scholarly journals Helicobacter pylori: From Bench to Bedside

1997 ◽  
Vol 11 (7) ◽  
pp. 589-596 ◽  
Author(s):  
N Chiba ◽  
A Matisko ◽  
P Sinclair ◽  
ABR Thomson
Keyword(s):  
Helicobacter Pylori ◽  
Paradigm Shift ◽  
Eradication Rate ◽  
Good Clinical Practice ◽  
Effective Vaccine ◽  
Ulcer Disease ◽  
Exponential Increase ◽  
Major Interest ◽  
H Pylori

With the exponential increase in research in the field ofHelicobacter pyloria paradigm shift has occurred. It is now recognized thatH pyloriis a chronic infection of the stomach causing inflammation. Some patients remain asymptomatic, while others may develop dyspepsia, duodenal or gastric ulcer, gastric cancer or a mucosa-associated lymphoid tissue lymphoma. However, the role ofH pyloriin contributing to nonulcer dyspepsia or nonsteroidal anti-inflammatory drug gastropathy remains controversial. An effective vaccine againstH pyloriis years away. Major interest has focused on the questions "who should be investigated and therefore treated" and "what is the latest gold standard for eradication ofH pylori"? In Europe, guidelines have been developed to help the practitioner answer these important questions. Canadian guidelines will soon be available. For persons with known peptic ulcer disease there should be unequivocal acceptance that the good clinical practice of eradicatingH pyloriwill result in substantial savings in health care expenses. The original 'classical triple therapy' (bismuth, metronidazole and tetracycline [BMT]) has now been surpassed by the combination of a proton pump inhibitor (PPI) plus two antibiotics (metronidazole plus clarithromycin; amoxicillin plus clarithromycin; or amoxicillin plus metronidazole), each given twice a day for one week. In Canada, the regimen of omeprazole plus one antibiotic (amoxicillin or clarithromycin) was approved recently but gives an eradication rate that is lower than the current target of 90%. According to the European (Mäastricht) recommendations, if a single treatment attempt with PPI plus two antibiotics fails, PPI plus BMT is recommended.

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 Relationship Between Mucosal TNF-α Expression and Th1, Th17, Th22 and Treg Responses in Helicobacter Pylori Infection

2021 ◽  
Author(s):  
Ghorbanali Rahimian ◽  
Milad Shahini Shams Abadi ◽  
Reza Ahmadi ◽  
Mohammedhadi Shafigh ◽  
Fatemeh Azadegan-Dehkordi
Keyword(s):  
Helicobacter Pylori ◽  
Gastric Mucosa ◽  
Treg Cells ◽  
Infected Group ◽  
Ulcer Disease ◽  
Tnf Α ◽  
H Pylori ◽  
Factor Α ◽  
Necrosis Factor

Abstract Background: Helicobacter pylori (H. pylori) -induced gastric inflammation in the gastric mucosa and significantly increases the risk of developing gastritis and peptic ulcer disease (PUD). The objective of this research is to determine the role of tumor necrosis factor-α (TNF-α) expression in the gastric mucosa of patients with H. pylori –associated gastritis and PUD compared to uninfected patients, and we determined the relation between TNF-α expression and Th1/Th17/Th22, and Treg cells.Methods: Fifty-five patients with H. pylori –associated gastritis, 47 patients with H. pylori –associated PUD, and 48 uninfected patients were in this research. Antrum biopsy was used to detect H. pylori, virulence factors and histopathological assessments.Results: Expression of TNF-α in the infected group was significantly higher than the uninfected group. Also, cagA/oipA-positive infected patients induce significantly more TNF-α expression than do cagA/oipA-negative infected patients. Expression of TNF-α was significantly increased in the PUD group than the gastritis group. Notably, TNF-α expression had a significant positive correlation with the frequency of Th1/Th17/Th22 lymphocytes in the PUD group.Conclusion: These findings indicate the importance of increasing TNF-α with Th1, Th17, Th22 responses increase as an important risk factor for PUD in context of H. pylori infection.

scholarly journals A study on healing of peptic ulcer disease after eradication of helicobacter pylori infection

2014 ◽  
Vol 43 (2) ◽  
pp. 84-89 ◽  
Author(s):  
Md Razibul Alam ◽  
Ershad Uddin Ahmed ◽  
Md Zahidur Rahman ◽  
ASM Nazmul Islam ◽  
Md Masudur Rahman Khan ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Triple Therapy ◽  
Ulcer Healing ◽  
Eradication Rate ◽  
Helicobacter Pylori Infection ◽  
Ulcer Disease ◽  
Standard Triple Therapy ◽  
H Pylori

There is intimate connection between peptic ulcer & Helicobacter pylori infection. But some uncertainties still surround the relationship between status of H. pylori infection and extent & time required for ulcer healing. This prospective observational study was carried out in the department of Gastroenterology, BSMMU, Dhaka from January 2007 to January 2008 to determine whether the successful eradication of H. pylori leads to adequate ulcer healing. To see the pattern of endoscopic findings in patients still having H. pylori infection after standard triple therapy for H. pylori were also a objective. Eighty nine consecutive patients, aged 15-60 years and of both genders, coming to the gastroenterology outpatient department with the symptoms suggestive of peptic ulcer disease and dyspepsia were included and H. pylori status was defined as positive if both rapid urease test & histopathology were positive. As found in this study, H. pylori was associated with 90% of duodenal ulcers and 80% of gastric ulcers. H. pylori eradication rate was 69%. Healing rate of duodenal ulcer and gastric ulcer after standard triple therapy for 14 days were 80% and 78% respectively. Adequate ulcer healing was achieved in this study despite relatively low eradication rate. Follow-up for additional period is required for recurrence of ulcer in 84 patients whose peptic ulcer disease had resolved but could not attain H. pylori eradication and H. pylori eradicated patients who are still having ulcer at endoscopy DOI: http://dx.doi.org/10.3329/bmj.v43i2.21388 Bangladesh Med J. 2014 May; 43 (2): 84-89

scholarly journals The Human Gastric Pathogen Helicobacter pylori and Its Association with Gastric Cancer and Ulcer Disease

Ulcers ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-23 ◽  
Author(s):  
Bianca Bauer ◽  
Thomas F. Meyer
Keyword(s):  
Gastric Cancer ◽  
Helicobacter Pylori ◽  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Strain Differences ◽  
Protective Effects ◽  
Ulcer Disease ◽  
Prophylactic Measures ◽  
H Pylori

With the momentous discovery in the 1980's that a bacterium, Helicobacter pylori, can cause peptic ulcer disease and gastric cancer, antibiotic therapies and prophylactic measures have been successful, only in part, in reducing the global burden of these diseases. To date, ~700,000 deaths worldwide are still attributable annually to gastric cancer alone. Here, we review H. pylori's contribution to the epidemiology and histopathology of both gastric cancer and peptic ulcer disease. Furthermore, we examine the host-pathogen relationship and H. pylori biology in context of these diseases, focusing on strain differences, virulence factors (CagA and VacA), immune activation and the challenges posed by resistance to existing therapies. We consider also the important role of host-genetic variants, for example, in inflammatory response genes, in determining infection outcome and the role of H. pylori in other pathologies—some accepted, for example, MALT lymphoma, and others more controversial, for example, idiopathic thrombocytic purpura. More recently, intriguing suggestions that H. pylori has protective effects in GERD and autoimmune diseases, such as asthma, have gained momentum. Therefore, we consider the basis for these suggestions and discuss the potential impact for future therapeutic rationales.

scholarly journals Possible Correlates of Long-Term Protection against Helicobacter pylori following Systemic or Combinations of Mucosal and Systemic Immunizations

2007 ◽  
Vol 75 (7) ◽  
pp. 3462-3469 ◽  
Author(s):  
Jennifer M. Taylor ◽  
Melanie E. Ziman ◽  
Julie Fong ◽  
Jay V. Solnick ◽  
Michael Vajdy
Keyword(s):  
Helicobacter Pylori ◽  
Protective Immunity ◽  
Interleukin 12 ◽  
Effective Vaccine ◽  
Correlates Of Protection ◽  
Oral Group ◽  
Efficient Route ◽  
H Pylori

ABSTRACT The ability to induce long-term immunity to Helicobacter pylori is necessary for an effective vaccine. This study was designed to establish the most efficient route(s) (systemic, mucosal, or a combination) of immunization for induction of long-term immunity and to define correlates of protection. Mice were immunized orally alone (oral group), intramuscularly (i.m.) alone (i.m. group), orally followed by i.m. (oral/i.m. group), or i.m. followed by orally (i.m./oral group). Long-term protective immunity to oral H. pylori challenge was observed 3 months after immunization through the i.m. or oral/i.m. route. Protection correlated with an increase in H. pylori-specific interleukin-12 and both immunoglobulin G1 (IgG1) and IgG2a serum titers following challenge. Mice that were not protected (oral or i.m./oral) had increased levels of IgA in both sera and Peyer's patches. This study demonstrates the ability to induce long-term immunity against H. pylori, provides correlates of protection, and illustrates the crucial role of the immunization route(s).

Eradication ofHelicobacter pylori in the Treatment of Peptic Ulcer Disease

1999 ◽  
Vol 12 (5) ◽  
pp. 380-390
Author(s):  
Heather Tangeman ◽  
Mary T. Roth
Keyword(s):  
Helicobacter Pylori ◽  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Current Clinical Practice ◽  
Ulcer Disease ◽  
Infection Treatment ◽  
Ulcer Relapse ◽  
H Pylori ◽  
Common Infection

Helicobacter pylori is responsible for the majority of cases of peptic ulcer disease. Peptic ulcer disease should no longer be regarded as a “chronic, recurring, lifelong disease, but rather a curable infection.” Treatment and eradication of H. pylori infection in patients with peptic ulcer disease has been shown to resolve the chronic inflammation present and prevent further ulcer relapse. Despite the vast amount of literature on H. pylori infection in peptic ulcer disease, the diagnosis and management of this common infection have become increasingly straightforward. This article will summarize the role of H. pylori in patients with peptic ulcer disease and will address the current clinical practice guidelines for diagnosis and treatment of H. pylori in the subset of patients.

scholarly journals COMPARISON OF EFFECTIVENESS OF STANDARD TRIPLE THERAPY VERSUS BISMUTH-BASED THERAPY FOR THE MANAGEMENT OF PEPTIC ULCER DISEASE DUE TO HELICOBACTER PYLORI

2020 ◽  
pp. 192-195
Author(s):  
MIRZA MISBA ALI BAIG ◽  
UZMA PARVEEN ◽  
RUQAIAH FAROOQ ◽  
MAIMUNA TABASSUM ◽  
FATIMA NAAZ ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Triple Therapy ◽  
Eradication Rate ◽  
Therapy Group ◽  
Quadruple Therapy ◽  
Ulcer Disease ◽  
Standard Triple Therapy ◽  
H Pylori

Objective: Helicobacter pylori is the primary agent causing peptic ulcer, therefore imposing a significant impact on health elated quality of life, consequently affecting nearly 50% of global population. The objective of this study is to determine and assess the effectiveness of triple therapy versus bismuth containing quadruple therapy for eradication of peptic ulcer disease due to H. pylori. Methods: A prospective randomized observational study was conducted at Princess Esra Hospital, Department of Gastroenterology for a period of 6 months. A total of 100 patients were randomly allocated in tow groups. The data were assessed using various parameters. H. pylori eradication was validated using rapid urease test done at the start treatment 4 weeks after the completion. Results: A total of 100 patients were recruited in the study. In triple therapy group medication adherence rate was found to be 82% in triple and 92% in quadruple therapy. The eradication rate was assessed using Chi-square test it was 82% and 97% in triple and quadruple therapy group, respectively. Hence, the difference was found to be statistically significant value <0.005. In addition, increased recurrence rate has been observed in triple therapy (17%) in contrast with quadruple therapy (2%). Conclusion: Addition of bismuth to significant triple therapy improves cure rates with minimal side effects. Interestingly, we observed that when bismuth was added, it produced a significant higher eradication rate (97%) when compared with standard triple therapy (82%). According to our study, bismuth is highly effective treatment of peptic ulcer disease.

scholarly journals Helicobacter pylori infection and chronic gastritis; use of the Updated Sydney System in histopathological evaluation of gastritis

2019 ◽  
Author(s):  
Nushka Ubhayawardana ◽  
Manjula Weerasekera ◽  
Kamani Samarasinghe ◽  
Sameera Premalal ◽  
Deepaka Weerasekera ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Chronic Gastritis ◽  
Variable Number ◽  
Ulcer Disease ◽  
Chronic Active Gastritis ◽  
Sydney System ◽  
Histologic Lesion ◽  
Updated Sydney System ◽  
H Pylori

Abstract Objective Helicobacter pylori is a major cause for chronic gastritis and further it is associated with development of peptic ulcer disease and gastric cancer. Therefore, the objective of this study was to classify gastritis according to the updated Sydney system guidelines and find the association of H. pylori with each of graded variable. Number of 152 dyspeptic patients who underwent upper gastro-intestinal endoscopy at a Teaching Hospital were enrolled. Of the 2 biopsies collected one was used for PCR to detect H. pylori. The other biopsy was fixed in formalin followed by paraffin embedding and stained with H&E stain. Gastritis was classified microscopically according to the updated Sydney system. Results : Gastritis was reported over a wide age group ranging from 18-84 years with a mean age of 51 years. Based on histological findings, 12% of patients were diagnosed as H. pylori associated chronic active gastritis. There was no significant association between each graded variable and H. pylori positivity. Of the 152 dyspeptic patients 34 were positive by PCR for H. pylori infection. All the dyspeptic patients with H. pylori infection had chronic active gastritis, suggesting an etiologic role of the bacterium in the histologic lesion.

scholarly journals Different dose of new generation proton pump inhibitors for the treatment of Helicobacter pylori infection: A meta-analysis

2021 ◽  
Vol 35 ◽  
pp. 205873842110303
Author(s):  
Wenwen Gao ◽  
Xiang Zhang ◽  
Yanhui Yin ◽  
Shuwen Yu ◽  
Lu Wang
Keyword(s):  
Helicobacter Pylori ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Eradication Rate ◽  
Standard Dose ◽  
Statistical Significance ◽  
High Dose ◽  
Clarithromycin Resistance ◽  
H Pylori ◽  
New Generation

The evidence on whether high-dose new generation proton pump inhibitors (PPIs) including rabeprazole and esomeprazole achieve a higher eradication rate of Helicobacter pylori has not been assessed. The primary comparison was eradication and adverse events (AEs) rate of standard (esomeprazole 20 mg bid, rabeprazole 10 mg bid) versus high-dose (esomeprazole 40 mg bid, rabeprazole 20 mg bid) PPIs. Sub-analyses were performed to evaluate the eradication rate between Asians and Caucasians, clarithromycin-resistance (CAM-R) strains, and clarithromycin-sensitivity (CAM-S) strains of different dose PPIs. We conducted a literature search for randomized controlled trials comparing high-with standard-dose esomeprazole and rabeprazole for H. pylori eradication and AEs. A total of 12 trials with 2237 patients were included. The eradication rate of high-dose PPIs was not significantly superior to standard-dose PPIs regimens: 85.3% versus 84.2%, OR 1.09 (0.86–1.37), P = 0.47. The high dose induced more AEs than those of the standard dose, but didn’t reach statistical significance (OR 1.25, 95% CI: 0.99–1.56, P = 0.06). Subgroup analysis showed that the difference in eradication rate of PPIs between high- and standard-dose groups were not statistically significant both in Asians (OR 0.99, 95% CI 0.75–1.32, P = 0.97) and Caucasians (OR 1.27, 95% CI 0.84–1.92, P = 0.26). Furthermore, there were similar eradication rates in CAM-S (OR 1.2; 95% CI 0.58–2.5; P = 0.63) and CAM-R strains (OR 1.08; 95% CI 0.45–2.56; P = 0.87) between the standard-and high-dose groups. High and standard dosages of new generation of the PPIs showed similar H. pylori eradication rates and AEs as well as between Asian versus Caucasian populations, with or without clarithromycin-resistance. However, further studies are needed to confirm.

scholarly journals Whole-Genome Sequencing and Comparative Genomics of Three Helicobacter pylori Strains Isolated from the Stomach of a Patient with Adenocarcinoma

Pathogens ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 331
Author(s):  
Montserrat Palau ◽  
Núria Piqué ◽  
M. José Ramírez-Lázaro ◽  
Sergio Lario ◽  
Xavier Calvet ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Whole Genome Sequencing ◽  
Genome Sequencing ◽  
Virulence Factors ◽  
Outer Membrane Proteins ◽  
Whole Genome ◽  
Flagellar Biosynthesis ◽  
H Pylori ◽  
Restriction Modification

Helicobacter pylori is a common pathogen associated with several severe digestive diseases. Although multiple virulence factors have been described, it is still unclear the role of virulence factors on H. pylori pathogenesis and disease progression. Whole genome sequencing could help to find genetic markers of virulence strains. In this work, we analyzed three complete genomes from isolates obtained at the same point in time from a stomach of a patient with adenocarcinoma, using multiple available bioinformatics tools. The genome analysis of the strains B508A-S1, B508A-T2A and B508A-T4 revealed that they were cagA, babA and sabB/hopO negative. The differences among the three genomes were mainly related to outer membrane proteins, methylases, restriction modification systems and flagellar biosynthesis proteins. The strain B508A-T2A was the only one presenting the genotype vacA s1, and had the most distinct genome as it exhibited fewer shared genes, higher number of unique genes, and more polymorphisms were found in this genome. With all the accumulated information, no significant differences were found among the isolates regarding virulence and origin of the isolates. Nevertheless, some B508A-T2A genome characteristics could be linked to the pathogenicity of H. pylori.

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