Esomeprazole induces upper gastrointestinal tract transmucosal permeability increase.

BACKGROUND: Proton pump inhibitors (PPIs) are one of the most widely used drug classes in the US and are now frontline medications for gastro-oesophageal reflux disease (GERD) and dyspepsia. In a previous work, we observed that a transmucosal, upper gastrointestinal (GI) leak exists in Barrett's oesophagus (BO) patients. PPI medications are commonly used by Barrett's patients. AIM: To examine if the PPI, esomeprazole, affects the barrier function of the upper GI tract. METHODS: The sucrose permeability test (SPT) was used to assess the possible effect of the PPI, esomeprazole, on upper GI leak in 37 first-time-presenting GERD patients and 25 healthy controls. RESULTS: Esomeprazole induced a significant transmucosal leak in the upper GI tract of patients taking the drug for the first time. The leak occurred quickly, within days of first taking the drug. The leak was also reversed within days of stopping the medication. CONCLUSIONS: This is the first patient-based study showing that a PPI compromises upper GI barrier function. There are potential implications for transmucosal leak of other medications that a patient on a PPI may be taking, as well as possible leak of endogenous peptides/proteins. The clinical consequences of this phenomenon are currently unknown, but are potentially important.

[The assessment of urinary nicotine metabolites concentration in children and teenagers with oesophagitis]. / Ocena stezen metabolitów nikotyny w moczu dzieci i mlodziezy z zapaleniem przelyku.

Tobacco smoke is important pathogenetic agent of stomach digestive and duodenum ulcers, oesophagitis as well as gastro-oesophageal reflux disease. The aim of work was the assessment of urinary nicotine metabolites concentration in children and teenagers diagnosed and treated in Paediatrics Chair of Medical University of Silesia by chronic stomach pains, or oesophagitis and gastrooesophageal reflux disease symptoms. Urine was sampled from 54 persons before gastrofiberoscopy, in which the main nicotine metabolites concentration was determined by ELISA method and given per creatinine concentration. It was shown, that 30% of examined population was intensively exposed to tobacco smoke (actively or passively smoking), but 37% passively exposed to nicotine. Significant higher nicotine metabolites concentration was stated in the currently H. pylori infected sick, however without differences of these biomarkers concentrations between group with oesophagis in endoscopy as well as histopathologic examination and group without these features.