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Ion-transport mechanisms evolve by changing ion-selectivity, such as switching from Na to H selectivity in secondary-active transporters or P-type-ATPases. Here we study primary-active transport via P-type ATPases using functional and structural analyses to demonstrate that four simultaneous residue substitutions transform the non-gastric H/K pump, a strict H-dependent electroneutral P-type ATPase, into a bona fide Na-dependent electrogenic Na/K pump. Conversion of a H-dependent primary-active transporter into a Na-dependent one provides a prototype for similar studies of ion-transport proteins. Moreover, we solve the structures of the wild-type non-gastric H/K pump, a suitable drug target to treat cystic fibrosis, and of its Na/K pump-mimicking mutant in two major conformations, providing insight on how Na binding drives a concerted mechanism leading to Na/K pump phosphorylation.
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http://dx.doi.org/10.1038/s41467-022-32793-0 | DOI Listing |
Over the past decades, acid production in the stomach has been regulated mainly by proton pump inhibitors (PPIs). However, despite their widespread use and solid evidence base for efficacy, PPIs have pharmacokinetic and pharmacodynamic limitations, such as a slow onset of action, response variability (dependent on CYP2C19 polymorphisms), and the need for activation in an acidic environment. These restrictions underscore the need for innovative molecular approaches to inhibiting acid production, which led to the development of a fundamentally different mechanism of action - potassium-competitive acid blockers (P-CABs), first introduced into clinical practice in 2015.
View Article and Find Full Text PDFAnn Med
December 2025
The First School of Clinical Medicine, Lanzhou University, Lanzhou, Gansu Province, China.
() infection is a primary pathogen responsible for gastrointestinal diseases, including gastritis, peptic ulcer disease, and gastric cancer. Therefore, the eradication of is crucial for the prevention and treatment of these conditions. However, the increasing antibiotic resistance has led to a gradual decline in the efficacy of traditional Proton Pump Inhibitors (PPIs) in triple or quadruple therapy, posing new challenges for eradication.
View Article and Find Full Text PDFFront Pharmacol
July 2025
Department of Cardiology and Clinical Pharmacology, Faculty of Health Sciences, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland.
The document comprehensively reviews proton pump inhibitors (PPIs), focusing on their pharmacodynamics, pharmacokinetics, drug interactions, toxicity, and clinical efficacy. PPIs irreversibly inhibit the H+/K+-ATPase enzyme in gastric parietal cells, effectively reducing gastric acid secretion. These drugs are widely prescribed for conditions like gastroesophageal reflux disease (GERD), peptic ulcer disease, eradication of and as a prevention against bleeding from gastrointestinal tract.
View Article and Find Full Text PDFParkinsons Dis
July 2025
Department of Clinical Sciences Lund, Faculty of Medicine, Lund University, Lund, Sweden.
It is unclear whether the two device-aided therapies (DATs: deep brain stimulation [DBS] and levodopa-carbidopa intestinal gel [LCIG]) affect personality in patients with Parkinson's disease (PD). This retrospective study aims to explore if patients with PD and their close relatives experience any changes in the patient's personality following the start of DAT. In total, 32 patients with DAT (17 DBS and 15 levodopa pump-based therapy) and their close relatives ( = 32) were asked to retrospectively assess potential personality changes in the patients using the Big Five Inventory (BFI) following DAT.
View Article and Find Full Text PDFTherap Adv Gastroenterol
July 2025
School of Pharmacy and Institute of New Drug Development, Jeonbuk National University, Geonji-ro 20, Jeonju 54907, Republic of Korea.
Background: Recent changes in the acid-related disease market, particularly the emergence of potassium-competitive acid blockers (P-CABs), require an updated analysis of trends in gastric acid suppressant utilization.
Objectives: As the use of P-CAB expands globally, a cross-sectional study is needed to assess its association with potential adverse events from a pharmacovigilance perspective.
Design: Cross-sectional study.