title: The effect of proton pump inhibitors on the gastric mucosal microenvironment.
abstract: BACKGROUND
  Proton pump inhibitors (PPIs) are widely applied for acid related disorders, and possess pleiotropic biological functions. The effect of PPIs on the gastric mucosa, neutrophil and Helicobacter pylori (H. pylori) infiltration and glandular atrophy has not been well investigated, particularly the duration of the effects of PPIs.
  
  
  OBJECTIVE
  To investigate the effects of PPIs on neutrophil infiltration, H. pylori infiltration and the gastric mucosa.
  
  
  METHODS
  A total of 76 adult patients with gastrointestinal symptoms who had undergone upper gastrointestinal endoscopy were enrolled in the study. Each patient's history was recorded, including smoking, alcohol consumption and the duration of PPI use prior to gastric biopsy. Endoscopic biopsies of gastric antral mucosa were performed and evaluated by histology. Neutrophil and H. pylori infiltration were graded by H & E staining in accordance with the updated Sydney system.
  
  
  RESULTS
  Among the 76 patients, 44 patients had H. pylori infection and 19 patients had taken PPIs for varying durations prior to gastric biopsy. Neutrophil infiltration was significantly inhibited by PPIs (p = 0.005). The duration of PPI use was correlated with inhibition of neutrophil and H. pylori infiltration. A logistical regression analysis demonstrated that PPIs significantly inhibited neutrophil infiltration in the gastric mucosa and were associated with atrophy of the mucosa.
  
  
  CONCLUSIONS
  PPIs attenuated neutrophil infiltration of gastric mucosa, and may be related to atrophy of the mucosa.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine,Taichung Veterans General Hospital, Taichung, Taiwan.|Department of Veterinary Medicine, School of Medicine, National Chung Hsing University, Taichung, Taiwan.|National Yang Ming University, Taipei, Taiwan.
authors.forename: Yen-Chun
authors.initials: YC
authors.lastname: Peng
authors.affiliation: Department of Medical Laboratory Science and Biotechnology, Central Taiwan University of Science and Technology, Taichung, Taiwan.
authors.forename: Lan-Ru
authors.initials: LR
authors.lastname: Huang
authors.affiliation: Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Hui-Ching
authors.initials: HC
authors.lastname: Ho
authors.affiliation: Department of Medical Laboratory Science and Biotechnology, Central Taiwan University of Science and Technology, Taichung, Taiwan.
authors.forename: Chi-Sen
authors.initials: CS
authors.lastname: Chang
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine,Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Shou-Wu
authors.initials: SW
authors.lastname: Lee
authors.affiliation: Laboratory Animal Service Center, Office of Research and Development, China Medical University, Taichung, Taiwan.
authors.forename: Ching-Chang
authors.initials: CC
authors.lastname: Cheng
authors.affiliation: Department of Pathology, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: May-Ching
authors.initials: MC
authors.lastname: Wen
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine,Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Hong-Zen
authors.initials: HZ
authors.lastname: Yeh
authors.affiliation: Department of Veterinary Medicine, School of Medicine, National Chung Hsing University, Taichung, Taiwan.
authors.forename: Shu-Peng
authors.initials: SP
authors.lastname: Ho
mesh_terms: D000328:Adult; D000368:Aged; D001284:Atrophy / Q000473:pathology; D060833:Cellular Microenvironment / Q000187:drug effects; D005260:Female; D005753:Gastric Mucosa / Q000187:drug effects* / Q000473:pathology*; D005756:Gastritis / Q000473:pathology; D016481:Helicobacter Infections / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D020556:Neutrophil Infiltration / Q000187:drug effects*; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*
chemical_list: D054328:Proton Pump Inhibitors
keywords: Helicobacter pylori; gastric mucosa; neutrophil; proton pump inhibitor