Prevacid
Appearance of myofibroblasts in the gastric mucosa after ingestion of ethanol and lansoprazole with reevaluation of the mucoid cap.

Nakamura M, Akiba Y, Oda M, Ishii H.

Department of Internal Medicine, Tokyo Denryoku Hospital, Tokyo, Japan.

The mucoid cap is important in the restitution of surface epithelial cells of the gastric mucosa. We conducted the present study to clarify the relationship of the mucoid cap and the myofibroblasts in the course of healing of the gastric mucosa with ethanol-induced damage. The effect of lansoprazole on ulcer healing was also evaluated. Wistar strain male rats were administered ethanol (50%) by gastric intubation. Thirty minutes later, either an aqueous solution of lansoprazole (LPZ; 10 mg/100 g of body weight), or the same amount of physiological saline was administered by gastric intubation. Localization of the myofibroblasts was evaluated at 1, 3, and 12 hr after LPZ treatment, and compared with the number and localization of cells positive for rhodamine-phalloidin. The concentration of basic fibroblast growth factor (FGF) was determined by EUSA. We observed PR 2D3-immunoreactive cells in the lamina propria mucosae of the control fundus that were weakly positive or negative for rhodamine-phalloidin. Erosive lesions reaching more than half of the whole gastric mucosal layer were induced 1 hr after ethanol ingestion. An abundance of PR 2D3 and rhodamine-phalloidin double-positive cells was present in the lamina propria mucosae just below the erosive lesion. The administration of LPZ brought about an increase in bFGF concentration, an acceleration of ulcer healing, and an increase in immunoreactivity to PR 2D3. In conclusion, LPZ strongly influenced the healing of gastric mucosal damage related to ethanol administration, possibly through an increase in the concentration of bFGF. The immunophenotype of the myofibroblasts changed to the muscle type during healing, suggesting an involvement of these cells in ulcer healing.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9622386&dopt=Abstract lansoprazole Prevacid



Prevacid
Complete elimination of reflux symptoms does not guarantee normalization of intraesophageal acid reflux in patients with Barrett's esophagus.

Ouatu-Lascar R, Triadafilopoulos G.

Gastroenterology Section, Palo Alto Veterans Affairs Health Care System, California 94304, USA.

OBJECTIVE: Normalization of intraesophageal acid exposure is increasingly recognized as a desired goal in the management of Barrett's esophagus. In this prospective trial, we studied patients with Barrett's esophagus by 24-h intraesophageal pH monitoring after having completely eliminated their reflux symptoms with lansoprazole, to determine whether they had achieved normalization of intraesophageal pH. METHODS: Thirty patients with Barrett's esophagus, all of whom had presented with reflux symptoms, were treated with lansoprazole (15-30 mg/day) until they were asymptomatic. Twenty-four-hour ambulatory pH monitoring was performed while they were receiving lansoprazole and were asymptomatic. RESULTS: Twelve patients (40%) showed persistent bipositional, pathologic acid reflux while on therapy, with a mean DeMeester score of 52.8 (95% CI: 33.8-71.8); the remaining 18 (60%) exhibited normalization of intraesophageal acid exposure with a score of 4.4 (95% CI: 2.3-6.6,p < 0.001). This inadequate control of intraesophageal pH is most likely due to incomplete gastric acid suppression induced by the drug and is associated with a variable acid (distal > proximal) exposure within the esophagus. The two groups were not different in regard to their symptom frequency and severity before therapy, amount of lansoprazole dosage required to eliminate symptoms, length of Barrett's metaplasia, presence of hiatal hernia, lower esophageal sphincter resting tone and length, or esophageal peristaltic function. CONCLUSION: Complete symptom eradication with lansoprazole (15-30 mg daily) in patients with Barrett's esophagus does not guarantee normalization of intraesophageal pH profile. If the goal of therapy in such patients is to achieve complete intraesophageal acid suppression, 24-h ambulatory esophageal pH monitoring should be performed to titrate therapy.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9625114&dopt=Abstract lansoprazole Prevacid



Prevacid
Effects of a proton-pump inhibitor in cystic fibrosis.

Tran TM, Van den Neucker A, Hendriks JJ, Forget P, Forget PP.

Department of Pediatrics, University Hospital of Maastricht, The Netherlands.

Most children with cystic fibrosis (CF) show persisting steatorrhoea even when treated with pancreatic enzyme. As a low duodenal pH could be responsible for this persisting fat loss, we evaluated the effects of a proton-pump inhibitor (lansoprazole) on both steatorrhoea and growth parameters in 15 CF patients, aged 3.1-22.6 y. Acid steatocrit, anthropometry and dual-energy X-ray absorptiometry were used to evaluate steatorrhoea and the nutritional status before, during and 3 months after stopping lansoprazole treatment (15 mg/d for 3 months). Mean +/- SD acid steatocrit values decreased from 37.1 +/- 8.8% to 28.5 +/- 10.6% (p = 0.02). Significant mean Z-score improvements were found for weight (+0.14; p = 0.02), height (+0.15; p = 0.03), subscapular (+0.61; p = 0.003), supra-iliac (+0.8; p = 0.002) and the sum of the four measured skinfolds (+0.61; p = 0.002). Z-scores deteriorated again after stopping lansoprazole. Fat mass and bone mineral content increased significantly on lansoprazole (p = 0.008 and p = 0.005, respectively). We conclude that lansoprazole as adjuvant therapy significantly improves both steatorrhoea and the nutritional status in CF children who maintain steatorrhoea while on pancreatic enzymes.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9641739&dopt=Abstract lansoprazole Prevacid



Prevacid
Bactericidal activity of lansoprazole and omeprazole against Helicobacter pylori in vitro.

Vogt K, Hahn H.

Department of Microbiology, Hospital Virchow and Charite, Humboldt University of Berlin, Germany.

The minimum inhibitory concentrations of 39 Helicobacter pylori strains against antibiotics (ampicillin, tetracycline, metronidazole), colloidal bismuth subcitrate and proton pump inhibitors were assessed by the agar dilution method. 20.5% of the strains were metronidazole resistent. The comparison of the bactericidal action of omeprazole and lansoprazole in a killing curve assay showed a dose-dependent reduction of viable bacteria after 24 h, lansoprazole being more effective than omeprazole. Under varying pH conditions, the antibacterial activity of lansoprazole was limited to a pH range of 6-7, reducing bacterial numbers up to 4 logarithmical steps within 24 h.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9689430&dopt=Abstract lansoprazole Prevacid



Prevacid
In vitro activity of ebrotidine, ranitidine, omeprazole, lansoprazole, and bismuth citrate against clinical isolates of Helicobacter pylori.

Alarcon T, Domingo D, Sanchez I, Sanz JC, Martinez MJ, Lopez-Brea M.

Department of Microbiology, Hospital Universitario de la Princesa, Madrid, Spain.

The aim of this study was to determine the in vitro activity of ranitidine, ebrotidine, bismuth citrate, omeprazole, and lansoprazole against 113 clinical isolates of Helicobacter pylori cultured from gastric biopsies. An agar dilution method using Mueller-Hinton agar plus 7%, horse blood, an inoculum of 10(6) cfu/spot, and incubation in a CO2 incubator for 2 to 5 days was used. The minimum inhibitory concentrations for 50 and 90% of the isolates tested, respectively, were as follows: ranitidine, 1024 and 1024 mg/l; ebrotidine, 64 and 256 mg/l; bismuth citrate, 1 and 4 mg/l; omeprazole, 16 and 16 mg/l; and lansoprazole, 1 and 1 mg/l. Ebrotidine was more active than ranitidine, and lansoprazole was the most active compound against the Helicobacter pylori isolates tested.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9707312&dopt=Abstract lansoprazole Prevacid