Treatment of Helicobacter pylori with potassium competitive acid blockers:A systematic review and meta-analysis

BACKGROUND Helicobacter pylori(H.pylori)infects over half the global population,causing gastrointestinal diseases like dyspepsia,gastritis,duodenitis,peptic ulcers,GMALT lymphoma,and gastric adenocarcinoma.Eradicating H.pylori is crucial for treating and preventing these conditions.While conventional proton pump inhibitor(PPI)-based triple therapy is effective,there’s growing interest in longer acid suppression therapies.Potassium competitive acid blocker(P-CAB)triple and dual therapy are new regimens for H.pylori eradication.Initially used in Asian populations,vonoprazan(VPZ)has been recently Food and Drug Administration-approved for H.pylori eradication.AIM To assess the efficacy of regimens containing P-CABs in eradicating H.pylori infection.METHODS This study,following PRISMA 2020 guidelines,conducted a systematic review and meta-analysis by searching MEDLINE and Scopus libraries for randomized clinical trials(RCTs)or observational studies with the following command:[("Helicobacter pylori"OR"H pylori")AND("Treatment"OR"Therapy"OR"Eradication")AND("Vonaprazan"OR"Potassium-Competitive Acid Blocker"OR"P-CAB"OR"PCAB"OR"Revaprazan"OR"Linaprazan"OR"Soraprazan"OR"Tegoprazan")].Studies comparing the efficacy of P-CABs-based treatment to classical PPIs in eradicating H.pylori were included.Exclusion criteria included case reports,case series,unpublished trials,or conference abstracts.Data variables encompassed age,diagnosis method,sample sizes,study duration,intervention and control,and H.pylori eradication method were gathered by two independent reviewers.Meta-analysis was performed in R software,and forest plots were generated.RESULTS A total of 256 references were initially retrieved through the search command.Ultimately,fifteen studies(7 RCTs,7 retrospective observational studies,and 1 comparative unique study)were included,comparing P-CAB triple therapy to PPI triple therapy.The intention-to-treat analysis involved 8049 patients,with 4471 in the P-CAB intervention group and 3578 in the PPI control group across these studies.The analysis revealed a significant difference in H.pylori eradication between VPZ triple therapy and PPI triple therapy in both RCTs and observational studies[risk ratio(RR)=1.17,95%confidence interval(CI):1.11-1.22,P<0.0001]and(RR=1.13,95%CI:1.09-1.17,P<0.0001],respectively.However,no significant difference was found between tegoprazan(TPZ)triple therapy and PPI triple therapy in both RCTs and observational studies(RR=1.04,95%CI:0.93-1.16,P=0.5)and(RR=1.03,95%CI:0.97-1.10,P=0.3),respectively.CONCLUSION VPZ-based triple therapy outperformed conventional PPI-based triple therapy in eradicating H.pylori,positioning it as a highly effective first-line regimen.Additionally,TPZ-based triple therapy was non-inferior to classical PPI triple therapy.

Baeyer-Villiger oxidation of cyclic ketones utilizing potassium peroxydisulfate(K_2S_2O_8) or sodium perborate(NaBO_3) in acidic media

The efficient, green, facile, mild and straightforward conversion procedure for the oxidation of cyclic ketones to lactones at room temperature utilizing potassium peroxydisulfate （K2S2O8） in acidic media is satisfactory to high yields without using traditional chlorinated solvents is reported. This oxidative reagent is cheap and friendly environmental procedure for industrial purposes than use of organic peracids.

Role of potassium in acid secretion

Potassium (K+) ions are critical for the activation and catalytic cycle of the gastric H+,K+-ATPase, resulting in the secretion of hydrochloric acid into the parietal cell canaliculus. As both symptom, severity and esophageal mucosal damage in gastro-esophageal reflux disease (GERD) are related to the degree of acid exposure, K+ is a logical target for approaches to inhibit acid production.The probable K+ binding site on the gastric H+,K+-ATPase has recently been described and studies are elucidating how K+ activates the enzyme. K+ channels in the apical membrane of the parietal cell are implicated in the recycling of K+ and, to date, three potential K+ channels (KCNQ1, Kir2.1 and Kir4.1) have been identified. The channels represent theoretical sites for agents to control acid secretion but it will be difficult to develop selective blockers. An alternative strategy is to prevent K+ from activating gastric H+,K+-ATPase; the potassiumcompetitive acid blocker (P-CAB) class inhibits acidsecretion by binding at or near the K+ binding site.Ongoing research is further defining the role of K+ in the functioning of the gastric H+,K+-ATPase, as well as determining the clinical utility of agents directed toward this important cation.

Effect of manganese and potassium addition on CeO_2-Al_2O_3 catalyst for hydrogenation of benzoic acid to benzaldehyde

A series of Mn/CeO2-Al2O3 and K/CeO2-Al2O3 catalysts for hydrogenation of benzoic acid to benzaldehyde were prepared to in- vestigate the effect of Mn, K addition on CeO2-Al2O3 catalyst. X-ray diffraction (XRD) and H2-temperature-programmed reduction (H2-TPR) results suggested that the interaction between CeO2 and MnOx enhanced the reducibility of catalysts and therefore benzoic acid conversion. The addition of K increased the number of basic number on the catalyst which leads to a high selectivity to benzaldehyde, but excessive addition imposed negative effects on the catalyst performance. A Mn-K/CeO2-Al2O3 catalyst was developed and investigated in the reaction. The simultaneous addition of Mn and K enhanced not only the catalytic activity but also the capacity to resist the coke formation over catalyst.

Effects of unsaturated fatty acids on calcium-activated potassium current in gastric myocytes of guinea pigs

AIM: To investigate the effects of exogenous unsaturated fatty acids on calcium-activated potassium current [IK(Ca)] in gastric antral circular myocytes of guinea pigs. METHODS: Gastric myocytes were isolated by collagenase from the antral circular layer of guinea pig stomach. The whole-cell patch clamp technique was used to record /K(Ca) in the isolated single smooth muscle cells with or without different concentrations of arachidonic acid (AA), linoleic acid (LA), and oleic acid (OA). RESULTS: AA at concentrations of 2,5 and 10 μmol/L markedly increased IK(Ca) in a dose-dependent manner. LA at concentrations of 5, 10 and 20 μmol/L also enhanced /K(Ca) in a dose-dependent manner. The increasing potency of AA, LA, and oleic acid (OA) on /K(Ca)at the same concentration (10μmol/L) was in the order of AA>LA>OA. AA (10 μmol/L)-induced increase of Ik(ca) was not blocked by H-7 (10 μmol/L), an inhibitor of protein kinase C (PKC), or indomethacin (10 μmol/L), an inhibitor of the cyclooxygenase pathway, and 17-octadecynoic acid (10 μmol/L), an inhibitor of the cytochrome P450 pathway, but weakened by nordihydroguaiaretic acid (10μmol/L), an inhibitor of the lipoxygenase pathway. CONCLUSION: Unsaturated fatty acids markedly increase Ik(Ca), and the enhancing potencies are related to the number of double bonds in the fatty acid chain. The lipoxygenase pathway of unsaturated fatty acid metabolism is involved in the unsaturated fatty acid-induced increase of IK(Ca) in gastric antral circular myocytes of guinea pigs.

Liver injury after aluminum potassium sulfate and tannic acid treatment of hemorrhoids

We are reporting a rare case of acute liver injury that developed after an internal hemorrhoid treatment with the aluminum potassium sulfate and tannic acid(ALTA) regimen. A 41-year-old man developed a fever and liver injury after undergoing internal hemorrhoid treatment with a submucosal injection of ALTA with lidocaine. The acute liver injury was classified clinically as hepatocellular and pathologically as cholestastic. We could not classify the mechanism of injury. High eosinophil and immunoglobulin E levels characterized the injury,and a drug lymphocyte stimulation test was negative on postoperative day 25. Fluid replacement for two weeks after hospitalization improved the liver injury. ALTA therapy involves injecting chemicals into the submucosa,from the rectum to the anus,and this is the first description of a case that developed a severe liver disorder after this treatment; hence,an analysis of future cases as they accumulate is desirable.

Aluminum potassium sulfate and tannic acid sclerotherapy for Goligher Grades Ⅱ and Ⅲ hemorrhoids: Results from a multicenter study

AIM: To show that aluminum potassium sulfate and tannic acid(ALTA) sclerotherapy has a high success rate for Grade Ⅱ and Ⅲ hemorrhoids.METHODS: This study was based on the clinical data of 604 patients with hemorrhoids who underwent ALTA sclerotherapy between January 2009 and February 2015. The objective of this study was to assess the efficacy of this treatment for Grades Ⅱ and Ⅲ hemorrhoids. Preoperative and postoperative symptoms, complications and success rate were all assessed retrospectively. Follow-up consisted of a simple questionnaire, physical examination and an anoscopy. Patients were followed-up at one day, one week, two weeks, one month, one year, two years, three years, four years and five years after the ALTA sclerotherapy.RESULTS: One hundred and sixty-nine patients were diagnosed with Grade Ⅱ hemorrhoids and 435 patients were diagnosed with Grade Ⅲ hemorrhoids. The one year, three year and five year cumulative success rates of ALTA sclerotherapy for Grades Ⅱ and Ⅲ hemo-rrhoids were 95.9% and 93.1%; 89.3% and 83.7%; and 89.3% and 78.2%, respectively. No significant differences were observed in the cumulative success rates after ALTA sclerotherapy between Grades Ⅱ and Ⅲ hemorrhoids(P = 0.09). There were forty-seven post-operative complications(low grade fever; anal pain; urinary retention; rectal ulcer; and others). No serious or life-threatening complications occurred and all cases improved through conservative treatment. At univariate analysis there were no predictive factors of failure.CONCLUSION: ALTA sclerotherapy has had a high success rate for Grade Ⅱ and Ⅲ hemorrhoids during five years of post-operative treatment. However, additional studies are needed to evaluate the efficacy of this ALTA sclerotherapy in the management of hemorrhoidal disease.

Usefulness of vonoprazan,a potassium ion-competitive acid blocker,for primary eradication of Helicobacter pylori

AIM To investigate usefulness of triple therapy with vonoprazan,a potassium ion-competitive acid blocker and antibiotics,for Helicobacter pylori(H.pylori) eradication.METHODS The H.pylori eradication rate was examined in 2507 patients(2055 undergoing primary eradication and 452 undergoing secondary eradication,excluding patients with subtotal gastrectomy) at the Japanese Red Cross Kyoto Daiichi Hospital from March 2013 to September 2015.For patients treated from March 2013 to February 2015,a proton pump inhibitor(PPI) was used to reduce acid secretion,while vonoprazan was used after March 2015.The success rates of the 2 regimens(PPI + amoxicillin + clarithromycin/metronidazole,or vonoprazan + amoxicillin + clarithromycin/metronidazole) were compared.RESULTS The success rate of primary H.pylori eradication was significantly higher in the vonoprazan group.When stratified by the underlying disease,a significant increase of the H.pylori eradication rate was observed in patients with chronic gastritis.A significantly lower H.pylori eradication rate was observed in younger patients compared to older patients in the PPI group,but there was no difference according to age in the vonoprazan group.On the otherhand,the success rate of secondary eradication was similar at approximately 90% in both groups.CONCLUSION Vonoprazan is very useful for primary eradication of H.pylori,and may become a first-line acid secretion inhibitor instead of PPIs.

Synthesis of Nicotinic Acid by Potassium Dichromate Oxidation

Nicotinic acid was synthesized from 3 methylpyridine with potassium dichromate as the oxidant. The reaction conditions, the product separation and analysis were studied. The results indicate that under the certain reaction conditions, the yield of nicotinic acid can reach 67.4%, the conversion can reach 99.7% and the selectivity can be as high as 99.8%. The final product has a high purity.

OsbZIP72 Is Involved in Transcriptional Gene-Regulation Pathway of Abscisic Acid Signal Transduction by Activating Rice High-Affinity Potassium Transporter OsHKT1;1

We created CRISPR-Cas9 knock-out and overexpressing OsbZIP72 transgenic rice plants to gain a better understanding of the role and molecular mechanism of OsbZIP72 gene in stress tolerance,which has remained largely elusive.OsbZIP72 was expressed and integrated into rice transgenic plant genomes,and the OsbZIP72 transcript in overexpression lines was elicited by salinity,abscisic acid(ABA)and drought stresses.OsbZIP72 overexpressing plants showed higher tolerance to drought and salinity stresses,while knock-out transgenic lines showed higher sensitivity to these stresses.The differentially expressed genes(DEGs)from RNA-sequencing data encompassed several abiotic stress genes,and the functional classification of these DEGs demonstrated the robust transcriptome diversity in OsbZIP72.Yeast one-hybrid,along with luciferase assay,indicated that OsbZIP72 acted as a transcriptional initiator.Remarkably,electrophoresis mobility assay revealed that OsbZIP72 bound directly to the ABAresponsive element in the OsHKT1;1 promoter region and activated its transcription.Overall,our findings revealed that OsbZIP72 can act as a transcriptional modulator with the ability to induce the expression of OsHKT1;1 in response to environmental stress through an ABA-dependent regulatory pathway,indicating that OsbZIP72 can play a crucial role in the ABA-mediated salt and drought tolerance pathway in rice.

Wet carbon-based solid acid/potassium permanganate as an efficient heterogeneous reagents for oxidation of alcohols under mild conditions

Wet carbon-based solid acid and potassium permanganate were used as new reagents for oxidation of alcohols to their corresponding aldehydes and ketones in heterogeneous mixtures. The experiments were done moderately at mild condition and high yields in suitable times were obtained.

Chlorogenic acid alters the voltage-gated potassium channel currents of trigeminal ganglion neurons

Chlorogenic acid（5-caffeoylquinic acid, CGA） is a phenolic compound that is found ubiquitously in plants, fruits and vegetables and is formed via the esterification of caffeic acid and quinic acid. In addition to its notable biological functions against cardiovascular diseases, type-2 diabetes and inflammatory conditions, CGA was recently hypothesized to be an alternative for the treatment of neurological diseases such as Alzheimer＇s disease and neuropathic pain disorders. However, its mechanism of action is unclear.Voltage-gated potassium channel（Kv） is a crucial factor in the electro-physiological processes of sensory neurons. Kv has also been identified as a potential therapeutic target for inflammation and neuropathic pain disorders. In this study, we analysed the effects of CGA on the two main subtypes of Kv in trigeminal ganglion neurons, namely, the IK,Aand IK,Vchannels. Trigeminal ganglion（TRG）neurons were acutely disassociated from the rat TRG, and two different doses of CGA（0.2 and 1 mmol·L21） were applied to the cells.Whole-cell patch-clamp recordings were performed to observe alterations in the activation and inactivation properties of the IK,Aand IK,Vchannels. The results demonstrated that 0.2 mmol·L21CGA decreased the peak current density of IK,A. Both 0.2 mmol·L21and1 mmol·L21CGA also caused a significant reduction in the activation and inactivation thresholds of IK,Aand IK,V. CGA exhibited a strong effect on the activation and inactivation velocities of IK,Aand IK,V. These findings provide novel evidence explaining the biological effects of CGA, especially regarding its neurological effects.

Relationship between Obesity, Serum Uric Acid, Serum Potassium and Glomerular Filtration Rate with Electric Left Ventricular Hypertrophy in Blacks Central Africans with High Blood Pressure

The authors conducted a retrospective study over a period of 6 months in a hypertensive population in order to determine the correlation between serum uric acid on glomerular filtration rate (GFR) and estimated serum potassium with left ventricular hypertrophy (LVH) and obesity. This study enrolled 122 patients including 63 women (51.6%). The mean age was 55.9 ± 10.6 years (range 30 to 74 years). Obesity weight was found in 38 cases (31.1%) of which 20?were men (33.9%) and 18 women (28.6%). Abdominal obesity was found in 104 cases (85.2%). The average serum uric acid in patients with obesity weight was 63.3 ± 18.9 mg/L vs 62.4 ± 14.2 mg/L for no-obese patients (p?= 0.63). The average serum potassium in obese patients was 4.06 ± 0.42 mEq/L vs 4.02 ± 0.46 mEq/L for no-obese (p?= 0.65). The average GFR was 73.4 ± 21.4 ml/L in obese patients vs 66.6 ± 22.6 ml/min in no-obese (p?= 0.03). The LVH was found in 81 cases (66.4%). The LVH was found in 65 (62.5%) obese patients vs?16 (88%) non-obese patients (OR = 4.8, 95% 1.04?-?22?p?= 0.02). Only abdominal?obesity has been correlated with left ventricular hypertrophy after multivariate analysis. Emphasis must be focused on public health actions for effective and appropriate measures against obesity and hypertension, whose prevalence is increasing in our region.

Oxidative Desulfurization of Model Sulfur Compound by Potassium Ferrate in the Presence of Phosphomolybdic Acid Catalyst

In this work, the removal of thiophene from simulated oil has been studied by using the adsorption, extraction and oxidation/adsorption methods, respectively. In the adsorptive desulfurization process, different commercial adsorbents were used to eliminate thiophene at ambient pressure and mild temperature, and the results showed that carbon powder had the best adsorption ability. In the extractive desulfurization process, the best desulfurization result was obtained when DMF is used. In the oxidative/adsorptive desulfurization procedure using synthesized potassium ferrate as the oxidant and phosphomolybdic acid solution as the catalyst, thiophene was oxidized and removed from hydrocarbons in combination with active carbon adsorption, and the residual sulfur content of simulated oil could be reduced to 15.3mg/L from the original level of 200mg/L, with the desulfurization rate reaching 92.3%.

Application of Biochemical Fulvic Acid Potassium in Transplantation of Trees

[Objective]The paper was to clarify the application of biochemical fulvic acid potassium on the survival rate and growth of various trees transplanted in the process of landscaping.[Method]Two experimental treatments(i.e.decomposed organic fertilizer+biochemical fulvic acid potassium water soluble fertilizer,decomposed organic fertilizer+compound fertilizer)were designed to determine the changes in physical and chemical properties before and after soil treatment,and the survival rate,plant height and ground diameter of four different cultivated plants within one year,and the effects of applying biochemical fulvic acid potassium on cultivated plants were investigated.[Result]The soil organic matter,total nitrogen,alkali-hydrolyzable nitrogen,soil available phosphorus,soil available potassium and p H value in the soil treated with decomposed organic fertilizer+biochemical fulvic acid potassium soluble fertilizer,and decomposed organic fertilizer+compound fertilizer increased significantly,and the soil bulk density decreased obviously.The survival rates,plant heights and ground diameters of four different cultivated plants were significantly improved after application of decomposed organic fertilizer+biochemical fulvic acid potassium water soluble fertilizer,and decomposed organic fer-tilizer+compound fertilizer(P<0.05).[Conclusion]The application of biochemical fulvic acid potassium on cultivated plants effectively improved soil fertility,increased the utilization of nitrogen,phosphorus and potassium,improved the growth of plants,and promoted the growth of landscaping plants after transplantation.

Potassium-competitive acid blockers-are they the next generation of proton pump inhibitors?

The modern lifestyle caters to an increase in the incidence of peptic ulcer disease,gastroesophageal reflux disease and several other acid-related conditions of the gut. The drugs to prevent these conditions work either through H2 receptor blockade or inhibition of the H^+, K^+ ATPase enzyme. Although proton pump inhibitors have been proven to be efficacious, they have a slow onset of action with limited resolution of symptoms in most patients. Potassium-competitive acid blockers(P-CABs) are novel drugs that bind reversibly to K^+ ions and block the H^+, K^+ ATPase enzyme, thus preventing acid production. P-CABs have a fast onset of action and have dose-dependent effects on acid production. Animal studies exist that differentiate the better results of P-CABs from proton pump inhibitors; further human trials will give a comprehensive picture of the results and will help to elucidate the therapeutic benefits of this new group of drugs.

Silencing gamma-aminobutyric acid A receptor alpha 1 subunit expression and outward potassium current in developing cortical neurons

We used RNA interference （RNAi） to disrupt synthesis of the cortical neuronal y-aminobutyric acid A receptor （GABAAR） al in rats during development, and measured outward K＋ currents during neuronal electrical activity using whole-cell patch-clamp techniques. Three pairs of small interfering RNA （siRNA） for GABAAR al subunit were designed using OligoEngine RNAi software. This siRNA was found to effectively inhibited GABAAR al mRNA expression in cortical neuronal culture in vitro, but did not significantly affect neuronal survival. Outward K^currents were decreased, indicating that GABAAR al subunits in developing neurons participate in neuronal function by regulating outward K＋ current.

Soybean Seed Protein, Oil, Fatty Acids, and Isoflavones Altered by Potassium Fertilizer Rates in the Midsouth

Previous research has shown that the effect of potassium fertilizer on soybean ([Glycine max (L.) Merr.] seed composition (protein, oil, fatty acids, and isoflavones) is still largely unknown. Therefore, the objective of this research was to investigate the effects of potassium application on seed protein, oil, fatty acids, and isoflavones under Midsouth environmental conditions. A three-year experiment was conducted in two locations (Milan, TN and Jackson, TN). Potassium (K) rates were applied in the form of K2O at a rate of 0 (Control, C), 45 (T1), 90 (T2), 134 (T3), and 179 (T4) kg·ha-1 in a randomized complete block design. The results showed that increasing the K application rate did not result in consistent effects on yield. However, increasing K application rate did increase protein, oleic acid, and individual and total isoflavone concentrations at both locations in 2008 and 2009. In Jackson in 2010, the increase of K rate did not change oleic acid, but resulted in an increase in glycitein and genistein isoflavone concentrations. In 2010, increasing K application rate increased protein concentrations, decreased individual and total isoflavones, and did not change oleic acid concentration at Milan. At the highest rate of K, 179 kg·ha-1, yield and some seed composition constituents were negatively impacted. Generally, K concentration in leaves at V5, R1, R3, and seed at harvest maturity stage (R8) increased with the increase of K rate applications. The research demonstrated that K application can alter seed composition, but this alteration depended on location, environmental stress factors, mainly heat and drought, K level in soil, and K application rate. Higher rates of K application may negatively impact seed composition constituents.

Potassium Dichromate Surface Modification of Polyglycolic Acid (PGA) Multifilament

For improving its hydrophilicity and biocompatibility,and preserving filament mechanical properties at the same time,polyglycolic acid( PGA) filament was modified by potassium dichromate solution with different processing time. Breaking force and water contact angle were tested. Surface changes before and after surface modifications were tested with scanning electron microscopy(SEM). Furthermore,differential scanning calorimeter(DSC) and Fourier transform infrared spectrometry(FTIR) were used to analyze the changes of molecular structure and functional group. Experimental results showed that 6 min was the most suitable time for improving hydrophilicity of PGA filament and preserving its mechanical properties.

Influence of Potassium Nutrition and Exogenous Organic Acids on Iron Uptake by Monocot and Dicot Plants

Iron (Fe) is a vital element for the survival and proliferation of all plants;therefore, Fe-biofortification by the application of chemical and organic fertilizers is being as an effective approach to fight hidden hunger retards the growth and development of crop plants. Two experiments were carried out to investigate the effect of potassium and exogenous organic acids on iron uptake by two different plants: one is monocotyledon, maize (Zea mays L.) and the second is dicotolydon pea (Pisum sativum L.) grown under controlled conditions. The seedlings were grown in sand culture in a greenhouse experiment and irrigated with one-tenth strength modified nutrient solution of Hoagland and Arnon as a base solution (pH 7.5), containing different iron treatments (0, 1, and 5 ppm as FeSO4·7H2O) combined with potassium nutrition (0, 5, 10, and 50 ppm as K2SO4). After 30 days, the best interaction treatment was selected for further experiment including 5.0 ppm Fe as FeSO4.7H2O and 50 ppm K as K2SO4 in combination with 1 × 10-5 mole/liter of one of the following organic acids: Citric acid, Oxalic acid, Formic acid, Acetic acid, Propionic acid, Tartaric acid, Succinic acid, Fumaric acid, Malic acid, Glutamic acid, besides the free organic acid nutrient solution as a control. Results revealed that the interaction between 5.0 ppm Fe and 50 ppm K was the best interaction treatment for increasing biomass production and iron uptake of maize and pea seedlings under applied condition. Furthermore, exogenous application of organic acids improves uptake and translocation of nutrient such as iron, potassium and phosphorus by the maize and pea plants. In conclusion, potassium nutrition and exogenous organic acids have the potential to stimulate Fe-uptake of monocot and dicot plants and mediate iron-biofortified crops.