Testing of Helicobacter pylori by Endoscopic Biopsy: The Clinical Dilemma of Suppressive Conditions

Digestion ◽  
2019 ◽  
Vol 101 (5) ◽  
pp. 552-556
Author(s):  
Richard F. Knoop ◽  
Golo Petzold ◽  
Ahmad Amanzada ◽  
Sebastian C.B. Bremer ◽  
Thomas M. Gress ◽  
...  
1999 ◽  
Vol 123 (9) ◽  
pp. 778-781 ◽  
Author(s):  
Maher Toulaymat ◽  
Sharon Marconi ◽  
Jane Garb ◽  
Christopher Otis ◽  
Shirin Nash

Abstract Objectives.—To describe the endoscopic biopsy pathology of Helicobacter pylori gastritis, compare bacterial detection by immunohistochemistry using a specific antibody with the Genta stain, and to compare the relative costs of the 2 techniques. Design.—One hundred cases of gastritis identified as positive for H pylori by Genta stain and 100 cases considered negative by the same technique were stained using an anti-H pylori–specific polyclonal antibody. Laboratory reagent and labor costs for the 2 methods were compared. Results.—Chronic active gastritis with lymphoid follicles was significantly associated with H pylori infection (P < .0001). The immunohistochemical method had a sensitivity of 97% and a specificity of 98% compared with the Genta stain, with strong agreement for grading density of organisms (κ = 0.85; P < .001). Reagent costs were similar for both methods, but immunohistochemistry using an autoimmunostainer required less dedicated technical time and hence was less expensive than the Genta stain. Conclusions.—Immunohistochemistry using a specific antibody is an accurate and cost-effective method for H pylori detection in gastric biopsies.


Author(s):  
Hazim Abdul Rahman Alhit

Editorial: Helicobacter pylori is a micro-aerophilic, helical-form gramnegative aggressive bacteria. Accordingly, the idiom “Helico” intimates its helical appearance, “bacter” symbolizes bacteria, while “pylori” denotes stomach due to the first and common site of this bacteria living. Further, Marshall B. and Warren R. observed and described it in 1982. Then, the followed investigators studied this bacterium in detail with its consequences and complexities [1]. Gastric upset (Indigestion), dyspepsia: means impaired gastric digestion. Accordingly, the patient complains of upper abdominal pain, heartburn, belching, nausea, even feeling earlier gastric fullness than expected while eating. Furthermore, there are many causes of indigestion like gastroesophageal reflux disease, ulcer disease, gastritis, and even gastric cancer. Hence, unexplained recent onset dyspepsia in older people may need additional examinations. Moreover, one of the common causes is Helicobacter pylori infection, which needs laboratory and endoscopic examination [2]. Argument Many theories investigated the etiology and pathogenesis of Helicobacter pylori infection, concerning chronic or acute gastritis. Hence, gastric upset is the main presentation of both types of gastritis. Evidences The genotype is valuable in determining the dominant Helicobacter pylori strains as the isolates were different genetically plus heterogeneous distribution. Accordingly, the vac and cag markers operate a significant function in defining clinical consequences. These virulence agents are present in a subset of Helicobacter pylori strains isolates like cagA, iceA, vacA, and ureC. Moreover, the cagA causes cytotoxins induction by the gastric epithelial cell as Interleukin 8 [3]. The molecular intercommunication researches exhibit that the act of acarus calamus in hindering biofilm formation in Helicobacter pylori is due to the inhibitory impact of phytobio-active component, β-sitosterol, on the quorum sensing molecules-ToxB, PhnB, DnaA, plus Sip. Consequently, this opinion may suggest the molecular mechanism of Helicobacter pylori in producing the acidrelated complaints and gives a clue to a new therapy [4]. Helicobacter pylori infection causes lncRNA risk impression linked to H. pylori in gastric cancer patients and can prognosticate the prediction of these patients [5]. There was a close relationship between raised serum IgE levels in Helicobacter pylori infected patients [6]. Counterargument The laboratory investigations of Helicobacter pylori infection depend on several factors like the fluctuations of serum antibody titers in a time series, the antigene detection in stool tests, the false-positive results of lab tests, or the manner of endoscopic biopsy collection. Furthermore, other factors like the variations in Cytotoxin-Associated Gene A (CagA) in East Asian patients. Moreover, the gastric nodularity or atrophy, the patient’s age, the severity of the gastric mucosal infection are causes of variations in Helicobacter pylori detection at the time of the investigation [7]. Refutation The significant markers of H. pylori, the presence of the vacuolating cytotoxin (vacA), the cytotoxin-associated gene A (cagA), which induced by the direct communication with gastric epithelium factor antigen (iceA gene), and the presence of urease C gene (ureC). Consequently, all these factors play the principal factors in deciding the gastric consequences of Helicobacter infections. Conclusion Helicobacter pylori induce gastric upset by several mechanisms to form numerous Gastric diseases.


2015 ◽  
Vol 12 (1) ◽  
pp. 29-31 ◽  
Author(s):  
PG Ghimire ◽  
P Ghimire ◽  
RG Goel ◽  
DV Bahl

Aim: To evaluate the spectrum of mucosal changes in endoscopy guided gastric biopsies and analyze the association of Helicobacter pylori with demographic factors.Materials and Methods: It was a cross sectional analytical study conducted in the Department of Pathology during the period from December 2011 to April 2012. A total of 52 endoscopic biopsy specimens, each fulfilling the inclusive criteria were selected and processed using standard histopathological technique and stained with Haematoxylin-Eosin stain and modified Giemsa stain for Helicobacter pylori. Histopathological, ultrasonographic and endoscopic findings were correlated. Data were analyzed using SPSS 17.Results: Out of 52 cases enrolled in our study, 29 (55.8%) were males and 23 (44.2%) were females with a male: female ratio of 1.2:1. H. pylori infection was present in 16 (30.8 %) of biopsies and was significantly greater in the younger age group between 21 to 40 years (p value <0.024). Histopathological examination showed atrophy of the gastric mucosa in 18 (34.6%) cases, dysplasia in one and intestinal metaplasia in three cases. Statistically significant relation (p value < 0.006) was seen between H. pylori and mucosal atrophy. No significant association was seen between gender and presence of H. pylori in the gastric mucosa (p value < 0.16).Conclusions: Histopathological study of endoscopic biopsy showed spectrum of changes in symptomatic cases. H pylori was seen significantly in younger age with atrophy of gastric mucosa as a significant finding.Journal of Nepalgunj Medical College Vol.12(1) 2014: 29-31


Gut ◽  
1998 ◽  
Vol 43 (4) ◽  
pp. 470-475 ◽  
Author(s):  
J L Newton ◽  
N Jordan ◽  
L Oliver ◽  
V Strugala ◽  
J Pearson ◽  
...  

Background—It has been proposed that a pathogenic effect of Helicobacter pylori is a weakening of the protective mucus barrier; however, this remains controversial.Aims—To clarify the effects of H pylori infection on the mucus gel barrier in vivo.Methods—Mucus gel polymeric structure and the thickness of the adherent mucus barrier were measured in endoscopic biopsy samples in subjects with and without H pyloriinfection.Results—There was a significant 18% reduction in the proportion of polymeric gel forming mucin in the adherent mucus layer in H pylori positive compared with negative subjects. There was no change in the adherent mucus thickness betweenH pylori positive and negative subjects without gastric atrophy (mean (SD): 104 (26) μm, 106 (30) μm respectively). There was however a significant reduction in mucus thickness in those H pylori positive subjects with underlying gastric atrophy (84 (13) μm, p=0.03) compared with those without atrophy.Conclusions—A partial breakdown in gel forming structure of the gastric mucus barrier does occur in H pylori infection per se but this is insufficient to cause a collapse of the mucus barrier.


2004 ◽  
Vol 11 (4) ◽  
pp. 775-779 ◽  
Author(s):  
Abdelfattah M. Attallah ◽  
Hisham Ismail ◽  
Gellan G. Ibrahim ◽  
Mohamed Abdel-Raouf ◽  
Ahmed M. El-Waseef ◽  
...  

ABSTRACT Recently, noninvasive diagnostic tests for Helicobacter pylori infection have gained in significance. We have developed a sensitive and specific noninvasive immunoassay based on the detection of an H. pylori circulating antigen (HpCA) in sera from H. pylori-infected individuals. Monospecific antibody and Western blot analyses were used to demonstrate the presence of the target antigen in H. pylori cell lysate and serum samples. A novel enzyme-linked immunosorbent assay (ELISA) was developed for the detection of HpCA in serum. Endoscopic biopsy specimens from the gastric antra of 221 individuals (143 males and 78 females) with dyspeptic symptoms were evaluated for H. pylori infection, with culture used as a “gold standard” for diagnosis. The target H. pylori antigen was identified at 58 kDa. HpCA has been detected by ELISA with high degrees of sensitivity, specificity, and efficiency (>90%), and ELISA results show no significant difference (P > 0.05) from results of H. pylori culture of gastric biopsy specimens. The test's positive and negative predictive values were also high (95 and 86%, respectively). In conclusion, a sensitive and specific immunoassay was developed for the detection of HpCA in human serum. This test can be applied for noninvasive laboratory and field diagnoses of H. pylori infection.


Author(s):  
Omer Abu Elgasim ◽  
Salman Taha Ahmed Elmukashfi ◽  
Rayan Abdelwahid Mohammed ◽  
Adil Elamin Faroug

Background: The gold standard for the diagnosis of Helicobacter pylori infection requires an endoscopic biopsy of gastric mucosa for histological examination, urease test and culture; however serological tests are useful as a screening test for Helicobacter pylori infection. Objective: To compare between Immunochromatographic Test and Enzyme Linked Immunosorbent Assay techniques in detection of Helicobacter pylori immunoglobulin gamma antibodies in serum of patients suffer from gastritis. Materials and Methods: 245 patients were screened for Helicobacter pylori infections by rapid urease test. Sera from these patients were tested for anti- Helicobacter pylori immunoglobulin gamma antibodies by Enzyme Linked Immunosorbent Assay and Immunochromatographic Test techniques. Results: Of 245 patients tested, Immunochromatographic Test positive/negative 114 (46.5%)/131 (53.5%), whereas Enzyme Linked Immunosorbent Assay positive/negative were 124 (50.6%)/121 (49.4%). Sensitivity/ specificity was 67.4%/74.5% and 90.2%/89.3% for Immunochromatographic Test/Enzyme Linked Immunosorbent Assay positive/negative, respectively. The diagnostic accuracy was 71%/89.7% for Immunochromatographic Test/Enzyme Linked Immunosorbent Assay, respectively. Conclusion: The Enzyme Linked Immunosorbent Assay technique was found to be more sensitive, specific and accurate compared to the Immunochromatographic Test while The Immunochromatographic Test is commercially available, inexpensive and easy to perform compared to the Enzyme Linked Immunosorbent Assay.


1970 ◽  
Vol 2 (2) ◽  
pp. 6-10 ◽  
Author(s):  
A Sultana ◽  
SM Badruddoza ◽  
F Rahman

This study had been planned to see the histomorphological pattern of gastric mucosal biopsy, demonstrate the organism H .Pylori and correlate with endoscopic findings. The study was carried out in the department of the Pathology Rajshahi Medical College, Rajshahi, Bangladesh, during the period from January 2006 to December 2007. Endoscopic biopsy specimens were obtained from 105 cases of gastro duodenal lesions. According to endoscopic findings out of 105 cases 69(65.7%) had gastric carcinoma, 06 (5.71%) had gastric ulcer, 05 (4.76%) had duodenal ulcer, 05 (476%) had gastritis and 20 (19.04%) had normal mucosa, reported as non-ulcer dyspepsia. Of the 69 endoscopically gastric carcinoma 59 (85.50%) were diagnosed histologically as adenocarcinoma and 10 (14.50%) were diagnosed histologically as chronic gastritis in which H.Pylori was positive in 27.5% and 14.50% positive in chronic gastritis. Of 06 gastric ulcer 03 (50%) was diagnosed histologically as gastritis and 03 (50%) were diagnosed histologically as gastric carcinoma. H. Pylori was positive in cent percent of gastritis. Of 05 duodenal ulcer 03 (60%) were diagnosed histologically as gastritis and 02 (40%) were diagnosed histologically as intestinal metaplasia H. Pylori was positive in 66.6% of duodenal ulcer. Of 05 gastritis were diagnosed histologically as gastritis 60% were postive for H.Pylori. Of 20 NUD 18 (90%) were diagnosed histologically as gastritis, 01 (05%) was diagnosed histologically as ulcer and 01 (05%) was diagnosed histologically as normal mucosa, all these cases no H. Pylori was found. Key Words: Helicobacter Pylori; Gastroduodenal Lesion; Association DOI: http://dx.doi.org/10.3329/akmmcj.v2i2.8164 AKMMC J 2011; 2(2): 06-10


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