{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T12:24:37Z","timestamp":1783513477718,"version":"3.55.0"},"reference-count":135,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceuticals"],"abstract":"<jats:p>Non-steroidal anti-inflammatory drugs (NSAIDs) are widely prescribed worldwide for their analgesic, antipyretic, and anti-inflammatory properties. However, their long-term use is associated with substantial gastrointestinal (GI) toxicity. Although upper GI injury has traditionally received greater attention, NSAID-induced enteropathy is now increasingly recognized as a common yet underdiagnosed condition. Advances in small-bowel imaging, particularly capsule endoscopy, have demonstrated that mucosal injury of the small intestine occurs in up to 70\u201380% of chronic NSAID users and may also develop after short-term exposure in otherwise healthy individuals, often without overt clinical symptoms. When symptoms do occur, NSAID-induced enteropathy is characterized by non-specific clinical manifestations and may lead to severe complications in approximately 1% of cases. The pathogenesis of NSAID-induced enteropathy is multifactorial and more complex than that underlying upper GI damage. It involves prostaglandin depletion, increased intestinal permeability, bile acid-mediated toxicity, enterohepatic recirculation of NSAIDs, and, importantly, interactions with the gut microbiota. Concomitant therapies, particularly proton pump inhibitors, may further aggravate small-bowel injury by promoting intestinal dysbiosis. Growing evidence supports a relevant contributory role for the gut microbiota as both a mediator and a modulator of NSAID-induced toxicity, affecting epithelial barrier function, oxidative stress, immune responses, and bile acid metabolism. This review provides an overview of current knowledge of NSAID-induced enteropathy, with a particular emphasis on the microbiota-driven mechanisms underlying mucosal injury. By integrating emerging microbiota-targeted therapeutic approaches, we propose a management algorithm that may help modify disease progression in a condition that remains frequently overlooked in clinical practice.<\/jats:p>","DOI":"10.3390\/ph19071045","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T13:19:31Z","timestamp":1783430371000},"page":"1045","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Gut Microbiota in NSAID Enteropathy: Current Evidence and Future Perspectives for Therapeutic Strategies"],"prefix":"10.3390","volume":"19","author":[{"given":"Stefania","family":"Piccirelli","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Endoscopy, Fondazione Poliambulanza Istituto Ospedaliero, 25124 Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3164-8243","authenticated-orcid":false,"given":"Brigida","family":"Barberio","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padova-Azienda Ospedaliera di Padova, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Tettoni","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Endoscopy, Fondazione Poliambulanza Istituto Ospedaliero, 25124 Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla","family":"Treppiccione","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Endoscopy, Fondazione Poliambulanza Istituto Ospedaliero, 25124 Brescia, Italy"},{"name":"Department of Translational Medicine and Surgery, Cattolica del Sacro Cuore University, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4058-079X","authenticated-orcid":false,"given":"Edoardo","family":"Pezzuto","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Endoscopy, Fondazione Poliambulanza Istituto Ospedaliero, 25124 Brescia, Italy"},{"name":"Department of Translational Medicine and Surgery, Cattolica del Sacro Cuore University, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Tabbone","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Endoscopy, Fondazione Poliambulanza Istituto Ospedaliero, 25124 Brescia, Italy"},{"name":"Department of Translational Medicine and Surgery, Cattolica del Sacro Cuore University, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7672-0686","authenticated-orcid":false,"given":"Daniele","family":"Salvi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Endoscopy, Fondazione Poliambulanza Istituto Ospedaliero, 25124 Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9816-4171","authenticated-orcid":false,"given":"Luisa","family":"Bertin","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padova-Azienda Ospedaliera di Padova, 35128 Padova, Italy"},{"name":"Gastroenterology Unit, Department of Surgery, Oncology, and Gastroenterology, University of Padova, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viviana","family":"Gerardi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Endoscopy, Fondazione Poliambulanza Istituto Ospedaliero, 25124 Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Cesaro","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Endoscopy, Fondazione Poliambulanza Istituto Ospedaliero, 25124 Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3187-2894","authenticated-orcid":false,"given":"Edoardo Vincenzo","family":"Savarino","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padova-Azienda Ospedaliera di Padova, 35128 Padova, Italy"},{"name":"Gastroenterology Unit, Department of Surgery, Oncology, and Gastroenterology, University of Padova, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1111\/1753-6405.12589","article-title":"Consumer knowledge about over-the-counter NSAIDs: They don\u2019t know what they don\u2019t know","volume":"41","author":"Mullan","year":"2017","journal-title":"Aust. N. Z. J. Public. Health"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"986","DOI":"10.1161\/ATVBAHA.110.207449","article-title":"Prostaglandins and inflammation","volume":"31","author":"Ricciotti","year":"2011","journal-title":"Arter. Thromb. Vasc. Biol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.1186\/ar4175","article-title":"Nonsteroidal anti-inflammatory drugs and upper and lower gastrointestinal mucosal damage","volume":"15","author":"Sostres","year":"2013","journal-title":"Arthritis Res. Ther."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Lim, D.H., Jung, K., Lee, S.B., Park, I.K., Cha, H.J., Park, J.H., Kim, B.G., Jung, S.W., Jeong, I.D., and Kim, J.H. (2020). Non-steroidal anti-inflammatory drug-induced enteropathy as a major risk factor for small bowel bleeding: A retrospective study. BMC Gastroenterol., 20.","DOI":"10.1186\/s12876-020-01329-5"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Maseda, D., and Ricciotti, E. (2020). NSAID-Gut Microbiota Interactions. Front. Pharmacol., 11.","DOI":"10.3389\/fphar.2020.01153"},{"key":"ref_6","first-page":"237","article-title":"Small intestinal ulcers and intestinal flora in rats given indomethacin","volume":"54","author":"Kent","year":"1969","journal-title":"Am. J. Pathol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1007\/s00535-014-1032-1","article-title":"NSAID enteropathy and bacteria: A complicated relationship","volume":"50","author":"Syer","year":"2015","journal-title":"J. Gastroenterol."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Wang, X., Tang, Q., Hou, H., Zhang, W., Li, M., Chen, D., Gu, Y., Wang, B., Hou, J., and Liu, Y. (2021). Gut Microbiota in NSAID Enteropathy: New Insights from Inside. Front. Cell. Infect. Microbiol., 11.","DOI":"10.3389\/fcimb.2021.679396"},{"key":"ref_9","unstructured":"Fortune Business Insights (2025, November 15). NSAIDs Market to Reach USD 24.35 Billion by 2027; Surging Research on Selective Cyclooxygenase-2 Inhibitors to Boost Growth. Available online: https:\/\/www.globenewswire.com\/news-release\/2020\/05\/28\/2040374\/0\/en\/NSAIDs-Market-to-Reach-USD-24-35-Billion-by-2027-Surging-Research-on-Selective-Cyclooxygenase-2-Inhibitors-to-Boost-Growth-Fortune-Business-Insights.html."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1861","DOI":"10.3748\/wjg.v19.i12.1861","article-title":"Mechanisms, prevention and clinical implications of nonsteroidal anti-inflammatory drug-enteropathy","volume":"19","author":"Wallace","year":"2013","journal-title":"World J. Gastroenterol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1302","DOI":"10.1136\/bmj.332.7553.1302","article-title":"Do selective cyclo-oxygenase-2 inhibitors and traditional non-steroidal anti-inflammatory drugs increase the risk of atherothrombosis? Meta-analysis of randomised trials","volume":"332","author":"Kearney","year":"2006","journal-title":"BMJ"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1136\/annrheumdis-2013-204155","article-title":"Gastrointestinal events in at-risk patients starting non-steroidal anti-inflammatory drugs (NSAIDs) for rheumatic diseases: The EVIDENCE study of European routine practice","volume":"74","author":"Lanas","year":"2015","journal-title":"Ann. Rheum. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"5882","DOI":"10.3748\/wjg.v29.i44.5882","article-title":"Changing trends and characteristics of peptic ulcer disease: A multicenter study from 2010 to 2019 in Korea","volume":"29","author":"Choi","year":"2023","journal-title":"World J. Gastroenterol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1247","DOI":"10.1001\/jama.284.10.1247","article-title":"Gastrointestinal toxicity with celecoxib vs nonsteroidal anti-inflammatory drugs for osteoarthritis and rheumatoid arthritis: The CLASS study: A randomized controlled trial. Celecoxib Long-term Arthritis Safety Study","volume":"284","author":"Silverstein","year":"2000","journal-title":"JAMA"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1520","DOI":"10.1056\/NEJM200011233432103","article-title":"Comparison of Upper Gastrointestinal Toxicity of Rofecoxib and Naproxen in Patients with Rheumatoid Arthritis","volume":"343","author":"Bombardier","year":"2000","journal-title":"N. Engl. J. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.1016\/j.gie.2008.08.017","article-title":"Prevention of nonsteroidal anti-inflammatory drug-induced small-intestinal injury by prostaglandin: A pilot randomized controlled trial evaluated by capsule endoscopy","volume":"69","author":"Fujimori","year":"2009","journal-title":"Gastrointest. Endosc."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1111\/j.1365-2036.2007.03312.x","article-title":"Small bowel mucosal injury is reduced in healthy subjects treated with celecoxib compared with ibuprofen plus omeprazole, as assessed by video capsule endoscopy","volume":"25","author":"Goldstein","year":"2007","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1172","DOI":"10.1053\/j.gastro.2005.03.020","article-title":"A quantitative analysis of NSAID-induced small bowel pathology by capsule enteroscopy","volume":"128","author":"Maiden","year":"2005","journal-title":"Gastroenterology"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/S1542-3565(04)00603-2","article-title":"Visible small-intestinal mucosal injury in chronic NSAID users","volume":"3","author":"Graham","year":"2005","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1159\/000190403","article-title":"Evaluation of small bowel injury in patients with rheumatoid arthritis by capsule endoscopy: Effects of anti-rheumatoid arthritis drugs","volume":"78","author":"Sugimori","year":"2008","journal-title":"Digestion"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1007\/s00535-007-2155-4","article-title":"Efficacy of rebamipide for diclofenac-induced small-intestinal mucosal injuries in healthy subjects: A prospective, randomized, double-blinded, placebo-controlled, cross-over study","volume":"43","author":"Niwa","year":"2008","journal-title":"J. Gastroenterol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1136\/gut.33.7.887","article-title":"Small bowel enteroscopy in undiagnosed gastrointestinal blood loss","volume":"33","author":"Morris","year":"1992","journal-title":"Gut"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1016\/S0140-6736(87)91075-0","article-title":"Blood and protein loss via small-intestinal inflammation induced by non-steroidal anti-inflammatory drugs","volume":"2","author":"Bjarnason","year":"1987","journal-title":"Lancet"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1007\/s00535-008-2182-9","article-title":"A prospective, single-blind trial comparing wireless capsule endoscopy and double-balloon enteroscopy in patients with obscure gastrointestinal bleeding","volume":"43","author":"Kameda","year":"2008","journal-title":"J. Gastroenterol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1111\/apt.12858","article-title":"Risk factors of symptomatic NSAID-induced small intestinal injury and diaphragm disease","volume":"40","author":"Ishihara","year":"2014","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/S1542-3565(04)00619-6","article-title":"Video capsule endoscopy to prospectively assess small bowel injury with celecoxib, naproxen plus omeprazole, and placebo","volume":"3","author":"Goldstein","year":"2005","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1111\/j.1365-2362.2010.02290.x","article-title":"Distribution of small intestinal mucosal injuries as a result of NSAID administration","volume":"40","author":"Fujimori","year":"2010","journal-title":"Eur. J. Clin. Investig."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1423","DOI":"10.1148\/rg.325115088","article-title":"Effectiveness of MR enterography for the assessment of small-bowel diseases beyond Crohn disease","volume":"32","author":"Oudjit","year":"2012","journal-title":"Radiographics"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1298","DOI":"10.1007\/s00261-022-03452-1","article-title":"Drug-induced bowel complications and toxicities: Imaging findings and pearls","volume":"47","author":"Srisajjakul","year":"2022","journal-title":"Abdom. Radiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1309\/7DDT5TDVB5C6BNHV","article-title":"Histopathology of Diaphragm Disease of the Small Intestine: A Study of 10 Cases from a Single Institution","volume":"130","year":"2008","journal-title":"Am. J. Clin. Pathol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1093\/ajcp\/110.5.622","article-title":"The histopathology of nonsteroidal anti-inflammatory drug-associated colitis","volume":"110","author":"Goldstein","year":"1998","journal-title":"Am. J. Clin. Pathol."},{"key":"ref_32","first-page":"2873","article-title":"Diaphragm disease compared with cryptogenic multifocal ulcerous stenosing enteritis","volume":"17","author":"Chung","year":"2011","journal-title":"World J. Gastroenterol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1414","DOI":"10.1097\/00000478-199911000-00013","article-title":"Clinical and pathologic overlap in nonsteroidal anti-inflammatory drug-related small bowel diaphragm disease and the neuromuscular and vascular hamartoma of the small bowel","volume":"23","author":"Cortina","year":"1999","journal-title":"Am. J. Surg. Pathol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1016\/S0140-6736(23)02586-2","article-title":"Crohn\u2019s disease","volume":"403","author":"Dolinger","year":"2024","journal-title":"Lancet"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1221","DOI":"10.1007\/s00428-024-03954-x","article-title":"Gastric-like (pseudopyloric and pseudofoveolar) metaplasia and Paneth cell hyperplasia-neglected histological features of chronic ileal inflammation","volume":"486","author":"Sejben","year":"2025","journal-title":"Virchows Arch."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1832","DOI":"10.1001\/jama.2024.19094","article-title":"Peptic Ulcer Disease: A Review","volume":"332","author":"Vakil","year":"2024","journal-title":"JAMA"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1146\/annurev.pharmtox.38.1.97","article-title":"Cyclooxygenases 1 and 2","volume":"38","author":"Vane","year":"1998","journal-title":"Annu. Rev. Pharmacol. Toxicol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1056\/NEJM200108093450607","article-title":"The coxibs, selective inhibitors of cyclooxygenase-2","volume":"345","author":"FitzGerald","year":"2001","journal-title":"N. Engl. J. Med."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Coxib traditional NSAIDTrialists\u2019 (CNT) Collaboration, Bhala, N., Emberson, J., Merhi, A., Abramson, S., Arber, N., Baron, J.A., Bombardier, C., Cannon, C., and Farkouh, M.E. (2013). BhalaVascular and upper gastrointestinal effects of non-steroidal anti-inflammatory drugs: Meta-analyses of individual participant data from randomised trials. Lancet, 382, 769\u2013779.","DOI":"10.1016\/S0140-6736(13)60900-9"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Kei, M., Uesawa, Y., and Kei, M. (2025). Comprehensive Analysis of Gastrointestinal Injury Induced by Nonsteroidal Anti-Inflammatory Drugs Using Data from FDA Adverse Event Reporting System Database. Pharmaceuticals, 18.","DOI":"10.20944\/preprints202507.1234.v1"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1111\/apt.13776","article-title":"Systematic review with meta-analysis: The gastrointestinal benefits of COX-2 selective inhibitors with concomitant use of low-dose aspirin","volume":"44","author":"Yuan","year":"2016","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1007\/s00535-011-0501-z","article-title":"Small bowel injury induced by selective cyclooxygenase-2 inhibitors: A prospective, double-blind, randomized clinical trial comparing celecoxib and meloxicam","volume":"47","author":"Maehata","year":"2012","journal-title":"J. Gastroenterol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1111\/j.1443-1661.2012.01379.x","article-title":"Evaluation of selective cyclooxygenase-2 inhibitor-induced small bowel injury: Randomized cross-over study compared with loxoprofen in healthy subjects","volume":"25","author":"Mizukami","year":"2013","journal-title":"Dig. Endosc."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1016\/j.cgh.2007.12.023","article-title":"Less small-bowel injury with lumiracoxib compared with naproxen plus omeprazole","volume":"6","author":"Hawkey","year":"2008","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1016\/j.dld.2012.12.005","article-title":"Risk factors for severe nonsteroidal anti-inflammatory drug-induced small intestinal damage","volume":"45","author":"Watanabe","year":"2013","journal-title":"Dig. Liver Dis."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1040","DOI":"10.1016\/j.cgh.2007.04.031","article-title":"Long-term effects of nonsteroidal anti-inflammatory drugs and cyclooxygenase-2 selective agents on the small bowel: A cross-sectional capsule enteroscopy study","volume":"5","author":"Maiden","year":"2007","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/S0140-6736(10)60673-3","article-title":"Celecoxib versus omeprazole and diclofenac in patients with osteoarthritis and rheumatoid arthritis (CONDOR): A randomised trial","volume":"376","author":"Chan","year":"2010","journal-title":"Lancet"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Lin, Q., Zhang, B., Dai, M., Cheng, Y., and Li, F. (2024). Aspirin Caused Intestinal Damage through FXR and ET-1 Signaling Pathways. Int. J. Mol. Sci., 25.","DOI":"10.3390\/ijms25063424"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1159\/000204465","article-title":"Incidence of small bowel injury induced by low-dose aspirin: A crossover study using capsule endoscopy in healthy volunteers","volume":"79","author":"Endo","year":"2009","journal-title":"Digestion"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1007\/s00535-009-0040-z","article-title":"Characteristics of small bowel injury in symptomatic chronic low-dose aspirin users: The experience of two medical centers in capsule endoscopy","volume":"44","author":"Endo","year":"2009","journal-title":"J. Gastroenterol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"224","DOI":"10.3164\/jcbn.18-16","article-title":"Dual antiplatelet therapy does not affect the incidence of low-dose aspirin-induced small intestinal mucosal injury in patients after percutaneous coronary intervention for coronary stenosis: A multicenter cross-sectional study","volume":"63","author":"Hara","year":"2018","journal-title":"J. Clin. Biochem. Nutr."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1016\/j.dld.2012.05.016","article-title":"Differences in the severity of small bowel mucosal injury based on the type of aspirin as evaluated by capsule endoscopy","volume":"44","author":"Endo","year":"2012","journal-title":"Dig. Liver Dis."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1111\/j.1476-5381.2011.01509.x","article-title":"NSAID gastropathy and enteropathy: Distinct pathogenesis likely necessitates distinct prevention strategies","volume":"165","author":"Wallace","year":"2012","journal-title":"Br. J. Pharmacol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1314","DOI":"10.1053\/j.gastro.2011.06.075","article-title":"Proton pump inhibitors exacerbate NSAID-induced small intestinal injury by inducing dysbiosis","volume":"141","author":"Wallace","year":"2011","journal-title":"Gastroenterology"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"S89","DOI":"10.1016\/S1590-8658(22)00318-8","article-title":"OC.08.5 the effects of long-term proton pump inhibitor therapy on gut microbiota\u2014a single-center experience","volume":"54","author":"Salvi","year":"2022","journal-title":"Dig. Liver Dis."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1016\/j.cgh.2015.10.022","article-title":"Proton Pump Inhibitors Increase Incidence of Nonsteroidal Anti-Inflammatory Drug-Induced Small Bowel Injury: A Randomized, Placebo-Controlled Trial","volume":"14","author":"Washio","year":"2016","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1933","DOI":"10.1007\/s12325-020-01338-6","article-title":"Influence of Microbiota on NSAID Enteropathy: A Systematic Review of Current Knowledge and the Role of Probiotics","volume":"37","author":"Rekatsina","year":"2020","journal-title":"Adv. Ther."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1248","DOI":"10.1124\/jpet.102.041715","article-title":"Role of cyclooxygenase (COX)-1 and COX-2 inhibition in nonsteroidal anti-inflammatory drug-induced intestinal damage in rats: Relation to various pathogenic events","volume":"303","author":"Tanaka","year":"2002","journal-title":"J. Pharmacol. Exp. Ther."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"894","DOI":"10.1023\/A:1014725024519","article-title":"16,16-Dimethyl prostaglandin E2 inhibits indomethacin-induced small intestinal lesions through EP3 and EP4 receptors","volume":"47","author":"Kunikata","year":"2002","journal-title":"Dig. Dis. Sci."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1325","DOI":"10.1038\/sj.bjp.0702426","article-title":"Effects of intravenous administration of prostacyclin on regional blood circulation in awake rats","volume":"126","author":"Raczka","year":"1999","journal-title":"Br. J. Pharmacol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"117","DOI":"10.3164\/jcbn.10-73","article-title":"Mitochondrial disorders in NSAIDs-induced small bowel injury","volume":"48","author":"Watanabe","year":"2011","journal-title":"J. Clin. Biochem. Nutr."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1046\/j.1365-2036.2000.00723.x","article-title":"Uncoupling of intestinal mitochondrial oxidative phosphorylation and inhibition of cyclooxygenase are required for the development of NSAID-enteropathy in the rat","volume":"14","author":"Somasundaram","year":"2000","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1136\/gut.41.3.344","article-title":"Mitochondrial damage: A possible mechanism of the \u201ctopical\u201d phase of NSAID induced injury to the rat intestine","volume":"41","author":"Somasundaram","year":"1997","journal-title":"Gut"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"108552","DOI":"10.1016\/j.abb.2020.108552","article-title":"Mechanistic perspective of morin protection against ketoprofen-induced gastric mucosal injury: Targeting HMGB1\/RAGE\/NF-\u03baB, DJ-1\/Nrf2\/HO-1 and PI3K\/mTOR pathways","volume":"693","author":"Arab","year":"2020","journal-title":"Arch. Biochem. Biophys."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1038\/mi.2015.89","article-title":"Mechanisms of NLRP3 inflammasome activation and its role in NSAID-induced enteropathy","volume":"9","author":"Higashimori","year":"2016","journal-title":"Mucosal Immunol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1111\/jphp.13227","article-title":"Natural polyphenols prevent indomethacin-induced and diclofenac-induced Caco-2 cell death by reducing endoplasmic reticulum stress regardless of their direct reactive oxygen species scavenging capacity","volume":"72","author":"Boonyong","year":"2020","journal-title":"J. Pharm. Pharmacol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1016\/j.cmet.2012.07.007","article-title":"IRE1\u03b1 induces thioredoxin-interacting protein to activate the NLRP3 inflammasome and promote programmed cell death under irremediable ER stress","volume":"16","author":"Lerner","year":"2012","journal-title":"Cell Metab."},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Chang, C.Y., Li, J.R., Wu, C.C., Wang, J.D., Liao, S.L., Chen, W.Y., Wang, W.Y., and Chen, C.J. (2020). Endoplasmic Reticulum Stress Contributes to Indomethacin-Induced Glioma Apoptosis. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21020557"},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Wu, H., Zeng, W., Dai, N., Gu, J., He, Y., Qin, H., Lin, L., Fu, X., Fu, B., and Xing, Z. (2025). Hyperoxia as a driver of gut dysbiosis. Front. Microbiol., 16.","DOI":"10.3389\/fmicb.2025.1675652"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"774","DOI":"10.1038\/s41579-021-00583-y","article-title":"When anaerobes encounter oxygen: Mechanisms of oxygen toxicity, tolerance and defence","volume":"19","author":"Lu","year":"2021","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1126\/science.aam9949","article-title":"Microbiota-activated PPAR-\u03b3 signaling inhibits dysbiotic Enterobacteriaceae expansion","volume":"357","author":"Byndloss","year":"2017","journal-title":"Science"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1016\/0090-6980(77)90178-2","article-title":"Resistance of germfree rats to indomethacin-induced intestinal lesions","volume":"14","author":"Robert","year":"1977","journal-title":"Prostaglandins"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1007\/s00535-016-1205-1","article-title":"Psychological stress exacerbates NSAID-induced small bowel injury by inducing changes in intestinal microbiota and permeability via glucocorticoid receptor signaling","volume":"52","author":"Yoshikawa","year":"2017","journal-title":"J. Gastroenterol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1038\/mi.2016.75","article-title":"Mechanisms of inflammation-driven bacterial dysbiosis in the gut","volume":"10","author":"Zeng","year":"2017","journal-title":"Mucosal Immunol."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"fiaf054","DOI":"10.1093\/femsec\/fiaf054","article-title":"Deciphering oxidative stress responses in human gut microbes and fecal microbiota: A cultivation-based approach","volume":"101","author":"Caflisch","year":"2025","journal-title":"FEMS Microbiol. Ecol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1128\/CMR.00008-07","article-title":"Bacteroides: The Good, the Bad, and the Nitty-Gritty","volume":"20","author":"Wexler","year":"2007","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_77","doi-asserted-by":"crossref","unstructured":"Naguib, M., Feldman, N., Zarodkiewicz, P., Shropshire, H., Biamis, C., El-Halfawy, O.M., McCain, J., Dezanet, C., D\u00e9cout, J.L., and Chen, Y. (2022). An evolutionary conserved detoxification system for membrane lipid\u2013derived peroxyl radicals in Gram-negative bacteria. PLoS Biol., 20.","DOI":"10.1371\/journal.pbio.3001610"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"40317","DOI":"10.1038\/srep40317","article-title":"Gut Microbiota Mediates Protection Against Enteropathy Induced by Indomethacin","volume":"7","author":"Xiao","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"fj201800560R","DOI":"10.1096\/fj.201800560R","article-title":"Sex differences in NSAID-induced perturbation of human intestinal barrier function and microbiota","volume":"32","author":"Edogawa","year":"2018","journal-title":"FASEB J."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1136\/gut.2007.125963","article-title":"Non-steroidal anti-inflammatory drug-induced small intestinal damage is Toll-like receptor 4 dependent","volume":"57","author":"Watanabe","year":"2008","journal-title":"Gut"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"1576","DOI":"10.1093\/molbev\/msy050","article-title":"Evolutionary Origins of Toll-like Receptor Signaling","volume":"35","author":"Brennan","year":"2018","journal-title":"Mol. Biol. Evol."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"2085","DOI":"10.1126\/science.282.5396.2085","article-title":"Defective LPS signaling in C3H\/HeJ and C57BL\/10ScCr mice: Mutations in Tlr4 gene","volume":"282","author":"Poltorak","year":"1998","journal-title":"Science"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"1777","DOI":"10.1084\/jem.189.11.1777","article-title":"MD-2, a molecule that confers lipopolysaccharide responsiveness on Toll-like receptor 4","volume":"189","author":"Shimazu","year":"1999","journal-title":"J. Exp. Med."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"1838","DOI":"10.1111\/j.1440-1746.2007.04905.x","article-title":"Butter feeding enhances TNF-alpha production from macrophages and lymphocyte adherence in murine small intestinal microvessels","volume":"22","author":"Fujiyama","year":"2007","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"5887","DOI":"10.4049\/jimmunol.167.10.5887","article-title":"Lipopolysaccharide stimulates the MyD88-independent pathway and results in activation of IFN-regulatory factor 3 and the expression of a subset of lipopolysaccharide-inducible genes","volume":"167","author":"Kawai","year":"2001","journal-title":"J. Immunol."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1080\/19490976.2016.1156827","article-title":"The microbiota-derived metabolite indole decreases mucosal inflammation and injury in a murine model of NSAID enteropathy","volume":"7","author":"Cohen","year":"2016","journal-title":"Gut Microbes"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.ajpath.2012.03.039","article-title":"High mobility group box 1 promotes small intestinal damage induced by nonsteroidal anti-inflammatory drugs through Toll-like receptor 4","volume":"181","author":"Nadatani","year":"2012","journal-title":"Am. J. Pathol."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"5230374","DOI":"10.1155\/2017\/5230374","article-title":"The Role of High-Mobility Group Box-1 and Its Crosstalk with Microbiome in Rheumatoid Arthritis","volume":"2017","author":"Biscetti","year":"2017","journal-title":"Mediat. Inflamm."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1007\/s10875-010-9505-3","article-title":"Alarmin HMGB1 is released in the small intestine of gnotobiotic piglets infected with enteric pathogens and its level in plasma reflects severity of sepsis","volume":"31","author":"Splichalova","year":"2011","journal-title":"J. Clin. Immunol."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"7764","DOI":"10.3748\/wjg.v21.i25.7764","article-title":"Overexpression of HMGB1 A-box reduced lipopolysaccharide-induced intestinal inflammation via HMGB1\/TLR4 signaling in vitro","volume":"21","author":"Wang","year":"2015","journal-title":"World J. Gastroenterol."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1007\/s00204-006-0149-2","article-title":"Role of bile in pathogenesis of indomethacin-induced enteropathy","volume":"81","author":"Jacob","year":"2007","journal-title":"Arch. Toxicol."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"14","DOI":"10.3390\/pathogens3010014","article-title":"Metabolism of cholesterol and bile acids by the gut microbiota","volume":"3","year":"2013","journal-title":"Pathogens"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"13580","DOI":"10.1073\/pnas.0804437105","article-title":"Functional and comparative metagenomic analysis of bile salt hydrolase activity in the human gut microbiome","volume":"105","author":"Jones","year":"2008","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_94","first-page":"G1249","article-title":"Taurochenodeoxycholic acid ameliorates and ursodeoxycholic acid exacerbates small intestinal inflammation","volume":"272","author":"Uchida","year":"1997","journal-title":"Am. J. Physiol."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1097\/01.SLA.0000060459.03270.E7","article-title":"NF-kappaB regulates intestinal epithelial cell and bile salt-induced migration after injury","volume":"237","author":"Strauch","year":"2003","journal-title":"Ann. Surg."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1136\/gutjnl-2012-302578","article-title":"Connecting dysbiosis, bile-acid dysmetabolism and gut inflammation in inflammatory bowel diseases","volume":"62","author":"Duboc","year":"2013","journal-title":"Gut"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1007\/BF01080872","article-title":"Pharmacokinetics and bioavailability of diclofenac in the rat","volume":"19","author":"Aristorena","year":"1991","journal-title":"J. Pharmacokinet. Biopharm."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1093\/toxsci\/61.1.49","article-title":"Characterization of rat and human UDP-glucuronosyltransferases responsible for the in vitro glucuronidation of diclofenac","volume":"61","author":"King","year":"2001","journal-title":"Toxicol. Sci."},{"key":"ref_99","first-page":"332","article-title":"Stereoselective metabolism of benoxaprofen in rats","volume":"26","author":"Mohri","year":"1998","journal-title":"Biliary Excretion Benoxaprofen Taur. Conjug. Glucuronide. Drug Metab. Dispos."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"1179","DOI":"10.1016\/S0016-5085(00)70371-4","article-title":"Role of biliary phosphatidylcholine in bile acid protection and NSAID injury of the ileal mucosa in rats","volume":"118","author":"Barrios","year":"2000","journal-title":"Gastroenterology"},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"e12725","DOI":"10.14814\/phy2.12725","article-title":"Indomethacin injury to the rat small intestine is dependent upon biliary secretion and is associated with overgrowth of enterococci","volume":"4","author":"Mayo","year":"2016","journal-title":"Physiol. Rep."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"1174","DOI":"10.1136\/gutjnl-2020-323071","article-title":"Gut microbiota-derived metabolites as central regulators in metabolic disorders","volume":"70","author":"Agus","year":"2021","journal-title":"Gut"},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1017\/S000711450888871X","article-title":"The effect of ageing with and without non-steroidal anti-inflammatory drugs on gastrointestinal microbiology and immunology","volume":"100","author":"Tiihonen","year":"2008","journal-title":"Br. J. Nutr."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"6734","DOI":"10.1038\/ncomms7734","article-title":"Metabolite-sensing receptors GPR43 and GPR109A facilitate dietary fibre-induced gut homeostasis through regulation of the inflammasome","volume":"6","author":"Macia","year":"2015","journal-title":"Nat. Commun."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1159\/000064419","article-title":"Pathogenic Importance of Intestinal Hypermotility in NSAID-Induced Small Intestinal Damage in Rats","volume":"66","author":"Takeuchi","year":"2002","journal-title":"Digestion"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1038\/ajg.2014.82","article-title":"Risk of upper gastrointestinal bleeding with selective serotonin reuptake inhibitors with or without concurrent nonsteroidal anti-inflammatory use: A systematic review and meta-analysis","volume":"109","author":"Anglin","year":"2014","journal-title":"Am. J. Gastroenterol."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"1395","DOI":"10.1096\/fj.14-259598","article-title":"Gut microbes promote colonic serotonin production through an effect of short-chain fatty acids on enterochromaffin cells","volume":"29","author":"Reigstad","year":"2015","journal-title":"FASEB J."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1016\/j.cell.2015.02.047","article-title":"Indigenous bacteria from the gut microbiota regulate host serotonin biosynthesis","volume":"161","author":"Yano","year":"2015","journal-title":"Cell"},{"key":"ref_109","doi-asserted-by":"crossref","unstructured":"Lanas, A., Garcia-Tell, G., Armada, B., and Oteo-Alvaro, A. (2011). Prescription patterns and appropriateness of NSAID therapy according to gastrointestinal risk and cardiovascular history in patients with diagnoses of osteoarthritis. BMC Med., 9.","DOI":"10.1186\/1741-7015-9-38"},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"361","DOI":"10.2147\/JPR.S156938","article-title":"Coprescribing proton-pump inhibitors with nonsteroidal anti-inflammatory drugs: Risks versus benefits","volume":"11","author":"Gwee","year":"2018","journal-title":"J. Pain. Res."},{"key":"ref_111","doi-asserted-by":"crossref","unstructured":"Colucci, R., Pellegrini, C., Fornai, M., Tirotta, E., Antonioli, L., Renzulli, C., Ghelardi, E., Piccoli, E., Gentile, D., and Benvenuti, L. (2018). Pathophysiology of NSAID-Associated Intestinal Lesions in the Rat: Luminal Bacteria and Mucosal Inflammation as Targets for Prevention. Front. Pharmacol., 9.","DOI":"10.3389\/fphar.2018.01340"},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"980","DOI":"10.1053\/j.gastro.2016.12.007","article-title":"Rifaximin Reduces the Number and Severity of Intestinal Lesions Associated with Use of Nonsteroidal Anti-Inflammatory Drugs in Humans","volume":"152","author":"Scarpignato","year":"2017","journal-title":"Gastroenterology"},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1038\/s41598-020-80482-z","article-title":"Probiotic lactobacilli as a promising strategy to ameliorate disorders associated with intestinal inflammation induced by a non-steroidal anti-inflammatory drug","volume":"11","author":"Monteros","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"G506","DOI":"10.1152\/ajpgi.90553.2008","article-title":"Probiotic Lactobacillus casei strain Shirota prevents indomethacin-induced small intestinal injury: Involvement of lactic acid","volume":"297","author":"Watanabe","year":"2009","journal-title":"Am. J. Physiol. Gastrointest. Liver Physiol."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"3215","DOI":"10.1111\/bph.16200","article-title":"Use of Saccharomyces boulardii CNCM I-745 as therapeutic strategy for prevention of nonsteroidal anti-inflammatory drug-induced intestinal injury","volume":"180","author":"Antonioli","year":"2023","journal-title":"Br. J. Pharmacol."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"20830","DOI":"10.1021\/acs.jafc.5c05590","article-title":"Competitive Inhibition of LPS Binding to CD14 by Bifidobacterium adolescentis FXJWS49M31 Polysaccharide Alleviates TNF-\u03b1 Secretion and Inflammatory Responses","volume":"73","author":"Yan","year":"2025","journal-title":"J. Agric. Food Chem."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1053\/j.gastro.2019.05.008","article-title":"Bifidobacteriumbreve Bif195 Protects Against Small-Intestinal Damage Caused by Acetylsalicylic Acid in Healthy Volunteers","volume":"157","author":"Mortensen","year":"2019","journal-title":"Gastroenterology"},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1111\/j.1365-2036.2007.03556.x","article-title":"Development of a capsule endoscopy scoring index for small bowel mucosal inflammatory change","volume":"27","author":"Gralnek","year":"2008","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1159\/000452361","article-title":"Yogurt Containing Lactobacillus gasseri Mitigates Aspirin-Induced Small Bowel Injuries: A Prospective, Randomized, Double-Blind, Placebo-Controlled Trial","volume":"95","author":"Suzuki","year":"2017","journal-title":"Digestion"},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1111\/j.1365-2036.2010.04324.x","article-title":"Clinical trial: The effects of a probiotic mixture on non-steroidal anti-inflammatory drug enteropathy\u2014A randomized, double-blind, cross-over, placebo-controlled study","volume":"32","author":"Montalto","year":"2010","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"4625","DOI":"10.1111\/bcp.14880","article-title":"Effects of Bifidobacterium animalis ssp. lactis 420 on gastrointestinal inflammation induced by a nonsteroidal anti-inflammatory drug: A randomized, placebo-controlled, double-blind clinical trial","volume":"87","author":"Forssten","year":"2021","journal-title":"Br. J. Clin. Pharmacol."},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"16796","DOI":"10.1038\/s41598-019-52980-2","article-title":"High-fat diet-mediated dysbiosis exacerbates NSAID-induced small intestinal damage through the induction of interleukin-17A","volume":"9","author":"Sugimura","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s10620-015-3963-7","article-title":"Prevention of NSAID-Enteropathy: A Soluble Problem?","volume":"61","author":"Wallace","year":"2016","journal-title":"Dig. Dis. Sci."},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"1903","DOI":"10.1007\/s10620-016-4086-5","article-title":"Soluble Dietary Fiber Can Protect the Gastrointestinal Mucosa Against Nonsteroidal Anti-Inflammatory Drugs in Mice","volume":"61","author":"Satoh","year":"2016","journal-title":"Dig. Dis. Sci."},{"key":"ref_125","doi-asserted-by":"crossref","unstructured":"Xue, S., Shi, W., Shi, T., Tuerxuntayi, A., Abulaiti, P., Liu, Z., Remutula, N., Nuermaimaiti, K., Xing, Y., and Abdukelimu, K. (2024). Resveratrol attenuates non-steroidal anti-inflammatory drug-induced intestinal injury in rats in a high-altitude hypoxic environment by modulating the TLR4\/NF\u03baB\/I\u03baB pathway and gut microbiota composition. PLoS ONE, 19.","DOI":"10.1371\/journal.pone.0305233"},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"5878","DOI":"10.1080\/10408398.2022.2159921","article-title":"Resveratrol in disease prevention and health promotion: A role of the gut microbiome","volume":"64","author":"Chen","year":"2024","journal-title":"Crit. Rev. Food Sci. Nutr."},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"fuad039","DOI":"10.1093\/femsre\/fuad039","article-title":"Faecalibacterium: A bacterial genus with promising human health applications","volume":"47","author":"Huillet","year":"2023","journal-title":"FEMS Microbiol. Rev."},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"wraf027","DOI":"10.1093\/ismejo\/wraf027","article-title":"Targeted prebiotic application of gluconic acid-containing oligosaccharides promotes Faecalibacterium growth through microbial cross-feeding networks","volume":"19","author":"Negishi","year":"2025","journal-title":"ISME J."},{"key":"ref_129","doi-asserted-by":"crossref","unstructured":"Arron, M.N.N., Bluiminck, S., Ten Broek, R.P.G., Ederveen, T.H.A., Alpert, L., Zaborina, O., Alverdy, J.C., and van Goor, H. (2024). The Combined Effect of Western Diet Consumption and Diclofenac Administration Alters the Gut Microbiota and Promotes Anastomotic Leakage in the Distal Colon. Biomedicines, 12.","DOI":"10.3390\/biomedicines12102170"},{"key":"ref_130","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1124\/jpet.111.191122","article-title":"Pharmacologic targeting of bacterial \u03b2-glucuronidase alleviates nonsteroidal anti-inflammatory drug-induced enteropathy in mice","volume":"341","author":"LoGuidice","year":"2012","journal-title":"J. Pharmacol. Exp. Ther."},{"key":"ref_131","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1016\/j.tips.2007.09.003","article-title":"Hydrogen sulfide-releasing anti-inflammatory drugs","volume":"28","author":"Wallace","year":"2007","journal-title":"Trends Pharmacol. Sci."},{"key":"ref_132","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.coph.2014.07.005","article-title":"Prophylactic effects of prostaglandin E2 on NSAID-induced enteropathy-role of EP4 receptors in its protective and healing-promoting effects","volume":"19","author":"Takeuchi","year":"2014","journal-title":"Curr. Opin. Pharmacol."},{"key":"ref_133","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1053\/j.gastro.2017.10.049","article-title":"Mechanisms of Damage to the Gastrointestinal Tract from Nonsteroidal Anti-Inflammatory Drugs","volume":"154","author":"Bjarnason","year":"2018","journal-title":"Gastroenterology"},{"key":"ref_134","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1016\/j.gtc.2009.03.007","article-title":"Nonsteroidal anti-inflammatory drugs and lower gastrointestinal complications","volume":"38","author":"Lanas","year":"2009","journal-title":"Gastroenterol. Clin. N. Am."},{"key":"ref_135","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1007\/s00535-012-0648-2","article-title":"NSAID enteropathy: Could probiotics prevent it?","volume":"48","author":"Montalto","year":"2013","journal-title":"J. Gastroenterol."}],"container-title":["Pharmaceuticals"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8247\/19\/7\/1045\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T12:07:27Z","timestamp":1783512447000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8247\/19\/7\/1045"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,7]]},"references-count":135,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["ph19071045"],"URL":"https:\/\/doi.org\/10.3390\/ph19071045","relation":{},"ISSN":["1424-8247"],"issn-type":[{"value":"1424-8247","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,7]]}}}