Published online Jun 28, 2021. doi: 10.3748/wjg.v27.i24.3595
Peer-review started: March 2, 2021
First decision: April 5, 2021
Revised: April 13, 2021
Accepted: May 21, 2021
Article in press: May 21, 2021
Published online: June 28, 2021
Processing time: 115 Days and 1 Hours
Helicobacter pylori (H. pylori) is recognized as an important human pathogen associated with superficial gastritis, atrophic gastritis, gastric cancer, etc., each of which has become a serious threat to human health and survival. The rate of drug resistance is increasing due to the wide use of antibiotics and high rates of resistance to clarithromycin, metronidazole, and levofloxacin are associated with the failure of H. pylori eradication. At present, the mechanism of antibiotic resistance of H. pylori is not completely understood. It is very difficult to prevent drug resistance and improve the rate of eradication of the target, thus warranting exploration of the mechanism of drug resistance to H. pylori, and provision of an experimental basis for the prevention and treatment of drug resistance.
Clarithromycin-resistant H. pylori urgently needs new antibiotics; however, antibiotic research and development are very difficult. If we can detect drug resistance by detecting drug-resistant genes in a timeous manner, this may help to alleviate the problem of clarithromycin resistance.
The objectives of this study were to investigate drug-resistant genes in H. pylori, and find a gene suited to early diagnosis of clarithromycin resistance, thereby rationalizing the rate of use of the drug.
H. pylori strains were isolated and cultured, minimal inhibitory concentrations were measured, and complete genome sequence was determined. Prediction and analysis of the function of drug-resistant genes indicated that the RNA expression of hp1181 and hp1184 increased in the H. pylori strains, which was the same in the artificially induced clarithromycin-resistant bacteria. The relationships between hp1181 or hp1184 and clarithromycin resistance were confirmed with gene mutant and drug-resistant strains.
Hp1181 and hp1184 genes were found in these H. pylori strains. Their expression was associated with clarithromycin resistance.
Hp1181 and hp1184 mutations may be the earliest and most persistent response to clarithromycin resistance, and they may be the main target genes for the diagnosis, prevention, and treatment of clarithromycin resistance.
The relationship between hp1181 or hp1184 and clarithromycin resistance was demonstrated, providing an improved experimental basis for early diagnosis of clarithromycin resistance in H. pylori.