Introduction: Peptic lesions usually develop when there is an imbalance between aggressive drivers and gastro-protective mediators that guard the lining of the gastrointestinal tract. The most crucial of these mediators are antioxidants, whose loss may predispose to oxidative stress, which is believed to be the main aggravator of several diseases including peptic ulcer. Proton pump inhibitors (PPIs) are drugs that are highly effective and widely used for therapeutic management of peptic disorders through inhibition of gastric acid secretion. In spite of this, oxidative damage may continue to be a major issue that can predispose to future lesions. Objective: The present study is designed to explore the possible antioxidant capability of different PPIs, including omeprazole, esomeprazole, lansoprazole, pantoprazole, and rabeprazole, in an aim to suggest an agent that, in addition to its acid-suppression properties, can provide antioxidant profit. Methods: The antioxidant activity of different PPIs was evaluated calorimetrically to test the ability of each drug to quench oxygen free radical, using the well-known stable free radical α,α-diphenyl-β-picrylhydrazyl (DPPH), and compared to ascorbic acid (AA; vitamin C). The measurements were performed using a spectrophotometer at 517 nm. Results: All the studied drugs reduced DPPH, but to different extents. However, omeprazole and esomeprazole showed the highest ability to scavenge free radicals (50% inhibitory concentrations [IC 50 s] of the percentage for free radical scavenging activity are 18.7 ± 5.7 and 18.7 ± 5.7, respectively, and the AA equivalents are 83,772 ± 11,887 and 81,732 ± 8,523 mg AA/100 g, respectively). Conversely, lansoprazole, pantoprazole, and rabeprazole might be having no role in this story (IC 50 s of the percentage for free radical scavenging activity are 49.3 ± 3.1, 49 ± 9.4, and 40.7 ± 7.2, respectively, and the AA equivalents are 30,458 ± 3,884, 32,222 ± 10,377, and 37,876 ± 8,816 mg AA/100 g, respectively). Conclusion: Thus, omeprazole and esomeprazole may confer a significant dual action in gastrointestinal protection by providing potent antioxidant properties in addition to their major role as acid-suppression agents. However, further studies are essential to elucidate the mechanism behind the difference between the drugs of the same class.

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Peptic ulcer (P.U.) is the gastrointestinal tract's most frequent disorder affecting mainly the stomach and duodenum. Surgical intervention, ingested materials and microbial infections may trigger inflammation that further predispose to oxidative stress. Proton pump inhibitors (PPIs) are group of compounds established for suppressions of gastric acid secretions profoundly and permanently over a reasonably long period of time. Oxidative stress has been shown to be involved in the pathophysiology of various diseases and disorders, including P.U. Particularly when H. pylori infection accompanies it. In addition to the colonization of this microorganism, gastric mucosa may be subjected to extreme oxidative stress with large levels of inflammatory cell aggregation, which may eventually predispose to the disorder. PPIs exert several effects other than gastric acid suppression that can be used to treat Helicobacter pylori infections, disorders of the respiratory tract, viral infections, and other conditions related to dysfunction of endothelium by activating endogenous antioxidant protection and reducing the release of cytokine. Recent therapeutic protocols have recommended PPIs as gastro-protective compounds not only because of their acid suppression properties, but also because of their potent antioxidant and anti-inflammatory properties. Keywords: Proton Pump Inhibitors, Peptic Ulcer, Oxidative Stress, H. pylori

Allergic rhinitis (AR) is a type of inflammatory condition that includes a group of symptoms, mainly affecting the nasal mucosa. Nasal obstruction, sneezing, stuffy or runny nose, in addition to swollen, itchy, red and watery eyes are the most common symptoms of the disease. These symptoms are triggered as a result of increased inflammatory mediators such as histamine and leukotrienes. Studies have recently shown the role of vitamin D (vit.D) in many allergic and immune conditions, where receptors for the active form of vit.D (1,25-dihydroxyvitamin D3) have been discovered on the surface of almost all types of inflammatory cells. Therefore, the present study was conducted to explore the level of vit. D in AR patients and its correlation with the severity of the disease. Two groups participated in the study; the first group included 49 patients who were diagnosed in a private otolaryngology clinic by the first author as having allergic rhinitis (AR group). The second one served as a control group and included 50 apparently healthy volunteers with no history of AR. The mean level of IgE and vit. D was found to be 326.3 and 10.2 ng/ml in the AR group, respectively, and 30.8 and 23.3 ng/ml in the control group, respectively. Ninety-three percent of AR patients have shown a deficiency in vit. D level, where 56% of this group showed severe deficiency. On the other hand, 34% of the control group has shown an insufficient level of vit. D. Additionally, 64% of AR patients have shown serum levels of IgE at values ranging between 100-299 ng/ml. Higher serum levels of IgE at values ranging between 300-599 ng/ml and 600-1000 ng/ml were observed in 25% and 11% of AR patients, respectively. The prevalence of low levels of vit. D in the AR group was significantly higher than that in the control group (P < 0.001). Vit. D deficiency is significantly related to severe AR symptoms and measuring serum vit. D level is recommended in the management plan of this group of patients.

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