The authors have analyzed research works, both by domestic and foreign researchers that dwell on frequency of H.pylori being resistant to antibacterial medications, the reasons for its occurrence, methods applied to determine it and ways to overcome it. Over the last 15 years there has been a growth in frequency of detecting H.pylori that was resistant to basic antibiotics used to eradicate the pathogen. The authors have established geographical diversity in resistance related to antibiotics intake by population. Bacteriological technique is the most valid for determining H.pylori sensitivity; however, it is rather difficult to apply it due to complicated procedures for the microorganism cultivation. Therefore, molecular-genetic techniques are widely used. H.pylori resistance to Clarithromycin has great practical significance as this antibiotic is able not only to produce antibacterial effects but also to destroy biofilms. Helicobacter that was resistant to Clarithromycin was the least frequently detected in northern European countries (1-3 %); it was the most frequently detected in Southern Europe, Asia,. Research performed in several Russian regions revealed significant variations in frequency of detecting H.pylori resistant to Clarithromycin (5-40 %) and a growth in dynamics of this detection (from 5 to 15 %). Frequency of detecting helicobacter resistance to another widely used medication, Metronidazole, is also different in different geographic regions; it amounts to 17 % in Europe, 24 % in Russia, and 92 % in Africa. H.pylori still has low resistance to Amoxicillin and another reserve medication, Rifabutin.The article also dwells on probable ways to overcome non-sensitivity of the pathogen to antibiotics and the necessity to develop procedures for treating H.pylori infection based on the results of examining the pathogen sensitivity with standardized techniques performed in different regions. Efficient H.pylori eradication reduces inflammation in the gastric mucosa, prevents ulcer formation and atrophy and reducers risks of stomach cancer.
Introduction: Establishing the reasons for the decrease in the effectiveness of anti-Helicobacter pylori therapy and proton pump inhibitors in the treatment of acid-dependent diseases is an urgent task due to high prevalence of these disorders undermining population health. Our objective was to conduct a literature review to assess the influence of the genetic polymorphism of cytochrome P-450 CYP2C19 on the eradication rate of Helicobacter pylori and the metabolism of proton pump inhibitors, to evaluate the effectiveness of their use, and to determine possible ways of overcoming refractoriness to these drugs in the clinic. Materials and methods: We analyzed published studies found in domestic (eLibrary, CyberLeninka.ru) and international (PubMed, Cochrane Library) databases. Results: We revealed a genetic polymorphism CYP2C19 of cytochrome P-450, according to which different types of drug metabolism were identified: fast, intermediate, slow, and ultrafast. The relationship of this polymorphism with biotransformation of proton pump inhibitors was then analyzed. In Russia, the predominance of fast and intermediate metabolism in individuals of the Caucasian race decreases the efficacy of acid-suppressive therapy and the Helicobacter pylori eradication rate. Correction of the daily dose and frequency of drug administration are necessary to increase the antisecretory effect of proton pump inhibitors. Discussion: The dependence of proton pump inhibitor biotransformation on the CYP2C19 polymorphism determines the differences between patients with different types of metabolism in the effectiveness of these drugs, the success of anti-Helicobacter pylori treatment, and clinical outcomes. Pharmacogenetic testing is useful for predicting the response to proton pump inhibitors, the likelihood of developing adverse events, and the possibility of personalized prescriptions in patients with acid-related diseases. Conclusion: Genetic testing of cytochrome CYP2C19 helps optimize the use of proton pump inhibitors, overcome refractoriness, and improve the quality of treatment of acid-dependent diseases and the overall Helicobacter pylori eradication rate.
The article presents the results of the examination of relatives of the patients with chronic H. pylori-associated gastritis. The genes of H. pylori pathogenicity were investigated by PCR to determine possible intrafamilial transmission of the infection. We established that in families of the patients with chronic gastritis, H. pylori was found in more than 60 % of relatives. The most similar spectrum of the genes of H. pylori pathogenicity was found in the samples of spouses, as well as in the mothers and the children. The study of H. pylori genovariant helps establish the mechanisms and ways of transmission of the infection, identify people infected with the microorganism with the most pronounced pathogenic potential and requiring therapy.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.