OBJECTIVE
To determine the level of expression of motilin (MT), vascular endothelial growth factor (VEGF), and somatostatin (SS) in the antral gastric mucosa in patients with NSAID gastropathy.
MATERIAL AND METHODS
153 patients using NSAIDs and 40 individuals not using NSAIDs were included in the study. All patients were divided into 4 groups: 1st — 51 people with NSAID gastropathy caused by acetylsalicylic acid; 2nd — 50 with NSAID-gastropathy caused by selective COX-2 inhibitors; 3rd — 52 without NSAID gastropathy, taking selective COX-2 inhibitors; 4th (comparison group) — 40 people not using NSAIDs. Patients underwent esophagogastroduodenoscopy with targeted biopsy of the antral gastric mucosa. The biopsy samples underwent cytological and immunohistochemical tests to verify Helicobacter pylori and determine MT, SS, and VEGF expression.
RESULTS
Diabetes mellitus, gastroesophageal reflux disease, and arterial hypertension were more prevalent in patients with NSAID gastropathy than in the 3d group (p<0.05). The incidence of stomach ulcers was twice as high in the 2nd group as it was in the 1st. The relative areas of VEGF, SS, and MT expression in the antral mucosa varied between all groups (p<0.05). In contrast to patients in the 3rd group, those with erosive and ulcerative lesions of the stomach had a lower relative area of VEGF and SS expression and a higher relative area of MT expression. The expression of these hormones was also lower in the 2nd group than in the 1st group (p<0.05).
CONCLUSIONS
VEGF, MT, and SS are crucial factors in the development of NSAID gastropathy. The absence of NSAID-gastropathy in the 3rd group without significant changes in the expression of VEGF, MT, and SS suggests the presence of some mechanisms that inhibit the development of erosive lesions in the gastric mucosa by stabilizing the local hormonal system.