Effects of pirenzepine on vonoprazan-induced gastric acid inhibition and hypergastrinemia
Effects of pirenzepine on vonoprazan-induced gastric acid inhibition and hypergastrinemia
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哌仑西平对沃诺拉赞诱导的胃酸抑制和高胃泌素血症的影响
DOI：
10.1007/s00228-021-03162-5
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发表时间：
2021
影响因子：
2.9
通讯作者：
Furuta Takahisa
中科院分区：
文献类型：
--
作者：
Suzuki Takahiro;Higuchi Tomohiro;Kagami Takuma;Uotani Takahiro;Yamade Mihoko;Tani Shinya;Hamaya Yasushi;Iwaizumi Moriya;Osawa Satoshi;Sugimoto Ken;Miyajima Hiroaki;Furuta Takahisa
背景与质子泵抑制剂相比，沃诺拉赞对胃酸分泌的抑制作用更大，可用于治疗酸相关疾病，如胃食管反流病。然而，存在一个问题，即沃诺拉赞会引起高胃泌素血症，这会带来类癌肿瘤的风险。先前的报告表明，哌仑西平，一种M1毒蕈碱受体拮抗剂，增强抑酸作用，同时抑制奥美拉唑诱导的高胃泌素血症。在这里，我们研究了哌仑西平是否能增强沃诺拉赞的胃酸抑制作用，而不会进一步增加血清胃泌素水平。MethodsEleven健康志愿者在三种不同方案的第7天接受24小时胃内pH监测和血清胃泌素测量：哌仑西平75 mg单药，沃诺拉赞10 mg单药，和沃诺拉赞10 mg+哌仑西平75 mg以随机交叉方式给药。结果哌仑西平75 mg，沃诺拉赞10 mg，和沃诺拉赞10 mg+哌仑西平75 mg分别为6.9%（2.4-32.8%）、88.4%（54.6-100%）和84.2%（40.3-100%）。血清胃泌素水平分别为79（75-210）pg/ml、310（110-870）pg/ml和170（140-930）pg/ml。在沃诺拉赞10 mg单药诱导的高胃泌素血症（胃泌素≥ 200 pg/ml）病例中，与哌仑西平联合治疗可显著降低血清胃泌素水平，从370 pg/ml降至180 pg/ml（P= 0.028）。结论尽管哌仑西平不会增强酸抑制作用，但它确实在一定程度上改善了沃诺拉赞诱导的高胃泌素血症。
BackgroundCompared to proton pump inhibitors, vonoprazan exerts a greater inhibitory effect on gastric acid secretion and is useful for treating acid-related diseases, such as gastro-esophageal reflux disease. However, there is a problem that vonoprazan causes hypergastrinemia, which confers a risk of carcinoid tumor. A previous report demonstrated that pirenzepine, an M1 muscarinic receptor antagonist, enhances the acid inhibitory effects while suppressing hypergastrinemia induced by omeprazole. Here, we examined whether pirenzepine enhances the gastric acid inhibitory effects of vonoprazan without further increasing serum gastrin levels.MethodsEleven healthy volunteers were subjected to 24-h intragastric pH monitoring and serum gastrin measurements on day 7 of three different regimens: pirenzepine 75 mg alone, vonoprazan 10 mg alone, and vonoprazan 10 mg plus pirenzepine 75 mg administered in a randomized crossover fashion.ResultsMedian pH 4 holding time ratios (range) achieved with pirenzepine 75 mg, vonoprazan 10 mg, and vonoprazan 10 mg plus pirenzepine 75 mg were 6.9% (2.4–32.8%), 88.4% (54.6–100%), and 84.2% (40.3–100%), respectively. Respective serum gastrin levels were 79 (75–210) pg/ml, 310 (110–870) pg/ml, and 170 (140–930) pg/ml. In cases with hypergastrinemia (gastrin ≥ 200 pg/ml) induced by vonoprazan 10 mg alone, concomitant treatment with pirenzepine significantly reduced serum gastrin levels from 370 to 180 pg/ml (P= 0.028).ConclusionAlthough pirenzepine does not enhance acid inhibition, it does improve hypergastrinemia induced by vonoprazan to some extent.
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影响因子：
6.7
作者：
M. Sugimoto;T. Furuta;N. Shirai;A. Nakamura;M. Kajimura;A. Hishida;K. Ohashi;T. Ishizaki
通讯作者：
M. Sugimoto;T. Furuta;N. Shirai;A. Nakamura;M. Kajimura;A. Hishida;K. Ohashi;T. Ishizaki
影响因子：
2.9
作者：
Takahiro Suzuki;Takuma Kagami;T. Uotani;M. Yamade;Yasushi Hamaya;M. Iwaizumi;S. Osawa;K. Sugimoto;H. Miyajima;T. Furuta
通讯作者：
Takahiro Suzuki;Takuma Kagami;T. Uotani;M. Yamade;Yasushi Hamaya;M. Iwaizumi;S. Osawa;K. Sugimoto;H. Miyajima;T. Furuta
DOI：
--
发表时间：
2002
期刊：
Gastrointestinal Function Regulation and Disturbances. 19
影响因子：
--
作者：
Adachi K;Katsube T;Kawamura A;Kinoshita Y.
通讯作者：
Kinoshita Y.
影响因子：
6.7
作者：
Furuta, T;Shirai, N;Hanai, H
通讯作者：
Hanai, H
影响因子：
2
作者：
Itoh, H;Naito, T;Takeyama, M
通讯作者：
Takeyama, M