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Biomedical subjects

B Wallmark

Publications and source records attributed to B Wallmark.

At least 37 records · Page 2Linked to original sources
PubMed1989

Biological basis of omeprazole therapy.

There are two means of reducing acid secretion. The best studied is inhibition of stimulation of the parietal cell. There are three major types of receptors that activate secretion by this cell and two classes of receptor antagonists, as well as at least two intracellular messenger pathways. The receptors are for histamine (H2 subtype), acetyl choline (M2 subtype) and gastrin. Antagonists of these receptors include the H2-antagonist class (Tagamet, Zantac and Pepcid), the M1 muscarinic antagonists (pirenzepine, telenzepine) and the gastrin antagonist, proglumide. The major pathway for stimulation appears to be the H2-receptor, since this is the only receptor that stimulates adenylate cyclase, and both acetyl choline and gastrin release histamine locally within the gastric mucosa. However, these agonists elevate intracellular calcium, which has a partially independent action on acid secretion. Accordingly, the most efficacious type of receptor antagonist will be of the H2 class, which is borne out by clinical experience. Prostaglandins of the E type prevent adenylate cyclase stimulation by histamine and are also effective antisecretory agents. It will be difficult to abolish acid secretion entirely by a single receptor antagonist, although longer-acting H2-antagonists should show clinical superiority to short-acting antagonists of this type. An alternative approach to acid suppression is to block the terminal step of acid secretion, the gastric proton pump (H+, K(+)-ATPase). This enzyme is virtually unique to the parietal cell and, when active, forms a very acidic space within the parietal cell called the secretory canaliculus. Activation of acid secretion involves several steps. The enzyme is present in cytosolic membranes when the cell is at rest and moves to the membrane of the secretory canaliculus when stimulated. Simultaneously, there is an increased permeability of potassium chloride (KCl), which allows presentation of K+ to the luminal surface of the pump and H+ for K+ exchange. The result is the secretion of HCl into the canaliculus, and hence into the gland lumen and then the stomach. There are two classes of pump inhibitors. One class is K+ competitive and relatively selective for the H+, K(+)-ATPase, as exemplified by SCH28080. This class has not yet been used in man. The other class is specific to the functioning H+, K(+)-ATPase in the stomach. It is exemplified by omeprazole (Losec). This compound is a weak base with a pKa of 4. In the unprotonated, uncharged form it will penetrate cell membranes and, at pH less than 4, it becomes protonated and therefore charged.(ABSTRACT TRUNCATED AT 400 WORDS)

Adenosine Triphosphatases↗
PubMed1989

Omeprazole: mode of action and effect on acid secretion in animals.

Stomach acid is generated by the parietal cell of the gastric mucosa. During the last two decades an enzyme called H+,K+-ATPase, has been discovered and shown to be the agent responsible for acid transport in the parietal cell. H+,K+-ATPase is thus the hydrogen ion pump of the stomach. Omeprazole is the first example of a clinically useful inhibitor of H+,K+-ATPase. In animals and in man, omeprazole has been shown to effectively antagonize gastric acid secretion, irrespective of the stimulus used to activate acid formation. Omeprazole was found to have a long duration of antisecretory effect. For a dose that initially gave near maximal inhibition of secretion, four days were required in order to restore the normal secretory rate. Extensive mechanism studies showed that omeprazole specifically bound to H+,K+-ATPase of the gastric mucosa. Furthermore, a parallel inhibition of both maximal acid secretion and of mucosal H+,K+-ATPase activity was found. These data strongly suggested that omeprazole inhibited acid secretion by blockade of H+,K+-ATPase. Studies on the chemical mechanism for inhibition of the pump revealed that omeprazole is concentrated in the acid canaliculus of the parietal cell due to its weak base properties. In acid, omeprazole is rearranged into a sulfenamide derivative which reacts with luminal sulfhydryl groups of the H+,K+-ATPase.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1988

Inhibition of gastric H+/K+-ATPase by substituted imidazo[1,2-a]pyridines.

A hydrophobic imidazopyridine, SCH 28080 (3-cyanomethyl-2-methyl-8-phenylmethoxy)imidazo[1,2-a]pyridine) has previously been shown to inhibit gastric acid secretion in vivo and in vitro. Studies of isolated gastric H+/K+-ATPase have demonstrated that SCH 28080 reversibly inhibited the enzyme and competitively interacted with the K+-stimulated ATPase and p-nitrophenylphosphatase activities of the H+/K+-ATPase. To elucidate the mechanism of inhibition further, for example to establish whether the inhibitor interaction occurs on the luminal or the cytosolic side of the enzyme or if compound pKa influences inhibition, SCH 28080 and three analogues have been studied. We have examined the effects on K+-stimulated ATPase activity in isolated ion-permeable membrane vesicles at different pH values and KCl concentrations. In ion-tight membrane fractions the effect on acid formation was estimated. The results are in agreement with the hypothesis that the protonated, and thus positively charged, form of SCH 28080 is the active species, and that the inhibitory effect is exerted by binding of the compound to the luminal side of the H+/K+-ATPase.

Adenosine Triphosphatases↗
PubMed1988

Inhibitory effects of cations on the gastric H+, K+ -ATPase. A potential-sensitive step in the K+ limb of the pump cycle.

The presence of a cation inhibitory site on the dephosphoform of the H+, K+ -ATPase was confirmed by comparing the effects of K+ and NH4+ on overall activity and on phosphorylation and dephosphorylation. Inhibition of ATPase activity was pronounced at high cation/ATP ratios, but NH4+ was much less effective. At 60 mM cation, although the ATPase activity was greater in the presence of NH4+ (17.1 mumol/mg.h) as compared to K+ (5.1 mumol/mg.h), dephosphorylation of preformed phosphoenzyme was faster with K+ (2101 min-1) than with NH4+ (1401 min-1). Increasing K+ concentrations at the cytosolic face of the enzyme, at constant ATP, decreased the rate of phosphorylation from 1343 to 360 min-1 at 25 mM K+. Increasing ATP concentrations in the presence of constant K+ concentrations accelerated ATPase activity and increased the steady-state phosphoenzyme level. Therefore, inhibition by cations was due to cation stabilization of a dephospho form of the enzyme at a cytosolically accessible cation-binding site. ATP promoted cation dissociation from this site. In ion-permeable vesicles, increasing K+ concentrations, at constant ATP, activated and then inhibited ATPase activity, with a K0.5(I) of 22 mM. In intact, ion-impermeable inside-out vesicles, in the presence of valinomycin, ATPase activity increased up to 175 mM K+. Collapse of this potential by the addition of the electrogenic protonophore 3,3',4', 5-tetrachlorosalicylanilide restored the K+ inhibition of ATPase activity. Thus, the cation inhibition of the ATPase activity appears to be voltage-sensitive; and hence, its connection to the voltage sensitivity of acid secretion demonstrated in intact gastric mucosa is discussed.

Adenosine Triphosphatases↗
PubMed1988

The catalytic mechanism of gastric H+/K+-ATPase: simulations of pre-steady-state and steady-state kinetic results.

A reaction cycle for the gastric H+/K+-ATPase is proposed. This has been used to simulate the results from four types of pre-steady-state and steady-state kinetic experiments: (1) the K+ dependence of the dephosphorylation of the phosphoenzyme; (2) the rate of phosphorylation of the enzyme by ATP at different concentrations; (3) the effect of ATP concentration on the steady-state rate of ATP hydrolysis; (4) the phosphoenzyme levels in the steady state at various ATP concentrations. A single set of equilibrium and rate constants can be used to reproduce the results from all four sets of experiments quite well. It is suggested that the steady-state rate equation is nonhyperbolic because ATP can react with the enzyme in both the E1 and the E2 state, but with a lower affinity in E2. No single step is by itself limiting the maximum turnover rate.

Adenosine Triphosphatases↗
PubMed1988

Specific labelling of gastric H+,K+-ATPase by omeprazole.

Acid secretion is conducted by the parietal cell of the gastric mucosa. The H+,K+-ATPase has been shown to be specifically located to this cell and during recent years been recognized as the gastric proton pump. Omeprazole, a known inhibitor of acid secretion, administered in vivo was found to bind specifically to the H+,K+-ATPase of the rabbit gastric mucosa. A stoichiometry of 2.1 mol radiolabel per mol phosphoenzyme was calculated at total inhibition of the H+,K+-ATPase enzyme activity. In isolated gastric glands prepared from omeprazole-treated animals, the secretagogue-induced increase in oxygen consumption, related to acid secretion, was inhibited to the same level as the H+,K+-ATPase activity. Both the degree of acid secretion inhibition induced by omeprazole and the amount of inhibitor bound to the H+,K+-ATPase were found to be dependent on the stimulation state of the parietal cell. Inhibition of secretion by the H2-receptor blocker ranitidine prior to omeprazole treatment prevented both the inhibition of H+,K+-ATPase and oxygen consumption normally observed with omeprazole and, furthermore, reduced the binding levels of radiolabel to the enzyme. Inhibition of acid secretion by the H+,K+-ATPase inhibitor SCH 28080 totally prevented the binding of radiolabel to the H+,K+-ATPase. The inhibition by omeprazole could be fully reversed in gastric glands and H+,K+-ATPase isolated from omeprazole-treated animals by addition of beta-mercaptoethanol. The major product formed during reactivation was the reduced form of omeprazole, compound H 168/22. Neutralization of the gastric glands in vitro with imidazole totally prevented the inhibitory action of omeprazole. These experiments demonstrate the necessity of acid for the inhibition of gastric acid secretion by omeprazole and the binding of the inhibitor to the H+,K+-ATPase, both in vivo and in vitro, and also the specificity of omeprazole for the H+,K+-ATPase.

Adenosine Triphosphatases↗
PubMed1988

Time-course of development and reversal of gastric endocrine cell hyperplasia after inhibition of acid secretion. Studies with omeprazole and ranitidine in intact and antrectomized rats.

In intact rats plasma gastrin levels were increased during a 20-wk treatment course with either omeprazole or ranitidine. Although plasma gastrin levels were the same during treatment, the enterochromaffinlike (ECL) cell density increased approximately linearly with time at a rate correlated to the plasma gastrin level. Antrectomy prevented the ECL cell hyperplasia seen in omeprazole-treated rats, suggesting that it was not caused by omeprazole per se. Changes in ECL cell density roughly paralleled changes in oxyntic mucosal histidine carboxylase activity and histamine concentration. Treatment with omeprazole also raised stomach weight and antral gastrin and gastrin cell density, reduced antral somatostatin cell density, but did not affect enterochromaffin cell density. Within 19 days of cessation of a 10-wk treatment course, plasma gastrin levels, oxyntic mucosal histidine decarboxylase activity, and antral gastrin and somatostatin cell densities had returned to control levels. The stomach weight was normal within 5-10 wk, antral gastrin concentration within 10 wk, and oxyntic mucosal ECL cell density and histamine concentration within 20 wk. After renewed treatment with omeprazole for 10 wk starting 10 wk after completion of the first omeprazole treatment period, changes in all parameters were of similar magnitude in animals previously treated with omeprazole and those previously treated with vehicle. The results suggest that the effects described are reversible and that gastrin cells turn over more rapidly than ECL cells.

Animals↗
PubMed1988

Rat parietal cell function after prolonged inhibition of gastric acid secretion.

Female rats were treated orally for 3 mo with omeprazole (40 and 400 mumol/kg). Both doses caused total inhibition of gastric acid secretion and recovery was parallel to that of H+-K+-ATPase activity (30-50 and 60-80% inhibition 24 h after doses, respectively). The H+-K+-ATPase activity returned to control levels within 1 wk after the last dose. Plasma gastrin levels were dose-dependently increased during treatment but reversed to control levels within 9 days after the last dose. Parallel with a general increase in corpus mucosal mass, both pepsinogen and H+-K+-ATPase total content increased. However, their tissue concentrations did not differ from control values, suggesting that neither parietal nor chief cell density are changed by omeprazole treatment and also that their growth is parallel to the general hyperplasia. In contrast, the oxyntic mucosal histamine concentration was increased, indicating an increase in the enterochromaffin-like (ECL) cell density. Maximal capacity of the mucosa to secrete acid increased in parallel with the increase in mucosal mass and total H+-K+-ATPase content. However, basal acid secretion did not differ between treatment groups. Increased capacity slowly declined toward control levels over the 70-day recovery period after withdrawal of omeprazole. These results suggest that hypergastrinemia, induced in the rat by pharmacological inhibition of gastric acid secretion, causes a hyperplasia of oxyntic mucosal cells, ECL cells growing faster than the others. The hyperplastic mucosa has an increased capacity to produce acid and is functionally normal.

Adenosine Triphosphatases↗
PubMed1988

Function and structure of parietal cells after H+-K+-ATPase blockade.

Omeprazole was administered to rabbits as a single dose or daily for 1 wk. H+-K+-ATPase and isolated gastric glands were prepared from the oxyntic corpus mucosa and used for functional and quantitative morphological studies. Both 10 and 100 mumol omeprazole/kg increased the pH of the gastric content when measured at death. The stimulated oxygen uptake and the rate of aminopyrine (AP) uptake were both inhibited in the isolated gastric gland preparations. Morphometric studies of biopsy specimens taken from the corpus mucosa and isolated gastric glands showed that omeprazole treatment increased the volume density of the acid compartments. This expansion provides an increased accumulation space for AP. Therefore, an increased AP uptake might be seen in glands isolated from omeprazole-treated animals. Blockade of the H2-receptor by ranitidine transformed the morphology of the cell into a more resting type and, furthermore, reduced the omeprazole-induced increase in the volume density of the acid compartments in the parietal cell. The H+-K+-ATPase activity measured in membrane fractions from the omeprazole-treated animals was decreased dose dependently and inhibited by 95% after 100 mumol omeprazole/kg. However, the concentration of the enzyme in these fractions did not change. These results indicate a specific inhibitory action of omeprazole on the H+-K+-ATPase.

Adenosine Triphosphatases↗
PubMed1988

Effects of some antisecretory drugs on acid production, intracellular free Ca2+, and cyclic AMP production in isolated pig parietal cells.

The effects of some inhibitors of acid secretion were tested on isolated, purified pig parietal cells. The cells were stimulated with 10(-4) M histamine, 10(-5) M carbachol, or 10(-7) M pentagastrin. The H,K-ATPase inhibitors SCH 28080 and omeprazole inhibited both the basal and secretagogue-stimulated acid production, as measured by aminopyrine accumulation, irrespective of the type of stimulator used. The IC50 value was 3-5 x 10(-9) M for SCH 28080 and 1-3 x 10(-8) M for omeprazole. Ranitidine inhibited the histamine-stimulated but not the basal acid production. The IC50 value was 2 x 10(-5) M. Stimulation of acid production with carbachol was blocked by pirenzepine, with an IC50 of 6 x 10(-7) M. Pirenzepine (10(-5) M) specifically blocked the carbachol-stimulated increase in cytosolic free Ca2+ in fura-2-loaded cells but not the increase in cytosolic free Ca2+ induced by histamine or pentagastrin. Ranitidine (10(-4) M) prevented the histamine-induced increase in Ca2+ and was also the only one of the four inhibitors which prevented the histamine-stimulated cAMP formation. SCH 28080 (10(-5) M) significantly potentiated the histamine-stimulated increase in cytosolic free Ca2+ and the formation of cAMP, whereas omeprazole (10(-5) M) was without effect.

Aminopyrine↗
PubMed1987

Inhibition of gastric H+,K+-ATPase and acid secretion by SCH 28080, a substituted pyridyl(1,2a)imidazole.

A hydrophobic amine, SCH 28080, 2-methyl-8-(phenylmethoxy)imidazo(1,2a)pyridine-3-acetonitrile, previously shown to inhibit gastric acid secretion in vivo and in vitro, was also shown to inhibit basal and stimulated aminopyrine accumulation in isolated gastric glands when histamine, high K+ concentrations, or dibutyryl cAMP were used as secretagogues. Stimulated, but not basal, oxygen consumption was also inhibited. Neutralization of the acid space of the parietal cell by high concentrations of the weak base, imidazole, reduced the potency of the drug, suggesting that SCH 28080 was active when protonated. Studies on the isolated H+,K+-ATPase showed that the compound inhibited the enzyme competitively with K+, whether ATP or p-nitrophenyl phosphate were used as substrates. In contrast, the inhibition was mixed with respect to p-nitrophenyl phosphate and uncompetitive with respect to ATP. The drug reduced the steady state level of the phosphoenzyme but not the observed rate constant for phosphoenzyme formation in the absence of K+ nor the quantity of phosphoenzyme reacting with K+. The drug quenched the fluorescence of fluorescein isothiocyanate-modified enzyme and also inhibited the ATP-independent K+ exchange reaction of the H+,K+-ATPase. Its action on gastric acid secretion can be explained by inhibition of the H+,K+-ATPase by reversible complexation of the enzyme. This class of compound, therefore, acts as a reversible inhibitor of gastric acid secretion.

Adenosine Triphosphatases↗
PubMed1987

Inhibition of (H+ + K+)-ATPase by omeprazole in isolated gastric vesicles requires proton transport.

Omeprazole was found to inhibit the (H+ + K+)-ATPase activity in isolated gastric vesicles only when acid was accumulated in the vesicle lumen. The ATPase activity was time- and dose-dependently inhibited in the presence of K+ and valinomycin. Under conditions in which no pH-gradient was generated, i.e., in the presence of K+ alone or NH4+, no effect of omeprazole was found. The degree of inhibition was directly correlated to the amount of inhibitor bound to the preparation. A stoichiometry of 2 mol radiolabelled inhibitor bound per mol phosphoenzyme was found on total inhibition of the K+ plus valinomycin-stimulated activity. This inhibitory action of omeprazole on the ATPase activity could be fully reversed by addition of beta-mercaptoethanol. The inhibition of the proton transport in the (H+ + K+)-ATPase-containing vesicles by omeprazole was also strictly correlated to the amount of bound inhibitor. The stoichiometry of binding at total inhibition of this reaction was found to be 1.4 mol per mol phosphoenzyme. The K+-stimulated p-nitrophenylphosphatase activity was inhibited in parallel with the ATPase activity, whereas the phosphoenzyme levels were affected to a lesser extent by omeprazole. Gel electrophoresis of an omeprazole-inhibited vesicle preparation showed that the radiolabel was mainly found at 94 kDa, the molecular weight of the (H+ + K+)-ATPase catalytic subunit(s).

4-Nitrophenylphosphatase↗
PubMed1986

Plasma gastrin and gastric enterochromaffinlike cell activation and proliferation. Studies with omeprazole and ranitidine in intact and antrectomized rats.

Unoperated female rats were subjected to daily oral treatment with omeprazole (10 or 400 mumol/kg body wt), ranitidine (175 + 175 + 350 mumol/kg body wt), or vehicle and antrectomized rats were treated with omeprazole (400 mumol/kg body wt) or vehicle. After 10 wk of treatment, plasma gastrin levels were high in unoperated rats treated with the high omeprazole dose and with ranitidine, and low in antrectomized controls. Plasma gastrin levels were slightly higher in the low-dose omeprazole group than in the intact controls. In antrectomized rats treated with the high dose of omeprazole, the plasma gastrin level was in the same range as in intact control rats. A close correlation (r = 0.89, p less than 0.0001) was found between the plasma gastrin level and the oxyntic mucosal enterochromaffinlike cell density (as well as the tissue levels of histidine decarboxylase and histamine in the oxyntic mucosa) in all groups. The somatostatin cell density in the oxyntic mucosa was not altered by the various treatments. During a recovery period of 10 wk after the 10-wk treatment, the enterochromaffinlike cell density and histamine concentration decreased by 30%-40% in the rats treated with the high dose of omeprazole, whereas the corresponding values increased by 50% and 40%, respectively, in the control rats. The difference between the two groups, however, was still statistically significant. Plasma gastrin levels and gastric histidine decarboxylase activity returned to control values during recovery. The results suggest that the observed changes in enterochromaffinlike cell density are related to the plasma gastrin levels and that they are reversible. it is concluded that neither omeprazole nor ranitidine per se is likely to induce proliferation of enterochromaffinlike cells.

Animals↗