Lansoprazole increases inorganic pyrophosphate in patients with pseudoxanthoma elasticum: a double-blind, randomized, placebo-controlled crossover trial

Pseudoxanthoma elasticum (PXE) is characterized by low levels of inorganic pyrophosphate (PPi) and a high activity of tissue-nonspecific alkaline phosphatase (TNAP). Lansoprazole is a partial inhibitor of TNAP. The aim was to investigate whether lansoprazole increases plasma PPi levels in subjects w...

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Detalles Bibliográficos
Autores: Murcia Casas, Belén, Carrillo Linares, Juan Luis, Baquero Aranda, Isabel, Rioja Villodres, José, Merino Bohórquez, Vicente, González Jiménez, Andrés, Rico Corral, Miguel Ángel, Valdivielso, Pedro
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2023
País:España
Institución:Universidad de Sevilla (US)
Repositorio:idUS. Depósito de Investigación de la Universidad de Sevilla
OAI Identifier:oai:idus.us.es:11441/156676
Acceso en línea:https://hdl.handle.net/11441/156676
https://doi.org/10.3390/ijms24054899
Access Level:acceso abierto
Palabra clave:pseudoxanthoma elasticum
inorganic pyrophosphate
lansoprazole
tissue-nonspecific alkaline phosphatase
Descripción
Sumario:Pseudoxanthoma elasticum (PXE) is characterized by low levels of inorganic pyrophosphate (PPi) and a high activity of tissue-nonspecific alkaline phosphatase (TNAP). Lansoprazole is a partial inhibitor of TNAP. The aim was to investigate whether lansoprazole increases plasma PPi levels in subjects with PXE.We conducted a 2 2 randomized, double-blind, placebo-controlled crossover trial in patients with PXE. Patients were allocated 30 mg/day of lansoprazole or a placebo in two sequences of 8 weeks. The primary outcome was the differences in plasma PPi levels between the placebo and lansoprazole phases. 29 patients were included in the study. There were eight drop-outs due to the pandemic lockdown after the first visit and one due to gastric intolerance, so twenty patients completed the trial. A generalized linear mixed model was used to evaluate the effect of lansoprazole. Overall, lansoprazole increased plasma PPi levels from 0.34 0.10 M to 0.41 0.16 M (p = 0.0302), with no statistically significant changes in TNAP activity. There were no important adverse events. 30 mg/day of lansoprazole was able to significantly increase plasma PPi in patients with PXE; despite this, the study should be replicated with a large number of participants in a multicenter trial, with a clinical end point as the primary outcome.