H. pylori Infection - An Overview

Comparison of the two recently identified genome sequences has revealed that, of the～1500 genes, some 60 % can be assigned a predicted function, while another 20 % have homologues of unknown identity. The remainder has no currently identified homologues. Of singular importance is the 'pathogenicity island' of which the cagA-gene is a marker. The vacA-gene is outside the pathogenicity island and is a true cytotoxin. The cag pathogenicity island encodes proteins associated with cell signaling and secretion systems for delivery of virulence factors to target cells. Certaingenotypes, particularly the cag-A positive,

H. pylori Infection - Basic and Clinical Outcomes

H. pylori infection causes invariably chronic inflammation of the gastric mucosa and predisposes for peptic ulcerations in the stomach and duodenum as well as for gastric neoplasias. A subset of patients with chronic gastritis and without additional lesions will develop dyspeptic symptoms, whereas around 80% of all infected may never experience any clinical manifestation. The determinants of different diseases conditions associated with the H. pylori infection are related to the variability of bacterial strains, host genetic factors, and ambiental conditions.

Racial Differences in H. pylori Infection and Disease Outcomes in a Mutiracial Asian Country

Malaysia epitomizes the multiraciality of a South East Asian country where three major Asian races: Malay, Chinese and Indians live together. The distribution of Hp infection amongst the differences in Malaysia show an interesting pattern with the Malays having a consistently low prevalence compared to the Chinese and Indians. In our seroepidemiological studies and in a large endoscopic survey, Chinese and Indian race remained as independent predictive factors for H.pylori infection, after adjusting for possible confounding factors such as social class and age.

Association between central serous chorioretinopathy and Helicobacter pylori infection: a systematic review and Meta-analysis

AIM:To investigate the association between central serous chorioretinopathy(CSC)and Helicobacter pylori(Hp)by summarizing all available evidence.METHODS:The Scopus,Embase,EBSCO,PubMed,Web of Science,and Cochrane Library databases for all relevant studies published from inception to October 2022 were searched,and manually searched for relevant reference lists as a supplement.Studies investigating the association between CSC and Hp infection were included.Finally,8 case-control studies were included in the Meta-analysis after study selection.RESULTS:The results showed no significant correlation between Hp infection and CSC[odds ratio(OR)1.89,95%confidential interval(CI)0.58–6.15,I2=96%,P=0.29].After subgroup analysis based on the degree of development of the study(developing/developed countries),it was found that the results of the two subgroups were the same as the whole,and no significant difference between the two subgroups existed.Meta-regression showed that the effect of sample size on heterogeneity among studies was more prominent(P<0.01,adjusted R^(2)=89.72%),which can explain 89.72%of the sources of heterogeneity.CONCLUSION:This Meta-analysis reveals no significant correlation between Hp infection and CSC,which still warrants further well-designed extensive sample studies to reach a more reliable conclusion and promote a better understanding of the treatment of CSC.

Estimate the Prevalence of Helicobacter pylori Infection among Diabetes & Non-Diabetes Mellitus Patients and Its Correlation with Malignant Gastritis Patients Attending in Lower Shabelle Region (Somalia)

Background: Several conducted studies have reported a higher and more frequent Helicobacter pylori infection rate in type 2 diabetes mellitus (T2DM). The aim of this study was to estimation the prevalence of H. pylori and its association between H. pylori infection and T2DM. Materials and Methods: A sectional-cross study was conducted based on 200 patients studded with socioeconomic characteristics through a questionnaire & H. pylori was diagnosed by serum anti-H. pylori immunoglobulin G (IgG) and IgA. Furthermore, patients were investigated for fasting blood glucose (FBG) levels, glycosylated hemoglobin (HbA1c), serum cholesterol, and other biochemistry parameters. Results: The findings showed The prevalence of Hp positive infection was significantly higher in the total sample was 134 with (67%). While 66 out of 200 patients with (33%) was H. pylori negative infection. of H. pylori. Further, the mean values were statistically significant for diabetes with H. pylori infection for IgG > 300 titer and IgA > 250 titer, regarding, HbA1C (7.52 ± 0.41) (P Conclusions: The current study revealed that H. pylori prevalence infections were significantly higher in diabetic patients studied compared to non-diabetic patients. Furthermore, T2DM patients infected with H. pylori positive reported a higher prevalence rate of symptoms than H. pylori negative.

Third-line and rescue therapy for refractory Helicobacter pylori infection: A systematic review

BACKGROUND Due to increasing resistance rates of Helicobacter pylori(H.pylori)to different antibiotics,failures in eradication therapies are becoming more frequent.Even though eradication criteria and treatment algorithms for first-line and second-line therapy against H.pylori infection are well-established,there is no clear recommendation for third-line and rescue therapy in refractory H.pylori infection.AIM To perform a systematic review evaluating the efficacy and safety of rescue therapies against refractory H.pylori infection.METHODS A systematic search of available rescue treatments for refractory H.pylori infection was conducted on the National Library of Medicine’s PubMed search platform based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Randomized or non-randomized clinical trials and observational studies evaluating the effectiveness of H.pylori infection rescue therapies were included.RESULTS Twenty-eight studies were included in the analysis of mean eradication rates as rescue therapy,and 21 of these were selected for analysis of mean eradication rate as third-line treatment.For rifabutin-,sitafloxacin-,levofloxacin-,or metronidazole-based triple-therapy as third-line treatment,mean eradication rates of 81.6%and 84.4%,79.4%and 81.5%,55.7%and 60.6%,and 62.0%and 63.0%were found in intention-to-treat(ITT)and per-protocol(PP)analysis,respectively.For third-line quadruple therapy,mean eradication rates of 69.2%and 72.1%were found for bismuth quadruple therapy(BQT),88.9%and 90.9%for bismuth quadruple therapy,three-in-one,Pylera®(BQT-Pylera),and 61.3%and 64.2%for non-BQT)in ITT and PP analysis,respectively.For rifabutin-,sitafloxacin-,levofloxacin-,or metronidazole-based triple therapy as rescue therapy,mean eradication rates of 75.4%and 78.8%,79.4 and 81.5%,55.7%and 60.6%,and 62.0%and 63.0%were found in ITT and PP analysis,respectively.For quadruple therapy as rescue treatment,mean eradication rates of 76.7%and 79.2%for BQT,84.9%and 87.8%for BQT-Pylera,and 61.3%and 64.2%for non-BQT were found in ITT and PP analysis,respectively.For susceptibility-guided therapy,mean eradication rates as third-line and rescue treatment were 75.0%in ITT and 79.2%in PP analysis.CONCLUSION We recommend sitafloxacin-based triple therapy containing vonoprazan in regions with low macrolide resistance profile.In regions with known resistance to macrolides or unavailability of bismuth,rifabutin-based triple therapy is recommended.

Treatment of Helicobacter pylori with potassium competitive acid blockers:A systematic review and meta-analysis

BACKGROUND Helicobacter pylori(H.pylori)infects over half the global population,causing gastrointestinal diseases like dyspepsia,gastritis,duodenitis,peptic ulcers,GMALT lymphoma,and gastric adenocarcinoma.Eradicating H.pylori is crucial for treating and preventing these conditions.While conventional proton pump inhibitor(PPI)-based triple therapy is effective,there’s growing interest in longer acid suppression therapies.Potassium competitive acid blocker(P-CAB)triple and dual therapy are new regimens for H.pylori eradication.Initially used in Asian populations,vonoprazan(VPZ)has been recently Food and Drug Administration-approved for H.pylori eradication.AIM To assess the efficacy of regimens containing P-CABs in eradicating H.pylori infection.METHODS This study,following PRISMA 2020 guidelines,conducted a systematic review and meta-analysis by searching MEDLINE and Scopus libraries for randomized clinical trials(RCTs)or observational studies with the following command:[("Helicobacter pylori"OR"H pylori")AND("Treatment"OR"Therapy"OR"Eradication")AND("Vonaprazan"OR"Potassium-Competitive Acid Blocker"OR"P-CAB"OR"PCAB"OR"Revaprazan"OR"Linaprazan"OR"Soraprazan"OR"Tegoprazan")].Studies comparing the efficacy of P-CABs-based treatment to classical PPIs in eradicating H.pylori were included.Exclusion criteria included case reports,case series,unpublished trials,or conference abstracts.Data variables encompassed age,diagnosis method,sample sizes,study duration,intervention and control,and H.pylori eradication method were gathered by two independent reviewers.Meta-analysis was performed in R software,and forest plots were generated.RESULTS A total of 256 references were initially retrieved through the search command.Ultimately,fifteen studies(7 RCTs,7 retrospective observational studies,and 1 comparative unique study)were included,comparing P-CAB triple therapy to PPI triple therapy.The intention-to-treat analysis involved 8049 patients,with 4471 in the P-CAB intervention group and 3578 in the PPI control group across these studies.The analysis revealed a significant difference in H.pylori eradication between VPZ triple therapy and PPI triple therapy in both RCTs and observational studies[risk ratio(RR)=1.17,95%confidence interval(CI):1.11-1.22,P<0.0001]and(RR=1.13,95%CI:1.09-1.17,P<0.0001],respectively.However,no significant difference was found between tegoprazan(TPZ)triple therapy and PPI triple therapy in both RCTs and observational studies(RR=1.04,95%CI:0.93-1.16,P=0.5)and(RR=1.03,95%CI:0.97-1.10,P=0.3),respectively.CONCLUSION VPZ-based triple therapy outperformed conventional PPI-based triple therapy in eradicating H.pylori,positioning it as a highly effective first-line regimen.Additionally,TPZ-based triple therapy was non-inferior to classical PPI triple therapy.

Effect of acacetin on inhibition of apoptosis in Helicobacter pyloriinfected gastric epithelial cell line

BACKGROUND Helicobacter pylori(H.pylori)infection can cause extensive apoptosis of gastric epithelial cells,serving as a critical catalyst in the progression from chronic gastritis,gastrointestinal metaplasia,and atypical gastric hyperplasia to gastric carcinoma.Prompt eradication of H.pylori is paramount for ameliorating the pathophysiological conditions associated with chronic inflammation of the gastric mucosa and the primary prevention of gastric cancer.Acacetin,which has multifaceted pharmacological activities such as anti-cancer,anti-inflammatory,and antioxidative properties,has been extensively investigated across various domains.Nevertheless,the impact and underlying mechanisms of action of acacetin on H.pylori-infected gastric mucosal epithelial cells remain unclear.AIM To explore the defensive effects of acacetin on apoptosis in H.pylori-infected GES-1 cells and to investigate the underlying mechanisms.METHODS GES-1 cells were treated with H.pylori and acacetin in vitro.Cell viability was assessed using the CCK-8 assay,cell mortality rate via lactate dehydrogenase assay,alterations in cell migration and healing capacities through the wound healing assay,rates of apoptosis via flow cytometry and TUNEL staining,and expression levels of apoptosis-associated proteins through western blot analysis.RESULTS H.pylori infection led to decreased GES-1 cell viability,increased cell mortality,suppressed cell migration,increased rate of apoptosis,increased expressions of Bax and cle-caspase3,and decreased Bcl-2 expression.Conversely,acacetin treatment enhanced cell viability,mitigated apoptosis induced by H.pylori infection,and modulated the expression of apoptosis-regulatory proteins by upregulating Bcl-2 and downregulating Bax and cleaved caspase-3.CONCLUSION Acacetin significantly improved GES-1 cell viability and inhibited apoptosis in H.pylori-infected GES-1 cells,thereby exerting a protective effect on gastric mucosal epithelial cells.

Research Progress of Radical Treatment of Helicobacter Pylori Based on Drug Sensitivity Test as First-Line Treatment

Helicobacter pylori (HP) infection is a global problem that affects about half of the world’s population and requires sufficient attention in clinical and scientific work. Due to differences in economic and medical conditions among countries around the world, there is currently no unified treatment plan for anti-HP. In China, empirical quadruple therapy is mainly used. With the abuse of antibiotics, many patients face the problem of secondary eradication after failure, and the resistance rate of HP is gradually increasing. After eradication failure, drug sensitivity cultivation is carried out to choose sensitive antibiotics for treatment. A new strategy is currently needed to address how to improve the eradication rate of HP during the first eradication. This article aims to discuss the first-line treatment plans and research progress for eradicating HP based on drug sensitivity testing before eradication. Compared with traditional empirical therapies, treatment based on drug sensitivity results can effectively improve the eradication rate of HP, and reduce drug resistance rates, and adverse reactions, among other benefits. .

Furazolidone-induced pulmonary toxicity in Helicobacter pylori infection:Two case reports

BACKGROUND Helicobacter pylori(H.pylori)infection is a global problem,causing significant morbidity and mortality.Furazolidone is recommended to eradicate H.pylori infections in China owing to the highly associated antibiotic resistance.CASE SUMMARY This article presents two cases of lung injury caused by furazolidone treatment of H.pylori infection and the relevant literature review.Two patients developed symptoms,including fever,cough,and fatigue after receiving a course of furazolidone for H.pylori infection.Chest computed tomography showed bilateral interstitial infiltrates.Laboratory studies revealed elevated blood eosinophil count.After discontinuing furazolidone with or without the use of corticosteroids,the symptoms improved rapidly.A PubMed database literature search revealed three reported cases of lung injury suggestive of furazolidone-induced pulmonary toxicity.CONCLUSION Clinicians should be aware of the side effects associated with the administration of furazolidone to eradicate H.pylori infection.

Helicobacter Pylori Infection and Gastroduodenal Lesions in Patients with Chronic Kidney Disease: A Comparative Study

Introduction: Gastroduodenal lesions are common in chronic kidney disease (CKD). They are linked to various factors including Helicobacter pylori infection (H. pylori). Few data are available in Africa on H. pylori infection and chronic kidney disease. The aim of this study was to assess the impact of H. pylori infection and to describe the gastroduodenal lesions found in patients with chronic kidney disease. Patients and Methods: A cross-sectional study was conducted, February 1st to May 31st, 2021, at the Douala General Hospital in Cameroon. We included patients with CKD classified as stages 3 to 5 according KDIGO classification, on hemodialysis or not, who agreed to participate in the study. They were matched with a “control” population including patients with normal renal function according to sex and age (ratio 1:2). Patients on antibiotics and/or proton pump inhibitors were excluded. We collected data from CKD patients and from medical records for non-CKD group. Each patient underwent an upper digestive endoscopy and identification of H. pylori using a urease rapid test. Logistic regression was used to identify independent associations for a significance level set at p Results: We included 99 patients including 33 with CKD and 66 control patients. Among patients with CKD, the predominance was male (n = 18/33 or 54.5%). The mean age was 51.2 ± 12.8 years. Arterial hypertension was the first etiology of CKD (n = 13 or 39.4%). The prevalence of H. pylori in patients with CKD was 63.6% versus 37.9% in control patients (p-value = 0.015). The main endoscopic lesions were erosive gastropathy (n = 14 or 42.4%) and erythematous gastropathy (n = 7 or 21.2%). Patients with CKD were 5 times more likely to have H. pylori infection (OR = 5.69;CI 95% 0.14 - 0.82;p = 0.017). Factors associated with H. pylori infection were chronic kidney disease (aOR = 1.02;CI 95% 0.14 - 0.82;p = 0.017) and hemodialysis (aOR = 10;CI 95% 1.08 - 91.9;p = 0.042). Conclusion: The prevalence of H. pylori infection is higher in patients with CKD. Endoscopic lesions are inflammatory. Factors associated with H. pylori infection are chronic kidney disease and hemodialysis.

Study on Professor Diangui Li's Medication Experience in Treating Atrophic Gastritis Concomitant with Helicobacter Pylori Infection Based on Data Mining

Objective Our objective was to explore the national traditional Chinese medicine by studying master Diangui Li's medication experience in treating atrophic gastritis(AG)concomitant with Helicobacter pylori(Hp)infection based on data mining,and to provide the reference for the clinical treatment of relevant diseases.Methods The Chinese medicine prescriptions of the patients'first visits to the Famous Doctors'Consultation Room in Hebei Provincial Hospital of Chinese Medicine from May 2019 to December 2022 were collected and frequency analysis of the Chinese herbs,association rules analysis of the Chinese herbs,and cluster analysis were conducted using the Famous Doctor Inheritance Assistance Platform.ResultsA total of 188 prescriptions were collected,with 136 kinds of Chinese herbs.The highest use frequency of Chinese herbs was 185 and the lowest was 1.There were 28 kinds of Chinese herbs with high use frequency.The top 10 herbs with the high use frequency include Baihuasheshecao(Hedyotis Diffusae Herba),Huanglian(Coptidis Rhizoma),Yinchen(Artemisiae Scopariae Herba),jigucao(Abriherba),Baishao(Paeoniae Radix Alba),Danggui(Angelicae Sinensis Radix),Banzhilian(Scutellariae Barbatae Herba),Baihe(Lili Bulbus),Zhishi(Auranti Immaturus Fructus),Chuanxiong(Chuanxiong Rhizoma).Chinese herbs with high frequency use are mostly heat-clearing herbs and qi-regulating herbs;the flavors of the herbs are mainly pungent,bitter,and sweet;the properties are mainly warm,cold,and neutral;the meridian tropism is mainly the spleen,liver,and stomach meridians.The core herbal medicines are Huanglian(Coptidis Rhizoma),Yinchen(Artemisiae Scopariae Herba),Baishao(Paeoniae Radix Alba),Danggui(Angelicae Sinensis Radix),etc.;the results of association rules:Jigucao(Abriherba)-Kushen(Sophorae Flavescentis Radix),Jjiaogulan(Gynostemmatis Pentaphylli Rhizoma seu Herba)-Banlangen(lsatidis Radix),Huangqin(Scutellariae Radix)-Banlangen(lsatidis Radix),etc.;the results of cluster analysis showed that there were 10 clusters:(1)Yinchen(Artemisiae Scopariae Herba),Huanglian(Coptidis Rhizoma),Baihuasheshecao(Hedyotis Diffusae Herba),Banzhilian(Scutellariae Barbatae Herba),Jigucao(Abriherba);(2)Baishao(Paeoniae Radix Alba),Danggui(Angelicae Sinensis Radix),Chuanxiong(Chuanxiong Rhizoma),Wuyao(Linderae Radix);(3)Yuanhu(Corydalis Rhizoma),Danshen(Salviae Miltiorrhizae Radix et Rhizoma),Baizhi(Angelicae Dahuricae Radix).Conclusions For the treatment of AG concomitant with Hp infection,Professor Diangui Li mainly adopts the method of clearing heat and removing the toxin,regulating qi and resolving phlegm,combining disease differentiation with syndrome differentiation,performing reinforcing method,and reducing method simultaneously to regulate the mechanism of the human body.

Clinical usefulness of linked color imaging in identifying Helicobacter pylori infection:A systematic review and meta-analysis

BACKGROUND Accurate diagnosis of Helicobacter pylori(H.pylori)infection status is a crucial premise for eradication therapy,as well as evaluation of risk for gastric cancer.Recent progress on imaging enhancement endoscopy(IEE)made it possible to not only detect precancerous lesions and early gastrointestinal cancers but also to predict H.pylori infection in real time.As a novel IEE modality,linked color imaging(LCI)has exhibited its value on diagnosis of lesions of gastric mucosa through emphasizing minor differences of color tone.AIM To compare the efficacy of LCI for H.pylori active infection vs conventional white light imaging(WLI).METHODS PubMed,Embase,Embase and Cochrane Library were searched up to the end of April 11,2022.The random-effects model was adopted to calculate the diagnostic efficacy of LCI and WLI.The calculation of sensitivity,specificity,and likelihood ratios were performed;symmetric receiver operator characteristic(SROC)curves and the areas under the SROC curves were computed.Quality of the included studies was chosen to assess using the quality assessment of diagnostic accuracy studies-2 tool.RESULTS Seven original studies were included in this study.The pooled sensitivity,specificity,positive likelihood rate,and negative likelihood rate of LCI for the diagnosis of H.pylori infection of gastric mucosa were 0.85[95%confidence interval(CI):0.76-0.92],0.82(95%CI:0.78-0.85),4.71(95%CI:3.7-5.9),and 0.18(95%CI:0.10-0.31)respectively,with diagnostic odds ratio=26(95%CI:13-52),SROC=0.87(95%CI:0.84-0.90),which showed superiority of diagnostic efficacy compared to WLI.CONCLUSION Our results showed LCI can improve efficacy of diagnosis on H.pylori infection,which represents a useful endoscopic evaluation modality for clinical practice.

口腔扁平苔藓患者Hp感染状况分析及其与免疫功能的关系

目的分析口腔扁平苔藓(OLP)患者幽门螺杆菌(Hp)感染状况及其与免疫功能相关性。方法回顾性选取2023年1—12月郑州大学第一附属医院收治的215例OLP患者作为OLP组,选取同期182例健康体检正常志愿者作为健康组。比较健康组、OLP组Hp感染情况,根据Hp检验结果将OLP组分为OLP阳性组和OLP阴性组,比较OLP阳性组和OLP阴性组各项免疫指标水平,分析免疫指标与OLP阳性相关性。结果健康组Hp感染率比OLP组更低;OLP阳性组总T淋巴细胞(T)+B淋巴细胞(B)+自然杀伤细胞(NK)、诱导T淋巴细胞(CD4^(+))、免疫球蛋白G(IgG)、补体C3(C3)、补体C4(C4)水平低于OLP阴性组,B淋巴细胞表面抗原(CD19^(+))、免疫球蛋白A(IgA)、免疫球蛋白M(IgM)水平高于OLP阴性组;相关性分析可知,总T+B+NK、CD4^(+)、IgG、C3、C4与OLP阳性呈负相关关系(r=-0.961,-0.754,-0.501,-0.145,-0.669,P<0.05),CD19^(+)、IgA、IgM与OLP阳性呈正相关关系(r=0.443,0.475,0.349,P<0.05)。结论OLP患者有较高Hp感染率,且感染Hp的患者免疫功能较差,其中总T+B+NK、CD4^(+)、IgG、C3、C4与OLP患者Hp阳性呈负相关,CD19^(+)、IgA、IgM与OLP患者Hp阳性呈正相关,临床可将以上免疫功能指标作为评估OLP患者Hp阳性的指标。