Combined Terapy Efect of D-002 and Omeprazole on Chronic Esophagitis Induced by Duodenal Refux in Rats Zamora Z * , Mena L, Molina V, Pérez Y, Oyarzabal A, Noa M, Valle M, Jiménez S and Medina JA Department of Pharmacology, Centre of Natural Products, National Centre for Scientifc Research, Cubanacan, Havana, Cuba * Corresponding author: Zamora Z, Department of Pharmacology, Centre of Natural Products, National Centre for Scientifc Research. P Box 6880, Cubanacan, Havana, Cuba, Fax: +53-7-336837, Tel: +53-7-2714200, E-mail: zullyt.zamora@cnic.edu.cu Citation: Zamora Z, Mena L, Molina V, Pérez Y, Oyarzabal A, et al. (2018) Combined Terapy Efect of D-002 and Omeprazole on Chronic Esophagitis Induced by Duodenal Refux in Rats. J Gastroenterol Metabol 1: 106 Abstract RESEARCH ARTICLE Open Access Volume 1 | Issue 1 ScholArena | www.scholarena.com Journal of Gastroenterology and Metabolism Gastroesophageal refux disease is a common gastrointestinal disorder. D-002 (beeswax alcohols) and omeprazole (OMP) present protective efects on esophagitis by refux. In this study, the efect of combined therapy D002 + OMP on duodenum-esophageal refux (DER) induced-esophagitis in rats was evaluated. Rats were randomized into fve groups: one negative control and fourth groups with DER, including a positive control, two with D-002 and OMP (200 and 20 mg/kg, respectively), and other with combination therapy D-002 + OMP (200 + 20 mg/kg, respectively). All treatments were orally administered for 14 days afer DER. Esophageal lesions’ index (ELI), Histological score (HS) and malondialdehyde (MDA) content in esophagus were determined. Positive controls exhibited increase ELI, HS and MDA in esophagus compared to negative controls. Te combination therapy lowered signifcantly both ELI (48.05%) and MDA (67.8%) compared to positive controls, but without signifcant diferences compared to their respective monotherapies. However, the combination therapy signifcantly reduced the HS respect to the positive control, reaching 96% inhibition, an efect that was higher than each of the monotherapies. In conclusion, the administration of the combination therapy (D-002 + OMP) represents an additional beneft in the protection of esophageal tissue with respect to treatment with monotherapies. List of abbreviations: OMP: Omeprazole; DER: Duodeno-Esophageal Refux; MDA: Malondialdehyde; ELI: Esophageal Lesion Index; HS: Histological Score; GERD: Gastroesophageal Refux Diseases; BE: Barrett´ Esophagus; ADC: Adenocarcinoma; PPI: Proton Pump Inhibitors; HsRA: H2 Receptor Antagonists; BA: Bile Acids; ESI: Esophageal Sphincter Inferior, COX-2: Cyclooxygenase 2; PGE2: Prostaglandin E2; GDER: Gastro-Duodeno-Esophageal refux Introduction Gastroesophageal refux disease (GERD) occurs when the stomach and duodenum content are regurgitated into esophagus, causing mucosal lesions and esophageal tissue changes [1]. Gastroesophageal refux leads to the adenocarcinoma (ADC) development that is one of its complications. In recent years the ADC incidence has increased faster than other tumors [2]. Keywords: D-002; Omeprazole; Rats; Duodenum Esophageal Refux; Esophagitis; Malondialdehyde Numerous studies investigate the ADC formation mechanism from GER that include both gastric and duodenal juices refuxed [3,4]. However, diferences between gastric and duodenal juice-induced damage was established, and non-acid (duodenal) refux showed to be particularly important in the progression from Barrett’s esophagus (BE) to ADC, confrming that duodenal juice may induce EB and ADC in rats [5,6]. So, the increase of ADC incidence is related to the acid suppression [7,8]. Tere are evidences that bile acids (BA) short exposures to esophageal tissue induce oxidative stress, DNA oxidative damage, mutations, and apoptosis, whereas bile refux long-term exposures lead to apoptosis resistance and eventually to develop ADC [9- 13]. It has been shown that due to the apoptosis resistance, as an adaptive process, BE formation occurs depending on the severity of the refux [14,15]. GERD conventional therapy involves the use of anti-secretory drugs such as proton pump inhibitors (PPI) and H2 receptor antagonists (HsRA) [16,17]. Article history: Received: 27 December 2017, Accepted: 18 April 2018, Published: 20 April 2018 ISSN: 2637-4641