avkАрхивъ внутренней медициныThe Russian Archives of Internal Medicine2226-67042411-6564“SINAPS” LLC10.20514/2226-6704-2022-12-4-245-253avk-1477Research ArticleЛЕКЦИИLECTURESИнгибиторы протонной помпы в период пандемии COVID-19Proton Pump Inhibitors in the COVID-19 Pandemichttps://orcid.org/0000-0001-5547-6741КуглерТ. Е.KuglerT. E.

Донецк

 

Donetsk

МаловичкоИ. С.MalovichkoI. S.

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Donetsk

https://orcid.org/0000-0003-3813-8200ГнилицкаяВ. Б.GnilitskayaV. B.

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Donetsk

https://orcid.org/0000-0002-9954-4715ХристуленкоА. Л.KhristulenkoA. L.

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Donetsk

ЯроваяН. Ф.YarovayaN. F.

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Donetsk

ГОО ВПО «Донецкий национальный медицинский университет им. М. Горького»ДНРState Educational Organization of Higher Professional Education «M. Gorky Donetsk National Medical University»DNR202229072022124245253Copyright © Куглер Т.Е., Маловичко И.С., Гнилицкая В.Б., Христуленко А.Л., Яровая Н.Ф., 20222022Куглер Т.Е., Маловичко И.С., Гнилицкая В.Б., Христуленко А.Л., Яровая Н.Ф.Kugler T.E., Malovichko I.S., Gnilitskaya V.B., Khristulenko A.L., Yarovaya N.F.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.medarhive.ru/jour/article/view/1477

Безопасность применения ингибиторов протонной помпы (ИПП) при коронавирусной инфекции (COVID-19) является недостаточно изученной. ИПП являются мощными супрессорами желудочной секреции и входят в десятку наиболее широко используемых препаратов в мире. Предполагается, что препараты влияют на восприимчивость к вирусу, тяжесть течения и исходы у пациентов с диагнозом COVID-19. Это беспокойство основано на механизме действия ИПП — подавлении кислотности желудочного сока, который считается первой линией защиты от инфекций. В совокупности результаты большинства исследований и метаанализов подтверждают возможность того, что использование ИПП может способствовать развитию более тяжелой формы COVID-19. Однако учесть все потенциальные факторы риска тяжести COVID-19 в реальной клинической практике представляется затруднительным, поэтому следует с большой осторожностью относиться к выводам о причинно-следственных связях применения ИПП. Дополнительная интересная точка зрения на использование ИПП во время пандемии заключается в том, что их прием может привести к снижению всасывания некоторых витаминов. С другой стороны, в литературе появилось несколько исследований в отношении защитных терапевтических эффектов ИПП. Все больше доказательств иммуномодулирующей и антифиброзной роли ИПП, что может быть использовано в лечении COVID-19. Кроме того, способность препаратов подщелачивать содержимое эндосом и лизосом служит препятствием для проникновения вируса в клетки. В представленном обзоре проанализированы возможные эффекты приема ИПП у пациентов с COVID-19.

The safety of proton pump inhibitors (PPIs) use in coronavirus infection (COVID-19) is not well understood. PPIs are potent suppressors of gastric secretion and become one of the ten most widely used drugs in the world. They are expected to influence virus susceptibility, severity, and outcomes in patients diagnosed with COVID-19. This concern is based on their mechanism of action — suppression of gastric acidity, which is considered the first line of defense against infections. Taken together, the results of most studies and meta-analyses support that PPIs use has been associated with increased risk of COVID-19 and severe outcomes. However, taking into account all potential risk factors for disease severity seems impossible in the real world in the context of COVID-19, so conclusions about causal relationships between PPI use and COVID-19 should be treated with great caution. An additional interesting point about the use of PPIs in the pandemic is that it reduced absorption of certain vitamins. On the other hand, several studies have appeared in the literature regarding the protective therapeutic effects of PPIs. There is growing evidence of an immunomodulatory and antifibrotic role of PPIs that could be used in the treatment of COVID-19. In addition, their ability to alkalize the contents of endosomes and lysosomes serves as an obstacle to the penetration of the virus into host cells. This review analyzes the possible effects of PPIs in patients with COVID-19.

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The authors declare that there are no conflicts of interest present.