Korean J Med.  2001 Apr;60(4):324-329.

The usefulness of PCR-based restriction fragment length polymorphism (RFLP) analysis for differentiating Helicobacter pylori strains after the triple therapy

• Park CH
• Lee SW
• Park DK
• Kim KJ
• Kwon S
• Jeen YT
• Chun HJ
• Lee HS
• Song CW
• Um SH
• Choi JH
• Kim CD
• Ryu HS
• Hyun JH

Abstract

BACKGROUND: The aim of this prospective study was to evaluate the usefulness of PCR-based restriction fragment length polymorphism (RFLP) analysis for differentiating H. pylori strains after the triple therapy in patients with duodenal ulcer.
METHODS
Following a 1-2 week regimen of omeprazole 40 mg, amoxicillin 2.0 g, and clarithromycin 1.0 g, twice daily, twenty patients with duodenal ulcer were enrolled. Ten patients (group 1) were not successfully treated, and another 10 patients (group 2) exhibited recurrence of infection. Follow-up diagnosis was performed by Giemsa stain and CLO test. RFLP profiles of antral and midbody biopsy specimens were compared before and after therapy. PCR products using the ureC gene were digested with restriction enzymes Hha I, Mbo I, and Hind III, and the fragments generated were analyzed by agarose gel electrophoresis.
RESULTS
Hha I, Mbo I, and Hind III digestion produced 13, 7, and 2 distinguishable digestion patterns, respectively. There was no difference in RFLP profiles before and after the therapy in 17 duodenal ulcer patients, while different RFLP profiles following therapy were discovered in 3 patients. Following treatment, one (group 2) patient differed in Mbo I, and two (one each from both groups) patients differed in Hha I and Mbo I RFLP patterns.
CONCLUSION
This study supports the hypothesis that PCR-based RFLP analysis can be useful for differentiating reinfection and recrudescence of H. pylori strains following triple therapy.

Keyword

Helicobacter pylori; Polymorphism, Restriction fragment length; Duodenal ulcer; Drug therapy

MeSH Terms

Amoxicillin
Azure Stains
Biopsy
Clarithromycin
Diagnosis
Digestion
Drug Therapy
Duodenal Ulcer
Electrophoresis, Agar Gel
Follow-Up Studies
Helicobacter pylori*
Helicobacter*
Humans
Omeprazole
Polymerase Chain Reaction
Polymorphism, Restriction Fragment Length*
Prospective Studies
Recurrence
Amoxicillin
Azure Stains
Clarithromycin
Omeprazole