Effect of vitamin C-releasing acetylsalicylic acid on gastric mucosal damage before and after Helicobacter pylori eradication therapy

• Published in: European journal of pharmacology Vol. 506; no. 2; pp. 169 - 177
• Main Authors: Konturek, Peter C., Kania, Joanna, Gessner, Uwe, Konturek, Stanisƚaw J., Hahn, Eckhart G., Konturek, Jan W.
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier B.V 15.12.2004; Elsevier
• Subjects: Acetylsalicylic acid; Adolescent; Adult; Anti-Inflammatory Agents, Non-Steroidal - pharmacology; Antioxidant enzyme; Ascorbic Acid - pharmacology; Aspirin - pharmacology; Biological and medical sciences; Blotting, Western; Catalase - biosynthesis; Catalase - genetics; Cytokines - metabolism; Female; Gastric Mucosa - pathology; Gastrointestinal Hemorrhage - pathology; Gene Expression Regulation, Enzymologic - drug effects; Glutathione Peroxidase - biosynthesis; Glutathione Peroxidase - genetics; Helicobacter Infections - drug therapy; Helicobacter Infections - pathology; Humans; Male; Medical sciences; NF-kappa B - metabolism; Nitric Oxide Synthase - biosynthesis; Nitric Oxide Synthase - genetics; Nitric Oxide Synthase Type II; Pharmacology. Drug treatments; Proinflammatory cytokine; Reverse Transcriptase Polymerase Chain Reaction; Stomach Ulcer - pathology; Superoxide Dismutase - biosynthesis; Superoxide Dismutase - genetics; Vitamin C; Acetylsalicylic acid; Antioxidant enzyme; Proinflammatory cytokine; Vitamin C; Prostaglandin-endoperoxide synthase; Stomach; Spirillales; Digestive system; Enzyme; Vitamin; Enzyme inhibitor; Spirillaceae; Antiplatelet agent; Non steroidal antiinflammatory agent; Analgesic; Treatment; Helicobacter pylori; Antipyretic; Bacteria; Oxidoreductases; Salicylates; Lesion
• ISSN: 0014-2999; 1879-0712
• DOI: 10.1016/j.ejphar.2004.10.048

The interaction between Helicobacter pylori ( H. pylori) and nonsteroidal anti-inflammatory drugs (NSAIDs) such as acetylsalicylic acid is still controversial. This study was designed to compare the effect of acetylsalicylic acid and vitamin C-releasing acetylsalicylic acid on the gastric mucosal damage and microbleeding before and after eradication of H. pylori in 10 young healthy volunteers. Acetylsalicylic acid induced significantly more gastric lesions and higher microbleeding than acetylsalicylic acid–vitamin C. After successful H. pylori eradication therapy, acetylsalicylic acid induced significantly higher mucosal lesions and microbleeding than before eradication. In contrast, after acetylsalicylic acid–vitamin C, gastric lesion index was significantly lower and eradication therapy failed to aggravate it. All H. pylori-positive subjects showed significant up-regulation of antioxidant enzyme (superoxide dismutase, catalase, glutathione peroxidase). Plain acetylsalicylic acid stronger than acetylsalicylic acid–vitamin C reduced gastric gene expression of these antioxidant enzymes. H. pylori eradication significantly decreased expression of these enzymes and this was further enhanced by plain acetylsalicylic acid, but not acetylsalicylic acid–vitamin C. Under plain acetylsalicylic acid therapy, the expression of proinflammatory cytokines was increased before and after eradication of H. pylori. We conclude that vitamin C combined with acetylsalicylic acid, unlike plain acetylsalicylic acid without vitamin C, protects gastric mucosa in man probably due the attenuation of oxidative stress and proinflammatory cytokines.