Basic Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 26, 2018; 6(12): 514-520
Published online Oct 26, 2018. doi: 10.12998/wjcc.v6.i12.514
CYP2C19 polymorphism has no influence on rabeprazole-based hybrid therapy for Helicobacter pylori eradication
Tsung-Jung Lin, Hsi-Chang Lee, Chih-Lin Lin, Chung-Kwe Wang, Kuan-Yang Chen, Deng-Chyang Wu
Tsung-Jung Lin, Department of Health care and Social Work, Taipei University of Marine Technology, New Taipei 25172, Taiwan
Tsung-Jung Lin, Hsi-Chang Lee, Chih-Lin Lin, Chung-Kwe Wang, Kuan-Yang Chen, Department of Gastroenterology, Taipei City Hospital, Taipei 10629, Taiwan
Kuan-Yang Chen, Institute of Clinical Medicine, National Yang-Ming University, Taipei 11221, Taiwan
Kuan-Yang Chen, Institute of Neuroscience, National Chengchi University, Taipei 11651, Taiwan
Deng-Chyang Wu, Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
Deng-Chyang Wu, Division of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
Deng-Chyang Wu, Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
Author contributions: Lin TJ, designed the study and wrote manuscript; Lin TJ, Lee HC, Lin CL, Wang CK, Chen KY, collected data; Wu DC, offered the idea of this study and helped in literature review; Lin TJ, Chen KY designed and supervised the study and statistical analysis.
Institutional review board statement: This study was carried out according to the principles of the Declaration of Helsinki and was approved by the Institutional Review Board and ethics committee of Taipei City Hospital (TCHIRB-1011111).
Conflict-of-interest statement: The authors declare no conflict of interest relevant to this study. The article had been published as a poster in the meeting of Asia Pacific Digestive Week 2015 in Taiwan.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Kuan-Yang Chen, MD, Attending Doctor, Department of Gastroenterology, Taipei City Hospital, 11F., No. 10, Sec. 4, Renai Rd., Da-an District, Taipei 10629, Taiwan. daa13@tpech.gov.tw
Telephone: +886-2-27093600-1159 Fax: +886-2-27047859
Received: June 9, 2018
Peer-review started: June 9, 2018
First decision: July 3, 2018
Revised: August 8, 2018
Accepted: August 30, 2018
Article in press: August 30, 2018
Published online: October 26, 2018
Processing time: 140 Days and 3.1 Hours
ARTICLE HIGHLIGHTS
Research background

In the initial study of hybrid therapy, no significant factors related to treatment failure were found; however, the cytochrome P450 2C19 (CYP2C19) polymorphism was not analyzed. Only one study addressed the influence of CYP2C19 by using hybrid therapy as a first-line treatment for Helicobacter pylori (H. pylori) eradication.

Research objectives

The aims of this study were to investigate the efficacy of hybrid therapy as a first-line treatment for H. pylori eradication, and to evaluate the independent predictors associated with eradication efficacy, including CYP2C19, the interleukin (IL)-1β-511 polymorphism, and antibiotic resistance.

Research methods

About 88 H. pylori-infected patients were recruited to receive 14-d of hybrid therapy. Endoscopies or 13C-urea tests were performed to determine the results of H. pylori eradication therapy. To investigate the impact on treatment effect, the genotypes of CYP2C19 and IL-1β were analyzed.

Research results

The total eradication rate of H. pylori was 92.94%. The rates of H. pylori eradiation were 89.19% in extensive metabolizers (EM) and 95.83% in non-EM, according to the CYP2C19 genotypes. Both the genotypes of CYP2C19 and IL-1β had no significant influence on the eradication rates of H. pylori.

Research conclusions

The CYP2C19 and IL-1β polymorphisms are not significantly independent factors on rabeprazole-based hybrid therapy for H. pylori eradication.

Research perspectives

The limitation of this study was that the number of patients may be too small to identify the significant factors predicting eradication failure. In addition, the findings suggest that rabeprazole may be used as a priority in EMs of CYP2C19 to maintain the eradication rate of H. pylori.