Protons motility

Peptic ulcer disease is associated with Helicobacter pylori infection in 90% of patients with gastric and duodenal ulceration. Elimination of H. pylori infection with antibiotics heals the peptic ulcer and the associated symptoms. Combination therapy with antibiotics, anti-secretory agents, namely H2-receptor antagonists or proton pump inhibitors, and bismuth salts has significantly improved the clinical outcome of peptic ulcer disease. Not all strains of H. pylori cause peptic ulcer disease, and other factors are necessary for H. pylori colonization and disease to occur. Flagellated motile bacteria resist peristalsis and adhere to gastric epithelium in a highly specific manner. 

Many elderly patients have decreased host defense mechanisms such as saliva production. More aggressive therapy with a proton pump inhibitor may be warranted in patients with symptomatic GERD in patients older than 60 years of age. Often these patients do not seek medical attention because they feel their symptoms are part of the normal aging process. They may present with atypical symptoms such as chest pain, asthma, hoarseness, coughing, wheezing, poor dentition, or jaw pain. Decreased GI motility is a common problem in elderly patients. Unfortunately, there are no good prokinetic agents available to these patients. 

Khan, S. and Macnab, R.M. (1980). Proton chemical potential, proton electrical potential, and bacterial motility./. Mol. Biol. 138, 599-614. 

The energy source for the motility is, again, more diverse in prokaryotes proton-motive force, sodium-motive force, or ATP. In eukaryotes, the energy source appears to be solely ATP. This may simply be due to the fact that, in prokaryotes only, the proton- or sodium-motive force is readily available for the motility organelle. There, the ion gradient is maintained across the cytoplasmic membrane. In eukaryotic cells, the ion gradient is maintained across the mitochondrial membrane and is, therefore, not directly available for motility. The outcome is that the molecular mechanisms underlying motility of eukaryotic cells are less diverse than those of prokaryotic cells. 

FLAGELLA - imdulating motion that creates force in the same direction as the axis of flagellum - its motility does not depend directly by ATP but by a protons gradient on one and other side of the membrane. rnym... 

The PPIs are prodrugs, activated by exposure to pHs less than 5. Once activated, the drugs bind irreversibly to the H+, K+- ATPase (the proton pump ) in the parietal ceU apical membrane, inhibiting its activity and decreasing gastric acid production by more than 95 %. The process is irreversible in that new enzyme needs to be produced to overcome the inhibition. PPIs have little effect on gastric acid volume and do not affect gastric motility. 

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