Omeprazole cancer
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Omeprazole and Cancer: A Comprehensive Review
Introduction to Omeprazole and Its Uses
Omeprazole is a widely used proton pump inhibitor (PPI) primarily prescribed for treating gastrointestinal disorders such as ulcers and gastroesophageal reflux disease (GERD). Despite its effectiveness in managing these conditions, recent research has raised concerns about its potential link to cancer, particularly with long-term use.
Omeprazole and Gastric Cancer Risk
Genomic Instability and Gastric Cancer
Long-term use of omeprazole has been associated with an increased risk of gastric cancer. Studies indicate that prolonged exposure to omeprazole can induce genomic instability, which is a precursor to cancer development. This instability is linked to various adverse effects, including atrophic gastritis, cobalamin deficiencies, and polyp development, which collectively contribute to an elevated cancer risk1.
Carcinogenesis in Mouse Models
Research involving mouse models has shown that omeprazole, especially when combined with nitrosamine (a known carcinogen), promotes carcinogenesis in the fore-stomach. This effect is attributed to the inhibition of lysosomal hydrolase activity and dysregulation of cancer-associated proteins, highlighting the potential carcinogenic risk of omeprazole in specific contexts4.
Protective Effects Against Colorectal Cancer
Inhibition of Colorectal Carcinogenesis
Contrary to its potential risks, omeprazole has demonstrated protective effects against colorectal cancer in various studies. In an experimental rat model, omeprazole significantly reduced the incidence and number of colorectal tumors induced by azoxymethane, despite causing hypergastrinaemia. This suggests that omeprazole may have a protective role against colorectal carcinogenesis2 7 10.
Chemopreventive Properties
Further studies have shown that omeprazole can inhibit the progression of colonic adenomas to adenocarcinomas. This effect is dose-dependent, with higher doses leading to a more significant reduction in tumor incidence and multiplicity. The mechanism involves the suppression of cell proliferation and anti-apoptotic proteins, alongside an increase in apoptosis8 9.
Omeprazole in Pancreatic and Gastric Cancer Treatment
Modulation of Chemoresistance
Omeprazole has been found to enhance the chemosensitivity of pancreatic and gastric cancer cells. It modulates the lysosomal transport pathway and autophagy, leading to programmed cell death in pancreatic cancer cells. This modulation helps overcome common resistance mechanisms, making chemotherapy more effective3 6.
Synergistic Effects with Chemoradiotherapy
In rectal cancer, omeprazole has shown a synergistic effect when used as an adjuvant to chemoradiotherapy. Patients receiving omeprazole alongside standard treatment exhibited improved therapy efficacy and reduced tumor recurrence rates. This suggests that omeprazole can enhance the overall effectiveness of cancer treatment regimens5.
Conclusion
Omeprazole presents a complex profile in the context of cancer. While it poses a potential risk for gastric cancer with long-term use, it also offers protective and therapeutic benefits against colorectal and pancreatic cancers. These dual effects underscore the importance of careful consideration and monitoring in the clinical use of omeprazole, particularly for long-term treatments. Further research is essential to fully understand the mechanisms behind these effects and to optimize the safe use of omeprazole in cancer prevention and treatment.
Sources and full results
Most relevant research papers on this topic
Pharmacological Effects and Toxicogenetic Impacts of Omeprazole: Genomic Instability and Cancer
Long-term use of omeprazole may induce genomic instability and increase the risk of certain types of cancer, requiring adequate precautions.
Systematic Review
Rigorous JournalOmeprazole inhibits colorectal carcinogenesis induced by azoxymethane in rats.
Omeprazole protects against colorectal carcinogenesis in rats, despite causing significant hypergastrinaemia, suggesting a potential protective mechanism for humans.
RCT
Animal StudyOmeprazole Inhibits Proliferation and Modulates Autophagy in Pancreatic Cancer Cells
Omeprazole inhibits pancreatic cancer cell proliferation and modulates autophagy, potentially circumventing common resistance mechanisms and leading to new clinical applications.
In Vitro Study
Highly CitedOmeprazole promotes carcinogenesis of fore-stomach in mice with co-stimulation of nitrosamine
Omeprazole promotes carcinogenesis of the mouse fore-stomach when combined with nitrosamine, but not the glandular stomach, due to inhibition of lysosomal hydrolase activity and dysregulation of cancer-associated proteins.
RCTAnimal StudyRigorous JournalEffects of omeprazole in improving concurrent chemoradiotherapy efficacy in rectal cancer
Omeprazole, when applied as an adjuvant drug in cancer treatment, improves chemoradiotherapy efficacy and decreases rectal cancer recurrence when applied as an adjuvant drug for relieving common side effects of chemotherapy.
Observational StudyRigorous JournalOmeprazole improves chemosensitivity of gastric cancer cells by m6A demethylase FTO-mediated activation of mTORC1 and DDIT3 up-regulation
Omeprazole improves chemosensitivity of gastric cancer cells by enhancing the activation of mTORC1 and DDIT3 expression, potentially benefiting patients with advanced gastric cancer.
In Vitro StudyRigorous JournalAnti-carcinogenic properties of omeprazole against human colon cancer cells and azoxymethane-induced colonic aberrant crypt foci formation in rats.
Omeprazole shows anti-carcinogenic properties against colon cancer cells, suppressing colonic aberrant crypt foci formation and inducing anti-apoptotic signals in rats.
Abstract 2820: Omeprazole alone, or in combination with Aspirin inhibits azoxymethane-induced colon adenoma progression to adenocarcinoma and carcinoma invasion in F344 rat model
Omeprazole alone or combined with aspirin significantly inhibits colon adenocarcinoma progression and carcinoma invasion in rats, with potential chemopreventive effects.
Non-RCTAnimal StudyOmeprazole Inhibits Pancreatic Cancer Cell Invasion through a Nongenomic Aryl Hydrocarbon Receptor Pathway.
Omeprazole and tranilast effectively inhibit pancreatic cancer cell invasion through a nongenomic aryl hydrocarbon receptor pathway, offering potential for targeted therapy.
In Vitro StudyProton Pump Inhibitor Omeprazole Suppresses Carcinogen-induced Colonic Adenoma Progression to Adenocarcinoma in F344 Rat
Omeprazole, a common medication for treating acid reflux, effectively suppresses colonic adenoma progression to carcinoma in a rat model, warranting further human evaluation.
Non-RCTAnimal Study