Outlook and potential for new drugs to optimize the quality of ulcer healing

Present therapy: Treatment of peptic ulceration is dominated by antisecretory drugs, and the prospect of developing new ulcer healing agents, irrespective of their effect on the quality of ulcer healing, must be considered bleak. Growth factors: Growth factors have long been known to stimulate repair of epidermal and epithelial wounds. The additional property of acid inhibition makes peptides such as urogastrone (human epidermal growth factor) potentially attractive as anti-ulcer agents. Indeed, growth factors appear to have superseded prostaglandins as the major target for ulcer research. However, potent mitogens are likely to present far greater problems than omeprazole in preclinical carcinogenicity testing and, consequently, it is unlikely that wound-healing agents will ever be developed by the pharmaceutical industry for ulcer therapy. Eradication of Helicobacter pylori: A simple and effective treatment for eradicating H. pylori is a more realistic target for future research. Since this strategy can prevent ulcer recurrence, anti-H. pylori therapy must, by definition, induce the best quality of healing. The prospect that H. pylori eradication might also inhibit the development of gastric cancer provides an added stimulus which may eventually lead to the introduction of a vaccine.