PMID- 33937401
OWN - NLM
STAT- MEDLINE
DCOM- 20210526
LR  - 20220422
IS  - 2314-6141 (Electronic)
IS  - 2314-6133 (Print)
VI  - 2021
DP  - 2021
TI  - Application of Visual Gene Clip-Based Tailored Therapy for the Eradication of 
      Helicobacter pylori.
PG  - 6150628
LID - 10.1155/2021/6150628 [doi]
LID - 6150628
AB  - BACKGROUND: Helicobacter pylori eradication with therapies employing a proton 
      pump inhibitor (PPI) and antimicrobial agents is mainly achieved via bacterial 
      susceptibility to antimicrobial agents and the magnitude of acid secretion 
      inhibition. However, annual eradication rates have greatly declined in Mainland 
      China, and therefore, tailored H. pylori eradication regimens that inhibit acid 
      secretion and employ optimal antimicrobial agents determined based on gene clip 
      testing may improve eradication rates. This study was aimed at evaluating the 
      efficacy of tailored H. pylori eradication therapy guided by visual gene clip 
      testing for antibiotic resistance and PPI metabolism genotypes. METHODS: This 
      prospective study included 244 patients (141 men and 103 women aged 20-79 years) 
      receiving initial treatment for H. pylori infection. Visual gene clip testing 
      using gastric mucosal specimens was performed to detect antibiotic resistance to 
      clarithromycin conferred by the A2142G and A2143G point mutations of the H. 
      pylori 23S rRNA gene and to levofloxacin conferred by the Asn87 and Asp91 point 
      mutations of the H. pylori gyrA gene. Patients received a 14-day bismuth 
      quadruple therapy regimen guided by testing for antibiotic resistance and CYP2C19 
      polymorphisms, and primary H. pylori eradication was assessed at least 4 weeks 
      after therapy. RESULTS: H. pylori strains were successfully isolated from the 
      gastric mucosa tissues of 244 patients. Antibiotic resistant isolates were 
      identified in 63 patients, with clarithromycin resistance observed in 50 
      patients, levofloxacin resistance in 7 patients, and dual resistance in 6 
      patients. The PPI metabolic genotype of CYP2C19 was detected in 242 of 244 cases, 
      and 97 cases were categorized as extensive metabolizers, 141 as intermediate 
      metabolizers, and 4 as poor metabolizers. Among the 242 patients who received 
      tailored therapy, the H. pylori eradication rate was 90.9% (95% confidence 
      interval 87.3%~94.6%) in the intention-to-treat analysis and 96.9% (95% 
      confidence interval 94.7%~99.2%) in the per protocol analysis. CONCLUSIONS: 
      Tailored therapy for H. pylori infection guided by determination of antibiotic 
      resistance and CYP2C19 polymorphism using visual gene chip technology may provide 
      high clinical effectiveness as initial H. pylori eradication therapy.
CI  - Copyright (c) 2021 Lili Yang et al.
FAU - Yang, Lili
AU  - Yang L
AD  - Department of Gastroenterology, Peking University Shenzhen Hospital, Shenzhen, 
      Guangdong Province, 518036, China.
FAU - Zou, Ao
AU  - Zou A
AD  - Department of Gastroenterology, Peking University Shenzhen Hospital, Shenzhen, 
      Guangdong Province, 518036, China.
FAU - Wu, Huihua
AU  - Wu H
AD  - Department of Gastroenterology, Peking University Shenzhen Hospital, Shenzhen, 
      Guangdong Province, 518036, China.
FAU - Guo, Hai
AU  - Guo H
AD  - Department of Gastroenterology, Peking University Shenzhen Hospital, Shenzhen, 
      Guangdong Province, 518036, China.
FAU - Zhang, Fangting
AU  - Zhang F
AD  - Department of Gastroenterology, Peking University Shenzhen Hospital, Shenzhen, 
      Guangdong Province, 518036, China.
FAU - Zou, Bing
AU  - Zou B
AD  - Department of Gastroenterology, Peking University Shenzhen Hospital, Shenzhen, 
      Guangdong Province, 518036, China.
FAU - Wang, Junping
AU  - Wang J
AUID- ORCID: 0000-0002-3124-3801
AD  - Department of Gastroenterology, Peking University Shenzhen Hospital, Shenzhen, 
      Guangdong Province, 518036, China.
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
DEP - 20210410
PL  - United States
TA  - Biomed Res Int
JT  - BioMed research international
JID - 101600173
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Proton Pump Inhibitors)
RN  - EC 1.14.14.1 (Cytochrome P-450 CYP2C19)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Anti-Bacterial Agents/pharmacology/therapeutic use
MH  - Cytochrome P-450 CYP2C19/genetics
MH  - *Disease Eradication
MH  - Drug Resistance, Microbial/drug effects/genetics
MH  - Female
MH  - Genotype
MH  - Helicobacter Infections/*genetics/microbiology/*therapy
MH  - Helicobacter pylori/drug effects/*physiology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Phenotype
MH  - Proton Pump Inhibitors/pharmacology/therapeutic use
MH  - Young Adult
PMC - PMC8055396
COIS- The authors declare that they have no conflicts of interests.
EDAT- 2021/05/04 06:00
MHDA- 2021/05/27 06:00
PMCR- 2021/04/10
CRDT- 2021/05/03 06:22
PHST- 2020/06/30 00:00 [received]
PHST- 2021/02/01 00:00 [revised]
PHST- 2021/04/06 00:00 [accepted]
PHST- 2021/05/03 06:22 [entrez]
PHST- 2021/05/04 06:00 [pubmed]
PHST- 2021/05/27 06:00 [medline]
PHST- 2021/04/10 00:00 [pmc-release]
AID - 10.1155/2021/6150628 [doi]
PST - epublish
SO  - Biomed Res Int. 2021 Apr 10;2021:6150628. doi: 10.1155/2021/6150628. eCollection 
      2021.