Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used as anti-inflammatory and analgesic agents. However, they often cause gastrointestinal injury in gastric lesions by inhibiting COX (cyclooxygenase) and detailed mechanism remains unclear. Thus, effective strategies are required to protect the gastrointestinal mucosa.
A research article to be published on February 28, 2009 in the World Journal of Gastroenterology addresses this question. The research team led by Dr. Choi from Korea Institute of Oriental Medicine investigated the protective effects of acupuncture against NSAID-induced ulceration in a rat model.
In their study, 72 rats were randomly divided into three groups including control (administered with distilled water), ASA group (administered 100 mg/kg ASA) and EA group (administered EA + 100 mg/kg ASA). Each rat was fasted for 18 to 24hours before experimentation, and lesion scores, gastric acidity, cyclooxygenase (COX)-1 and -2 mRNA levels, and total nitric oxide (NO) concentration were measured.
They found that the lesion scores of the EA group were significantly lower than those of the NSAID-induced ulceration group. Gastric acidity of NSAID-induced ulceration group and EA group was reduced as compared to the control group. COX-1 and -2 mRNA levels were significantly increased in the EA group as compared to the control and NSAID-induced ulceration group, and NO levels were also significantly increased in the EA group as compared to the NSAID-induced ulceration group.
The inducible expression of COX-1 in the early phase and COX-2 in the late phase suggests that EA pretreatment might up-regulate the mucosal defense mechanism. The total NO concentration in the EA group was significantly increased with respect to that of the NSAID-induced ulceration group. The total NO likely protected the gastric mucosa against NSAID-induced toxicity. In conclusion, EA-mediated protection against ASA-induced ulceration in rats may occur via gastric defense components.
By understanding the time-dependent expression of COX by EA pretreatment, this study may represent a future strategy for acupuncture therapeutic intervention in the treatment of patients with gastritis by Non-steroidal anti-inflammatory drugs.