PMID- 18477258
OWN - NLM
STAT- MEDLINE
DCOM- 20080630
LR  - 20161020
IS  - 1442-2050 (Electronic)
IS  - 1120-8694 (Linking)
VI  - 21
IP  - 4
DP  - 2008
TI  - The effect of oral administration of ursodeoxycholic acid and high-dose proton 
      pump inhibitors on the histology of Barrett's esophagus.
PG  - 346-54
LID - 10.1111/j.1442-2050.2007.00782.x [doi]
AB  - Bile acids may play a role in the pathogenesis of Barrett's esophagus (BE). Bile 
      composition can be influenced by oral administration of ursodeoxycholic acid 
      (UDCA). We prospectively investigated the effect of proton pump inhibitors (PPI) 
      supplemented with UDCA in vivo in patients with BE. Patients with no or low-grade 
      dysplasia who were clinically asymptomatic on PPI were eligible for the study. In 
      order to exclude the effects of acid reflux, all patients were initially treated 
      with 40 mg esomeprazole (ESO) twice daily for 6 months and continued on this dose 
      till the end of the study (t = 12 months). During a period of 6 months (t = 6 
      month - t = 12 month) patients were treated with oral UDCA (600 mg twice daily). 
      Patients underwent endoscopy at t = 0 months, t = 6 months and t = 12 months with 
      multiple biopsies of the distal and proximal BE segment, normal squamous and 
      gastric cardia. In addition, pH was measured at t = 0 months and t = 6 months 
      using a BRAVO wireless pH capsule. Bile was sampled at the beginning of the UDCA 
      treatment and 6 months later (t = 6 month and t = 12 month). All biopsies were 
      reviewed for the extent of metaplasia, dysplasia, and acute and chronic 
      inflammation. In addition, proliferation (Ki67), differentiation (villin, 
      cytokeratins 7 and 20) and inflammation (COX-2) were investigated by 
      immunohistochemistry (IHC). Nine patients (mean age 60 years, median BE length 7 
      cm) were included, of whom six had no dysplasia and three had low-grade 
      dysplasia. pH measurements revealed a normal acid exposure in most patients at t 
      = 0 and t = 6 months. In addition, bile composition analysis demonstrated the 
      efficacy of UDCA. Combining the results of both phases of the study, no 
      significant changes were seen in any of the histological or IHC parameters. 
      Differentiation and proliferation parameters showed no significant changes. In 
      this study, in BE patients who were clinically asymptomatic on PPI, increasing 
      the PPI dose to the maximum for 6 months followed by the addition of UDCA for 6 
      months did not result in significant histological or IHC changes in their BE.
FAU - Bozikas, A
AU  - Bozikas A
AD  - Department of Gastroenterology and Hepatology, Academic Medical Center, 
      Amsterdam, The Netherlands.
FAU - Marsman, W A
AU  - Marsman WA
FAU - Rosmolen, W D
AU  - Rosmolen WD
FAU - van Baal, J W P M
AU  - van Baal JW
FAU - Kulik, W
AU  - Kulik W
FAU - ten Kate, F J W
AU  - ten Kate FJ
FAU - Krishnadath, K K
AU  - Krishnadath KK
FAU - Bergman, J J G H M
AU  - Bergman JJ
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Dis Esophagus
JT  - Diseases of the esophagus : official journal of the International Society for 
      Diseases of the Esophagus
JID - 8809160
RN  - 0 (Cholagogues and Choleretics)
RN  - 0 (Proton Pump Inhibitors)
RN  - 724L30Y2QR (Ursodeoxycholic Acid)
SB  - IM
MH  - Administration, Oral
MH  - Barrett Esophagus/*drug therapy/*pathology
MH  - Cholagogues and Choleretics/*administration & dosage
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Proton Pump Inhibitors/*administration & dosage
MH  - Ursodeoxycholic Acid/*administration & dosage
EDAT- 2008/05/15 09:00
MHDA- 2008/07/01 09:00
CRDT- 2008/05/15 09:00
PHST- 2008/05/15 09:00 [pubmed]
PHST- 2008/07/01 09:00 [medline]
PHST- 2008/05/15 09:00 [entrez]
AID - DES782 [pii]
AID - 10.1111/j.1442-2050.2007.00782.x [doi]
PST - ppublish
SO  - Dis Esophagus. 2008;21(4):346-54. doi: 10.1111/j.1442-2050.2007.00782.x.