STW 5 is effective against nonsteroidal anti-inflammatory drugs induced gastro-duodenal lesions in rats

World J Gastroenterol. 2019 Oct 21;25(39):5926-5935. doi: 10.3748/wjg.v25.i39.5926.

Abstract

Background: Proton pump inhibitors are often used to prevent gastro-intestinal lesions induced by nonsteroidal anti-inflammatory drugs. However, they are not always effective against both gastric and duodenal lesions and their use is not devoid of side effects.

Aim: To explore the mechanisms mediating the clinical efficacy of STW 5 in gastro-duodenal lesions induced by nonsteroidal anti-inflammatory drugs (NSAIDs), exemplified here by diclofenac, in a comparison to omeprazole.

Methods: Gastro-duodenal lesions were induced in rats by oral administration of diclofenac (5 mg/kg) for 6 successive days. One group was given concurrently STW 5 (5 mL/kg) while another was given omeprazole (20 mg/kg). A day later, animals were sacrificed, stomach and duodenum excised and divided into 2 segments: One for histological examination and one for measuring inflammatory mediators (tumor necrosis factor α, interleukins-1β and 10), oxidative stress enzyme (heme oxygenase-1) and apoptosis regulator (B-cell lymphoma 2).

Results: Diclofenac caused overt histological damage in both tissues, associated with parallel changes in all parameters measured. STW 5 and omeprazole effectively prevented these changes, but STW 5 superseded omeprazole in protecting against histological damage, particularly in the duodenum.

Conclusion: The findings support the therapeutic usefulness of STW 5 and its superiority over omeprazole as adjuvant therapy to NSAIDs to protect against their possible gastro-duodenal side effects.

Keywords: Diclofenac; Gastro-intestinal lesions; Inflammation; Omeprazole; STW 5.

MeSH terms

  • Animals
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
  • Diclofenac / adverse effects
  • Disease Models, Animal
  • Duodenal Ulcer / chemically induced
  • Duodenal Ulcer / drug therapy*
  • Duodenal Ulcer / pathology
  • Duodenum / drug effects
  • Duodenum / pathology
  • Female
  • Gastric Mucosa / drug effects
  • Gastric Mucosa / pathology
  • Humans
  • Intestinal Mucosa / drug effects
  • Intestinal Mucosa / pathology
  • Plant Extracts / administration & dosage*
  • Protective Agents / administration & dosage*
  • Rats
  • Rats, Wistar
  • Stomach Ulcer / chemically induced
  • Stomach Ulcer / drug therapy*
  • Stomach Ulcer / pathology
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Plant Extracts
  • Protective Agents
  • iberogast
  • Diclofenac