Potential anti-inflammatory effects of proton pump inhibitors: A review and discussion of the clinical implications

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

Research output: Contribution to journalReview articlepeer-review

216 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)2312-2317
Number of pages6
JournalDigestive Diseases and Sciences
Volume54
Issue number11
DOIs
StatePublished - Nov 2009

Keywords

  • Anti-inflammatory agents
  • Anti-oxidants
  • Eosinophilic esophagitis
  • Inflammation
  • Oxidative stress
  • Proton pump inhibitors

ASJC Scopus subject areas

  • Physiology
  • Gastroenterology

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