Current trends in the treatment of upper gastrointestinal disease

doi:10.1053/bega.2002.0338

Best Practice & Research Clinical Gastroenterology

Volume 16, Issue 6, December 2002, Pages 835-849

https://doi.org/10.1053/bega.2002.0338 Get rights and content

Abstract

The past 25 years have seen an amazing improvement in the treatment and understanding of acid-related disorders. In particular, the introduction of selective histamine receptor antagonists and proton pump inhibitors has made the medical control of acid secretion an effective means of therapy. The demonstration that infection with Helicobacter pylori is responsible for most cases of peptic ulcer disease resulted in another major improvement in therapy in these areas as a result of the eradication of the organism. Research continues in an attempt to find improved means of acid control and better methods for the eradication of H. pylori based on unique proteins expressed by the organism to resist gastric acidity.

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Cited by (20)

Temporal trends in dietary supplement prescriptions of United States military service members suggest a decrease in pyridoxine and increase in vitamin D supplements from 2005 to 2013
2016, Nutrition Research
Citation Excerpt :
In the 1970’s, a class of acid suppressive drugs, histamine 2 receptor antagonists (H2RAs), was developed. In the 1990’s, proton pump inhibitors (PPIs) were developed that were extremely effective in blocking the final common pathway of gastric acid secretion, the hydrogen/potassium-APTase proton pump [60]. Other drugs in development or on the market for GERD include potassium-competitive acid blockers and drugs that reduce transient lower esophageal sphincter relaxation (TLESR reducers) [61].
Dietary supplements (DSs) can be obtained over-the-counter but can also be prescribed by health-care providers for therapeutic reasons. Few studies have documented this later source despite the fact that 79% of physicians and 82% of nurses have recommended DSs to patients. This investigation assessed prevalence and temporal trends in oral DS prescriptions filled by all United States service members (SMs) from 2005 to 2013 (n = 1 427 080 ± 22 139, mean ± standard deviation (SD)/y). We hypothesize that there would be temporal variations in specific types of DSs. Data obtained from Department of Defense Pharmacy Data Transaction System were grouped by American Hospital Formulary System pharmacologic-therapeutic classifications and prevalence examined over time. About 11% of SMs filled one or more DS prescriptions of 235 180 ± 4926 (mean ± SD) prescriptions/y over the 9-year period. Curve-fitting techniques indicated significant linear declines over time for multivitamins (P = .004), iron preparations (P < .001), antacids (P < .001), and vitamin B and B complex vitamins (P < .001). There were significant quadratic trends indicating a rise in early years followed by a leveling off in later years for replacement preparations (P < .001) and vitamin C (P < .001). There were significant quadratic trends (P < .001) for vitamin E indicating a decline in early years and leveling off in later years, and vitamin D indicating little change in early years followed by a large rise subsequently (P < .001). This study identified temporal trends in specific DS categories that may be associated with changing perceptions of prescribers and/or patients of the appropriate roles of DSs in medicine and public health.
Roles of phosphorylation-dependent and -independent mechanisms in the regulation of histamine H2 receptor by G protein-coupled receptor kinase 2
2011, Journal of Biological Chemistry
Citation Excerpt :
Its effects are mediated by four well characterized receptor subtypes belonging to the large family of GPCRs. Particularly, the histamine H2 receptor (H2R) mediates hypotension, flushing, headache, increased gastric acid production, and enhanced vascular permeability (15, 16). This receptor subtype is coupled to a Gαs protein, and its activation leads to increase cAMP production and triggers rapid receptor desensitization (17).
It is widely assumed that G protein-coupled receptor kinase 2 (GRK2)-mediated specific inhibition of G protein-coupled receptors (GPCRs) response involves GRK-mediated receptor phosphorylation followed by β-arrestin binding and subsequent uncoupling from the heterotrimeric G protein. It has recently become evident that GRK2-mediated GPCRs regulation also involves phosphorylation-independent mechanisms. In the present study we investigated whether the histamine H2 receptor (H2R), a Gα_s-coupled GPCR known to be desensitized by GRK2, needs to be phosphorylated for its desensitization and/or internalization and resensitization. For this purpose we evaluated the effect of the phosphorylating-deficient GRK2K220R mutant on H2R signaling in U937, COS7, and HEK293T cells. We found that although this mutant functioned as dominant negative concerning receptor internalization and resensitization, it desensitized H2R signaling in the same degree as the GRK2 wild type. To identify the domains responsible for the kinase-independent receptor desensitization, we co-transfected the receptor with constructions encoding the GRK2 RGS-homology domain (RH) and the RH or the kinase domain fused to the pleckstrin-homology domain. Results demonstrated that the RH domain of GRK2 was sufficient to desensitize the H2R. Moreover, disruption of RGS functions by the use of GRK2D110A/K220R double mutant, although coimmunoprecipitating with the H2R, reversed GRK2K220R-mediated H2R desensitization. Overall, these results indicate that GRK2 induces desensitization of H2R through a phosphorylation-independent and RGS-dependent mechanism and extends the GRK2 RH domain-mediated regulation of GPCRs beyond Gα_q-coupled receptors. On the other hand, GRK2 kinase activity proved to be necessary for receptor internalization and the resulting resensitization.
Advances in gastrointestinal pharmacotherapy
2005, Clinical Gastroenterology and Hepatology
The medical management of patients with gastrointestinal diseases is advancing rapidly. At a recent symposium held during Digestive Disease Week in Chicago in May of 2005, specific attention was given to the future prospects for medical management of 3 common gastrointestinal disease areas: antisecretory therapy, chronic hepatitis C, and inflammatory bowel disease. Antisecretory approaches include drug combinations including a proton pump inhibitor, potassium competitive acid blockers, and antigastrin agents. The latter two classes are still experimental, but the former combinations have potential to enhance the highly effective agents currently available. The focus of treatment advances in chronic hepatitis C in the immediate future is the discovery of more effective treatment regimens for nonresponders to prior therapy, who are becoming the largest group of patients seeking treatment of hepatitis C. The combination of peginterferon with ribavirin results in 6%–15% sustained virologic response rates in patients who were prior nonresponders to standard interferon plus ribavirin. Newer strategies to eradicate hepatitis C virus infection using different interferons, such as interferon alfacon-1 or higher doses of peginterferon, or long-term maintenance peginterferon, are undergoing study and show promise based on data from preliminary studies. Several immunomodulators have promise in inflammatory bowel disease, although the risk-benefit ratio and costs of therapy require evaluation. Nevertheless, the success of new biologics such as anti-TNFα agents augurs well for effective future therapies.
Demographic factors associated with dietary supplement prescriptions filled by United States Military Service Members 2005-2013
2017, BMC Complementary and Alternative Medicine
Functional dairy foods and flora modulation
2016, Development and Manufacture of Yogurt and Other Functional Dairy Products
Antiulcer, wound healing and hepatoprotective activities of the seaweeds Gracilaria crassa, Turbinaria ornata and Laurencia papillosa from the southeast coast of india
2013, Brazilian Journal of Pharmaceutical Sciences

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Best Practice & Research Clinical Gastroenterology

Abstract

References (32)

Is there an optimal degree of acid suppression for healing of duodenal ulcers? A model of the relationship between ulcer healing and acid suppression

Gastroenterology

Reversal of anti-secretory activity of omeprazole by sulfhydryl compounds in isolated rabbit gastric glands

Biochimica et Biophysica Acta

Inhibition of gastric H⁺,K⁺-ATPase and acid secretion by SCH 28080, a substituted pyridyl(1,2a)imidazole

Journal of Biological Chemistry

Helicobacter pylori in gastric cancer established by CagA immunoblot as a marker of past infection

Gastroenterology

UreI-encoded urea channel of Helicobacter pylori is essential for both gastric colonization of and persistence in gerbils

Gastroenterology

Definition and antagonism of histamine H2 receptors

Nature

Histamine in endocrine cells in the stomach

Histochemistry

Unidentified curved bacilli on gastric epithelium in active chronic gastritis

Lancet

Metronidazole, omeprazole and clarithromycin: an effective combination therapy for Helicobacter pylori infection

Alimentary Pharmacology and Therapeutics

Esomeprazole provides improved acid control vs. omeprazole in patients with symptoms of gastro-oesophageal reflux disease

Alimentary Pharmacology and Therapeutics

The pharmacology of the gastric acid pump: the H⁺,K⁺ ATPase

Annual Review of Pharmacology and Toxicology

Crystal structure of the calcium pump of sarcoplasmic reticulum at 2·6 A resolution

Nature

Comparative pharmacokinetic/pharmacodynamic analysis of proton pump inhibitors omeprazole, lansoprazole and pantoprazole, in humans

European Journal of Drug Metabolism and Pharmacokinetics

Mutational analysis of the K⁺-competitive inhibitor site of gastric H,K-ATPase

Biochemistry

Cited by (20)

Temporal trends in dietary supplement prescriptions of United States military service members suggest a decrease in pyridoxine and increase in vitamin D supplements from 2005 to 2013

Roles of phosphorylation-dependent and -independent mechanisms in the regulation of histamine H2 receptor by G protein-coupled receptor kinase 2

Advances in gastrointestinal pharmacotherapy

Demographic factors associated with dietary supplement prescriptions filled by United States Military Service Members 2005-2013

Functional dairy foods and flora modulation

Antiulcer, wound healing and hepatoprotective activities of the seaweeds Gracilaria crassa, Turbinaria ornata and Laurencia papillosa from the southeast coast of india

Regular ArticleCurrent trends in the treatment of upper gastrointestinal disease

Abstract

Gastroenterology

Biochimica et Biophysica Acta

Journal of Biological Chemistry

Gastroenterology

Gastroenterology

Definition and antagonism of histamine H2 receptors

Nature

Histamine in endocrine cells in the stomach

Histochemistry

Unidentified curved bacilli on gastric epithelium in active chronic gastritis

Lancet

Metronidazole, omeprazole and clarithromycin: an effective combination therapy for Helicobacter pylori infection

Alimentary Pharmacology and Therapeutics

Esomeprazole provides improved acid control vs. omeprazole in patients with symptoms of gastro-oesophageal reflux disease

Alimentary Pharmacology and Therapeutics

The pharmacology of the gastric acid pump: the H+,K+ ATPase

Annual Review of Pharmacology and Toxicology

Crystal structure of the calcium pump of sarcoplasmic reticulum at 2·6 A resolution

Nature

Comparative pharmacokinetic/pharmacodynamic analysis of proton pump inhibitors omeprazole, lansoprazole and pantoprazole, in humans

European Journal of Drug Metabolism and Pharmacokinetics

Mutational analysis of the K+-competitive inhibitor site of gastric H,K-ATPase

Biochemistry

Regular Article
Current trends in the treatment of upper gastrointestinal disease

The pharmacology of the gastric acid pump: the H⁺,K⁺ ATPase

Mutational analysis of the K⁺-competitive inhibitor site of gastric H,K-ATPase