Polymorphism of interleukin-1beta affects the eradication rates of Helicobacter pylori by triple therapy.
OBJECTIVE
Polymorphism in interleukin-1beta (IL-1beta) is associated with intragastric pH levels in Helicobacter pylori-positive subjects. Intragastric pH levels affect the activity of antibiotics against H. pylori in the stomach. The aim of this study was to investigate whether IL-1beta polymorphism is associated with eradication rates of H. pylori by triple therapy with a proton pump inhibitor (PPI), amoxicillin, and clarithromycin.


METHODS
Three hundred thirty-six patients infected with H. pylori completed treatment with omeprazole, 20 mg, or lansoprazole, 30 mg twice daily; clarithromycin, 200 mg 3 times daily; and amoxicillin, 500 mg 3 times daily, for 1 week. IL-1beta-511 and CYP2C19 genotypes of patients and sensitivity of H. pylori to clarithromycin and amoxicillin were determined.


RESULTS
Logistic regression analysis showed that the IL-1beta-511 polymorphism, as well as CYP2C19 genotype of patients and clarithromycin-resistance of H. pylori, was associated with successful eradication. Eradication rates for H. pylori were 77.3% (75 of 97; 95% confidence interval, 67.5-84.6), 89.6% (147 of 164; 95% confidence interval, 83.9-93.1), and 94.7% (95% confidence interval, 86.9-98.5) in patients with the C/C, C/T, and T/T genotypes of IL-1beta-511, respectively (P = 0.0014).


CONCLUSIONS
IL-1beta-511 polymorphism is one of the determinants of successful eradication of H. pylori using triple therapy with a PPI, amoxicillin, and clarithromycin, together with CYP2C19 genotype and bacterial resistance to clarithromycin.
Furuta
Takahisa
T
First Department of Medicine, Hamamatsu University School of Medicine, 1-20-1, Handa-Yama, Hamamatsu 431-3192, Japan. furuta@hama-med.ac.jp
Shirai
Naohito
N
Xiao
Fang
F
El-Omar
Emad M
EM
Rabkin
Charles S
CS
Sugimura
Haruhiko
H
Ishizaki
Takashi
T
Ohashi
Kyoichi
K
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000328:Adult; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000890:Anti-Infective Agents / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D000918:Antibody Specificity / Q000187:drug effects / Q000235:genetics; D001189:Aryl Hydrocarbon Hydroxylases / Q000187:drug effects / Q000235:genetics; D017291:Clarithromycin / Q000627:therapeutic use; D065731:Cytochrome P-450 CYP2C19; D024901:Drug Resistance, Multiple, Bacterial / Q000187:drug effects / Q000235:genetics; D004359:Drug Therapy, Combination; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005756:Gastritis / Q000235:genetics / Q000382:microbiology; D020022:Genetic Predisposition to Disease / Q000235:genetics; D005838:Genotype; D016481:Helicobacter Infections / Q000235:genetics* / Q000382:microbiology*; D016480:Helicobacter pylori / Q000187:drug effects* / Q000235:genetics*; D006801:Humans; D007375:Interleukin-1 / Q000235:genetics*; D064747:Lansoprazole; D008297:Male; D008875:Middle Aged; D006899:Mixed Function Oxygenases / Q000187:drug effects / Q000235:genetics; D009154:Mutation / Q000187:drug effects / Q000235:genetics; D009853:Omeprazole / Q000031:analogs & derivatives* / Q000037:antagonists & inhibitors / Q000627:therapeutic use; D010349:Patient Compliance; D010437:Peptic Ulcer / Q000235:genetics / Q000382:microbiology; D011110:Polymorphism, Genetic / Q000187:drug effects* / Q000235:genetics*; D054328:Proton Pump Inhibitors; D017494:Proton Pumps / Q000627:therapeutic use; D016896:Treatment Outcome
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D000897:Anti-Ulcer Agents; D007375:Interleukin-1; D054328:Proton Pump Inhibitors; D017494:Proton Pumps; D064747:Lansoprazole; D000658:Amoxicillin; D006899:Mixed Function Oxygenases; D001189:Aryl Hydrocarbon Hydroxylases; C045793:CYP2C19 protein, human; D065731:Cytochrome P-450 CYP2C19; D017291:Clarithromycin; D009853:Omeprazole