Suppression of cell pyroptosis by omeprazole through PDE4-mediated autophagy in gastric epithelial cells

Helicobacter pylori is a risk factor for the development of peptic ulcers with autophagy dysfunction.Omeprazole was widely known as the first-line regimen for H.pylori-associated gastritis.Objectives:The objective of this work was to assess the role of omeprazole on cell pyroptosis and autophagy.Methods:The clinical samples were collected.Quantitative polymerase chain reaction,western blotting,enzyme linked immunosorbent assay,and immunofluorescence(IF)analysis were conducted to reveal the mechanism of omeprazole on cell pyroptosis and autophagy.Results:The results revealed that omeprazole could decrease cell pyroptosis,which was attributed to the downregulation of cleaved caspase-1 expression,resulting in the inhibition of gasdermin E and interleukin-18/1βmaturation and secretion as well as the resolution of inflammation.Mechanistically,omeprazole treatment led to drastic downregulation of mammalian target of rapamycin(mTOR)activity was observed in BGC823 cells,leading to enhanced autophagy characterized by increased LC3II expression,which further reduced cell pyroptosis.This omeprazole-mediated phenomenon was enhanced after phosphodiesterase-4(PDE4)inhibitor dipyridamole(DIP)treatment.In addition,activation of mTOR by MHY1485 could rescue the suppression of cell pyroptosis induced by omeprazole.Most importantly,IF analysis suggested that phosphorylation of mTOR and PDE4 activity and caspase-1 were enhanced in H.pylori-infected gastric mucosa.Conclusion:These findings indicate that omeprazole suppresses cell pyroptosis through PDE4-mediated autophagy in gastric epithelial cells,and DIP enhanced the omeprazole-mediated inhibition of cell pyroptosis,implying that DIP is an alternative combined therapy strategy in improving the treatment of patients with H.pylori infection.

Clinical Effect of Omeprazole Combined with Amoxicillin in the Treatment of Gastric Ulcer

Objective:To investigate the therapeutic effect of omeprazole+amoxicillin in patients with gastric ulcers.Methods:62 cases of patients with gastric ulcers who were treated from January 2022 to December 2022 were recruited and randomly divided into groups.Omeprazole+amoxicillin treatment was included in the study group,and amoxicillin treatment was included in the control group.The score of gastric ulcer symptoms,time of symptom resolution,gastrointestinal hormone index,and adverse reactions were compared.Results:The gastric ulcer symptom scores in the study group were lower than those in the control group(P<0.05);the gastric ulcer symptoms and Helicobacter pylori-negative time in the study group were shorter than those in the control group(P<0.05);the gastrointestinal hormone indexes in the study group were better than those in the control group(P<0.05);the adverse reaction rate of gastric ulcer in the study group was lower than that in the control group(P<0.05).Conclusion:Omeprazole+amoxicillin in the treatment of gastric ulcers can regulate gastrointestinal hormones,relieve gastric ulcer symptoms,and shorten the duration of ulcers,which is highly effective and feasible.

comparison between tocotrienol and omeprazole on gastric growth factors in stress-exposed rats

AIM To investigate and compare the effects of tocotrienol and omeprazole on gastric growth factors in rats exposed to water-immersion restraint stress(WIRS).METHODS Twenty-eight male Wistar rats were randomly assigned to four groups of seven rats. The two control groups were administered vitamin-free palm oil(vehicle) and the two treatment groups were given omeprazole(20 mg/kg) or tocotrienol(60 mg/kg) by oral gavage. After 28 d of treatment, rats from one control group and both treated groups were subjected to WIRS one time for 3.5 h. Gastric lesions were measured and gastric tissues were obtained to measure vascular endothelial growth factor(VEGF), epidermal growth factor(EGF), basic fibroblast growth factor(b FGF), and transforming growth factor-alpha(TGF-α) m RNA expression. RESULTS Rats exposed to WIRS for 3.5 h demonstrated the presence of considerable ulcers in the form of gastric erosion. The lesion index in the stressed control(S) group was increased(P < 0.001) compared to the tocotrienol treated and omeprazole treated groups. Stress led to a decrease in gastric VEGF(P < 0.001), b FGF(P < 0.001) and TGF-α(P < 0.001) m RNA levels and caused an increase in EGF m RNA(P < 0.001) that was statistically significant compared to the nonstressed control group. Although both treatment agents exerted similar ulcer reducing ability, only treatment with tocotrienol led to increased expression of VEGF(P = 0.008), b FGF(P = 0.001) and TGF-α(P = 0.002) m RNA.CONCLUSION Tocotrienol provides gastroprotective effects in WIRSinduced ulcers. Compared to omeprazole, tocotrienol exerts a similar protective effect, albeit through multiple mechanisms of protection, particularly through up-regulation of growth factors that assist in repair of gastric tissue injuries.

Effects of omeprazole in improving concurrent chemoradiotherapy efficacy in rectal cancer

AIM To explore the effects of omeprazole on chemoradiotherapy efficacy and tumor recurrence in rectal cancer. METHODS The medical data of 125 rectal cancer patients who received the same neoadjuvant chemoradiotherapy(CRT) followed by surgery were retrospectively collected. Patients who received omeprazole(OME) orally at a dose of 20 mg at least once daily for six days and/or intravenously at 40 mg a day were recognized as eligible OME users(EOU). Otherwise, patients were regarded as non-eligible OME users(non-EOU).Moreover, a preferred OME dose cut-off of 200 mg on tumor recurrence was obtained by receiver operating characteristic(ROC) curves. Patients were divided into two groups: the effective OME group(EOG, OME ≥ 200 mg) and the non-effective OME group(non-EOG, OME < 200 mg). RESULTS The good response rate of CRT efficacy(50.8%) in EOU was significantly increased compared with nonEOU(30.6%)(P = 0.02). The recurrence rate in the EOG was 10.3%, which was significantly lower compared with 31.3% in non-EOG(P = 0.025). The good response rate of CRT efficacy in EOG was 55.2%, which was obviously higher compared with 36.5% in non-EOG, with a significant difference(P = 0.072). Multivariate Cox analysis demonstrated that OME(nonEOG and EOG) was an independent and significant impact factor for DFS(P = 0.048, HR = 0.30, 95%CI: 0.09-0.99).CONCLUSION When applied as an adjuvant drug in cancer treatment for relieving common side effects of chemotherapy, omeprazole has a synergetic effect in improving CRT efficacy and decreasing rectal cancer recurrence.

Protective effect of omeprazole on gastric mucosal of cirrhotic portal hypertension rats

Objective:To observe the protective effect of omeprazole on gastric mucosal of cirrhotic portal hypertension rats.Methods:All rats were randomly divided into normal control group,cirrhosis and treatment group.Thioacetamide was used to establish rat model of cirrhotic portal hypertension.The necrotic tissue of gastric mucosa ulcer focus,degree of neutrophils infiltration at the ulcer margin,portal pressure,portal venous flow,abdominal aortic pressure,abdominal aortic blood flow at front end,gastric mucosal blood flow(GMBF),glycoprotein(GP)of gastric mucosa,basal acid secretion,H' back-diffusion,gastric mucosal damage index,NO,prostaglandin E_2(PGE_2) and tumor necrosis factor-α(TNF-α) were determined respectively,and the pathological changes of gastric mucosa were also observed by microscope.Results:Compared with cirrhosis group and the control group,the ulcer bottom necrotic material,gastric neutrophil infiltration and UI of the treatment group were all decreased significantly(P<0.01),GMBF value,GP values,serum NO,PGE_2,TNF- a were all significantly increased.Conclusions:Omeprazole has an important protective effect on gastric mucosal and it can increase gastric mucosal blood flow and related to many factors.

Unusual retention behavior of omeprazole and its chiral impurities B and E on the amylose tris(3-chloro-5-methylphenylcarbamate)chiral stationary phase in polar organic mode

Recent reports have demonstrated that the new commercially available immobilized-type chiral stationary phases（CSPs） containing amylose tris（3-chloro-5-methylphenylcarbamate）（ACMPC） as a selector exhibit not only an exceptionally high enantioselectivity in high-performance liquid chromatography（HPLC） but they are also applicable to a wide range of chiral analytes. Herein, we report the results obtained in the HPLC analysis of omeprazole and its impurities B and E on the ACMPC-based Chiralpak IG-3 CSP（CSP） under polar organic conditions. A systematic evaluation of the retention characteristics of the selected benzimidazole chiral probes was carried out by changing the composition of the mobile phase and the column temperature. It is worth emphasizing that the high affinity of both enantiomers of all analytes recorded in pure methanol mode dramatically decreased incorporating small volumes of either basic or acid additives in the mobile phase. Unspecified sites of the IG-3 CSP presumably involved in strong and non-stereoselective H-bonding contacts with chiral analytes are assumed responsible for the unproductive retention process.

Effects of omeprazole or pantoprazole on platelet function in non-ST-segment elevation acute coronary syndrome patients receiving clopidogrel

Background: This study evaluated the effect of omeprazole or pantoprazole on platelet reactivity in non-STsegment elevation acute coronary syndrome(NSTE-ACS) patients receiving clopidogrel.Methods: Consecutive patients with NSTE-ACS(n =620) from general hospital of Shenyang Military Command were randomized to the omeprazole or pantoprazole(20mg/d) group(1:1), and received routine dual antiplatelet treatment. Patients' reversion rate of adenosine diphosphate-induced platelet aggregation(ADP-PA) was assessed at baseline, 12 to 24 h after administration of medication, and after 72 h of percutaneous coronary intervention(PCI). The primary endpoint of the study was platelet reactivity assessed with ADP-PA at 30 days after PCI. Adverse events(AEs) were recorded for 30-day and 180-day follow-up periods.Results: There were no significant differences between both the groups in platelet response to clopidogrel at 12–24h after drug administration(54.09%±18.90% vs. 51.62%±19.85%, P=0.12), 72 h after PCI(52.15%±19.45% vs. 49.66%±20.05%, P=0.18), and 30 days after PCI(50.44%±14.54% vs. 48.52%±15.08%, P=0.17). The rate of AEs did not differ significantly between groups during the 30-day(15.2% vs. 14.8%, P=0.91) and 180-day(16.5% vs. 14.5%, P=0.50) follow-up periods after PCI.Conclusion: The addition of omeprazole or pantoprazole to clopidogrel did not restrict the effect of platelet aggregation by reducing the conversion of clopidogrel. Compared with clopidogrel alone, pantoprazole-clopidogrel and omeprazoleclopidogrel combinations did not increase the incidence of adverse clinical events during 30-day and 180-day follow-up periods after PCI.

Ternary phase diagrams and solvate transformation thermodynamics of omeprazole sodium in different solvent mixtures

Omeprazole sodium(OMS), a typical non-hydrogen bond donors API, is only available in solvates so far, including monohydrate, ethanol solvate and methanol solvate. The methanol solvate was found for the first time. Solvate transformation thermodynamics of OMS was studied in this paper. First, the ternary phase diagrams forming two solvates for OMS in binary solvent mixtures including methanol + water, ethanol + water, and methanol+ ethanol were measured at temperature ranging of T =(278.15 to 313.15) K under atmospheric pressure. Further, the standard equilibrium constants of the solvate transformation reactions were evaluated according to the chemical reaction isothermal equation. The standard molar Gibbs free energy, the standard molar enthalpy, and the standard molar entropy of solvate transformation reactions were then calculated based on van't Hoff equation. Moreover, the thermodynamic stability of the OMS solvate was analyzed based on phase diagram. The results are of great importance to develop a crystallization process for manufacturing OMS solvate, and could be helpful to other solvate transformation research.

奥美拉唑(Omeprazole)

奥美拉唑是第一个作用于胃酸分泌最后共同环节的新一类药物,它通过改变胃壁细胞中H^+/K^+—ATP酶活性而抑制胃酸的分泌。它的发现使人们对胃分泌机理以及常规胃肠道肿瘤的产生有了新的认识与见解,并使胃酸性疾病的治疗有了新的发展。

Formulation Development of Generic Omeprazole 20 mg Enteric Coated Tablets

Omeprazole is a potent proton pump inhibitor with powerful inhibition of secretion of gastric juice. Oral site-specific drug delivery systems have recently attracted a great interest for the local treatment of bowel disease and for improving systemic absorption of drugs which are unstable in the stomach. However, microenvironment in the gastrointestinal tract and varying absorption mechanisms cause hindrance for the formulation and optimization of oral drug delivery. The objective of the study was to develop and optimize enteric coating process for omeprazole tablets. Different batches of core tablets were sub coated, one set sub coated with opadry and another with a mixture of light magnesium oxide, magnesium stearate and absolute alcohol omeprazole magnesium. Seal coating was applied by using opadry to achieve certain weight gain and to protect omeprazole from acidic coating polymers. A comparative dissolution test was performed. The variation of thickness and diameter were observed to be minimal with a weight gain of 3% - 4% of enteric polymer. Disintegration test showed that in each tested batch the enteric coated layer remained intact in 0.1N HCl for 2 hours and when exposed to alkaline media of phosphate buffer pH 6.8, it dissolved within few minutes. Dissolution release was 98.8% to 102.4% within two hours when the product was exposed to phosphate buffer pH 6.8 after 2 hours. The similarity and dis-similarity factors were calculated and observed to be 54 to 61 and 4 to 5 respectively. Therefore a simple and good enteric coating process was developed and tested with potential for transfer this technology into local pharmaceutical industries using cheap and easily available materials.

TNF-α、IL-6、IL-1β Effect of omeprazole combined with amoxicillin on cytokines in gingival crevicular fluid of patients with periodontal disease

Objective:To investigate the TNF-α、IL-6、IL-1βeffect of omeprazole combined with amoxicillin on cytokines in gingival crevicular fluid of patients with periodontal disease.Methods:102 patients with periodontal disease who were treated in our hospital from June 2016 to March 2018 were selected.Randomly divided into two groups,the control group was treated with omeprazole alone,and the research group was treated with omeprazole combined with amoxicillin.The levels of inflammatory cytokines(TNF-α、IL-6、IL-1β),therapeutic effects and adverse reactions to drugs were compared between the two groups.Results:the levels of inflammatory factors(TNF-α、IL-6、IL-1β)in the study group were lower than those in the control group(P<0.05).The therapeutic effect(82.4%)of the control group was lower than that of the study group(96.1%)(P<0.05).The incidence of adverse reactions to drugs in the study group(3.8%)was lower than that in the control group(21.5%)(P<0.05).Conclusion:joint take omeprazole amoxicillin treatment of periodontal disease patients achieved ideal therapeutic efficacy.

Effect of somatostatin combined with omeprazole on serum inflammatory factors and intestinal mucosal barrier function in severe acute pancreatitis

Objective:To investigate the effect of somatostatin combined with omeprazole on serum inflammatory factors and intestinal mucosal barrier function in severe acute pancreatitis. Methods: patients with severe acute pancreatitis who were treated in Zigong Third People's Hospital between August 2014 and December 2017 were chosen and divided into two groups by random number table method. Control group received conventional + omeprazole treatment, combined group received conventional + somatostatin + omeprazole treatment and the treatment lasted for 1 week. The differences in serum levels of inflammatory factors, chemokines and intestinal mucosal barrier function indexes were compared between the two groups immediately after admission and after 1 week of treatment.Results: After 1 week of treatment, serum IL-1β, IL-8, IL-18, hs-CRP, MCP-1, FKN, CINC, D-Lactate, DAO, Endotoxin and FABP levels of both groups significantly decreased and serum IL-1β, IL-8, IL-18, hs-CRP, MCP-1, FKN, CINC, D-Lactate, DAO, Endotoxin and FABP levels of combined group were significantly lower than those of control group.Conclusion: Somatostatin combined with omeprazole therapy for severe acute pancreatitis can effectively alleviate the inflammatory response and protect the intestinal mucosal barrier function.

A meta-analysis of Banxia Xiexin decoction versus omeprazole in the treatment of gastroesophageal reflux disease

Objective:To investigate the clinical efficacy and safety of Banxia Xiexin decoction and omeprazole in the treatment of gastroesophageal reflux disease(GERD).Methods:EMbase,Cochrane,PubMed,CNKI,Wan Fang and VIP database were searched from inception to November 2018 according to the search strategy.Eligible randomized controlled clinical trials related to the efficacy of omeprazole compared with Banxia Xiexin decoction in the treatment of GERD were included according to the inclusion and exclusion criteria.Total effective rate,pathological improvement rate,total symptom score,acid reflux symptoms,heartburn symptoms,improvement of post-sternal pain symptoms,and incidence of adverse reactions were evaluated.Data analysis was performed with RevMan5.3 software provided by Cochrane Collaboration.Results:A total of 15 studies were enrolled,including 1,532 patients.Meta-analysis results showed that the total effective rate of Banxia Xiexinfang was higher than that of omeprazole in the treatment of GERD(odds ratio(OR)=3.99,95%confidence intervals(CI)(2.58,6.15),P<0.00001).Pathological improvement under endoscopy was not obvious(OR=1.98,95%CI(0.94,4.19),P=0.07)between the two groups.The total symptom score improved significantly,indicating that Banxia Xiexin decoction has an objective advantage over omeprazole in the treatment of GERD(standardised mean difference(SMD)=?2.56,95%CI(?3.86,?1.26),P=0.0001),The incidence of adverse reactions in patients treated with Banxia Xiexin decoction is lower than omeprazole group(OR=0.09,95%CI(0.02,0.39),P=0.001].In addition,total effective rate of Banxia Xiexin decoction combined with omeprazole was higher than omeprazole alone(OR=6.31,95%CI(2.86,13.92),P<0.00001).Conclusion:Banxia Xiexin decoction is superior to omeprazole in total effective rate,total symptom score and adverse reaction rate in the treatment of GERD.The clinical efficacy of Banxia Xiexin decoction combined with omeprazole is better than that of omeprazole alone.However,due to the low quality of the included literatures,large-scale and high-quality RCTs are still needed for further confirmation.

FDA批准新复方Aspirin and Omeprazole迟释片上市

美国FDA于2016年9月14日批准 Aralez制药公司的Aspirin and Omeprazole（参考译名：阿司匹林-奥美拉唑,商品名：Yosprala ）迟释片上市,用于有阿司匹林相关胃溃疡风险患者心脑血管事件的二级预防.

Analysis of the Effect of Pantoprazole and Omeprazole on Pain Relief in Patients with Gastric Ulcer

Objective:To analyze the effect of pantoprazole and omeprazole in the treatment of patients with gastric ulcer.Methods:The treatment effect,recurrence rate,helicobacter pylori negative conversion rate,adverse reaction status and pain relief time of the two groups were compared.Results:The total effective rate of the experimental group(97.78%,44/45)was higher than that of the control group(84.44%,38/45),P<0.05;The recurrence rate(4.44%,2/45)and Helicobacter pylori negative conversion rate(95.56%,43/45)of the experimental group were significantly higher than those of the control group(P<0.05);The incidence of adverse reactions in the experimental group(11.11%,5/45)was lower than that in the control group(15.56%,7/45)(P>0.05);The pain relief time of the experimental group was(2.24±1.16)d,which was shorter than that of the control group(P<0.05).Conclusion:In the process of clinical treatment of gastric ulcer,pantoprazole has significant curative effect and low recurrence rate,which can eradicate Helicobacter pylori as soon as possible,shorten the pain time and make the treatment safer.

Efficacy and Safety of Omeprazole and Amoxicillin in the Treatment of Gastric Ulcer

Objective:To study the effect of omeprazole and amoxicillin in the treatment of patients with gastric ulcer.Methods:88 patients with gastric ulcer in our hospital from March 2018 to March 2020 were selected as research subjects and divided into experimental group(44 cases were treated with omeprazole+amoxicillin)and control group(44 cases were treated with omeprazole).The therapeutic effect,13C positive rate of breath test before and after treatment,recurrence rate within half a year and adverse reactions were compared between the two groups.Results:The total effective rate of the experimental group(97.73%,43/44)was higher than that of the control group(84.09%,37/44),P<0.05;After treatment,the 13C positive rate of breath test in the experimental group(22.73%,10/44)was lower than that in the control group(47.73%,21/44),P<0.05;The recurrence rate in the experimental group was 4.55%(2/44),which was significantly higher than that in the control group(20.45%,9/44),P<0.05;The incidence of adverse reactions in the experimental group(9.09%,4/44)was significantly lower than that in the control group(15.91%,7/44),P<0.05.Conclusion:In the process of clinical treatment of gastric ulcer,omeprazole combined with amoxicillin has significant effect,not only the recurrence rate is low,but also the incidence of adverse events should be less,and the treatment is safer.

Dilated intercellular spaces in gastroesophageal reflux disease patients and the changes of intercellular spaces after omeprazole treatment

Background Gastroesophageal reflux disease （GERD） is a common disorder. Dilation of intercellular spaces of esophageal epithelium has been revealed at transmission electron microscopy both in the rabbit acid-perfused esophagus and in esophageal biopsies from GERD patients. This study aimed to observe the changes of the intercellular spaces of squamous epithelium of lower esophagus in patients with GERD and the changes of intercellular spaces of patients with erosive esophagitis （EE） before and after omeprazole treatment. Methods Outpatients having GERD symptoms for more than 3 months and volunteers were collected. All of them underwent gastroendoscopy and 24-hour ambulatory pH monitoring. Biopsies were taken from the lower esophagus （2 cm above Z-line） for electron microscope examination. Five healthy volunteers, six non-erosive reflux disease （NERD） patients, and five EE patients were enrolled. Intercellular spaces of GERD patients and controls were calculated. Then we selected 20 patients with EE diagnosed by gastroendoscopy. All of them were treated with omeprazole （Losec, 20 mg bid） for 4 weeks then underwent gastroendoscopy again. Biopsies were taken from 2 cm above Z-line for electron microscope examination. All the patients completed the questionnaire about reflux symptoms before and after treatment. Results Intercellular spaces of esophageal epithelial cell in volunteers, NERD patients and EE patients were （0.37±0.07）μm, （1.31±0.08）μm, and （1.33±0.14）μm, respectively, with significant differences between the control group and the NERD group （P=0.000）. In the 20 EE patients, the mean intercellular space before treatment was （1.14±0.15） μm After treatment the intercellular space was （0.51±0.18）μm, a significant difference compared with pre-treatment measurements （P=0.000）. Conclusions Dilated intercellular spaces （DIS） were seen in both NERD and EE cases. The dilated intercellular spaces of esophaaeal epithelium in EE patients could be recovered after a short time nf treatment with omeprazole.

埃索美拉唑钠预防咽喉肿瘤术后并发应激性溃疡出血的研究

我们对80例咽喉肿瘤术后患者分别采用埃索美拉唑和泮托拉唑进行应激性溃疡出血预防性治疗的对比研究。1资料与方法1.1一般资料。选择2011年2月～11月我科咽喉肿瘤患者80例,随机分为2组,治疗组40例,男36例,女4例,平均年龄57.2岁;对照组40例,男35例,女5例,平均年龄59.8岁。两组患者年龄、性别、病种、手术时间、吸烟史、饮酒史比较差异无明显差异。

Clinical relevance of clopidogrel-proton pump inhibitors interaction

Clopidogrel is a widely used antiplatelet agent for the secondary prevention of cardiovascular events in patients with stable coronary heart disease, acute coronary syndromes and ischemic stroke. Even though clopidogrel is safer than aspirin in terms of risk for gastrointestinal(GI) bleeding, the elderly, and patients with a history of prior GI bleeding, with Helicobacter pylori infection or those who are also treated with aspirin, anticoagulants, corticosteroids or nonsteroidal antiinflammatory drugs are at high risk for GI complications when treated with clopidogrel. Accordingly, proton pump inhibitors are frequently administered in combination with clopidogrel to reduce the risk for GI bleeding. Nevertheless, pharmacodynamic studies suggest that omeprazole might attenuate the antiplatelet effect of clopidogrel. However, in observational studies, this interaction does not appear to translate into increased cardiovascular risk in patients treated with this combination. Moreover, in the only randomized, double-blind study that assessed the cardiovascular implications of combining clopidogrel and omeprazole, patients treated with clopidogrel/omeprazole combination had reduced risk for GI events and similar risk for cardiovascular events than patients treated with clopidogrel and placebo. However, the premature interruption of the study and the lack of power analysis in terms of the cardiovascular endpoint do not allow definite conclusions regarding the cardiovascular safety of clopidogrel/omeprazole combination. Other proton pump inhibitors do not appear to interact with clopidogrel. Nevertheless, given the limitations of existing observational and interventional studies, the decision to administer proton pump inhibitors to patients treated with clopidogrel should be individualized based on the patient's bleeding and cardiovascular risk.

Relationship between the acid-suppression efficacy of proton pump inhibitors and CYP2C19 genetic polymorphism in patients with peptic ulcer

Objective To investigate acid-suppression efficacy of proton pump inhibitors(PPIs) in relation to CYP2C19 genetic polymorphism on patients with peptic ulcer. Methods By an open, randomized and control trial, fifty nine patients with active peptic ulcer were randomly assigned to receive one of three PPIs on a single dose (20 mg of each drug): omeprazole group (n=19), rabeprazole group (n=20) and esomeprazole group (n=20). Intragastric pH was recorded 1 hour before and 24 hours after administration. CYP2C19 genotype was tested in all patients. Results The EMs/PMs ratio of each group was 16/3,17/3 and 17/3, respectively. The total time that intragastric pH>4, time percent pH>4 and median pH in PMs patients were significantly higher than those in EMs patients of omeprazole group (P<0.05). But all these differences were not found in rabeprazole group and esomeprazole group. The pH of nocturnal acid breakthrough(NAB) in both rabeprazole group and esomeprazole group was higher than that of omeprazole group, while there was no significant difference between rabeprazole group and esomeprazole group.Conclusion The acid-suppression efficacy of omeprazole is highly dependent on CYP2C19 genetic polymorphism, while CYP2C19 genetic polymorphism may have a little influence on the acid-suppression efficacy of rabeprazole and esomeprazole. The acid-suppression action of rabeprazole and esomeprazole is superior to omeprazole, especially on night acid secretion.