Mucosal coating agents and other nonantisecretory agents. Are they cytoprotective?

Gastric cytoprotection is protection against gross and histological gastric mucosal injury by a mechanism other than inhibition of neutralization of gastric acid secretion. Animal studies have shown that a variety of agents afford such a protective effect. With some of these agents, a similar protective effect has been shown in man. This protective effect must be distinguished from an action that enhances healing of an already established mucosal lesion as an ulcer. It is yet to be established that the cytoprotective effect of an agent enhances ulcer healing. Agents other than prostaglandins that have been shown to possess such a cytoprotective effect in animals are reviewed. Some, such as sucralfate, act via stimulation of endogenous prostaglandin synthesis, while others, such as DeNol, neomycin, and meciadanol, do not. Investigation of the mechanism through which these agents enhance gastric mucosal defense is a fertile field for investigation.