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Alternative Therapies in Health and... Mar 2023Helicobacter pylori (Hp) is one of the most prevalent pathogenic microorganisms in the world, which is related to gastric ulcer.
BACKGROUND
Helicobacter pylori (Hp) is one of the most prevalent pathogenic microorganisms in the world, which is related to gastric ulcer.
OBJECTIVE
To observe the effect of lansoprazole and omeprazole combined with antibiotics on gastric juice pH and inflammatory factors in elderly patients with Hp positive gastric ulcer.
DESIGN
This study was a prospective observation study.
SETTING
This study was performed in Department of Gastroenterology, First Affiliated Hospital of Soochow University.
PARTICIPANTS
One hundred and ten elder patients with Hp positive gastric ulcer admitted to our hospital from January 2019 to May 2020.
INTERVENTION
The control group was treated with omeprazole combined with antibiotics, and the observation group was treated with lansoprazole combined with antibiotics.
PRIMARY OUTCOME MEASURES
The level of gastric juice pH, interleukin-1 (IL-1), interleukin-8 (IL-8), tumor necrosis factor-α (TNF-α) and heat shock protein-70 (HSP-70).
METHODS
The changes of gastric juice pH value, IL-1, IL-8, TNF-α and HSP-70 levels before and after treatment were detected in the two groups. The total effective rate, Hp eradication rate, mature type of regenerated mucosal tissue surrounding ulcer and adverse reaction rate were statistically analyzed.
RESULTS
The total effective rate and Hp eradication rate in the observation group were higher than those in the control group, while the adverse reaction rate in the observation group was lower than that in the control group (P < .05). After treatment, the pH value of gastric juice and HSP-70 in the observation group were higher than those in the control group, while the IL-1, IL-8 and TNF-α were lower than those in the control group (P < .05). The mature type of regenerated mucosal tissue structure around ulcer in the observation group was better than that in the control group (P < .05).
CONCLUSION
The overall effect of lansoprazole combined with antibiotics in the treatment of Hp positive gastric ulcer in the elderly is better than that of omeprazole combined with antibiotics.
Topics: Humans; Aged; Omeprazole; Lansoprazole; Stomach Ulcer; Interleukin-8; Anti-Ulcer Agents; Tumor Necrosis Factor-alpha; Ulcer; Prospective Studies; Helicobacter Infections; Anti-Bacterial Agents; Gastric Juice; Anti-Infective Agents; Interleukin-1; Hydrogen-Ion Concentration; Helicobacter pylori; Drug Therapy, Combination
PubMed: 36525356
DOI: No ID Found -
Scientific Reports Nov 2022The proton pump inhibitor lansoprazole has been previously identified to upregulate the expression and transcriptional activity of runt-related transcription factor 2...
The proton pump inhibitor lansoprazole has been previously identified to upregulate the expression and transcriptional activity of runt-related transcription factor 2 (Runx2) that promotes lineage commitment and differentiation of osteoprogenitor cells. We could not elicit the expected efficacy of insoluble lansoprazole in enhancing osteogenesis when combined with beta-tricalcium phosphate (β-TCP) bone substitutes. This study aimed to evaluate the effects of soluble lansoprazole on in vitro osteoblastogenesis and new bone formation in vivo. Commercially available human mesenchymal stem cells or patient-derived bone marrow-derived stromal cells were treated with 20 µM of soluble lansoprazole at the beginning of osteogenic induction. Soluble lansoprazole-impregnated β-TCP materials were embedded in the cortical bone defect model of rabbits. Rabbits were sacrificed four weeks postoperatively and undecalcified bone specimens were prepared for evaluation of intra-material new bone formation. Only a 1-day treatment with soluble lansoprazole facilitated osteoblastic differentiation and matrix calcium deposition when added to undifferentiated human mesenchymal stromal cells at the beginning of the osteogenic differentiation. Soluble lansoprazole dose-dependently accelerated intra-material new bone formation when being impregnated with porous β-TCP artificial bones. Local use of soluble lansoprazole can be applicable for fracture and bone defect repair when combined with porous β-TCP scaffolds.
Topics: Animals; Humans; Rabbits; Lansoprazole; Osteogenesis; Calcium Phosphates; Bone Regeneration; Lagomorpha
PubMed: 36446942
DOI: 10.1038/s41598-022-25184-4 -
British Journal of Clinical Pharmacology Jan 2022Helicobacter pylori (Hp) eradication plays a key role in the treatment and prevention of peptic ulcer diseases. Increasing clarithromycin resistance in Hp necessitates... (Randomized Controlled Trial)
Randomized Controlled Trial
AIMS
Helicobacter pylori (Hp) eradication plays a key role in the treatment and prevention of peptic ulcer diseases. Increasing clarithromycin resistance in Hp necessitates more effective treatments for eradication, such as bismuth-containing quadruple therapy. We aimed to compare the safety and pharmacokinetics (PK) of bismuth between vonoprazan- and lansoprazole-containing quadruple therapy in Hp-positive subjects.
METHODS
In this randomised, double-blind, parallel-group study, Hp-positive subjects were randomised to receive vonoprazan- or lansoprazole-containing quadruple therapy. Each subject received vonoprazan 20 mg or lansoprazole 30 mg combined with bismuth 220 mg, clarithromycin 500 mg and amoxicillin 1000 mg twice daily for 14 days. Blood sampling and urine collection for bismuth PK were conducted predose and up to 12 hours postdose at steady-state. The PK parameters of bismuth were derived using a noncompartmental method and compared between treatments. An exploratory breath test for Hp was conducted at screening and at the follow-up visit on day 42. Safety was assessed by adverse event monitoring, physical examinations, vital signs, 12-lead electrocardiograms and clinical laboratory tests.
RESULTS
A total of 30 subjects were randomised and 26 subjects completed the study (12 in the vonoprazan group and 14 in the lansoprazole group). The systemic exposure of bismuth in the 2 treatments was comparable (~5% difference). All subjects turned negative for Hp at the follow-up visit. No significant difference in safety profiles was noted between the 2 treatments.
CONCLUSION
The systemic exposure of bismuth was similar between vonoprazan- and lansoprazole-containing quadruple therapy. Vonoprazan-containing quadruple therapy was safe and well tolerated.
Topics: Amoxicillin; Anti-Bacterial Agents; Bismuth; Clarithromycin; Drug Therapy, Combination; Helicobacter Infections; Helicobacter pylori; Humans; Lansoprazole; Pyrroles; Sulfonamides; Treatment Outcome
PubMed: 34080718
DOI: 10.1111/bcp.14934 -
Nihon Ronen Igakkai Zasshi. Japanese... 2023Proton-pump inhibitors (PPIs) are widely used. However, reports of their adverse effects are increasing. Older patients are prone to developing hyponatremia due to...
AIM
Proton-pump inhibitors (PPIs) are widely used. However, reports of their adverse effects are increasing. Older patients are prone to developing hyponatremia due to various factors. The special environment of a geriatric healthcare facility tends to subject these patients to long-term medication use. Therefore, we hypothesized that nursing home residents receiving PPIs will present hyponatremia.
METHODS
The residents of Shonan Silver Garden, a long-term care health facility for older adults, were divided into two groups: a control group (n=61) which did not receive proton-pump inhibitors and a PPI group (n=29), which received proton-pump inhibitors for at least 6 months. The PPI group was further divided into the lansoprazole group (LPZ group) and the other PPI group. Other PPI users were excluded due to small numbers. The blood test results were compared between the control and LPZ groups. In the LPZ group, blood samples were taken 1 month after the discontinuation of lansoprazole, and serum Na level was compared to the level before discontinuation.
RESULTS
Blood Na levels in the PPI were lower than those in the control group, and hyponatremia (<136 mEq/L) was more frequent in the LPZ group than in the control group. There were no significant differences in other blood test parameters between the control and LPZ groups. At one month after the discontinuation of lansoprazole, serum Na levels were significantly increased; however, they remained lower than those in the control group.
CONCLUSION
A higher rate of hyponatremia was induced in older residents of long-term care facilities who took lansoprazole for >6 months in comparison to those who did not take lansoprazole.
Topics: Aged; Humans; Hyponatremia; Lansoprazole; Nursing Homes; Proton Pump Inhibitors
PubMed: 37225507
DOI: 10.3143/geriatrics.60.153 -
International Journal of Medical... 2023Cancer has been linked to metabolic disorders and diverse gene mutations. Metformin, which is widely used to treat type 2 diabetes, inhibits the growth of cancer cells...
Cancer has been linked to metabolic disorders and diverse gene mutations. Metformin, which is widely used to treat type 2 diabetes, inhibits the growth of cancer cells in animal models. Here we investigated the effects of metformin on human gastric cancer cell lines. We also investigated the synergistic anticancer effect of metformin and proton pump inhibitors. Lansoprazole, a proton pump inhibitor, is effective for treating gastroesophageal reflux disease. Our results revealed that metformin and lansoprazole can significantly inhibit cancer cell growth in a dose-dependent manner by suppressing cell cycle progression and inducing apoptosis. Low concentrations of metformin and lansoprazole have a synergistic effect on AGS cell growth inhibition. In summary, our findings suggest a new and safe treatment protocol for treating stomach cancers.
Topics: Animals; Humans; Lansoprazole; Metformin; Stomach Neoplasms; Diabetes Mellitus, Type 2; Proton Pump Inhibitors
PubMed: 37213670
DOI: 10.7150/ijms.82407 -
Yakugaku Zasshi : Journal of the... Jun 2006Lansoprazole is extensively metabolized by CYP2C19 and CYP3A4 in the liver, whereas rabeprazole is primarily converted non-enzymatically to rabeprazole-thioether, with... (Review)
Review
Lansoprazole is extensively metabolized by CYP2C19 and CYP3A4 in the liver, whereas rabeprazole is primarily converted non-enzymatically to rabeprazole-thioether, with only some being oxidized by CYP2C19 and CYP3A4. Lansoprazole and rabeprazole possess asymmetric sulfur in their chemical structure and have typically been used clinically as a racemic mixture. This article reviews the pharmacokinetic differences between enantiomers of lansoprazole and rabeprazole in relation to the CYP2C19 genotypes. In our studies in healthy Japanese subjects, the magnitude of contribution of each lansoprazole enantiomer for CYP2C19 was greater than that for CYP3A4. CYP2C19 influenced the disposition of (S)-lansoprazole to a greater extent than the (R)-enantiomer. The R/S ratios for the AUC of lansoprazole in CYP2C19 homEMs, hetEMs and PMs was 12.7, 8.5 and 5.8, respectively. On the other hand, (R)-rabeprazole disposition was influenced to a greater degree by CYP2C19 genetic polymorphisms than (S)-rabeprazole. However, the R/S ratios for the AUC of rabeprazole in CYP2C19 homEMs, hetEMs and PMs was only 1.8, 2.2 and 2.4, respectively, suggesting a lesser effect of CYP2C19 polymorphisms on the stereoselective disposition of rabeprazole compared to lansoprazole. Such a difference in the AUC between rabeprazole enantiomers is likely to be dependent on stereoselectivity in the CYP3A4-mediated metabolic conversion from rabeprazole-thioether to rabeprazole. Both enantiomers of these PPIs have been reported to possess equal potency. Therefore, particularly with lansoprazole, the use of (R)-lansoprazole alone would be highly desirable for use in clinical applications.
Topics: 2-Pyridinylmethylsulfinylbenzimidazoles; Aryl Hydrocarbon Hydroxylases; Benzimidazoles; Cytochrome P-450 CYP2C19; Cytochrome P-450 CYP3A; Cytochrome P-450 Enzyme System; Dexlansoprazole; Genotype; Humans; Lansoprazole; Mixed Function Oxygenases; Omeprazole; Polymorphism, Genetic; Proton Pump Inhibitors; Rabeprazole; Stereoisomerism
PubMed: 16755125
DOI: 10.1248/yakushi.126.395 -
Basic & Clinical Pharmacology &... Aug 2019
Topics: Cardiovascular Diseases; Cathepsin B; Cysteine Endopeptidases; Cysteine Proteinase Inhibitors; Endothelium, Vascular; Humans; Lansoprazole; Omeprazole; Oxidative Stress; Proton Pump Inhibitors; Xanthine Dehydrogenase
PubMed: 30980783
DOI: 10.1111/bcpt.13237 -
PloS One 2014Benzimidazole drugs lansoprazole and omeprazole are used for treatment of various gastrointestinal pathologies. Both compounds cause drug-drug interactions because they...
Benzimidazole drugs lansoprazole and omeprazole are used for treatment of various gastrointestinal pathologies. Both compounds cause drug-drug interactions because they activate aryl hydrocarbon receptor and induce CYP1A genes. In the current paper, we examined the effects of lansoprazole and omeprazole enantiomers on the expression of key drug-metabolizing enzyme CYP3A4 in human hepatocytes and human cancer cell lines. Lansoprazole enantiomers, but not omeprazole, were equipotent inducers of CYP3A4 mRNA in HepG2 cells. All forms (S-, R-, rac-) of lansoprazole and omeprazole induced CYP3A4 mRNA and protein in human hepatocytes. The quantitative profiles of CYP3A4 induction by individual forms of lansoprazole and omeprazole exerted enantiospecific patterns. Lansoprazole dose-dependently activated pregnane X receptor PXR in gene reporter assays, and slightly modulated rifampicin-inducible PXR activity, with similar potency for each enantiomer. Omeprazole dose-dependently activated PXR and inhibited rifampicin-inducible PXR activity. The effects of S-omeprazole were much stronger as compared to those of R-omeprazole. All forms of lansoprazole, but not omeprazole, slightly activated glucocorticoid receptor and augmented dexamethasone-induced GR transcriptional activity. Omeprazole and lansoprazole influenced basal and ligand inducible expression of tyrosine aminotransferase, a GR-target gene, in HepG2 cells and human hepatocytes. Overall, we demonstrate here that omeprazole and lansoprazole enantiomers induce CYP3A4 in HepG2 cells and human hepatocytes. The induction comprises differential interactions of omeprazole and lansoprazole with transcriptional regulators PXR and GR, and some of the effects were enantiospecific. The data presented here might be of toxicological and clinical importance, since the effects occurred in therapeutically relevant concentrations.
Topics: Anti-Ulcer Agents; Cells, Cultured; Cytochrome P-450 CYP3A; Hep G2 Cells; Hepatocytes; Humans; Lansoprazole; Omeprazole; Pregnane X Receptor; Receptors, Glucocorticoid; Receptors, Steroid
PubMed: 25141173
DOI: 10.1371/journal.pone.0105580 -
Gut Jun 2018Compare efficacy and safety of vonoprazan and lansoprazole for secondary prevention of low-dose aspirin (LDA)-associated peptic ulcers in a 24-week study and long-term... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
Compare efficacy and safety of vonoprazan and lansoprazole for secondary prevention of low-dose aspirin (LDA)-associated peptic ulcers in a 24-week study and long-term extension therapy in separate study.
DESIGN
Double-blind, randomised, non-inferiority study; single-blind extension study at 104 Japanese sites, including 621 patients (439 in extension) with a history of peptic ulcers who required long-term LDA therapy. Randomised (1:1:1, computer generated) patients received lansoprazole 15 mg (n=217), vonoprazan 10 mg (n=202) or vonoprazan 20 mg (n=202) once daily for 24 weeks (double blind) and ≤2 years (extension). The following measurements were made: 24-week (primary outcome; double blind) and 12-week peptic ulcer recurrence rate, 24-week GI bleeding rate, cumulative incidences of peptic ulcer recurrence and GI bleeding, treatment-emergent adverse events, laboratory results, serum gastrin and pepsinogen I/II concentrations.
RESULTS
The 24-week peptic ulcer recurrence rate was 2.8%, 0.5% and 1.5% in the lansoprazole 15 mg, vonoprazan 10 mg and vonoprazan 20 mg groups, respectively. Vonoprazan was non-inferior (Farrington and Manning test: margin 8.7%, significance level 2.5%) to lansoprazole. In the post hoc analyses of the extension study, peptic ulcer recurrence rates were significantly lower with vonoprazan 10 mg (log-rank test, P=0.039), but not vonoprazan 20 mg (P=0.260), compared with lansoprazole 15 mg. GI bleeding rates were higher with lansoprazole compared with two doses of vonoprazan in both 24-week study and extension study.
CONCLUSION
Vonoprazan (10 and 20 mg) was as effective as lansoprazole (15 mg) in preventing peptic ulcer recurrence during LDA therapy, had a similar long-term safety profile and was well tolerated.
TRIAL REGISTRATION NUMBERS
NCT01452763; NCT01456247.
Topics: Aged; Aged, 80 and over; Anti-Inflammatory Agents, Non-Steroidal; Anti-Ulcer Agents; Aspirin; Double-Blind Method; Female; Follow-Up Studies; Gastrointestinal Hemorrhage; Humans; Japan; Lansoprazole; Male; Middle Aged; Peptic Ulcer; Pyrroles; Recurrence; Secondary Prevention; Sulfonamides; Treatment Outcome
PubMed: 29196436
DOI: 10.1136/gutjnl-2017-314852 -
Life Sciences Dec 2019Lansoprazole (LPZ) is one of the most commonly prescribed drugs for treatment of acid-related diseases, and it is increasingly recognized for its potential application...
AIMS
Lansoprazole (LPZ) is one of the most commonly prescribed drugs for treatment of acid-related diseases, and it is increasingly recognized for its potential application as an anti-diabetic therapy. Although LPZ target tissues remain poorly understood, possible sites of action include adipose tissue. In this study, we assessed effects of LPZ on adipocyte differentiation and function by using 3T3-L1 preadipocytes and HFD-induced obesity mice as an in vitro and in vivo model, respectively.
MAIN METHODS
Oil red O staining and intracellular triacylglycerol content were used to determine lipid accumulation. Glucose uptake was performed to measure mature adipocyte function. Expression of adipocyte genes was determined by qRT-PCR and immunoblotting.
KEY FINDINGS
LPZ has dual effects on differentiation of 3T3-L1 cells. At low concentrations, LPZ enhanced adipocyte differentiation via induction of PPARγ and C/EBPα, two master adipogenic transcription factors, as well as lipogenic proteins, ACC1 and FASN. Increasing of adipocyte number subsequently increased basal and insulin-stimulated glucose uptake, and expression of Glut4 mRNA. Conversely, high concentrations of LPZ strongly inhibited differentiation and expression of PPARγ and C/EBPα, and maintained expression of preadipocytes markers, β-catenin and Pref-1. Inhibition of adipogenesis by LPZ reduced mature adipocyte number, Glut4 mRNA expression and insulin-stimulated glucose uptake. In addition, treatment with LPZ at 200 mg/kg significantly reduced body weight gain and total fat mass in HFD-induced obese mice.
SIGNIFICANCE
These results indicate that effects of LPZ on adipocyte differentiation are dependent on concentration and are correlated with PPARγ and C/EBPα.
Topics: 3T3-L1 Cells; Adipocytes; Adipogenesis; Animals; CCAAT-Enhancer-Binding Protein-alpha; Cell Differentiation; Diet, High-Fat; Glucose Transporter Type 4; Insulin; Lansoprazole; Lipid Metabolism; Lipogenesis; Male; Mice; Mice, Inbred C57BL; Obesity; PPAR gamma; Triglycerides
PubMed: 31644894
DOI: 10.1016/j.lfs.2019.116897