Observational Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 21, 2017; 23(7): 1268-1277
Published online Feb 21, 2017. doi: 10.3748/wjg.v23.i7.1268
Effects of hydrotalcite combined with esomeprazole on gastric ulcer healing quality: A clinical observation study
Rui-Qi Yang, Hua Mao, Li-Yun Huang, Pei-Zhu Su, Min Lu
Rui-Qi Yang, Hua Mao, Li-Yun Huang, Pei-Zhu Su, Min Lu, Department of Digestive Diseases, Zhujiang Hospital of Southern Medical University, Guangzhou 510280, Guangdong Province, China
Author contributions: Yang RQ performed the experiments, analyzed data, interpreted the results of the experiments, prepared figures, and drafted the manuscript; Mao H conceived and designed the research; Huang LY performed the experiments and prepared figures; Su PZ performed the experiments and analyzed data; Lu M performed the experiments and interpreted the results of the experiments; all authors have read and approved the final version to be published.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of Zhujiang Hospital of Southern Medical University, Guangzhou, China, approval No. 2014-XHNK-003.
Informed consent statement: All patients gave written informed consent.
Clinical trial registration statement: This study is registered at http://www.chictr.org.cn/usercenter.aspx. The registration identification number is ChiCTR-IPR-16008317.
Conflict-of-interest statement: The authors declared that there is no conflict of interest related to this study.
Data sharing statement: The authors confirm that all data underlying the findings are fully available without restriction. All relevant data are within the paper and its supporting information files.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Hua Mao, Professor, Department of Digestive Diseases, Zhujiang Hospital of Southern Medical University, No. 253, Middle Gongye Avenue, Guangzhou 510280, Guangdong Province, China. maohua1963@126.com
Telephone: +86-13556196250 Fax: +86-13556196250
Received: May 26, 2016
Peer-review started: May 30, 2016
First decision: July 29, 2016
Revised: August 26, 2016
Accepted: September 14, 2016
Article in press: September 14, 2016
Published online: February 21, 2017
Processing time: 269 Days and 21.7 Hours
Abstract
AIM

To evaluate the effects of hydrotalcite combined with esomeprazole on gastric ulcer healing quality.

METHODS

Forty-eight patients diagnosed with gastric ulcer between June 2014 and February 2016 were randomly allocated to the combination therapy group or monotherapy group. The former received hydrotalcite combined with esomeprazole, and the latter received esomeprazole alone, for 8 wk. Twenty-four healthy volunteers were recruited and acted as the healthy control group. Endoscopic ulcer healing was observed using white light endoscopy and narrow band imaging magnifying endoscopy. The composition of collagen fibers, amount of collagen deposition, expression of factor VIII and TGF-β1, and hydroxyproline content were analyzed by Masson staining, immunohistochemistry, immunofluorescent imaging and ELISA.

RESULTS

Following treatment, changes in the gastric microvascular network were statistically different between the combination therapy group and the monotherapy group (P < 0.05). There were significant differences (P < 0.05) in collagen deposition, expression level of Factor VIII and TGF-β1, and hydroxyproline content in the two treatment groups compared with the healthy control group. These parameters in the combination therapy group were significantly higher than in the monotherapy group (P < 0.05). The ratio of collagen I to collagen III was statistically different among the three groups, and was significantly higher in the combination therapy group than in the monotherapy group (P < 0.05).

CONCLUSION

Hydrotalcite combined with esomeprazole is superior to esomeprazole alone in improving gastric ulcer healing quality in terms of improving microvascular morphology, degree of structure maturity and function of regenerated mucosa.

Keywords: Hydrotalcite; Esomeprazole; Gastric ulcer; Quality of ulcer healing

Core tip: Gastric ulcer is mainly caused by an imbalance in defense mechanisms and injurious factors at the gastric mucosa, and has a high recurrence rate. Previous studies comparing the efficacy of hydrotalcite combined with esomeprazole vs esomeprazole therapy alone for the treatment of gastric ulcer have shown unclear results. In the present study, we conducted a clinical observation study involving 48 patients diagnosed with gastric ulcer treated with either hydrotalcite combined with esomeprazole or esomeprazole alone. The results showed that hydrotalcite combined with esomeprazole was superior to esomeprazole alone in improving gastric ulcer healing quality.