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Potential Anti-inflammatory Effects of Proton Pump Inhibitors: A Review and Discussion of the Clinical Implications

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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.

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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).

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Authors and Affiliations

  1. VA North Texas Healthcare System, Dallas, TX, USA

    Ramalinga R. Kedika, Rhonda F. Souza & Stuart Jon Spechler

  2. The University of Texas Southwestern Medical Center, Dallas, TX, USA

    Ramalinga R. Kedika, Rhonda F. Souza & Stuart Jon Spechler

  3. Division of Gastroenterology, Dallas VA Medical Center, 4500 South Lancaster Road, Dallas, TX, 75216, USA

    Stuart Jon Spechler

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  1. Ramalinga R. Kedika
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  2. Rhonda F. Souza
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Correspondence to Stuart Jon Spechler.

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Kedika, R.R., Souza, R.F. & Spechler, S.J. Potential Anti-inflammatory Effects of Proton Pump Inhibitors: A Review and Discussion of the Clinical Implications. Dig Dis Sci 54, 2312–2317 (2009). https://doi.org/10.1007/s10620-009-0951-9

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