To the Editor We read with interest the article by Gomm and colleagues1 on an association between proton pump inhibitors and dementia. Concerning a possible mechanism, we would like to focus on our 2 previous studies showing that acidic gastric juice protected mice against prion infection.2,3 Prions are well known to induce neurodegeneration.4 The role of the gastric juice in the defense against infections has been underestimated, particularly for prion infections because prion infectivity is preserved after acid exposure. However, gastric juice is not only an acid, but a unique combination of a highly acidic juice with proteolytic and even lipolytic activities. Biological functions, such as production of gastric juice, should not be taken away unnecessarily.
Waldum HL, Martinsen TC. Proton Pump Inhibitors and Dementia Incidence. JAMA Neurol. 2016;73(8):1026. doi:10.1001/jamaneurol.2016.1497