A novel gene associated with small bowel bleeding in patients taking low-dose aspirin

Abstract

Objective: We have previously revealed the clinical factors and genetic polymorphisms associated with gastrointestinal mucosal injury and bleeding, induced by low-dose aspirin (LDA). After performing genome-wide analysis of single nucleotide polymorphisms (SNPs) using the Drug Metabolizing Enzymes and Transporters (DMET) system among drug metabolism and transporter genes, certain SNPs were found to increase the risk for LDA-induced small bowel bleeding. The aim of this study was to identify the SNPs involved in LDA-induced small bowel bleeding. Subjects and methods: Subjects were patients taking LDA, with small bowel bleeding diagnosed using capsule endoscopy. We investigated the clinical characteristics and the previously identified SNPs, that were examined by the DNA direct sequence method. Results: 56 patients with bleeding and 410 controls taking LDA were enrolled. The risk factors associated with small bowel bleeding included smoking, cerebrovascular diseases, chronic renal failure, non-steroidal anti-inflammatory drug (NSAID) or anticoagulants combination, and two SNPs (CYP4F11 20043G > A (D446N) rs1060463, GSTP1 313A > G rs1695). After propensity score matching, GSTP1 rs1695 was significantly associated with small bowel bleeding. Conclusion:The GSTP1 SNP may be a predictive marker for small bowel bleeding among patients taking LDA.

Proton Pump Inhibitors Increase the Risk of Nonsteroidal Anti-inflammatory Drug-Related Small-Bowel Injury: A Systematic Review With Meta-analysis

“…The remaining 110 articles underwent full-text review, after which 96 were excluded for the reasons stated in Figure 1 . Ultimately, 14 studies were included ( 5 – 7 , 16 – 26 ). Of these, 11 studies were included in the endoscopy-verified small-bowel injury prevalence analysis, 5 studies assessed the association between the number of small-bowel mucosal injuries and coadministration of PPIs, 2 studies investigated the association between changes in hemoglobin levels and PPIs, and 3 studies were included in the endoscopy-verified small-bowel bleeding risk analysis.…”