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Post a Comment H. pylori eradication therapy: impact of gastric mucosa atrophy on transport of amoxicillin to H. pylori colonization area
- Authors: Sablina A.O.1, Sablin O.A.1, Andreeva J.V.2, Rodionov G.G.1, Shantyr I.I.1, Ushal I.E.1, Samusenko I.A.1
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Affiliations:
- Nikiforov Russian Center of Emergency and Radiation Medicine
- Pavlov Institute of Physiology
- Issue: Vol 13, No 2 (2021)
- Pages: 57-66
- Section: Original research
- URL: https://journals.rcsi.science/vszgmu/article/view/70280
- DOI: https://doi.org/10.17816/mechnikov70280
- ID: 70280
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Abstract
AIM: The aim was to assess systemic transport of amoxicillin, the most common antibiotic in H. pylori eradication regimens to the gastric in atrophic gastritis.
MATERIALS AND METHODS: Systemic transport of amoxicillin to the gastric lumen of rats was evaluated in washes from the gastric mucosa in the model of atrophic gastritis after intravenous drug infusion. Transport of amoxicillin from bloodstream to the gastric lumen was also assessed in patients with atrophic and non-atrophic gastritis in aspirated via nasogastric probe gastric juice after oral drug administration. Amoxicillin concentration was measured in samples using liquid chromatography-mass spectrometry.
RESULTS: In rats with induced atrophic gastritis, hyperemia and acute erosions of the gastric mucosa, as well as microscopic signs of non-active chronic body gastritis and non-active antral atrophic gastritis were found. Amoxicillin concentration in washes from the gastric mucosa was significantly (p < 0.01) higher in rats of experimental group than in control group at all time points (30, 60, 120, 240 min after drug infusion). The lowest mean amoxicillin concentration in gastric juice was observed in patients with antral atrophy (p < 0.01). The maximum amoxicillin concentration in gastric secretion was found at the 180th min of aspiration in patients with atrophy of gastric mucosa, while in patients of the group of comparison it was found at 30-120th min of aspiration.
CONCLUSIONS: Acute gastric mucosa erosions enhance amoxicillin delivery to gastric lumen in rats. Atrophy of antral mucosa more than in the corpus is characterized by decreased amoxicillin transfer from systemic bloodstream to gastric lumen in patients after oral amoxicillin intake. The gastric mucosa atrophy should be taken into consideration while predicting the efficacy of H. pylori eradication therapy in patients with chronic gastritis.
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##article.viewOnOriginalSite##About the authors
Anastasiya O. Sablina
Nikiforov Russian Center of Emergency and Radiation Medicine
Author for correspondence.
Email: a.o.sablina@mail.ru
ORCID iD: 0000-0002-0337-453X
SPIN-code: 1044-8392
Scopus Author ID: 57216203494
MD, PhD student
Russian Federation, 4/2 Academica Lebedeva str., Saint Petersburg, 194044Oleg A. Sablin
Nikiforov Russian Center of Emergency and Radiation Medicine
Email: gastroleg@yandex.ru
ORCID iD: 0000-0002-2597-1220
SPIN-code: 5446-2329
Scopus Author ID: 6508192177
ResearcherId: U-1854-2017
MD, Dr. Sci. (Med.), Professor
Russian Federation, 4/2 Academica Lebedeva str., Saint Petersburg, 194044Julia V. Andreeva
Pavlov Institute of Physiology
Email: jandreeva@mail.ru
ORCID iD: 0000-0002-7360-9306
SPIN-code: 5122-4026
Scopus Author ID: 42960935800
ResearcherId: AAO-9573-2021
Cand. Sci. (Biol.)
Russian Federation, Saint PetersburgGennadii G. Rodionov
Nikiforov Russian Center of Emergency and Radiation Medicine
Email: rodgengeor@yandex.ru
ORCID iD: 0000-0001-6237-7848
SPIN-code: 6471-3933
Scopus Author ID: 57220177362
ResearcherId: AAQ-5773-2021
MD, Dr. Sci. (Med.), Assistant Professor
Russian Federation, 4/2 Academica Lebedeva str., Saint Petersburg, 194044I. I. Shantyr
Nikiforov Russian Center of Emergency and Radiation Medicine
Email: shantyr@arcerm.spb.ru
ORCID iD: 0000-0003-1840-5770
SPIN-code: 8038-2999
Scopus Author ID: 57216182544
MD, Dr. Sci. (Med.), Professor
Russian Federation, 4/2 Academica Lebedeva str., Saint Petersburg, 194044Inna E. Ushal
Nikiforov Russian Center of Emergency and Radiation Medicine
Email: innaushal@mail.ru
ORCID iD: 0000-0001-5857-3627
SPIN-code: 4726-8832
Scopus Author ID: 23111545700
Cand. Sci. (Biol.)
Russian Federation, 4/2 Academica Lebedeva str., Saint Petersburg, 194044Igor A. Samusenko
Nikiforov Russian Center of Emergency and Radiation Medicine
Email: egors_2000@mail.ru
ORCID iD: 0000-0003-0622-3515
SPIN-code: 6669-5602
Scopus Author ID: 14020322000
Cand. Sci. (Med.)
Russian Federation, 4/2 Academica Lebedeva str., Saint Petersburg, 194044References
- Goddard AF. Review article: factors influencing antibiotic transfer across the gastric mucosa. Aliment Pharmacol Ther. 1998;12(12):1175–1184. doi: 10.1046/j.1365-2036.1998.00425.x
- Zheng H-L, Hu Y-M, Bao J-J, Ju H-M. Transfer and distribution of amoxicillin in the rat gastric mucosa and gastric juice and the effects of rabeprazole. Acta Pharmacol Sin. 2010;31(4):501–508. doi: 10.1038/aps.2009.191
- Shore PA, Brodie BB, Hogben CAM. The gastric secretion of drugs: a pH partititon hypothesis. J Pharmacol Exp Ther. 1957;119(3):361–369.
- Kurumado K, Yamakawa T, Ohara T. Changes in arterioles of the human gastric mucosa with atrophic gastritis. Hepatogastroenterology. 1990;37(2):235–238.
- Denisov NL, Ivashkin VT, Lobzin JuV, Golofeevskij VJu. Efficacy of Helicobacter pylori eradication in relation to the level of secretory immunoglobulin A production and morphological changes of the stomach mucosa. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2007;17(3):40–46. (In Russ.)
- Noguchi T, Umegaki E, Shimamoto C, Katsu K-I. Effect of long-term administration of ammonia water on rat gastric mucosa – combined effect of gastric mucosal protective agents. Bulletin of the Osaka Medical College. 2007;53(1):69–78.
- Dixon MF, Genta RM, Yardley JH, Correa P. Classification and grading of gastritis. The updated Sydney System. International Workshop on the Histopathology of Gastritis Houston 1994. Am J Surg Pathol. 1996;20(10):1161–1181. doi: 10.1097/00000478-199610000-00001
- Erah PO, Goddard AF, Barrett DA, et al. The stability of amoxicillin, clarithromycin and metronidazole in gastric juice: relevance to the treatment of Helicobacter Pylori infection. J Antimicrob Chemother. 1997;39(1):5–12. doi: 10.1093/jac/39.1.5
- Benini L, Castellani G, Bardelli E, et al. Omeprazole causes delay in gastric emptying of digestible meals. Dig Dis Sci. 1996;41(3):469–474. doi: 10.1007/BF02282320
- Peterson WL. The role of antisecretory drugs in the treatment of Helicobacter pylori infection. Aliment Pharmacol Ther. 1997;11 Suppl 1: 21–25. doi: 10.1046/j.1365-2036.11.s1.4.x
- Goddard AF, Jessa MJ, Barrett DA, et al. Effect of omeprazole on the distribution of metronidazole, amoxicillin and clarithromycin in human gastric juice. Gastroenterology. 1996;111(2):358–367. doi: 10.1053/gast.1996.v111.pm8690200
- Calafatti AS, don Santos A, da Saliva CM, et al. Transfer of metronidazole to gastric juice: impact of Helicobacter pylori infection and omeprazole. Scand J Gastroenterol. 2000;35(7):699–704. doi: 10.1080/003655200750023354
- Pedrazzoli JJ, Calafatti SA, Ortiz RA, et al. Transfer of clarithromycin to gastric juice is enhanced by omeprazole in Helicobacter pylori-infected individuals. Scand J Gastroenterol. 2001;36(12):1248–1253. doi: 10.1080/003655201317097074
- Ortiz RAM, Calafatti SA, Corazzi A, et al. Amoxicillin and ampicillin are not transferred to gastric juice irrespective of Helicobacter pylori status or acid blockade by omeprazole. Aliment Pharmacol Ther. 2002;16(6):1163–1170. doi: 10.1046/j.1365-2036.2002.01262.x
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