[Influence of long-term gastric acid suppression therapy on the expression of serum gastrin, chromogranin A, and ghrelin].
OBJECTIVE
Long-term use of proton pump inhibitor (PPI) induces hypergastrinemia, which results from the suppression of gastric acid secretion. Hypergastrinemia causes enterochromaffin-like (ECL) cell hyperplasia, which is a predisposing factor of carcinoid tumor of stomach. The aim of this study was to identify the effect of long-term gastric acid suppression on the gastric peptides levels, such as gastrin, chromogranin A, or ghrelin.


METHODS
Control group included patients who had no medication over six months. Both H(2)RA (H(2) receptor antagonist) and PPI groups had medication at least for six months. Fasting blood was taken from each patient to assay serum gastrin, chromogranin A, and ghrelin by RIA and ELISA techniques.


RESULTS
The patients with the above reference range of serum gastrin and chromogranin A were more commonly found in PPI group compared to control and H(2)RA group. However, serum ghrelin level was within the reference range in all the patients regardless of groups. There was no difference in the ratio of serum gastrin/chromogranin A among three groups. Both average serum levels of gastrin and chromogranin A were significantly elevated in PPI group compared to control and H(2)RA group. There was a significant correlation between the level of serum gastrin and chromogranin A.


CONCLUSIONS
Long-term administration of H(2)RA does not affect the serum gastrin and chromogranin A level. However, long-term administration of PPI increases serum gastrin and chromogranin A. Ghrelin may influence gastric acid secretion in other pathway than ECL cell-mediated pathway such as gastrin or chromogranin A.
Kim
Byung-Wook
BW
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Lee
Bo-In
BI
Kim
Hyung-Keun
HK
Cho
Young-Seok
YS
Chae
Hiun-Suk
HS
Lee
Hae-Kyung
HK
Kim
Hyun-Jung
HJ
Han
Sok-Won
SW
D000328:Adult; D000368:Aged; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D053379:Chromogranin A / Q000097:blood*; D005260:Female; D005755:Gastrins / Q000097:blood*; D054439:Ghrelin / Q000097:blood*; D006635:Histamine H2 Antagonists / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D013997:Time Factors
D000897:Anti-Ulcer Agents; D053379:Chromogranin A; D005755:Gastrins; D054439:Ghrelin; D006635:Histamine H2 Antagonists; D054328:Proton Pump Inhibitors