131530 20240212142201.0 doi 10.1053/j.gastro.2017.10.049 sideral 104937 ART-2018-104937 eng Bjarnason, I. Mechanisms of Damage to the Gastrointestinal Tract From Nonsteroidal Anti-Inflammatory Drugs 2018 Nonsteroidal anti-inflammatory drugs (NSAIDs) can damage the gastrointestinal tract, causing widespread morbidity and mortality. Although mechanisms of damage involve the activities of prostaglandin-endoperoxide synthase 1 (PTGS1 or cyclooxygenase [COX] 1) and PTGS1 (COX2), other factors are involved. We review the mechanisms of gastrointestinal damage induction by NSAIDs via COX-mediated and COX-independent processes. NSAIDs interact with phospholipids and uncouple mitochondrial oxidative phosphorylation, which initiates biochemical changes that impair function of the gastrointestinal barrier. The resulting increase in intestinal permeability leads to low-grade inflammation. NSAID inhibition of COX enzymes, along with luminal aggressors, results in erosions and ulcers, with potential complications of bleeding, protein loss, stricture formation, and perforation. We propose a model for NSAID-induced damage to the gastrointestinal tract that includes these complex, interacting, and inter-dependent factors. This model highlights the obstacles for the development of safer NSAIDs. info:eu-repo/semantics/closedAccess All rights reserved http://www.europeana.eu/rights/rr-f/ 19.233 2018 GASTROENTEROLOGY & HEPATOLOGY 2 / 84 = 0.024 2018 Q1 T1 7.384 2018 Hepatology 2018 Q1 Gastroenterology 2018 Q1 info:eu-repo/semantics/review info:eu-repo/semantics/publishedVersion Scarpignato, C. Holmgren, E. Olszewski, M. Rainsford, K.D. Lanas, A. Universidad de Zaragoza (orcid)0000-0001-5932-2889 1007 610 Universidad de Zaragoza Dpto. Medicina, Psiqu. y Derm. Area Medicina 154, 3 (2018), 500-514 Gastroenterology Gastroenterology 0016-5085 1810252 http://zaguan.unizar.es/record/131530/files/texto_completo.pdf Versión publicada 3207613 http://zaguan.unizar.es/record/131530/files/texto_completo.jpg?subformat=icon icon Versión publicada oai:zaguan.unizar.es:131530 articulos driver 2024-02-12-13:53:56 ARTICLE