Can Helicobacter pylori be eradicated with high-dose proton pump inhibitor in extensive metabolizers with the CYP2C19 genotypic polymorphism?

ORMECI A., Emrence Z., BARAN B., SOYER O., GOKTURK S., EVIRGEN S., ...Daha Fazla

EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES, cilt.20, sa.9, ss.1795-1797, 2016 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 20 Sayı: 9
  • Basım Tarihi: 2016
  • Dergi Adı: EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.1795-1797
  • Anahtar Kelimeler: CYP2C19, Homozygote extensive metabolizers, Proton pump inhibitors, High dose proton pump inhibitors, TRIPLE THERAPY, S-MEPHENYTOIN, GASTRIC-JUICE, OMEPRAZOLE, CLARITHROMYCIN, METRONIDAZOLE, AMOXICILLIN, INFECTION
  • İstanbul Üniversitesi Adresli: Evet

Özet

Proton pump inhibitors (PPI) metabolism and pharmacokinetics are regulated by cytochrome P450 enzymes in the liver. Cytochrome P450 2C19 (CYP2C19) polymorphism plays an import role in the metabolism of PPIs. The three possible genotypes for CYP2C19 each has a distinct effect on the pharmacodynamics of PPIs. Homozygote extensive metabolizers (HomEM) are the most frequent genotype and have two wild-types (non-mutant) (*1/*1) alleles. HomEM is associated with increased enzyme activity, which increases the rate of PPI metabolism. Intragastric pH, which is required for eradication, is lowest in HomEM. In HomEMs, an insufficient increase in intragastric pH results in decreased anti-Helicobacter pylori (HP) efficacy of the antibiotics and, therefore, lower eradication rates. We determined whether the HP eradication rate would increase after high-dose PPI treatment of extensive PPI metabolizers who had been treated unsuccessfully with a standard PPI dose.