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[Mechanisms of direct gastric mucosal damage by NSAIDs].

Authors
  • Kobayashi, Takeaki
  • Yabana, Tsuyoshi
Type
Published Article
Journal
Nihon rinsho. Japanese journal of clinical medicine
Publication Date
Oct 01, 2007
Volume
65
Issue
10
Pages
1803–1806
Identifiers
PMID: 17926527
Source
Medline
License
Unknown

Abstract

Since gastric mucosal membrane, that is the most important part of mucosal barrier, is a lipid-protein layer, ionized and water-soluble NSAIDs are restricted in their transport. In the highly acidic condition of gastric juice, however most of NSAIDs are non-ionized and fat-soluble, dissolve rapidly in lipid-protein layer, and is rapidly absorbed from the acid gastric contents. Within the gastric mucosal cells in neutral condition, NSAIDs are ionized and H+ ions are released. Intracellular NSAIDs cause impairment of gastric mucosal barrier by reduction and alteration of mucous secretion and/or reduction of mucosal ATP. Intracellular H+ ions provoke the mast cells to release histamine which causes mucosal micro-vascular damage. Finally, auto-digestion by gastric juice in this impaired mucosa makes the variegated mucosal lesions.

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