Potential immunological consequences of pharmacological suppression of gastric acid production in patients with multiple sclerosis

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dc.contributor.author Biswas, Sangita
dc.contributor.author Benedict, Stephen H
dc.contributor.author Lynch, Sharon G
dc.contributor.author LeVine, Steven M
dc.date.accessioned 2015-05-27T09:39:41Z
dc.date.available 2015-05-27T09:39:41Z
dc.date.issued 2012-06-07
dc.identifier http://dx.doi.org/10.1186/1741-7015-10-57
dc.identifier.uri http://hdl.handle.net/2271/1321
dc.description.abstract Abstract Corticosteroids are standard treatment for patients with multiple sclerosis experiencing acute relapse. Because dyspeptic pain is a common side effect of this intervention, patients can be given a histamine receptor-2 antagonist, proton pump inhibitor or antacid to prevent or ameliorate this disturbance. Additionally, patients with multiple sclerosis may be taking these medications independent of corticosteroid treatment. Interventions for gastric disturbances can influence the activation state of the immune system, a principal mediator of pathology in multiple sclerosis. Although histamine release promotes inflammation, activation of the histamine receptor-2 can suppress a proinflammatory immune response, and blocking histamine receptor-2 with an antagonist could shift the balance more towards immune stimulation. Studies utilizing an animal model of multiple sclerosis indicate that histamine receptor-2 antagonists potentially augment disease activity in patients with multiple sclerosis. In contrast, proton pump inhibitors appear to favor immune suppression, but have not been studied in models of multiple sclerosis. Antacids, histamine receptor-2 antagonists and proton pump inhibitors also could alter the intestinal microflora, which may indirectly lead to immune stimulation. Additionally, elevated gastric pH can promote the vitamin B12 deficiency that patients with multiple sclerosis are at risk of developing. Here, we review possible roles of gastric acid inhibitors on immunopathogenic mechanisms associated with multiple sclerosis.
dc.title Potential immunological consequences of pharmacological suppression of gastric acid production in patients with multiple sclerosis
dc.type Journal Article
dc.date.updated 2012-06-29T15:08:18Z
dc.description.version Peer Reviewed
dc.language.rfc3066 en
dc.rights.holder Sangita Biswas et al.; licensee BioMed Central Ltd.

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