chondroitin-sulfates and Stomach-Ulcer

BACKGROUND Cameron lesions are linear erosions and ulcers on the crests of gastric mucosal folds in the neck of a hiatal hernia and can be difficult to diagnose and treat. This report is of a case of chronic iron deficiency in a 61-year-old woman with a late diagnosis of a Cameron lesion, who did not respond to a single treatment with the proton pump inhibitor (PPI) pantoprazole, but was then treated with oral poloxamer 407 with hyaluronic acid and chondroitin sulfate in addition to PPI. CASE REPORT We report the case of a 61-year-old women with recurrent iron-deficiency anemia, first diagnosed 40 years prior to her presentation at our Endoscopy Unit, and an ongoing melena. We discovered an intrahiatal gastric mucosal defect, which we at first treated with proton pump inhibitors and sucralfate. After a follow-up gastroscopy revealed the persistence of the lesion, we decided to incorporate into the treatment a gel-like substance containing, among others, hyaluronic acid and chondroitin sulfate, and observed that the lesion resolved completely. CONCLUSIONS This report highlights that Cameron lesions should be considered in patients with hiatal hernia who have iron-deficiency anemia and can be diagnosed on upper endoscopy. Further clinical studies are required to determine the role of combined poloxamer 407 with hyaluronic acid and chondroitin sulfate in the management of Cameron lesions.

Topics: Adjuvants, Immunologic; Anemia, Iron-Deficiency; Chondroitin Sulfates; Chronic Disease; Drug Carriers; Female; Gastroscopy; Hernia, Hiatal; Humans; Hyaluronic Acid; Middle Aged; Pantoprazole; Poloxamer; Proton Pump Inhibitors; Stomach Ulcer

Sturgeon cartilage, which is rich in chondroitin sulfate (CS), is usually discarded during sturgeon utilization. In this paper, CS was isolated from large hybrid sturgeon skull and backbone and named SCS and BCS, respectively. Their structures were investigated via Fourier transform infrared (FT-IR) spectroscopy, nuclear magnetic resonance (NMR) spectroscopy and high performance liquid chromatography (HPLC). The average molecular weights of SCS and BCS were ~ 30-44 kDa. Disaccharide analysis indicated that SCS and BCS had similar chemical structures and were composed of ΔUA-[1 → 3]-GalNAc (ΔDi0S, 14.71%, 16.04%), ΔUA-[1 → 3]-GalNAc-4 s (ΔDi4S, 32.01%, 37.78%) and ΔUA-[1 → 3]-GalNAc-6 s (ΔDi6S, 53.27%, 46.18%). The gastroprotective effect of SCS and BCS were studied using a rat model of ethanol-induced gastric ulcers. Both SCS and BCS had apparent gastroprotective activity and their ulcer inhibition rate reached ~ 35%-45%, which was similar to that of omeprazole (~41%). These results provide useful strategies for the high-value utilization of sturgeon cartilage.

Topics: Animals; Cartilage; Chondroitin Sulfates; Ethanol; Rats; Spectroscopy, Fourier Transform Infrared; Stomach Ulcer

Topics: Animals; Anti-Ulcer Agents; Chondroitin Sulfates; Dextrins; Female; Heparin; Male; Panax; Pectins; Plants, Medicinal; Polysaccharides; Rats; Stomach Ulcer