PRAZANs or PCABs, Potassium Competitive Acid Blockers: A New Therapeutic Class in Acid-Related Diseases
Abstract
Acid-related diseases occur due to physiological and protective oscillation of the gastric environment that leads to excessive secretion of acid. The gastric H+/K+-ATPase, an integral membrane protein that belongs to the P2-type ATPase family, is an important enzyme, commonly known as a proton pump, which is responsible for gastric acid secretion. Indeed, it is a site of action of several proton pump inhibitors (PPIs), such as omeprazole, pantoprazole, lansoprazole, rabeprazole, etc., which act by inhibiting this enzyme. The main component of gastric acid is hydrochloric acid, which is secreted by parietal cells and plays a role in regulating the digestion process. Over-secretion or abnormality in this process leads to several acid-related diseases potentiated by the risk factors, such as bacterial infection by Helicobacter pylori, the use of drugs (NSAIDs, oral iron preparations, gastric irritants), and physiological stress that significantly cause peptic ulcer disease. Owing to the irreversible inhibition and limitations associated with the long-term use of PPIs, potassium competitive acid blockers (PCABs), also known as PRAZANs, have been developed as a novel therapeutic approach to treat acid-related diseases, such as gastric ulcers, erosive esophagitis, and gastroesophageal reflux disease (GERD). Indeed, PCABs competitively and reversibly block the potassium-binding site of the H+/K+-ATPase enzyme to reduce the excessive acid secretion with a faster onset of action than…
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