Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), 7006 Trondheim, Norway.
Department of Gastroenterology and Hepatology, Clinic of Internal Medicine, St Olav's Hospital-Trondheim University Hospital, 7006 Trondheim, Norway.
Int J Mol Sci. 2019 Nov 29;20(23):6031. doi: 10.3390/ijms20236031.
Gastric juice is a unique combination of hydrochloric acid (HCl), lipase, and pepsin. Acidic gastric juice is found in all vertebrates, and its main function is to inactivate microorganisms. The phylogenetic preservation of this energy-consuming and, at times, hazardous function (acid-related diseases) reflects its biological importance. Proton pump inhibitors (PPIs) are one of the most widely used drugs in the world. Due to the reduced prevalence of infection as well as the increased use of inhibitors of gastric acid secretion, the latter has become the most important cause of gastric hypoacidity. In the present manuscript, we review the microbiological consequences of removing gastric acidity. The resulting susceptibility to infections has not been studied extensively, and focus has mainly been restricted to bacterial and parasitic agents only. The strongest evidence concerning the relationship between hypochlorhydria and predisposition to infections relates to bacterial infections affecting the gastrointestinal tract. However, several other clinical settings with increased susceptibility to infections due to inhibited gastric acidity are discussed. We also discuss the impact of hypochlorhydria on the gut microbiome.
胃液是盐酸（HCl）、脂肪酶和胃蛋白酶的独特组合。酸性胃液存在于所有脊椎动物中，其主要功能是使微生物失活。这种消耗能量且有时具有危害性的功能（与酸相关的疾病）在进化上得以保留，反映了其生物学重要性。质子泵抑制剂（PPIs）是世界上使用最广泛的药物之一。由于 感染的流行率降低以及胃酸分泌抑制剂的使用增加，后者已成为导致胃酸过少的最重要原因。在本手稿中，我们回顾了消除胃酸对微生物的影响。尚未广泛研究由此导致的易感性，并且主要集中在细菌和寄生虫制剂上。与胃酸过少和感染易感性之间的关系最密切的证据涉及影响胃肠道的细菌性感染。但是，我们还讨论了由于胃酸抑制而导致易感性增加的其他几种临床情况。我们还讨论了胃酸过少对肠道微生物组的影响。
