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首页> 外文期刊>Annals of the New York Academy of Sciences >Gastrointestinal pharmacology: practical tips for the esophagologist
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Gastrointestinal pharmacology: practical tips for the esophagologist

机译：胃肠药理学：食管学家的实用提示

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Gastroesophageal reflux disease (GERD) is primarily a motor disorder, and its pathogenesis is multifactorial. As a consequence, treatment should be able to address the underlying pathophysiology. Proton pump inhibitors (PPIs) are the mainstay of medical therapy for GERD, but these drugs only provide the control of symptoms and lesions without curing the disease. However, continuous acid suppression with PPIs is recommended for patients with Barrett's esophagus because of their potential chemopreventive effects. In addition to the antisecretory activity, these compounds display several pharmacological properties, often overlooked in clinical practice. PPIs can indeed affect gastric motility, exert a mucosal protective effect, and an antioxidant, anti-inflammatory, and antineoplastic activity, also protecting cancer cells from developing chemo- or radiotherapeutic resistance. Even in the third millennium, current pharmacologic approaches to address GERD are limited. Reflux inhibitors represent a promise unfulfilled, effective and safe prokinetics are lacking, and antidepressants, despite being effective in selected patients, give rise to adverse events in a large proportion of them. While waiting for new drug classes (like potassium-competitive acid blockers), reassessing old drugs (namely alginate-containing formulations), and paving the new avenue of esophageal mucosal protection are, at the present time, the only reliable alternatives to acid suppression.
机译：胃食管反流疾病（GERD）主要是电机障碍，其发病机制是多因素。因此，治疗应该能够解决潜在的病理生理学。质子泵抑制剂（PPI）是GERD的医疗治疗的主要药剂，但这些药物仅提供症状和病变的控制而不治愈该疾病。然而，由于其潜在的化学预防效应，建议对Barrett食管的患者建议使用PPI的连续酸抑制。除了防血变活性外，这些化合物还显示出几种药理性质，通常忽略临床实践。 PPI确实可以影响胃动力，施加粘膜保护作用，以及抗氧化剂，抗炎和抗肿瘤活性，也保护癌细胞免于显影化学或放射治疗抗性。即使在第三千年中，目前的地址GERD的药理学方法也有限。回流抑制剂代表承诺未实现，缺乏有效和安全的发起性，并且尽管在选定患者中有效，但抗抑郁药仍然会产生不良事件。在等待新的药物课程（如竞争力的酸阻滞剂），重新评估旧药物（即含藻酸盐的配方），并在当前铺平食管粘膜保护的新途径是酸抑制的唯一可靠的替代品。

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