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. 2022 Jun 30:13:888610.
doi: 10.3389/fphar.2022.888610. eCollection 2022.

Associations Between Asthma Diagnosis/Asthma Exacerbation and Previous Proton-Pump Inhibitor use: A Nested Case-Control Study Using a National Health Screening Cohort

Hyo Geun Choi  1 , Chanyang Min  2 , Dae Myoung Yoo  2 , Bruce K Tan  3 , Joo-Hee Kim  4 , Hwan Il Kim  4 , Ji-Young Park  4 , Sunghoon Park  4 , Yong Il Hwang  4 , Seung Hun Jang  4 , Ki-Suck Jung  4
Affiliations

Associations Between Asthma Diagnosis/Asthma Exacerbation and Previous Proton-Pump Inhibitor use: A Nested Case-Control Study Using a National Health Screening Cohort

Hyo Geun Choi et al. Front Pharmacol. .

Abstract

Background: Proton-pump inhibitors (PPIs) block acid secretion from gastric parietal cells; however, recent studies have reported that PPIs have antioxidant and anti-inflammatory properties in various cells. Newer PPIs are stronger inhibitors of acid secretion; however, the anti-inflammatory effects of these drugs have not been assessed. We evaluated anti-inflammatory effect of PPIs on the development of asthma/asthma exacerbation (AE) in a national health screening cohort. Methods: This case-control study comprised 64,809 participants with asthma who were 1:1 matched with controls from the Korean National Health Insurance Service-Health Screening Cohort. Conditional logistic regression analysis was used to evaluate the effect of previous PPI use on an asthma diagnosis in all participants. Unconditional logistic regression was used to assess the effect of PPI use on AE in participants with asthma. These relationships were estimated in a subgroup analysis according to PPI generation. Results: Overall, PPI use increased the risk of asthma diagnosis [adjusted odds ratio (aOR) = 1.29, 95% confidence interval (CI) = 1.23-1.35, p < 0.001]. Use of the first-generation PPIs was associated with asthma (aOR = 1.34, 95% CI = 1.18-1.52, p < 0.001), while use of second-generation PPIs was not (aOR = 0.97, 95% CI = 0.82-1.15, p = 0.748). In contrast, overall PPI use decreased the risk of AE in participants with asthma (aOR = 0.79, 95% CI = 0.75-0.84, p < 0.001), although this effect was observed only for second-generation PPIs (aOR = 0.76, 95% CI = 0.65-0.89, p = 0.001). Conclusion: PPI use increased the risk for subsequent asthma diagnosis. However, this effect was confined to first-generation PPIs. Second-generation PPIs decreased the risk of AE.

Keywords: asthma; cohort studies; exacerbation (symptom flare up); inflammation; proton pump inhibitor (PPI).

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
A schematic illustration of the participant selection process that was used in the present study. Of 514,866 participants, 64,809 asthma participants were matched with the same number of control participants for age, sex, income, and region of residence.
FIGURE 2
FIGURE 2
Odds ratios (95% confidence intervals) of PPI prescription history/PPI prescription dates/prescription dates of each generation of PPI for asthma diagnosis.
FIGURE 3
FIGURE 3
Odds ratios (95% confidence intervals) of PPI prescription history/PPI prescription dates/prescription dates of each generation of PPI for asthma exacerbation.
See this image and copyright information in PMC

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References

    1. American Lung Association Asthma Clinical Research Centers Mastronarde J. G., Anthonisen N. R., Castro M., Holbrook J. T., Leone F. T., Teague W. G., et al. (2009). Efficacy of Esomeprazole for Treatment of Poorly Controlled Asthma. N. Engl. J. Med. 360 (15), 1487–1499. 10.1056/NEJMoa0806290 - DOI - PMC - PubMed
    1. Barcik W., Boutin R. C. T., Sokolowska M., Finlay B. B. (2020). The Role of Lung and Gut Microbiota in the Pathology of Asthma. Immunity 52 (2), 241–255. 10.1016/j.immuni.2020.01.007 - DOI - PMC - PubMed
    1. Begley L., Madapoosi S., Opron K., Ndum O., Baptist A., Rysso K., et al. (2018). Gut Microbiota Relationships to Lung Function and Adult Asthma Phenotype: A Pilot Study. BMJ Open Respir. Res. 5 (1), e000324. 10.1136/bmjresp-2018-000324 - DOI - PMC - PubMed
    1. Belei O., Olariu L., Dobrescu A., Marcovici T., Marginean O. (2018). Is it Useful to Administer Probiotics Together with Proton Pump Inhibitors in Children with Gastroesophageal Reflux? J. Neurogastroenterol. Motil. 24 (1), 51–57. 10.5056/jnm17059 - DOI - PMC - PubMed
    1. Besancon M., Simon A., Sachs G., Shin J. M. (1997). Sites of Reaction of the Gastric H,K-ATPase with Extracytoplasmic Thiol Reagents. J. Biol. Chem. 272 (36), 22438–22446. 10.1074/jbc.272.36.22438 - DOI - PubMed

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