J Appl Biomed 12:263-269, 2014 | DOI: 10.1016/j.jab.2014.02.001

Expressions of P-glycoprotein in treatment - Resistant Helicobacter pylori patients

Marhanis Omar^a,*, Andrew Crowe^b, Chin Yen Tay^c, Jeffery Hughes^b

^a Faculty of Pharmacy, Universiti Kebangsaan Malaysia, 53000 Kuala Lumpur, Malaysia

^b School of Pharmacy, Curtin University, GPO Box U1987, Perth, Western Australia 6845, Australia

^c School of Pathology and Laboratory Medicine, University of Western Australia, Western Australia 6009 Australia

Objective
There is an increasing incidence of Helicobacter pylori eradication therapy failure secondary to antibiotic resistance. In this study, we aimed to assess the P-glycoprotein expression levels among subjects who were H. pylori-positive and received multiple courses of eradication therapy to understand factors that may associate with their non-responses.
Methods
Eleven resistant subjects were recruited during their hospital visit for upper gastrointestinal endoscopies. H. pylori infection status was confirmed by rapid urease test and bacterial culture. P-glycoprotein expressions from the antral and duodenal biopsies were measured by Western blot. The data was compared with H. pylori-negative (n = 54) and H. pylori-positive-treatment naïve (n = 22) that were recruited earlier in another study.
Results
The resistant group showed higher relative antral P-glycoprotein expression compared to the H. pylori-negative group (p = 0.0361). Most subjects demonstrated resistance to clarithromycin (72%), metronidazole (63.6%) or both (54.5%). No significant difference was observed between the P-glycoprotein expression in H. pylori-treatment resistant and H. pylori-positive-treatment naïve groups (p = 0.319).
Conclusion
H. pylori infection induces the expression of P-glycoprotein in the antrum. This study shows a potential protective mechanism which may be exploited through the use of P-glycoprotein inducers, such as rifabutin, may be beneficial in eradication regimens.

Keywords: Protein expression; ABCB1; Antibiotic resistance; Peptic ulcer disease; Gastrointestinal tract

Received: September 20, 2013; Revised: January 28, 2014; Accepted: February 4, 2014; Published: November 1, 2014  Show citation