Is an acid pH medium required for the protective effect of sucralfate against mucosal injury?

It has been suggested that an acidic medium is required for the action of sucralfate in providing mucosal protection. We have examined the effect of sucralfate (300 mg/kg) at an acidic pH of 1.5 and a near-neutral pH of 6.5 on the occurrence of mucosal damage induced in rats by aspirin alone and aspirin combined with bile acids. Fasting Sprague-Dawley rats received test solutions by oral intubation, and their stomachs were examined four hours later for the presence of hemorrhagic erosions. Sucralfate significantly reduced mucosal erosions induced by aspirin alone and aspirin combined with bile acids at pHs of both 1.5 and 6.5. These results indicate that the protective effect of sucralfate against mucosal injury induced by aspirin and bile acids is not dependent on an acidic medium.