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An assessment of human gastric fluid composition as a function of PPI usage.

Publication ,  Journal Article
Foltz, E; Azad, S; Everett, ML; Holzknecht, ZE; Sanders, NL; Thompson, JW; Dubois, LG; Parker, W; Keshavjee, S; Palmer, SM; Davis, RD; Lin, SS
Published in: Physiol Rep
January 1, 2015

The standard of care for chronic gastro-esophageal reflux disease (GERD), which affects up to 40% of the population, is the use of drugs such as proton pump inhibitors (PPIs) that block the production of stomach acid. Despite widespread use, the effects of PPIs on gastric fluid remain poorly characterized. In this study, gastric fluid was collected from patients undergoing cardiac surgery who were not (n = 40) or were (n = 25) actively taking PPIs. Various enzymatic and immunoassays as well as mass spectrometry were utilized to analyze the concentrations of bile, gastricsin, trypsin, and pepsin in the gastric fluid. Proteomic analyses by mass spectrometry suggested that degradation of trypsin at low pH might account, at least in part, for the observation that patients taking PPIs have a greater likelihood of having high concentrations of trypsin in their gastric fluid. In general, the concentrations of all analytes evaluated varied over several orders of magnitude, covering a minimum of a 2000-fold range (gastricsin) and a maximum of a 1 × 10(6) -fold range (trypsin). Furthermore, the concentrations of various analytes were poorly correlated with one another in the samples. For example, trypsin and bile concentrations showed a significant (P < 0.0001) but not strong correlation (r = 0.54). Finally, direct assessment of bacterial concentrations by flow cytometry revealed that PPIs did not cause a profound increase in microbial load in the gastric fluid. These results further delineate the profound effects that PPI usage has on the physiology of the stomach.

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Published In

Physiol Rep

DOI

ISSN

2051-817X

Publication Date

January 1, 2015

Volume

3

Issue

1

Location

United States

Related Subject Headings

  • 3208 Medical physiology
  • 1116 Medical Physiology
  • 1103 Clinical Sciences
  • 0606 Physiology
 

Citation

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Foltz, E., Azad, S., Everett, M. L., Holzknecht, Z. E., Sanders, N. L., Thompson, J. W., … Lin, S. S. (2015). An assessment of human gastric fluid composition as a function of PPI usage. Physiol Rep, 3(1). https://doi.org/10.14814/phy2.12269
Foltz, Emily, Sassan Azad, Mary Lou Everett, Zoie E. Holzknecht, Nathan L. Sanders, J Will Thompson, Laura G. Dubois, et al. “An assessment of human gastric fluid composition as a function of PPI usage.Physiol Rep 3, no. 1 (January 1, 2015). https://doi.org/10.14814/phy2.12269.
Foltz E, Azad S, Everett ML, Holzknecht ZE, Sanders NL, Thompson JW, et al. An assessment of human gastric fluid composition as a function of PPI usage. Physiol Rep. 2015 Jan 1;3(1).
Foltz, Emily, et al. “An assessment of human gastric fluid composition as a function of PPI usage.Physiol Rep, vol. 3, no. 1, Jan. 2015. Pubmed, doi:10.14814/phy2.12269.
Foltz E, Azad S, Everett ML, Holzknecht ZE, Sanders NL, Thompson JW, Dubois LG, Parker W, Keshavjee S, Palmer SM, Davis RD, Lin SS. An assessment of human gastric fluid composition as a function of PPI usage. Physiol Rep. 2015 Jan 1;3(1).

Published In

Physiol Rep

DOI

ISSN

2051-817X

Publication Date

January 1, 2015

Volume

3

Issue

1

Location

United States

Related Subject Headings

  • 3208 Medical physiology
  • 1116 Medical Physiology
  • 1103 Clinical Sciences
  • 0606 Physiology