细胞色素P450 2C19基因多态性影响兰索拉唑对糜烂性反流性食管炎复发的预防效果。
Cytochrome P450 2C19 polymorphism influences the preventive effect of lansoprazole on the recurrence of erosive reflux esophagitis.
作者信息
Kawamura Masashi, Ohara Shuichi, Koike Tomoyuki, Iijima Katsunori, Suzuki Hitoshi, Kayaba Shoichi, Noguchi Kenji, Abe Shinya, Noguchi Mitsunori, Shimosegawa Toru
机构信息
Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan.
出版信息
J Gastroenterol Hepatol. 2007 Feb;22(2):222-6. doi: 10.1111/j.1440-1746.2006.04419.x.
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.
背景
兰索拉唑（LPZ）抑制胃酸分泌的疗效受细胞色素P450 2C19（CYP2C19）基因多态性影响。本研究旨在探讨CYP2C19基因多态性对LPZ维持治疗期间糜烂性反流性食管炎（RE）缓解情况的影响。
方法
纳入82例经8周LPZ治疗后糜烂性RE初步愈合的日本患者。作为维持治疗，患者接受LPZ（15毫克/天）治疗6个月。治疗前评估CYP2C19基因型、幽门螺杆菌感染状况和血清胃蛋白酶原（PG）I/II比值。在6个月时或症状复发时通过内镜检查调查患者的复发情况。
结果
纯合子广泛代谢者（纯合子-EM）、杂合子EM（杂合子-EM）和慢代谢者（PM）中6个月后缓解的患者比例分别为61.5%、78.0%和100%。仍处于缓解状态的PM患者百分比显著高于纯合子-EM或杂合子-EM。
结论
LPZ（15毫克/天）作为糜烂性RE维持治疗的疗效受CYP2C19基因多态性影响。
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