Effect of Omeprazole Dose, Nonsteroidal Anti-inflammatory Agents, and Smoking on Repair Mechanisms in Acute Peptic Ulcer Bleeding

Tuomo Rantanen, Marianne Udd, Teemu Honkanen, Pekka Miettinen, Vesa Kärjä, Lassi Rantanen, Risto Julkunen, Harri Mustonen, Timo Paavonen, Niku Oksala

Research output: Contribution to journalArticleScientificpeer-review

4 Citations (Scopus)


Background: Peptic ulcer bleeding (PUB) is a major cause of upper gastrointestinal bleeding. The effect of omeprazole on mucosal repair is unknown. Aims: We studied the effect of omeprazole, nonsteroidal anti-inflammatory agents, and smoking on PUB. Methods: There were 43 PUB patients who received regular or high dose of omeprazole for 72 h. Biopsies from antrum and corpus were taken before and after treatment. Biopsy samples from 20 celiac disease patients worked as controls. The expression of Ki-67, Bcl-2, COX-2, Hsp27, and Hsp70 was analyzed from patients and controls. Results: Bcl-2 expression in PUB patients was lower than in controls. However, Bcl-2 increased significantly from 5.0 (SD 4.5) to 9.1 % (SD 6.7), p = 0.0004, in the antrum after omeprazole. In univariate analysis, a high omeprazole dose caused a more profound increase in Ki-67 expression in the corpus: 35.3 % (SD 54.8) than a regular dose: −10.1 % (SD 40.6), p = 0.022. In multivariate analysis, Ki-67 decreased significantly in the corpus between the pre- and posttreatment period (p = 0.011), while a high omeprazole dose (p = 0.0265), the use of NSAIDs (p = 0.0208), and smoking (p = 0.0296) significantly increased Ki-67 expression. Bcl-2 in the corpus increased significantly (p = 0.0003) after treatment. Conclusions: Our findings suggest that Bcl-2 may be an important factor in the pathogenesis of a peptic ulcer and PUB. In addition, high-dose omeprazole increased the expression of Ki-67, which may enhance the healing process of a peptic ulcer.

Original languageEnglish
Pages (from-to)2666-2674
Number of pages9
JournalDigestive Diseases and Sciences
Issue number11
Publication statusPublished - 2014
Publication typeA1 Journal article-refereed


  • High and regular dose
  • Nonsteroidal anti-inflammatory agents
  • Omeprazole
  • Peptic ulcer bleeding
  • Repair mechanisms
  • Smoking

Publication forum classification

  • Publication forum level 1


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