title: Potential anti-inflammatory effects of proton pump inhibitors: a review and discussion of the clinical implications.
abstract: 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.
authors.affiliation: VA North Texas Healthcare System, Dallas, TX, USA.
authors.forename: Ramalinga R
authors.initials: RR
authors.lastname: Kedika
authors.forename: Rhonda F
authors.initials: RF
authors.lastname: Souza
authors.forename: Stuart Jon
authors.initials: SJ
authors.lastname: Spechler
mesh_terms: D000975:Antioxidants / Q000494:pharmacology / Q000627:therapeutic use*; D016207:Cytokines / Q000096:biosynthesis; D042783:Endothelial Cells / Q000187:drug effects / Q000378:metabolism; D005753:Gastric Mucosa / Q000187:drug effects / Q000378:metabolism; D041981:Gastrointestinal Tract / Q000382:microbiology; D006801:Humans; D007249:Inflammation / Q000188:drug therapy* / Q000378:metabolism; D010437:Peptic Ulcer / Q000175:diagnosis / Q000188:drug therapy*; D054328:Proton Pump Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D000975:Antioxidants; D016207:Cytokines; D054328:Proton Pump Inhibitors