Helicobacter Pylori
Copyright ©2005 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 14, 2005; 11(18): 2720-2725
Published online May 14, 2005. doi: 10.3748/wjg.v11.i18.2720
Increased activity of Pgp multidrug transporter in patients with Helicobacter pylori infection
Zarko Babic, Ivna Svoboda-Beusan, Nastja Kucisec-Tepes, Dragan Dekaris, Rosana Troskot
Zarko Babic, Rosana Troskot, University Department of Medicine, Department of Gastroenterology, Sveti Duh General Hospital, Zagreb, Croatia
Ivna Svoboda-Beusan, Dragan Dekaris, Institute of Immunology, Department of Cellular Immunology, Zagreb, Croatia
Nastja Kucisec-Tepes, University Department of Microbiology, Sveti Duh General Hospital, Zagreb, Croatia
Author contributions: All authors contributed equally to the work.
Supported by Sveti Duh General Hospital, Zagreb, Croatia, approval, No. UR/P-10/1998
Correspondence to: Assistant Professor Zarko Babic, MD, PhD, Fabkoviæeva 3, Zagreb HR-10000, Croatia. zarko.babic@zg.hinet.hr
Telephone: +385-1-3712111 Fax: +385-1-3745550
Received: March 15, 2004
Revised: March 16, 2004
Accepted: July 9, 2004
Published online: May 14, 2005

AIM: To determine whether local antibiotic resistance involves P-glycoprotein (Pgp)-mediated active drug out-pumping during Helicobacter pylori (H pylori) infection treatment with classic antibiotic therapy.

METHODS: Pgp activity was determined in gastric mucosa biopsy specimens obtained from 53 patients with pathohistologically verified gastritis and microbiologically confirmed H pylori infection, and compared with the Pgp activity in 12 control subjects with normal endoscopic findings. The H pylori positive patients were treated with short-term 7-d therapy consisting of two antibiotics (amoxicillin and azithromycin/metronidazole and clarithromycin) and a proton pump inhibitor. Pgp activity was determined by flow cytometry in the test of rhodamine dye efflux and quantified as mean fluorescence ratio (RMF).

RESULTS: Upon the first cycle, H pylori was successfully eradicated in 20 patients, whereas therapy was continued in 33 patients. In the course of antibiotic therapy, RMF increased (P<0.05) and gastric cells showed higher rhodamine dye efflux. The mean pre-treatment RMF values were also higher (P<0.0001) in patients with multiple therapeutic failure than in those with successful H pylori eradication and control subjects.

CONCLUSION: Pgp might be one of the causes of therapy failure in patients with H pylori and antibiotic therapy could be chosen and followed up on the basis of the Pgp transporter local activity.

Keywords: H pylori, RMF, Pgp