The CYP2C19 polymorphisms effects on H. pylori cure rate in proton pump inhibitor-based therapeutic regimens: An updated meta-analysis

Ghazvini, Kiarash; Kamali, Hossein; Hosseininasab-nodoushan, Seyed-Abolfazl; Keikha, Masoud

doi:10.1016/j.genrep.2021.101340

Cited by 6 publications

(3 citation statements)

References 90 publications

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“…The proposed concept for the personalized SUP in ICU patients is based on the data from the "Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for CYP2C19 and Proton Pump Inhibitor Dosing" (20), "Proton Pump Inhibitors: U.S. Food and Drug Administration-Approved Indications and Dosages for Use in Adults" (17,21), information from PharmGKB database and from The Dutch Pharmacogenetics Working Group (DPWG) (22), and recent scientific studies (23)(24)(25)(26)(27)(28).…”

Section: Methodsmentioning

confidence: 99%

“…Moreover, the eradication of H. pylori is facilitated in PMs compared to other metabolizers ( 28 ). A meta-analysis showed that a rabeprazole-based eradication program is less affected by the CYP2C19 polymorphisms than the treatment by first-generation PPIs ( 27 ). Thus, increasing the dose of omeprazole, lansoprazole, or pantoprazole by 50–100% for the treatment of H. pylori infection in EMs and RMs is recommended.…”

Section: A Proposed Concept For the Personalized Sup By Ppi In Icu Pa...mentioning

confidence: 99%

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CYP2C19 Gene Profiling as a Tool for Personalized Stress Ulcer Prophylaxis With Proton Pump Inhibitors in Critically Ill Patients - Recommendations Proposal

et al. 2022

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To this date, there are no recommendations for personalized stress ulcer prophylaxis (SUP) in critical care that would take the patient's individual genetic predispositions into account. Of drugs used for this purpose, proton pump inhibitors (PPIs) are the first-choice drugs in intensive care unit patients. The degradation of proton pump inhibitors is mediated by cytochrome P450 (CYP) enzymes; in particular, CYP2C19 and, to a lesser extent, CYP3A4 are involved. Expression and metabolic activity of, namely in, CYP2C19 is significantly affected by single nucleotide polymorphisms, the drug metabolization rate varies greatly from ultrarapid to poor and likely influences the optimal dosage. As these CYP2C19 predictive phenotypes via CYP2C19 haplogenotypes (rs12248560/rs4244285) can be relatively easily determined using the current standard equipment of hospital laboratories, we prepared a set of recommendations for personalized PPI-based stress ulcer prophylaxis taking into account the patient's CYP2C19 predictive phenotype determined in this way. These recommendations are valid, in particular, for European, American and African populations, because these populations have the high representations of the CYP2C19*17 allele associated with the overexpression of the CYP2C19 gene and ultrarapid degradation of PPIs. We propose the CYP2C19 gene profiling as a tool for personalized SUP with PPI in critically ill patients.

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Section: Methodsmentioning

confidence: 99%

Section: A Proposed Concept For the Personalized Sup By Ppi In Icu Pa...mentioning

confidence: 99%

CYP2C19 Gene Profiling as a Tool for Personalized Stress Ulcer Prophylaxis With Proton Pump Inhibitors in Critically Ill Patients - Recommendations Proposal

et al. 2022

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“…There are three common polymorphisms: homozygous extensive metabolisers (which are more commonly found in a European population and result in quick rates of metabolism of PPIs), heterozygous, and poor-metaboliser genotypes, which tend to have slower metabolism of PPIs [ 56 ]. Slow metabolisers are believed to have the best effect on outcomes [ 57 ]. Specific PPIs are thought to be less affected by this than others, such as Rabeprazole.…”

Section: Management: Treatmentmentioning

confidence: 99%

Current and Future Perspectives on the Management of Helicobacter pylori: A Narrative Review

Deane,

Kelly,

O’Morain

2024

Antibiotics

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The prevalence of Helicobacter pylori (H. pylori), a pathogen, has decreased globally in the last decade. To date, the management of H. pylori has focused on a reactive approach, whereby those diagnosed are treated with antimicrobials and acid suppression in combination. This review article provides an overview of the shift in the management of H. pylori from a reactive approach towards a proactive ‘screen and treat’ approach; the article reflects the current pharmacological landscape for H. pylori treatment by exploring similarities such as the first-line prescription of quadruple therapy in most countries and provides a summary table of the best practice guidance from Europe, Asia, and North America. It explores significant ongoing challenges in management, such as rising antimicrobial resistance rates, and explores a potential ‘work smart’ approach to antimicrobial susceptibility testing. We explore the role of registry databases in providing data on treatment efficacy and safety and how they can support a strategic approach to H. pylori treatment. We question if such a database’s availability, update, and regular audit should serve as a key quality indicator in a population screening programme. Despite a call for vaccination against H. pylori and decades of research, not many have made it to a phase-three clinical trial. We explore the challenges that have complicated the development of such a vaccine, such as the genetic diversity of H. pylori, immunotolerance, and limitations of mouse models in research; we reflect on how these challenges are contributing to a low likelihood of having a vaccine in the short–medium term. Lastly, it explores the heterogeneity in research on probiotics and their role as an adjunct in the management of H. pylori.

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Adhesion, infection, and therapeutic treatment of Helicobacter pylori: a review on current aspects and future promise

Ong,

Lin

2024

Discov Appl Sci

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Background Helicobacter pylori is a Gram-negative bacterium infecting over half of the human population worldwide. In addition to causing chronic gastritis, the bacterial infection often progresses to gastrointestinal pathologies at various degrees, including gastric carcinoma. World Health Organization announced in 1994 that H. pylori is Group 1 carcinogen. Although antibiotics-based treatment is mostly effective, the alarming rise in drug resistance have resulted in a serious concern for the health. Main body This review covers the aspects of bacterial infection, epidemiology and therapy of H. pylori. An additional emphasis is placed on the bacterial adhesion and anti-adhesion because the attachment of H. pylori to gastric epithelial cells is crucial for the pathogenesis. We review several anti-adhesion agents that have been shown to interfere with the bacterial adhesion. These agents can either function as receptor and adhesin analogs or foster preventive probiotics. Furthermore, cholesteryl 6′-O-acyl-α-d-glucopyranoside (CAG), exclusively produced in H. pylori by the unique biosynthetic pathway, has been shown critical for the bacterial virulence. Studies are reviewed to show how CAG influences bacterial adhesion by affecting membrane features, including lipid rafts clustering. Conclusion Owing to the emerging threat of multiple drug resistance, current therapy is not always effective to H. pylori infection, demonstrating the necessity to develop other alternatives. The approaches of anti-adhesion appear to be attractive since they blockade the initial step of bacterial pathogenesis. This in-depth review of anti-adhesive agents and corresponding mechanisms showcases their potential for future development of therapeutic intervention.

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The CYP2C19 polymorphisms effects on H. pylori cure rate in proton pump inhibitor-based therapeutic regimens: An updated meta-analysis

Cited by 6 publications

References 90 publications

CYP2C19 Gene Profiling as a Tool for Personalized Stress Ulcer Prophylaxis With Proton Pump Inhibitors in Critically Ill Patients - Recommendations Proposal

CYP2C19 Gene Profiling as a Tool for Personalized Stress Ulcer Prophylaxis With Proton Pump Inhibitors in Critically Ill Patients - Recommendations Proposal

Current and Future Perspectives on the Management of Helicobacter pylori: A Narrative Review

Adhesion, infection, and therapeutic treatment of Helicobacter pylori: a review on current aspects and future promise

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