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Chen D, Hagen SJ, Boyce M, Zhao CM. Neuroendocrine mechanism of gastric acid secretion: Historical perspectives and recent developments in physiology and pharmacology. J Neuroendocrinol 2023; 35:e13305. [PMID: 37317882 PMCID: PMC10656367 DOI: 10.1111/jne.13305] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 04/24/2023] [Accepted: 05/10/2023] [Indexed: 06/16/2023]
Abstract
The physiology of gastric acid secretion is one of the earliest subjects in medical literature and has been continuously studied since 1833. Starting with the notion that neural stimulation alone drives acid secretion, progress in understanding the physiology and pathophysiology of this process has led to the development of therapeutic strategies for patients with acid-related diseases. For instance, understanding the physiology of parietal cells led to the developments of histamine 2 receptor blockers, proton pump inhibitors (PPIs), and recently, potassium-competitive acid blockers. Furthermore, understanding the physiology and pathophysiology of gastrin has led to the development of gastrin/CCK2 receptor (CCK2 R) antagonists. The need for refinement of existing drugs in patients have led to second and third generation drugs with better efficacy at blocking acid secretion. Further understanding of the mechanism of acid secretion by gene targeting in mice has enabled us to dissect the unique role for each regulator to leverage and justify the development of new targeted therapeutics for acid-related disorders. Further research on the mechanism of stimulation of gastric acid secretion and the physiological significances of gastric acidity in gut microbiome is needed in the future.
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Affiliation(s)
- Duan Chen
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Susan J Hagen
- Department of Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | | | - Chun-Mei Zhao
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
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Fei HJ, Chen SC, Zhang JY, Li SY, Zhang LL, Chen YY, Chang CX, Xu CM. Identification of significant biomarkers and pathways associated with gastric carcinogenesis by whole genome-wide expression profiling analysis. Int J Oncol 2018; 52:955-966. [PMID: 29328368 DOI: 10.3892/ijo.2018.4243] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 01/04/2018] [Indexed: 12/11/2022] Open
Abstract
The incidence of gastric cancer (GC) is extremely high in East Asia. GC is also one of the most common and lethal forms of cancer from a global perspective. However, to date, we have not been able to determine one or several genes as biomarkers in the diagnosis of GC and have also been unable to identify the genes which are important in the therapy of GC. In this study, we analyzed all genome-wide expression profiling arrays uploaded onto the Gene Expression Omnibus (GEO) database to filtrate the differentially expressed genes (DEGs) between normal stomach tissues and GC tissues. GSE13911, GSE19826 and GSE79973 were based on the GPL570 platform, and GSE29272 was based on the GPL96 platform. We screened out the DEGs from the two platforms and by selecting the intersection of these two platforms, we identified the common DEGs in the sequencing data from different laboratories. Finally, we obtained 3 upregulated and 34 downregulated DEGs in GC from 384 samples. As the number of downregulated DEGs was greater than that of the upregulated DEGs, functional analysis and pathway enrichment analysis were performed on the downregulated DEGs. Through our analysis, we identified the most significant genes associated with GC, such as secreted phosphoprotein 1 (SPP1), sulfatase 1 (SULF1), thrombospondin 2 (THBS2), ATPase H+/K+ transporting beta subunit (ATP4B), gastric intrinsic factor (GIF) and gastrokine 1 (GKN1). The prognostic power of these genes was corroborated in the Oncomine database and by Kaplan-Meier plotter (KM-plotter) analysis. Moreover, gastric acid secretion, collecting duct acid secretion, nitrogen metabolism and drug metabolism were significantly related to GC. Thus, these genes and pathways may be potential targets for improving the diagnosis and clinical effects in patients with GC.
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Affiliation(s)
- Hong-Jun Fei
- Department of Reproductive Genetics, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, P.R. China
| | - Song-Chang Chen
- Department of Reproductive Genetics, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, P.R. China
| | - Jun-Yu Zhang
- Department of Reproductive Genetics, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, P.R. China
| | - Shu-Yuan Li
- Department of Reproductive Genetics, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, P.R. China
| | - Lan-Lan Zhang
- Department of Reproductive Genetics, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, P.R. China
| | - Yi-Yao Chen
- Department of Reproductive Genetics, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, P.R. China
| | - Chun-Xin Chang
- Department of Reproductive Genetics, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, P.R. China
| | - Chen-Ming Xu
- Department of Reproductive Genetics, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, P.R. China
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Jana K, Bandyopadhyay T, Ganguly B. Revealing the Mechanistic Pathway of Acid Activation of Proton Pump Inhibitors To Inhibit the Gastric Proton Pump: A DFT Study. J Phys Chem B 2016; 120:13031-13038. [DOI: 10.1021/acs.jpcb.6b09334] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Kalyanashis Jana
- Computation
and Simulation Unit (Analytical Discipline and Centralized Instrument
Facility), CSIR−Central Salt and Marine Chemicals Research Institute, Bhavnagar 364002, Gujarat India
- Academy of Scientific and Innovative Research, CSIR−CSMCRI, Bhavnagar 364002, Gujarat India
| | - Tusar Bandyopadhyay
- Theorectical
Chemistry Section, Chemistry Group MOD LAB, Bhabha Atomic Research Centre, Trombay, Mumbai, 400 085, India
| | - Bishwajit Ganguly
- Computation
and Simulation Unit (Analytical Discipline and Centralized Instrument
Facility), CSIR−Central Salt and Marine Chemicals Research Institute, Bhavnagar 364002, Gujarat India
- Academy of Scientific and Innovative Research, CSIR−CSMCRI, Bhavnagar 364002, Gujarat India
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Posovszky C, Wabitsch M. Regulation of appetite, satiation, and body weight by enteroendocrine cells. Part 1: characteristics of enteroendocrine cells and their capability of weight regulation. Horm Res Paediatr 2015; 83:1-10. [PMID: 25471008 DOI: 10.1159/000368898] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Accepted: 09/23/2014] [Indexed: 11/19/2022] Open
Abstract
The gastrointestinal tract is the gateway for food in our body. Food ingestion and the ensuing digestive processes depend on the composition and amount of ingested nutrients. This complex process of nutrient digestion and absorption is effectively regulated by the enteroendocrine system. Enteroendocrine cells (EECs) reside scattered throughout the intestinal epithelium. They express nutrient receptors that face the lumen and secrete peptide hormones in response to food. Besides regulating digestion, gastrointestinal endocrine cells are involved in the regulation of appetite and satiety. The first part of this review describes the anatomical and biological characteristics of EECs and discusses the capability of their hormones to influence appetite, satiety, and body weight. In the second part, we then discuss the therapeutic potential of EECs in the treatment of obesity.
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Affiliation(s)
- Carsten Posovszky
- University Outpatient Clinic for Pediatric Gastroenterology, and Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany
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Di Mario F, Goni E. Gastric acid secretion: changes during a century. Best Pract Res Clin Gastroenterol 2014; 28:953-65. [PMID: 25439063 DOI: 10.1016/j.bpg.2014.10.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2014] [Revised: 10/21/2014] [Accepted: 10/21/2014] [Indexed: 01/31/2023]
Abstract
The advances in knowledge of gastric physiology within the past century have been the most exciting and important in this area of interest for many decades. The aim of this presentation consists of a comprehensive review of the extensive recent literature on this topic in order to highlight milestones in the field of gastric physiology, in particular in gastric acid secretion, gastric pathophysiology, acid-related diseases and use of acid regulatory drugs. Moreover, in the 21st century there have been many epidemiologic changes as well as a decrease of Helicobacter pylori infection and gastric cancer together with an increase of gastroesophageal reflux disease and the related increase of pomp proton inhibitor wide use.
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Affiliation(s)
- Francesco Di Mario
- Department of Clinical and Experimental Medicine, University of Parma, School of Medicine, Via Gramsci 14, 43125, Parma, Italy.
| | - Elisabetta Goni
- Department of Clinical and Experimental Medicine, University of Parma, School of Medicine, Via Gramsci 14, 43125, Parma, Italy.
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Kawai T, Takahashi S, Suzuki H, Sasaki H, Nagahara A, Asaoka D, Matsuhisa T, Masaoaka T, Nishizawa T, Suzuki M, Ito M, Kurihara N, Omata F, Mizuno S, Torii A, Kawakami K, Ohkusa T, Tokunaga K, Mine T, Sakaki N. Changes in the first line Helicobacter pylori eradication rates using the triple therapy-a multicenter study in the Tokyo metropolitan area (Tokyo Helicobacter pylori study group). J Gastroenterol Hepatol 2014; 29 Suppl 4:29-32. [PMID: 25521730 DOI: 10.1111/jgh.12796] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIM Helicobacter pylori (H. pylori) infection is a strong risk factor for the development of gastric cancer. In 2013, the Japanese government approved H. pylori eradication therapy in patients with chronic gastritis as well as peptic ulcer. However, the continuing decline in eradication rates for first-line H. pylori eradication therapies is an urgent problem. In this study, we investigated changes in the first-line eradication rate from 2001 to 2010. METHODS Eradication rates for 7-day triple therapy [proton pump inhibitor (rabeprazole 20 mg, lansoprazole 60 mg, or omeprazole 40 mg)+amoxicillin 1500 mg + clarithromycin (CAM) 400 or 800 mg, daily] were collated from 14 hospitals in the Tokyo metropolitan area. The urea breath test was used for the evaluation of eradication. The cut-off value was less than 2.5%. RESULTS The yearly eradication rates (intention to treat/per protocol) were 78.5/79.5% (2001, n=242), 71.2%/72.9% (2002, n=208), 67.8%/70.5% (2003, n=183), 75.6%/84.6% (2004, n=131), 56.4%/70.5% (2005, n=114), 70.5%/75.8% (2006, n=271), 67.4%/82.0% (2007, n=135), 64.0%/76.3% (2008, n=261), 60.5%/74.3% (2009, n=329), and 66.5%/78.8% (2010, n=370), respectively. Examination of eradication rates according to CAM dosage revealed an eradication rate of 65.6% (383/584) for CAM 400 mg daily, and 68.5% (1124/1642) for CAM 800 mg daily, with no significant difference seen between dosages. CONCLUSION In recent years, eradication rates for first-line triple therapy have obviously decreased, but no noticeable decrease has occurred after 2001.
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Affiliation(s)
- Takashi Kawai
- Endoscopy Center, Tokyo Medical University, Tokyo, Japan
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Corleto VD, Festa S, Di Giulio E, Annibale B. Proton pump inhibitor therapy and potential long-term harm. Curr Opin Endocrinol Diabetes Obes 2014; 21:3-8. [PMID: 24310148 DOI: 10.1097/med.0000000000000031] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE OF REVIEW This review summarizes the recent literature on the potential side-effects of proton pump inhibitors (PPIs) and known interactions with the metabolism/absorption of other drugs. RECENT FINDINGS Data confirm that PPIs are a very well tolerated drug class. Their high safety, efficacy and wide distribution lead to overuse, inappropriate dosage or excessive duration of treatment. Despite the absorption of micronutrients or other plausible effects on the development of bacterial infections linked to PPI-induced hypochlorhydria, it is difficult to demonstrate an association between PPI and specific symptoms. A possible negative effect of PPIs on bone integrity appears weak, but hypomagnesemia is likely a PPI drug class effect. A higher risk of Clostridium difficile infection and other infectious diseases such as small intestinal bacterial overgrowth and spontaneous bacterial peritonitis remain controversial in PPI users. However, the careful use of PPIs in cirrhotic or otherwise fragile patients is mandatory. Short-term or long-term PPI use may trigger microscopic colitis, and the management of this condition may include PPI withdrawal. The effect of PPIs on stimulating exocrine or endocrine gastric cell proliferation is poorly understood. A diagnostic delay or masking of diseases such as gastrinoma is difficult to evaluate. SUMMARY Short-term standard dose PPI treatment is low risk. Long-term PPI use may complicate health conditions by various mechanisms linked to PPIs and/or to hypochlorhydria.
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Affiliation(s)
- Vito Domenico Corleto
- aDepartment of Gastroenterology and Digestive Endoscopy, School of Medicine and Psychology, Sapienza University of Rome, Sant'Andrea Hospital bCentro Ricerche S. Pietro, Ospedale S. Pietro, Rome, Italy
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Souza RCAD, Lima JHC. Helicobacter pylori and gastroesophageal reflux disease: a review of this intriguing relationship. Dis Esophagus 2009; 22:256-63. [PMID: 19425207 DOI: 10.1111/j.1442-2050.2008.00911.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
A possible association between gastroesophageal reflux disease (GERD) and Helicobacter pylori (H. pylori) infection has been the subject of study and debate in recent years. This review discusses the pathophysiological and immunological mechanisms implicated in this relationship. Although gastric secretion in the majority of H. pylori-infected individuals is unaltered, this review considers how the bacteria may interfere with gastric acid production and what role it may play in GERD. We also identify the epidemiological evidence that confirms that GERD develops after the infection has been eradicated. Lastly, we clarify how the host's immune response and bacterial virulence factors interfere with this relationship, explaining the highly conflicting results in the literature.
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Affiliation(s)
- R Canzi Almada de Souza
- Department of Clinical Medicine, Division of Gastroenterology, Federal University of Paraná, Curitiba-PR-CEP, Brazil.
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Hsu SJ, Patel A, Larsen PD, Bohmann DJ, Bauer RJ, Ma JK, Masat L, Roell M, Babuka SJ, Hansen RK, White M, Haak-Frendscho M. Development of XPA067.06, a potent high affinity human anti-gastrin monoclonal antibody. Biochem Pharmacol 2008; 76:340-52. [DOI: 10.1016/j.bcp.2008.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2008] [Revised: 05/09/2008] [Accepted: 05/13/2008] [Indexed: 10/22/2022]
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Shin JM, Vagin O, Munson K, Kidd M, Modlin IM, Sachs G. Molecular mechanisms in therapy of acid-related diseases. Cell Mol Life Sci 2008; 65:264-81. [PMID: 17928953 PMCID: PMC3081136 DOI: 10.1007/s00018-007-7249-x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Inhibition of gastric acid secretion is the mainstay of the treatment of gastroesophageal reflux disease and peptic ulceration; therapies to inhibit acid are among the best-selling drugs worldwide. Highly effective agents targeting the histamine H2 receptor were first identified in the 1970s. These were followed by the development of irreversible inhibitors of the parietal cell hydrogen-potassium ATPase (the proton pump inhibitors) that inhibit acid secretion much more effectively. Reviewed here are the chemistry, biological targets and pharmacology of these drugs, with reference to their current and evolving clinical utilities. Future directions in the development of acid inhibitory drugs include modifications of current agents and the emergence of a novel class of agents, the acid pump antagonists.
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Affiliation(s)
- J. M. Shin
- Department of Physiology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California USA
- VA Greater Los Angeles Healthcare System, West LA Medical Center, 11301 Wilshire Boulevard, Building 113, Los Angeles, California 90073 USA
| | - O. Vagin
- Department of Physiology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California USA
- VA Greater Los Angeles Healthcare System, West LA Medical Center, 11301 Wilshire Boulevard, Building 113, Los Angeles, California 90073 USA
| | - K. Munson
- Department of Physiology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California USA
- VA Greater Los Angeles Healthcare System, West LA Medical Center, 11301 Wilshire Boulevard, Building 113, Los Angeles, California 90073 USA
| | - M. Kidd
- Department of Surgery, Yale University School of Medicine, TMP202, 333 Cedar Street, New Haven Connecticut, 06520-8062 USA
| | - I. M. Modlin
- Department of Surgery, Yale University School of Medicine, TMP202, 333 Cedar Street, New Haven Connecticut, 06520-8062 USA
| | - G. Sachs
- Department of Physiology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California USA
- VA Greater Los Angeles Healthcare System, West LA Medical Center, 11301 Wilshire Boulevard, Building 113, Los Angeles, California 90073 USA
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Scarpignato C. New drugs to suppress acid secretion: current and future developments. ACTA ACUST UNITED AC 2007. [DOI: 10.1016/j.ddstr.2007.09.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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