Abstract.
Inhibition of gastric acid secretion is the mainstay of the treatment of gastroesophageal reflux disease and peptic ulceration; therapies to inhibit acid are among the best-selling drugs worldwide. Highly effective agents targeting the histamine H2 receptor were first identified in the 1970s. These were followed by the development of irreversible inhibitors of the parietal cell hydrogen-potassium ATPase (the proton pump inhibitors) that inhibit acid secretion much more effectively. Reviewed here are the chemistry, biological targets and pharmacology of these drugs, with reference to their current and evolving clinical utilities. Future directions in the development of acid inhibitory drugs include modifications of current agents and the emergence of a novel class of agents, the acid pump antagonists.
Keywords. Gastric acid secretion; peptic ulcer; gastroesophageal reflux disease; proton pump inhibitors; pharmacology; H,K ATPase
Footnotes
Received 30 May 2007; received after revision 15 August 2007; accepted 13 September 2007
An erratum to this article is available at http://dx.doi.org/10.1007/s00018-010-0621-2.