Sequelae of hypergastrinemia due to long-term administration of proton pumPinhibitors and its management

Abstract

Abstract: Proton pumPinhibitor (PPI) is considered as the standard treatment for acid-related disorders.However,its long-term use, especially in patients with gastroesophageal reflux disease, would cause potential risks,such as hypergastrinemia along with reduced gastric acidity,hyperplasia of enterochromaffin cells (ECL), gastric neoplasms, rebound gastric acid hypersecretion when PPI treatment is stopped, increased oxyntic gastritis in patients with H.pylori infection, and the possible stimulation of growth of non-gastric tumours due to hypergastrinaemia.Each of these trends has led to numerous studies and evaluations on the potential risk-benefit ratio of the long-term use of PPIs, and countermeasures are being proposed for these problems.

Key words: proton pumPinhibitor, hypergastrinemia, gastrointestinal neoplasms

CLC Number:

R969

SHEN Jian, WU Jian-xin, LI Ding-guo. Sequelae of hypergastrinemia due to long-term administration of proton pumPinhibitors and its management[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2006, 11(12): 1321-1325.

References

1 Jensen RT.Consequences of long-term proton pumPblockade:insights from studies of patients with gastrinomas[J].Basic Clin Pharmcol Tox, 2006;98:4-19
2 Rindi G, Fiocca R, Morocutti A, Jacobs A, Miller N, Thjodleifsson B, et al.Effects of 5 years of treatment with rabeprazole or omeprazole on the gastric mucosa[J].Eur J Gastroenterol Hepatol, 2005;17:559-66
3 Klotz U, Schwab M, Treiber G.CYP2C19 polymorphism and proton pumPinhibitors[J].Basic Clin Pharmcol Tox, 2004;95:2-8
4Kuipers EJ, Nelis GF, Klinkenberg-Knol EC, Snel P, Goldfain D, Kolkman JJ, et al.Cure of Helicobacter pylori infection in patients with refluxs oesophagitis treated with long-term omeprazole reverses gastritis without exacerbation of reflux disease:results of randomized controlled trial[J].Gut, 2004;53:12-20
5Fossmark R, Johnsen G, Johanessen E, Waldum HL.Rebound acid hypersecretion after long-term inhibition of gastric acid secretion[J].Sliment Parmacol Ther, 2005;21:149-54
6 McColl KE.Helicobacter pylori infection and long term proton pumPinhibitor therapy[J].Gut, 2004;53:57
7 Qvigstad G, Waldum H.Rebound hypersecretion after inhibition of gastric acid secretion[J].Basic Clin Pharmacol Toxicol,2004;94:202-8
8 Geboes K, Dekker W, Mulder CJ, Nusteling K, Dutch Study Group.Long-term lansoprazole treatment for gastro-oesophageal reflux disease:clinical efficacy and influence on gastric mucosa[J].Aliment Pharmacol Ther, 2001;15:1189-826
9 Klinkenberg-Knol EC, Nelis F, Dent J, Snel P, Mitchell B,Prichard P, et al.Long-term omeprazole treatment in resistant gastroesophageal reflux disease:efficacy, safety, and influence on gastric mucosa[J].Gastroenterology, 2000;118:661-9
10 Uemura N, Okamoto S, Yamamoto SH.Pylori infection and the development of gastric cancer[J].Keio JMed, 2002;51:63-8
11 Flejou JF.Barrett' s oesophagus:from metaplasia to dysplasia and cancer[J].Gut, 2005;54:6-12
12 Peghini PL, Annibale B, Azzoni C, Milione M, Corleto VD,Gibril F, et al.Effect of chronic hypergastrinemia on human enterchromaffin-like cells:insight from patients with sprodiac gastrinomas[J].Gastroenterology, 2002;123:68-85
13 Smith AM, Watson SA.Gasrtin and gastrin receptor activation:an early event in the adenoma-carcinoma sequence[J].Gut,2000;47:820-4
14 Waldum HL, Gustafsson B, Fossmark R, Qvigstad G.Antiulcer drugs and gastric cancer[J].Dig Dis Sci, 2005;50:S39-44
15 Watson SA, Morris TM, McWilliams DF, Harris J, Evans S,Smith A, et al.Potential role of endocrine gastrin in the colonic adenoma carcinoma sequence[J].Br J Cancer, 2002;87:567-73
16 Raghunath AS, O' Morain C, McLoughlin RC.Review article:the Chin J Clin Pharmacol Ther 2006 Dec;11(12)long-term use of proton-pumPinhibitors[J].Aliment Pharmacol Ther, 2005;22:55-63
17 Lassen A, Hallas J, Schaffalitzky de Muckadell OB.Use of antisecretory medication:a population-based cohort study[J].Aliment Pharmacol Ther, 2004;20:577-83
18 Lassen A, Hallas J, de Muckadell OB.Eradication of Helicobacter pylori and use of antisecretory drugs:population based cohort study[J].BMJ, 2003;327:603
19 Jacobson BC, Ferris TG, Shea TL, Mahlis EM, Lee TH,Wang TC.Who is using chronic acid suppression therapy and why[J] ? Am J Gastroenterol, 2003;98:51-8
20 Bateman DN, Colin-Jones D, Hartz S, Langman M, Logan RF, Mant J, et al.Mortality study of 18 000 patients treated with omeprazole[J].Gut, 2003;52:942-6
21 Bour B, Staub JL, Chousterman M, Labayle D, Nalet B, Nouel O, et al.Long-term treatment of gastro-oesophageal reflux disease patients with frequent symptomatic relapses using rabeprazole:on-demand treatment compared with continuous treatment[J].Aliment Pharmacol Ther, 2005;21:805-12
22 Fennerty MB.Review article:alternative approaches to the long-term management of GERD[J].Aliment Pharmacol Ther,2005;22:39-44

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