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Old 08-17-2012, 08:24 AM   #1
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Lightbulb Potential drug to stop/reverse PPI dependency

I think it just the other day that I said the medical establishment is too busy fighting over whether whether rebound exists to start studying it in a useful way. Time to eat my words.

The July issue of the British Journal of Pharmacology says that researchers succeeded in preventing PPI dependency through a new substance which they call a cholecystokinin CCK2 receptor antagonist. They've only tested it on rats, no human trials yet.

You see, PPIs suppress acid production. However, the body wants stomach acid, so it tries to compensate. Something in the upper stomach called the parietal cell mass gets bigger. Parietal cells produce a hormone called gastrin, which causes those proton pumps to produce hydrochloric acid. This is why rebound occurs. It takes weeks for the parietal cell mass to shrink back down and gastrin levels to return to normal, hence rebound lasts a long time.

Unfortunately, I could only get the abstract. If I have time, I'll take a trip to a library with a journal subscription and get the whole thing. But here's the most exciting thing I've seen so far. They gave rats omeprazole for a while, watched their gastrin levels rise. Then they stopped the omeprazole and gave them this new drug for 3 days. There was no rebound and the gastrin levels returned to normal. Three days. Not two miserable months, three reasonably comfortable days.

The authors also discussed the possibility of using the new drug by itself as a treatment for acid reflux, but I'm most exciting about the chance to reverse rebound without that nasty taper. In fact, there are several companies looking at this drug pathway to treat acid reflux!

Now, rats are not people, and anything could happen between here and the market. We might discover that this just doesn't work in people, or that there are dangerous side effects. Even if it does work, it takes years of human trials to bring a drug to market. Still, it's the most exciting science news I've heard since the Mars lander last week.

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