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Antimicrobial activity against Helicobacter pylori (Hp) of Omeprazole vs Esomeprazole
Abstracts
205
207
Antitmcmbiel activity againstHebcobaeterpylori (HP) of Omeprazolevs Esomepmzole Gatta L, Peme F, Nat& F, Ricci C, Tampieri A, D’Anna L, Miglioli M, Vain D. 1stMedical Clinic, University ofBologna, Bologna; Military Hospital, Rome,Italy s. Orsola Beckground: Several studieshave shown proton pump inhibitors (PPI) exen a specific antibacterial activity againstHp in vitro. Esomepramleis a novel PPI. It is anenantiomorphof Omepramle and expaimental studieshave shown it inhibits acid secretionmore effectivelv than Omeommle. km: to ;ompare the antimicrobial activity againstHp in vitm ofbath PPIs a&sing the m&ma1 tibitory concentration(MICs). Methods: Hp strains isolatedt&n patients who underwent endoscopyin mu unit were studied.Stock c&res were storedat -Sb in Brucellabmtb with 10% fetal calf serum (Fcs: pH 7.0) mlpplementedwith 20% glycerol. All plates were prepareted extemvoranmuslv. McFarland 4 sumensionwere meoaredin Bmcella broth frcm 72 hour aear plate &res and inoculatedwith e&em appa&s delivering 106organism ca.per spot, o& columbiaagar enrichedwith 5 % horse blood andcontaining tbc PPIs at the concentrationsranging from 0,125to 128mg/ml. The plateswere immediately incubatedat 37 C in a micmaembic atmosphere&us with GasPaks) andread after 72h.The MICs were defined as the lowest concentrationwith completegrowth inhibition. Results: So far 19 strains have beenexamined(7 duodenalulcers, I2 non ulcer dyspepsia) (m/f ,3/7, mean age48 yrs, rangeage 28-71 yrs). The MIC50 endMIC90 for Esomeorazoleand Omemw& were 16Wml. 128 ie/ml for both PPI respectively. 14 strains showedthe same sus&tibility to both Pits, h st&s were 2 to 4 folds more suscevtibleto Esomewawle, one strain wee2 fold more susceptibleta Omeerazole.No differences were ken betweens&ins coming tiom patientswith endwit&t ducdenal&er. Conclusion: Esomeprazolewas more active thenOmepremle againstone fitlh of the strains. Clinical comparativestudies are necessaryto determinew&her the superior antimicrobial activity of Esomeprazolecould enhancethe rate of eradicationHp infection. This study was fmmded by SIGE Schoolarshiu2001
299
HP strains
MIC (mcg/ml) hepfaZ0le
6 7 8 9 10
C266 C262 Cl24 Cl18 C28
0,125 4 124 16 8
Esomeprazole 0,125 1 124 16 16
GENOMKS KNOWLEDGE SHOULD HELP THE MANAGEMENT OF HBLICGBACTER PYLORl (HP) INFECTION? SaponeA, PemeF, Vaim D, Trespidi S, PaolieiM, TempieriA, Ricci C, Miglkdi M, Biii GL, CaetelliForti 0. Depemnxt of PharmacologyandInternalMedicine,University of Bologna,Bologna,Itely. Aim: To improvethempeuticgein, basicm&cular biologytechniquesare introduced.This study tries to join sevwl researchinterests:basicandclinical.Genomicderivedintbrmetionssbadd be wed to 1) prso& therapy;2) increasetkmpeutic slxzess; 3) dradc3uy reducedrugs tbih andappearance of nw e&biotic resiraance,4) improvethe complienee.Roton pmqn inhibitorsare gerrmlly mtaboliscd by CYPZCI9, md to a lesm extent,3A4; on ot& handclmithmmycia (Cl) is mainly mnaboliscdby CYP3A4, md to a ksser extent,2CI9. uetbods: To studyclinical phamecologicel failure,DNA samplesof 290patientswere.x&al. PCR,rest&tan enzymedigestionandsequencing mutatedCYP2Cl9 (variants: ‘2 and ‘3) and3A4 (*1B, l 2 and‘3) aklcs isofonm weresssewd. HP msitives were&lined i3ccdhe to cuitumand/orbiaolow olu -test. Results:The *enotwe data arr shovm ii3the tebk. HO % He 5 0 0 0 1.0 1 0 3A4.3 0.3 2 0 1.0 I 0 Fortv out of 50 therapyfilwe patienta(80%) weremt carryins mutetioa Interestingly,they were alI Ci susceptible. Conclusions:Theseresuhssuggestthat gemmix infm’mationcould klp te managethedrug toxicity and therapeuticfeilwe.
A90
ATROPHIC GASTRITIS AND =TINAI. MBTAPLASIA DO NOT IMPROVE AFT= HELICOBACTER PYLORI ERADICATTON IN A 12 MONTHS FOLLOW-UP Iacopini F, Paolti OA, Comolazio A, Rivers M, CriepinoP. Pica R Rosa 9. Nerdi F, Paoluzi P Gastmentemlogy, Depariment of clinical Sciences;*Department of Pathology, Univemity ‘la Sapinua; Rome; Italy. Background: Chronic atmpbic gastritis and iawtimd mstepl& are colrclated to H. py&xi (Hp) infection and considered ar lesionsincreasing the risk of camxr. Aim: To investigate the outcome of Hp-positive auphjc gastritis andintestinal mefaplariatier eradictia Mahcds: Two hundred andninety pts with Hp-pa&e gastritis diakmorcdby histology and rapid ureas test were emolled m the study md famd to ba eradicatedat 2 d a& a PPI-basedtriple-tbanpy. Two heedred andtwenty-lwo (76%) and 210 (72%) out of 2% enrolled pts were anbaed at 6 end I2 months. Gastritis andHm were asawed accord@ to the updatedSydney system on 2 biopsies rpec~enchtslcntmm~~~m~~~~~~dm2,6~dlZmomhsllftaHp mdicatien. Results: In Hpporitive gut&is. tivity, chronic intlanmation rmdintatinal snaplasiz iu lntrum were aignific~,Iy more severe thanin cmplu (p=o.OOl). In antrum mid cows, activity andcbmnic intkmmation deeread eignificamly et 2 months afterHp.emdicetion ~<0.001)Mdquitedi saneared a& 6 months WO.oOO1l. Atmohic natrbir andintestinal mctaplasiain antrem ~‘SigaiGcantly mom di& than h co& i did not changedat 12 months after Hp-eradication (M T&la). Conehniats: In patientswith Iip-pesitive gartritis, H.pylori eradication doss not indw a regression of ntmphic gaitis ad intcrrinnl metaplaxa wbilc active and chmnic inflammaion diaappcarprugxesively in 12montbaof follow-up.
205
207
Antitmcmbiel activity againstHebcobaeterpylori (HP) of Omeprazolevs Esomepmzole Gatta L, Peme F, Nat& F, Ricci C, Tampieri A, D’Anna L, Miglioli M, Vain D. 1stMedical Clinic, University ofBologna, Bologna; Military Hospital, Rome,Italy s. Orsola Beckground: Several studieshave shown proton pump inhibitors (PPI) exen a specific antibacterial activity againstHp in vitro. Esomepramleis a novel PPI. It is anenantiomorphof Omepramle and expaimental studieshave shown it inhibits acid secretionmore effectivelv than Omeommle. km: to ;ompare the antimicrobial activity againstHp in vitm ofbath PPIs a&sing the m&ma1 tibitory concentration(MICs). Methods: Hp strains isolatedt&n patients who underwent endoscopyin mu unit were studied.Stock c&res were storedat -Sb in Brucellabmtb with 10% fetal calf serum (Fcs: pH 7.0) mlpplementedwith 20% glycerol. All plates were prepareted extemvoranmuslv. McFarland 4 sumensionwere meoaredin Bmcella broth frcm 72 hour aear plate &res and inoculatedwith e&em appa&s delivering 106organism ca.per spot, o& columbiaagar enrichedwith 5 % horse blood andcontaining tbc PPIs at the concentrationsranging from 0,125to 128mg/ml. The plateswere immediately incubatedat 37 C in a micmaembic atmosphere&us with GasPaks) andread after 72h.The MICs were defined as the lowest concentrationwith completegrowth inhibition. Results: So far 19 strains have beenexamined(7 duodenalulcers, I2 non ulcer dyspepsia) (m/f ,3/7, mean age48 yrs, rangeage 28-71 yrs). The MIC50 endMIC90 for Esomeorazoleand Omemw& were 16Wml. 128 ie/ml for both PPI respectively. 14 strains showedthe same sus&tibility to both Pits, h st&s were 2 to 4 folds more suscevtibleto Esomewawle, one strain wee2 fold more susceptibleta Omeerazole.No differences were ken betweens&ins coming tiom patientswith endwit&t ducdenal&er. Conclusion: Esomeprazolewas more active thenOmepremle againstone fitlh of the strains. Clinical comparativestudies are necessaryto determinew&her the superior antimicrobial activity of Esomeprazolecould enhancethe rate of eradicationHp infection. This study was fmmded by SIGE Schoolarshiu2001
299
HP strains
MIC (mcg/ml) hepfaZ0le
6 7 8 9 10
C266 C262 Cl24 Cl18 C28
0,125 4 124 16 8
Esomeprazole 0,125 1 124 16 16
GENOMKS KNOWLEDGE SHOULD HELP THE MANAGEMENT OF HBLICGBACTER PYLORl (HP) INFECTION? SaponeA, PemeF, Vaim D, Trespidi S, PaolieiM, TempieriA, Ricci C, Miglkdi M, Biii GL, CaetelliForti 0. Depemnxt of PharmacologyandInternalMedicine,University of Bologna,Bologna,Itely. Aim: To improvethempeuticgein, basicm&cular biologytechniquesare introduced.This study tries to join sevwl researchinterests:basicandclinical.Genomicderivedintbrmetionssbadd be wed to 1) prso& therapy;2) increasetkmpeutic slxzess; 3) dradc3uy reducedrugs tbih andappearance of nw e&biotic resiraance,4) improvethe complienee.Roton pmqn inhibitorsare gerrmlly mtaboliscd by CYPZCI9, md to a lesm extent,3A4; on ot& handclmithmmycia (Cl) is mainly mnaboliscdby CYP3A4, md to a ksser extent,2CI9. uetbods: To studyclinical phamecologicel failure,DNA samplesof 290patientswere.x&al. PCR,rest&tan enzymedigestionandsequencing mutatedCYP2Cl9 (variants: ‘2 and ‘3) and3A4 (*1B, l 2 and‘3) aklcs isofonm weresssewd. HP msitives were&lined i3ccdhe to cuitumand/orbiaolow olu -test. Results:The *enotwe data arr shovm ii3the tebk. HO % He 5 0 0 0 1.0 1 0 3A4.3 0.3 2 0 1.0 I 0 Fortv out of 50 therapyfilwe patienta(80%) weremt carryins mutetioa Interestingly,they were alI Ci susceptible. Conclusions:Theseresuhssuggestthat gemmix infm’mationcould klp te managethedrug toxicity and therapeuticfeilwe.
A90
ATROPHIC GASTRITIS AND =TINAI. MBTAPLASIA DO NOT IMPROVE AFT= HELICOBACTER PYLORI ERADICATTON IN A 12 MONTHS FOLLOW-UP Iacopini F, Paolti OA, Comolazio A, Rivers M, CriepinoP. Pica R Rosa 9. Nerdi F, Paoluzi P Gastmentemlogy, Depariment of clinical Sciences;*Department of Pathology, Univemity ‘la Sapinua; Rome; Italy. Background: Chronic atmpbic gastritis and iawtimd mstepl& are colrclated to H. py&xi (Hp) infection and considered ar lesionsincreasing the risk of camxr. Aim: To investigate the outcome of Hp-positive auphjc gastritis andintestinal mefaplariatier eradictia Mahcds: Two hundred andninety pts with Hp-pa&e gastritis diakmorcdby histology and rapid ureas test were emolled m the study md famd to ba eradicatedat 2 d a& a PPI-basedtriple-tbanpy. Two heedred andtwenty-lwo (76%) and 210 (72%) out of 2% enrolled pts were anbaed at 6 end I2 months. Gastritis andHm were asawed accord@ to the updatedSydney system on 2 biopsies rpec~enchtslcntmm~~~m~~~~~~dm2,6~dlZmomhsllftaHp mdicatien. Results: In Hpporitive gut&is. tivity, chronic intlanmation rmdintatinal snaplasiz iu lntrum were aignific~,Iy more severe thanin cmplu (p=o.OOl). In antrum mid cows, activity andcbmnic intkmmation deeread eignificamly et 2 months afterHp.emdicetion ~<0.001)Mdquitedi saneared a& 6 months WO.oOO1l. Atmohic natrbir andintestinal mctaplasiain antrem ~‘SigaiGcantly mom di& than h co& i did not changedat 12 months after Hp-eradication (M T&la). Conehniats: In patientswith Iip-pesitive gartritis, H.pylori eradication doss not indw a regression of ntmphic gaitis ad intcrrinnl metaplaxa wbilc active and chmnic inflammaion diaappcarprugxesively in 12montbaof follow-up.