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The Phylogeny and Biological Function of Gastric Juice—Microbiological Consequences of Removing Gastric Acid

1
Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), 7006 Trondheim, Norway
2
Department of Gastroenterology and Hepatology, Clinic of Internal Medicine, St Olav’s Hospital—Trondheim University Hospital, 7006 Trondheim, Norway
*
Author to whom correspondence should be addressed.
Int. J. Mol. Sci. 2019, 20(23), 6031; https://doi.org/10.3390/ijms20236031
Received: 3 November 2019 / Revised: 24 November 2019 / Accepted: 25 November 2019 / Published: 29 November 2019
(This article belongs to the Special Issue Proton-Pump Inhibitors (PPIs))
Gastric juice is a unique combination of hydrochloric acid (HCl), lipase, and pepsin. Acidic gastric juice is found in all vertebrates, and its main function is to inactivate microorganisms. The phylogenetic preservation of this energy-consuming and, at times, hazardous function (acid-related diseases) reflects its biological importance. Proton pump inhibitors (PPIs) are one of the most widely used drugs in the world. Due to the reduced prevalence of Helicobacter pylori infection as well as the increased use of inhibitors of gastric acid secretion, the latter has become the most important cause of gastric hypoacidity. In the present manuscript, we review the microbiological consequences of removing gastric acidity. The resulting susceptibility to infections has not been studied extensively, and focus has mainly been restricted to bacterial and parasitic agents only. The strongest evidence concerning the relationship between hypochlorhydria and predisposition to infections relates to bacterial infections affecting the gastrointestinal tract. However, several other clinical settings with increased susceptibility to infections due to inhibited gastric acidity are discussed. We also discuss the impact of hypochlorhydria on the gut microbiome. View Full-Text
Keywords: gastric juice; gastric acidity; hypochlorhydria; proton pump inhibitors; gastointestinal infections; pneumonia; adverse effects; microbiome gastric juice; gastric acidity; hypochlorhydria; proton pump inhibitors; gastointestinal infections; pneumonia; adverse effects; microbiome
MDPI and ACS Style

Martinsen, T.C.; Fossmark, R.; Waldum, H.L. The Phylogeny and Biological Function of Gastric Juice—Microbiological Consequences of Removing Gastric Acid. Int. J. Mol. Sci. 2019, 20, 6031.

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