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Gut Oct 2007Standard triple therapies are the most used treatment in clinical practice. However, a critical fall in the H pylori eradication rate following these therapies has been... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Standard triple therapies are the most used treatment in clinical practice. However, a critical fall in the H pylori eradication rate following these therapies has been observed in the last few years. The sequential regimen is a novel, promising therapeutic approach.
OBJECTIVES
To evaluate the available data on the sequential therapy regimen.
METHODS
A pooled-data analysis of all studies on the sequential regimen was performed. The eradication rate was calculated according to gastroduodenal pathology, proton pump inhibitor used, antibiotic resistance, as well as setting (paediatric or geriatric patients). Compliance, side effects, and cost implications were also evaluated.
RESULTS
Overall, more than 1800 patients have been treated with the sequential regimen. Such a therapy was superior to 7-10 days triple therapies in paediatric, adult and elderly patients, achieving an eradication rate constantly higher than 90% at ITT analysis. Although primary clarithromycin resistance reduced the efficacy of such a therapy, a success rate significantly higher than that observed with the standard 7-10 days triple therapies was found.
CONCLUSION
The 10-day sequential treatment regimen achieves higher eradication rates than standard triple therapies.
Topics: Adolescent; Age Factors; Aged; Aged, 80 and over; Anti-Bacterial Agents; Anti-Ulcer Agents; Child; Child, Preschool; Drug Administration Schedule; Drug Therapy, Combination; Helicobacter Infections; Helicobacter pylori; Humans; Proton Pump Inhibitors; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 17566020
DOI: 10.1136/gut.2007.125658 -
Journal of Ethnopharmacology Apr 2011Simaba ferruginea A. St-Hil. (Simaroubaceae) is a subshrub typical of the Brazilian Cerrado, whose rhizomes are popularly used as infusion or decoction for the treatment...
RELEVANCE
Simaba ferruginea A. St-Hil. (Simaroubaceae) is a subshrub typical of the Brazilian Cerrado, whose rhizomes are popularly used as infusion or decoction for the treatment of gastric ulcers, diarrhea and fever.
AIM OF THE STUDY
To evaluate the pharmacological mechanism(s) of action of the antiulcer effects of the methanol extract of Simaba ferruginea and its alkaloid canthin-6-one.
MATERIALS AND METHODS
Rhizome of Simaba ferruginea was macerated with methanol to obtain the methanol extract (MESf) from which was obtained, the chloroform fraction. Canthin-6-one alkaloid (Cant) was purified and then isolated from the chloroform fraction (CFSf). The isolated Cant was identified by HPLC. Anti-ulcer assays were determined using ethanol and indomethacin-induced ulcer models in mice and rats respectively. In order to determine the probable mechanisms of actions of MESf and Cant animals were pretreated with l-NAME prior to anti-ulcer agent treatments and ulcer induction and nitric oxide (NO) level determined in order to assess NO involvement in the gastroprotective effects. Assays of malondialdehyde (MDA), myeloperoxidase (MPO), pro-inflammatory cytokines: interleukin 8 (IL-8) and tumor necrosis factor-alpha (TNF-α) and prostaglandin E(2) (PGE(2)) were also carried out according to previously described methods.
RESULTS
The results indicate that the antiulcerogenic effects of MESf and Cant in ethanol-induced ulcer is mediated in part through increase in the production of protective endogenous NO as the antiulcerogenic activity of MESf and Cant was reduced in animals pre-treated with l-NAME. In indomethacin-induced ulcer pre-treatment with MESf and Cant showed reduction in the levels of MPO and MDA in the gastric tissue, thus indicating the participation of the antioxidant mechanisms on the gastroprotective effects. The plasma levels of IL-8 in ulcerated rats with indomethacin were also reduced by Cant, but not by MESf, indicating that inhibition of this cytokine contributes to the gastroprotective effect of Cant. However MESf and Cant had no effect on the mucosal membrane levels of PGE(2), indicating that the gastroprotective effects of these agents is independent of PGE(2) modulation.
CONCLUSION
The results obtained in this study with MESf and Cant added insights into the pharmacological mechanisms involved in their mode of antiulcer action. The results indicate that Cant is one of the compounds responsible for these effects. Such findings are of extreme importance in the strive for future development of potent, safer and effective antiulcer agent. The efficacy of MESf and Cant in gastroprotection shows that Simaba ferruginea might be a promising antiulcer herbal medicine, in addition to confirming the popular use of this plant against gastric ulcer models utilised in this study.
Topics: Animals; Anti-Ulcer Agents; Carbolines; Cytokines; Dinoprostone; Disease Models, Animal; Indole Alkaloids; Indoles; Male; Malondialdehyde; Methanol; Naphthyridines; Peroxidase; Plant Extracts; Rats; Rats, Wistar; Simaroubaceae; Stomach Ulcer
PubMed: 21236329
DOI: 10.1016/j.jep.2011.01.009 -
Journal of Ethnopharmacology Feb 2012Campomanesia lineatifolia Ruiz and Pav. (Myrtaceae) is a native edible species found in the Amazon Rainforest, commonly known as gabiroba. In Brazil, Campomanesia...
ETHNOPHARMACOLOGICAL RELEVANCE
Campomanesia lineatifolia Ruiz and Pav. (Myrtaceae) is a native edible species found in the Amazon Rainforest, commonly known as gabiroba. In Brazil, Campomanesia species are frequently used in traditional medicine for gastrointestinal disorders.
MATERIALS AND METHODS
The present study performed phytochemical analyses and determined both the in vitro antioxidant activity of the ethanolic extract of Campomanesia lineatifolia leaves (EEC) as well as its ethyl acetate fraction (EAFC). In this analysis, quercetin was used as a positive control. Gastroprotective activity was also investigated at different oral doses in two experimental models in rats - gastric lesion induced by ethanol and gastric lesion induced by indomethacin. In this analysis, cimetidine and sucralfate were used as positive controls. The area of gastric lesion underwent macroscopic and histomorphometric evaluations, while the mucus content was estimated by applying the periodic acid-Schiff stain. Oral acute toxicity was also assessed.
RESULTS
Phytochemical studies revealed the presence of flavonoids and tannins. Catechin and quercitrin were isolated by bioguided chromatographic fractionation of EAFC. EEC and EAFC presented in vitro antioxidant activity. The oral administration of EEC and EAFC at doses 100-400 mg/kg (ethanol model) and at doses of 400-1200 mg/kg (indomethacin model) proved to be effective in preventing gastric ulcerations in rats. Pretreatment with EAFC (400mg/kg) significantly increased the gastric mucus content in the ethanol model. No animals died during the acute oral toxicology test.
CONCLUSIONS
Results confirm the Brazilian ethnopharmacological use of Campomanesia lineatifolia as a gastroprotective agent and indicate that the anti-ulcer effect is most likely mediated by scavenging free radicals due to the polyphenol content and, at least in part, by increasing the mucus secretion and the mucosal defense. In addition, EEC and EAFC were found to be safe when applied to a 2000 mg/kg single oral dose.
Topics: Animals; Anti-Ulcer Agents; Antioxidants; Brazil; Catechin; Flavonoids; Gastric Mucosa; Male; Mucus; Myrtaceae; Phytotherapy; Plant Extracts; Plant Leaves; Quercetin; Rats; Rats, Wistar; Stomach Ulcer; Tannins
PubMed: 22178179
DOI: 10.1016/j.jep.2011.12.014 -
Antimicrobial Agents and Chemotherapy Aug 2002The benzimidazole compound omeprazole, used widely for the treatment of peptic ulcer disease, inhibits the growth of Leishmania donovani, the causative agent of visceral...
The benzimidazole compound omeprazole, used widely for the treatment of peptic ulcer disease, inhibits the growth of Leishmania donovani, the causative agent of visceral leishmaniasis. Promastigotes cultured at acidic pH and amastigotes within infected macrophages are reduced 90% or more with 150 microM omeprazole. Antiparasitic action of the drug is due to its inhibition of the P-type K(+),H(+)-ATPase on the surface membrane. This enzyme is important for pH homeostasis and the maintenance of proton motive force across the membrane in Leishmania. The drug is effective only at acidic pH, a condition that mimics the in vivo environment within the phagolysosomal vesicles where the amastigote form of the parasite resides. Omeprazole deserves consideration as an alternative to currently available chemotherapeutics, which have severe toxic side effects.
Topics: Animals; Anti-Ulcer Agents; Antiprotozoal Agents; Cell Membrane; Dose-Response Relationship, Drug; H(+)-K(+)-Exchanging ATPase; Hydrogen; Hydrogen-Ion Concentration; Leishmania donovani; Macrophages, Peritoneal; Mice; Mice, Inbred CBA; Omeprazole; Proton Pump Inhibitors
PubMed: 12121934
DOI: 10.1128/AAC.46.8.2569-2574.2002 -
Cleveland Clinic Journal of Medicine Jul 2000The withdrawal of cisapride from the market will present challenges for physicians treating patients with nocturnal heartburn, gastroparesis, and dyspepsia. However,... (Review)
Review
The withdrawal of cisapride from the market will present challenges for physicians treating patients with nocturnal heartburn, gastroparesis, and dyspepsia. However, alternatives to the drug exist, and it will continue to be available under a limited-access program for patients for whom other drug treatments fail.
Topics: Anti-Ulcer Agents; Arrhythmias, Cardiac; Cisapride; Drug and Narcotic Control; Dyspepsia; Female; Gastroesophageal Reflux; Heartburn; Humans; Male; Risk Assessment; United States
PubMed: 10902234
DOI: 10.3949/ccjm.67.7.471 -
Oxidative Medicine and Cellular... 2019Ethnomedicinal studies in the Amazon community and in the Northeast region of Brazil highlight the use of fruits for the treatment of gastric problems. However, there...
Ethnomedicinal studies in the Amazon community and in the Northeast region of Brazil highlight the use of fruits for the treatment of gastric problems. However, there are no data in the literature of this pharmacological activity. Thus, the aim of this paper is to provide a scientific basis for the use of the dry extract of pods (DELfp) for the treatment of peptic ulcers. Phytochemical characterization was performed by HPLC/MS. antioxidant activity was assessed using DPPH, ABTS, phosphomolybdenum, and superoxide radical scavenging activity. The gastroprotective activity, the ability to stimulate mucus production, the antisecretory activity, and the influence of -SH and NO compounds on the antiulcerogenic activity of DELfp were evaluated. The healing activity was determined by the acetic acid-induced chronic ulcer model. Anti- activity was investigated. HPLC/MS results identified the presence of phenolic compounds, gallic acid and ellagic acid, in DELfp. The extract showed antioxidant activity . In ulcers induced by absolute ethanol and acidified ethanol, the ED values of DELfp were 113 and 185.7 mg/kg, respectively. DELfp (100, 200, and 400 mg/kg) inhibited indomethacin-induced lesions by 66.7, 69.6, and 65.8%, respectively. DELfp (200 mg/kg) reduced gastric secretion and H concentration in the gastric contents and showed to be independent of nitric oxide (NO) and dependent on sulfhydryl (-SH) compounds in the protection of the gastric mucosa. In the chronic ulcer model, DELfp reduced the area of the gastric lesion. DELfp also showed anti- activity. In conclusion, DELfp showed antioxidant, gastroprotective, healing, and antiulcerogenic activities. The mechanism of these actions seems to be mediated by different pathways and involves the reduction of gastric secretion and H concentration, dependence on sulfhydryl compounds, and anti- activity. All these actions support the medicinal use of this species in the management of peptic ulcers.
Topics: Acetic Acid; Animals; Anti-Ulcer Agents; Antioxidants; Chromatography, High Pressure Liquid; Fabaceae; Female; Gastric Mucosa; Helicobacter pylori; Mass Spectrometry; Nitric Oxide; Phenols; Plant Extracts; Rats; Rats, Wistar; Stomach Ulcer; Sulfhydryl Compounds
PubMed: 31827669
DOI: 10.1155/2019/1983137 -
The Ulster Medical Journal Jan 2006
Review
Topics: Anti-Ulcer Agents; Endoscopy, Digestive System; Gastrointestinal Hemorrhage; Humans; Retreatment; Risk Assessment; Thrombosis
PubMed: 16457402
DOI: No ID Found -
Asian Pacific Journal of Tropical... Jan 2011To investigated the antisecrectory activities of the methanol extract, chloroform fraction and methanol fraction of Picralima nitida seeds.
OBJECTIVE
To investigated the antisecrectory activities of the methanol extract, chloroform fraction and methanol fraction of Picralima nitida seeds.
METHODS
The methanol extract of Picralima nitida seeds was fractionated into chloroform fraction and methanol fraction. They were evaluated for antiulcer activity and gastric emptying time in rats using aspirin-pylorus-ligation model.
RESULTS
Oral administration of the methanol extract, chloroform fraction and methanol fraction at 1 000 mg/kg reduced gastric ulcer by 56.4%, 40.0% and 56.3%, respectively; and the fractions of the extract significantly (P<0.05) reduced gastric emptying time when compared to the control. Gastric acidity was significantly decreased when compared with saline group, 40.25 mEq/L in methanol extract, 50.0 mEq/L in chloroform fraction 51.25 mEq/L in methanol fraction but had no significant effect on the gastric secretion volume.
CONCLUSIONS
These findings showed that methanol extract, chloroform fraction and methanol fraction of the seeds of Picralima possessed potent antiulcer properties and some antisecretory properties.
Topics: Administration, Oral; Animals; Antacids; Anti-Ulcer Agents; Apocynaceae; Gastric Acidity Determination; Gastric Emptying; Mass Screening; Plant Extracts; Rats; Seeds; Time Factors; Treatment Outcome
PubMed: 21771407
DOI: 10.1016/S1995-7645(11)60023-0 -
Alimentary Pharmacology & Therapeutics May 2004To compare the pharmacokinetics and pharmacodynamics of lansoprazole 30 mg administered intravenously in 0.9% NaCl or in polyethylene glycol, or orally. (Clinical Trial)
Clinical Trial Comparative Study Randomized Controlled Trial
AIM
To compare the pharmacokinetics and pharmacodynamics of lansoprazole 30 mg administered intravenously in 0.9% NaCl or in polyethylene glycol, or orally.
METHODS
Twenty-nine subjects received lansoprazole orally on days 1-7 and intravenous lansoprazole in NaCl on days 8-14. Blood samples were collected on days 1, 7, 8 and 14. Fasting basal acid output and pentagastrin-stimulated maximal acid output were determined on days -1, 8, 9 and 15. Thirty-six different subjects received one of four regimen sequences: intravenous lansoprazole in NaCl, intravenous in polyethylene glycol, per orally, or intravenous placebo, each for 5 days. Twenty-four hour intragastric pH was recorded on days 1 and 5.
RESULTS
Intravenous and per oral lansoprazole for 7 days produced equivalent basal acid output and maximal acid output suppression. Pharmacokinetics and mean pH values with intravenous lansoprazole in NaCl or polyethylene glycol were equivalent. Both produced mean pH and percentages of time pH above 3, 4, 5 and 6 that were significantly greater than did per orally.
CONCLUSIONS
Intravenous lansoprazole inhibits acid secretion as effectively in NaCl as in polyethylene glycol, and its onset of action is faster than per oral lansoprazole.
Topics: 2-Pyridinylmethylsulfinylbenzimidazoles; Administration, Oral; Anti-Ulcer Agents; Chlorates; Cross-Over Studies; Drug Carriers; Ethylene Glycol; Female; Gastric Acid; Humans; Infusions, Intravenous; Lansoprazole; Male; Omeprazole
PubMed: 15142201
DOI: 10.1111/j.1365-2036.2004.01942.x -
British Medical Journal (Clinical... Oct 1984
Topics: Anti-Ulcer Agents; Duodenal Ulcer; Humans; Time Factors
PubMed: 6435789
DOI: 10.1136/bmj.289.6452.1095