Influence of CYP2C19 functional polymorphism on Helicobacter pylori eradication

BEKAR, Aynur; SANDIKÇI, Macit; Akkız, Hikmet; ÖZDİL, Burhan; Akgöllü, Ersin; Bayram, Süleyman

Influence of CYP2C19 functional polymorphism on Helicobacter pylori eradication

Burhan ÖZDİL, (Çukurova Üniversitesi, Tıp Fakültesi, Adana, Türkiye)

Hikmet AKKIZ, (Çukurova Üniversitesi, Tıp Fakültesi, Adana, Türkiye)

Süleyman BAYRAM, (Çukurova Üniversitesi, Tıp Fakültesi, Adana, Türkiye)

Aynur BEKAR, (Çukurova Üniversitesi, Tıp Fakültesi, Adana, Türkiye)

Ersin AKGÖLLÜ, (Çukurova Üniversitesi, Tıp Fakültesi, Adana, Türkiye)

Macit SANDIKÇI (Çukurova Üniversitesi, Tıp Fakültesi, Adana, Türkiye)

Turkish Journal of Gastroenterology

2 0

Yıl: 2010 Cilt: 21 Sayı: 1 Sayfa Aralığı: 23 - 28 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Influence of CYP2C19 functional polymorphism on Helicobacter pylori eradication

Öz:

Proton pompa inhibitörler, büyük ölçüde karaciğerde bulunan sitokrom P450 2C19 (CYP2C19) enzimi tarafından metabolize edilirler. Sitokrom P450 2C19 enziminin fonksiyonel polimorfizmi proton pompa inhibitörleri asit'baskılayıcı etkilerini değiştirebilir. Bu çalışmada, sitokrom P450 2C19 polimorfizminin proton pompa inhibitörler'temelli tedavilerde Helikobakter pilori eradikasyonu üzerinde etkisini araştırmayı amaçladık. Yöntem: Bu çalışmada, Helikobakter pilori'ye bağlı kronik gastrit tanısı olan 105 hastada sitokrom P450 2C19 genotipinin sıklığını ve bu genotipin Helikobakter pilori eradikasyon oranını belirledik. Üst gastrointestinal endoskopi ve gastrik biyopsi her hastada uygulandı. Helikobakter pilori tanısı histolojik olarak konuldu. Hastalara lansoprazol, amoksisilin ve klaritromisin günde 2 kez olmak üzere 14 gün süreyle uygulandı. Helikobakter pilori eradikasyonunu belirlemek üzere tedaviden bir ay sonra tüm hastalara 13C üre-solunum testi yapıldı. sitokrom P450 2C19 polimorfizmi polimeraz zincir reaksiyonu temelli-RFLP yöntemi ile saptandı. Bulgular: Sitokrom P450 2C19 polimorfizmleri 3 gruba ayrıldı; hızlı metabolize edici, orta derecede metabolize edici ve yavaş metabolize edici olmak üzere. Hastalarımız arasında, hızlı metabolize edici %72 oranında, orta derecede metabolize edici %23 oranında ve yavaş metabolize edici ise %5 oranında belirlendi. Helikobakter pilori eradikasyon oranı hızlı metabolize edici grupta %70 oranında, orta derecede metabolize edici grupta %92 ve yavaş metabolize edici grupta ise %80 oranında saptandı. Sonuç: Bulgularımız hızlı metabolize edici grupta Helikobakter pilori eradikasyon oranının düşük olduğunu doğrulamaktadır. Tedavi öncesi sitokrom P450 2C19 genotipinin belirlenmesi tedavi başarısının öngörülmesi açısından yararlı olur. Hızlı metabolize edici hastalarda Helikobakter pilori eradikasyon oranını yükseltmek amacıyla alternatif tedaviler denenebilir.

Anahtar Kelime: Genotip Helicobacter enfeksiyonları Sitokrom P-450 enzim sistemi Proton pompa inhibitörleri Klaritromisin 2-Piridinmetilsülfinilbenzimidazol Helicobacter pylori Polimorfizm, genetik Amoksisilin

Konular: Cerrahi

CYP2C19 fonksiyonel polimorfizminin Helicobacter pylori eradikasyonu üzerine etkisi

Öz:

Proton pump inhibitors are mainly metabolized by cytochrome P450 2C19 in the liver. Recently, some studies have shown that the acid�suppressing effect of proton pump inhibitors are influenced by a functional polymorphism of cytochrome P450 2C19. The aim of the present study was to investigate the effect of cytochrome P450 2C19 polymorphism on Helicobacter pylori eradication in patients who received proton pump inhibitors�based triple therapy. Methods: We determined the incidence of cytochrome P450 2C19 genotypes and the effect of cytochrome P450 2C19 genotypes on Helicobacter pylori eradication rates in 105 patients with Helicobacter pylori-positive chronic gastritis. Upper endoscopic procedure and gastric biopsies were performed in all patients. Helicobacter pylori was demonstrated histologically. Lansoprazole, amoxicillin and clarithromycin twice a day for 14 days were prescribed for those found to be infected with Helicobacter pylori. More than one month after the medication, a 13C urea breath test was conducted to examine the success or failure of the eradication treatment. Cytochrome P450 2C19 polymorphism was analyzed by the polymerase chain reaction�restriction fragment length polymorphism method. Results: The genotypes of cytochrome P450 2C19 were classified into the three groups, as rapid extensive metabolizer, intermediate metabolizer and poor metabolizer. In our patient population, the frequencies of rapid extensive metabolizer, intermediate metabolizer and poor metabolizer were 72%, 23% and 5%, respectively. The eradication rate was 70.0% for rapid extensive metabolizer, 92% for intermediate metabolizer and 80% for poor metabolizer. The eradication rate was highest in intermediate metabolizer patients. Conclusions: The present study confirmed the low eradication rate for rapid extensive metabolizer. Our findings provide evidence that the cytochrome P450 2C19 genotype is useful to predict the success of treatment. For the rapid extensive metabolizer group, alternative regimens can be tried to increase the Helicobacter pylori eradication rates.

Anahtar Kelime: Proton Pump Inhibitors Clarithromycin 2-Pyridinylmethylsulfinylbenzimidazoles Helicobacter pylori Polymorphism, Genetic Amoxicillin Genotype Helicobacter Infections Cytochrome P-450 Enzyme System

Konular: Cerrahi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	ÖZDİL B, Akkız H, Bayram S, BEKAR A, Akgöllü E, SANDIKÇI M (2010). Influence of CYP2C19 functional polymorphism on Helicobacter pylori eradication. , 23 - 28.
Chicago	ÖZDİL Burhan,Akkız Hikmet,Bayram Süleyman,BEKAR Aynur,Akgöllü Ersin,SANDIKÇI Macit Influence of CYP2C19 functional polymorphism on Helicobacter pylori eradication. (2010): 23 - 28.
MLA	ÖZDİL Burhan,Akkız Hikmet,Bayram Süleyman,BEKAR Aynur,Akgöllü Ersin,SANDIKÇI Macit Influence of CYP2C19 functional polymorphism on Helicobacter pylori eradication. , 2010, ss.23 - 28.
AMA	ÖZDİL B,Akkız H,Bayram S,BEKAR A,Akgöllü E,SANDIKÇI M Influence of CYP2C19 functional polymorphism on Helicobacter pylori eradication. . 2010; 23 - 28.
Vancouver	ÖZDİL B,Akkız H,Bayram S,BEKAR A,Akgöllü E,SANDIKÇI M Influence of CYP2C19 functional polymorphism on Helicobacter pylori eradication. . 2010; 23 - 28.
IEEE	ÖZDİL B,Akkız H,Bayram S,BEKAR A,Akgöllü E,SANDIKÇI M "Influence of CYP2C19 functional polymorphism on Helicobacter pylori eradication." , ss.23 - 28, 2010.
ISNAD	ÖZDİL, Burhan vd. "Influence of CYP2C19 functional polymorphism on Helicobacter pylori eradication". (2010), 23-28.

APA	ÖZDİL B, Akkız H, Bayram S, BEKAR A, Akgöllü E, SANDIKÇI M (2010). Influence of CYP2C19 functional polymorphism on Helicobacter pylori eradication. Turkish Journal of Gastroenterology, 21(1), 23 - 28.
Chicago	ÖZDİL Burhan,Akkız Hikmet,Bayram Süleyman,BEKAR Aynur,Akgöllü Ersin,SANDIKÇI Macit Influence of CYP2C19 functional polymorphism on Helicobacter pylori eradication. Turkish Journal of Gastroenterology 21, no.1 (2010): 23 - 28.
MLA	ÖZDİL Burhan,Akkız Hikmet,Bayram Süleyman,BEKAR Aynur,Akgöllü Ersin,SANDIKÇI Macit Influence of CYP2C19 functional polymorphism on Helicobacter pylori eradication. Turkish Journal of Gastroenterology, vol.21, no.1, 2010, ss.23 - 28.
AMA	ÖZDİL B,Akkız H,Bayram S,BEKAR A,Akgöllü E,SANDIKÇI M Influence of CYP2C19 functional polymorphism on Helicobacter pylori eradication. Turkish Journal of Gastroenterology. 2010; 21(1): 23 - 28.
Vancouver	ÖZDİL B,Akkız H,Bayram S,BEKAR A,Akgöllü E,SANDIKÇI M Influence of CYP2C19 functional polymorphism on Helicobacter pylori eradication. Turkish Journal of Gastroenterology. 2010; 21(1): 23 - 28.
IEEE	ÖZDİL B,Akkız H,Bayram S,BEKAR A,Akgöllü E,SANDIKÇI M "Influence of CYP2C19 functional polymorphism on Helicobacter pylori eradication." Turkish Journal of Gastroenterology, 21, ss.23 - 28, 2010.
ISNAD	ÖZDİL, Burhan vd. "Influence of CYP2C19 functional polymorphism on Helicobacter pylori eradication". Turkish Journal of Gastroenterology 21/1 (2010), 23-28.