The Phylogeny and Biological Function of Gastric Juice—Microbiological Consequences of Removing Gastric Acid

Abstract

Gastric juice is a unique combination of hydrochloric acid (HCl), lipase, and pepsin. Acidic gastric juice is found in all vertebrates, and its main function is to inactivate microorganisms. The phylogenetic preservation of this energy-consuming and, at times, hazardous function (acid-related diseases) reflects its biological importance. Proton pump inhibitors (PPIs) are one of the most widely used drugs in the world. Due to the reduced prevalence of Helicobacter pylori infection as well as the increased use of inhibitors of gastric acid secretion, the latter has become the most important cause of gastric hypoacidity. In the present manuscript, we review the microbiological consequences of removing gastric acidity. The resulting susceptibility to infections has not been studied extensively, and focus has mainly been restricted to bacterial and parasitic agents only. The strongest evidence concerning the relationship between hypochlorhydria and predisposition to infections relates to bacterial infections affecting the gastrointestinal tract. However, several other clinical settings with increased susceptibility to infections due to inhibited gastric acidity are discussed. We also discuss the impact of hypochlorhydria on the gut microbiome.

Influence of In Vitro Digestion on Composition, Bioaccessibility and Antioxidant Activity of Food Polyphenols—A Non-Systematic Review

“…Polypeptides, starch sucrose, fats, proteins, starch/glycogen Aminopeptidase, amylase, sucrose, lipase, chymotrypsin, pancreatic amylase amino acids, maltose and dextrins, glucose and fructose, glycerol and fatty acids, amino acids, maltose and isomaltose [13][14][15][16] Large Intestine neutral absorption of water and salts, production and absorption of vitamins, propelling feces for elimination from organism [17,18] Aside from the most important nutrients such as peptides, carbohydrates and lipids that act as energy and cell building sources, digested food also includes other types of substances that are responsible for cell protection and regeneration. Among them are secondary plant metabolites (e.g., polyphenols, terpenes) various in terms of their biological activity.…”

Proton Pump Inhibitors are Risk Factors for Viral Infections: Even for COVID-19?

“…One of the main functions of gastric juice is to inactivate swallowed microorganisms, thereby inhibiting infectious agents from reaching the intestine. Gastric juice is thus the first line of defence against pathogens, yet very few studies have documented the effect of PPI-induced reduced gastric acidity on the susceptibility to viral infections [ 3 ]. Among those who have studied this, Weiss and Clark determined the sensitivity of several rotavirus strains (one bovine, two simian, and one human) to the inactivation by the natural human gastric fluids, and reported rapid inactivation of rotaviruses; each strain was inactivated at pH 2 (half-life of 60 s or less) but there was only a minimal effect at pH 4 [ 4 ].…”

The Potential Benefits of Vonoprazan as Helicobacter pylori Infection Therapy

“…Hypergastrinemia can trigger gastric enterochromaffin cell hyperplasia and increase the risk of gastric endocrine tumors [ 86 , 87 ]. Hypochlorhydria precipitated by acid inhibition can alter the gut microbiome, increasing the risk of developing antibiotic-associated diarrhea caused by Clostridium difficile and spontaneous bacterial peritonitis [ 88 , 89 ]. Excessive acid suppression can also cause malabsorption, resulting in the onset of iron deficiency anemia, megaloblastic anemia, hypomagnesia, and hypocalcemia [ 46 , 90 ].…”