Consilium MedicumConsilium MedicumConsilium MedicumConsilium Medicum2075-17532542-2170Consilium Medicum9687610.26442/20751753.2019.2.180171ArticlesСтатьиResearch ArticleInfluence of proton pump inhibitors on cognitive function and dementia riskВлияние ингибиторов протонной помпы на когнитивные функции и риск деменцииOstroumovaOlga D.ОстроумоваОльга Дмитриевна

D. Sci. (Med.), Full Prof.

д-р мед. наук, проф., зав. лаб. клин. фармакологии и фармакотерапии; ОСП «Российский геронтологический научно-клинический центр».

ostroumova.olga@mail.ruPereverzevAnton P.ПереверзевАнтон Павлович

Cand. Sci. (Med.)

канд. мед. наук, науч. сотр. лаб. клин. фармакологии и фармакотерапии

acchirurg@mail.ruPirogov Russian National Research Medical University - Russian Clinical and Research Center of GerontologyФГБОУ ВО «РНИМУ им. Н.И.Пирогова»15022019212VOL 21, NO2 (2019)ТОМ 21, №2 (2019)313619012022Copyright ©; 2019, Consilium MedicumCopyright ©; 2019, ООО "Консилиум Медикум"2019Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://consilium.orscience.ru/2075-1753/article/view/96876

During the last half of the 20th century change of population age structure with constant increase of elderly and senior age population is observed all over the world. It determines the importance of prevention and treatment of great number of age-associated diseases including neurological ones. Proton pump inhibitors (PPI) use is one of possible risk factors for dementia and Alzheimer's disease development. The authors have performed research and data analysis on association of PPI use and dementia development. Acquired results are presented in the article. It has been shown that PPI use may influence b-amyloid production as they change b-secretase 1 and g-secretase activity - the enzymes responsible for b-amyloid precursor protein degradation, that results in increase of b-amyloid production. It was also demonstrated that cognitive impairment development in PPI use may be mediated by vitamin B12 deficit. Also the authors performed analysis of different PPI physical and chemical properties in order to develop suggestions on cognitive impairment risk decrease in patients with contributing risk factors. The performed analysis allowed to identify pantoprazole as one of the most appropriate medications for gastrointestinal disease treatment in patients with high risk of cognitive impairment and dementia development/progression.

Начиная со 2-й половины XX в. во всем мире наблюдается изменение возрастной структуры населения с постоянным увеличением в популяции доли людей пожилого и старческого возраста, что обусловливает актуальность профилактики и лечения большого количества возраст-ассоциированных заболеваний, в том числе неврологических. Одним из возможных факторов риска развития деменции и болезни Альцгеймера является прием ингибиторов протонной помпы (ИПП). Авторами проведен поиск и анализ данных о связи между приемом ИПП и развитием деменции, результат которого представлен в данной статье. Выявлено, что ИПП могут влиять на продукцию b-амилоида, они изменяют активность b-секретазы 1 и g-секретазы - двух ферментов, отвечающих за деградацию белка-предшественника b-амилоида, что приводит к увеличению образования b-амилоида. Также показано, что развитие когнитивных нарушений при приеме ИПП может быть опосредовано дефицитом витамина В12. На основании полученных данных с целью разработки предложения по снижению риска развития когнитивных нарушений и деменции у пациентов с сопутствующими факторами риска проведен анализ физико-химических свойств различных ИПП, который позволил выделить пантопразол как один из наиболее оптимальных препаратов для лечения заболеваний желудочно-кишечного тракта у пациентов, имеющих высокий риск возникновения/прогрессирования когнитивных нарушений и деменции.

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