Mössner J, Caca K
University of Leipzig, Leipzig, Germany.
Eur J Clin Invest. 2005 Aug;35(8):469-75. doi: 10.1111/j.1365-2362.2005.01543.x.
Understanding the physiology of gastric acid secretion and the pathophysiology of acid-related diseases (e.g. gastrooesophageal reflux and peptic ulcer) has led to the development of numerous ways to decrease acid exposure. Pharmacologically one can try to neutralize secreted acid by antacids, prevent stimulation of the parietal cell, improve mucosal defences and block the functioning of the proton pump. Proton pump inhibitors (PPIs) inhibit the final step of acid secretion, and are currently the most potent acid inhibitors. Major therapeutic improvement within the PPI class appears unlikely, as agents in this class share similar chemistry, mode of action, and pharmacokinetic profiles. New approaches that block acid secretion are now being developed. Gastrin (CCK2) receptor antagonists and potassium-competitive acid blockers (P-CABs) are in clinical development.
对胃酸分泌生理学以及酸相关疾病（如胃食管反流和消化性溃疡）病理生理学的理解，促使了多种减少酸暴露方法的发展。在药理学上，可以尝试通过抗酸剂中和分泌的酸，防止壁细胞受到刺激，改善黏膜防御并阻断质子泵的功能。质子泵抑制剂（PPIs）抑制胃酸分泌的最后一步，是目前最强效的酸抑制剂。由于该类药物具有相似的化学结构、作用方式和药代动力学特征，因此在质子泵抑制剂类别内取得重大治疗进展似乎不太可能。目前正在研发阻断胃酸分泌的新方法。胃泌素（CCK2）受体拮抗剂和钾竞争性酸阻滞剂（P-CABs）正在进行临床开发。
