FEATURES OF CHANGES IN THE GASTRIC MUCOSAL PROTECTIVE BARRIER DURING COMBINED ADMINISTRATION OF INDOMETHACIN WITH ENALAPRIL, OMEPRAZOLE, AND FAMOTIDINE
Abstract
As is well known, the relationship between the acid-peptic factor and the condition of the gastric protective barrier plays a crucial role in the mechanisms of damage to the gastroduodenal mucosa. It has been established that NSAID-induced gastropathies are invariably accompanied by increased acid-peptic aggression and impaired protective properties of the gastroduodenal mucosal barrier. Therefore, the treatment of NSAID-induced gastropathies should be aimed both at suppressing acid-peptic aggression and at stimulating protective mechanisms. Unfortunately, the issue of enhancing the protective properties of the mucosal barrier remains unresolved. The use of synthetic prostaglandins for this purpose is still insufficiently studied, while their high cost and frequent adverse effects often limit their clinical application. Considerable progress has been achieved in suppressing acid-peptic aggression through the use of H2-histamine receptor antagonists and proton pump inhibitors. However, their efficacy has mainly been investigated from the standpoint of acid suppression, whereas their effects on the gastric mucosal protective barrier remain inadequately studied.
References
1. Lowry O.H., Rosebrough N.J., Farr A.L., Randall R.J. Protein measurement with the folin phenol reagent. J Biol Chem. 1951;193(1):265–275.
2. Gottschalk A. Glycoproteins. Amsterdam: Elsevier; 1969. P. 228–331.
3. Linevik L.I. Advances in Biological Chemistry. Moscow; 1962. Vol. 4. 193 p.
4. Rabinovich P.D., Milyushkin P.V. Biological oxidation and basic gastric functions in peptic ulcer disease. Terapevticheskii Arkhiv. 1979;(11):103–105.
5. Vatier J., Poitevin C., Mignoum K. Sialic acid as a marker of gastric mucus glycoprotein proteolysis. Gastroenterol Clin Biol. 1985;9(12):108–110.
6. Khamraev A.A. Helicobacter pylori infection and gastric mucosal barrier protection. Doctoral dissertation. Tashkent; 2005.
7. Yakubov A.V., Khamraev A.A. Influence of triple therapy on insoluble gastric glycoproteins. Conference proceedings. Tashkent; 2005:218–219.
8. Lazebnik L.B., et al. NSAID-induced gastroenteropathies: prevention and treatment guidelines. Experimental and Clinical Gastroenterology. 2024;235(3):7–32.
9. Bakulin I.G., et al. Rebamipide: thirty years of clinical use. Terapevticheskii Arkhiv. 2024;96(12):1217–1222.
10. Jia X., He Y., Li L., Xu D. Pharmacological targeting of gastric mucosal barrier. Frontiers in Pharmacology. 2023;14:1091530.
11. Yamate S., et al. Continuous co-prescription of rebamipide prevents upper gastrointestinal bleeding in NSAID users. PLOS ONE. 2024.
12. Garegnani L., et al. Proton pump inhibitors for prevention of NSAID-induced ulcers. Cochrane Database Syst Rev. 2025;5: CD014585.
