NOVEL PRECLINICAL PHARMACOLOGICAL SCREENING MODELS FOR ANTI-ULCER ACTIVITY WITH EMERGING THERAPEUTIC TARGETS
Peptic Ulcer: Screening Models and Applications
DOI:
https://doi.org/10.55766/sujst6602Keywords:
H. pylori, Histamine, in vitro, Peptic ulcer in vivo, Protective, StomachAbstract
A peptic ulcer is a gastrointestinal disorder that causes discomfort, morbidity, and mortality in humans as a result of unhealthy food, smoking, alcohol intake, frequent use of Nonsteroidal Anti-inflammatory Drugs (NSAIDs), Helicobacter pylori (H. pylori), and a sedentary lifestyle. Ulceration forms in the stomach, or duodenum, when there is an imbalance between the protective factors of the gastroduodenal mucosa, such as bicarbonate and mucus, and the offensive factors, such as stomach acid and pepsin synthesis. This results in the development of tiny lesions that cause pain. So, it requires effective therapeutic strategies. There are several approaches for assessing the anti-ulcer activity of natural or synthetic drugs. These strategies are known as experimental animal models. The primary objective of this review is to explain the different types of models, such as in vivo and in vitro, that have been utilized to produce gastric and duodenal ulcers to identify the healing features and properties of various innovative and current medications. This review also discusses the principles, procedures, applications, and parameters of different types of models. In addition, it also delves into the advantages, disadvantages, and challenges related to the use of these screening models.
References
Abbasi-Kangevari, M., Ahmadi, N., Fattahi, N., Rezaei, N., Malekpour, M.-R., Ghamari, S.-H., Moghaddam, S.S., Azadnajafabad, S., Esfahani, Z., and Kolahi, A.-A. (2022). Quality of care of peptic ulcer disease worldwide: A systematic analysis for the global burden of disease study 1990-2019. PLOS ONE, 17(8):e0271284. https://doi.org/10.1371/journal.pone.0271284
Abdullah, E.M. (2011). The Interaction of H. pylori and Non-Steroidal Anti-Inflammatory Drugs and Their Effect on Induction of Peptic Ulcer. Al-Anbar Medical Journal, 9(1):110-117.
Adinortey, M.B., Ansah, C., Asiedu-Larbi, J., Kwofie, S.K., Bockarie, A.S., Barnes, P., Aboagye, B., Helegbe, G.K., Boison, D., and Nyarko, A.K. (2022a). In vivo inhibition of gastric acid secretions and H+/K+-ATPase activity, and enhancement of mucin activity by Dissotis rotundifolia plant extract. Scientific African, 17:e01317. https://doi.org/10.1016/j.sciaf.2022.e01317
Adinortey, M.B., Ansah, C., Galyuon, I., and Nyarko, A. (2013b). In vivo models used for evaluation of potential antigastroduodenal ulcer agents. Ulcers, 2013, Article 796405 https://doi.org/10.1155/2013/796405
Ahmad, H., Wadud, A., Jahan, N., and Hasan, I. (2015). Anti-ulcer activity of Rhus coriaria in indomethacin and water immersion restraint induced gastric ulcer in experimental rats. International Journal of Medicine and Medical Sciences, 7(3):61-66. https://doi.org/10.5897/ijmms2014.1103
Akash, S.R., Tabassum, A., Aditee, L.M., Rahman, A., Hossain, M.I., Hannan, M.A., and Uddin, M.J. (2024). Pharmacological insight of rutin as a potential candidate against peptic ulcer. Biomedicine and Pharmacotherapy, 177:116961. https://doi.org/10.1016/j.biopha.2024.116961
Al-Gabri, N., Elnagar, G.M., Saghir, S.A., El-Shaibany, A., Alnomasy, S.F., Althafar, Z.M., Elkomy, N.M., Elaasser, M.M., Abdoh, M.S., and Yosri, M. (2022). Preliminary study of gastroprotective effect of Aloe perryi and date palm extracts on pyloric ligation‐induced gastric ulcer in experimental rats. BioMed Research International, 2022(1):9246785. https://doi.org/10.1155/2022/9246785
Altwejry, A.S., Alsaiari, O.A., Saleem, E.R., Alshanbri, N.K., Alzahrani, A.A., Alamri, S.M., Mahfouz, A.S.A.-D., Alghamdi, T.A., Asiri, F.M., and Alzahrani, A.A. (2020). An overview on peptic ulcer disease, diagnosis and management approach. Pharmacophore, 11(2-2020):123-126. https://doi.org/10.51847/sh2oyuk
Aman, R.M., Zaghloul, R.A., and El-Dahhan, M.S. (2021). Formulation, optimization and characterization of allantoin-loaded chitosan nanoparticles to alleviate ethanol-induced gastric ulcer: in-vitro and in-vivo studies. Scientific Reports, 11(1):2216. https://doi.org/10.1038/s41598-021-81183-x
Andargie, Y., Sisay, W., Molla, M., Norahun, A., and Singh, P. (2022). Evaluation of the antiulcer activity of methanolic extract and solvent fractions of the leaves of Calpurnia aurea (Ait.) Benth. (Fabaceae) in rats. Evidence-Based Complementary and Alternative Medicine, 2022(1):4199284. https://doi.org/10.1155/2022/4199284
Ansari, S. and Yamaoka, Y. (2022). Animal models and Helicobacter pylori infection. Journal of Clinical Medicine, 11(11):3141. https://doi.org/10.3390/jcm11113141
Arige, S. and Rao, L. (2017). A review on pharmacological screening of anti ulcer agents. International Journal of Medical Laboratory Research, 2(3):44-54.
Bae, D.-K., Park, D., Lee, S. H., Yang, G., Yang, Y.-H., Kim, T.K., Choi, Y.J., Kim, J.J., Jeon, J.H., and Jang, M.-J. (2011). Different antiulcer activities of pantoprazole in stress, alcohol and pylorus ligation-induced ulcer models. Laboratory Animal Research, 27(1):47-52. https://doi.org/10.5625/lar.2011.27.1.47
Bandyopadhyay, U., Das, D., Bandyopadhyay, D., Bhattacharjee, M., and Banerjee, R.K. (1999). Role of reactive oxygen species in mercaptomethylimidazole-induced gastric acid secretion and stress-induced gastric ulceration. Current Science, 76(1):55-63.
Beiranvand, M. (2022). A review of the most common in vivo models of stomach ulcers and natural and synthetic anti-ulcer compounds: A comparative systematic study. Phytomedicine Plus, 2(2):100264. https://doi.org/10.1016/j.phyplu.2022.100264
Bhajoni, P.S., Meshram, G.G., and Lahkar, M. (2016). Evaluation of the antiulcer activity of the leaves of Azadirachta indica: An experimental study. Integrative Medicine International, 3(1-2):10-16. https://doi.org/10.1159/000442750
Bhattamisra, S.K., Hooi, L.P., Shyan, L.P., Chieh, L.B., Candasamy, M., and Sahu, P.S. (2019). Effect of geraniol and clarithromycin combination against gastric ulcers induced by acetic acid and Helicobacter pylori in rats. Pharmacognosy Research, 11(4):356-362. https://doi.org/10.4103/pr.pr_21_19
Blutt, S.E. and Estes, M.K. (2022). Organoid models for infectious disease. Annual Review of Medicine, 73(1):167-182. https://doi.org/10.1146/annurev-med-042320-023055
Bonfils, S. and Lambling, A. (1963). Psychological factors and psychopharmacological actions in the restraint-induced gastric ulcer. In: Pathophysiology of Peptic Ulcer: Proceedings of the Second World, edited by Stanley C. Skoryna, Montreal: McGill-Queen’s University Press, p. 153-171. https://doi.org/10.1515/9780773593855-011
Brodie, D.A. and Hanson, H.M. (1960). A study of the factors involved in the production of gastric ulcers by the restraint technique. Gastroenterology, 38(3):353-360. https://doi.org/10.1016/s0016-5085(60)80137-0
Canadas-Ortega, M., Mühlbacher, I., Posselt, G., Diechler, S., Ferner, C.D., Boccellato, F., Koch, O.O., Neureiter, D., Weitzendorfer, M., Emmanuel, K., and Wessler, S. (2024). HtrA-Dependent E-Cadherin Shedding Impairs the Epithelial Barrier Function in Primary Gastric Epithelial Cells and Gastric Organoids. International Journal of Molecular Sciences, 25(13):7083. https://doi.org/10.3390/ijms25137083
Chattopadhyay, I., Bandyopadhyay, U., Biswas, K., Maity, P., and Banerjee, R.K. (2006). Indomethacin inactivates gastric peroxidase to induce reactive-oxygen-mediated gastric mucosal injury and curcumin protects it by preventing peroxidase inactivation and scavenging reactive oxygen. Free Radical Biology and Medicine, 40(8):1397-1408. https://doi.org/10.1016/j.freeradbiomed.2005.12.016
Cheng, Y.T., Lu, C.C., and Yen, G.C. (2017). Phytochemicals enhance antioxidant enzyme expression to protect against NSAID‐induced oxidative damage of the gastrointestinal mucosa. Molecular Nutrition and Food Research, 61(6):1600659. https://doi.org/10.1002/mnfr.201600659
Choi, K.-Y.G., Wu, B.C., Lee, A.H.-Y., Baquir, B., and Hancock, R.E.W. (2020). Utilizing Organoid and Air-Liquid Interface Models as a Screening Method in the Development of New Host Defense Peptides. Frontiers in Cellular and Infection Microbiology, 10:228. https://doi.org/10.3389/fcimb.2020.00228
Ciubotaru, A.D. and Leferman, C.-E. (2021). Case Report: Peptic ulcer disease following short-term use of nonsteroidal anti-inflammatory drugs in a 3-year-old child. F1000Research, 9(419):419. https://doi.org/10.12688/f1000research.24007.2
Cua, S.J., Lirazan, M., and Alvarez, M.R. (2018). In vitro Antacid Screening of the Aqueous and Ethanolic Leaf Extracts of Ixora Coccinea (Linn). and Mimosa Pudica (Linn.). Oriental Journal of Chemistry. 34(5). https://doi.org/10.13005/ojc/340504
Dilpreet, K., Sunsil, K., Ramica, R., and Rana, A. (2012). Protective effect of Tinospora cordifalia against reserpine induced ulcer model. International Research Journal of Pharmacy, 3(8):275-279.
Dong, S., Wang, X., Liu, Y., Qiao, L., Xue, Q., Zhou, Y., Xu, Z., Chen, Q., Chen, C., and Liu, N. (2025). A novel gastric ulcer model in rats using filter paper with acetic acid. PLOS ONE, 20(4):e0319096. https://doi.org/10.1371/journal.pone.0319096
Drini, M. (2017). Peptic ulcer disease and non-steroidal anti-inflammatory drugs. Australian Prescriber, 40(3):91. https://doi.org/10.18773/austprescr.2017.037
Duh, P.-D., Yen, G.-C., Yen, W.-J., and Chang, L.-W. (2001). Antioxidant effects of water extracts from barley (Hordeum vulgare L.) prepared under different roasting temperatures. Journal of Agricultural and Food Chemistry, 49(3):1455-1463. https://doi.org/10.1021/jf000882l
Fauzia, K.A., Effendi, W.I., Alfaray, R.I., Malaty, H.M., Yamaoka, Y., and Mifthussurur, M. (2024). Molecular Mechanisms of Biofilm Formation in Helicobacter pylori. Antibiotics, 13(10):976. https://doi.org/10.3390/antibiotics13100976.
Fazalda, A., Quraisiah, A., and Nur Azlina, M.F. (2018). Antiulcer effect of honey in nonsteroidal anti‐inflammatory drugs induced gastric ulcer model in rats: A systematic review. Evidence-Based Complementary and Alternative Medicine, 2018(1):7515692. https://doi.org/10.1155/2018/7515692
Feng, L., Bao, T., Bai, L., Mu, X., Ta, N., Bao, M., Li, Y., Zhang, J., Fu, M., and Chen, Y. (2023). Mongolian medicine formulae Ruda-6 alleviates indomethacin-induced gastric ulcer by regulating gut microbiome and serum metabolomics in rats. Journal of Ethnopharmacology, 314:116545. https://doi.org/10.1016/j.jep.2023.116545
Fokunang, E.T., Pougoue, J.K., Njunkio, B., Ngoupayo, J., Gatsing, D., Tomkins, P.T., and Fokunang, C.N. (2019). Phytochemical screening and in vivo evaluation of antiulcer properties of secondary metabolites in aqueous extracts of Ficus. thonningii Blume tested on Wistar rats. International Journal of Biological and Chemical Sciences, 13(1):475-492. https://doi.org/10.4314/ijbcs.v13i1.38
Fordtran, J.S., Morawski, S.G., and Richardson, C.T. (1973). In vivo and in vitro evaluation of liquid antacids. New England Journal of Medicine, 288(18):923-928. https://doi.org/10.1056/nejm197305032881801
Fulga, S., Pelin, A.-M., Ghiciuc, C.M., and Lupușoru, E.C. (2020). Particularities of experimental models used to induce gastric ulcer. ARS Medica Tomitana, 25(4):179-184. https://doi.org/10.2478/arsm-2019-0035
Hatware, K.V., Sharma, S., Patil, K., Shete, M., Karri, S., and Gupta, G. (2018). Evidence for gastroprotective, anti-inflammatory and antioxidant potential of methanolic extract of Cordia dichotoma leaves on indomethacin and stress induced gastric lesions in Wistar rats. Biomedicine and Pharmacotherapy, 103:317-325. https://doi.org/10.1016/j.biopha.2018.04.007
Houshia, O.J., AbuEid, M., Zaid, O., Zaid, M., and Al-daqqa, N. (2012). Assessment of the value of the antacid contents of selected palestinian plants. American Journal of Chemistry, 2(6):322-325. https://doi.org/10.5923/j.chemistry.20120206.05
Idowu, S., Bertrand, P.P., and Walduck, A.K. (2022). Gastric organoids: Advancing the study of H. pylori pathogenesis and inflammation. Helicobacter, 27(3):e12891. https://doi.org/10.1111/hel.12891
Itoh, Y. and Noguchi, R. (2000). Pre-treatment with mild whole-body heating prevents gastric ulcer induced by restraint and water-immersion stress in rats. International Journal of Hyperthermia, 16(2):183-191. https://doi.org/10.1080/026567300285376
Jain, N.K., Singh, N., Kannojiya, P., Garud, N., Garud, A., and Tonpay, S. (2010). Pharmacological screening of antiulcer agents: A Review. International Journal of Pharmaceutical Sciences and Research, 1(9):29-37.
Jainu, M. and Devi, C.S.S. (2006). Antiulcerogenic and ulcer healing effects of Solanum nigrum (L.) on experimental ulcer models: possible mechanism for the inhibition of acid formation. Journal of Ethnopharmacology, 104(1-2):156-163. https://doi.org/10.1016/j.jep.2005.08.064
Jia, Y.-T., Wei, W., Ma, B., Xu, Y., Liu, W.-J., Wang, Y., Lv, K.-Y., Tang, H.-T., Wei, D., and Xia, Z.-F. (2007). Activation of p38 MAPK by reactive oxygen species is essential in a rat model of stress-induced gastric mucosal injury. The Journal of Immunology, 179(11):7808-7819. https://doi.org/10.4049/jimmunol.179.11.7808
Kalaichelvi, K., Sharmila, S., and Dhivya, S. (2018). In vitro antioxidant and antiulcerogenic activity of Cayratia pedata var. Glabra against experimentally induced gastric lesions in Wistar strain albino rats. Asian Journal of Pharmaceutical and Clinical Research, 11(1):105-110. https://doi.org/10.22159/ajpcr.2017.v11i1.19986
Kaur, A., Kumar, S., and Sharma, R. (2012). Assessment of anti-ulcer activity of Rheum emodii rhizomes extract. Indo Global Journal of Pharmaceutical Sciences, 2(3):333-341. https://doi.org/10.35652/igjps.2012.38
Kavitt, R.T., Lipowska, A.M., Anyane-Yeboa, A., and Gralnek, I.M. (2019). Diagnosis and treatment of peptic ulcer disease. The American Journal of Medicine, 132(4):447-456. https://doi.org/10.1016/j.amjmed.2018.12.009
Khan, M.S., Arora, P., Kalra, N., and Arora, N. (2022). In Vivo and In Vitro Animal Models for Ulcer: A Conscious Review. Journal of Drug Delivery and Therapeutics, 12(6):227-231. https://doi.org/10.22270/jddt.v12i6.5690
Khatoon, A., Sachan, V., Kori, P., Khushtar, M., and Pujari, N.M. (2024). Current Practices and Emerging Technologies in Animal Models for Gastric Ulcer Research. Journal of Drug Discovery and Health Sciences, 1(03):153-160. https://doi.org/10.21590/jddhs.01.03.05
Khoshnoud, M.J., Rashedinia, M., Keshavarzi, M., Sakhteman, A.H., Izadi, V., and Derakhshanfar, A. (2022). The therapeutic potential of trifluoperazine against ethanol and cold water stress-induced gastric lesions in rat. Trends in Pharmaceutical Sciences, 8(1):13-24.
Kitagawa, H., Fujiwara, M., and Osumi, Y. (1979). Effects of water-immersion stress on gastric secretion and mucosal blood flow in rats. Gastroenterology, 77(2):298-302. https://doi.org/10.1016/0016-5085(79)90281-6
Kulkarni, S.K. (1987). Hand book of Experimental Pharmacology. Vallabh Prakashan.
Lanas, A. and Chan, F.K. (2017). Peptic ulcer disease. The Lancet, 390(10094):613-624. https://doi.org/10.1016/s0140-6736(16)32404-7
Lenka, S. and Bhuyan, R. (2022). Management of H. pylori induced pepticulcer-a phytotherapeutic approach. Journal of Pure and Applied Microbiology, 16(3):1530-1537. https://doi.org/10.22207/jpam.16.3.36
Levine, R. (1971). A method for rapid production of stress ulcers in rats. Peptic Ulcer, p. 92-97.
Li, G.-J., Sun, P., Wang, R., Zhou, Y.-L., Qian, Y., and Zhao, X. (2014). Preventive effect of polysaccharide of Larimichthys crocea swim bladder on reserpine induced gastric ulcer in ICR mice. The Korean Journal of Physiology and Pharmacology: Official Journal of the Korean Physiological Society and the Korean Society of Pharmacology, 18(2):183-190. https://doi.org/10.4196/kjpp.2014.18.2.183
Lirazan, M., Cua, S.J., and Alvarez, M.R.S. (2018). In Vitro Antacid Screening of the Aqueous and Ethanolic Leaf Extracts of Triticum Aestivum (Linn.) and Hordeum Vulgare (Linn.). Oriental journal of chemistry, 34:93-99. https://doi.org/10.13005/ojc/340110
Lourenço, B.N., dos Santos, T., Oliveira, C., Barrias, C.C., and Granja, P.L. (2018). Bioengineering a novel 3D in vitro model of gastric mucosa for stomach permeability studies. Acta Biomaterialia, 82:68-78. https://doi.org/10.1016/j.actbio.2018.10.007
Lu, S., Wu, D., Sun, G., Geng, F., Shen, Y., Tan, J., Sun, X., and Luo, Y. (2019). Gastroprotective effects of Kangfuxin against water-immersion and restraint stress-induced gastric ulcer in rats: roles of antioxidation, anti-inflammation, and pro-survival. Pharmaceutical Biology, 57(1):770-777. https://doi.org/10.1080/13880209.2019.1682620
Mahmoud, M.F., Abdo, W., Nabil, M., Drissi, B., El-Shazly, A.M., Abdelfattah, M.A., and Sobeh, M. (2023). Apple (Malus domestica Borkh) leaves attenuate indomethacin-induced gastric ulcer in rats. Biomedicine and Pharmacotherapy, 160:114331. https://doi.org/10.1016/j.biopha.2023.114331
Malik, T.F., Gnanapandithan, K., and Singh, K. (2022). Peptic ulcer disease [Updated 2021 Jul 29]. In: StatPearls [Internet]. StatPearls Publishing.
Meena, D. and Jayanthi, M. (2018). In-vivo models used for pre-clinical evaluation of anti-ulcer activity. Austin Pharmacology & Pharmaceutics, 3(2):1017.
Mekonnen, A.N., Asrade Atnafie, S., and Wahab Atta, M.A. (2020). Evaluation of antiulcer activity of 80% methanol extract and solvent fractions of the root of Croton macrostachyus Hocsht: Ex Del. (Euphorbiaceae) in rodents. Evidence-Based Complementary and Alternative Medicine, 2020(1):2809270. https://doi.org/10.1155/2020/2809270
Mishra, A.P., Bajpai, A., and Chandra, S. (2019a). A comprehensive review on the screening models for the pharmacological assessment of antiulcer drugs. Current Clinical Pharmacology, 14(3):175-196. https://doi.org/10.2174/1574884714666190312143846
Mishra, S., Balaji, O., Rao, V., and Adiga, S. (2019b). Gastroprotective activity of sesame (Sesamum indicum) seeds extract in alendronate-induced gastric ulcer in rats. Asian Journal of Pharmaceutical and Clinical Research, 12(10):214-217. https://doi.org/10.22159/ajpcr.2019.v12i10.35203
Monteiro, K.M., Spindola, H.M., Possenti, A., Tinti, S.V., Ruiz, A.L., Longato, G.B., Fiorito, G.F., Marchetti, G.M., Shiozawa, L., and Piloni, B.U. (2013). Characterization of a refinement of the “pylorus ligation” model of rat gastric ulceration resulting in “no pain” and a more specific pharmacological response. Journal of Pharmacological and Toxicological Methods, 67(2):121-128. https://doi.org/10.1016/j.vascn.2012.09.002
Mugwena, N.W. (2020). A synopsis of medicinally important indigenous species of the genus Scabiosa (Caprifoliaceae), an evaluation of their biological activity and synergistic properties of Scabiosa columbaria, [MSc. Thesis]. University of Johannesburg (South Africa), 113p.
Naik, A., Shankar, M., Sowjanya, R., Sireesha, B., and Yudharaj, P. (2016). Methods on employed in screening of antiulcer drugs-an overview. International Journal of Novel Trends in Pharmaceutical Sciences, 6(5):111-119.
Ogino, K., Hobara, T., Kawamoto, T., Kobayashi, H., Iwamoto, S., Oka, S., and Okazaki, Y. (1990). Mechanism of diethyldithiocarbamate-induced gastric ulcer formation in the rat. Pharmacology & Toxicology, 66(2):133-137. https://doi.org/10.1111/j.1600-0773.1990.tb00719.x
Okabe, S. and Amagase, K. (2005). An overview of acetic acid ulcer models-the history and state of the art of peptic ulcer research-. Biological and Pharmaceutical Bulletin, 28(8):1321-1341. https://doi.org/10.1248/bpb.28.1321
Okokon, J.E. and Nwafor, P.A. (2009). Antiulcer and anticonvulsant activity of Croton zambesicus. Pakistan Journal of Pharmaceutical Sciences, 22(4):384-390.
Olbe, L., Fändriks, L., Hamlet, A., Svennerholm, A.-M., and Thoreson, A.-C. (2000). Mechanisms involved in Helicobacter pylori induced duodenal ulcer disease: an overview. World Journal of Gastroenterology, 6(5):619. https://doi.org/10.3748/wjg.v6.i5.619
Ollivier, A., Mahe, M.M., and Guasch, G. (2021). Modeling gastrointestinal diseases using organoids to understand healing and regenerative processes. Cells, 10(6):1331. https://doi.org/10.3390/cells10061331
Ommurugan, B. and Rao, V. (2019). Pharmacotherapy of Peptic Ulcer Disease and Latest Research. Gastritis-New Approaches and Treatments, 126. https://doi.org/10.5772/intechopen.86386
Pandey, A., Saraswat, N., Wal, P., Pal, R.S., Wal, A., and Maurya, D. (2019). A detailed review on: recent advances, pathophysiological studies and mechanism of peptic ulcer. Research Journal of Pharmacology and Pharmacodynamics, 11(4):165-170. https://doi.org/10.5958/2321-5836.2019.00029.6
Pare, W. and Redei, E. (1993). Depressive behavior and stress ulcer in Wistar Kyoto rats. Journal of Physiology-Paris, 87(4):229-238. https://doi.org/10.1016/0928-4257(93)90010-q
Peiffer, S., Pelton, M., Keeney, L., Kwon, E.G., Ofosu-Okromah, R., Acharya, Y., Chinchilli, V.M., Soybel, D.I., Oh, J.S., and Ssentongo, P. (2020). Risk factors of perioperative mortality from complicated peptic ulcer disease in Africa: Systematic review and meta-analysis. BMJ Open Gastroenterology, 7(1):e000350. https://doi.org/10.1136/bmjgast-2019-000350
Pleguezuelos‐Manzano, C., Puschhof, J., van den Brink, S., Geurts, V., Beumer, J., and Clevers, H. (2020). Establishment and culture of human intestinal organoids derived from adult stem cells. Current Protocols in Immunology, 130(1):e106. https://doi.org/10.1002/cpim.106
Prayoga, D.K., Aulifa, D.L., Budiman, A., and Levita, J. (2024). Plants with anti-ulcer activity and mechanism: a review of preclinical and clinical studies. Drug Design, Development and Therapy, 18:193-213. https://doi.org/10.2147/DDDT.S446949
Ramakrishnan, K. and Salinas, R.C. (2007). Peptic ulcer disease. American Family Physician, 76(7):1005-1012.
Rao, A.S., Lakshmi, N.B., Medhi, B., and Prakash, A. (2014). Pharmacological Screening Methods and Toxicology. PharmaMed Press, p. 239-44.
Raza, H., Abbas, Q., Hassan, M., Eo, S.-H., Ashraf, Z., Kim, D., Phull, A.R., Kim, S.J., Kang, S.K., and Seo, S.-Y. (2017). Isolation, characterization, and in silico, in vitro and in vivo antiulcer studies of isoimperatorin crystallized from Ostericum koreanum. Pharmaceutical Biology, 55(1):218-226. https://doi.org/10.1080/13880209.2016.1257641
Reddy, V.P., Sudheshna, G., Afsar, S., Saran, S., Kumar, S.N., Ram, C.R., and Reddy, K.R. (2012). Evaluation of anti-ulcer activity of Citrullus colocynthis fruit against pylorus ligation induced ulcers in male wistar rats. International Journal of Pharmacy and Pharmaceutical Sciences, 4(2):446-451.
Rethinavel, H.S., Selvaraj, D.B., Balakrishnan, S.J., Andrews, J.F.V., Joseph, J.H.M., and Kandasamy, M. (2022). Omeprazole treatment manifests anxiolytic effects in a cysteamine hydrochloride induced mouse model of gastrointestinal disorder. Heliyon, 8(6):e09787. https://doi.org/10.1016/j.heliyon.2022.e09787
Sabapaty, A., Lin, P.Y., and Dunn, J.C.Y. (2023). Effect of air-liquid interface on cultured human intestinal epithelial cells. FASEB BioAdvances, 6:41-52. https://doi.org/10.1096/fba.2023-00132
Saghaei, F., Karimi, I., Jouyban, A., and Samini, M. (2012). Effects of captopril on the cysteamine-induced duodenal ulcer in the rat. Experimental and Toxicologic Pathology, 64(4):373-377. https://doi.org/10.1016/j.etp.2010.10.001
Sahoo, S.K., Sahoo, H.B., Priyadarshini, D., Soundarya, G., Kumar, C.K., and Rani, K.U. (2016). Antiulcer activity of ethanolic extract of Salvadora indica (W.) leaves on albino rats. Journal of clinical and diagnostic research: JCDR, 10(9):FF07. https://doi.org/10.7860/jcdr/2016/20384.8470
Sairam, K., Rao, C.V., Babu, M.D., Kumar, K.V., Agrawal, V., and Goel, R.K. (2002). Antiulcerogenic effect of methanolic extract of Emblica officinalis: an experimental study. Journal of Ethnopharmacology, 82(1):1-9. https://doi.org/10.1016/s0378-8741(02)00041-7
Salari, N., Darvishi, N., Shohaimi, S., Bartina, Y., Ahmadipanah, M., Salari, H.R., and Mohammadi, M. (2022). The global prevalence of peptic ulcer in the world: A systematic review and meta-analysis. Indian Journal of Surgery, 84(5):913-921. https://doi.org/10.1007/s12262-021-03189-z
Salem Sokar, S., Elsayed Elsayad, M., and Sabri Ali, H. (2016). Serotonin and histamine mediate gastroprotective effect of fluoxetine against experimentally-induced ulcers in rats. Journal of Immunotoxicology, 13(5):638-651. https://doi.org/10.3109/1547691x.2016.1145158
Sandhya, S., Ramana K.V., and Vinod, K.R. (2015). A comparative evaluation of in vitro antacid activity of two Tephrosia species using modified artificial stomach model. Hygeia Journal for Drugs and Medicines, 7(2):9-17. https://doi.org/10.15254/H.J.D.Med.7.2015.146
Sarfraz, M. (2018). Peptic ulcer disease. Independent Review, 20:1-6.
Satapathy, T., Sen, K., Sahu, S., Pradhan, B., Gupta, A., Khan, M.A., Kumar, D., Satapathy, A., and Yadav, N. (2024). Experimental animal models for gastric ulcer/peptic ulcer: An overview. Journal of Drug Delivery and Therapeutics, 14(1):182-192. https://doi.org/10.22270/jddt.v14i1.6258
Schlaermann, P., Toelle, B., Berger, H., Schmidt, S.C., Glanemann, M., Ordemann, J., Bartfeld, S., Mollenkopf, H.-J., and Meyer, T. F. (2014). A novel human gastric primary cell culture system for modelling Helicobacter pylori infection in vitro. Gut, 65:202-213. https://doi.org/10.1136/gutjnl-2014-307949
Selye, H. (1936). A syndrome produced by diverse nocuous agents. Nature, 138:32. https://doi.org/10.1038/138032a0
Selye, H. and Szabo, S. (1973). Experimental model for production of perforating duodenal ulcers by cysteamine in the rat. Nature, 244(5416):458-459. https://doi.org/10.1038/244458a0
Shams, S.G.E. and Eissa, R.G. (2022). Amelioration of ethanol-induced gastric ulcer in rats by quercetin: implication of Nrf2/HO1 and HMGB1/TLR4/NF-κB pathways. Heliyon, 8(10):e11159. https://doi.org/10.1016/j.heliyon.2022.e11159
Shatri, A.M.N. (2023). Evaluation of the acid-neutralizing and cytotoxicity properties of novel plant mucilage used as an alternative treatment for peptic ulcers and as antacids in Namibia. Acta Scientiarum Biological Sciences, 45:e64407. https://doi.org/10.4025/actascibiolsci.v45i1.64407
Shay, H. (1945). A simple method for the uniform production of gastric ulceration in the rats. Gastroenterology, 5:143-149.
Shivam, S. and Chandra, P. (2020). Pharmacological screening techniques for evaluation of gastric ulcers: Principles, mechanism and procedures. International Journal of Pharmaceutical Sciences Review and Research, 65(1):224-232. https://doi.org/10.47583/ijpsrr.2020.v65i01.032
Singh, R., Gupta, A., and Patel, S. (2022). Pharmacological Screening Model and Its Treatment of Peptic Ulcer Disease. Journal for Research in Applied Sciences and Biotechnology, 1(5):36-47. https://doi.org/10.55544/jrasb.1.5.4
Singh, V.K. and Seed, T.M. (2021). How necessary are animal models for modern drug discovery? Expert opinion on drug discovery, 16(12):1391-1397. https://doi.org/10.1080/17460441.2021.1972255
Sirmagul, B., Kilic, F., Batu, O., and Erol, K. (2004). The effects of verapamil on stress-and histamine-induced gastric lesions in rats. Methods and Findings in Experimental and Clinical Pharmacology, 26(10):763-767. https://doi.org/10.1358/mf.2004.26.10.872557
Sisay, Z.W. and Jemere, A.T. (2020). Evaluation of the anti-ulcer activity of hydromethanolic crude extract and solvent fractions of the root of Rumex nepalensis in Rats. Journal of Experimental Pharmacology, 12:325-337. https://doi.org/10.2147/JEP.S258586
Sistani Karampour, N., Arzi, A., Rezaie, A., Pashmforoosh, M., and Kordi, F. (2019). Gastroprotective effect of zingerone on ethanol-induced gastric ulcers in rats. Medicina, 55(3):64. https://doi.org/10.3390/medicina55030064
Suleyman, H., Albayrak, A., Bilici, M., Cadirci, E., and Halici, Z. (2010). Different mechanisms in formation and prevention of indomethacin-induced gastric ulcers. Inflammation, 33:224-234. https://doi.org/10.1007/s10753-009-9176-5
Sung, J., Kuipers, E., and El‐Serag, H. (2009). Systematic review: the global incidence and prevalence of peptic ulcer disease. Alimentary pharmacology and therapeutics, 29(9):938-946. https://doi.org/10.1111/j.1365-2036.2009.03960.x
Takagi, K., okabe, S., and Saziki, R. (1969). A new method for the production of chronic gastric ulcer in rats and the effect of several drugs on its healing. The Japanese Journal of Pharmacology, 19(3):418-426. https://doi.org/10.1254/jjp.19.418
Thabrew, M.I. and Arawwawala, L.D.A.M. (2018). An overview of in vivo and in vitro models that can be used for evaluating anti-gastric ulcer potential of medicinal plants. Austin Biology, 1(2):1007.
Toktay, E. and Selli, J. (2022). Histopathological overview of experimental ulcer models. The Eurasian Journal of Medicine, 54(Suppl 1):S120. https://doi.org/10.5152/eurasianjmed.2022.22312
Tripathi, K.D. (2013). Essentials of Medical Pharmacology. 7th ed. Jaypee Brothers Medical Publishers (P) Ltd., New Delhi, p. 816-835.
Umre, R., Ganeshpurkar, A., Ganeshpurkar, A., Pandey, S., Pandey, V., Shrivastava, A., and Dubey, N. (2018). In vitro, in vivo and in silico antiulcer activity of ferulic acid. Future Journal of Pharmaceutical Sciences, 4(2):248-253. https://doi.org/10.1016/j.fjps.2018.08.001
Vatier, J., Celice-Pingaud, C., and Farinotti, R. (1998). Interests of the ‘artifical stomach’ techniques to study antacid formulations: Comparison with in vivo evaluation. Fundamental and Clinical Pharmacology, 12(6):573-583. https://doi.org/10.1111/j.1472-8206.1998.tb00989.x
Vatier, J., Malikova‐Sekera, E., Vitre, M., and Mignon, M. (1992). An artificial stomach‐duodenum model for the in‐vitro evaluation of antacids. Alimentary Pharmacology and Therapeutics, 6(4):447-458. https://doi.org/10.1111/j.1365-2036.1992.tb00558.x
Vogel, H.G. and Vogel, W.H. (2002). Drug Discovery and Evaluation: Pharmacological Assays. 2nd ed. Springer Ver Lag Berlin Heidelberg, NY, p. 435-436. http://doi.org/10.1007/3-540-29837-1
Wallace, J.L., McKnight, W., Reuter, B.K., and Vergnolle, N. (2000). NSAID-induced gastric damage in rats: requirement for inhibition of both cyclooxygenase 1 and 2. Gastroenterology, 119(3):706-714. https://doi.org/10.1053/gast.2000.16510
Wang, S., Zhang, T., Li, D., and Cao, X. (2025). The global, regional and national burden of peptic ulcer disease attributable to smoking from 1990 to 2021: A population-based study. Preventive Medicine Reports, 51:103019. https://doi.org/10.1016/j.pmedr.2025.103019
Warzecha, Z., Ceranowicz, D., Dembiński, A., Ceranowicz, P., Cieszkowski, J., Kuwahara, A., Kato, I., Dembiński, M., and Konturek, P. C. (2012). Ghrelin accelerates the healing of cysteamine-induced duodenal ulcers in rats. Medical Science Monitor, 18(5):BR181. https://doi.org/10.12659/msm.882727
Xie, X., Ren, K., Zhou, Z., Dang, C., and Zhang, H. (2022). The global, regional and national burden of peptic ulcer disease from 1990 to 2019: a population-based study. BMC Gastroenterology, 22(1):58. https://doi.org/10.1186/s12876-022-02130-2
Yadav, P., Ganeshpurkar, A., and Rai, G. (2012). In vitro H+-K+ ATPase inhibitory potential of methanolic extract of Cissus quadrangularis Linn. Pharmacognosy Research, 4(2):123. https://doi.org/10.4103/0974-8490.94738
Yuan, Y., Padol, I.T., and Hunt, R.H. (2006). Peptic ulcer disease today. Nature Clinical Practice Gastroenterology and Hepatology, 3(2):80-89. https://doi.org/10.1038/ncpgasthep0393
Yusuf, S., Adelaiye, A.B., Nok, A.J., Ameh, D.A., and Balogun, E.O. (2008). Effect of acute bilateral adrenalectomy and reserpine on gastric mucus secretion and mucosal injury in pyloric ligated rats. African Journal of Biotechnology, 7(17):3143-3148. https://doi.org/10.5897/AJB08.358
Zaki, M., Coudron, P.E., McCuen, R.W., Harrington, L., Chu, S., and Schubert, M.L. (2013). H. pylori acutely inhibits gastric secretion by activating CGRP sensory neurons coupled to stimulation of somatostatin and inhibition of histamine secretion. American Journal of Physiology-Gastrointestinal and Liver Physiology, 304(8):G715-G722. https://doi.org/10.1152/ajpgi.00187.2012
Zhang, S. and Moss, S.F. (2012). Rodent Models of Helicobacter Infection, Inflammation, and Disease. In: Houghton, J. (eds) Helicobacter Species. Methods in Molecular Biology, Humana Press, Totowa, NJ, 921:89-98. https://doi.org/10.1007/978-1-62703-005-2_12
Zhang, Z., Yan, W., Zhang, X., Wang, J., Zhang, Z., Lin, Z., Wang, L., Chen, J., Liu, D., and Zhang, W. (2023). Peptic ulcer disease burden, trends, and inequalities in 204 countries and territories, 1990-2019: a population-based study. Therapeutic Advances in Gastroenterology, 16:17562848231210375. https://doi.org/10.1177/17562848231210375
Zhou, C., Chen, J., Liu, K., Maharajan, K., Zhang, Y., Hou, L., Li, J., Mi, M., and Xia, Q. (2023). Isoalantolactone protects against ethanol-induced gastric ulcer via alleviating inflammation through regulation of PI3K-Akt signaling pathway and Th17 cell differentiation. Biomedicine and Pharmacotherapy, 160:114315. https://doi.org/10.1016/j.biopha.2023.114315
Zhou, Y.-L., Wang, R., Feng, X., and Zhao, X. (2014). Preventive effect of insect tea against reserpine‑induced gastric ulcers in mice. Experimental and Therapeutic Medicine, 8(4):1318-1324. https://doi.org/10.3892/etm.2014.1859








