Tolerance During 8 Days of High-Dose H2-Blockade: Placebo Controlled Studies of 24 Hour Acidity and Gastrin

Smith, J. T. L.; Gavey, C. J.; Nwokolo, CU; Pounder, RE

doi:10.1042/cs078012p

Cited by 34 publications

(52 citation statements)

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“…Some of the studies with histamine H 2 -receptor antagonists show a correlation between the increase in serum gastrin and the development of tolerance to acid inhibition. 21,22 Since this effect occurs after only a few days with histamine H 2 -receptor antagonists, 18,21 an increase of the G-cell mass is clearly not necessary for the development of tolerance. It is presently unknown whether G-cell hyperplasia is part of this process during long-term acid inhibition.…”

Section: Tolerance To Acid-inhibitory Drugsmentioning

confidence: 99%

Review article: the pharmacological inhibition of gastric acid secretion—tolerance and rebound

Sandvik

Brenna

Waldum

1997

Aliment Pharmacol Ther

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During the last decade our understanding of the regulation of gastric acid secretion has changed considerably. The recognition that gastrin acts mainly by releasing histamine from the enterochromaffin‐like (ECL) cell is of major importance. It is now necessary to review and seek new explanations for the development of tolerance and for the post‐treatment acid hypersecretion that may be observed when treatment with acid‐secretory inhibitors is discontinued. Tolerance and rebound related to H2‐receptor antagonists has previously been explained as upregulation of gastrin and/or histamine H2‐receptors, and/or an increased parietal cell mass. Experimental evidence for these theories is scarce. On the other hand, tolerance can now be explained by a gastrin‐induced increase in ECL cell‐derived histamine at the parietal cell H2‐receptor competing with the antagonist. The lack of tolerance to proton pump inhibitors may be explained by their mode of action, being non‐competitive and acting at the H+, K+‐ATPase rather than at stimulatory receptors. Post‐treatment rebound acid hypersecretion can be understood as gastrin upregulating and/or stimulating growth of the ECL cell, leading to increased amounts of releasable histamine post‐treatment. Novel experimental data strongly support this view of the development of tolerance and post‐treatment rebound acid hypersecretion.

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Section: Tolerance To Acid-inhibitory Drugsmentioning

confidence: 99%

Review article: the pharmacological inhibition of gastric acid secretion—tolerance and rebound

Sandvik

Brenna

Waldum

1997

Aliment Pharmacol Ther

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“…Recent experiments at the Royal Free Hospital have shown that the phenomenon of nocturnal hyperacidity exists for only six days after 25 days of dosing with ranitidine 300 mg at night -from days [9][10][11][12][13][14][15][16][17][18][19][20][21] …”

Section: Discussionmentioning

confidence: 99%

Rebound intragastric hyperacidity after abrupt withdrawal of histamine H2 receptor blockade.

Nwokolo

Smith

Sawyerr

et al. 1991

Gut

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“…This type of experiment pro vides the opportunity to generate a large amount of data with quite remarkable repro ducibility -in triplicate studies in 8 subjects who were studied on three occasions -on the 1st, 8th and 15th days of dosing with placebo there were no significant differences between the median values and 24-hour integrated intragastric acidity for the three studies: 861, 885 and 1,028 mmol h/1, respectively (0.3 < p < 0.5). The median 24-hour intragastric plasma gastrin concentrations for the three studies were also not significantly different: 196, 209 and 198 pmol h/1, respectively; 0.95 < p < 0.98) [12], The key to success for this type of largescale experiment is detailed planning before hand, together with an enthusiastic and welltrained team of investigators. In this regard, we have always been extremely lucky to re ceive help from the clinical medical students from the Royal Free Hospital School of Medicine.…”

Section: Resultsmentioning

confidence: 99%

Royal Free Hospital Protocol for 24-Hour Intragastric Acidity and Plasma Gastrin Concentration

Pounder

Lanzon-Miller²,

Smith³

et al. 1990

Dig Dis

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The Royal Free Hospital protocol for simultaneous measurement of 24-hour intragastric acidity and plasma gastrin concentration is described in detail. The methods of analysing such data are discussed, with recommendations for a standard four-way analysis: median hourly 24-hour intragastric acidity or pH, or plasma gastrin concentration; integrated 24-hour intragastric acidity, or plasma gastrin concentration; analysis of integrated values according to meal-related intervals; and quantification of the percentage of time in a 24-hour period that intragastric pH is greater than 3.

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Tolerance During 8 Days of High-Dose H2-Blockade: Placebo Controlled Studies of 24 Hour Acidity and Gastrin

Cited by 34 publications

References 0 publications

Review article: the pharmacological inhibition of gastric acid secretion—tolerance and rebound

Review article: the pharmacological inhibition of gastric acid secretion—tolerance and rebound

Rebound intragastric hyperacidity after abrupt withdrawal of histamine H2 receptor blockade.

Royal Free Hospital Protocol for 24-Hour Intragastric Acidity and Plasma Gastrin Concentration

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