We treat one thing...
Proton pump inhibitors (PPIs) block the operation of cellular pumps that transport hydrogen ions from cells and form the mucous membrane. When the pumps stop functioning, there is a decrease in acidity and, eventually, tissue damage. Population studies have previously shown a higher rate of dementia in people using PPIs, but the form of this association remained unknown.
Suppression of the synthesis of an important neurotransmitter
The researchers used three-dimensional computer modeling to study how six drugs from the PPIs group based on various active substances interacted with the enzyme choline-acetyltransferase, whose function is to synthesize the neurotransmitter acetylcholine. Acetylcholine is necessary for the transmission of signals between nerve cells, it works only if a sufficient amount of the substance is produced. The simulation showed that all the tested drugs were able to bind to the enzyme.
The researchers then analyzed the effect of this binding. They found that all drugs inhibit the enzyme, leading to a decrease in acetylcholine production, and the stronger the binding, the stronger the inhibitory effect. Preparations based on the active substances omeprazole, esomeprazole, tenatoprazole and rabeprazole had the greatest affinity and therefore were the strongest inhibitors of the enzyme, while pantoprazole and lansoprazole derivatives were the weakest.
Illustration of the effect of proton pump inhibitors on the enzyme synthesizing the neurotransmitter acetylcholine. Source: Karolinska Institutet.
Currently, additional research is needed to study how the data obtained correspond to the processes occurring in the body. However, the authors already advise avoiding excessive use of PPIs.
Avoid excessive use of PPIs
The researchers recommend paying special attention to older patients and patients who have already been diagnosed with dementia. The same applies to patients with myodystrophy, such as amyotrophic lateral sclerosis (ALS), since acetylcholine is an indispensable motor neurotransmitter. In such cases, doctors should prescribe drugs with the weakest effect, in the minimum dose and for the shortest possible time.
The researchers emphasize that the correct use of medications is also safe for the elderly if they receive them for a limited time and when really necessary, since the human nervous system is quite flexible when it comes to resistance to short-term exposure.
Proton pump inhibitors affect the synthesis of acetylcholine, which plays an important role in conditions such as Alzheimer's disease. Since there is no effective treatment for this disease, it is important to avoid risk factors.
Article by R.Kumar et al. Proton pump inhibitors act with unprecedented potencies as inhibitors of the acetylcholine biosynthesizing enzyme – A plausible missing link for their association with incident of dementia published in the journal Alzheimer's & Dementia.
Aminat Adzhieva, portal "Eternal Youth" http://vechnayamolodost.ru according to Karolinska Institutet: Newly discovered mechanism can explain increased risk of dementia.