scholarly journals Non-invasive assessment of gastric secretory function in centenarians

2017 ◽  
Vol 3 (1) ◽  
Author(s):  
Antonio Tursi ◽  
Rudi De Bastiani ◽  
Marilisa Franceschi ◽  
Elisabetta Goni ◽  
Matteo Riccò ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Proton Pump Inhibitor ◽  
Gastric Secretion ◽  
Acid Secretion ◽  
Serological Markers ◽  
Secretory Function ◽  
Igg Antibodies ◽  
Gastric Function ◽  
Non Invasive ◽  
H Pylori

Gastric acid secretion is believed to decrease in the aging stomach, but the number of elderly patients on proton pump inhibitor (PPI) therapy is increasing. The aim was to assess gastric function by means of serology (PGI, PGII, G17 and IgG antibodies against <em>Helicobacter pylori</em>) in centenarians. Twenty-five centenarians (2 males, 23 females, mean age 101.3 years, range 100- 106 years) underwent to serological gastric markers assessment by means of Gastropanel<sup>®</sup>. Patients with laboratory signs of severe oxyntic gastric atrophy (OGA) underwent gastroscopy with biopsy samples. Twelve patients (48.0%) had serological values according to normal gastric secretion; 3 patients (12%) had serological values according to severe OGA, confirmed by histology; 21 patients (84.0%) had serological values according to <em>H. pylori</em> infection. Acid secretion seems to be preserved in a large part of centenarians. Serological markers may be helpful to identify patients affected by OGA, in whom the administration of PPI is inappropriate.

scholarly journals Canadian Helicobacter Study Group Consensus Conference: Update on the Approach to Helicobacter Pylori Infection in Children and Adolescents – an Evidence-Based Evaluation

2005 ◽  
Vol 19 (7) ◽  
pp. 399-408 ◽  
Author(s):  
Nicola L Jones ◽  
Philip Sherman ◽  
Carlo A Fallone ◽  
Nigel Flook ◽  
Fiona Smaill ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Helicobacter Pylori ◽  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Consensus Conference ◽  
Helicobacter Pylori Infection ◽  
Diagnostic Tools ◽  
Study Group ◽  
Evidence Based ◽  
H Pylori

As an update to previously published recommendations for the management of Helicobacter pylori infection, an evidence-based appraisal of 14 topics was undertaken in a consensus conference sponsored by the Canadian Helicobacter Study Group. The goal was to update guidelines based on the best available evidence using an established and uniform methodology to address and formulate recommendations for each topic. The degree of consensus for each recommendation is also presented. The clinical issues addressed and recommendations made were: population-based screening for H pylori in asymptomatic children to prevent gastric cancer is not warranted; testing for H pylori in children should be considered if there is a family history of gastric cancer; the goal of diagnostic interventions should be to determine the cause of presenting gastrointestinal symptoms and not the presence of H pylori infection; recurrent abdominal pain of childhood is not an indication to test for H pylori infection; H pylori testing is not required in patients with newly diagnosed gastroesophageal reflux disease; H pylori testing may be considered before the use of long-term proton pump inhibitor therapy; testing for H pylori infection should be considered in children with refractory iron deficiency anemia when no other cause has been found; when investigation of pediatric patients with persistent or severe upper abdominal symptoms is indicated, upper endoscopy with biopsy is the investigation of choice; the 13C-urea breath test is currently the best noninvasive diagnostic test for H pylori infection in children; there is currently insufficient evidence to recommend stool antigen tests as acceptable diagnostic tools for H pylori infection; serological antibody tests are not recommended as diagnostic tools for H pylori infection in children; first-line therapy for H pylori infection in children is a twice-daily, triple-drug regimen comprised of a proton pump inhibitor plus two antibiotics (clarithromycin plus amoxicillin or metronidazole); the optimal treatment period for H pylori infection in children is 14 days; and H pylori culture and antibiotic sensitivity testing should be made available to monitor population antibiotic resistance and manage treatment failures.

scholarly journals Preliminary Serological Study of Helicobacter pylori Infection in Some University Students

2020 ◽  
Vol 6 ◽  
pp. 1
Author(s):  
Abdullah A Mahrazi ◽  
Mohammad A Khibrani ◽  
Khatib S Ismail ◽  
Emad Abada ◽  
◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
University Students ◽  
Large Scale ◽  
Confirmatory Test ◽  
Enzyme Linked Immunosorbent Assay ◽  
Blood Collection ◽  
Igg Antibodies ◽  
Igm Antibodies ◽  
H Pylori

Helicobacter pylori has been associated with peptic ulcer and gastric carcinoma. This study aimed to find the seroprevalence of H. pylori infection in some male students of Jazan University, Saudi Arabia. Twenty students were enrolled in the study (n = 20). Informed consent was obtained from the students. About 2 ml blood was collected intravenously in Improvacuter® evacuated blood collection tubes. The blood was allowed to clot at room temperature. The serum was collected and stored at –20°C for further use. The separated serum was used to detect IgG and IgM antibodies by Enzyme Linked Immunosorbent Assay (ELISA) against H. pylori for the in vitro diagnosis. A total of 11 (55.00%) students tested positive for IgG antibodies against H. pylori indicating previous infection. All the samples tested negative for IgM antibodies against H. pylori indicating no active infection. The seroprevalance of IgG antibodies against H. pylori was found to be very high in some male university students and is a cause of concern regarding their health. Obesity (p < 0.05; Value statistically significant), stress and bad eating habits, eating out, drinking carbonated beverages, and eating spicy food were some of the factors found to be associated with IgG seropositive students. The students were counseled and were instructed to undergo a confirmatory test and get medical intervention. Further large-scale studies need to be performed to plan action against this disease causing organism and to improve the health of students.

scholarly journals The Patterns and Associated Cost of Serologic Testing for Helicobacter pylori in the U.S. Military Health System

2020 ◽  
Vol 185 (9-10) ◽  
pp. e1417-e1419
Author(s):  
Kevin Pak ◽  
Zachary Junga ◽  
Andrew Mertz ◽  
Manish Singla
Keyword(s):  
Helicobacter Pylori ◽  
Clinical Utility ◽  
Igg Antibodies ◽  
Military Health System ◽  
Military Health ◽  
Igm Antibodies ◽  
Serologic Testing ◽  
Stool Antigen ◽  
H Pylori ◽  
The U.S

Abstract Introduction Helicobacter pylori (H. pylori) infection affects about half of the world’s population and can lead to multiple complications if left untreated. Testing for H. pylori infection in appropriate patients with prompt treatment followed by the testing of eradication is the standard of care in the United States. Active Duty Service members (ADSMs) in the U.S. military are a unique patient population that may be at higher risk for acquiring H. pylori infection given frequent deployments to developing countries. Noninvasive diagnostic strategies include the urea breath test, the stool antigen test, and serologic testing, which include H. pylori immunoglobulin M (IgM), immunoglobulin A (IgA), and immunoglobulin G (IgG) antibodies. Among noninvasive methods, the least sensitive is serology, and although there is clinical utility in testing for H. pylori IgG antibodies, H. pylori IgA or IgM antibodies have limited clinical utility. Despite this, H. pylori IgA and IgM antibodies are still widely ordered across the Military Health System. Materials and Methods In order to determine how frequently this testing is being ordered and the associated cost, we conducted a retrospective cross-sectional study of H. pylori serologic testing utilization in the MHS from October 2015 to September 2018 in adult patients using the MHS Data Repository. All H. pylori IgM, IgA, and IgG antibodies, H. pylori stool antigen tests, and H. pylori urea breath tests were queried during this time period across all ADSMs, retirees, and ADSM dependents for all adults. Cost information was obtained from LabCorp, and the institutional price used for cost analysis was the same throughout all military treatment facilities in the Department of Defense (DOD). Results We discovered that over a 3-yr period, 1,916 H. pylori IgA and 2,492 IgM antibodies were ordered. In total, the DOD spent close to $400,000 on antibody-based testing for H. pylori not accounting for indirect associated costs like personnel, supplies, repeat testing, as well as the costs of delayed diagnosis and associated complications. Conclusion H. pylori IgM and IgA have limited clinical utility, are inaccurate, and are costly to maintain, especially when more accurate alternative tests are available. Based on our analysis, we strongly recommend the removal of the H. pylori IgA and IgM serologic tests throughout the DOD in order to improve the efficiency and quality of care for patients suspected of having an H. pylori infection. Further research is needed to determine how these tests are ordered, how providers are responding to the results of the serologic tests, and if noninvasive testing is being ordered appropriately.

scholarly journals European Registry on Helicobacter pylori Management: single-capsule bismuth quadruple therapy is effective in real-world clinical practice

2020 ◽  
pp. 205064062097261
Author(s):  
Olga P Nyssen ◽  
Angeles Perez-Aisa ◽  
Manuel Castro-Fernandez ◽  
Rinaldo Pellicano ◽  
Jose M. Huguet ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Clinical Practice ◽  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Real World ◽  
Case Report Form ◽  
First Line ◽  
Quadruple Therapy ◽  
Intention To Treat ◽  
H Pylori

Background There has been resurgence in the use of bismuth quadruple therapy (proton pump inhibitor, bismuth, tetracycline and metronidazole) for treating Helicobacter pylori infection thanks to a three-in-one single-capsule formulation. Objective To evaluate the effectiveness and safety of the single-capsule bismuth quadruple therapy. Methods Data were collected in a multicentre, prospective registry of the clinical practice of gastroenterologists on the management of H. pylori infection, where patients were registered at the Asociación Española de Gastroenterología REDCap database on an electronic case report form until January 2020. Effectiveness by modified intention-to-treat and per-protocol as well as multivariable analysis were performed. Independent factors evaluated were: age, gender, indication, compliance, proton pump inhibitor dose and treatment line. Results Finally, 2100 patients were prescribed single-capsule bismuth quadruple therapy following the technical sheet (i.e. three capsules every 6 hours for 10 days). The majority of these patients were naive (64%), with an average age of 50 years, 64% women and 16% with peptic ulcer. An overall modified intention-to-treat effectiveness of 92% was achieved. Eradication was over 90% in first-line treatment (95% modified intention-to-treat, n = 1166), and this was maintained as a rescue therapy, both in second (89% modified intention-to-treat, n = 375) and subsequent lines of therapy (third to sixth line: 92% modified intention-to-treat, n = 236). Compliance was the factor most closely associated with treatment effectiveness. Adverse events were generally mild to moderate, and 3% of patients reported a severe adverse event, leading to discontinuation of treatment in 1.7% of cases. Conclusions Single-capsule bismuth quadruple therapy achieved H. pylori eradication in approximately 90% of patients in real-world clinical practice, both as a first-line and rescue treatment, with good compliance and a favourable safety profile.

scholarly journals Correlates of infection with Helicobacter pylori positive and negative cytotoxin-associated gene A phenotypes among Arab and Jewish residents of Jerusalem

2019 ◽  
Vol 147 ◽  
Author(s):  
K. Muhsen ◽  
R. Sinnereich ◽  
G. Beer-Davidson ◽  
H. Nassar ◽  
W. Abu Ahmed ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Former Soviet Union ◽  
Enzyme Linked Immunosorbent Assay ◽  
Igg Antibodies ◽  
Multinomial Regression ◽  
Igg Antibody ◽  
Sibship Size ◽  
Cross Sectional ◽  
Cytotoxin Associated Gene A ◽  
H Pylori

Abstract We examined the prevalence and correlates of Helicobacter pylori (H. pylori) infection according to cytotoxin-associated gene A (CagA) phenotype, a main virulence antigen, among the ethnically diverse population groups of Jerusalem. A cross-sectional study was undertaken in Arab (N = 959) and Jewish (N = 692) adults, randomly selected from Israel's national population registry in age-sex and population strata. Sera were tested for H. pylori immunoglobulin G (IgG) antibodies. Positive samples were tested for virulence IgG antibodies to recombinant CagA protein, by enzyme-linked immunosorbent assay. Multinomial regression models were fitted to examine associations of sociodemographic factors with H. pylori phenotypes. H. pylori IgG antibody sero-prevalence was 83.3% (95% confidence interval (CI) 80.0%–85.5%) and 61.4% (95% CI 57.7%–65.0%) among Arabs and Jews, respectively. Among H. pylori positives, the respective CagA IgG antibody sero-positivity was 42.3% (95% CI 38.9%–45.8%) and 32.5% (95% CI 28.2%–37.1%). Among Jews, being born in the Former Soviet Union, the Middle East and North Africa, vs. Israel and the Americas, was positively associated with CagA sero-positivity. In both populations, sibship size was positively associated with both CagA positive and negative phenotypes; and education was inversely associated. In conclusion, CagA positive and negative infection had similar correlates, suggesting shared sources of these two H. pylori phenotypes.

Peroral immunization with Helicobacter pylori adhesin protein genetically linked to cholera toxin A2B subunits

2001 ◽  
Vol 100 (3) ◽  
pp. 291-298 ◽  
Author(s):  
Byung Oh KIM ◽  
Sung Seup SHIN ◽  
Young Hyo YOO ◽  
Suhkneung PYO
Keyword(s):  
Helicobacter Pylori ◽  
Cholera Toxin ◽  
Vaccine Development ◽  
Protective Antigen ◽  
Oral Immunization ◽  
Size Exclusion ◽  
Vaccine Antigen ◽  
Igg Antibodies ◽  
Serum Igg ◽  
H Pylori

Helicobacter pylori is a major cause of gastric-associated diseases. To evaluate the efficacy of a possible vaccine antigen against H. pylori infection, the chimaeric construct adhesin–CTXA2B, derived from H. pylori adhesin genetically coupled to cholera toxin (CTX) subunits A2 and B (CTXA2B), was expressed in Escherichia coli as an insoluble recombinant chimaeric protein. The protein was then purified by denaturation, renaturation and size-exclusion chromatography. The composition of purified adhesin–CTXA2B was verified by SDS/PAGE and Western blotting with antibodies to antigenic components of adhesin and CTXB, and confirmed as a chimaeric protein with GM1-ganglioside binding activity and adhesin epitopes by a GM1-ELISA developed using antibodies to adhesin. Oral immunization of mice with adhesin–CTXA2B induced higher levels of mucosal IgA and serum IgG antibodies to H. pylori adhesin and to CTXB than in mice immunized with adhesin or CTXA2B alone. Adhesin–CTXA2B was also demonstrated to be a potential protective antigen in a mouse model of H. pylori infection. The immunization of mice with adhesin–CTXA2B protected 62.5% of mice infected with H. pylori SS1 strain, whereas adhesin immunization was not able to confer protection to mice. This protection may be correlated with high levels of mucosal IgA and serum IgG antibodies against H. pylori adhesin. Taken together, the results indicate that the genetically linked CTXA2B acts as a useful mucosal adjuvant, and that the adhesin–CTXA2B chimaeric protein could be a potential component in future H. pylori vaccine development.

scholarly journals Helicobacter pylori infection potentiates the inhibition of gastric acid secretion by omeprazole

Gut ◽  
1999 ◽  
Vol 44 (4) ◽  
pp. 468-475 ◽  
Author(s):  
D Gillen ◽  
A A Wirz ◽  
W D Neithercut ◽  
J E S Ardill ◽  
K E L McColl
Keyword(s):  
Helicobacter Pylori ◽  
Acid Secretion ◽  
Gastric Acid Secretion ◽  
Gastric Acid ◽  
Acid Output ◽  
Intragastric Ph ◽  
Ammonia Production ◽  
Intragastric Acid ◽  
H Pylori

BACKGROUNDOmeprazole has a greater intragastric pH elevating effect in Helicobacter pylori positive than negative subjects. Ammonia production byH pylori has been suggested as a probable mechanism.AIMSTo assess the effect ofH pylori status on gastric acid secretion during omeprazole treatment, and to examine the possible role of ammonia neutralisation of intragastric acid in increased omeprazole efficacy in infected subjects.METHODSTwentyH pylori positive and 12H pylori negative healthy volunteers were examined before and six to eight weeks after commencing omeprazole 40 mg/day. On both occasions plasma gastrin and acid output were measured basally and in response to increasing doses of gastrin 17 (G-17). Gastric juice ammonium concentrations were also measured.RESULTSPrior to omeprazole, measurements were similar in the H pyloripositive and negative subjects. During omeprazole, median basal intragastric pH was higher in the H pyloripositive (7.95) versus negative (3.75) subjects (p<0.002). During omeprazole basal, submaximal (180 pmol/kg/h G-17), and maximal acid outputs (800 pmol/kg/h G-17) were lower in H pylori positive subjects (0.0, 3.6, 6.0 mmol/h respectively) versus negative subjects (0.3, 14.2, 18.6 mmol/h) (p<0.03 for each). This effect was not explained by neutralisation by ammonia.CONCLUSIONThe presence ofH pylori infection leads to a more profound suppression of acid secretion during omeprazole treatment. The effect cannot be explained by neutralisation of intragastric acid by bacterial ammonia production and its precise mechanism has to be explained.

scholarly journals Relation between Helicobacter pylori infection and gastrointestinal symptoms and syndromes

Gut ◽  
1997 ◽  
Vol 41 (2) ◽  
pp. 169-176 ◽  
Author(s):  
S Rosenstock ◽  
L Kay ◽  
C Rosenstock ◽  
L P Andersen ◽  
O Bonnevie ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Epigastric Pain ◽  
Gastrointestinal Symptoms ◽  
Igg Antibodies ◽  
Serum Samples ◽  
Ulcer Disease ◽  
Abdominal Symptoms ◽  
Nocturnal Pain ◽  
H Pylori ◽  
Upper Dyspepsia

Background—Helicobacter pylori is a human pathogen that colonises the gastric mucosa and causes permanent gastric inflammation.Aims—To assess the symptoms of H pylori infection in an adult unselected population.Subjects—A random sample of 3589 adult Danes who were examined in 1982 and 1987 (n=2987).Methods—Abdominal symptoms within the preceding year were recorded at both attendances. Circulating IgG antibodies against H pylori in serum samples drawn in 1982 were measured by using in-house indirect enzyme linked immunosorbent assays (ELISA).Results—People with increased levels of IgG antibodies to H pylori were more likely than uninfected individuals to report heartburn (odds ratio (OR) = 1.26, 95% confidence interval (CI) 1.03–1.54) and abdominal pain characterised by daily length (OR = 1.33, 95% CI 0.92–1.91), nocturnal occurrence (OR = 1.62, 95% CI 1.19–2.19), spring aggravation (OR = 1.68, 95% CI 0.70–4.05), and no relation to meals (OR = 0.62, 95% CI 0.43–0.91) or stress (OR = 0.69, 95% CI 0.50–0.95). The inclusion of people with increased levels of IgG antibodies to H pylori, but without upper dyspepsia, at study entry significantly increased the likelihood of reporting upper dyspepsia at follow up (OR = 1.71, 95% CI 1.24–2.36). People with epigastric pain and increased levels of IgM antibodies to H pylori only indicative of acute H pylori infection were more likely to report nocturnal pain, heartburn, nausea, and vomiting.Conclusions—H pylori infection may precede the development of dyspepsia and is associated with a variety of gastrointestinal symptoms in people with no history of peptic ulcer disease.

scholarly journals Comparison of IL-6, IL-8 Concentrations in H. pylori- and non-H. pylori-associated Gastritis

2014 ◽  
Vol 6 (3) ◽  
pp. 163 ◽  
Author(s):  
Gontar Alamsyah Siregar ◽  
Sahat Salim ◽  
Ricky Rivalino Sitepu
Keyword(s):  
Helicobacter Pylori ◽  
Serum Levels ◽  
Cross Sectional Study ◽  
Bivariate Analysis ◽  
Rapid Urease Test ◽  
Serum Samples ◽  
Cross Sectional ◽  
Non Invasive ◽  
Urease Test ◽  
H Pylori

BACKGROUND: Helicobacter pylori is a non-invasive microorganism causing intense gastric mucosal inflammatory and immune reaction. The gastric mucosal levels of the proinflammatory cytokines Interleukin 6 (IL-6) and IL-8 have been reported to be increased in H. pylori infection, but the serum levels in H. pylori infection is still controversial. The purpose of this study was to investigate the serum levels of IL-6 and IL-8 in H. pylori infection.METHODS: A cross sectional study was done on eighty consecutive gastritis patients admitted to endoscopy units at Adam Malik General Hospital and Permata Bunda Hospital, Medan, Indonesia from May-October 2014. Histopathology was performed for the diagnosis of gastritis. Rapid urease test for diagnosis of H. pylori infection. Serum samples were obtained to determine circulating IL-6 and IL-8. Univariate and bivariate analysis (independent t test) were done.RESULTS: There were 41.25% patients infected with H. pylori. Circulatory IL-6 levels were significantly higher in H. pylori-infected patients compared to H. pylori negative, but there were no differences between serum levels of IL-8 in H. pylori positive and negative patients.CONCLUSION: The immune response to H. pylori promotes systemic inflammation, which was reflected in an increased level of serum IL-6. Serum levels of IL-8 were not significantly different between H. pylori positive and negative.KEYWORDS: Helicobacter pylori, gastritis, IL-6, IL-8, cytokine

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