Delay in oral mucosal ulcer healing by aspirin is linked to the disturbances in p38 mitogen-activated protein kinase activation

Background: Among the early manifestations of oral mucosal impairment by nonsteroidal anti-inflammatory drugs is the delay in soft oral tissue repair brought about by the amplification of apoptotic events. In this study, we investigated the effect of a specific inhibitor of p38 mitogen-activated protein kinase (p38 MAPK), SB 203580, on the rate of buccal mucosal ulcer healing and the apoptotic processes in rats subjected to intragastric administration of aspirin. Methods: Groups of rats with experimentally induced buccal mucosal ulcers were administered twice daily for 10 days with SB 203580 (5, 10, and 20 mg/kg) or vehicle followed 30 min later by concomitant administration (twice daily for 10 days) of aspirin at 20 mg/kg. The animals were killed at different periods of treatment and their mucosal tissue subjected to macroscopic assessment of ulcer healing rate, measurement of soluble tumor necrosis factor-α (TNF-α), and the assay of epithelial cell apoptosis. Results: In the control group the ulcer healed by the tenth day and the rate of healing was not affected by SB 203580 administration, whereas a 54.8% reduction in the ulcer area was attained in the presence of aspirin administration. Moreover, by the tenth day, the delay in ulcer healing caused by aspirin was manifested in a 5.6-fold higher rate of apoptosis and a 5.2-fold higher level of soluble TNF-α. Treatment with SB 203580 produced dose-dependent reduction (59.5-74.8%) in aspirin-induced increase in the mucosal level of soluble TNF-α, evoked 53.2-69.7% decrease in the rate of epithelial cell apoptosis, and led to a marked reversal (51.8-73.9%) in aspirin-induced delay in ulcer healing. Conclusions: The results of our findings link the delay in buccal mucosal ulcer healing caused by aspirin ingestion to the disturbances in the p38 MAPK activation.