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Open Access 01-12-2012 | Review

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

Authors: Sangita Biswas, Stephen H Benedict, Sharon G Lynch, Steven M LeVine

Published in: BMC Medicine | Issue 1/2012

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.

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The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1741-7015/10/57/prepub

Title: Potential immunological consequences of pharmacological suppression of gastric acid production in patients with multiple sclerosis
Authors: Sangita Biswas
Stephen H Benedict
Sharon G Lynch
Steven M LeVine
Publication date: 01-12-2012
Publisher: BioMed Central
Published in: BMC Medicine / Issue 1/2012
Electronic ISSN: 1741-7015
DOI: https://doi.org/10.1186/1741-7015-10-57

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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