Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
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Effect of IL-1 Polymorphisms, CYP2C19 Genotype and Antibiotic Resistance on Helicobacter pylori Eradication Comparing Between 10-day Sequential Therapy and 14-day Standard Triple Therapy with Four-Times-Daily-Dosing of Amoxicillin in Thailand: a Prospective Randomized Study

  • Published : 2016.06.01
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Abstract

Background: Studies of effects of IL-1 polymorphisms, CYP2C19 genotype together with antibiotic resistance for H. pylori eradication are rare worldwide. The present study was designed to evaluate efficacy of 10-day sequential therapy (SQT) and 14-day standard triple therapy (STT) with four- times-daily dosing of amoxicillin for H. pylori eradication related to these important host and bacterial factors in Thailand. Materials and Methods: This prospective randomized study was performed during March 2015 to January 2016. H. pylori infected gastritis patients were randomized to receive 10-day sequential therapy and 14-day standard triple therapy. CYP2C19 genotyping, IL1 polymorphism (IL-1B and IL-1RN genotypes) and antibiotic susceptibility tests were performed in all patients. 13C-UBT was conducted to confirm H. pylori eradication at least 4 weeks after treatment. Results: A total of 100 patients (33 males and 67 females, mean age=51.1 years) were enrolled. Eradication rate by PP analysis was 97.9% (47/48) with the 10-day SQT regimen and 87.8% (43/49) with 14-day STT regimen (97.9% vs 87.8%; p-value=0.053). Antibiotic susceptibility testing demonstrated 45% resistance to metronidazole, 14.8% to clarithromycin, and 24.1% to levofloxacin. CYP2C19 genotyping revealed 44.9% RM, 49% IM and 6.1% PM. IL-1B and IL-1RN genotypes were demonstrated as 21.4% for CC, 48.1% for TC, 36.8% for TT, 72.7% for 1/1, and 21.2% for 1/2 genotypes, respectively. The 10-day SQT regimen provided 100% eradication in patients with clarithromycin or dual clarithromycin and levofloxacin H. pylori resistant strains. Moreover, the 10-day SQT regimen resulted in a 100% eradication rate in all patients with CYP2C19 genotype RM and almost type of IL-1B (TC and TT) and IL1-RN genotypes ( 1/2 and other). Conclusions: Treatment with 10-day sequential therapy is highly effective for H. pylori eradication regardless of the effects of clarithromycin resistance, dual clarithromycin and levofloxacin resistance, CYP2C19 genotype, IL-1B and IL1-RN genetic polymorphisms and can be used as effective first line therapy in Thailand.

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References

  1. Chey WD, Wong BC (2007). American College of Gastroenterology guideline on the management of Helicobacter pylori infection. Am J Gastroenterol, 102, 1808-25. https://doi.org/10.1111/j.1572-0241.2007.01393.x
  2. Demirel BB, Akkas BE, Vural GU (2013). Clinical factors related with helicobacter pylori infection - is there an association with gastric cancer history in first- degree family members? Asian Pac J Cancer Prev, 14, 1797-1802. https://doi.org/10.7314/APJCP.2013.14.3.1797
  3. Ford AC, Forman D, Hunt RH, et al (2014). Helicobacter pylori eradication therapy to prevent gastric cancer in healthy asymptomatic infected individuals: systematic review and meta-analysis of randomised controlled trials. BMJ, 348, 3174. https://doi.org/10.1136/bmj.g3174
  4. Furuta T, Shirai N, Takashima M, et al (2001). Effect of genotypic differences in CYP2C19 on cure rates for Helicobacter pylori infection by triple therapy with a proton pump inhibitor, amoxicillin, and clarithromycin. Clin Pharmacol Ther, 69, 158-68. https://doi.org/10.1067/mcp.2001.113959
  5. Furuta T, Sugimoto M, Yamade M, et al (2014). Effect of dosing schemes of amoxicillin on eradication rates of Helicobacter pylori with amoxicillin-based triple therapy. J Clin Pharmacol, 54, 258-66. https://doi.org/10.1002/jcph.195
  6. Gatta L, Vakil N, Leandro G, et al (2009). Sequential therapy or triple therapy for Helicobacter pylori infection: systematic review and meta-analysis of randomized controlled trials in adults and children. Am J Gastroenterol, 104, 3069–79. https://doi.org/10.1038/ajg.2009.555
  7. Graham DY (2009). Efficient identification and evaluation of effective Helicobacter pylori therapies. Clin Gastroenterol Hepatol, 7, 145-8. https://doi.org/10.1016/j.cgh.2008.10.024
  8. Jafri NS, Hornung CA, Howden CW, (2008). Meta-analysis: sequential therapy appears superior to standard therapy for Helicobacter pylori infection in patients naive to treatment. Ann Intern Med, 148, 923-31. https://doi.org/10.7326/0003-4819-148-12-200806170-00226
  9. Jainan W, Vilaichone RK (2014). Effects of the CYP2C19 genetic polymorphism on gastritis, peptic ulcer disease, peptic ulcer bleeding and gastric cancer. Asian Pac J Cancer Prev, 15, 10957-60
  10. Mahachai V, Sirimontaporn N, Tumwasorn S, et al (2011). Sequential therapy in clarithromycin-sensitive and -resistant Helicobacter pylori based on polymerase chain reaction molecular test. J Gastroenterol Hepatol, 26, 825-8. https://doi.org/10.1111/j.1440-1746.2011.06660.x
  11. Malfertheiner P, Megraud F, O’Morain CA, et al (2012). Management of Helicobacter pylori infection--the maastricht iv/ florence consensus report. Gut, 61, 646-64. https://doi.org/10.1136/gutjnl-2012-302084
  12. Prapitpaiboon H, Mahachai V, Vilaichone RK (2015). High efficacy of levofloxacin-dexlansoprazole-based quadruple therapy as a first line treatment for Helicobacter pylori eradication in Thailand. Asian Pac J Cancer Prev, 16, 4353-6. https://doi.org/10.7314/APJCP.2015.16.10.4353
  13. Sirimontaporn N, Thong-Ngam D, Tumwasorn S, et al (2010). Ten-day sequential therapy of Helicobacter pylori infection in Thailand. Am J Gastroenterol, 105, 1071–5. https://doi.org/10.1038/ajg.2009.708
  14. Srinarong C, Siramolpiwat S, Wongcha-um A, et al (2014). Improved eradication rate of standard triple therapy by adding bismuth and probiotic supplement for Helicobacter pylori treatment in Thailand. Asian Pac J Cancer Prev, 15, 9909-13. https://doi.org/10.7314/APJCP.2014.15.22.9909
  15. Vilaichone RK, Gumnarai P, Ratanachu-Ek T, et al (2013). Nationwide survey of Helicobacter pylori antibiotic resistance in Thailand. Diagn Microbiol Infect Dis, 77, 346-9. https://doi.org/10.1016/j.diagmicrobio.2013.08.010
  16. Vilaichone RK, Mahachai V (2001). Current management of Helicobacter pylori infection. J Med Assoc Thai, 84, 32-38.
  17. Vilaichone RK, Mahachai V, Tumwasorn S, et al (2005). Gastric mucosal cytokine levels in relation to host interleukin-1 polymorphisms and Helicobacter pylori cagA genotype. Scand J Gastroenterol, 40, 530-39
  18. Vilaichone RK, Mahachai V, Graham DY (2006). Helicobacter pylori diagnosis and management. Gastroenterol Clin North Am, 35, 229-47. https://doi.org/10.1016/j.gtc.2006.03.004
  19. Vilaichone RK, Prapitpaiboon H, Gamnarai P, et al (2015). Seven-day bismuth-based quadruple therapy as an initial treatment for Helicobacter pylori infection in a high metronidazole resistant area. Asian Pac J Cancer Prev, 16, 6089-6092. https://doi.org/10.7314/APJCP.2015.16.14.6089
  20. Yamada S, Onda M, Kato S, et al (2001). Genetic differences in CYP2C19 single nucleotide polymorphisms among four Asian populations. J Gastroenterol, 36, 669-72. https://doi.org/10.1007/s005350170029
  21. Zullo A, De Francesco V, Hassan C, et al (2007). The sequential therapy regimen for Helicobacter pylori eradication: a pooled-data analysis. Gut, 56, 1353-7. https://doi.org/10.1136/gut.2007.125658