Basic Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Pathophysiol. Feb 15, 2015; 6(1): 23-28
Published online Feb 15, 2015. doi: 10.4291/wjgp.v6.i1.23
Rabeprazole is effective for bile reflux oesophagitis after total gastrectomy in a rat model
Naoki Hashimoto
Naoki Hashimoto, School of Medicine, Kinki University, Osaka 589-8511, Japan
Author contributions: Hashimoto N solely contributed to this paper.
Ethics approval: The study was reviewed and approved by Kinki University, School of Medicine.
Institutional animal care and use committee: All procedures involving animals were reviewed and approved by the Institutional Animal Care and Use Committee of Kinki University (KAME21-005). The animal protocol was designed to minimize pain or discomfort to the animals. The animals were acclimatized to laboratory conditions (23°C,12 h/12 h light/dark, 50% humidity, ad libitum access to food and water) for two weeks prior to experimentation. Intragastric gavage administration was carried out with conscious animals, using straight gavage needles appropriate for the animal size (15-17 g body weight: 22 gauge, 1 inch length, 1.25 mm ball diameter). All animals were euthanized by barbiturate overdose (intravenous injection, 150 mg/kg pentobarbital sodium) for tissue collection.
Conflict-of-interest: Naoki Hashimoto has not received fees for serving as a speaker. Naoki Hashimoto has not received research funding from any organizations. Naoki Hashimoto is not an employee of any organizations. Naoki Hashimoto does not own stocks and or shares. Naoki Hashimoto does not own patent.
Data sharing: I declare data sharing statement in World Journal Gastrointestinal Pathophysiology. Technical appendix, statistical code, and dataset available from the corresponding author at email address or URL. Participants gave informed consent for data sharing.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Naoki Hashimoto, MD, PhD, School of Medicine, Kinki University, 377-2 Ohnohigashi, Oosaka-sayama-shi, Osaka 589-8511, Japan. gojigen000@gmail.com
Telephone: +81-723-660221 Fax: +81-723-683382
Received: May 21, 2014
Peer-review started: May 21, 2014
First decision: June 27, 2014
Revised: November 18, 2014
Accepted: January 18, 2015
Article in press: January 18, 2015
Published online: February 15, 2015
Processing time: 266 Days and 6.5 Hours
Abstract

AIM: To elucidate the effect of a proton pump inhibitor (PPI, rabeparazole) on oesophageal bile reflux in oesophagitis after total gastrectomy.

METHODS: Twenty-one 8-week-old male Wistar rats were studied. They were performed oesophagoduodenostomy of total gastrectomy to induce oesophageal reflux of biliary and pancreatic juice. Five rats were performed the sham operation (Sham). On post-operative day 7, they were treated with saline (Control) (n = 8) or PPI (rabeprazole, 30 mg/kg per day, ip ) (n = 8) for 2 wk. On post-operative 21, all rats were sacrificed and each oesophagus was evaluated histologically. Oesophageal injury was evaluated by macroscopic and microscopic findings as well as the expression of cyclooxygenase-2 (COX2). We measured bile acid in the oesophageal lumen and the common bile duct.

RESULTS: At 3 wk after surgery, a histological study analysis revealed an increase in the thickness of the epithelium, elongation of the lamina propria and basal cell hyperplasia in the oesophageal mucosa. The macroscopic ulcer score and microscopic ulcer length of the control group were significantly higher compared to those of the rabeprazole- treated group. The expression of COX2 was significantly increased according to the immunostaining in the control group compared to rabeprazole- treated group. Although there was no difference between the control and PPI groups in the total bile acid in the common bile duct, the bile acid activity in the oesophageal lumen was significantly decreased in the rabeprazole- treated group due to augmentation of the duodenal motor complex.

CONCLUSION: With this model, rabeprazole is good effect for reflux esophagitis after total gastrectomy from bile reflux. Bile acid is an important factor in the mucosal lesion induced by duodenal reflux.

Keywords: Oesophagoduodenostomy; Reflux oesophagitis; Proton pump inhibitor; Rabeprazole

Core tip: To elucidate the effect of proton pump inhibitor (PPI, rabeparazole) on reflux oesophagitis. Sixteen 8-week-old male Wistar rats were studied. They were performed oesophagoduodenostomy of total gastrectomy to induce oesophageal reflux of biliary and pancreatic juice. Five rats were performed the sham operation (Sham). On post-operative day 7, they were treated with saline (Control) (n = 8) or PPI (rabeprazole, 30 mg/kg per day, ip) (n = 8) for 2 wk. On post-operative 21, all rats were sacrificed and each oesophagus was evaluated histologically. Oesophageal injury was evaluated by macroscopic and microscopic findings as well as the expression of cyclooxygenase-2 (COX2). We measured bile acid in the oesophageal lumen and the common bile duct. The macroscopic ulcer score and microscopic ulcer length of the control group were significantly higher compared to those of the rabeprazole- treated group. The expression of COX2 was significantly increased according to the immunostaining in the control group compared to rabeprazole- treated group. Although there was no difference between the control and PPI groups in the total bile acid in the common bile duct, the bile acid activity in the oesophageal lumen was significantly decreased in the rabeprazole- treated group due to augmentation of the duodenal motor complex. With this model, rabeprazole is good effect for reflux oesophagitis after total gastrectomy from bile reflux.