PMID- 8857304
OWN - NLM
STAT- MEDLINE
DCOM- 19961219
LR  - 20190914
IS  - 0163-7258 (Print)
IS  - 0163-7258 (Linking)
VI  - 69
IP  - 1
DP  - 1996
TI  - The chemotherapeutic effects of H+/K+ inhibitors on Helicobacter pylori 
      infection.
PG  - 79-83
AB  - Helicobacter pylori's powerful urease enzyme is essential for colonisation and 
      adaptation to the acid milieu of the stomach. Eradication of infection with 
      "standard triple therapy" abolishes the chronic immunological and inflammatory 
      responses to H. pylori and, thus, cures gastritis and peptic ulcer. In vitro, 
      proton pump inhibitors (PPI) are active against H. pylori with minimum inhibitory 
      concentrations that compare favourably with bismuth salts. PPIs are also potent 
      urease inhibitors, but because PPIs are also active against urease-negative 
      mutant Helicobacter spp., it is unlikely that urease inhibition alone accounts 
      for their anti-H. pylori activity. Early reports suggested that omeprazole 
      monotherapy was able to eradicate H. pylori. This has not been confirmed by more 
      comprehensive studies, which have shown that treatment with omeprazole is 
      associated with a shift of infection from the antrum to the corpus. The 
      explanation for this observation is unclear, but does not appear to be due to 
      bacterial overgrowth. Raising the intragastric pH with a PPI lowers the minimum 
      inhibitory concentration of the many antimicrobials, while decreasing the acid 
      storage pool increases the intramucosal concentration. Dual therapy (omeprazole 
      with either amoxycillin or clarithromycin) is a more logical and highly effective 
      alternative to standard triple therapy, with fewer side effects and better 
      patient compliance. However, H. pylori eradication regimens based on a PPI and 
      two antimicrobials will be the first-line treatment for H. pylori gastritis and 
      peptic ulcer in the future.
FAU - Logan, R P
AU  - Logan RP
AD  - Parkside Helicobacter Study Group, Central Middlesex and St. Mary's Hospitals, 
      London, UK.
LA  - eng
PT  - Journal Article
PL  - England
TA  - Pharmacol Ther
JT  - Pharmacology & therapeutics
JID - 7905840
RN  - 0 (2-Pyridinylmethylsulfinylbenzimidazoles)
RN  - 0 (Enzyme Inhibitors)
RN  - 0K5C5T2QPG (Lansoprazole)
RN  - EC 3.5.1.5 (Urease)
RN  - KG60484QX9 (Omeprazole)
SB  - IM
MH  - 2-Pyridinylmethylsulfinylbenzimidazoles
MH  - Down-Regulation
MH  - Duodenal Ulcer/prevention & control
MH  - Enzyme Inhibitors/*pharmacology
MH  - Helicobacter pylori/*drug effects
MH  - Hydrogen-Ion Concentration
MH  - In Vitro Techniques
MH  - Lansoprazole
MH  - Omeprazole/*analogs & derivatives/*pharmacology
MH  - Pyloric Antrum/*enzymology
MH  - Urease/*metabolism
EDAT- 1996/01/01 00:00
MHDA- 1996/01/01 00:01
CRDT- 1996/01/01 00:00
PHST- 1996/01/01 00:00 [pubmed]
PHST- 1996/01/01 00:01 [medline]
PHST- 1996/01/01 00:00 [entrez]
AID - 0163725895020322 [pii]
AID - 10.1016/0163-7258(95)02032-2 [doi]
PST - ppublish
SO  - Pharmacol Ther. 1996;69(1):79-83. doi: 10.1016/0163-7258(95)02032-2.