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Schleimhautschutz und Ulkusheilung durch Antacida

  • A. Tarnawski
  • H. Gergely
  • T. G. Douglass
Chapter

Zusammenfassung

Aluminiumhaltige Antacida können die Magenschleimhäute gegen verschiedene ulzerogene und nekrotisierende Agenzien, zu denen auch 0,6 M HC1 und absoluter Alkohol zählen, schützen. Da eine durch Alkohol hervorgerufene Magenschleimhautnekrose nicht von der Magensäure abhängt und nicht durch H2-Rezeptorantagonisten vermindert werden kann, wird die schützende Wirkung der Antacida nicht durch die Fähigkeit zur Säureneutralisierung hervorgerufen, sondern durch andere Mechanismen. Da angesäuerte Antacida die Magenschleimhaut sogar wirksamer schützen können als Antacida mit intakter Neutralisierungsfähigkeit, wird deutlich, daß dieser Mechanismus nicht von der Neutralisierungskapazität abhängt und daher alle Merkmale eines zytoprotektiven Effektes aufweist. Während die Mechanismen des durch Antacida induzierten Schleimhautschutzes nicht bekannt sind, wird angenommen, daß die Stimulierung der Mukus-, Bikarbonat- und Prostaglandinsekretion die Schutzwirkung vermittelt.

Die Angiogenese—die Bildung neuer Mikrogefäße—spielt bei der Wundheilung und Geweberegeneration eine wichtige Rolle. Interessanterweise konnte Maalox 70 die Gefäßbildung in durch Äthanol akut verletzten Magenschleimhäuten signifikant stimulieren, und zwar in einem vergleichbaren Ausmaß wie saurer Fibrolasten-Wachstumsfaktor. Darüber hinaus konnte Maalox 70 die inhibitorische Wirkung von Indometacin auf die Angiogenese in Magenschleimhautläsionen aufheben. Neue experimentelle Daten zeigen, daß aluminiumhaltige Antacida (Maalox 70) nicht nur die Heilung experimentell ausgelöster Magengeschwüre beschleunigen können, sondern auch die qualitative Wiederherstellung der Schleimhautarchitektur verbessern. Ein direkter Vergleich zwischen einer Behandlung mit Maalox 70 und Omeprazol machte deutlich, daß ersteres zu einer qualitativ besseren Ulkusausheilung führte.

Mucosal protection and ulcer healing by antacids

Abstract

Aluminum-containing antacids are able to protect the gastric mucosa against various ulcerogenic and necrotizing agents including 0.6 M HCl and absolute alcohol. Since gastric mucosal necrosis produced by alcohol is independent of luminal acid and cannot be reduced by H2-receptor antagonists, the protective action of antacids is accomplished by mechanism(s) other than acid-neutralizing ability. In addition, since acidified antacids can protect the gastric mucosa even more effectively than an antacid with intact neutralizing ability, it is clear that such action is independent of acid-neutralizing ability and therefore has all the features of cytoprotection. While the mechanisms of antacid-induced mucosal protection are not known, stimulation of mucus, bicarbonate and prostaglandin secretion are suggested to mediate protective action.

Angiogenesis — the formation of new microvessels — plays an important role in wound healing and tissue regeneration. Interestingly, Maalox 70 was found to significantly stimulate angiogenesis in gastric mucosa injured acutely by ethanol, at a rate comparable to that induced by acidic fibroblast growth factor. Moreover, Maalox 70 was able to overcome the inhibitory action of indomethacin on angiogenesis in injured gastric mucosa. New experimental data indicate that aluminum containing antacid (Maalox 70) not only accelerates healing of experimental gastric ulcer but also improves the quality of mucosal architecture reconstruction. Direct comparison of Maalox 70 and omeprazole treatment demonstrated that the former provided much better quality of ulcer healing than the omeprazole.

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Copyright information

© Springer Fachmedien Wiesbaden 1992

Authors and Affiliations

  • A. Tarnawski
    • 1
    • 2
  • H. Gergely
    • 1
    • 2
  • T. G. Douglass
    • 1
    • 2
  1. 1.Dept. of Medicine/Gastroenterology Veterans Administration Medical CenterUniversity of CaliforniaIrvineUSA
  2. 2.California State UniversityLong BeachUSA

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