REVIEW ARTICLE - NONSTEROIDAL ANTIINFLAMMATORY DRUG-INDUCED GASTROINTESTINAL PERMEABILITY

Non-steroidal anti-inflammatory drugs induce damage throughout the ent ire gastrointestinal tract, Administration of site-specific permeabili ty probes is a non-invasive technique for assessing the functional int egrity of the gastrointestinal mucosa, A systematic search for NSAID-i nduced permeability studies using MEDLINE and EMBASE, and an analysis of the literature on NSAID-induced gastrointestinal permeability, were carried out, The advantages and disadvantages of the various probes a nd study protocols are discussed. Identification of the underlying mec hanisms of regulatory control of the epithelial tight junction is stil l needed, A greater appreciation of the pharmacokinetics and distribut ion of NSAIDs, coupled with gastrointestinal permeability studies, may help delineate the pathogenesis of NSAID-induced gastrointestinal tox icity, Non-invasive tests of gastric, intestinal and colonic permeabil ity have shown promise in both basic research and in clinical practice , While such tests could not replace endoscopy, they may represent cli nically useful techniques for identifying patients who would benefit f rom endoscopy, to assess the response to treatment, and perhaps to pre dict the clinical course of disease.