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Drugs for improving esophageal mucosa defense: Where are we now and where are we going?

Title: Drugs for improving esophageal mucosa defense: Where are we now and where are we going?
Authors: Savarino E.; Zentilin P.; Marabotto E.; Pellegatta G.; Coppo C.; Brunacci M.; Dulbecco P.; Savarino V.
Contributors: Savarino, E.; Zentilin, P.; Marabotto, E.; Pellegatta, G.; Coppo, C.; Brunacci, M.; Dulbecco, P.; Savarino, V.
Publisher Information: Hellenic Society of Gastroenterology
Publication Year: 2017
Collection: Padua Research Archive (IRIS - Università degli Studi di Padova)
Subject Terms: Gastroesophageal reflux disease; Histology; Impedance-pH monitoring; Mucosal integrity; Non-erosive reflux disease
Description: In the past, the attention of physiologists and doctors has been mainly focused on the key role of acid in the pathogenesis of gastroesophageal reflux disease (GERD), but increasing evidence that 20-40% of reflux patients respond not at all or only partially to proton pump inhibitors (PPIs) has underlined the concept that factors other than acid are implicated in its development and the elicitation of symptoms. Among these, impaired mucosal integrity, particularly in most patients with non-erosive reflux disease, has recently been reincluded and the reinforcement of defensive mechanisms and/or its protection has been reappointed as a renewed therapeutic target for the management of GERD patients. In this review we will summarize the existing knowledge of the old and novel compounds able to produce this therapeutic effect, including sucralfate, alginate-based drugs, and a new medical device consisting of hyaluronic acid and chondroitin sulfate dispersed in a bioadhesive carrier, together with the potential indications for their use. It is to be stressed, however, that, although these compounds may represent a real alternative to PPI therapy in GERD, the combination of mucosal protection with acid suppression may help manage many cases with a partial or unsatisfactory response to PPIs alone.
Document Type: article in journal/newspaper
File Description: STAMPA
Language: English
Relation: info:eu-repo/semantics/altIdentifier/pmid/29118552; info:eu-repo/semantics/altIdentifier/wos/WOS:000427442900001; volume:30; issue:6; firstpage:585; lastpage:591; numberofpages:7; journal:ANNALS OF GASTROENTEROLOGY; https://hdl.handle.net/11577/3333942
DOI: 10.20524/aog.2017.0187
Availability: https://hdl.handle.net/11577/3333942; https://doi.org/10.20524/aog.2017.0187
Accession Number: edsbas.55218188
Database: BASE