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Proton Pump Inhibitors and Radiofrequency Ablation for Treatment of Barrett's Esophagus

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Authors
Dugalić, Predrag
Đuranović, Srđan
Pavlović-Marković, Aleksandra
Dugalić, Vladimir
Tomašević, Ratko
Gluvić, Zoran
Obradović, Milan M.
Bajić, Vladan P.
Isenović, Esma R.
Article (Published version)
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© 2020 Bentham Science Publishers
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Abstract
Gastroesophageal Reflux Disease (GERD) is characterized by acid and bile reflux in the dis-tal oesophagus, and this may cause the development of reflux esophagitis and Barrett’s oesophagus (BE). The natural histological course of untreated BE is non-dysplastic or benign BE (ND), then low-grade (LGD) and High-Grade Dysplastic (HGD) BE, with the expected increase in malignancy transfer to oesophagal adenocarcinoma (EAC). The gold standard for BE diagnostics involves high-resolution white-light endoscopy, followed by uniform endoscopy findings description (Prague classification) with biopsy performance according to Seattle protocol. The medical treatment of GERD and BE includes the use of proton pump inhibitors (PPIs) regarding symptoms control. It is noteworthy that long-term use of PPIs increases gastrin level, which can contribute to transfer from BE to EAC, as a result of its effects on the proliferation of BE epithelium. Endoscopy treatment includes a wide range of re-section and abl...ative techniques, such as radio-frequency ablation (RFA), often concomitantly used in everyday endoscopy practice (multimodal therapy). RFA promotes mucosal necrosis of treated oesophagal region via high-frequency energy. Laparoscopic surgery, partial or total fundoplication, is reserved for PPIs and endoscopy indolent patients or in those with progressive disease. This review aims to explain distinct effects of PPIs and RFA modalities, illuminate certain aspects of molecular mechanisms involved, as well as the effects of their concomitant use regarding the treatment of BE and prevention of its transfer to EAC.

Keywords:
GERD / Barrett's oesophagus / proton pump inhibitors / radio-frequency ablation / action of PPIs / oesophagus
Source:
Mini-Reviews in Medicinal Chemistry, 2020, 20, 11, 975-987
Funding / projects:
  • Hormonal regulation of expression and activity of the nitric oxide synthase and sodium-potassium pump in experimental models of insulin resistance, diabetes and cardiovascular disorders (RS-173033)

DOI: 10.2174/1389557519666191015203636

ISSN: 1389-5575

PubMed: 31644405

WoS: 000551675400003

Scopus: 2-s2.0-85088276768
[ Google Scholar ]
1
URI
https://vinar.vin.bg.ac.rs/handle/123456789/9104
Collections
  • Radovi istraživača
  • 080 - Laboratorija za radiobiologiju i molekularnu genetiku
Institution/Community
Vinča
TY  - JOUR
AU  - Dugalić, Predrag
AU  - Đuranović, Srđan
AU  - Pavlović-Marković, Aleksandra
AU  - Dugalić, Vladimir
AU  - Tomašević, Ratko
AU  - Gluvić, Zoran
AU  - Obradović, Milan M.
AU  - Bajić, Vladan P.
AU  - Isenović, Esma R.
PY  - 2020
UR  - https://vinar.vin.bg.ac.rs/handle/123456789/9104
AB  - Gastroesophageal Reflux Disease (GERD) is characterized by acid and bile reflux in the dis-tal oesophagus, and this may cause the development of reflux esophagitis and Barrett’s oesophagus (BE). The natural histological course of untreated BE is non-dysplastic or benign BE (ND), then low-grade (LGD) and High-Grade Dysplastic (HGD) BE, with the expected increase in malignancy transfer to oesophagal adenocarcinoma (EAC). The gold standard for BE diagnostics involves high-resolution white-light endoscopy, followed by uniform endoscopy findings description (Prague classification) with biopsy performance according to Seattle protocol. The medical treatment of GERD and BE includes the use of proton pump inhibitors (PPIs) regarding symptoms control. It is noteworthy that long-term use of PPIs increases gastrin level, which can contribute to transfer from BE to EAC, as a result of its effects on the proliferation of BE epithelium. Endoscopy treatment includes a wide range of re-section and ablative techniques, such as radio-frequency ablation (RFA), often concomitantly used in everyday endoscopy practice (multimodal therapy). RFA promotes mucosal necrosis of treated oesophagal region via high-frequency energy. Laparoscopic surgery, partial or total fundoplication, is reserved for PPIs and endoscopy indolent patients or in those with progressive disease. This review aims to explain distinct effects of PPIs and RFA modalities, illuminate certain aspects of molecular mechanisms involved, as well as the effects of their concomitant use regarding the treatment of BE and prevention of its transfer to EAC.
T2  - Mini-Reviews in Medicinal Chemistry
T1  - Proton Pump Inhibitors and Radiofrequency Ablation for Treatment of Barrett's Esophagus
VL  - 20
IS  - 11
SP  - 975
EP  - 987
DO  - 10.2174/1389557519666191015203636
ER  - 
@article{
author = "Dugalić, Predrag and Đuranović, Srđan and Pavlović-Marković, Aleksandra and Dugalić, Vladimir and Tomašević, Ratko and Gluvić, Zoran and Obradović, Milan M. and Bajić, Vladan P. and Isenović, Esma R.",
year = "2020",
abstract = "Gastroesophageal Reflux Disease (GERD) is characterized by acid and bile reflux in the dis-tal oesophagus, and this may cause the development of reflux esophagitis and Barrett’s oesophagus (BE). The natural histological course of untreated BE is non-dysplastic or benign BE (ND), then low-grade (LGD) and High-Grade Dysplastic (HGD) BE, with the expected increase in malignancy transfer to oesophagal adenocarcinoma (EAC). The gold standard for BE diagnostics involves high-resolution white-light endoscopy, followed by uniform endoscopy findings description (Prague classification) with biopsy performance according to Seattle protocol. The medical treatment of GERD and BE includes the use of proton pump inhibitors (PPIs) regarding symptoms control. It is noteworthy that long-term use of PPIs increases gastrin level, which can contribute to transfer from BE to EAC, as a result of its effects on the proliferation of BE epithelium. Endoscopy treatment includes a wide range of re-section and ablative techniques, such as radio-frequency ablation (RFA), often concomitantly used in everyday endoscopy practice (multimodal therapy). RFA promotes mucosal necrosis of treated oesophagal region via high-frequency energy. Laparoscopic surgery, partial or total fundoplication, is reserved for PPIs and endoscopy indolent patients or in those with progressive disease. This review aims to explain distinct effects of PPIs and RFA modalities, illuminate certain aspects of molecular mechanisms involved, as well as the effects of their concomitant use regarding the treatment of BE and prevention of its transfer to EAC.",
journal = "Mini-Reviews in Medicinal Chemistry",
title = "Proton Pump Inhibitors and Radiofrequency Ablation for Treatment of Barrett's Esophagus",
volume = "20",
number = "11",
pages = "975-987",
doi = "10.2174/1389557519666191015203636"
}
Dugalić, P., Đuranović, S., Pavlović-Marković, A., Dugalić, V., Tomašević, R., Gluvić, Z., Obradović, M. M., Bajić, V. P.,& Isenović, E. R.. (2020). Proton Pump Inhibitors and Radiofrequency Ablation for Treatment of Barrett's Esophagus. in Mini-Reviews in Medicinal Chemistry, 20(11), 975-987.
https://doi.org/10.2174/1389557519666191015203636
Dugalić P, Đuranović S, Pavlović-Marković A, Dugalić V, Tomašević R, Gluvić Z, Obradović MM, Bajić VP, Isenović ER. Proton Pump Inhibitors and Radiofrequency Ablation for Treatment of Barrett's Esophagus. in Mini-Reviews in Medicinal Chemistry. 2020;20(11):975-987.
doi:10.2174/1389557519666191015203636 .
Dugalić, Predrag, Đuranović, Srđan, Pavlović-Marković, Aleksandra, Dugalić, Vladimir, Tomašević, Ratko, Gluvić, Zoran, Obradović, Milan M., Bajić, Vladan P., Isenović, Esma R., "Proton Pump Inhibitors and Radiofrequency Ablation for Treatment of Barrett's Esophagus" in Mini-Reviews in Medicinal Chemistry, 20, no. 11 (2020):975-987,
https://doi.org/10.2174/1389557519666191015203636 . .

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