Table 3 Summary of key effects of acid suppressing agents in relation to multiple sclerosis
Agent | Response |
|---|---|
H2R antagonists | No reports of acute worsening of MS disease status Increases EAE incidence Promotes Th1 and Th17 responses Promotes production of proinflammatory cytokines Promotes T cell response, for example, proliferation Promotes suppression of Th2 response Block suppression of dendritic cells |
PPIs | No reports of acute worsening of MS disease status Not studied in EAE Suppresses reactive oxygen species Lessens expression of adhesion molecules Suppresses production of proinflammatory cytokines |
Increased gastric pH (H2R antagonists, PPIs, or antacids) | No reports of acute worsening of MS disease status Possibly alters microflora in the stomach and small intestine Possibly alters neutrophil response Can lead to vitamin B12 deficiency |