title: Cytochrome P450 2C19 polymorphism influences the preventive effect of lansoprazole on the recurrence of erosive reflux esophagitis.
abstract: BACKGROUND
  The efficacy of lansoprazole (LPZ) at inhibiting gastric acid secretion is influenced by cytochrome P450 2C19 (CYP2C19) polymorphism. The purpose of the present study was to investigate whether CYP2C19 polymorphism had an influence on the remission of erosive reflux esophagitis (RE) during maintenance therapy with LPZ.
  
  
  METHODS
  Eighty-two Japanese patients with initial healing of erosive RE by 8 weeks of LPZ therapy were enrolled. As maintenance therapy, the patients were treated with LPZ (15 mg/day) for 6 months. The CYP2C19 genotype, Helicobacter pylori infection status, and serum pepsinogen (PG) I/II ratio were assessed before treatment. The patients were investigated for relapse by endoscopy at 6 months or when symptoms recurred.
  
  
  RESULTS
  The proportion of patients in remission after 6 months was 61.5%, 78.0%, and 100% among homozygous extensive metabolizers (homo-EM), heterozygous EM (hetero-EM), and poor metabolizers (PM), respectively. The percentage of PM patients who remained in remission was significantly higher than that of homo-EM or hetero-EM.
  
  
  CONCLUSIONS
  The efficacy of LPZ (15 mg/day) as maintenance therapy for erosive RE is influenced by CYP2C19 polymorphism.
authors.affiliation: Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan. dq8m-kwmr@asahi-net.or.jp
authors.forename: Masashi
authors.initials: M
authors.lastname: Kawamura
authors.forename: Shuichi
authors.initials: S
authors.lastname: Ohara
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Koike
authors.forename: Katsunori
authors.initials: K
authors.lastname: Iijima
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Suzuki
authors.forename: Shoichi
authors.initials: S
authors.lastname: Kayaba
authors.forename: Kenji
authors.initials: K
authors.lastname: Noguchi
authors.forename: Shinya
authors.initials: S
authors.lastname: Abe
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Noguchi
authors.forename: Toru
authors.initials: T
authors.lastname: Shimosegawa
mesh_terms: D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000627:therapeutic use*; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D001189:Aryl Hydrocarbon Hydroxylases / Q000235:genetics*; D065731:Cytochrome P-450 CYP2C19; D004941:Esophagitis / Q000209:etiology / Q000235:genetics* / Q000517:prevention & control*; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications*; D006801:Humans; D064747:Lansoprazole; D008297:Male; D008875:Middle Aged; D006899:Mixed Function Oxygenases / Q000235:genetics*; D011110:Polymorphism, Genetic; D012008:Recurrence; D012074:Remission Induction
chemical_list: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents; D064747:Lansoprazole; D006899:Mixed Function Oxygenases; D001189:Aryl Hydrocarbon Hydroxylases; C045793:CYP2C19 protein, human; D065731:Cytochrome P-450 CYP2C19