TY - JOUR
T1 - Potential anti-inflammatory effects of proton pump inhibitors
T2 - A review and discussion of the clinical implications
AU - Kedika, Ramalinga R.
AU - Souza, Rhonda F.
AU - Spechler, Stuart Jon
N1 - Funding Information:
Acknowledgments This work was supported by the Office of Medical Research, Department of Veterans Affairs (R.F. Souza and S.J. Spechler) and the National Institutes of Health (R01-CA134571 to R.F. Souza and S.J. Spechler, and R01-DK63621 to R.F. Souza).
PY - 2009/11
Y1 - 2009/11
N2 - Proton pump inhibitors (PPIs) are potent blockers of gastric acid secretion, and are widely regarded as the agents of choice for the treatment of acid-peptic disorders. For patients with upper gastrointestinal symptoms of uncertain etiology, improvement with PPI therapy is considered prima facie evidence of a pathogenetic role for acid-peptic disease. In addition to anti-secretory effects, however, PPIs have been found to have anti-oxidant properties and direct effects on neutrophils, monocytes, endothelial, and epithelial cells that might prevent inflammation. Those anti-inflammatory effects of the PPIs might influence a variety of inflammatory disorders, both peptic and non-peptic, within and outside of the gastrointestinal tract. The purpose of this report is to review the mechanisms whereby PPIs might exert anti-inflammatory effects exclusive of gastric acid inhibition, to discuss the clinical implications of those effects, and to emphasize that a clinical response to PPIs should not be construed as proof for an underlying acid-peptic disorder.
AB - Proton pump inhibitors (PPIs) are potent blockers of gastric acid secretion, and are widely regarded as the agents of choice for the treatment of acid-peptic disorders. For patients with upper gastrointestinal symptoms of uncertain etiology, improvement with PPI therapy is considered prima facie evidence of a pathogenetic role for acid-peptic disease. In addition to anti-secretory effects, however, PPIs have been found to have anti-oxidant properties and direct effects on neutrophils, monocytes, endothelial, and epithelial cells that might prevent inflammation. Those anti-inflammatory effects of the PPIs might influence a variety of inflammatory disorders, both peptic and non-peptic, within and outside of the gastrointestinal tract. The purpose of this report is to review the mechanisms whereby PPIs might exert anti-inflammatory effects exclusive of gastric acid inhibition, to discuss the clinical implications of those effects, and to emphasize that a clinical response to PPIs should not be construed as proof for an underlying acid-peptic disorder.
KW - Anti-inflammatory agents
KW - Anti-oxidants
KW - Eosinophilic esophagitis
KW - Inflammation
KW - Oxidative stress
KW - Proton pump inhibitors
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U2 - 10.1007/s10620-009-0951-9
DO - 10.1007/s10620-009-0951-9
M3 - Review article
C2 - 19714466
AN - SCOPUS:70350212812
SN - 0163-2116
VL - 54
SP - 2312
EP - 2317
JO - Digestive Diseases and Sciences
JF - Digestive Diseases and Sciences
IS - 11
ER -