Therapeutic impact of CYP2C19 pharmacogenetics on proton pump inhibitor-based eradication therapy for Helicobacter pylori.
Therapeutic impact of CYP2C19 pharmacogenetics on proton pump inhibitor-based eradication therapy for Helicobacter pylori.
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CYP2C19 药物遗传学对基于质子泵抑制剂的幽门螺杆菌根除疗法的治疗影响。
DOI：
10.1358/mf.2003.25.2.723687
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发表时间：
2003
影响因子：
--
通讯作者：
T. Ishizaki
中科院分区：
文献类型：
--
作者：
T. Furuta;N. Shirai;K. Ohashi;T. Ishizaki
目前根除幽门螺杆菌的方法包括一种质子泵抑制剂(PPI)和一种或两种抗菌剂，如阿莫西林(AMPC)、克拉霉素(CAM)或甲硝唑(MNZ)。PPI在肝脏中主要由S-美苯妥因4‘-羟基酶(CYP2C19)代谢。CYP2C19基因多态性与PPI的药代动力学和药效学相关。基于PPI的疗法的根治率也受到这种基因型以及细菌对抗生素的耐药性的影响。基于CYP2C19相关药物遗传学或药物基因组学和细菌耐药性的个体化治疗策略有望提高初始治疗的治愈率。还有必要认识到，在这种治疗方案中使用的一些药物之间可能存在药物-药物相互作用。
Current regimens for the eradication of Helicobacter pylori consist of a proton pump inhibitor (PPI) plus one or two antibacterial agents, such as amoxicillin (AMPC), clarithromycin (CAM) or metronidazole (MNZ). PPIs are mainly metabolized by S-mephenytoin 4'-hydroxylase (CYP2C19) in the liver. The polymorphism of CYP2C19 is associated with the pharmacokinetics and pharmacodynamics of PPIs. Eradication rates by PPI-based therapies are also affected by this genotype, as well as bacterial resistance to antibiotics. An individualized treatment strategy based on CYP2C19-related pharmacogenetics or pharmacogenomics and bacterial resistance is expected to increase the cure rate of the initial treatment. It is also necessary to recognize that there is a possible drug-drug interaction between some of the drugs used in this treatment regimen.