scholarly journals Evaluation of Salivary Antibodies to Detect Infection with Helicobacter pylori

1997 ◽  
Vol 11 (5) ◽  
pp. 437-440 ◽  
Author(s):  
Mark B Loeb ◽  
Robert H Riddell ◽  
Cindy James ◽  
Richard Hunt ◽  
Fiona M Smaill
Keyword(s):  
Helicobacter Pylori ◽  
Predictive Value ◽  
Tertiary Care ◽  
Eradication Therapy ◽  
Igg Antibody ◽  
Silver Stain ◽  
Ulcer Disease ◽  
Tertiary Centre ◽  
Gastric Biopsies ◽  
H Pylori

Helicobacter pylori infection is an important cause of peptic ulcer disease and chronic gastritis. Infection with this bacterium stimulates the production of immunoglobulin (Ig) G antibody. Salivary IgG antibody tests to detect H pylori infection offer a convenient and noninvasive method of diagnosis. To evaluate an IgG salivary antibody kit, saliva was collected from 157 out-patients with dyspepsia referred for endoscopy to a tertiary centre. A salivary IgG ELISA antibody assay was performed using the Helisal Helicobacter pylori (IgG) assay kit, and at least four gastric biopsies were obtained. H pylori infection was confirmed by demonstration of the organism on Warthin-Starry silver stain (sensitivity 85%, specificity 55%). The prevalence of infection with H pylori was 30%. When the analysis was redone, excluding those treated with eradication therapy, the results were similar (sensitivity 86%, specificity 58%). The positive predictive value of the assay was 45% and the negative predictive value was 90%. Despite the ease of sampling, the assay used has limited diagnostic utility, lacking the predictive value to indicate which patients referred with dyspeptic symptoms to a tertiary care setting are infected with H pylori.

scholarly journals Prospective study to evaluate the number and the location of biopsies in rapid urease test for diagnosis of Helicobacter Pylori

2017 ◽  
Vol 8 (1) ◽  
Author(s):  
Antoine Abou Rached ◽  
Jowana Saba ◽  
Cesar Yaghi ◽  
Joyce Sanyour ◽  
Ahmad El Hajjar ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Rapid Test ◽  
Rapid Urease Test ◽  
Ulcer Disease ◽  
Urease Test ◽  
Gastric Biopsies ◽  
H Pylori ◽  
Antral Biopsy

Helicobacter pylori (H. pylori) can cause a wide variety of illnesses such as peptic ulcer disease, gastric adenocarcinoma and mucosa-associated lymphoid tissue (MALT) lymphoma. The diagnosis and eradication of H. pylori are crucial. The diagnosis of H. pylori is usually based on the rapid urease test (RUT) and gastric antral biopsy for histology. The aim of this study is to evaluate the numbers of needed biopsies and their location (antrum/fundus) to obtain optimal result for the diagnosis of H. pylori. Three hundred fifty consecutive patients were recruited, 210 fulfill the inclusion criteria and had nine gastric biopsies for the detection of H. pylori infection: two antral for the first RUT (RUT1), one antral and one fundic for the second (RUT2), one antral for the third (RUT3) and two antral with two fundic for histology (HES, Giemsa, PAS). The reading of the 3 types of RUT was performed at 1 hour, 3 hours and 24 hours and biopsies were read by two experienced pathologists not informed about the result of RUT. Results of RUT were considered positive if H. pylori was found on histology of at least one biopsy. The RUT1 at 1h, 3h and 24h has a sensitivity of 72%, 82% and 89% and a specificity of 100%, 99% and 87% respectively. The positive predictive value (PPV) was 100%, 99% and 85% respectively and the negative predictive value (NPV) of 81%, 87% and 90%. The RUT2 at 1h, 3h and 24h, respectively, had a sensitivity of 86%, 87% and 91% and a specificity of 99%, 97% and 90%. The PPV was 99%, 96% and 88% and NPV of 89%, 90%, 94%. The RUT3 at 1h, 3h and 24h, respectively, had a sensitivity of 70%, 74% and 84% and a specificity of 99%, 99% and 94%. The PPV was 99%, 99% and 92% and NPV of 79%, 81% and 87%. The best sensitivity and specificity were obtained for RUT1 read at 3h, for RUT2 read 1h and 3h, and the RUT3 read at 24h.This study demonstrates that the best sensitivity and specificity of rapid test for urease is obtained when fundic plus antral biopsy specimens are used with a reading time at 3 hours.

Helicobacter pylori causes gastrointestinal hemorrhage in patients with congenital bleeding disorders

2003 ◽  
Vol 89 (04) ◽  
pp. 741-746 ◽  
Author(s):  
Ann-Sofie Rehnberg ◽  
Marju Hein ◽  
Olga Hegedus ◽  
Per Lindmarker ◽  
Per Hellström ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Gastrointestinal Hemorrhage ◽  
Breath Test ◽  
Eradication Therapy ◽  
Urea Breath Test ◽  
Von Willebrand Disease ◽  
Bleeding Disorders ◽  
Ulcer Disease ◽  
H Pylori ◽  
One Year

Summary Helicobacter pylori (H. pylori) infection is associated with peptic ulcer disease and gastric cancer. The eradication of H. pylori is of special interest in patients with congenital bleeding disorders, for whom treatment of gastrointestinal hemorrhage with factor concentrates is costly. The prevalence of H. pylori varies between different populations and identification of high-risk subgroups may allow for more targeted screening and eradication of the infection. We performed a 5-year retrospective study of gastrointestinal bleeding, combined with screening and treatment for H. pylori and a long-term prospective follow-up in 168 Swedish and 23 Estonian patients with hemophilia or von Willebrand disease. The prevalence of seropositivity was lower in Sweden than in Estonia (28 versus 48%, p = 0.03), lower in native Swedes than in non-Nordic immigrants to Sweden (20 versus 76%, p = 0.0001) and lower in patients less than 40 years of age than older patients (16 versus 38%, p = 0.002). The incidence of gastrointestinal hemorrhages among the 35 Swedish patients with active H. pylori infection, confirmed by a urea breath test, was 6.0 per 100 patient-years before eradication therapy versus 1.7 during the prospective followup. A negative urea breath test one month after therapy always remained negative after one year. Screening, followed by treatment of all infected patients, yielded a reduction of direct costs over a 5-year period of 130 US-$ per screened patient. We conclude that screening and eradication therapy for infection with H. pylori in patients with congenital bleeding disorders is an effective and economic strategy.

scholarly journals The role of acid inhibition in Helicobacter pylori eradication

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 1747 ◽  
Author(s):  
David R. Scott ◽  
George Sachs ◽  
Elizabeth A. Marcus
Keyword(s):  
Helicobacter Pylori ◽  
Urease Activity ◽  
Eradication Therapy ◽  
Acid Inhibition ◽  
Acid Suppression ◽  
Helicobacter Pylori Eradication ◽  
Ulcer Disease ◽  
Chronic Active Gastritis ◽  
H Pylori

Infection of the stomach by the gastric pathogen Helicobacter pylori results in chronic active gastritis and leads to the development of gastric and duodenal ulcer disease and gastric adenocarcinoma. Eradication of H. pylori infection improves or resolves the associated pathology. Current treatments of H. pylori infection rely on acid suppression in combination with at least two antibiotics. The role of acid suppression in eradication therapy has been variously attributed to antibacterial activity of proton pump inhibitors directly or through inhibition of urease activity or increased stability and activity of antibiotics. Here we discuss the effect of acid suppression on enhanced replicative capacity of H. pylori to permit the bactericidal activity of growth-dependent antibiotics. The future of eradication therapy will rely on improvement of acid inhibition along with current antibiotics or the development of novel compounds targeting the organism’s ability to survive in acid.

scholarly journals Detection of Antibody againstHelicobacter pyloriin the Saliva of Patients with Dyspepsia

1994 ◽  
Vol 8 (7) ◽  
pp. 408-412 ◽  
Author(s):  
Robert L Clancy ◽  
Allan W Cripps ◽  
Diana C Taylor ◽  
Lois A McShane ◽  
Victor J Webster
Keyword(s):  
Helicobacter Pylori ◽  
Predictive Value ◽  
Serum Antibody ◽  
Eradication Therapy ◽  
Elisa Assay ◽  
Local Production ◽  
Clinical Value ◽  
Gut Mucosa ◽  
H Pylori ◽  
Serum Elisa

There is a need to develop noninvasive assays to detectHelicobacter pyloriinfection in the gastric mucosa, Current dogma predicts that the presence of antibody within saliva should accurately reflect contemporary colonization of the gut mucosa. This study examined the clinical value of a saliva enzyme-linked immunoadsorbent assay (ELISA) for anti-H pyloriantibody, compared with the serum ELISA assay, and found the sensitivity of the saliva assay was 89%, specificity 94%, accuracy 93%, positive predictive value 89% and negative predictive value 94%. Assessment following eradication therapy demonstrated that salivary antibody was a more sensitive indicator of colonization than was serum antibody. The immunoglobulin G antibody in saliva correlated best with colonization, and regression analysis was most consistent with a local production of antibody. These results indicate that detection of antibody in saliva contributes to diagnosis and management ofH pyloriinfection.

scholarly journals Helicobacter pylori CagA seropositivity in adult Bangladeshi patients with peptic ulcer and erosion

2020 ◽  
Vol 14 (1) ◽  
pp. 36-40
Author(s):  
Fahmida Rahman ◽  
Khandaker Shadia ◽  
Salma Khatun ◽  
Mafruha Mahmud ◽  
Indrajit Kumar Dutta ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Peptic Ulcer ◽  
Enzyme Linked Immunosorbent Assay ◽  
Rapid Urease Test ◽  
Igg Antibody ◽  
Ulcer Disease ◽  
Urease Test ◽  
Urease Production ◽  
Stool Antigen ◽  
H Pylori

Background: CagA IgG antibody in sera might indicate presence of virulent Helicobacter pylori in patients with peptic ulcer disease. Present study was performed to find out the prevalence of CagA IgG antibody in patients with peptic ulcer/erosion. Methods: Any case that had peptic ulcer/erosion, plus positive for rapid urease test (RUT) or H. pylori stool antigen (HpSAg) or serum anti-H. pylori IgG/IgA were included in the study and named as H. pylori positive case. H. pylori positive cases were tested for CagA IgG antibody. Anti-H. pylori IgG, IgA and CagA IgG antibodies were determined by enzyme-linked immunosorbent assay (ELISA) and stool antigen by rapid immunochromatographic test (ICT). Urease production in biopsy sample was detected by RUT. Results: Total 86 H. pylori positive patients were included in the study. Out of 86 patients, CagA IgG was positive in 34 (39.5%; 95% CI: 0.30,0.50) cases. CagA seropositivity rate in ulcer and erosion cases were 58.8% (95% CI: 0.36,0.78) and 34.8% (95% CI: 0.25,0.47) respectively. H. pylori stool antigen and IgA antibodies were positive in all (100%) CagA antibody positive ulcer cases while the rates were significantly less among the CagA antibody negative cases (42.8% and 28.6%; p<0.05). However, in CagA antibody positive erosion cases, the rates were not significantly different from CagA antibody negative cases. Conclusion: The study has demonstrated that the CagA positive strain is less prevalent in erosion than ulcer cases. Ibrahim Med. Coll. J. 2020; 14(1): 36-40

scholarly journals Eradication Therapy Should Be Different for Dyspeptic Patients than for Ulcer Patients

2003 ◽  
Vol 17 (suppl b) ◽  
pp. 41B-45B ◽  
Author(s):  
Wink A de Boer
Keyword(s):  
Helicobacter Pylori ◽  
Peptic Ulcer ◽  
Eradication Therapy ◽  
Cure Rate ◽  
Ulcer Disease ◽  
Biological Explanation ◽  
Choice Of Treatment ◽  
H Pylori ◽  
Different Strains ◽  
Cure Rates

Physicians should try to achieve an optimal cure rate with their initialHelicobacter pylorieradication therapy. Most physicians use the same treatment in all their patients.H pyloriinfection in patients with peptic ulcer disease (PUD) is more likely to be cured than that in patients with functional dyspepsia (FD). Differences in cure rates of 5% to 15% are usually reported, which is considered to be clinically relevant. A plausible biological explanation for this finding suggests that different strains (virulent [cagA+,vacAtype s1] compared with nonvirulent strains [cagA–,vacAtype s2]) in PUD and FD induce different changes in the gastric mucosa, and this facilitates or impairs antimicrobial efficacy. Physicians should be aware that most published treatment studies have included only PUD patients. This means that in clinical practice cure rates obtained in patients with FD or perhaps uninvestigated dyspepsia are usually lower than those reported in the literature. This has implications for the choice of treatment. Physicians should consider prolonging the duration of initialHelicobactereradication therapy from seven to 10 to 14 days in patients without ulcers.

Apparent Intracellular Helicobacter pylori Detected by Immunohistochemistry: The Missing Link in Eradication Failure

2020 ◽  
Author(s):  
Andrea Beer ◽  
Helmut Hudler ◽  
Maria Hader ◽  
Michael Kundi ◽  
Susanne Hudler ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Eradication Therapy ◽  
Test Results ◽  
First Line ◽  
Before And After ◽  
Living Bacterium ◽  
Gastric Biopsies ◽  
Polymerase Chain ◽  
H Pylori ◽  
The Impact

Abstract Background Helicobacter pylori is primarily an extracellularly living bacterium. However, seemingly intracellular occurrence can often be detected by immunohistochemical stains. Considering antimicrobial resistance, we investigated the impact of the apparent intracellular H. pylori (aiHp) on treatment failure of first-line triple therapies. Methods Gastric biopsies of 814 patients infected with H. pylori naive to treatment were analyzed before and after eradication therapy by immunohistochemistry. Of these, 373 received treatment consisting of amoxicillin, clarithromycin, and proton pump inhibitor (AC/PPI). Availability of polymerase chain reaction-based clarithromycin susceptibility test results from pretreatment gastric biopsies was a precondition for matching 52 aiHp to 52 non-aiHp cases within the AC/PPI group. Results AiHp were detected mostly in low counts predominantly in corpus biopsies, rarely in antrum biopsies (95.2% vs 24.6%); they were found in 497 (61%) of all patients and in 192 of 373 patients (51.5%) in the AC/PPI group. The eradication rate in aiHp versus non-aiHp cases was 44.4% versus 72.9% in the entire sample and 45.3% versus 66.8% in the AC/PPI group. Among the 104 paired patients, respective values were 46.2% versus 78.8%; in clarithromycin-susceptible cases, 60.6% versus 91.9%. Both aiHp and resistance to clarithromycin proved to be highly significant (P ≤ .001) and independent predictors of eradication failure. Twelve of 13 aiHp cases with a clarithromycin-sensitive strain who failed eradication developed resistance to the antibiotic. Conclusions AiHp found by immunohistochemical staining especially in corpus biopsies proved to be a risk factor for failure of first-line triple therapies; occurrence of aiHp should be considered with regard to therapy options.

scholarly journals Assessment of symptomatic response as predictor ofHelicobacter pylori status following eradication therapy in patients with ulcer

Gut ◽  
1998 ◽  
Vol 42 (5) ◽  
pp. 618-622 ◽  
Author(s):  
K E L McColl ◽  
A El-Nujumi ◽  
L S Murray ◽  
E M El-Omar ◽  
A Dickson ◽  
...  
Keyword(s):  
Predictive Value ◽  
Complete Resolution ◽  
Eradication Therapy ◽  
Post Treatment ◽  
Powerful Predictor ◽  
Ulcer Disease ◽  
Validated Questionnaire ◽  
Dyspeptic Symptoms ◽  
H Pylori ◽  
Future Management

Background—Helicobacter pylorieradication therapy is routinely used for treating patients with peptic ulcer disease.Aims—To assess the value of symptomatic response to H pylori eradication therapy as a marker of post-treatment H pylori status.Patients and methods—One hundred and nine dyspeptic patients with active duodenal or gastric ulceration associated with H pylori infection had their symptoms measured by a validated questionnaire before and three months followingH pylori eradication therapy. The symptomatic response was compared with post-treatment H pylori status as determined by the 14C urea breath test.Results—An eradication rate of 84% was achieved. Of the 92 patients eradicated of H pylori, 47% experienced complete or near complete resolution of dyspepsia. Of the 17 patients in whom the infection was not eradicated, only one (6%) experienced resolution of dyspepsia. Resolution of dyspepsia was therefore a powerful predictor of eradication of H pyloriwith a predictive value of 98%. In contrast, persistence of dyspepsia was a weak predictor of persisting infection with a predictive value of only 25%. Excluding patients with endoscopic evidence of coexisting oesophagitis and/or retrosternal discomfort or reflux at initial presentation did not increase the predictive value of persisting dyspepsia for persisting infection.Conclusions—Complete resolution of dyspeptic symptoms is a powerful predictor of eradication of H pylori infection in ulcer patients. Persistence of symptoms is a weak predictor of persisting infection and patients with persisting dyspepsia must have their H pylori status rechecked to guide future management.

scholarly journals Helicobacter pylori: Basic Mechanisms to Clinical Cure

1995 ◽  
Vol 9 (2) ◽  
pp. 91-95 ◽  
Author(s):  
ABR Thomson ◽  
CN Williams
Keyword(s):  
Gastric Cancer ◽  
Duodenal Ulcer ◽  
Helicobacter Pylori ◽  
Peptic Ulcer ◽  
Clinical Cure ◽  
Eradication Therapy ◽  
Dual Therapy ◽  
Quadruple Therapy ◽  
Ulcer Disease ◽  
H Pylori

Since its rediscovery 10 years ago,Helicobacter pylorihas reshaped our thinking about the course of peptic ulcer disease. Our approach to the patient with a duodenal ulcer has become one of attempting eradication therapy at the time of first diagnosis, in the hope of curing the ulcer disease. Gastric and duodenal ulceration are only two of the manifestations of this chronic antral infection; other complications ofH pyloriinclude gastritis, gastric cancer and possible maltomas. Therapy ofH pyloriinfection is complicated and involves dual therapy with an antibiotic plus a protein pump inhibitor, such as omeprazole 20 mg bid plus amoxicillin 1 g bid for two weeks, triple or quadruple therapy with bismuth, two antibiotics and an H2-receptor antagonist. Vaccination againstH pyloriis on the far horizon.

scholarly journals Evaluation of Pyloriset Screen, a Rapid Whole-Blood Diagnostic Test for Helicobacter pylori Infection

1998 ◽  
Vol 36 (4) ◽  
pp. 955-957 ◽  
Author(s):  
Aino Oksanen ◽  
Lea Veijola ◽  
Pentti Sipponen ◽  
Knut-Olof Schauman ◽  
Hilpi Rautelin
Keyword(s):  
Helicobacter Pylori ◽  
Whole Blood ◽  
Predictive Value ◽  
Screen Test ◽  
Latex Agglutination ◽  
Histologic Examination ◽  
Serum Samples ◽  
Igg Antibody ◽  
Noninvasive Methods ◽  
H Pylori

Helicobacter pylori infection can be detected by several invasive tests based on gastroscopy and by noninvasive methods such as serologic assays. Noninvasive tests can be used not only in addition to invasive tests but also by themselves to screen forH. pylori infection in patients who are not in urgent need of endoscopy. Lately, rapid qualitative serologic tests have been developed. In the present study, the accuracy of a novel rapid whole-blood test, Pyloriset Screen, detecting immunoglobulin G (IgG) and IgA antibodies against H. pylori was evaluated. A total of 207 consecutive adult outpatients referred for upper endoscopy were enrolled. Gastric biopsy specimens were taken from the antrum and corpus for histologic examination and rapid urease testing. Cultures were available for 113 patients. Serum samples collected from all patients were tested for H. pylori antibodies by two enzyme immunoassays (EIAs) (Pyloriset EIA and an in-house EIA), a rapid latex agglutination test (Pyloriset Dry), and Pyloriset Screen. Patients were considered H. pylori positive if helicobacters were seen on histologic examination (77 patients) or, if in combination with histologically verified (although helicobacter-negative) gastritis, their IgG antibody titers were elevated in the two EIAs (five patients). The Pyloriset Screen test had a sensitivity of 95%, a specificity of 94%, a positive predictive value of 91%, and a negative predictive value of 97%. Among 63 patients under the age of 45 years, the Pyloriset Screen test did not miss a single H. pylori diagnosis, and only 1 patient had a false-positive result. Pyloriset Screen could be used reliably to screen for H. pylori infection.

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