Proton pump inhibitors: mechanism of action and application in medicine

Proton pump inhibitors include a group of pharmacological drugs that reduce the intensity of hydrochloric acid secretion in the stomach. Having a direct effect on the secretory tubules, they effectively lead to the desired therapeutic effect in ulcers, erosive gastritis, GERD. The composition of the group includes a set of drugs similar in chemical structure, but with different pharmacodynamic parameters, that is, drugs almost equally affect the secretory cells, but do it in different concentrations and at different rates.

Proton pump inhibitors: the moments of molecular effects of drugs

Proton pump is a complex protein structure that regulates the entry of hydrogen ions into the lumen of the stomach. It consists of two chemically dissimilar elements, otherwise called subunits. The first is exclusively protein and is constructed of amino acids. In the membrane of the lining cell, it behaves in a special way, crossing it 10 times, which leads to the formation of 5 loops of the secretory canal. Passing through their cavity, the ions enter the lumen of the stomach and provide acidification of the medium and the fall of the hydrogen index. Moreover, it is in one of the loops that the active center of the protein is located - a sequence of 800 amino acids that catalyzes the decomposition of ATP, the main energy substrate of the cell.

The other subunit is a complex protein, i.e., consists of a polypeptide sequence ordered according to a certain structure and a glycoprotein chain. The overwhelming part of the molecule is outside the cytoplasm, and the glycoprotein part is probably an extracytoplasmic receptor complex that catches the signal for the activation of the enzyme H + \ K + -ATPase. In this case, the protein part of the molecule crosses the membrane once, which indicates its importance as a linking element between the outer receptor and the first subunit responsible for carrying out a catalytic reaction to synthesize protons.

Correspondingly, the structure of the proton pump of the secretory tubules of the lining cells can be concluded as to the simple way to suppress the secretion of H + in the cavity of the organ. The most justified option is the inhibition of the enzyme responsible for the synthesis, which is what proton pump inhibitors do.

Use of inhibitors in medical practice

In medicine , proton pump inhibitors are used quite extensively, especially in gastroenterology, which is due to their ability to reduce the acidity of the gastric secretion, and therefore to reduce the intensity of the damaging effect on the walls of the stomach, which is especially important in its inflammation. In this case, the therapeutic effect does not depend on the etiology of the inflammatory process, because by means of it the aggressive influence of the environment on the integrity of the organ is removed. Also, the spectrum of pathologies, for the effective treatment of which proton pump inhibitors are used, is widened due to gastric ulcers and duodenal ulcers, GERD of erosive and non-erosive forms.

The most common drugs include proton pump inhibitors with the following generic names omeprazole, rabeprazole, pantoprazole, lansoprazole, esomeprazole and others. Among them are commercial names, for example, such as "Omez". Medicinal products are available in the form of capsules. They are taken internally in a dosage prescribed by a specialist, which varies depending on the particular type of pathology. This allows for an independent reception, as there is a group of patients who complain of seasonal exacerbations of chronic gastric or duodenal ulcers. In other cases, the appointment is discussed with the doctor at the time of admission.