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The effects of high-dose esomeprazole on gastric and oesophageal acid exposure and molecular markers in Barrett's oesophagus.
- Source :
-
Alimentary pharmacology & therapeutics [Aliment Pharmacol Ther] 2010 Oct; Vol. 32 (8), pp. 1023-30. Date of Electronic Publication: 2010 Aug 15. - Publication Year :
- 2010
-
Abstract
- Background: Acid reflux is often difficult to control medically.<br />Aim: To assess the effect of 40 mg twice daily esomeprazole (high-dose) on gastric and oesophageal pH and symptoms, and biomarkers relevant to adenocarcinoma, in patients with Barrett's oesophagus (BO).<br />Methods: Eighteen patients, treated with proton pump inhibitors as prescribed by their treating doctor, had their therapy increased to high-dose esomeprazole for 6 months.<br />Results: At entry into the study, 9/18 patients had excessive 24-h oesophageal acid exposure, and gastric pH remained <4 for >16 h in 8/18. With high-dose esomeprazole, excessive acid exposure occurred in 2/18 patients, and gastric pH <4 was decreased from 38% of overall recording time and 53% of the nocturnal period to 15% and 17%, respectively (P < 0.001). There was a reduction in self-assessed symptoms of heartburn (P = 0.0005) and regurgitation (P < 0.0001), and inflammation and proliferation in the Barrett's mucosa. There was no significant change in p53, MGMT or COX-2 expression, or in aberrant DNA methylation.<br />Conclusions: High-dose esomeprazole achieved higher levels of gastric acid suppression and control of oesophageal acid reflux and symptoms, with significant decreases in inflammation and epithelial proliferation. There was no reversal of aberrant DNA methylation.<br /> (© 2010 Blackwell Publishing Ltd.)
- Subjects :
- Adult
Aged
Anti-Ulcer Agents administration & dosage
Barrett Esophagus genetics
Barrett Esophagus physiopathology
Biopsy
Cell Proliferation drug effects
DNA Methylation
Esomeprazole administration & dosage
Esophagus pathology
Esophagus physiology
Female
Humans
Hydrogen-Ion Concentration
Inflammation
Male
Middle Aged
Mucous Membrane cytology
Mucous Membrane pathology
Stomach physiology
Tumor Suppressor Proteins analysis
Anti-Ulcer Agents therapeutic use
Barrett Esophagus drug therapy
Esomeprazole therapeutic use
Proton Pump Inhibitors administration & dosage
Proton Pump Inhibitors therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1365-2036
- Volume :
- 32
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Alimentary pharmacology & therapeutics
- Publication Type :
- Academic Journal
- Accession number :
- 20937048
- Full Text :
- https://doi.org/10.1111/j.1365-2036.2010.04428.x