Skip to main content
Gut logoLink to Gut
. 1994 Jul;35(7):909–915. doi: 10.1136/gut.35.7.909

Pentoxifylline prevents indomethacin induced acute gastric mucosal damage in rats: role of tumour necrosis factor alpha.

L Santucci 1, S Fiorucci 1, M Giansanti 1, P M Brunori 1, F M Di Matteo 1, A Morelli 1
PMCID: PMC1374837  PMID: 8063218

Abstract

Neutrophil adherence within the gastric microcirculation is thought to be a major step in the pathogenesis of gastric mucosal damage induced by indomethacin. Pentoxifylline, a methylxanthine derivative, prevents leukocyte adherence to vascular endothelium and protects organs from shock by reducing tumour necrosis factor alpha (TNF alpha) concentrations. Rats were treated with 20 mg/kg oral indomethacin, pretreated with vehicle or with four different doses of pentoxifylline intraperitoneally, and killed after three hours. The gross gastric mucosal injury, neutrophil margination into the gastric microcirculation, mucosal concentrations of 6-keto-prostaglandin F1 alpha (PGF1 alpha), and PGE2 and serum TNF alpha values were measured. Whether the pentoxifylline induced protection involved nitric oxide mediated pathways or gastric acid secretion was evaluated. The data indicate that pentoxifylline reduces indomethacin induced mucosal damage and neutrophil margination in a dose dependent manner without exerting any effect on gastric mucosal prostaglandin concentrations. The maximally effective dose (200 mg/kg) of pentoxifylline reduced gastric damage by 90% and slightly stimulated acid secretion. The effect of pentoxifylline was not affected by pretreatment with the nitric oxide inhibitor. Pentoxifylline prevented the indomethacin induced increase in TNF alpha concentrations in a dose dependent fashion. Serum TNF alpha values were 30.5 (7.0) IU/ml (mean (SEM)) in rats treated with indomethacin alone and 5.0 (2.5) IU/ml (p < 0.01) in rats treated with indomethacin plus 200 mg/kg pentoxifylline. Pentoxifylline, therefore, prevents the acute gastric mucosal damage and neutrophil margination induced by indomethacin and reduces indomethacin induced release of TNF alpha.

Full text

PDF
909

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Birdsall H. H. Induction of ICAM-1 on human neural cells and mechanisms of neutrophil-mediated injury. Am J Pathol. 1991 Dec;139(6):1341–1350. [PMC free article] [PubMed] [Google Scholar]
  2. Doherty G. M., Jensen J. C., Alexander H. R., Buresh C. M., Norton J. A. Pentoxifylline suppression of tumor necrosis factor gene transcription. Surgery. 1991 Aug;110(2):192–198. [PubMed] [Google Scholar]
  3. Dustin M. L., Springer T. A. T-cell receptor cross-linking transiently stimulates adhesiveness through LFA-1. Nature. 1989 Oct 19;341(6243):619–624. doi: 10.1038/341619a0. [DOI] [PubMed] [Google Scholar]
  4. Edwards M. J., Abney D. L., Miller F. N. Pentoxifylline inhibits interleukin-2-induced leukocyte-endothelial adherence and reduces systemic toxicity. Surgery. 1991 Aug;110(2):199–204. [PubMed] [Google Scholar]
  5. Farman N., Pradelles P., Bonvalet J. P. PGE2, PGF2 alpha, 6-keto-PGF1 alpha, and TxB2 synthesis along the rabbit nephron. Am J Physiol. 1987 Jan;252(1 Pt 2):F53–F59. doi: 10.1152/ajprenal.1987.252.1.F53. [DOI] [PubMed] [Google Scholar]
  6. Ferreri N. R., Sarr T., Askenase P. W., Ruddle N. H. Molecular regulation of tumor necrosis factor-alpha and lymphotoxin production in T cells. Inhibition by prostaglandin E2. J Biol Chem. 1992 May 5;267(13):9443–9449. [PubMed] [Google Scholar]
  7. Fieren M. W., van den Bemd G. J., Ben-Efraim S., Bonta I. L. Prostaglandin E2 inhibits the release of tumor necrosis factor-alpha, rather than interleukin 1 beta, from human macrophages. Immunol Lett. 1992 Jan;31(1):85–90. doi: 10.1016/0165-2478(92)90015-g. [DOI] [PubMed] [Google Scholar]
  8. Flynn W. J., Cryer H. G., Garrison R. N. Pentoxifylline restores intestinal microvascular blood flow during resuscitated hemorrhagic shock. Surgery. 1991 Aug;110(2):350–356. [PubMed] [Google Scholar]
  9. Ivey K. J. Mechanisms of nonsteroidal anti-inflammatory drug-induced gastric damage. Actions of therapeutic agents. Am J Med. 1988 Feb 22;84(2A):41–48. doi: 10.1016/0002-9343(88)90253-7. [DOI] [PubMed] [Google Scholar]
  10. Kettelhut I. C., Fiers W., Goldberg A. L. The toxic effects of tumor necrosis factor in vivo and their prevention by cyclooxygenase inhibitors. Proc Natl Acad Sci U S A. 1987 Jun;84(12):4273–4277. doi: 10.1073/pnas.84.12.4273. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Kitahora T., Guth P. H. Effect of aspirin plus hydrochloric acid on the gastric mucosal microcirculation. Gastroenterology. 1987 Oct;93(4):810–817. doi: 10.1016/0016-5085(87)90444-6. [DOI] [PubMed] [Google Scholar]
  12. Lau A. S., Livesey J. F. Endotoxin induction of tumor necrosis factor is enhanced by acid-labile interferon-alpha in acquired immunodeficiency syndrome. J Clin Invest. 1989 Sep;84(3):738–743. doi: 10.1172/JCI114231. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. LeMay L. G., Vander A. J., Kluger M. J. The effects of pentoxifylline on lipopolysaccharide (LPS) fever, plasma interleukin 6 (IL 6), and tumor necrosis factor (TNF) in the rat. Cytokine. 1990 Jul;2(4):300–306. doi: 10.1016/1043-4666(90)90032-o. [DOI] [PubMed] [Google Scholar]
  14. Lee M., Aldred K., Lee E., Feldman M. Aspirin-induced acute gastric mucosal injury is a neutrophil-dependent process in rats. Am J Physiol. 1992 Dec;263(6 Pt 1):G920–G926. doi: 10.1152/ajpgi.1992.263.6.G920. [DOI] [PubMed] [Google Scholar]
  15. Marcinkiewicz J. In vitro cytokine release by activated murine peritoneal macrophages: role of prostaglandins in the differential regulation of tumor necrosis factor alpha, interleukin 1, and interleukin 6. Cytokine. 1991 Jul;3(4):327–332. doi: 10.1016/1043-4666(91)90501-4. [DOI] [PubMed] [Google Scholar]
  16. Martich G. D., Parker M. M., Cunnion R. E., Suffredini A. F. Effects of ibuprofen and pentoxifylline on the cardiovascular response of normal humans to endotoxin. J Appl Physiol (1985) 1992 Sep;73(3):925–931. doi: 10.1152/jappl.1992.73.3.925. [DOI] [PubMed] [Google Scholar]
  17. Oka Y., Murata A., Nishijima J., Hiraoka N., Yasuda T., Kitagawa K., Ogawa M., Mori T. Inhibitory effect of pentoxifylline and prostaglandin E1 on the release of neutrophil elastase from FMLP-stimulated neutrophils. J Med. 1991;22(6):371–382. [PubMed] [Google Scholar]
  18. Pohlman T. H., Stanness K. A., Beatty P. G., Ochs H. D., Harlan J. M. An endothelial cell surface factor(s) induced in vitro by lipopolysaccharide, interleukin 1, and tumor necrosis factor-alpha increases neutrophil adherence by a CDw18-dependent mechanism. J Immunol. 1986 Jun 15;136(12):4548–4553. [PubMed] [Google Scholar]
  19. Pradelles P., Grassi J., Maclouf J. Enzyme immunoassays of eicosanoids using acetylcholine esterase as label: an alternative to radioimmunoassay. Anal Chem. 1985 Jun;57(7):1170–1173. doi: 10.1021/ac00284a003. [DOI] [PubMed] [Google Scholar]
  20. Redfern J. S., Lee E., Feldman M. Effect of indomethacin on gastric mucosal prostaglandins in humans. Correlation with mucosal damage. Gastroenterology. 1987 Apr;92(4):969–977. doi: 10.1016/0016-5085(87)90972-3. [DOI] [PubMed] [Google Scholar]
  21. Remick D. G., Kunkel R. G., Larrick J. W., Kunkel S. L. Acute in vivo effects of human recombinant tumor necrosis factor. Lab Invest. 1987 Jun;56(6):583–590. [PubMed] [Google Scholar]
  22. Sayers T. J., Wiltrout T. A., Bull C. A., Denn A. C., 3rd, Pilaro A. M., Lokesh B. Effect of cytokines on polymorphonuclear neutrophil infiltration in the mouse. Prostaglandin- and leukotriene-independent induction of infiltration by IL-1 and tumor necrosis factor. J Immunol. 1988 Sep 1;141(5):1670–1677. [PubMed] [Google Scholar]
  23. Spatafora M., Chiappara G., D'Amico D., Volpes D., Melis M., Pace E., Merendino A. Effect of indomethacin on the kinetics of tumour necrosis factor alpha release and tumour necrosis factor alpha gene expression by human blood monocytes. Pharmacol Res. 1991 Apr;23(3):247–257. doi: 10.1016/s1043-6618(05)80084-2. [DOI] [PubMed] [Google Scholar]
  24. Thiel M., Bardenheuer H., Pöch G., Madel C., Peter K. Pentoxifylline does not act via adenosine receptors in the inhibition of the superoxide anion production of human polymorphonuclear leukocytes. Biochem Biophys Res Commun. 1991 Oct 15;180(1):53–58. doi: 10.1016/s0006-291x(05)81253-7. [DOI] [PubMed] [Google Scholar]
  25. Tracey K. J., Beutler B., Lowry S. F., Merryweather J., Wolpe S., Milsark I. W., Hariri R. J., Fahey T. J., 3rd, Zentella A., Albert J. D. Shock and tissue injury induced by recombinant human cachectin. Science. 1986 Oct 24;234(4775):470–474. doi: 10.1126/science.3764421. [DOI] [PubMed] [Google Scholar]
  26. Vedder N. B., Winn R. K., Rice C. L., Chi E. Y., Arfors K. E., Harlan J. M. A monoclonal antibody to the adherence-promoting leukocyte glycoprotein, CD18, reduces organ injury and improves survival from hemorrhagic shock and resuscitation in rabbits. J Clin Invest. 1988 Mar;81(3):939–944. doi: 10.1172/JCI113407. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Wallace J. L., Arfors K. E., McKnight G. W. A monoclonal antibody against the CD18 leukocyte adhesion molecule prevents indomethacin-induced gastric damage in the rabbit. Gastroenterology. 1991 Apr;100(4):878–883. doi: 10.1016/0016-5085(91)90259-n. [DOI] [PubMed] [Google Scholar]
  28. Wallace J. L., Keenan C. M., Cucala M., Mugridge K. G., Parente L. Mechanisms underlying the protective effects of interleukin 1 in experimental nonsteroidal anti-inflammatory drug gastropathy. Gastroenterology. 1992 Apr;102(4 Pt 1):1176–1185. [PubMed] [Google Scholar]
  29. Wallace J. L., Keenan C. M., Granger D. N. Gastric ulceration induced by nonsteroidal anti-inflammatory drugs is a neutrophil-dependent process. Am J Physiol. 1990 Sep;259(3 Pt 1):G462–G467. doi: 10.1152/ajpgi.1990.259.3.G462. [DOI] [PubMed] [Google Scholar]
  30. Whittle B. J., Lopez-Belmonte J., Moncada S. Regulation of gastric mucosal integrity by endogenous nitric oxide: interactions with prostanoids and sensory neuropeptides in the rat. Br J Pharmacol. 1990 Mar;99(3):607–611. doi: 10.1111/j.1476-5381.1990.tb12977.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Yonemaru M., Hatherill J. R., Hoffmann H., Zheng H., Ishii K., Raffin T. A. Pentoxifylline does not attenuate acute lung injury in the absence of granulocytes. J Appl Physiol (1985) 1991 Jul;71(1):342–351. doi: 10.1152/jappl.1991.71.1.342. [DOI] [PubMed] [Google Scholar]
  32. Zabel P., Schönharting M. M., Schade U. F., Schlaak M. Effects of pentoxifylline in endotoxinemia in human volunteers. Prog Clin Biol Res. 1991;367:207–213. [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES