inhibiteurs de pompes à protons et leurs petites complications ......
Proton Pump Inhibitors Exacerbate NSAID-Induced Small Intestinal Injury by Inducing Dysbiosis
Original Research Article
Gastroenterology, Volume 141, Issue 4, October 2011, Pages 1314-1322.e5
John L. Wallace, Stephanie Syer, Emmanuel Denou, Giada de Palma, Linda Vong, Webb McKnight, Jennifer Jury, Manlio Bolla, Premysl Bercik, Stephen M. Collins, Elena Verdu, Ennio Ongini
Both PPIs significantly exacerbated naproxen- and celecoxib-induced intestinal ulceration and bleeding in the rat. Omeprazole treatment did not result in mucosal injury or inflammation; however, there were marked shifts in numbers and types of enteric bacteria, including a significant reduction (∼80%) of jejunal Actinobacteria and Bifidobacteria spp. Restoration of small intestinal Actinobacteria numbers through administration of selected (Bifidobacteria enriched) commensal bacteria during treatment with omeprazole and naproxen prevented intestinal ulceration/bleeding. Colonization of germ-free mice with jejunal bacteria from PPI-treated rats increased the severity of NSAID-induced intestinal injury, as compared with mice colonized with bacteria from vehicle-treated rats.
PPIs exacerbate NSAID-induced intestinal damage at least in part because of significant shifts in enteric microbial populations. Prevention or reversal of this dysbiosis may be a viable option for reducing the incidence and severity of NSAID enteropathy.
2 Proton Pump Inhibitors and Low-Dose Aspirin Markedly Exacerbate NSAID-Induced Small Intestinal Injury: A Link to Dysbiosis?
Gastroenterology, Volume 140, Issue 5, Supplement 1, May 2011, Page S-87
John L. Wallace, Emmanuel Denou, Linda Vong, Stephanie D. Syer, Webb McKnight, Jennifer Jury, Elena F. Verdu, Premysl Bercik, Stephen M. Collins, Manlio Bolla, Ennio Ongini