Effect of Proton-Pump Inhibitor Therapy on Serum Chromogranin A Level

Abstract

Background: The neuroendocrine marker, chromogranin A (CgA) increases during medium- or long-term proton-pump inhibitor (PPI) treatment. Aims: To analyze the effect of ultra-short-term and diverse dose of PPI therapy on serum CgA and gastrin levels and evaluate the effect of PPI treatment cessation. Patients and Methods: Fasting serum CgA and gastrin were determined in newly diagnosed gastroesophageal reflux disease (GERD) patients (n = 54) treated with diverse doses of PPI during a 28-day period, in patients treated with PPIs for at least 6 months (n = 42), and in subjects where PPI treatment could be stopped (n = 11). Results: A significant stepwise increase of CgA levels was observed after 5 days during the 28-day period treatment with all PPI doses. Gastrin increased significantly also in the standard and high-dose PPI subgroups. The most prominent increase of CgA was observed in the high-dose PPI subgroup. Serum CgA and gastrin were markedly elevated after 6 months of PPI treatment, and decreased significantly after 5 days of PPI discontinuation. Conclusions: Serum CgA increases significantly even after ultra-short-term (5 days) PPI therapy. After long-term treatment, 5-day cessation of PPI therapy is sufficient to decrease significantly both CgA and gastrin levels.

The role of chromogranin-A and its derived peptide, WE-14 in the development of type 1 diabetes mellitus

“…Külön említést érdemel, hogy a hypoaciditas, atrophiás gastritis, valamint a savszekréció-gátlás (például protonpumpagátló vagy hisztamin H 2 -receptor-blokkoló kezelés) emeli a szérum-CgA-szintet másodlagos hypergastrinaemia és a gyomor enterokromaffi nszerű sejtjeinek serkentése által [36,37]. A CgA mérése előtt az ilyen típusú kezelések felfüggesztése javasolt, a gyógy-szertípustól függően legalább három felezési idő erejéig [38].…”

The Role of the Acute Octreotide Suppression Test in Detecting Patients with Neuroendocrine Neoplasms

“…However, participants in our study were required to fast during the test and not to take PPIs prior to the test, both of which has not been specified in the aforementioned study. This may be important since both feeding and PPIs may influence serum CgA levels [11,21]. Moreover, patients with poorly differentiated tumors, large tumor burden, and poor functional status were excluded from their study, which might be important when interpreting AOST results.…”

“…However, increased serum CgA can be found in patients with sepsis [2], acute exacerbation of rheumatoid arthritis [3], inflammatory bowel disease [4], various metastatic malignancies [5], heart and renal failure [6,7], complicated myocardial infarction [8], arterial hypertension [9], and chronic atrophic gastritis [10]. Moreover, the use of proton pump inhibitors (PPIs) may also increase CgA serum levels [11].…”

Gastric secretion

“…Serum CgA has been used as a sensitive marker for the diagnosis of neuroendocrine tumors. However, it should be noted that CgA is elevated in patients with atrophic gastritis as well as those treated with PPIs for as short as 5 days [50].…”