[The influence of genetic factors on the effectiveness of eradication therapy of Helicobacter pylori infection in children].

Efficacy of sequential eradication therapy for H. pylori was studied in 176 adolescents (mean age 14.3 years) with different PPI metabolism types. Group I consisted from the patients received omeprazole as PPI in combined treatment with amoxycilline, clarithromycine and tinidazole, Group II--patients treated with rabeprazole in the combination with the same antibacterial drugs. In all the patients, CYP2C19 genotype was identified as a control rate of PPI metabolism (extensive, intermediate and poor metabolizers). Sequential therapy in the children with intermediate and poor metabolic activity demonstrated a high eradication rate irrespective of PPI type (> 80%). In the patients with extensive metabolism taking omeprazole, eradication standard turned out to be lower (63.4%) than in the rabeprazole group (82.3%) (p = 0.026). Results of our survey confirmed a potential advantage of rabeprazole-based treatment compared with omeprazole-containing regimen in the sequential treatment of H. pylori infection in childhood.

[Rifaximin in combined treatment of the Helicobacter pylori infection in childhood].

AIM: To provide a pilot study of empiric rifaximin, bismuth subcitrate, furazolidone/nifuratel triple therapy for H. pylori gastritis in childhood. MATERIALS AND METHODS: Forty one pediatric outpatients (27 females, mean age 14.5 +/- 1.4 ys) with H. pylori-associated chronic gastritis who underwent endoscopy for dyspeptic symptoms received the combination of bismuth subcitrate (8/mg/kg/day, q. d. s.) for 14 days, rifaximin (800 mg/day) for 10 days and furazolidone (10 mg/kg/day, q. d. s.) or nifuratel (15 mg/kg/two times daily) for 10 days. H. pylori status was determined before the treatment by modified Giemsa staining/urease test and after the treatment (in 4-6 weeks) by ammonia breath test. RESULTS: H. pylori was eradicated in 35 children (85.4%; 95% CI: 75.4-96.4 ITT and PP tests). There were no serious adverse reactions and were no withdrawals due to any side effects. CONCLUSION: The combination of rifaximin, bismuth subcitrate and furazolidone/nifuratel was an effective and tolerable regimen for initial H. pylori eradication.

[Immune polymorphism analysis of HLA class II antigens in ulcer diseases associated with Helicobacter pylori in children].

UNLABELLED: Previous investigations have linked specific HLA class II alleles DRB1 and DQB1 to H. pylori infection (Y. Huang et al., 2005). AIM: to investigate potential contribution of HLA-DRB1 and DQB1 alleles in H. pylori infection susceptibility in a Russian pediatric population. METHODS: Polymerase chain reaction-sequence specific primer (PCR-SSP) method was used to study the HLA-DRB1, DQB1 allelic frequency distribution in 162 children (93 female) with H. pylori infection was determined by culture, breath test and histology. RESULTS: The carrier frequency of DQB1*03 was higher among H. pylori--positive patients with chronic gastritis only compared with H. pylori-negative patients. The difference in carrier frequencies for HLA-DRB1*17 was higher in H. pylori-positive ulcer patients compared with an uninfected controls (chi2 = 3.69, p = 0.027). In addition, the frequency of genotypes that possess HLA-DQB1*07 allele in the H. pylori-positive children (with peptic ulcer/ chronic gastritis only) was significantly lower than that in the H. pylori-negative control group. CONCLUSIONS: HLA-DQB1*07 allele may be associated with protection against H. pylori infection independently of clinical outcome. At the same time, HLA-DRB1*17 allele might be associated with susceptible gene to peptic ulcer formation among H. pylori-positive children.

[Rifaksimin in complex treatment of Helicobacter pylori infection in children (a pilot study)].

AIM: To provide a pilot study of empiric rifaximin, bismuth subcitrate, furazolidone/nifuratel triple therapy for H. pylori gastritis in childhood. MATERIALS AND METHODS: Forty one pediatric outpatients (27 females, mean age 14.5+/-1.4 ys) with H. pylori-associated chronic gastritis who underwent endoscopy for dyspeptic symptoms received the combination of bismuth subcitrate (8 mg/kg/day, q. d. s.) for 14 days, rifaximin (800 mg/day) for 10 days and furazolidone (10 mg/kg/day, q. d. s.) or nifuratel (15 mg/kg/two times daily) for 10 days. H. pylori status was determined before the treatment by modified Giemsa staining/urease test and after the treatment (in 4-6 weeks) by ammonia breath test. RESULTS: H. pylori was eradicated in 35 children (85.4%; 95%CI: 75.4-96.4 ITT and PP tests). There were no serious adverse reactions and were no withdrawals due to any side effects. CONCLUSION: The combination of rifaximin, bismuth subcitrate and furazolidone/nifuratel was an effective and tolerable regimen for initial H. pylori eradication.

[Study of gene polymorphism responsible for metabolism of proton pump inhibitors in children with H. pylori infection: is there a correlation with efficacy of eradication treatment?].

UNLABELLED: THE AIM of this study was to determine the effects of CYP2C19 polymorphism on H. pylori eradication in pediatric population in the Republic of Bashkortostan. METHODS: Fifty-nine children were entered into the study (age range: 12 to 17; 22 female). All the patients were infected with H. pylori and received the combination of omeprazole (1 mg/kg/day), furazolidone (10 mg/kg/day) and amoxicilline (25 mg/kg/day) or clarithromycin (7.5 mg/kg/day) for 10 days. The participants were classified into 3 groups according to CYP2C19 genotype; rapid metabolizers (RM) (54.2%), intermediate metabolizers (IM) (35.6%) and poor metabolizers (PM) (10.2%). H. pylori infection status was assessed before and after the treatment. RESULTS: The eradication rate was 65.6% for RM, 71.4% for IM, and 83.3% for PM. CONCLUSION: The present study confirmed the low eradication rate for RM and for the IM groups. Alternative regimens expected to be with a higher eradication rate should be recommended (rabeprazole-based treatment).

[Gastritis associated with Helicobacter pylori in the material of gastrobiopsies in the group of children with dyspepsia].

Helicobacter pylori (HP) was studied in gastrobiopsies from 180 children, 9 to 17 years old with chronic dyspeptic symptoms. The presence of HP was found in the stomach mucosa of 78.9% patients. The important morphological marker of HP-infection was presence of lymphoid follicles and signs of "active" chronic gastritis in the stomach mucosa (p < 0.001). Thus HP may be considered as an essential pathogenetic factor of chronic dyspeptic syndrome in children of a school age.