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Oxidative damages are critical in pathogenesis of reflux esophagitis: implication of antioxidants in its treatment

Oh, TY; Lee, JS; Ahn, BO; Cho, H; Kim, WB; Kim, YB; Surh, YJ; Cho, SW; Hahm, KB
Free radical biology & medicine, 30(8):905-915, 2001
Journal Title
Free radical biology & medicine
BACKGROUND: The facts that the severity of reflux esophagitis cannot be accurately predicted on the basis of acid exposure and acid suppression treatment is not enough for the complete healing, suggested that other damaging factors might be involved in pathogenesis of reflux esophagitis.

AIMS: The present study was designed to evaluate the oxidative stress as the major pathogenic factor of reflux esophagitis and the importance of antioxidant in treatment of reflux esophagitis.

MATERIALS AND METHODS: Reflux esophagitis was induced by the insertion of small caliber ring (3 mm in diameter) into the duodenum 1 cm distal to the ligament of Treitz in rats. Results: DA-9601, a novel antioxidant substance, attenuated the gross esophagitis significantly compared to that treated with ranitidine, histamine-2 receptor antagonist (H2-RA), in a dose-dependent manner. Severe, hemorrhagic, and longitudinal ulcerations were developed in H2-RA pretreated group, whereas mildly scattered erosions were observed in antioxidant-pretreated group. Significantly increased amounts of malondialdehyde (MDA), increased NF-kappaB activation, and the mucosal depletion of reduced glutathione (GSH) were observed in the esophagus of reflux esophagitis. H2-RA treatment didn't affect the levels of GSH and MDA, whereas DA-9601 attenuated the decrement of the GSH levels and significantly decreased lipid peroxides in the esophagus. Antioxidants treatment showed significant reductions in the activation of NF-kappaB, inflammation-associated transcription factor, especially p50 component in accordance with significant higher levels of NF-kappaB repressor, IkappaBalpha expression.

CONCLUSION: Oxygen-derived free radicals seem to be one of the important mediators in generation of reflux esophagitis, which suggests that the combination of antioxidant and anti-secretory medications will be ideal and more beneficial in the prevention and treatment of reflux esophagitis than currently prescribed antisecretory treatment alone.
MeSH terms
AnimalsAnti-Ulcer Agents/pharmacologyAnti-Ulcer Agents/therapeutic useAntioxidants/pharmacologyAntioxidants/therapeutic use*Blotting, WesternCyclooxygenase 2DNA/geneticsDNA/metabolismDNA-Binding Proteins/metabolismElectrophoresis, Polyacrylamide GelEsophagitis, Peptic/drug therapy*Esophagitis, Peptic/etiologyEsophagitis, Peptic/metabolism*Esophagitis, Peptic/pathologyEsophagus/drug effectsEsophagus/enzymologyEsophagus/metabolismEsophagus/pathology*Gastric Acid/metabolismGlutathione/metabolismI-kappa B Proteins*Inflammation/drug therapyInflammation/metabolismInflammation/pathologyIsoenzymes/metabolismLipid Peroxides/metabolismMaleMalondialdehyde/metabolismNF-kappa B/metabolismNitric Oxide Synthase/metabolismNitric Oxide Synthase Type IIOxidative Stress*/drug effectsPharmaceutical PreparationsPlant Extracts/pharmacologyPlant Extracts/therapeutic useProstaglandin-Endoperoxide Synthases/metabolismRanitidine/pharmacologyRanitidine/therapeutic useRatsRats, Sprague-Dawley
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Pathology
Journal Papers > School of Medicine / Graduate School of Medicine > Gastroenterology
AJOU Authors
김, 영배조, 성원함, 기백
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