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The effect of short-term oral treatment with omeprazole or pantoprazole on the function of polymorphonuclear
Maja Kostrzewska1, Marzena Garley2, Wioletta Ratajczak-Wrona2
1a Department of Gastroenterology and Internal Medicine, Medical University of Bialystok, Bialystok, Poland.
Abstract:
Recent studies report an increased risk of enteric infections in patients treated with proton pump inhibitors (PPIs). Polymorphonuclear neutrophils (PMNs) play a key role in host response to bacterial infection. We evaluated the effect of omeprazole and pantoprazole treatment on the PMN function. Fifteen patients were treated with omeprazole 20 mg daily and 15 patients with pantoprazole 40 mg daily for 7 days. Treatment with omeprazole or pantoprazole had no effect on spontaneous nitroblue tetrazolium (NBT) test results. Significant increase in the percentage of phagocytes in the omeprazole group in stimulated NBT test (by 69%) was found. Treatment with omeprazole or pantoprazole had no effect on nitric oxide (NO) concentration in the PMN culture supernatant and serum, cyclic guanosine monophosphate concentration in the PMN culture supernatant and serum, as well as inducible nitric oxide synthase (iNOS) protein expression and p38 mitogen-activated protein kinase activity in PMNs. In conclusion, treatment with PPI has no effect on NO production and p38 mitogen-activated protein kinase activity in PMNs. Interestingly, short-term treatment with omeprazole but not with pantoprazole enhances PMN reactive oxygen species production.
Insights
Proton pump inhibitors (PPIs) like omeprazole may increase enteric infection risk. Short-term omeprazole use enhances polymorphonuclear neutrophil (PMN) reactive oxygen species production, potentially impacting infection response.
Area of Science:
- Immunology
- Pharmacology
Background:
- Proton pump inhibitors (PPIs) are linked to increased enteric infection risk.
- Polymorphonuclear neutrophils (PMNs) are crucial for bacterial infection defense.
Purpose of the Study:
- To investigate the impact of omeprazole and pantoprazole on PMN function.
- To assess effects on PMN reactive oxygen species production and other key indicators.
Main Methods:
- 15 patients received omeprazole (20 mg/day) and 15 received pantoprazole (40 mg/day) for 7 days.
- Evaluated PMN function using nitroblue tetrazolium (NBT) tests, nitric oxide (NO) concentration, cyclic guanosine monophosphate (cGMP) levels, inducible nitric oxide synthase (iNOS) expression, and p38 MAPK activity.
Main Results:
- Omeprazole and pantoprazole did not affect spontaneous NBT tests or NO production.
- Omeprazole significantly increased phagocyte percentage in stimulated NBT tests (69% increase).
- Neither PPI affected NO, cGMP, iNOS expression, or p38 MAPK activity, but omeprazole enhanced PMN reactive oxygen species production.
Conclusions:
- Short-term PPI treatment does not impair NO production or p38 MAPK activity in PMNs.
- Omeprazole, unlike pantoprazole, enhances PMN reactive oxygen species production, suggesting a potential mechanism for altered infection risk.
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