The Effect Of Cytochrome P4502C19Gene Polymorphism On Helicobacter Pylori Eradication Rate

The effect of cytochrome P4502C19(CYP2C19) polymorphism on Helicobacter pylori eradication rate used omeprazole-based triple10-days therapy and the efficacy of rabeprazole-based triple therapy as a remedial regimen for the losers of H.pylori eradication.Method:Thirty nine patients were chronic superficial gastritis, atrophic gastritis or gastric ulcer tested by endoscopy and positive in H.pylori infection diagnosed by13C urea breath test. All patients were treated10-days by OAC regimen including omeprazole, amoxicillin, clarithromycin. The CYP2C19genotype including EM, IM and PM were deteimined by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and gene sequencing methods. H.pylori status was judged by13C-urea breath test at least one month after the end of treatment. The losers of eradication in EM and IM genotypes groups were treated by RAC regimen including rabeprazole, amoxicillin, clarithromycin. Eradication losers of PM group were given OAF program consisting of omeprazole, amoxicillin, furazolidone. H.pylori status was judged by13C-urea breath test at least one month after the end of treatment.Result:All39patients completed the treatment. Helicobacter pylori eradication rate calculated by the ITT and PP was66.7%. The eradication rate of Hp in EM, IM and PM genotype was47.1%,76.9%,88.9%, respectively. H.pylori eradication rate of EM genotype groupe was significantly lower than the poor metabolizer (P<0.05). There were no statistically significant differences between IM and EM (P>0.05) or PM (P>0.05). The hp eradication rate of smokers was significantly lower than non-smokers (P<0.05). There were no significant difference between different gender, age and drinking among patients of Hp eradication rate (P>0.05). There was no significant difference among chronic superficial gastritis, atrophic gastritis and gastric ulcer groups of H. pylori eradication rate (P>0.05). The eradication losers of EM and IM groups were treated by RAC regimen, and the eradication rate (82%) was higher than OAC regimen, but there were no statistically significant differences between two regimens (P>0.05).Conclusion:CYP2C19gene polymorphism has a significant effect on Hp eradication rates. Requiring large sample study to verify rabeprazole-based triple therapy can overcome EM and IM of omeprazole-based triple therapy for H. pylori eradication.