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雑誌文献

臨床検査54巻10号

2010年10月発行

文献概要

今月の主題 ファーマコゲノミクス 各論

ファーマコゲノミクスを活用したHelicobacter pylori除菌療法の有効性予測

著者: 古田隆久1 杉本光繁1 小平知世2 西野眞史2 山出美穂子2 魚谷貴洋2

所属機関: 1浜松医科大学臨床研究管理センター 2浜松医科大学第一内科

ページ範囲:P.1163 - P.1170

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 Helicobacter pylori(H.pylori)の除菌療法の成否にはH.pyloriの抗菌薬のへの耐性の有無だけでなく,プロトンポンプ阻害薬(PPI)の代謝酵素であるCYP2C19活性の個体差の影響を受ける.H.pyloriのクラリスロマイシン耐性やキノロンへの耐性の有無,CYP2C19の活性の個体差は遺伝子検査にて判定可能である.そこで,筆者などはこうした遺伝子情報に応じたテーラーメイドのH.pylori除菌療法を確立した.テーラーメイドの除菌療法の除菌率は,標準療法よりも有意に高かった.したがって,ファーマコゲノミクス(PGx)情報に基づく治療の個別化はH.pyloriの除菌療法において有用であると考えられた.

参考文献

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7) Sugimoto M, Furuta T, Shirai N, et al:Evidence that the Degree and Duration of Acid Suppression are Related to Helicobacter pylori Eradication by Triple Therapy. Helicobacter 12:317-323,2007
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9) Nakamura A, Furuta T, Shirai N, et al:Determination of mutations of the 23S rRNA gene of Helicobacter pylori by allele specific primer-polymerase chain reaction method. J Gastroenterol Hepatol 22:1057-1063,2007
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12) Furuta T, Ohashi K, Kamata T, et al:Effect of genetic differences in omeprazole metabolism on cure rates for Helicobacter pylori infection and peptic ulcer. Ann Intern Med 129:1027-1030,1998
13) Shirai N, Furuta T, Moriyama Y, et al:Effects of CYP2C19 genotypic differences in the metabolism of omeprazole and rabeprazole on intragastric pH. Aliment Pharmacol Ther 15:1929-1937,2001
14) Furuta T, Shirai N, Sugimoto M, et al:Effect of concomitant dosing of famotidine with lansoprazole on gastric acid secretion in relation to CYP2C19 genotype status. Aliment Pharmacol Ther 22:67-74,2005
15) Okudaira K, Furuta T, Shirai N, et al:Concomitant dosing of famotidine with a triple therapy increases the cure rates of Helicobacter pylori infections in patients with the homozygous extensive metabolizer genotype of CYP2C19. Aliment Pharmacol Ther 21:491-497,2005

掲載誌情報

出版社:株式会社医学書院

電子版ISSN:1882-1367

印刷版ISSN:0485-1420

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