National Institute of Genetic Engineering and Biotechnology, Pajoohesh Boulevard, Km 17, Tehran-Karaj Highway,Tehran, Iran.
Arch Iran Med. 2010 Sep;13(5):406-12.
There are different clinical responses to omeprazole treatment in Iranian patients with gastroesophageal reflux disease. Omeprazole is metabolized in the liver by the cytochrome p450 2c19 (CYP2C19) enzyme. Two common polymorphisms of the CYP2C19 gene affect CYP2C19 enzyme activity. We investigated the effect of CYP2C19 gene polymorphisms on the clinical response to treatment with omeprazole in Iranian patients with erosive reflux esophagitis.
Eighty-two Iranian patients with reflux esophagitis were enrolled in the study and underwent treatment with omeprazole at 40 mg daily for 4 weeks. A 2 mL sample of venous blood was obtained from each subject. CYP2C19 genetic polymorphisms were detected using the PCR-RFLP method. The patients were grouped into homo-extensive metabolizers and hetero-extensive metabolizers based on their CYP2C19 polymorphism. The grade of esophagitis was determined via endoscopy. The symptoms score was assessed at the beginning of treatment.
Our results showed that the rate of complete clinical response to treatment with omeprazole was 95% in the hetero-extensive metabolizers group, which was higher than in the homo-extensive metabolizers group (P<0.001).
CYP2C19 polymorphism influences the therapeutic efficacy of omeprazole in the treatment of Iranian patients with erosive reflux esophagitis. The clinical response and endoscopic healing of esophagitis are both affected by CYP2C19 genotype condition.
在伊朗胃食管反流病患者中，奥美拉唑治疗存在不同的临床反应。奥美拉唑在肝脏中通过细胞色素 p450 2c19（CYP2C19）酶代谢。CYP2C19 基因的两种常见多态性影响 CYP2C19 酶活性。我们研究了 CYP2C19 基因多态性对伊朗糜烂性反流性食管炎患者接受奥美拉唑治疗的临床反应的影响。
82 例伊朗反流性食管炎患者入组本研究，接受奥美拉唑 40mg 每日治疗 4 周。从每位受试者中抽取 2ml 静脉血。采用 PCR-RFLP 法检测 CYP2C19 基因多态性。根据 CYP2C19 多态性，将患者分为同型广泛代谢者和异型广泛代谢者。通过内镜确定食管炎的严重程度。在治疗开始时评估症状评分。
我们的结果显示，在异型广泛代谢者组中，奥美拉唑治疗的完全临床反应率为 95%，高于同型广泛代谢者组（P<0.001）。
CYP2C19 多态性影响奥美拉唑治疗伊朗糜烂性反流性食管炎患者的疗效。CYP2C19 基因型状况影响食管炎的临床反应和内镜愈合。
