those in group B (P < 0.01). Serum MDA and the mRNA and protein expression of NLRP3, caspase-1, IL-18, IL-1β, and ASC in gastric tissue in group B were significantly higher than those in group A (P < 0.01). Serum MDA and the mRNA and protein expression of NLRP3, caspase-1, IL-18, IL-1β, and ASC in gastric tissue of rats in groups C, D, E, and F were significantly lower than those in group B (P < 0.01).

CONCLUSION

Ginkgolide protects against ethanol-induced gastric ulcer through the NLRP3 pathway.

Equine Squamous Gastric Disease: Prevalence, Impact and Management

This narrative review explores the etiopathogenesis, clinical signs, diagnosis and treatment of ESGD (equine squamous gastric disease) and discusses the impact of this commonly encountered condition on the equine industry. ESGD refers specifically to peptic injury of the squamous mucosa of the stomach. Prevalence is highest in performance horses, but the disease has been documented across many breeds and ages, including in feral horses and foals. The pathogenesis of ESGD is well understood. Intensive management and exercise are important factors that contribute to a disruption of the normal stratification of gastric pH. This results in exposure of the vulnerable squamous mucosa to acid, leading to ulceration. Clinical signs are variable and there is little evidence to support a direct association between reported signs and the presence or absence of lesions seen on gastroscopy. Management is aimed at acid suppression and mitigation of known risk factors.

Medicinal Plants in the Treatment of Peptic Ulcer Disease: A Review

Peptic Ulcer Disease (PUD) is the most common disorder of the stomach and duodenum, which is associated with Helicobacter pylori infection. PUD occurs due to an imbalance between offensive and defensive factors and Proton Pump Inhibitors (PPI), Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) and antibiotics are frequently used for the treatment. Recently, medicinal plants have emerged as efficacious, safe and widely available alternative therapies for PUD. The aim of this review was to study the medicinal plants and phytochemicals, which have been used for PUD treatment to evaluate the potential role of natural compounds to develop herbal remedies for PUD. Information was obtained using a literature search of electronic databases, such as Web of Science, Google Scholar, PubMed, Sci Finder, Reaxys and Cochrane. Common and scientific names of the plants and keywords such as 'peptic ulcer', 'gastric ulcer', 'stomach ulcer' and 'duodenal ulcer' were used for search. Eventually, 279 plants from 89 families were identified and information on the plant families, part of the plant used, chemical constituents, extracts, ulcer model used and dosage were abstracted. The results indicated that most of the anti-PUD plants were from Asteraceae (7.1%) and Fabaceae (6.8%) families while flavonoids (49%), tannins (13%), saponins (10%) and alkaloids (9%) were the most common natural compounds in plants with anti-PUD activity.

Inter-observer variability of two grading systems for equine glandular gastric disease

BACKGROUND

Equine glandular gastric disease (EGGD) is recognised as a separate entity to equine squamous gastric disease (ESGD) and it is recommended that lesions are graded differently. Currently, no validated scoring system exists for EGGD.

OBJECTIVES

To determine inter-observer reliability of two previously described grading systems for EGGD and to assess if agreement improved with gastroscopy experience, specialist training or familiarity with the descriptive system.

STUDY DESIGN

Cross-sectional survey.

METHODS

A link to an electronic questionnaire containing 20 images of glandular lesions was circulated. Respondents were asked to score lesions using descriptive terminology and a 0-2 verbal rating scale (VRS). Krippendorff's alpha reliability estimate was used to assess inter-rater agreement. A mixed effects model was used to determine which descriptive categories were associated with lesions being described as severe and decision to treat.

RESULTS

Eighty-two veterinarians responded, 49 diplomates and 33 non-diplomates. There was no agreement when all four descriptive variables were combined (α = 0.19). Agreement was fair to moderate for severity (α = 0.52), distribution (α = 0.44), appearance (α = 0.38) and shape (α = 0.32). Agreement for the VRS was similar to that for severity (α = 0.53). Agreement was better among diplomates across all categories. Lesion appearance and shape, but not distribution, were associated with both a decision to treat; and lesions being described as severe (P =< .05). A VRS score 2/2 was associated with a lesion being described as severe (OR 75.2, 95% CI 51.12-110.48, P =< .001).

MAIN LIMITATIONS

Intra-observer variability was not assessed. The number of images is relatively small, and the decision to treat is based on several factors in practice.

CONCLUSIONS

Overall, agreement for the descriptive system was poor. Better delineation of descriptive category boundaries and characteristics should be determined. Agreement was similar when comparing the severity category and the VRS. Extrapolation to a VRS based on lesion severity may therefore be possible.

Protective and Therapeutic Effects of Aloe Vera Gel on Ulcerative Colitis Induced by Acetic Acid in Rats

Ulcerative colitis (UC) is a chronic intestinal inflammation. Common clinical symptoms are weight loss, diarrhea, ulcers, and inflammation. Aloe vera (AV) has several medicinal properties including antioxidant, anti-inflammatory analgesic, and improvement of gastric and skin ulcers. This study aimed to investigate the protective and therapeutic effects of AV gel on acetic acid-induced UC in rats. UC was induced in 48 rats by injection of 4% acetic acid into the rectum. Protective and treatment groups received treatments 7 days before and after the induction of colitis, respectively. The negative control group, the positive control group, and AV groups received distilled water, sulfasalazine, and 50 and 300 mg/kg of gel extract, respectively. Water and food intake and body weight changes were recorded. The extent of the mucosal ulcers, colon tissue thickening, and mucosal bleeding were scored by the Gerald classification system score (microscopy observations). Slides of tissues were prepared for pathologic assay using the modified Wallace method (macroscopic observations). The results of the macroscopic and microscopic examination showed protective and therapeutic effects of 50 mg/kg dose of AV on acetic acid-induced colitis in rats which reduces the inflammation, ulcers and tissue damage compared with negative control (p < 0.05). There were no significant changes in the amount of water and food intake, body weight changes, and colon weight in protective and treatment groups. Based on the results, AV gel could be used to improve the symptoms of UC, as well as prevent people who are susceptible to the UC.

A Botanical-Based Equine Nutraceutical Reduces Gastric Smooth Muscle Contractile Force In Vitro

The objective of this study was to evaluate the effect of a botanical-based equine nutraceutical on contractility of gastric smooth muscle in vitro. Gastric ulcers are prevalent in performance horses and negatively impact horse welfare. Gastric hypermotility has been positively associated with the development of gastric ulceration in nonequine species, and reduction of hypermotility may be protective against their development. Stomachs from 12 pigs processed for food at a provincially inspected abattoir were collected within 1 hour of slaughter. Explants of nonglandular gastric tissue were prepared and suspended in a tissue bath, attached to a force transducer, in the presence or absence of a simulated digest extract of the nutraceutical. Tissue was stimulated to contract using increasing doses of acetylcholine. Peak and mean contractile force over 1 and 2 minutes after exposure to acetylcholine were measured. Exposure of gastric smooth muscle to the nutraceutical significantly reduced contractility of the tissue. These data provide support for the use of this nutraceutical to reduce contractility of nonglandular gastric smooth muscle and may indicate a protective effect of this nutraceutical in horses with mechanically induced gastric ulcers. Future studies are needed to clarify the role of gastric hypermotility on development of equine gastric ulcers and to determine the effect of this nutraceutical on equine gastric contractility and ulcerogenesis in vivo.

1-Deoxynojirimycin (DNJ) Ameliorates Indomethacin-Induced Gastric Ulcer in Mice by Affecting NF-kappaB Signaling Pathway

Gastric ulcer (GU) is a main threat to public health. 1-Deoxynojirimycin (DNJ) has antioxidant and anti-inflammatory properties and may prevent GU but related mechanism remains unclear. DNJ was extracted from the supernatants of Bacillus subtilis by using ethanol and purified by using CM-Sepharose chromatography. A GU mouse model was induced by indomethacin. The functional role of DNJ in GU mice was explored by measuring the main molecules in the NF-KappaB pathway. After the model establishment, 40 GU mice were evenly assigned into five categories: IG (received vehicle control), LG (10 μg DNJ daily), MG (20 μg DNJ daily), HG (40 μg DNJ daily), and RG (0.5 mg ranitidine daily). Meanwhile, eight healthy mice were assigned as a control group (CG). After 1-month therapy, weight and gastric volume were investigated. The levels of serum inflammatory cytokines (IL-6 and TNF-α), antioxidant indices [superoxide dismutase (SOD), catalase (CAT), and reduced glutathione (GSH)], and oxidant biomarker malondialdehyde (MDA) were examined via ELISA. Meanwhile, inflammatory cytokine (IL-6 and TNF-α) levels, and key molecules (NF-κB p65), cyclooxygenase 1 (COX-1 and COX2) involved in NF-κB pathway, were analyzed by using Western Blot. COX-1 and COX-2 levels were further measured by immunohistochemistry. The effects of DNJ on gastric functions were explored by measuring the changes of Motilin (MOT), Substance P (SP), Somatostatin (SS), and Vasoactive intestinal peptide (VIP) in GU mouse models with ELISA Kits. The results indicated that DNJ prevented indomethacin-caused increase of gastric volume. DNJ improved histopathology of GU mice when compared with the mice from IG group (P < 0.05). DNJ consumption decreased the levels of IL-6 and TNF-α (P < 0.05). DNJ increased antioxidant indices of GU mice by improving the activities of SOD, CAT and reduced GSH, and reduced MDA levels (P < 0.05). DNJ increased the levels of prostaglandin E2, COX-1, COX2, and reduced the levels of and NF-κB p65 (P < 0.05). DNJ showed protection for gastric functions of GU mice by reducing the levels of MOT and SP, and increasing the levels of SS and VIP. DNJ treatment inactivates NF-κB signaling pathway, and increases anti-ulceration ability of the models.