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Clinical importance of nonsteroidal anti-inflammatory drug enteropathy: the relevance of tumor necrosis factor as a promising target

  • Devendra Pratap Singh
    Affiliations
    Department of Pharmacology and Toxicology, B. V. Patel Pharmaceutical Education and Research Development (PERD) Centre, Thaltej, Ahmedabad, Gujarat, India

    Registered Ph.D Scholar (External) at Institute of Pharmacy, NIRMA University, Sarkhej-Gandhinagar Highway, Ahmedabad, Gujarat, India
    Search for articles by this author
  • Swapnil P. Borse
    Affiliations
    Department of Pharmacology and Toxicology, B. V. Patel Pharmaceutical Education and Research Development (PERD) Centre, Thaltej, Ahmedabad, Gujarat, India

    Registered Ph.D Scholar (External) at Institute of Pharmacy, NIRMA University, Sarkhej-Gandhinagar Highway, Ahmedabad, Gujarat, India
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  • Manish Nivsarkar
    Correspondence
    Reprint requests: Dr. Manish Nivsarkar, Director, B. V. Patel Pharmaceutical Education and Research Development (PERD) Centre, S. G. Highway, Thaltej, Ahmedabad – 380054, Gujarat, India.
    Affiliations
    Department of Pharmacology and Toxicology, B. V. Patel Pharmaceutical Education and Research Development (PERD) Centre, Thaltej, Ahmedabad, Gujarat, India
    Search for articles by this author
Published:March 28, 2016DOI:https://doi.org/10.1016/j.trsl.2016.03.014
      The pathogenesis of nonsteroidal anti-inflammatory drug (NSAID) enteropathy is still unclear, and consequently, there is no approved therapeutic strategy for ameliorating such damage. On the other hand, molecular treatment strategies targeting tumor necrosis factor (TNF) exerts beneficial effects on NSAID-induced intestinal lesions in rodents and rheumatoid arthritis patients. Thus, TNF appears to be a potential therapeutic target for both the prevention and treatment of NSAID enteropathy. However, the causative relationship between TNF and NSAID enteropathy is largely unknown. Currently approved anti-TNF agents are highly expensive and exhibit numerous side effects. Hence, in this review, the pivotal role of TNF in NSAID enteropathy has been summarized and plant-derived polyphenols have been suggested as useful alternative anti-TNF agents because of their ability to suppress TNF activated inflammatory pathways both in vitro and in vivo.

      Abbreviations:

      ATP (adenosine triphosphate), CE (capsule endoscopy), DBE (double-balloon endoscopy), FDA (Food and Drug Administration), GI (gastrointestinal), GTPase (guanosine triphosphatase), H2RAs (histamine 2 receptor antagonists), IL (interleukin), LPS (lipopolysaccharide), MPTP (mitochondrial permeability transition pore), NADPH (nicotinamide adenine dinucleotide phosphate), NOD2 (nucleotide-binding oligomerization domain 2), NSAIDs (nonsteroidal anti-inflammatory drugs), PGs (prostaglandins), PPIs (proton pump inhibitors), RA (rheumatoid arthritis), RAC1 (ras-related C3 botulinum toxin substrate 1), RIRR (ROS-induced ROS release), ROS (reactive oxygen species), TLR (toll-like receptor), TNF (Tumor necrosis factor)
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