James, M.w.; Bebb, J.R.; Atherton, C.T.; Bailey-Flitter, N.; Zaitoun, A.; Hawkey, C.J.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA82
Academic Journal
Introduction: Animal studies support a central role for leukocytes in acute NSAID associated injury, which can be abrogated by pre-treatment with anti-leukocyte antibodies. However, with chronic human use inflammatory cells are seldom seen without H pylori infection. Because appreciation of a role for leukocytes in early human pathogenesis would be important and to test the relevance of animal models of NSAID damage to humans we performed an intensive endoscopic and histological evaluation of the acute effects of naproxen in humans. Methods: Eight healthy H pylori -ve human volunteers were randomised to receive naproxen 500 mg twice daily or no treatment for 48 h. Endoscopy was performed before and 3, 12, and 48 hours after dosing. Serial antral biopsies were analysed by blinded histology. Results: Increased neutrophil margination and vascular plugging were not seen over a time course in which they are prominent in animal models. Any changes were mild and showed no evidence of progressive evolution, with no differences between naproxen and placebo. The table shows the number of subjects with individual changes at any time point. Conclusion: In H pylori -ve human volunteers, acute naproxen therapy does not replicate the changes seen in animal models, calling their relevance into question. How H pylori +ve individuals respond remains to be determined.


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