AIMTo develop a novel Helicobacter pylori (H. pylori) CagA antibody enzyme-linked immunosorbent assay (ELISA) suitable for detecting serum anti-CagA antibodies with high sensitivity.METHODSRecombinant East Asian-type ...AIMTo develop a novel Helicobacter pylori (H. pylori) CagA antibody enzyme-linked immunosorbent assay (ELISA) suitable for detecting serum anti-CagA antibodies with high sensitivity.METHODSRecombinant East Asian-type CagA protein was purified and immobilized for ELISA. Serum samples from 217 Vietnamese individuals (110 H. pylori-infected and 107 uninfected individuals) were applied. Conventional ELISA from Western-type CagA and our East Asian-type CagA ELISA were evaluated by comparing 38 subjects with the Western-type genotype and 72 subjects with the East Asian-type cagA genotype. Histological scores of the gastric mucosa were determined using the updated Sydney System to examine the relationship with anti-CagA antibody titers.RESULTSRecombinant 70-100 kDa fragments were immobilized on the ELISA plate. In ROC analysis, the area under the curve of our East Asian-type CagA ELISA was comparable to that of conventional CagA ELISA. The sensitivity of the two ELISAs differed depending on the cagA genotype. The sensitivity of East Asian-type CagA ELISA was higher for subjects infected with East Asian-type cagA H. pylori (P < 0.001), and the sensitivity of the conventional CagA ELISA tended to be higher for subjects infected with Western cagA H. pylori (P = 0.056). The titer of anti-CagA antibody tended to correlate with monocyte infiltration scores (r = 0.25, P = 0.058) and was inversely correlated with H. pylori density (r = -0.26, P = 0.043).CONCLUSIONThe novel ELISA is useful to detect anti-CagA antibodies in East Asian countries, and the titer may be a marker for predicting chronic gastritis.展开更多
AIM To study the characteristics of upper digestive tract diseases (UDTDs) in the fishermen of the Bohai Bay. METHODS An investigation was carried out in 1488 fishermen with symptoms of UDTDs except liver, biliary ...AIM To study the characteristics of upper digestive tract diseases (UDTDs) in the fishermen of the Bohai Bay. METHODS An investigation was carried out in 1488 fishermen with symptoms of UDTDs except liver, biliary and pancreatic diseases during the period from December 1991 to February 1995, which included medical history inquiry, physical, gastroscopic and pathological examinations, detection of Helicobacter pylori ( H. pylori) infection, and nitrate content in their drinking water. RESULTS Among the 1488 subjects investigated, 1467 suffered from one or more diseases among 14 kinds of UDTDs, most of which were chronic atrophic gastritis (CAG, 1103 cases), peptic ulcer (268 cases), and cancer of the upper digestive tract (25 cases). CONCLUSION Incidence rate of UDTDs tends to be high among the fishermen, especially CAG, peptic ulcer and upper digestive tract cancer, and complicated state of illness due to their special life habits, and high nitrate content in their drinking water, etc, and UDTDs in fishermen is significantly different from that in inland residents in clinical manifestations.展开更多
目的:研究本地区幽门螺杆菌(Helicobacter pylori,H.pylori)的体外培养6种抗生素的药敏情况,以两种敏感抗生素的四联个体化方案与的四联经验治疗方案进行疗效对比,为临床用药提供参考依据.方法:选取乐清地区1000例经14C呼气试验及胃镜...目的:研究本地区幽门螺杆菌(Helicobacter pylori,H.pylori)的体外培养6种抗生素的药敏情况,以两种敏感抗生素的四联个体化方案与的四联经验治疗方案进行疗效对比,为临床用药提供参考依据.方法:选取乐清地区1000例经14C呼气试验及胃镜检查后诊断为上消化道疾病的H.pylori感染的患者,按照随机数字表法分为2组,观察组取胃黏膜标本行H.pylori培养与药敏试验,根据药敏结果选择2种抗生素,加用埃索美拉唑片20 mg 2次/d、枸橼酸铋钾片0.6 g 2次/d;经验组500例选择阿莫西林胶囊1.0 g 2次/d、克拉霉素片0.5 g 2次/d,埃索美拉唑片20 mg 2次/d、枸橼酸铋钾片0.6 g 2次/d,疗程均为2 wk,治疗结束后4 wk复查14C呼气试验,阳性者为根除治疗失败,阴性者为根除治疗成功.结果:观察组总体耐药情况:阿莫西林耐药0例(0.0%),克拉霉素耐药54例(17.3%),左氧氟沙星耐药88例(28.1%),甲硝唑耐药299例(95.5%),呋喃唑酮耐药1例(0.3%),庆大霉素耐药0例(0.0%).观察组313例,8例失访,305例完成治疗,281例根除成功.经验组500例,28例失访,472例完成治疗,405例根除治疗成功.两组对比,观察组方案治疗(per-protocol,PP)根除率92.1%高于经验组根除率85.8%,两组间差异有统计学意义(P<0.05).观察组意向治疗(intention-to-treat,ITT)根除率89.8%高于经验组根除率81.0%,两组间差异有统计学意义(P<0.05).结论:本地区上消化道疾病患者的H.pylori体外培养对阿莫西林、呋喃唑酮、庆大霉素耐药率较低,对克拉霉素、左氧氟沙星、甲硝唑耐药率较高.以H.pylori培养加药敏为基础的个体化四联方案根除率高于经验四联方案根除率,是目前有效的H.pylori根除方案,值得推广.展开更多
基金the National Institutes of Health,No.DK62813Grants-in-Aid for Scientific Research from the Ministry of Education,Culture,Sports,Science,and Technology of Japan(in part),No.25293104,No.26640114 and No.15H02657)theJapan Society for the Promotion of Science Institutional Program for Young Researcher Overseas Visits and the Strategic Funds for the Promotion of Science and Technology from the Japan Science and Technology Agency
文摘AIMTo develop a novel Helicobacter pylori (H. pylori) CagA antibody enzyme-linked immunosorbent assay (ELISA) suitable for detecting serum anti-CagA antibodies with high sensitivity.METHODSRecombinant East Asian-type CagA protein was purified and immobilized for ELISA. Serum samples from 217 Vietnamese individuals (110 H. pylori-infected and 107 uninfected individuals) were applied. Conventional ELISA from Western-type CagA and our East Asian-type CagA ELISA were evaluated by comparing 38 subjects with the Western-type genotype and 72 subjects with the East Asian-type cagA genotype. Histological scores of the gastric mucosa were determined using the updated Sydney System to examine the relationship with anti-CagA antibody titers.RESULTSRecombinant 70-100 kDa fragments were immobilized on the ELISA plate. In ROC analysis, the area under the curve of our East Asian-type CagA ELISA was comparable to that of conventional CagA ELISA. The sensitivity of the two ELISAs differed depending on the cagA genotype. The sensitivity of East Asian-type CagA ELISA was higher for subjects infected with East Asian-type cagA H. pylori (P < 0.001), and the sensitivity of the conventional CagA ELISA tended to be higher for subjects infected with Western cagA H. pylori (P = 0.056). The titer of anti-CagA antibody tended to correlate with monocyte infiltration scores (r = 0.25, P = 0.058) and was inversely correlated with H. pylori density (r = -0.26, P = 0.043).CONCLUSIONThe novel ELISA is useful to detect anti-CagA antibodies in East Asian countries, and the titer may be a marker for predicting chronic gastritis.
文摘AIM To study the characteristics of upper digestive tract diseases (UDTDs) in the fishermen of the Bohai Bay. METHODS An investigation was carried out in 1488 fishermen with symptoms of UDTDs except liver, biliary and pancreatic diseases during the period from December 1991 to February 1995, which included medical history inquiry, physical, gastroscopic and pathological examinations, detection of Helicobacter pylori ( H. pylori) infection, and nitrate content in their drinking water. RESULTS Among the 1488 subjects investigated, 1467 suffered from one or more diseases among 14 kinds of UDTDs, most of which were chronic atrophic gastritis (CAG, 1103 cases), peptic ulcer (268 cases), and cancer of the upper digestive tract (25 cases). CONCLUSION Incidence rate of UDTDs tends to be high among the fishermen, especially CAG, peptic ulcer and upper digestive tract cancer, and complicated state of illness due to their special life habits, and high nitrate content in their drinking water, etc, and UDTDs in fishermen is significantly different from that in inland residents in clinical manifestations.
文摘目的:研究本地区幽门螺杆菌(Helicobacter pylori,H.pylori)的体外培养6种抗生素的药敏情况,以两种敏感抗生素的四联个体化方案与的四联经验治疗方案进行疗效对比,为临床用药提供参考依据.方法:选取乐清地区1000例经14C呼气试验及胃镜检查后诊断为上消化道疾病的H.pylori感染的患者,按照随机数字表法分为2组,观察组取胃黏膜标本行H.pylori培养与药敏试验,根据药敏结果选择2种抗生素,加用埃索美拉唑片20 mg 2次/d、枸橼酸铋钾片0.6 g 2次/d;经验组500例选择阿莫西林胶囊1.0 g 2次/d、克拉霉素片0.5 g 2次/d,埃索美拉唑片20 mg 2次/d、枸橼酸铋钾片0.6 g 2次/d,疗程均为2 wk,治疗结束后4 wk复查14C呼气试验,阳性者为根除治疗失败,阴性者为根除治疗成功.结果:观察组总体耐药情况:阿莫西林耐药0例(0.0%),克拉霉素耐药54例(17.3%),左氧氟沙星耐药88例(28.1%),甲硝唑耐药299例(95.5%),呋喃唑酮耐药1例(0.3%),庆大霉素耐药0例(0.0%).观察组313例,8例失访,305例完成治疗,281例根除成功.经验组500例,28例失访,472例完成治疗,405例根除治疗成功.两组对比,观察组方案治疗(per-protocol,PP)根除率92.1%高于经验组根除率85.8%,两组间差异有统计学意义(P<0.05).观察组意向治疗(intention-to-treat,ITT)根除率89.8%高于经验组根除率81.0%,两组间差异有统计学意义(P<0.05).结论:本地区上消化道疾病患者的H.pylori体外培养对阿莫西林、呋喃唑酮、庆大霉素耐药率较低,对克拉霉素、左氧氟沙星、甲硝唑耐药率较高.以H.pylori培养加药敏为基础的个体化四联方案根除率高于经验四联方案根除率,是目前有效的H.pylori根除方案,值得推广.