Influence Of CytochrosomeP450 2C19 Genetic Polymorphism On PPI For Helicobacter Pylori Eradication

Objective:This subject will study the influence of Cytochrosome P450 2C19 genetic polymorphism on PPI for Helicobacter pylori eradication,which will more scientific and reasonable choose the PPI in clinical for the individual therapy scheme.And it also provides the biomolecular evidence for Helicobacter pylori eradication base on the PPI.Methods:1.A total of 509 patients were collected who treated in the second affiliated hospital of Nanchang university during the period of January 2014-December 2014,drawed 2-3ml peripheral blood with EDTA anticoagulant.We are getting the results of CYP2C19 genetype through the extraction of DNA,sample amplification,hybridization and the report output, then can be divided into wild-type homozygous CYP2C19*1/*1,homozygous mutant CYP2C19*1/*2(681G>A),homozygous mutant CYP2C19*1/*3(636G>A),mutant heterozygote CYP2C19*2/*2(681G>A),mutant heterozygote CYP2C19*3/*3(636G>A),mutant heterozygote CYP2C19*2/*3(681G>A、636G>A).2.A total 145 of the 509 patients with positive Hp were randomly collected and anti-Hp treatment which was the scheme of the PPI(omeprazole, lansoprazole,pantoprazole,esomeprazole,rabeprazole, ilaprazole)+ amoxicillin+ clarithromycin was performed on these patients for two weeks.At least,detection of Hp after discontinued at least 4 weeks by 13 C urea breath test.3.According to the standard triple therapy in eradicating Helicobacter pylori treatment regimens in addition, 145 patients were included, and then according to the different PPI,the first generation of PPI group includ and the second generation of PPI group.4.Combined with 145 cases of patients with different effects on CYP2C19 polymorphism with two generations of PPI-based anti-Hp efficacy, we use thestatistical analysis, to observe whether the difference was statistically significant.Results:1.509 cases of patients with CYP2C19 allele frequencies were extensive metabolizers accounted for 40.67%, accounting for 44.99% intermediate metabolizers, poor metabolizers accounted for 14.34%.2.Normally 509 cases of patients with CYP2C19 genotyping analysis, gender between genotypes, it has no significant differences in age, but by age group shows that the older model, the lower the proportion of PM, especially in people over 80 years of age.3.CYP2C19 gene polymorphism has high-impact effect of anti-Hp on the first-generation PPI group and little effect of anti-Hp on the second- generation PPI group.4.The comparative analysis of Hp eradication rates between the two generations PPI,Hp eradication rate of first-generation PPI group derived EM and IM type PPI group was significantly lower than the second generation PPI, and the Hp eradication rates of PM type are all very high in two generations.Conclusions:1.CYP2C19 gene insists gene polymorphism, the population of the region CYP2C19 genotype can be divided mainly wild-type homozygotes and homozygous mutant,and mutant heterozygotes is relatively rare.2.CYP2C19 gene polymorphism has the greater impact about anti-Hp on the first-generation PPI,which poor metabolizers(PM) was significantly higher in patients with Hp eradication extensive metabolizers(EM)(P <0.05).3.CYP2C19 gene polymorphism has little impact about anti-Hp on the second generation PPI,extensive metabolizers(EM), intermediate metabolizers(IM) and poor metabolizers(PM) in patients with Hp eradication rate was no significant difference(P> 0.05), and it has the higher Hp eradication rates(over 90%).4.Hp eradication rate of the second-generation PPI group was significantly higher than the first-generation PPI group.About Hp eradication rate,there was a significant difference(P <0.05) in EM and IM patients between the two generations of PPI group,while in PM patients there was no significant difference(P> 0.05) between the twogenerations of PPI group.5.CYP2C19 gene polymorphism may provides a basis for rational drug use PP I in molecular biology.