Document Detail


Role of free radical scavengers in the management of refractory duodenal ulceration. A new approach.
MedLine Citation:
PMID:  8277768     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This prospective randomized double blind study examined the influence of free radical scavengers on the healing and recurrence of refractory duodenal ulceration. To this end, allopurinol (50 mg, four times a day) -a hydroxyl radical scavenger and an inhibitor of xanthine oxidase, the enzyme which forms superoxide radicals--and dimethyl sulfoxide (DMSO, 500 mg, four times a day)--a hydroxyl radical scavenger--were administered orally. Three hundred and sixty-three consecutive patients with duodenal ulceration that did not heal despite 3 months of treatment with cimetidine, who were cigarette smokers and social drinkers, were randomized to receive 800 mg cimetidine twice a day alone or with either allopurinol or DMSO. In 315 patients who were evaluable for efficacy analysis, the healing rate at 8 weeks was, for cimetidine alone, 60%; for cimetidine with DMSO, 100%; and for cimetidine with allopurinol, 100%. The healing efficacy of cimetidine was therefore significantly (P < 0.01) heightened by DMSO and allopurinol. The patients whose ulcers healed were instituted on maintenance treatment for 1 year and received 800 mg cimetidine at bedtime alone or with either DMSO or allopurinol. In 218 patients who were evaluable for efficacy analysis, the cumulative relapse rate at 1 year was, for cimetidine alone, 29%; for cimetidine with DMSO, 8%; and for cimetidine with allopurinol, 7% DMSO with cimetidine and allopurinol with cimetidine were, therefore, superior to cimetidine alone (P < 0.01) in preventing ulcer relapse. The results suggest that oxygen-derived free radicals are implicated in the mechanism of refractory duodenal ulceration and that scavenging these radicals stimulates healing and reduces recurrence of the ulceration.
Authors:
A S Salim
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The Journal of surgical research     Volume:  56     ISSN:  0022-4804     ISO Abbreviation:  J. Surg. Res.     Publication Date:  1994 Jan 
Date Detail:
Created Date:  1994-02-04     Completed Date:  1994-02-04     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0376340     Medline TA:  J Surg Res     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  45-52     Citation Subset:  IM    
Affiliation:
University Department of Surgery, Medical City, Baghdad, Iraq.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Alcohol Drinking
Allopurinol / administration & dosage,  therapeutic use*
Cimetidine / administration & dosage,  therapeutic use
Dimethyl Sulfoxide / administration & dosage,  therapeutic use*
Double-Blind Method
Drug Therapy, Combination
Duodenal Ulcer / drug therapy*
Female
Free Radical Scavengers*
Humans
Hydroxyl Radical / metabolism
Male
Middle Aged
Prospective Studies
Recurrence
Smoking
Xanthine Oxidase / antagonists & inhibitors
Chemical
Reg. No./Substance:
0/Free Radical Scavengers; 315-30-0/Allopurinol; 3352-57-6/Hydroxyl Radical; 51481-61-9/Cimetidine; 67-68-5/Dimethyl Sulfoxide; EC 1.17.3.2/Xanthine Oxidase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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