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Influences of proinflammatory and anti‐inflammatory cytokine polymorphisms on eradication rates of clarithromycin‐sensitive strains of Helicobacter pylori by triple therapy
Author(s) -
Sugimoto Mitsushige,
Furuta Takahisa,
Shirai Naohito,
Ikuma Mutsuhiro,
Hishida Akira,
Ishizaki Takashi
Publication year - 2006
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1016/j.clpt.2006.03.007
Subject(s) - cyp2c19 , omeprazole , helicobacter pylori , clarithromycin , lansoprazole , proinflammatory cytokine , gastroenterology , proton pump inhibitor , medicine , amoxicillin , genotype , pharmacology , immunology , inflammation , biology , antibiotics , microbiology and biotechnology , biochemistry , cytochrome p450 , metabolism , gene
Backgrounds and Aims Polymorphisms of proinflammatory cytokines, such as interleukin (IL) 1β and tumor necrosis factor (TNF) α, are associated with individual differences in gastric mucosal inflammation and acid inhibition in response to Helicobacter pylori infection. We investigated whether inflammation‐related cytokine polymorphisms would influence the eradication rates of H pylori by a triple‐therapy regimen. Methods Three hundred sixty patients infected with clarithromycin‐sensitive strains of H pylori were genotyped for IL1B −511, IL1RN , TNFA −857/−863/−1031, IL10 −1082/−819/−592, and CYP2C19 and underwent triple therapy for 1 week with a proton pump inhibitor (20 mg omeprazole, 30 mg lansoprazole, or 10 mg rabeprazole) twice daily, 400 mg clarithromycin twice daily, and 750 mg amoxicillin (INN, amoxicilline) twice daily. The influences of the previously mentioned polymorphisms on the eradication rates were analyzed. Results The intention‐to‐treat–based total eradication rate was 83.6% (301/360). The logistic regression analysis revealed that polymorphisms of CYP2C19 and IL1B −511 were independently associated with the eradication rates, but other cytokine polymorphisms were not associated with these rates. The eradication rates in patients with IL1B −511 C/C, C/T, and T/T genotypes were 72.2% (70/97), 87.7% (164/187), and 88.2% (67/76), respectively ( P = .0017). When patients were stratified by CYP2C19 genotype status, IL1B −511 genotype–dependent differences in eradication rates were observed in homozygous extensive metabolizers (EMs) but not in heterozygous EMs and poor metabolizers of CYP2C19 . The eradication rate in homozygous EM patients with the IL1B −511 C/C genotype was quite low (51.1% [22/43]). Conclusions IL1B −511 polymorphism, but not IL1RN , TNFA , or IL10 polymorphism, is one of the determinants of triple therapy for clarithromycin‐sensitive strains of H pylori in CYP2C19 homozygous EMs. Clinical Pharmacology & Therapeutics (2006) 80 , 41–50; doi: 10.1016/j.clpt.2006.03.007