Gastric Damage by Drugs and the Role of the Mucosal Barrier

Cimetidine decreases indomethacin induced duodenal mucosal damage in patients with acute musculoskeletal disorders

The effect of two doses of cimetidine, 400 mg at night and 400 mg bd, on the protection of indomethacin (50 mg tid) induced mucosal damage was evaluated in a double blind study in patients with acute musculoskeletal disorders. Endoscopic mucosal lesions were scored before and after five to seven days of treatment. One hundred and ninety one patients were endoscoped before the trial, 34 (17.8%) had greater than one erosion and were not recruited. Forty patients were excluded for non-compliance, or lost to follow up. At the second endoscopy, oesophageal, and fundic damage was negligible. Gastric and duodenal lesion score in patients treated with cimetidine 400 mg bd: 2.7 (0.5) (SE); n = 42) was significantly lower (p less than 0.0122) than in placebo treated patients: 6.1 (0.9) (n = 50) or in patients treated with cimetidine 400 mg at night 7.1 (0.8) (n = 21). Cimetidine 400 mg bd provided significant protection for the duodenum, but its protection of antral mucosa did not reach statistical significance. There was no correlation between upper gastrointestinal symptoms and endoscopic findings.

Beneficial effects of methionine and histidine in aspirin solutions on gastric mucosal damage in rats

Amino acids methionine and histidine, which are soluble in propylene glycol, were investigated for their purported beneficial effects on aspirin-induced gastric mucosal damage in the rat. The pathognomonic changes observed microscopically in the fundic region of the stomach of animals administered daily doses (100 mg/kg), for up to 15 days, of aspirin solutions (0.36 M) in propylene glycol incorporated with the amino acids were compared with those of animals given equivalent quantities of aspirin in an aqueous suspension combined with an aluminum hydroxide antacid. A "delayed" onset of aspirin-induced cellular damage due to the presence of amino acids, analogous to that associated with the use of antacids, was found as determined partly by differences in the staining ability of injured cells with hematoxylin and eosin.