The effect of omeprazole on human natural killer cell activity

Aybay, Cemalettin; İmir, Turgut; Okur, Hamza

doi:10.1016/0306-3623(94)00301-3

Cited by 61 publications

(54 citation statements)

References 39 publications

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“…52 Third, in vitro studies have shown that acid-suppressive drugs may impair the function of neutrophils and the activity of natural killer cells. [53][54][55][56][57][58][59] Interestingly, the most striking increase in the risk of pneumonia in association with proton pump inhibitors was observed in the first week of use. The risk of pneumonia in association with use of proton pump inhibitors was attenuated, but still significant, between 30 and 180 days.…”

Section: Main Findingsmentioning

confidence: 99%

Use of acid-suppressive drugs and risk of pneumonia: a systematic review and meta-analysis

Eom¹,

Jeon²,

Lim³

et al. 2010

Canadian Medical Association Journal

354

222

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Background: Observational studies and randomized controlled trials have yielded inconsistent findings about the association between the use of acid-suppressive drugs and the risk of pneumonia. We performed a systematic review and meta-analysis to summarize this association. Methods:We searched three electronic databases (MEDLIN E [PubMed], Embase and the Cochrane Library) from inception to Aug. 28, 2009. Two evaluators independently extracted data. Because of heterogeneity, we used random-effects meta-analysis to obtain pooled estimates of effect. Results:We identified 31 studies: five casecontrol studies, three cohort studies and 23 randomized controlled trials. A meta-analysis of the eight observational studies showed that the overall risk of pneumonia was higher among people using proton pump inhibitors (adjusted odds ratio [OR] 1.27, 95% confidence interval [CI] 1.11-1.46, I 2 90.5%) and histamine 2 receptor antagonists (adjusted OR 1.22, 95% CI 1.09-1.36, I 2 0.0%). In the randomized controlled trials, use of histamine 2 receptor antagonists was associated with an elevated risk of hospital-acquired pneumonia (relative risk 1.22, 95% CI 1.01-1.48, I 2 30.6%).Interpretation: Use of a proton pump inhibitor or histamine 2 receptor antagonist may be associated with an increased risk of both community-and hospital-acquired pneumonia. Given these potential adverse effects, clinicians should use caution in prescribing acid-suppressive drugs for patients at risk.

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Section: Main Findingsmentioning

confidence: 99%

Use of acid-suppressive drugs and risk of pneumonia: a systematic review and meta-analysis

Eom¹,

Jeon²,

Lim³

et al. 2010

Canadian Medical Association Journal

354

222

View full text Add to dashboard Cite

show abstract

“…The humoral defense mechanism against bacterial colonization is mediated by the white blood cells. In vitro studies [43][44][45] have assessed the cytotoxicity of natural killer (NK) cells when exposed to target cells in varying ratios and in different solution media. Not surprisingly, as the ratio of NK cells to target cells increased, the percentage of target cells lysed increased, suggesting a positive correlation.…”

Section: Ppis and Pneumonia-pathophysiologymentioning

confidence: 99%

“…Not surprisingly, as the ratio of NK cells to target cells increased, the percentage of target cells lysed increased, suggesting a positive correlation. The varying ratios of NK cells to target cells were then exposed to media with an omeprazole concentration ranging between 0 µmol/L and 288 µmol/L [43,44] . The cytotoxic potential of the NK cells decreased with increasing concentrations of omeprazole in the solution media, suggesting an inverse correlation.…”

Section: Ppis and Pneumonia-pathophysiologymentioning

confidence: 99%

“…The NK cells recovered 75% of their cytotoxicity when the media solution was rinsed of omeprazole. By rechallenging the rinsed NK cells with a second omeprazole solution, the cytotoxic activity of the NK cells was again reduced [43] . The reversible interaction between the omeprazole solution and the NK cell's cytotoxicity appeared to be dependent on continuous exposure to the omeprazole.…”

Section: Ppis and Pneumonia-pathophysiologymentioning

confidence: 99%

“…Secondly, 75% of the cytotoxic inhibitory effect was washed out when the solution was rinsed of the omeprazole. Knowing the plasma half-life of the PPIs ranges between 30 min and 90 min, the NK cell exposure to PPIs would be limited as the PPI would be readily cleared from the systemic circulation [43] .…”

Section: Ppis and Pneumonia-pathophysiologymentioning

confidence: 99%

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Proton pump inhibitor-associated pneumonia: Not a breath of fresh air after all?

Fohl

Regal²

2011

WJGPT

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Over the past two decades, proton pump inhibitors (PPIs) have emerged as highly effective and relatively safe agents for the treatment of a variety of gastrointestinal disorders. Unfortunately, this desirable pharmacological profile has also contributed to superfluous and widespread use in both the inpatient and outpatient settings. While generally well-tolerated, research published over the last decade has associated these agents

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Acid-Suppressive Medication Use and the Risk for Hospital-Acquired Pneumonia

Herzig¹

2009

JAMA

426

273

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Context The use of acid-suppressive medication has been steadily increasing, particularly in the inpatient setting, despite lack of an accepted indication in the majority of these patients. Objective To examine the association between acid-suppressive medication and hospital-acquired pneumonia. Design, Setting, and Patients Prospective pharmacoepidemiologic cohort study. All patients who were admitted to a large, urban, academic medical center in Boston, Massachusetts, from January 2004 through December 2007; at least 18 years of age; and hospitalized for 3 or more days were eligible for inclusion. Admissions with time spent in the intensive care unit were excluded. Acid-suppressive medication use was defined as any order for a proton-pump inhibitor or histamine 2 receptor antagonist. Traditional and propensity-matched multivariable logistic regression were used to control for confounders. Main Outcome Measure Incidence of hospital-acquired pneumonia, defined via codes from the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM), in patients exposed and unexposed to acid-suppressive medication. Results The final cohort comprised 63 878 admissions. Acid-suppressive medication was ordered in 52% of admissions and hospital-acquired pneumonia occurred in 2219 admissions (3.5%). The unadjusted incidence of hospital-acquired pneumonia was higher in the group exposed to acid-suppressive medication than in the unexposed group (4.9% vs 2.0%; odds ratio [OR], 2.6; 95% confidence interval [CI], 2.3-2.8). Using multivariable logistic regression, the adjusted OR of hospital-acquired pneumonia in the group exposed to acid-suppressive medication was 1.3 (95% CI, 1.1-1.4). The matched propensity-score analyses yielded identical results. The association was significant for proton-pump inhibitors (OR, 1.3; 95% CI, 1.1-1.4) but not for histamine 2 receptor antagonists (OR, 1.2; 95% CI, 0.98-1.4). Conclusions In this large, hospital-based pharmacoepidemiologic cohort, acidsuppressive medication use was associated with 30% increased odds of hospitalacquired pneumonia. In subset analyses, statistically significant risk was demonstrated only for proton-pump inhibitor use.

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The effect of omeprazole on human natural killer cell activity

Cited by 61 publications

References 39 publications

Use of acid-suppressive drugs and risk of pneumonia: a systematic review and meta-analysis

Use of acid-suppressive drugs and risk of pneumonia: a systematic review and meta-analysis

Proton pump inhibitor-associated pneumonia: Not a breath of fresh air after all?

Acid-Suppressive Medication Use and the Risk for Hospital-Acquired Pneumonia

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