Transepithelial leak in Barrett's esophagus patients: the role of proton pump inhibitors.

Aim: To determine if the observed paracellular sucrose leak in Barrett's esophagus patients is due to their proton pump inhibitor (PPI) use.

Methods: The in vivo sucrose permeability test was administered to healthy controls, to Barrett's patients and to non-Barrett's patients on continuous PPI therapy. Degree of leak was tested for correlation with presence of Barrett's, use of PPIs, and length of Barrett's segment and duration of PPI use.

Tumor necrosis factor blockade for treatment of inflammatory bowel disease: efficacy and safety.

Inflammatory bowel disease (IBD), including Crohn's Disease (CD) and Ulcerative Colitis (UC), is characterized by inflammation of the gastrointestinal tract. In UC, inflammation is confined to the mucosa, initially involving the rectum, and may extend proximally to involve the entire colon. In CD, transmural inflammation may affect any portion of the GI tract.

Proton pump inhibitors: actions and reactions.

Proton pump inhibitors are the second most commonly prescribed drug class in the United States. The increased utilization of PPIs parallels the rising incidence of reflux disease. Owing to their clinical efficacy and relative lack of tachyphylaxis, PPIs have largely displaced H-2 receptor antagonists in the treatment of acid peptic disorders.

Taribavirin for the treatment of chronic hepatitis C.

Background: The current standard therapy for chronic hepatitis C virus (HCV), combination therapy with pegylated interferon and ribavirin, is plagued by a number of side effects, most notably anemia. This anemia is typically managed with a reduction of ribavirin dosing, which may lead to reduced efficacy. Taribavirin, an oral prodrug of ribavirin, which has been shown to induce a lesser degree of anemia, is being investigated for the treatment of chronic HCV.

Absence of Na+/sugar cotransport activity in Barrett's metaplasia.

Aim: To evaluate the presence of Na+-dependent, active, sugar transport in Barrett's epithelia as an intestinal biomarker, based on the well-documented, morphological intestinal phenotype of Barrett's esophagus (BE).

Methods: We examined uptake of the nonmeta-bolizable glucose analogue, alpha-methyl-D-glucoside (AMG), a substrate for the entire sodium glucose cotransporter (SGLT) family of transport proteins. During upper endoscopy, patients with BE or with uncomplicated gastroesophageal reflux disease (GERD) allowed for duodenal, gastric fundic, and esophageal mucosal biopsies to be taken.

Keynote review: epithelial and endothelial barriers in human disease.

There is a spectrum of distinct disease states that have in common their effect of breaking down epithelial and/or endothelial barrier function. Fluid compartmentalization goes awry, with profound implications for epithelial and stromal homeostasis, fluid and/or electrolyte balance, generation of inflammatory states, and even tumor microenvironment. Specific effects on the tight junction are found to be integral to bacterial invasion and tumor progression.