CagA and vacA allelic combination of Helicobacter pylori in gastroduodenal disorders

Epstein–Barr virus (EBV) and Helicobacter pylori (H. pylori) are two pathogens associated with the development of various human cancers. The coexistence of both microorganisms in gastric cancer specimens has been increasingly reported, suggesting that crosstalk of both pathogens may be implicated in the carcinogenesis process. Considering that chronic inflammation is an initial step in the development of several cancers, including gastric cancer, we conducted a systematic review to comprehensively evaluate publications in which EBV and H. pylori co-infection has been documented in patients with non-malignant gastroduodenal disorders (NMGDs), including gastritis, peptic ulcer disease (PUD), and dyspepsia. We searched the PubMed database up to August 2019, as well as publication references and, among the nine studies that met the inclusion criteria, we identified six studies assessing EBV infection directly in gastric tissues (total 949 patients) and three studies in which EBV infection status was determined by serological methods (total 662 patients). Due to the substantial methodological and clinical heterogeneity among studies identified, we could not conduct a meta-analysis. The overall prevalence of EBV + H. pylori co-infection in NMGDs was 34% (range 1.8% to 60%). A higher co-infection rate (EBV + H. pylori) was reported in studies in which EBV was documented by serological methods in comparison with studies in which EBV infection was directly assessed in gastric specimens. The majority of these studies were conducted in Latin-America and India, with most of them comparing NMGDs with gastric cancer, but there were no studies comparing the co-infection rate in NMGDs with that in asymptomatic individuals. In comparison with gastritis caused by only one of these pathogens, EBV + H. pylori co-infection was associated with increased severity of gastric inflammation. In conclusion, only relatively small studies testing EBV and H. pylori co-infection in NMGDs have been published to date and the variable report results are likely influenced by geographic factors and detection methods.

Download Full-text

NEW ASPECTS OF ERADICATIVE ANTI-HELICOBACTER PYLORI IN TYPE 2 DIABETIC PATIENTS WITH CHRONIC GASTRODUODENAL DISORDERS

Bulletin physiology and pathology of respiration ◽

10.12737/article_5a9f26b390ffc9.29034415 ◽

2018 ◽

Vol 1 (67) ◽

pp. 70-76

Author(s):

Марина Мартынюк ◽

Marina Martynuk ◽

Юрий Федорченко ◽

Yuri Fedorchenko

Keyword(s):

Helicobacter Pylori ◽

Combined Therapy ◽

Randomized Study ◽

Positive Influence ◽

Diabetic Patients ◽

Bacterial Antigen ◽

Type 2 Diabetic Patients ◽

Type 2 Diabetic ◽

Gastroduodenal Disorders

The aim of the study was to analyze the effectiveness of different regimens of anti-Helicobacter pylori therapy and their influence on the small intestinal overgrowth syndrome (SIBOS) in type 2 diabetic patients with chronic gastroduodenal disorders. For this purpose an open comparative randomized study was performed in 138 type 2 diabetic patients with chronic gastroduodenal disorders, aged 54.4±5.2 on average. Gastroduodenal pathology was confirmed by gastroduodenoscopy, the H.pylori contamination by use of the unease method or finding bacterial antigen in excrements. The SIBOS was recognized by a respiratory hydrogen method with lactulose. Depending on the type of anti-H.pylori regimen all the patients were divided into 3 groups. Optimization 14-days triple therapy by use of Rabeprazol instead of Omeprazol was found to be effective with 80.6% of H.pylori eradication. Addition of both vismuth and probiotic resulted in increased eradication up to 94.1%, while the optimized triple regimen with Metronidazol and probiotic (intensified combined therapy) proved to be the most effective (97.2%) in H.pylori eradication. All 3 regimens of anti-H.pylori therapy resulted in the decreased number of SIBOS cases, but the best results in comparison with the initial data were obtained in the groups on the triple optimized and intensive combined therapy – up to 60 and 78.3%, respectively. The positive influence of anti-H.pylori therapy on SIBOS seen in the study allows the authors to propose one more indication for anti-H.pylori therapy.

Download Full-text