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Influence of CYP2C19 polymorphism and Helicobacter pylori genotype determined from gastric tissue samples on response to triple therapy for H pylori infection.
- Source :
-
Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association [Clin Gastroenterol Hepatol] 2005 Jun; Vol. 3 (6), pp. 564-73. - Publication Year :
- 2005
-
Abstract
- Background & Aims: The relationship between single nucleotide polymorphisms (SNPs) and clinical outcomes has been intensively studied. We intended to determine SNPs of CYP2C19 and 23S rRNA of Helicobacter pylori by using rapid urease test (RUT)-positive gastric mucosal samples.<br />Methods: One hundred thirty-nine patients with H pylori -positive results based on RUT completed 1-week treatment with lansoprazole 30 mg twice a day, clarithromycin 200 mg 3 times daily, and amoxicillin 500 mg 3 times daily. SNPs from adenine to guanine at positions 2142 and 2143 of 23S rRNA of H pylori (A2142G and A2143G) and SNPs from guanine to adenine at positions 681 in exon 5 (* 2 ) and 636 in exon 4 (* 3 ) of CYP2C19 were determined by the serial invasive signal amplification reaction assay by using DNAs extracted from gastric tissue samples already used for RUT. Minimum inhibitory concentrations of clarithromycin for H pylori were determined by culture test. CYP2C19 genotypes were classified into the rapid metabolizer (* 1 /* 1 ), intermediate metabolizer (* 1 /* 2 or * 1 /* 3 ), and poor metabolizer (* 2 /* 2 , * 2 /* 3 , or * 3 /* 3 ) groups.<br />Results: H pylori strains with A2142G or A2143G mutation had higher minimum inhibitory concentrations for clarithromycin. Cure rates in rapid, intermediate, and poor metabolizer groups were 57.8% (95% confidence interval, 42.1%-72.4%), 88.2% (78.1%-94.8%), and 92.3% (74.9%-99.1%), respectively ( P < .001). Cure rates in strains with and without A2142G or A2143G mutation were 48.3% (29.4%-67.5%) and 87.3% (79.5%-92.7%), respectively ( P < .001).<br />Conclusions: SNPs of CYP2C19 and 23S rRNA of H pylori using RUT-positive gastric mucosal samples could be predictable determinants for H pylori eradication by triple therapy.
- Subjects :
- 2-Pyridinylmethylsulfinylbenzimidazoles
Adolescent
Adult
Aged
Amoxicillin therapeutic use
Aryl Hydrocarbon Hydroxylases metabolism
Biopsy
Clarithromycin therapeutic use
Colony Count, Microbial
Cytochrome P-450 CYP2C19
Endoscopy, Gastrointestinal
Female
Gastric Mucosa metabolism
Gastritis drug therapy
Gastritis metabolism
Gastritis microbiology
Genotype
Helicobacter Infections metabolism
Helicobacter Infections microbiology
Humans
Lansoprazole
Male
Middle Aged
Mixed Function Oxygenases metabolism
Mutation
Omeprazole analogs & derivatives
Omeprazole therapeutic use
Polymerase Chain Reaction
RNA, Bacterial drug effects
RNA, Bacterial genetics
RNA, Ribosomal, 23S drug effects
Treatment Outcome
Anti-Infective Agents therapeutic use
Aryl Hydrocarbon Hydroxylases genetics
Gastric Mucosa microbiology
Helicobacter Infections drug therapy
Helicobacter pylori genetics
Helicobacter pylori isolation & purification
Mixed Function Oxygenases genetics
Polymorphism, Restriction Fragment Length
RNA, Ribosomal, 23S genetics
Subjects
Details
- Language :
- English
- ISSN :
- 1542-3565
- Volume :
- 3
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
- Publication Type :
- Academic Journal
- Accession number :
- 15952098
- Full Text :
- https://doi.org/10.1016/s1542-3565(04)00779-7