Esomeprazole,one of the proton pump inhibitors(PPIs),has been widely used in acid-related diseases,such as gastro-esophageal reflux disease and Helicobacter pylori infection.Compared with other PPIs,esomeprazole has higher acid control efficiency,bioavailability,stability,and less interindividual variation depending on its pharmacokinetic properties.Esomeprazole was considered safe for long-term administration.However,several recent studies have contradicted its absolute safety,and some detrimental cases have been reported in some special groups,such as pregnant women and patients with liver cirrhosis.Because acid-related diseases usually require long-term therapy and esomeprazole inhibits CYP2C19 enzyme that increases the probability of drug-drug interaction,these risks have become a concern.Recent studies have shown that esomeprazole not only inhibits acid secretion,but also exhibits acid-independent effects in inflammatory conditions.Esomeprazole can modulate NF-κb activation to resist tissue oxidation and apoptosis in gastric ulcer.In CCL4-induced liver fibrosis,esomeprazole improves oxidative stress,fibrogenesis,and apoptosis,but the mechanism still remains unclear.This review summarized the property of esomeprazole and its potential risk for administration,and its latest research progress,which may facilitate clinicians to better use and avoid the potential risks.
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