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Sample records for anti-helicobacter pylori therapy

  1. A new look at anti-Helicobacter pylori therapy

    Institute of Scientific and Technical Information of China (English)

    Seng-Kee Chuah; Feng-Woei Tsay; Ping-I Hsu; Deng-Chyang Wu

    2011-01-01

    With the rising prevalence of antimicrobial resistance, the treatment success of standard triple therapy has recently declined to unacceptable levels (i.e., 80% or less) in most countries. Therefore, several treatment regimens have emerged to cure Helicobacter pylori (H .pylori)infection. Novel first-line anti-H. pylorii therapies in 2011 include sequential therapy, concomitant quadruple therapy, hybrid (dual-concomitant) therapy and bismuth-containing quadruple therapy. After the failure of standard triple therapy, a bismuth-containing quadruple therapy comprising a proton pump inhibitor (PPI), bismuth, tetracycline and metronidazole can be employed as rescue treatment. Recently, triple therapy combining a PPI, levofloxacin and amoxicillin has been proposed as an alternative to the standard rescue therapy. This salvage regimen can achieve a higher eradication rate than bismuth-containing quadruple therapy in some regions and has less adverse effects. The best second-line therapy for patients who fail to eradicate H. pylori with first-line therapies containing clarithromycin, amoxicillin and metronidazole is unclear. However, a levofloxacin-based triple therapy is an accepted rescue treatment. Most guidelines suggest that patients requiring third-line therapy should be referred to a medical center and treated according to the antibiotic susceptibility test. Nonetheless, an empirical therapy (such as levofloxacin-based or furazolidone-based therapies) can be employed to terminate H. pylorii infection if antimicrobial sensitivity data are unavailable.

  2. Anti-Helicobacter pylori therapy significantly reduces Helicobacter pylori-induced gastric mucosal damage in Mongolian gerbils

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    Chun-Chao Chang; Sheng-Hsuan Chen; Gi-Shih Lien; Yuarn-Jang Lee; Horng-Yuan Lou; Ching-Ruey Hsieh; Chia-Lang Fang; Shiann Pan

    2005-01-01

    AIM: To investigate the effectiveness of 4 d' anti-Helicobacter pyloritherapy on the H pylori-infected Mongolian gerbils based on physiological and pathological changes.METHODS: We used 6-wk-old male gerbils orally inoculated with H pylori (ATCC43504, 2x108 CFU/mL).Seven weeks after H pylori inoculation, the animals of study group received 4 d' anti-H pylori triple therapy (H pylorieradicated group). Seven days later, all animals of the H pylori-eradicated and control groups (H pylori-infected& H pylori-uninfected groups) were sacrificed. We examined gastric mucosal lesions macroscopically, studied gastritis microscopically and determined the stomach weight ratio, myeloperoxidase (MPO) activity and prostaglandin (PG) E2 level.RESULTS: The results showed that both macroscopic and histological gastric damages were significantly less in H pylori-eradicated group than H pylori-infected group.Stomach weight ratio, MPO activity and PGE2 levels were significantly higher in H pylori-infected group than those in the other two groups.CONCLUSION: Four days' anti-H pylori therapy was effective in the improvement of H pylori-induced gastric lesions in Mongolian gerbils.

  3. Anti- Helicobacter pylori therapy followed by celecoxib on progression of gastric precancerous lesions

    Institute of Scientific and Technical Information of China (English)

    Li-Jing Zhang; Shi-Yan Wang; Xiao-Hui Huo; Zhen-Long Zhu; Jian-Kun Chu; Jin-Cheng Ma; Dong-Sheng Cui; Ping Gu; Zeng-Ren Zhao; Ming-Wei Wang; Jun Yu

    2009-01-01

    AIM:To evaluate whether celecoxib,a selective cyclooxygenase 2 (COX-2) inhibitor,could reduce the severity of gastric precancerous lesions following Helicobacter pylori (H pylori) eradication.METHODS:H pylori-eradicated patients with gastric precancerous lesions randomly received either celecoxib (n=30) or placebo (n=30) for up to 3 mo.COX-2 expression and activity was determined by immunostaining and prostaglandin E2 (PGE2) assay,cell proliferation by Ki-67 immunostaining,apoptosis by TUNEL staining and angiogenesis by microvascular density (MVD) assay using CD31 staining.RESULTS:COX-2 protein expression was significantly increased in gastric precancerous lesions (atrophy,intestinal metaplasia and dysplasia,respectively) compared with chronic gastritis,and was concomitant with an increase in cell proliferation and angiogenesis.A significant improvement in precancerous lesions was observed in patients who received celecoxib compared with those who received placebo (P<0.001).Of these three changes,84.6% of sites with dysplasia regressed in patients treated with celecoxib (P=0.002) compared with 60% in the placebo group,suggesting that celecoxib was effective on the regression of dysplasia.COX-2 protein expression (P<0.001) and COX-2 activity (P<0.001) in the gastric tissues were consistently lower in celecoxib-treated patients compared with the placebo-treated subjects.Moreover,it was also shown that celecoxib suppressed cell proliferation (P<0.01),induced cell apoptosis (P<0.01) and inhibited angiogenesis with decreased MVD (P<0.001).However,all of these effects were not seen in placebo-treated subjects.Furthermore,COX-2 inhibition resulted in the up-regulation of PPARg expression,a protective molecule with anti-neoplastic effects.CONCLUSION:H pylori eradication therapy followed by celecoxib treatment improves gastric precancerous lesions by inhibiting COX-2 activity,inducing apoptosis,and suppressing cell proliferation and angiogenesis.

  4. Design and evaluation of controlled release mucoadhesive microspheres of amoxicillin for anti Helicobacter pylori therapy

    OpenAIRE

    N Venkateswaramurthy; Sambathkumar, R.; Perumal, P.

    2011-01-01

    The aim of this study was to develop controlled release mucoadhesive microspheres of amoxicillin trihydrate for the treatment of peptic ulcer disease caused by Helicobacter pylori (H. pylori). Microspheres were prepared by solvent evaporation technique using carbopol 974P, hydroxypropyl methyl cellulose K4M (HPMC K4M) and Eudragit RS 100. The prepared microspheres were subjected to evaluation for particle size, incorporation efficiency, in vitro mucoadhesion and in vitro drug release characte...

  5. Design and evaluation of controlled release mucoadhesive microspheres of amoxicillin for anti Helicobacter pylori therapy

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    N Venkateswaramurthy

    2011-01-01

    Full Text Available The aim of this study was to develop controlled release mucoadhesive microspheres of amoxicillin trihydrate for the treatment of peptic ulcer disease caused by Helicobacter pylori (H. pylori. Microspheres were prepared by solvent evaporation technique using carbopol 974P, hydroxypropyl methyl cellulose K4M (HPMC K4M and Eudragit RS 100. The prepared microspheres were subjected to evaluation for particle size, incorporation efficiency, in vitro mucoadhesion and in vitro drug release characteristics. Absence of drug-polymer interaction was confirmed using differential scanning calorimetry analysis and fourier transform infrared spectrophotometry. The prepared microspheres showed a strong mucoadhesive property. The polymer concentration influenced the in vitro drug release significantly in 0.1N HCl. The particle sizes of systems ranged between 123±8.35 μm and 524±11.54 μm. Percent drug entrapment and release profiles of amoxicillin trihydrate in 0.1 N HCl were determined using high-performance liquid chromatography. The percentage drug entrapment and percentage yield of formulations were about 56.71±1.66% to 88.32±0.65% and 39.20±1.62% to 92.40±1.32%, respectively. The stability of the drugs was assessed in 0.1 N HCl. The results further substantiated that mucoadhesive microspheres improved the gastric stability of amoxicillin trihydrate (due to entrapment within the microsphere. From the above results, it was concluded that the mucoadhesive microspheres of amoxicillin trihydrate has feasibility for eradicating H. pylori from the stomach more effectively because of the prolonged gastrointestinal residence time and controlled release of drug from the formulation.

  6. ASSESSMENT OF RELATED ANAMNESTIC AND CLINICAL FACTORS ON EFFICACY AND SAFETY OF ANTI-HELICOBACTER PYLORI THERAPY

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    D. N. Andreev

    2016-01-01

    Full Text Available The article presents the results of a prospective clinical study in which 100 patients with H. pylori-associated peptic ulcer disease of stomach/duodenum were examined. The aim of the study was to assess the effect of concomitant anamnestic and clinical factors on the efficacy and safety of eradication therapy (ET. Type 2 diabetes mellitus is a factor that significantly reduces the efficiency of ET with OR 0.21 (95% CI 0,06-0,69, p = 0,0102. Using a macrolide antibiotics prior to ET during the previous 12 months is associated with a reduction in the effectiveness of H. pylori eradication with OR 0.27 (95% CI 0,08-0,90, p = 0,0342. Despite the lack of statistical significance observed negative effect on the efficiency of ET factors such as smoking and increased BMI. Smoking, female gender, age over 50 years and the presence of type 2 diabetes mellitus had no significant impact on the safety profile of ET. 

  7. Development of pH-responsive chitosan/heparin nanoparticles for stomach-specific anti-Helicobacter pylori therapy.

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    Lin, Yu-Hsin; Chang, Chiung-Hung; Wu, Yu-Shiun; Hsu, Yuan-Man; Chiou, Shu-Fen; Chen, Yi-Jen

    2009-07-01

    The microorganism now known as Helicobacter pylori is considered to be an important factor in the etiology of peptic ulcers. It can secrete urease enzyme and buffer gastric acids to survive in the stomach. H. pylori can colonize the gastric mucosa and preferentially adheres near the cell-cell junctions of the gastric mucous cells. In this study, pH-responsive nanoparticles were produced instantaneously upon the addition of heparin solution to a chitosan solution with magnetic stirring at room temperature. The nanoparticles appeared to have a particle size of 130-300 nm, with a positive surface charge, and were stable at pH 1.2-2.5, allowing them to protect an incorporated drug from destructive gastric acids. We also demonstrated that the prepared nanoparticles can adhere to and infiltrate cell-cell junctions and interact locally with H. pylori infection sites in intercellular spaces.

  8. Screening test for anti-Helicobacter pylori activity of traditional Chinese herbal medicines

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    AIM:To evaluate the anti-Helicobacter pylori (H.pylori) activity of 50 traditional Chinese herbal medicines in order to provide the primary evidence for their use in clinical practice.METHODS:A susceptibility test of water extract from 50 selected traditional Chinese herbal medicines for in vitro H.pylori Sydney strain 1 was performed with broth dilution method.Anti-H.pylori activity of the selected Chinese herbal medicines was evaluated according to their minimum inhibitory concentration (MIC).RESULTS:The ...

  9. Does the antibody production ability affect the serum anti-Helicobacter pylori Ig G titer?

    Institute of Scientific and Technical Information of China (English)

    Hyun Ah Chung; Sun-Young Lee; Hee Won Moon; Jeong Hwan Kim; In-Kyung Sung; Hyung Seok Park; Chan Sup Shim; Hye Seung Han

    2016-01-01

    AIM: To investigate the relationship between serum titers of anti-Helicobacter pylori(H.pylori) immunoglobulin G(IgG) and hepatitis B virus surface antibody(HBsA b).METHODS: Korean adults were included whose samples had positive Giemsa staining on endoscopic biopsy and were studied in the hepatitis B virus surface antigen(HBsA g)/HBsA b serologic assay,pepsinogen(PG) assay,and H.pylori serologic test on the same day.Subjects were excluded if they were positive for HBs Ag,had a recent history of medication,or had other medical condition(s).We analyzed the effects of the following factors on serum titers of HBsA b and the anti-H.pylori IgG : Age,density of H.pylori infiltration in biopsy samples,serum concentrations of PG Ⅰ and PG Ⅱ,PG Ⅰ/Ⅱ ratio,and white blood cell count.RESULTS: Of 111 included subjects,74(66.7%) exhibited a positive HBsA b finding.The serum anti-H.pylori IgG titer did not correlate with the serum HBsA b titer(P = 0.185); however,it correlated with the degree of H.pylori infiltration on gastric biopsy(P < 0.001) and serum PG Ⅱ concentration(P = 0.042).According to the density of H.pylori infiltration on gastric biopsy,subjects could be subdivided into those with a marked(median: 3.95,range 0.82-4.00)(P = 0.458),moderate(median: 3.37,range 1.86-4.00),and mild H.pylori infiltrations(median: 2.39,range 0.36-4.00)(P < 0.001).Subjects with a marked H.pylori infiltration on gastric biopsy had the highest serological titer,whereas in subjects with moderate and mild H.pylori infiltrations titers were correspondingly lower(P < 0.001).After the successful eradication,significant decreases of the degree of H.pylori infiltration(P < 0.001),serum anti-H.pylori IgG titer(P < 0.001),and serum concentrations of PG I(P = 0.028) and PG Ⅱ(P = 0.028) were observed.CONCLUSION: The anti-H.pylori IgG assay can be used to estimate the burden of bacteria in immunocompetent hosts with H.pylori infection,regardless of the HBsA b titer after HBV vaccination.

  10. In vitro evaluation of Bacopa monniera on anti-Helicobacter pylori activity and accumulation of prostaglandins.

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    Goel, R K; Sairam, K; Babu, M Dora; Tavares, I A; Raman, A

    2003-01-01

    Bacopa monniera is an Indian tratidional medicine widely used to improve intellectual functions. Earlier, we had reported the prophylactic and curative effects of standardized extract of Bacopa monniera (BME) in various gastric ulcer models. The effect was due to augmentation of the defensive mucosal factors like increase in mucin secretion, life span of mucosal cells and gastric antioxidant effect rather than on the offensive acid-pepsin secretion. The present study includes evaluation of standardized BME (bacoside A content--35.5 +/- 0.9) on other contributing factors towards ulcerogenesis. BME in the dose of 1000 microg/ml showed anti-Helicobacter pylori activity in vitrol and in the dose of 10 microg/ml increased in vitro of prostanoids (PGE and PGI2) in human colonic mucosal incubates. It may be concluded that these factors may contribute to antiulcerogenic activity of BME.

  11. Preparation, characterization, and anti-Helicobacter pylori activity of Bi3+-Hericium erinaceus polysaccharide complex.

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    Zhu, Yang; Chen, Yao; Li, Qian; Zhao, Ting; Zhang, Ming; Feng, Weiwei; Takase, Mohammed; Wu, Xueshan; Zhou, Zhaoxiang; Yang, Liuqing; Wu, Xiangyang

    2014-09-22

    Two new Bi3+-Hericium erinaceus polysaccharide (BiHEP) complexes were prepared using Bi3+ and two purified polysaccharides from H. erinaceus (HEPs), respectively. The complexes were characterized by elemental analysis, FT-IR, CD, SEM, AFM, XRD, and TG. The anti-Helicobacter pylori (Hp) activities in vitro by agar dilution assay of the complexes were evaluated. The molecular weights of HEPs were 197 and 20 kDa, respectively. All the analyses confirmed the formation of new BiHEP complexes with lower content of Bi3+ compared with colloidal bismuth subcitrate (CBS), the most utilized bismuth preparation clinically. Furthermore, HEPs themselves have definite inhibition effects on Hp, and BiHEP complexes have lower content of Bi exhibited strong inhibition effects on Hp (MIC=20 μg/mL), similar to that of CBS with higher content of Bi. The study provides a basis for further development of multiple treatments of Hp infection or new medicines.

  12. In vitro and In vivo Anti-Helicobacter pylori Activities of Centella asiatica Leaf Extract

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    Zheng, Hong-Mei; Choi, Myung-Joo; Kim, Jae Min; Lee, Kye Wan; Park, Yu Hwa; Lee, Don Haeng

    2016-01-01

    Helicobacter pylori infection is associated with an increased risk of developing upper gastrointestinal tract diseases. However, treatment failure is a major cause of concern mainly due to possible recurrence of infection, the side effects, and resistance to antibiotics. The aim of this study was to investigate the activities of Centella asiatica leaf extract (CAE) against H. pylori both in vitro and in vivo. The minimum inhibitory concentrations (MICs) against 55 clinically isolated strains of H. pylori were tested using an agar dilution method. The MICs of CAE ranged from 0.125 mg/mL to 8 mg/mL, effectiveness in inhibiting H. pylori growth was 2 mg/mL. The anti-H. pylori effects of CAE in vivo were also examined in H. pylori-infected C57BL/6 mice. CAE was orally administrated once daily for 3 weeks at doses of 50 mg/kg and 250 mg/kg. CAE at the 50 mg/kg dose significantly reduced H. pylori colonization in mice gastric mucosa. Our study provides novel insights into the therapeutic effects of CAE against H. pylori infection, and it suggests that CAE may be useful as an alternative therapy. PMID:27752495

  13. Vitamin-C as anti-Helicobacter pylori agent: More prophylactic than curative- Critical review

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    Jagannath Pal

    2011-01-01

    Full Text Available Potential of nonantibiotic therapies for treatment of Helicobacter pylori-related acid peptic disease remains underexplored. Several clinical studies have shown that higher prevalence of H. pylori infection is associated with low Vitamin C (Vit C level in serum and gastric juice. However, there is no consensus regarding the usefulness of Vit C supplementation in the management of H. pylori infection. Surveying the existing literature we conclude that high concentration of Vit C in gastric juice might inactivate H. pylori urease, the key enzyme for the pathogen′s survival and colonization into acidic stomach. Once infection established, urease is not very important for its survival. The role of Vit-C as anti-H. pylori agent in peptic ulcer diseases appears to be preventive rather than curative. Rather than supplementing high dose of Vit C along with conventional triple therapy, it is preferable to complete the conventional therapy and thereafter start Vit C supplementation for extended period which would prevent reinfection in susceptible individuals, provided the patients are not achlorhydric. Further studies are required to prove the role of Vit C in susceptible population.

  14. [Is anti-helicobacter therapy a rational approach in treatment of erosive and ulcerous lesions of the gastroduodenal mucosa in patients with inflamatory bowel diseases?].

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    Maev, I V; Gadzhieva, M G

    2005-01-01

    The study revealed changes in the oesophagogastroduodenal mucosa in 110 patients with IBD; in 60.9% of cases these changes were associated with Helicobacter pylori. 35 patients with IBD were examined to form two groups. The first group (20 patients) received rabeprazol (pariet) in a dose of 20 mg per day; the rest 15 patients were administered 120 mg of de-nol four times a day; amoxicicline and furazolidon were used as additional therapy in cases with Helicobacter pylori. The study showed that successful eradication did not always result in erosion epithelization but, on the contrary, only 40% cases of clinical and endoscopic remission were associated with Helicobacter pylori elimination. These data suggest that anti-helicobacter therapy is not a rational approach in treatment of this category of patients.

  15. Anti-helicobacter pylori effect of total alkaloids of sophora alopecuroides in vivo

    Institute of Scientific and Technical Information of China (English)

    Tian Aiping; Xu Ting; Liu Kaiyun; Zou Quanming; Yan Xiang

    2014-01-01

    triple therapy (P <0.001); thirdly,HE staining showed that the inflammation on mice gastric mucosal membrane were also relieved obviously in TASA combined treatments and conventional triple therapy compared with normal saline treated mice,moreover,from immunohistochemistry results,H.pylori-induced IL-8,COX-2,and NF-KB were consistently suppressed in seventh,eighth,ninth,and tenth group to a certain extent.Conclusion These results open the possibility of taking TASA as an anti-inflammatory agent for H.pylori gastritis.

  16. Tmplications of anti-parietal cell antibodies and anti-Helicobacter pylori antibodies in histological gastritis and patient outcome

    Institute of Scientific and Technical Information of China (English)

    Ching-Chu Lo; Nan-Jing Peng; Ping-I Hsu; Gin-Ho Lo; Kwok-Hung Lai; Hui-Hwa Tseng; Chiun-Ku Lin; Hoi-Hung Chan; Wei-Lun Tsai; Wen-Chi Chen

    2005-01-01

    AIM: To develop a serum or histological marker for early discovery of gastric atrophy or intestinal metaplasia.METHODS: This study enrolled 44 patients with gastric adenocarcinoma, 52 patients with duodenal ulcer, 14 patients with gastric ulcer and 42 consecutive healthy adults as controls. Each patient received an endoscopy and five biopsy samples were obtained. The degrees of histological parameters of gastritis were categorized following the Updated Sydney System. Anti-parietal cell antibodies (APCA)and anti- Helicobacter pylori( H pylori) antibodies (AHPA)were analyzed by immunoassays. Hpylori infection was diagnosed by rapid urease test and histological examination.RESULTS: Patients with gastric cancer and gastric ulcer are significantly older than healthy subjects, while also displaying higher frequency of APCA than healthy controls.Patients with positive APCA showed higher scores in gastric atrophy and intestinal metaplasia of corpus than patients with negative APCA. Patients with positive AHPA had higher scores in gastric atrophy, intestinal metaplasia, and gastric inflammation of antrum than those patients with negative AHPA. Elderly patients had greater prevalence rates of APCA. Following multivariant logistic regression analysis,the only significant risk factor for antral atrophy is positive AHPA, while that for corpus atrophy is positive APCA.CONCLUSION: The existence of positive APCA correlates with glandular atrophy in corpus and the presence of positive AHPA correlates with glandular atrophy in antrum.The existence of serum APCA and AHPA betokensglandular atrophy and requires further examination for gastric cancer.

  17. Comparison of Salivary Anti Helicobacter pylori IgG with Serum IgG and Bacteriological Tests in Detecting Helicobacter pylori Infections

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    H Ghasemian safaei

    2005-01-01

    Full Text Available Background: This study was conducted to compare the efficacy of enzyme-linked immunosorbent assay (ELISA for detecting anti-Helicobacter pylori (H. pylori specific IgG antibodies in specimens of oral fluid and serum with bacteriological tests. Methods: Antral biopsy specimens, as well as serum and oral fluid samples were collected from 97 patients who underwent upper gastrointestinal endoscopy. The presence or absence of current H. pylori infection was determined by culture, histology and urease detection. Anti-H. pylori specific IgG was detected in serum and oral fluid, using an established lab-made, and a commercial ELISA kit. The obtained data were compared with results of bacteriological tests. Results: In all, 62 (64% of 97 patients were positive for H. pylori by one or more of the gold standard tests (culture, histology and urease detection. Lab-made enzyme-linked immunoassay of oral fluid had a sensitivity and specificity of 92% and 83% respectively. A sensitivity and specificity of 87% and 83%, respectively, was obtained with the commercial kit. Lab-made enzyme-linked immunoassay of serum samples had a sensitivity and specificity of 90% and 88%, respectively. A sensitivity of 86% and specificity of 86% was obtained with the commercial kit. Conclusion: Detection of anti-H. pylori specific IgG in oral fluid by ELISA is comparable in sensitivity and specificity with serum based methods. Oral fluid based ELISA could provide a reliable, non-invasive method for the diagnosis of H. pylori infection. Saliva testing may have a role in epidemiological studies. Keywords: Helicobacter pylori, ELISA, Oral fluid

  18. Anti-Helicobacter pylori activity and immunostimulatory effect of extracts from Byrsonima crassa Nied. (Malpighiaceae

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    Vilegas Wagner

    2009-01-01

    Full Text Available Abstract Background Several in vitro studies have looked at the effect of medicinal plant extracts against Helicobacter pylori (H. pylori. Regardless of the popular use of Byrsonima crassa (B. crassa as antiemetic, diuretic, febrifuge, to treat diarrhea, gastritis and ulcers, there is no data on its effects against H. pylori. In this study, we evaluated the anti-H. pylori of B. crassa leaves extracts and its effects on reactive oxygen/nitrogen intermediates induction by murine peritoneal macrophages. Methods The minimal inhibitory concentration (MIC was determined by broth microdilution method and the production of hydrogen peroxide (H2O2 and nitric oxide (NO by the horseradish peroxidase-dependent oxidation of phenol red and Griess reaction, respectively. Results The methanolic (MeOH and chloroformic (CHCl3 extracts inhibit, in vitro, the growth of H. pylori with MIC value of 1024 μg/ml. The MeOH extract induced the production H2O2 and NO, but CHCl3 extract only NO. Conclusion Based in our results, B. crassa can be considered a source of compounds with anti-H. pylori activity, but its use should be done with caution in treatment of the gastritis and peptic ulcers, since the reactive oxygen/nitrogen intermediates are involved in the pathogenesis of gastric mucosal injury induced by ulcerogenic agents and H. pylori infections.

  19. Chemical composition and anti-Helicobacter pylori effect of Satureja bachtiarica Bunge essential oil.

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    Falsafi, Tahereh; Moradi, Parisa; Mahboubi, Mohaddese; Rahimi, Ebrahim; Momtaz, Hassan; Hamedi, Behzhad

    2015-01-15

    Resistance of H. pylori strains to common antibiotics has been developed in different parts of the world and continues to increase. It is important to investigate the novel and efficient anti-H. pylori drugs, among which the plants would be suitable sources. Satureja bachtiarica Bunge is traditionally used as antimicrobial agent. In this study, we evaluated the antibacterial activity of S. bachtiarica Bunge essential oil against 10 clinical isolates of Helicobacter pylori by disc diffusion and agar dilution methods. The chemical composition of essential oil was analyzed by GC and GC-MS. Carvacrol (45.5%) and thymol (27.9%) were the primary constituents of oil, followed by p-cymene (4.4%), and γ-terpinene (4.0%). S. bachtiarica essential oil showed strong antibacterial activity against clinical isolates of H. pylori (17.6 ± 1.1 mm and 0.035 ± 0.13 μl/ml). Carvacrol, as the first main component, had a significant role in this effect, whereas in the presence of thymol, the antibacterial effect of carvacrol was reduced. Therefore, S. bachtiarica essential oil can be applied as an alternative agent for treatment of H. pylori infections. More studies would be required to better clarify its mechanism of action on H. pylori.

  20. Preliminary Phytochemical Screening and In Vitro Anti-Helicobacter pylori Activity of Extracts of the Stem Bark of Bridelia micrantha (Hochst., Baill., Euphorbiaceae

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    Pascal O. Bessong

    2011-07-01

    Full Text Available Helicobacter pylori is a major risk factor for gastritis, ulcers and gastric cancer. This study was aimed to determine the antimicrobial activity of the stem bark of Bridelia. micrantha on H. pylori isolated in South Africa. Extracts and clarithromycin were tested against 31 clinical strains, including a standard strain (NCTC 11638 of H. pylori, by measuring the diameters of the corresponding inhibition zones, followed by determination of the Minimum Inhibitory Concentration (MIC (using metronidazole, and amoxicillin as control antibiotics and the rate of kill. Preliminary phytochemical screening was also done. Inhibition zone diameters which ranged from 0–23 mm were observed for all five of the extracts and 0–35 mm for clarithromycin. Marked susceptibility of strains (100% was noted for the acetone extract (P < 0.05, followed by ethyl acetate extract (93.5%. The MIC50 values ranged from 0.0048 to 0.156 mg/mL for the ethyl acetate extract and 0.0048 to 0.313 mg/mL for the acetone extract. The MIC90 values ranged from 0.0048 to 2.5 mg/mL for the ethyl acetate extract and 0.078 to >0.625 mg/mL for the acetone extract, respectively. Insignificant statistical difference in potency was observed when comparing the crude ethyl acetate extract to metronidazole and amoxicillin (P > 0.05. Complete killing of strain PE430C by the ethyl acetate extract was observed at 0.1 mg/mL (2 × MIC and 0.2 mg/mL (4 × MIC at 66 and 72 h. For strain PE369C, 100% killing was observed at 0.1 mg/mL (2 × MIC in 66 and 72 h. The ethyl acetate extract could thus be a potential source of lead molecules for the design of new anti-Helicobacter pylori therapies as this study further confirmed the presence of phytochemicals including alkaloids, flavonoids, steroids, tannins and saponins.

  1. Anti-Helicobacter pylori activity of plant extracts traditionally used for the treatment of gastrointestinal disorders

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    Laura Lúcia Cogo

    2010-06-01

    Full Text Available The antibacterial activity of plant extracts obtained from Bixa orellana L., Chamomilla recutita L., Ilex paraguariensis A. St.-Hil., Malva sylvestris L., Plantago major L. and Rheum rhaponticum L. has been evaluated against two reference strains and eleven clinical isolates of Helicobacter pylori. All the plant species chosen are used in popular Brazilian cuisine and folk medicine in the treatment of gastrointestinal disorders. Initial screening was made by the disk diffusion test and then minimum inhibitory concentration was determined by the agar dilution method. The results presented in this work demonstrated that among the plant preparations analyzed, B. orellana L., C. recutita L., I. paraguariensis A. St.-Hil. and M. sylvestris L. were capable of inhibiting the in vitro growth of H. pylori.

  2. Anti-Helicobacter pylori activity of plant extracts traditionally used for the treatment of gastrointestinal disorders.

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    Cogo, Laura Lúcia; Monteiro, Cristina Leise Bastos; Miguel, Marilis Dallarmi; Miguel, Obdulio Gomes; Cunico, Miriam Machado; Ribeiro, Marcelo Lima; de Camargo, Eloá Ramalho; Kussen, Gislene Maria Botão; Nogueira, Keite da Silva; Costa, Libera Maria Dalla

    2010-04-01

    The antibacterial activity of plant extracts obtained from Bixa orellana L., Chamomilla recutita L., Ilex paraguariensis A. St.-Hil., Malva sylvestris L., Plantago major L. and Rheum rhaponticum L. has been evaluated against two reference strains and eleven clinical isolates of Helicobacter pylori. All the plant species chosen are used in popular Brazilian cuisine and folk medicine in the treatment of gastrointestinal disorders. Initial screening was made by the disk diffusion test and then minimum inhibitory concentration was determined by the agar dilution method. The results presented in this work demonstrated that among the plant preparations analyzed, B. orellana L., C. recutita L., I. paraguariensis A. St.-Hil. and M. sylvestris L. were capable of inhibiting the in vitro growth of H. pylori.

  3. Serum anti-Helicobacter pylori immunoglobulin G titer correlates with grade of histological gastritis, mucosal bacterial density, and levels of serum biomarkers.

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    Tu, Huakang; Sun, Liping; Dong, Xiao; Gong, Yuehua; Xu, Qian; Jing, Jingjing; Yuan, Yuan

    2014-03-01

    OBJECTIVE. Clinical implications of serum anti-Helicobacter pylori immunoglobulin G (IgG) titer were unclear. This study investigated the associations of serum anti-H. pylori IgG titer with grade of histological gastritis, mucosal bacterial density and levels of serum biomarkers, including pepsinogen (PG) I, PGII, PGI/II ratio and gastrin-17. MATERIAL AND METHODS. Study participants were from a screening program in northern China. Serum anti-H. pylori IgG measurements were available for 5922 patients with superficial gastritis. Serum anti-H. pylori IgG titer and serum biomarkers were measured using ELISA, and gastric biopsies were evaluated using standardized criteria. RESULTS. In patients with mild, moderate or severe superficial gastritis, the mean serum anti-H. pylori IgG titers were 17.3, 33.4 and 54.4 EIU (p for trend gastritis, mucosal bacterial density and concentrations of serum PGI, PGII and gastrin-17, and negatively with PGI/II ratio.

  4. Mechanochemical synthesis and in vitro anti-Helicobacter pylori and uresase inhibitory activities of novel zinc(II)-famotidine complex.

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    Amin, Muhammad; Iqbal, Mohammad S; Hughes, Roy W; Khan, Safyan A; Reynolds, Paul A; Enne, Virve I; Sajjad-ur-Rahman; Mirza, Akmal S

    2010-06-01

    The mechanochemical synthesis and characterization of a zinc complex with famotidine is described. The complex was characterized by microanalysis and a number of spectroscopic techniques. The complex was of M:L dihydrate type. Derivatization of famotidine with zinc appears to enhance the activity of the drug by inhibiting the growth of Helicobacter pylori (two reference and 34 clinical isolates). The complex inhibited the growth of H. pylori in an MIC range of 1-8 microg mL(-1). The anti-H. pylori activity of the zinc-famotidine complex against antibiotic-resistant strains was nearly comparable to that of antibiotic-susceptible strains. The complex was found to be far less toxic than the parent drug, as demonstrated by its higher LD(50) value. In the human urease enzyme inhibition assay the complex exhibited significant inhibition. The new complex appears to be more useful in eradicating both the antibiotic-susceptible and antibiotic-resistant strains of H. pylori.

  5. Clinical study on verrucous gastritis treated with HF electrocoagulation and anti-helicobacter pylori drug under endoscope%药物联合内镜下高频电凝治疗疣状胃炎的疗效观察

    Institute of Scientific and Technical Information of China (English)

    程桐花; 朱贞祥

    2011-01-01

    Aim To investigate the effect on verrucous gastritis treated with high frequency( HF )electrocoagulation and anti-helicobacter pylori( HP)drug under endoscope. Methods After gastroscopic diagnosis,86 cases of patients with verrucous gastritis were divided into group A and B by random. In group A,HF electrocoagulation was conducted on verrucous lesions of the each case under gastroscope, and the eradication therapy for HP was conducted after the surgery. But for Group B, only the eradication therapy for HP was conducted. In four weeks later,we not only compared the eradication rate of HP in the two groups, but also the effect on verrucous lesions, and the effect in 6 months after the treatment. Results In four weeks later,eradication therapy of HP showed no difference in the two groups,but the effect were significantly different not only four weeks but also six months later. Conclusion The effect of the therapy with HF electrocoagulation under endoscope is better than that only with anti-HP drug for verrucous gastritis.%目的 探讨内镜下高频电凝联合药物抗幽门螺杆菌(HP)治疗疣状胃炎(VG)的疗效.方法 经胃镜诊断疣状胃炎86例患者,随机将其分为A(52例)、B(34例)两组.A组在胃镜下对所有疣状病变进行高频电凝疗法,术后予HP药物根除治疗.B组只予HP药物根除治疗.比较两组患者疗程结束后4周时HP根除率和疣状病变治疗效果,24周时疣状病变的治疗效果.结果 两组在疗程结束后4周HP根治率无明显差异,4周和24周疣状病变治效果有显著差异.结论 内镜下高频电凝联合药物抗HP疗法较单药物抗HP疗法治疗疣状胃炎效果更佳.

  6. Effects of Anti-Helicobacter pylori Treatment as Part of Antiemetic Cancer Chemotherapy%抗幽门螺杆菌治疗在肿瘤化疗止吐中的作用研究

    Institute of Scientific and Technical Information of China (English)

    朴瑛; 刘兆喆; 丁震宇; 徐龙; 郭放; 孙庆庆; 谢晓冬

    2012-01-01

    Objective: This work aims to assess the effects of anti-Helicobacter pylori (anti-H. pylori) therapy combined with antiemetic drugs on chemotherapy-induced gastrointestinal toxicity. Methods: Out of the 176 patients who were enrolled in the research from January 2010 to January 2011, 86 were infected by H. pylori. Infected patients were randomly divided into Groups A and B. Patients in Group A (n= 43) received anti-H. pylori therapy combined with antiemetic drugs (20 mg omeprazole, 500 mg clarithromycin, and 500 mg tinidazole, twice a day, plus 5 mg tropisetron, for four weeks) Patients in Group B (n=43) only received antiemetic drugs (5 mg tropisetron for four weeks). No statistical significance was observed between Groups A and B for gender, age, and clinical manifestations. Clinical symptoms were observed and evaluated based on the gastrointestinal reaction indexing standards of the World Health Organization. The H. pylori eradication rate was assessed by 4C-urea breath test. Results: The vomiting severity was higher in the patients who were infected by H. pylori and subsequently underwent chemotherapy compared with the non-infected patients. Significant differences were observed between grades Ⅲ and Ⅳ vomiting (x2=21.92, P<0.001), as well as between grades I and Ⅱvomiting (x2=9.73, PO.01). The degree of nausea and vomiting was reduced in the patients who underwent anti-H. pylori therapy combined with antiemetic drugs, compared with those who only received antiemetic drugs. The total efficiency of the treatment was significantly higher in group A than in group B (x2=4.46, P<0.05). Conclusion: Anti-H. pylori treatment combined with antiemetic drugs may effectively reduce and relieve chemotherapy-induced gastrointestinal toxicity for patients infected with H. pylori.%目的:评估抗幽门螺杆菌(Helicobacter pylori,HP)治疗及联合常规止吐药物对肿瘤患者化疗所致胃肠道不良反应的疗效.方法:2010年1月至2011年1

  7. Efficacy of Probiotic Supplementation Therapy for Helicobacter pylori Eradication: A Meta-Analysis of Randomized Controlled Trials

    Science.gov (United States)

    Deng, Jiaqi; Yan, Qiong; Yang, Chun; Xia, Guodong; Zhou, Xian

    2016-01-01

    Background Traditional Helicobacter pylori (H. pylori) eradication therapies have shown efficacies below 80% in several studies, and their use has been accompanied by antibiotic-related side effects. Some recent studies have reported that supplementing standard therapies with probiotics can improve the efficacy and tolerability of Helicobacter pylori eradication therapy. Objective To assess the effects of probiotic supplementation on the eradication rates and therapy-related adverse event rates of anti-Helicobacter pylori regimens. Methods We searched PubMed, Medline, the Cochrane Central Registry of Controlled Trials and the Chinese Biomedical Database for eligible randomized controlled trials published through July, 2015. Review Manager 5.3 was used for all statistical analyses. Results Thirteen randomized controlled trials involving a total of 2306 patients were included in our analysis. Intent-to-treat (ITT) analysis performed using a fixed-effects model (test for heterogeneity I2 = 45%) showed that the pooled relative risk (RR) of eradication was significantly higher in the probiotic supplementation group than in the control group [RR 1.15, 95% confidence interval (CI): 1.10–1.20, Ppylori eradication rates. However, supplementation with Lactobacillus alone did not significantly decrease the overall incidence of side effects (RR = 0.61, 95% CI: 0.11–3.51, P = 0.58). Our study also showed that probiotic supplementation before, during or after H. pylori eradication therapy improved eradication rates, regardless of supplementation duration. Furthermore, probiotic supplementation during H. pylori treatment reduced the incidence of side effects. Conclusion Probiotic supplementation during anti-Helicobacter pylori treatment may be effective for improving H. pylori eradication rates, minimizing the incidence of therapy-related adverse events and alleviating most disease-related clinical symptoms. However, our results should be interpreted with caution because of

  8. Anti-Helicobacter pylori activity and oxidative burst inhibition by the naphthoquinone 5-methoxy-3,4-dehydroxanthomegnin from Paepalanthus latipes

    Directory of Open Access Journals (Sweden)

    Rodrigo Rezende Kitagawa

    2012-02-01

    Full Text Available Helicobacter pylori is a bacterium recognized as the major cause of chronic gastritis and peptic ulcers. Infection by H. pylori induces inflammatory responses and pathological changes in the gastric microenvironment. The host Keywords: immune cells (especially neutrophils release inflammatory mediators and large 5-methoxy-3,4-dehydroxanthomegnin amounts of reactive oxygen species (ROS, which are associated with an increased Helicobacter pyloririsk of developing gastric cancer. In this study, we evaluated the anti-H. pylori and oxidative burst antioxidantactivitiesofa1,4-naphthoquinone-5-methoxy-3,4-dehydroxanthomegnin. Paepalanthus latipes The antimicrobial activity was assessed using a spectrophotometric microdilution technique, and antioxidant activity was assessed by noting the effect of 5-methoxy3,4-dehydroxanthomegnin on the neutrophil oxidative burst using luminol-and lucigenin-amplified chemiluminescence. The results showed that 5-methoxy-3,4dehydroxanthomegnin is a potent anti-H. pylori compound (MIC 64 µg/mL and MBC 128 µg/mL and a strong antioxidant. 5-Methoxy-3,4-dehydroxanthomegnin decreased luminol- and lucigenin-amplified chemiluminescence, with ED50 values of 1.58±0.09 µg/mL and 5.4±0.15 µg/mL, respectively, reflecting an inhibitory effect on the oxidative burst. These results indicate that 5-methoxy-3,4-dehydroxanthomegnin is a promising compound for the prevention and treatment of diseases caused by H. pylori infection, such as gastritis, peptic ulceration, and gastric cancer, because reactive oxygen intermediates are involved in the pathogenesis of gastric mucosal injury induced by H. pylori infections.

  9. Seroprevalence of anti-Helicobacter pylori and anti-CagA antibodies in peptic ulcer and healthy subjects in the city of Rafsanjan

    Directory of Open Access Journals (Sweden)

    Abdollah Jafarzadeh

    2006-12-01

    Full Text Available BACKGROUND: Helicobacter pylori (H. pylori infection is thought to play an etiologic role in several gastroduodenal diseases including gastric ulcer, duodenal ulcer, gastric MALT lymphoma, and distal gastric cancer. Several studies have suggested that H. pylori which express cytotoxin-associated gene A (CagA may be more virulent than those that do not, but limited populations have been studied to date. The aims of the present study were to evaluate the seroprevalence of anti-H. pylori IgG, IgA and anti-CagA antibodies in peptic ulcer (PU patients and healthy individuals in the city of Rafsanjan. METHODS: A total of 60 PU patients (30 males and 30 females, aged 17 to 60 years and 138 age-matched healthy individuals (65 males, 73 females were enrolled in this study. Diagnosis of PU disease was established on the basis of findings by gastrointestinal endoscopy. The control group was recruited from among healthy blood donors referred to Blood Transfusion Center of Rafsanjan. A blood sample was collected from each participant and the sera were tested for the presence of anti- H. pylori IgG and IgA antibodies and antibody to bacterial virulence factor (CagA by use of enzyme-linked immunosorbent assay. The serum concentrations of anti-H. pylori IgA and anti-CagA antibody were expressed as mean ± SD in each group. RESULTS: In PU patients the overall seroprevalence of anti-H. pylori IgG (95.8%, IgA (96.6% and anti-CagA (91.6% were higher than those observed in the control group (73.2%, P<0.003; 79%, P<0.002; 47.82%, P<0.0000001; respectively. In the control group the prevalence of serum anti-CagA IgG antibodies was significantly higher in males compared to females (58.46% vs. 38.35%; P<0.01. Moreover, the mean titer of anti-H. pylori IgA antibodies was significantly higher in anti-CagA+ subjects compared to anti-CagA- subjects (47.5 Uarb/ml ± 35 vs. 27 Uarb/ml ± 18; P<0.01. Furthermore, an inverse association was found between levels and the

  10. Bioactive compounds of Crocus sativus L. and their semi-synthetic derivatives as promising anti-Helicobacter pylori, anti-malarial and anti-leishmanial agents.

    Science.gov (United States)

    De Monte, Celeste; Bizzarri, Bruna; Gidaro, Maria Concetta; Carradori, Simone; Mollica, Adriano; Luisi, Grazia; Granese, Arianna; Alcaro, Stefano; Costa, Giosuè; Basilico, Nicoletta; Parapini, Silvia; Scaltrito, Maria Maddalena; Masia, Carla; Sisto, Francesca

    2015-12-01

    Crocus sativus L. is known in herbal medicine for the various pharmacological effects of its components, but no data are found in literature about its biological properties toward Helicobacter pylori, Plasmodium spp. and Leishmania spp. In this work, the potential anti-bacterial and anti-parasitic effects of crocin and safranal, two important bioactive components in C. sativus, were explored, and also some semi-synthetic derivatives of safranal were tested in order to establish which modifications in the chemical structure could improve the biological activity. According to our promising results, we virtually screened our compounds by means of molecular modeling studies against the main H. pylori enzymes in order to unravel their putative mechanism of action.

  11. In vitro and in vivo anti-Helicobacter pylori activities of FEMY-R7 composed of fucoidan and evening primrose extract.

    Science.gov (United States)

    Cai, Jingmei; Kim, Tae-Su; Jang, Ja Young; Kim, Jihyun; Shin, Kyungha; Lee, Sung-Pyo; Choi, Ehn-Kyoung; Kim, Sa-Hyun; Park, Min; Kim, Jong Bae; Kim, Yun-Bae

    2014-03-01

    Effects of FEMY-R7, composed of fucoidan and evening primrose extract, on the bacterial growth and intragastric infection of Helicobacter pylori as well as gastric secretion were investigated in comparison with a proton-pump inhibitor pantoprazole. For in vitro anti-bacterial activity test, H. pylori (1×10(8) CFU/mL) was incubated with a serially-diluted FEMY-R7 for 3 days. As a result, FEMY-R7 fully inhibited the bacterial growth at 100 µg/mL, which was determined to be a minimal inhibitory concentration. In addition, 6-hour incubation with H. pylori, FEMY-R7 inhibited urease activity in a concentration-dependent manner, showing a median inhibitory concentration of 1,500 µg/mL. In vivo elimination study, male C57BL/6 mice were infected with the bacteria by intragastric inoculation (5×10(9) CFU/mouse) 3 times at 2-day intervals, and simultaneously, orally treated twice a day with 10, 30 or 100 mg/kg FEMY-R7 for 7 days. In Campylobcter-like organism-detection test and bacterial identification, FEMY-R7 exerted a high bacteria-eliminating capacity at 30-100 mg/kg, comparably to 30 mg/kg pantoprazole. In contrast to a strong antacid activity of pantoprazole in a pylorus-ligation study, FEMY-R7 did not significantly affect gastric pH, free HCl, and total acidity, although it significantly decreased fluid volume at a low dose (10 mg/kg). The results indicate that FEMY-R7 eliminate H. pylori from gastric mucosa by directly killing the bacteria and preventing their adhesion and invasion, rather than by inhibiting gastric secretion or mucosal damage.

  12. Anti-Helicobacter pylori activity in vitro of chamomile flowers, coneflower herbs, peppermint leaves and thyme herbs – a preliminary report

    Directory of Open Access Journals (Sweden)

    Malm Anna

    2015-03-01

    Full Text Available Recently, several studies have been undertaken so as to develop more effective therapeutic approaches towards eradicating Helicobacter pylori. Among these is phytotherapy. The aim of this study was to investigate the activity in vitro of the plant extracts obtained from common herbs cultivated in the Lubelszczyzna region against the reference strain H. pylori ATCC 43504. Among these are thyme herbs, chamomile flowers, peppermint leaves and coneflower herbs. Herein, it was found that the MIC values of the assayed extracts were as follows: the extracts from coneflower herbs showed anti-H. pylori activity with MIC = 31.3-125 μg/ml; the extracts from chamomile flowers demonstrated MIC = 31.3-62.5 μg/ ml; the extracts from peppermint leaves had MIC = 15.6-250 μg/ml; and the extracts from thyme herbs revealed MIC = 15.6-62.5 μg/ml, depending on the solvent used. The most active were the extracts obtained with ethyl acetate or ethanol alcohol absolute 99.8%. These showing MIC within the range of 15.6-62.5 μg/ml, while the lowest activity was observed in case of the extract obtained with 70% aqueous ethanol. This last showing MIC within the range of 62.5-250 μg/ml. The MIC values of essential oil components were 15.6 μg/ml for bisabolol and menthol or 31.3 μg/ml for thymol. The obtained data indicate that the assayed herbs possessed promising anti-H. pylori bioactivity.

  13. Anti-Helicobacter pylori activities of FEMY-R7 composed of fucoidan and evening primrose extract in mice and humans.

    Science.gov (United States)

    Kim, Tae-Su; Choi, Ehn-Kyoung; Kim, Jihyun; Shin, Kyungha; Lee, Sung-Pyo; Choi, Youngjin; Jeon, Joseph H; Kim, Yun-Bae

    2014-09-01

    Helicobacter pylori-eliminating effects of FEMY-R7, composed of fucoidan and evening primrose extract, were investigated in mice and humans. Male C57BL/6 mice were infected with the bacteria by intragastric inoculation (1×10(9) CFU/mouse) 3 times at 2-day intervals, and simultaneously, orally treated twice a day with 10 or 100 mg/kg FEMY-R7 for 2 weeks. In Campylobcter-like organism-detection test, FEMY-R7 markedly reduced the urease-positive reactivity. In a clinical sudy, human subjects, confirmed to be infected with Helicobacter pylori, were orally administered twice a day with a capsule containing 150 mg FEMY-R7 for 8 weeks. FEMY-R7 significantly decreased both the Delta over baseline-value in urea breath test and the serum pepsinogens I and II levels. The results indicate that FEMY-R7 not only eliminates H. pylori from gastric mucosa of animals and humans, but also improves gastric function.

  14. Komplet remission af højmalignt lymfom i ventriklen efter eradikation af Helicobacter pylori

    DEFF Research Database (Denmark)

    Høeg, Rasmus Tetens; Skau, Anne-Marie; Nørgaard, Peter

    2011-01-01

    A 91 year-old man was found to have diffuse large cell B-cell lymphoma (DLBCL), localized to the stomach. Because of his age, his only treatment was anti-Helicobacter pylori therapy. He achieved a complete remission, and six months after the initial presentation, there were no signs of recurrence...

  15. Helicobacter pylori therapy:Present and future

    Institute of Scientific and Technical Information of China (English)

    Vincenzo; De; Francesco; Enzo; Ierardi; Cesare; Hassan; Angelo; Zullo

    2012-01-01

    Helicobacter pylori(H.pylori) plays a crucial role in the pathogenesis of chronic active gastritis,peptic ulcer and gastric mucosa-associated lymphoid tissue-lymphoma,and is also involved in carcinogenesis of the stomach.H.pylori treatment still remains a challenge for physicians,since no current first-line therapy is able to cure the infection in all treated patients.Several factors may help in the eradication of therapy failure.We reviewed both bacterial and host factors involved in therapeutic management of the H.pylori infection.In addition,we evaluated data on the most successful therapy regimens-sequential and concomitant therapies-currently available for H.pylori eradication.

  16. Identification of novel scaffolds for potential anti-Helicobacter pylori agents based on the crystal structure of H. pylori 3-deoxy-d-manno-octulosonate 8-phosphate synthase (HpKDO8PS).

    Science.gov (United States)

    Cho, Sujin; Im, Hookang; Lee, Ki-Young; Chen, Jie; Kang, Hae Ju; Yoon, Hye-Jin; Min, Kyung Hoon; Lee, Kang Ro; Park, Hyun-Ju; Lee, Bong-Jin

    2016-01-27

    The crystal structure of 3-deoxy-d-manno-octulosonate-8-phosphate synthase (KDO8PS) from Helicobacter pylori (HpKDO8PS) was determined alone and within various complexes, revealing an extra helix (HE) that is absent in the structures of KDO8PS from other organisms. In contrast to the metal coordination of the KDO8PS enzyme from Aquifex aeolicus, HpKDO8PS is specifically coordinated with Cd(2+) or Zn(2+) ions, and isothermal titration calorimetry (ITC) and differential scanning fluorimetry (DSF) revealed that Cd(2+) thermally stabilizes the protein structure more efficiently than Zn(2+). In the substrate-bound structure, water molecules play a key role in fixing residues in the proper configuration to achieve a compact structure. Using the structures of HpKDO8PS and API [arabinose 5-phosphate (A5P) and phosphoenolpyruvate (PEP) bisubstrate inhibitor], we generated 21 compounds showing potential HpKDO8PS-binding properties via in silico virtual screening. The capacity of three, avicularin, hyperin, and MC181, to bind to HpKDO8PS was confirmed through saturation transfer difference (STD) experiments, and we identified their specific ligand binding modes by combining competition experiments and docking simulation analysis. Hyperin was confirmed to bind to the A5P binding site, primarily via hydrophilic interaction, whereas MC181 bound to both the PEP and A5P binding sites through hydrophilic and hydrophobic interactions. These results were consistent with the epitope mapping by STD. Our results are expected to provide clues for the development of HpKDO8PS inhibitors.

  17. Furazolidone therapy for Helicobacter pylori: Is it effective and safe?

    Institute of Scientific and Technical Information of China (English)

    Vincenzo De Francesco; Enzo Ierardi; Cesare Hassan; Angelo Zullo

    2009-01-01

    Some aspects related with the use of furazolidone as a rescue therapy for Helicobacter pylori ( H pylori) infection should be remarked, especially regarding its potential oncologic risk. The inclusion of furazolidone in a treatment regimen for H pylori infection is, at least, controversial, and it does not appear to be safe.

  18. Rescue Therapy for Helicobacter pylori Infection 2012

    Directory of Open Access Journals (Sweden)

    Javier P. Gisbert

    2012-01-01

    Full Text Available Helicobacter pylori infection is the main cause of gastritis, gastroduodenal ulcer disease, and gastric cancer. After 30 years of experience in H. pylori treatment, however, the ideal regimen to treat this infection has still to be found. Nowadays, apart from having to know well first-line eradication regimens, we must also be prepared to face treatment failures. In designing a treatment strategy, we should not only focus on the results of primary therapy alone but also on the final—overall—eradication rate. The choice of a “rescue” treatment depends on which treatment is used initially. If a first-line clarithromycin-based regimen was used, a second-line metronidazole-based treatment (quadruple therapy may be used afterwards, and then a levofloxacin-based combination would be a third-line “rescue” option. Alternatively, it has recently been suggested that levofloxacin-based “rescue” therapy constitutes an encouraging 2nd-line strategy, representing an alternative to quadruple therapy in patients with previous PPI-clarithromycin-amoxicillin failure, with the advantage of efficacy, simplicity and safety. In this case, quadruple regimen may be reserved as a 3rd-line “rescue” option. Even after two consecutive failures, several studies have demonstrated that H. pylori eradication can finally be achieved in almost all patients if several “rescue” therapies are consecutively given.

  19. 丁香对幽门螺杆菌的体外抑菌作用%Anti-Helicobacter Pylori Action of Eugenol and Essential Oil from Eugenia Caryophyllata in vitro

    Institute of Scientific and Technical Information of China (English)

    韩艳; 王庆伟; 张琰; 刘新友; 覃华; 杜小燕

    2011-01-01

    目的 考察丁香挥发油及丁香酚体外抑制幽门螺杆菌的活性.方法 水蒸气蒸馏法提取丁香挥发油,采用高效液相色谱法测定挥发油丁香酚的含量.以氨苄西林为对照,体外法测定丁香挥发油、丁香提取挥发油后的水提取物及丁香酚对8种幽门螺杆菌菌株的最小抑菌浓度(MIC).结果 氨苄西林对8种幽门螺杆菌菌株的MIC范围为1.25~2.50 μg·mL-1,丁香挥发油的MIC范围为5.00~10.00 μg·mL-1,丁香酚的MIC范围为2.50~5.00 μg·mL-1,丁香提取挥发油后的水提取物无抑菌作用.结论 丁香抑制幽门螺杆菌的活性成分是其挥发油中的主要成分丁香酚.%Objective To study the antibacterial effects of eugenol and essential oil from Euggenia Cairyphyllata against helicobacter pylori in vitro. Methods The essential oil was obtained by steam distillation. The concentration of eugenol was determined by HPLC. MIC against helicobacter pylori of eugenol, essential oil from Eugenia Caryophyllata and aqueous extract of Eugenia Caryophyllata except essential oil were determined in vitro with ampieillin as a control drug. Results The range of MIC against 8 helicobacter pylori was 1.25-2.50 μg· mL-1 for ampicillin, 5.00-10. 00 μg· mL-1 for the essential oil, 2.50-5.00 μg· mL-1 for eugenol. The aqueous extract showed no effect against helicobacter pylori. Conclusion The main active component from Eugenia Caryophyllata against H. pylori is eugenol of essential oil.

  20. Hybrid Therapy Regimen for Helicobacter Pylori Eradication

    Institute of Scientific and Technical Information of China (English)

    Zhi-Qiang Song; Jian Liu; Li-Ya Zhou

    2016-01-01

    Objective:Helicobacterpylori (H.pylori) eradication remains a challenge with increasing antibiotic resistance.Hybrid therapy has attracted widespread attention because of initial report with good efficacy and safety.However,many issues on hybrid therapy are still unclear such as the eradication efficacy,safety,compliance,influencing factors,correlation with antibiotic resistance,and comparison with other regimens.Therefore,a comprehensive review on the evidence of hybrid therapy for H.pylori infection was conducted.Data Sources:The data used in this review were mainly from PubMed articles published in English up to September 30,2015,searching by the terms of"Helicobacterpylori" or "H.pylori",and "hybrid".Study Selection:Clinical research articles were selected mainly according to their level of relevance to this topic.Results:Totally,1871 patients of 12 studies received hybrid therapy.The eradication rates were 77.6-97.4% in intention-to-treat and 82.6-99.1% in per-protocol analyses.Compliance was 93.3-100.0%,overall adverse effects rate was 14.5-67.5%,and discontinued medication rate due to adverse effects was 0-6.7%.H.pylori culture and sensitivity test were performed only in 13.3% patients.Pooled analysis showed that the eradication rates with dual clarithromycin and metronidazole susceptible,isolated metronidazole or clarithromycin resistance,and dual clarithromycin and metronidazole resistance were 98.5%,97.6%,92.9%,and 80.0%,respectively.Overall,the efficacy,compliance,and safety of hybrid therapy were similar with sequential or concomitant therapy.However,hybrid therapy might be superior to sequential therapy in Asians.Conclusions:Hybrid therapy showed wide differences in the efficacy but consistently good compliance and safety across different regions.Dual clarithromycin and metronidazole resistance were the key factor to efficacy.Hybrid therapy was similar to sequential or concomitant therapy in the efficacy,safety,and compliance.

  1. Current Therapy for Helicobacter pylori Infection in Children and Adolescents

    Directory of Open Access Journals (Sweden)

    Benjamin D Gold

    1999-01-01

    Full Text Available Helicobacter pylori infects approximately 50% of the world’s population and is a definitive cause of gastroduodenal disease (ie, gastritis, duodenal and gastric ulcers in children and adults. Four consensus conferences held around the globe have brought together clinicians, scientists, epidemiologists and health care economists to discuss the role of the gastric pathogen H pylori in human gastroduodenal disease. At each of these conferences, the overriding objective was to reach a consensus on the development of practical guidelines for the diagnosis and treatment of H pylori-infected individuals. However, it was not until the Canadian H pylori Consensus Conference, held in November 1997, that the issues of H pylori infection in children were addressed. Therapies for H pylori infection in children, presented in part at the First Canadian Paediatric H pylori Consensus Conference, held in Victoria, British Columbia, November 1998, are reviewed in this paper.

  2. Effective predictive factors for regression of gastric MALT lymphoma after anti-Helicobacter pylori treatment%胃粘膜相关淋巴样组织淋巴瘤抗H.Pylori治疗的有效预测因子

    Institute of Scientific and Technical Information of China (English)

    胡莲; 李昌平

    2006-01-01

    胃粘膜相关淋巴样组织(MALT)型结外边缘区B细胞淋巴瘤发病机制主要与幽门螺杆菌(H.pylori)感染有关,目前认为根治H.pylori治疗已成为胃粘膜相关淋巴样组织淋巴瘤的一线治疗.然而,抗H.pylori治疗不能使胃MALT淋巴瘤100%完全缓解,即使完全缓解后仍有复发的可能.随着研究的深入,哪些患者更能从抗H.pylori治疗中受益,抗H.pylori治疗后随访是目前研究的热点.此文对胃MALT淋巴瘤与H.pylori的关系,抗H.pylori治疗的有效预测、随访作一综述.

  3. Non-pharmacological treatment of Helicobacter pylori

    Institute of Scientific and Technical Information of China (English)

    Haim Shmuely; Noam Domniz; Jacob Yahav

    2016-01-01

    Many food and plant extracts have shown in vitro antiHelicobacter pylori(H.pylori)activity,but are less effective in vivo.The anti-H.pylori effects of these extracts are mainly permeabilitization of the membrane,anti-adhesion,inhibition of bacterial enzymes andbacterial grown.We,herein,review treatment effects of cranberry,garlic,curcumin,ginger and pistacia gum against H.pylori in both in vitro,animal studies and in vivo studies.

  4. Helicobacter pylori infection: an overview in 2013, focus on therapy

    Institute of Scientific and Technical Information of China (English)

    Cui Rongli; Zhou Liya

    2014-01-01

    Objective This article aimed to review the incidence of Helicobacterpylori (H.pylon) infection and its therapy.Data sources Relevant articles published in English were identified by searching in PubMed from 2000 to 2013,with keywords "H.pylori".Important references from selected articles were also retrieved from Elsevier,Wiley,EBSCO,and SPRINGER.The Chinese articles published were searched from China National Knowledge Infrastructure (CNKI).Study selection Articles about "prevalence","gastric carcinoma","peptic ulcer","gastroesophageal reflux disease","functional dyspepsia","pathogenic mechanism","therapy","eradication rate","antibiotic resistance",and "gene polymorphisms" were selected.Results The decreased infection rates of H.pylori could also be linked to the changed disease spectrum,such as the decreased morbidity and recurrence rate of H.pylori-related peptic ulcer,and the increased morbidity of gastroesophageal reflux.Although different treatment regimens have been used for H.pylori infection,the H.pylori eradication rate declined gradually.Due to primary resistance to antibiotics,the gene polymorphism of host and infected strain,and the therapy regimes,H.pylori eradication became even more difficult.Conclusions The prevalence of H.py/ori infection had been decreasing,but the rate of eradication failure has dramatically risen in many countries due to resistance to antibiotic.H.pylori therapy in clinical practice is becoming proqressively more difficult.

  5. Quinolone-containing therapies in the eradication of Helicobacter pylori.

    Science.gov (United States)

    Chuah, Seng-Kee; Tai, Wei-Chen; Lee, Chen-Hsiang; Liang, Chih-Ming; Hu, Tsung-Hui

    2014-01-01

    Fluoroquinolones, especially levofloxacin, are used in the eradication of Helicobacter pylori worldwide. Many consensus guidelines recommend that the second-line rescue therapy for H. pylori eradication consists of a proton pump inhibitor, a quinolone, and amoxicillin as an option. Unfortunately, quinolone is well associated with a risk of developing bacterial resistance. In this paper, we review quinolone-containing H. pylori eradication regimens and the challenges that influence the efficacy of eradication. It is generally suggested that the use of levofloxacin should be confined to "rescue" therapy only, in order to avoid a further rapid increase in the resistance of H. pylori to quinolone. The impact of quinolone-containing H. pylori eradication regimens on public health issues such as tuberculosis treatment must always be taken into account. Exposure to quinolone is relevant to delays in diagnosing tuberculosis and the development of drug resistance. Extending the duration of treatment to 14 days improves eradication rates by >90%. Tailored therapy to detect fluoroquinolone-resistant strains can be done by culture-based and molecular methods to provide better eradication rates. Molecular methods are achieved by using a real-time polymerase chain reaction to detect the presence of a gyrA mutation, which is predictive of treatment failure with quinolones-containing triple therapy.

  6. A study of Helicobacter pylori infection in diabetes mellitus

    OpenAIRE

    Khwaja Saifullah Zafar; Vidyasagar Ram; Manoj Kumar

    2016-01-01

    Background: Helicobacter pylori is the most common bacterial infection in human beings. The aim was to study the association of Helicobacter pylori infection in patients of diabetes mellitus. Design of the study was observational analytic cross sectional study. Methods: A total of 69 subjects were studied. Of these 30 were non diabetics and 39 were diabetics, with disease duration more than 1 year. The serological diagnosis of H. pylori was made by Anti- Helicobacter pylori antibody test....

  7. Detection of serum anti- Helicobacter pyloriimmunoglobulin G in patients with different digestive malignant tumors

    Institute of Scientific and Technical Information of China (English)

    Ke-Xia Wang; Xue-Feng Wang; Jiang-Long Peng; Yu-Bao Cui; Jian Wang; Chao-Pin Li

    2003-01-01

    AIM: To investigate the seroprevalence of Helicobacter pylori infection in patients with different digestive malignant tumors.METHODS: Enzyme linked immunosorbent assay (ELISA) was used to detect serum anti-Helicobacter pylori IgG antibody in 374 patients with different digestive malignant tumors and 310 healthy subjects (normal control group).RESULTS: The seroprevalence of Helicobacter pylori infection was 61.50 %(230/374) and 46.77 % (145/310),respectively, in patients with digestive tumors and normal controls (P<0.05). The seroprevalence was 52.38 % (33/63),86.60 % (84/97), 83.14 % (84/101), 45.24 (19/42),51.13 % (18/35) and 44.44 % (16/36), respectively in patients with carcinomas of esophagus, stomach, duodenum,rectum, colon and liver (P<0.01). In patients with intestinal and diffuse type gastric cancers, the seroprevalence was 93.75 % (60/64) and 72.73 % (24/33), respectively (P<0.05).In patients with gastric antral and cardiac cancers, the seroprevalence was 96.43 % (54/56) and 73.17 % (30/41),respectively (P<0.05). In patients with ulcerous and proliferous type duodenal cancers, the seroprevalence of H pylori infection was 91.04 % (61/67) and 52.27 % (23/44),respectively (P<0.05). In patients with duodenal bulb and descending cancers, the seroprevalence was 94.20 % (65/69) and 45.20 % (19/42), respectively (P<0.05).CONCLUSION:Hpyloriinfection is associated with occurrence and development of gastric and duodenal carcinomas.Furthermore, it is also associated with histological type and locations of gastric and duodenal carcinomas.

  8. Helicobacter pylori eradication therapy: A review of current trends.

    Science.gov (United States)

    Olokoba, A B; Obateru, O A; Bojuwoye, M O

    2013-01-01

    Helicobacter pylori has been implicated in the formation of chronic gastritis, peptic ulcer disease, mucosa-associated lymphoid tissue lymphoma and gastric cancer. Eradication of H. Pylori has been recommended as treatment and prevention for these complications. This review is based on a search of Medline, the Cochrane Database of Systemic Reviews, and citation lists of relevant publications. Subject heading and key words used include H. Pylori, current treatment and emerging therapy. Only articles in English were included. There has been a substantial decline in the H. pylori eradication rates over the years, despite the use of proton pump inhibitor and bismuth salts for triple and quadruple therapies respectively. The reasons for eradication failure are diverse, among them, antibiotic resistance is an important factor in the treatment failure. Primary resistance to clarithromycin or metronidazole significantly affects the efficacy of eradication therapy. This has led to the introduction of second line, third line "rescue," and sequential therapies for resistant cases. Subsequently, new antibiotic combinations with proton-pump inhibitors and bismuth salts are being studied in the last decade, to find out the antibiotics that are capable of increasing the eradication rates. Some of these antibiotics include Levofloxacin, Doxycycline, Rifaximin, Rifampicin, Furazolidone based therapies. Studies are ongoing to determine the efficacy of Lactoferrin based therapy.

  9. Helicobacter pylori eradication therapy: A review of current trends

    Directory of Open Access Journals (Sweden)

    A B Olokoba

    2013-01-01

    Full Text Available Helicobacter pylori has been implicated in the formation of chronic gastritis, peptic ulcer disease, mucosa-associated lymphoid tissue lymphoma and gastric cancer. Eradication of H. Pylori has been recommended as treatment and prevention for these complications. This review is based on a search of Medline, the Cochrane Database of Systemic Reviews, and citation lists of relevant publications. Subject heading and key words used include H. Pylori, current treatment and emerging therapy. Only articles in English were included. There has been a substantial decline in the H. pylori eradication rates over the years, despite the use of proton pump inhibitor and bismuth salts for triple and quadruple therapies respectively. The reasons for eradication failure are diverse, among them, antibiotic resistance is an important factor in the treatment failure. Primary resistance to clarithromycin or metronidazole significantly affects the efficacy of eradication therapy. This has led to the introduction of second line, third line "rescue," and sequential therapies for resistant cases. Subsequently, new antibiotic combinations with proton-pump inhibitors and bismuth salts are being studied in the last decade, to find out the antibiotics that are capable of increasing the eradication rates. Some of these antibiotics include Levofloxacin, Doxycycline, Rifaximin, Rifampicin, Furazolidone based therapies. Studies are ongoing to determine the efficacy of Lactoferrin based therapy.

  10. Alternative therapies for Helicobacter pylori: probiotics and phytomedicine.

    Science.gov (United States)

    Vítor, Jorge M B; Vale, Filipa F

    2011-11-01

    Helicobacter pylori is a common human pathogen infecting about 30% of children and 60% of adults worldwide and is responsible for diseases such as gastritis, peptic ulcer and gastric cancer. Treatment against H. pylori is based on the use of antibiotics, but therapy failure can be higher than 20% and is essentially due to an increase in the prevalence of antibiotic-resistant bacteria, which has led to the search for alternative therapies. In this review, we discuss alternative therapies for H. pylori, mainly phytotherapy and probiotics. Probiotics are live organisms or produced substances that are orally administrated, usually in addition to conventional antibiotic therapy. They may modulate the human microbiota and promote health, prevent antibiotic side effects, stimulate the immune response and directly compete with pathogenic bacteria. Phytomedicine consists of the use of plant extracts as medicines or health-promoting agents, but in most cases the molecular mode of action of the active ingredients of these herbal extracts is unknown. Possible mechanisms include inhibition of H. pylori urease enzyme, disruption of bacterial cell membrane, and modulation of the host immune system. Other alternative therapies are also reviewed.

  11. Third-line rescue therapy for Helicobacter pylori infection

    Institute of Scientific and Technical Information of China (English)

    Rossella Cianci; Massimo Montalto; Franco Pandolfi; Giovan Battista Gasbarrini; Giovanni Cammarota

    2006-01-01

    H pylori gastric infection is one of the most prevalent infectious diseases worldwide. The discovery that most upper gastrointestinal diseases are related to H pylori infection and therefore can be treated with antibiotics is an important medical advance. Currently, a first-line triple therapy based on proton pump inhibitor (PPI) or ranitidine bismuth citrate (RBC) plus two antibiotics (darithromycin and amoxicillin or nitroimidazole) is recommended by all consensus conferences and guidelines. Even with the correct use of this drug combination, infection can not be eradicated in up to 23% of patients. Therefore, several second line therapies have been recommended. A 7 d quadruple therapy based on PPI, bismuth, tetracycline and metronidazole is the more frequently accepted. However, with second-line therapy, bacterial eradication may fail in up to 40% of cases. When H pylori eradication is strictly indicated the choice of further treatment is controversial. Currently, a standard third-line therapy is lacking and various protocols have been proposed. Even after two consecutive failures, the most recent literature data have demonstrated that H pylori eradication can be achieved in almost all patients, even when antibiotic susceptibility is not tested. Different possibilities of empirical treatment exist and the available third-line strategies are herein reviewed.

  12. Helicobacter pylori eradication: Sequential therapy and Lactobacillus reuteri supplementation

    Institute of Scientific and Technical Information of China (English)

    Cesare Efrati; Giorgia Nicolini; Claudio Cannaviello; Nicole Piazza O'Sed; Stefano Valabrega

    2012-01-01

    AIM:TO evaluate the role of sequential therapy and Lactobacillus reuteri (L.reuteri) supplementation,in the eradication treatment of He/icobacter pylori (H.pylori).METHODS:H.pylori infection was diagnosed in 90 adult dyspeptic patients.Patients were excluded if previously treated for H.pylori infection or if they were taking a proton pump inhibitor (PPI),H2-receptor antagonist or antibiotics.Patients were assigned to receive one of the following therapies:(1) 7-d triple therapy (PPI plus clarithromycin and amoxicillin or metronidazole) plus L.reuteri supplementation during antibiotic treatment; (2) 7-d triple therapy plus L.reuteri supplementation after antibiotic treatment;(3) sequential regimen (5-d PPI plus amoxicillin therapy followed by a 5-d PPI,clarithromycin and tinidazole) plus L.reuteri supplementation during antibiotic treatment; and (4) sequential regimen plus L.reuteri supplementation after antibiotic treatment.Successful eradication therapy was defined as a negative urea breath test at least 4 wk following treatment.RESULTS:Ninety adult dyspeptic patients were enrolled,and 83 (30 male,53 female; mean age 57 ± 13 years) completed the study.Nineteen patients were administered a 7-d triple treatment:11 with L.reuteri supplementation during and 8 after therapy.Sixty-four patients were administered a sequential regimen:32 with L.reuteri supplementation during and 32 after therapy.The eradication rate was significantly higher in the sequential group compared with the 7-d triple regimen (88% vs 63%,P =0.01).No difference was found between two types of PPI.No difference in eradication rates was observed between patients submitted to L.reuteri supplementation during or after antibiotic treatment.Compliance with therapy was excellent in all patients.No difference in adverse effects was observed between the different antibiotic treatments and between patients submitted to L.reuteri supplementation during and after antibiotic treatment.There was a low

  13. Effect of Helicobacter pylori Eradication on Reflux Esophagitis Therapy: A Multi-center Randomized Control Study

    Institute of Scientific and Technical Information of China (English)

    Yan Xue; Li-Ya Zhou; San-Ren Lin; Xiao-Hua Hou; Zhao-Shen Li; Min-Hu Chen; Xiu-E Yan

    2015-01-01

    Background:Helicobacterpylori (H.pylori) frequently colonizes the stomach.Gastroesophageal reflux disease (GERD) is a common and costly disease.But the relationship ofH.pylori and GERD is still unclear.This study aimed to explore the effect ofH.pylori and its eradication on reflux esophagitis therapy.Methods:Patients diagnosed with reflux esophagitis by endoscopy were enrolled;based on rapid urease test and Warth-Starry stain,they were divided into H.pylori positive and negative groups.H.pylori positive patients were randomly given H.pylori eradication treatment for 1 0 days,then esomeprazole 20 mg bid for 46 days.The other patients received esomeprazole 20 mg bid therapy for 8 weeks.After treatment,three patient groups were obtained:H.pylori positive eradicated,H.pylori positive uneradicated,and H.pylori negative.Before and after therapy,reflux symptoms were scored and compared.Healing rates were compared among groups.The x2 test and t-test were used,respectively,for enumeration and measurement data.Results:There were 176 H.pylori positive (with 92 eradication cases) and 180 negative cases.Healing rates in the H.pylori positive eradicated and H.pylori positive uneradicated groups reached 80.4% and 79.8% (P =0.911),with reflux symptom scores of 0.22 and 0.14 (P =0.588).Healing rates of esophagitis in the H.pylori positive uneradicated and H.pylori negative groups were,respectively,79.8% and 82.2% (P =0.848);reflux symptom scores were 0.14 and 0.21 (P =0.546).Conclusions:Based on esomeprazole therapy,H.pylori infection and eradication have no significant effect on reflux esophagitis therapy.

  14. Helicobacter pylori eradication using tetracycline and furazolidone versus amoxicillin and azithromycin in lansoprazole based triple therapy: an open randomized clinical trial Erradicação de Helicobacter pylori com o uso de tetraciclina e furazolidona versus amoxicilina e azitromicina em terapia tríplice com lansoprazol

    Directory of Open Access Journals (Sweden)

    Laura Cidrão Frota

    2005-06-01

    Full Text Available BACKGROUND: Optimal anti-Helicobacter pylori treatment has not yet been established. AIM: To evaluate H. pylori eradication using tetracycline and furazolidone versus amoxicillin and azithromycin in lansoprazole based triple therapy in northeastern of Brazil. PATIENTS AND METHODS: One hundred and four patients with H. pylori infection, as determined by rapid urease testing and histology, were randomly assigned to receive either: lansoprazole (30 mg q.d., tetracycline (500 mg q.i.d., and furazolidone (200 mg t.i.d. for 7 days (LTF; n = 52; or lansoprazole (30 mg b.i.d. and amoxicillin (1 g b.i.d. for 1 week, plus azithromycin (500 mg q.d. for the first 3 days (LAAz; n = 52. H. pylori eradication was assessed 3 months following completion of therapy by means of rapid urease testing, histology and a 14C-urea breath test. RESULTS: H. pylori eradication was achieved in 46 of 52 (88.4%, 95% CI: 77.5%-95.1% patients in LTF group and in 14 of 52 (26.9%, 95% CI: 16.2%-40,1% patients in LAAz group. On a per-protocol analysis, eradication rates were 91.8% (95% CI: 81.4%-97.3% and 28.5% (95% CI: 17.2%-42.3%, respectively in LTF and LAAz groups. CONCLUSION: The LAAz regimen yielded unacceptably low eradication rates. On the other hand, the LTF scheme represents a suitable alternative for H. pylori eradication.RACIONAL: Ainda não está estabelecida a melhor terapêutica anti-H. pylori. OBJETIVO: Avaliar a erradicação de H.pylori usando tetraciclina e furazolidona versus amoxicilina e azitromicina em terapia tríplice com lansoprazol no nordeste do Brasil. PACIENTES E MÉTODOS: Cento e quatro pacientes infectados por H. pylori, diagnosticado através do teste rápido da urease e histologia, foram selecionados aleatoriamente para receber: lansoprazol (30 mg q.d., tetraciclina (500 mg q.i.d., furazolidona (200 mg t.i.d. por 7 dias (LTF; n = 52; ou lansoprazol (30 mg b.i.d. e amoxicilina (1 g b.i.d. por 1 semana, mais azitromicina (500 mg q.d. nos primeiros 3

  15. Standard triple, bismuth pectin quadruple and sequential therapies for Helicobacter pylori eradication

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    AIM: To compare the effectiveness of standard triple, bismuth pectin quadruple and sequential therapies for Helicobacter pylori (H. pylori ) eradication in a randomized, double-blinded, comparative clinical trial in China. METHODS: A total of 215 H. pylori -positive patients were enrolled in the study and randomly allocated into three groups: group A (n = 72) received a 10-d bismuth pectin quadruple therapy (20 mg rabeprazole bid , 1000 mg amoxicillin bid , 100 mg bismuth pectin qid , and 500 mg levofloxaci...

  16. Hybrid Therapy Regimen for Helicobacter Pylori Eradication

    Directory of Open Access Journals (Sweden)

    Zhi-Qiang Song

    2016-01-01

    Conclusions: Hybrid therapy showed wide differences in the efficacy but consistently good compliance and safety across different regions. Dual clarithromycin and metronidazole resistance were the key factor to efficacy. Hybrid therapy was similar to sequential or concomitant therapy in the efficacy, safety, and compliance.

  17. [Clinical significance of Helicobacter pylori in children with idiopathic thrombocytopenic purpura].

    Science.gov (United States)

    Tang, Ying; Wang, Shu-Chun; Wang, Lu-Juan; Liu, Yong; Wang, Hai-Ying; Wang, Zhan-Ju

    2013-04-01

    This study was aimed to investigate the clinic significance of helicobacter pylori (HP) in children with idiopathic thrombocytopenic purpura (ITP). The infection of HP in 92 ITP children was determined by (13) C-Urea Breath Test, the same test was also performed on 66 healthy children. The 68 children infected with HP were randomly divided into 2 groups: single drug group treated only with corticosteroid and; combined drug group treated with corticosteroid and anti-helicobacter pylori treatment. The results showed that 68 patients infected with HP were found in 92 ITP children (74.7%), 26 patients infected with HP were observed in 66 healthy children (39.4%), which was lower than that in ITP children (74.7%, P helicobacter pylori therapy, the total effective rate and cure rate of ITP patients increased respectively from 73.5% to 94.1%, and the total recurrence rate (17.0%) was much lower than single drug group (47.1%, P helicobacter pylori group was higher than that in the single drug group (P helicobacter pylori therapy would help to improve the therapeutic efficacy and reduce the recurrence of ITP children.

  18. Pharmacoeconomics of Helicobacter pylori : eradication versus maintenance therapy in controlling peptic ulcer disease

    NARCIS (Netherlands)

    Klok, R M; Brouwers, J R; Postma, Maarten

    2001-01-01

    We performed an electronic search in Medline and EMBASE for papers comparing Helicobacter pylori eradication and H(2)RA-maintenance therapy in peptic ulcer. Treatment to eradicate H. pylori in patients with a proven ulcer has a favorable cost-effectiveness compared with maintenance therapy, with ben

  19. Importance of post-treatment follow-up to secure sufficient eradication therapy for Helicobacter pylori

    DEFF Research Database (Denmark)

    Roug, Stine; Madsen, Lone Galmstrup

    2012-01-01

    To optimize the care for Helicobacter pylori-associated diseases, we wanted to evaluate the completeness of follow-up after H. pylori eradication therapy in a single Danish endoscopy unit. Furthermore, the eradication rates and possible clinical characteristics associated with failure...

  20. Clinical Outcome of Eradication Therapy for Gastric Mucosa-Associated Lymphoid Tissue Lymphoma according to H. pylori Infection Status

    Directory of Open Access Journals (Sweden)

    Ju Seok Kim

    2016-01-01

    Full Text Available Background. To evaluate the long-term outcome of H. pylori eradication therapy for gastric MALT lymphoma according to the presence of H. pylori infection. Methods. We retrospectively reviewed the medical records of patients between January 2001 and June 2014. The clinicopathologic characteristics and clinical outcomes were compared between H. pylori-positive and H. pylori-negative gastric MALT lymphoma groups. Results. Fifty-four patients were enrolled: 12 H. pylori-negative and 42 H. pylori-positive patients. The tumor was located more frequently in both the proximal and distal parts of the stomach (P=0.001, and the percentage of multiple lesions was significantly greater in the H. pylori-negative group (P=0.046. Forty-seven patients received initial eradication therapy, and 85% (35/41 of H. pylori-positive patients and 50% (3/6 of H. pylori-negative patients achieved complete remission after eradication therapy. The presence of multiple lesions was a predictive factor for unresponsiveness to H. pylori eradication (P=0.024. The efficacy of eradication therapy (P=0.133, complete remission (CR maintenance period, and relapse after eradication therapy were not significantly different between the two groups. Conclusions. H. pylori eradication therapy could be an effective first-line treatment for localized H. pylori-negative gastric MALT lymphoma, especially for single lesions.

  1. Helicobacter Pylori eradication therapy: getting research into practice.

    LENUS (Irish Health Repository)

    McDonnell, R

    2003-01-01

    Helicobacter Pylori (H. Pylori) is the primary cause of duodenal ulcer (DU). Guidelines recommend that all patients with DU be considered for Helicobacter Pylori Eradication Therapy (HPET). However, the proportion of patients with DU on long term anti-ulcer medication receiving HPET is small. This study examined the effectiveness of the continuing medical education (CME) network of the Irish College of General Practitioners (ICGP) in promoting best practice in DU treatment among GPs in an eastern region of Ireland. Ninty eight GPs recruited from the CME network of the ICGP were randomised in two cohorts. Cohort 1 received an (early) intervention; GPs were asked to identify their patients with DU receiving long term anti-ulcer medication and prescribe HPET according to defined criteria. Cohort 2 received the intervention later. Prescribing of HPET was monitored using routine prescribing data. Twenty per cent (286\\/1,422) of patients in cohort 1 and 19.2% (127\\/661) in cohort 2 had a DU. After exclusions, 53% (152\\/286) in cohort 1 and 30.7% (39\\/127) in cohort 2, were eligible for HPET. A significantly higher proportion of patients in cohort 1 received HPET compared with cohort 2 during the early intervention period (13.8% vs 0.0%, p<0.05). Reasons for not prescribing HPET included concurrent illness in patients, failure to comply with treatment. Best practice guidelines on HPET treatment of DU can be successfully applied using CME networks. This model could be repeated in another therapeutic area where established research is not yet current practice.

  2. Comparison of Triple Therapy plus Probiotic Yogurt vs. Standard Triple Therapy on Helicobacter Pylori Eradication

    Directory of Open Access Journals (Sweden)

    Vahid Mirzaee

    2013-04-01

    Full Text Available Background: Treatment of Helicobacter pylori as a major cause of gastric diseases is of utmost concern. We aimed to assess efficacy of triple therapy (amoxicillin, clarithromycin and pantoprazole plus probiotic yogurt (PY on eradication of H. pylori. Materials and Methods: Total 102 H. pylori positive patients were divided to 3 groups equally and randomly. For treatment of each group amoxicillin, clarithromycin and pantoprazole were used. Group A had additional PY and Group B ordinary low fat yogurt in their regimen as well. These groups were compared regarding treatment success.Results: Total number of 88 patients finished the treatment course. The most common experienced side effects were dysgeusia in groups A and B (25.8% and 32.3%, respectively, and dysgeusia with diarrhea and abdominal pain (30.8% in group C. Eradication rate was, respectively, 61.3%, 64.5% and 71.3% in group A, B and C of which difference was not statistically significant. However, the difference between 3 groups in regard to education level was statistically significant (p=0.005.Conclusion: PY enriched triple therapy has decreased side effects of antibiotics consumption; however, this has no impact on eradication of H. pylori. PY and triple therapy can be used concomitantly to increase the patient tolerance.

  3. Eradication of H pylori infection in a rural population:One-day quadruple therapy versus 7-day triple therapy

    Institute of Scientific and Technical Information of China (English)

    Lian Zhang; Wei-Cheng You; Lin Shen; Jun-Ling Ma; Kai-Feng Pan; Wei-Dong Liu; Jie Li; Shu-Dong Xiao; San-Ren Lin; Meinhard Classen

    2006-01-01

    AIM: To compare the one-day quadruple therapy with a standard 7-d triple therapy for H pylori eradication in a rural population of China.METHODS: A total of 396 patients with 13C-urea breath test positive for H pylori were assigned into two groups:239 patients received one-day quadruple therapy (amoxicillin 2000 mg qid; metronidazole 500 mg qid; bismuth citrate 900 mg qid and lansoprazole 60 mg once daily)and 157 patients received 7-d standard triple therapy (amoxicillin 1000 mg bid; clarithromycin 500 mg bid and lansoprazole 30 mg bid). All the patients underwent a 13C-UBT to assess the eradication of H pylori infection six weeks after treatment.RESULTS: Two hundred and twenty-nine patients completed the one-day therapy (95.8%) and 148patients completed the 7-d therapy (94.2%). The oneday therapy eradicated H pylori infection in 64 patients (27.95%). In contrast, 103 patients (69.59%) were H pylori negative after the 7-d therapy (P < 0.01).CONCLUSION: This pilot study suggests there is no beneficial effect of the one-day therapy in treatment of H pylori infection compared with the 7-d standard therapy.

  4. A case of severe pseudomembranous colitis diagnosed by colonoscopy after Helicobacter pylori eradication.

    Science.gov (United States)

    Sato, Satoshi; Chinda, Daisuke; Yamai, Kiyonori; Satake, Ryu; Soma, Yasushi; Shimoyama, Tadashi; Fukuda, Shinsaku

    2014-06-01

    A 65-year-old male was admitted for hemorrhagic gastric ulcer. Since anti-Helicobacter pylori-immunoglobulin G antibody tested positive, eradication therapy was administered using rabeprazole, amoxicillin, and clarithromycin. During hospitalization, colonoscopy showed normal colonic mucosa except for a polyp of the sigmoid colon. He was discharged 4 days after finishing eradication therapy, but fever up and diarrhea appeared on the following day. After re-admission, colonoscopy revealed multiple yellowish-white, small circular membranous elevations, and a diagnosis of pseudomembranous colitis was made. He was successfully treated by oral administration of vancomycin. Concomitant use of antibiotics and a proton pump inhibitor for a hospitalized patient is a risk for pseudomembranous colitis. However, H. pylori eradication therapy should be started at re-introduction of oral feeding in cases of bleeding ulcers because rebleeding can be mortal in patients in 'poor general condition'. Physicians should consider pseudomembranous colitis as a diagnosis for the patients with diarrhea and high fever following H. pylori eradication therapy.

  5. In vitro characterization of the anti-bacterial activity of SQ109 against Helicobacter pylori.

    Directory of Open Access Journals (Sweden)

    Morris O Makobongo

    Full Text Available The most evident challenge to treatment of Helicobacter pylori, a bacterium responsible for gastritis, peptic ulcers and gastric cancer, is the increasing rate of resistance to all currently used therapeutic antibiotics. Thus, the development of novel therapies is urgently required. N-geranyl-N'-(2-adamantyl ethane-1, 2-diamine (SQ109 is an ethylene diamine-based antitubercular drug that is currently in clinical trials for the treatment of tuberculosis (TB. Previous pharmacokinetic studies of SQ109 revealed that persistently high concentrations of SQ109 remain in the stomach 4 hours post oral administration in rats. This finding, combined with the need for new anti-Helicobacter therapies, prompted us to define the in vitro efficacy of SQ109 against H. pylori. Liquid broth micro-dilution was used for susceptibility studies to determine the antimicrobial activity of SQ109 against a total of 6 laboratory strains and 20 clinical isolates of H. pylori; the clinical isolates included a multi-drug resistant strain. All strains tested were susceptible to SQ109 with MIC and MBC ranges of 6-10 µM and 50-60 µM, respectively. SQ109 killing kinetics were concentration- and time-dependent. SQ109 killed H. pylori in 8-10 h at 140 µM (2MBCs or 4-6 h at 200 µM (~3MBCs. Importantly, though the kinetics of killing were altered, SQ109 retained potent bactericidal activity against H. pylori at low pH. Additionally, SQ109 demonstrated robust thermal stability and was effective at killing slow growing or static bacteria. In fact, pretreatment of cultures with a bacteriostatic concentration of chloramphenicol (Cm synergized the effects of typically bacteriostatic concentrations of SQ109 to the level of five-logs of bacterial killing. A molar-to-molar comparison of the efficacy of SQ109 as compared to metronidazole (MTZ, amoxicillin (AMX, rifampicin (RIF and clarithromycin (CLR, revealed that SQ109 was superior to MTZ, AMX and RIF but not to CLR. Finally, the

  6. Successful isolation of Helicobacter pylori after prolonged incubation from a patient with failed eradication therapy

    Institute of Scientific and Technical Information of China (English)

    Yan Yin; Li-Hua He; Jian-Zhong Zhang

    2009-01-01

    Helicobacter pylori ( H pylori), a gastric pathogen, is a major cause of chronic gastritis and peptic ulcer disease, and is an important risk factor for the development of gastric malignancies. Culture of the bacterium from gastric biopsy is essential for the determination of drug resistance of H pylori. However, the isolation rates of H pylori from infected individuals vary from 23.5% to 97% due to a number of factors such as biopsy preparation, cultural environment, medium and the method adopted. In the present case, we found that a prolonged incubation period of up to 19 d allowed successful isolation of H pylori from a patient who received triple therapy that failed to eradicate the bacterium.

  7. Addition of cranberry to proton pump inhibitor-based triple therapy for Helicobacter pylori eradication

    Science.gov (United States)

    Seyyedmajidi, Mohammadreza; Ahmadi, Anahita; Hajiebrahimi, Shahin; Seyedmajidi, Seyedali; Rajabikashani, Majid; Firoozabadi, Mona; Vafaeimanesh, Jamshid

    2016-01-01

    Objective: Proton pump inhibitor-based triple therapy with two antibiotics for Helicobacter pylori eradication is widely accepted, but this combination fails in a considerable number of cases. Some studies have shown that cranberry inhibits the adhesion of a wide range of microbial pathogens, including H. pylori. The aim of this study was to assess the effect of cranberry on H. pylori eradication with a standard therapy including lansoprazole, clarithromycin, and amoxicillin (LCA) in patients with peptic ulcer disease (PUD). Methods: In this study, H. pylori-positive patients with PUD were randomized into two groups: Group A: A 14-day LCA triple therapy with 30 mg lansoprazole bid, 1000 mg amoxicillin bid, and 500 mg clarithromycin bid; Group B: A 14-day 500 mg cranberry capsules bid plus LCA triple therapy. A 13C-urea breath test was performed for eradication assessment 6 weeks after the completion of the treatment. Findings: Two hundred patients (53.5% males, between 23 and 77 years, mean age ± standard deviation: 50.29 ± 17.79 years) continued treatment protocols and underwent 13C-urea breath testing. H. pylori eradication was achieved in 74% in Group A (LCA without cranberry) and 89% in Group B (LCA with cranberry) (P = 0.042). Conclusion: The addition of cranberry to LCA triple therapy for H. pylori has a higher rate of eradication than the standard regimen alone (up to 89% and significant). PMID:27843960

  8. Pseudomembranous colitis associated with a triple therapy for Helicobacter pylori eradication.

    Science.gov (United States)

    Trifan, Anca; Girleanu, Irina; Cojocariu, Camelia; Sfarti, Catalin; Singeap, Ana Maria; Dorobat, Carmen; Grigore, Lucia; Stanciu, Carol

    2013-11-14

    Helicobacter pylori (H. pylori) is one of the most common chronic bacterial infections in humans, affecting half of world's population. Therapy for H. pylori infection has proven to be both effective and safe. The one-week triple therapy including proton pump inhibitor, clarithromycin, and amoxicillin or metronidazole is still recommended as a first-line treatment to eradicate H. pylori infection in countries with low clarithromycin resistance. Generally, this therapy is well-tolerated, with only a few and usually minor side effects. However, rare but severe adverse effects such as pseudomembranous colitis have been reported, Clostridium difficile (C. difficile) infection being the main causative factor in all cases. We report the cases of two women who developed pseudomembranous colitis after a 1-wk triple therapy consisting of pantoprazole 20 mg bid, clarithromycin 500 mg bid, and amoxicillin 1 g bid to eradicate H. pylori infection. A limited colonoscopy showed typical appearance of pseudomembranous colitis, and the stool test for C. difficile toxins was positive. Rapid resolution of symptoms and negative C. difficile toxins were obtained in both patients with oral vancomycin. No relapse occurred during a four and eleven-month, respectively, follow up. These cases suggest that physicians should have a high index of suspicion for pseudomembranous colitis when evaluate patients with diarrhea following H. pylori eradication therapy.

  9. Onset of Ulcerative Colitis after Helicobacter pylori Eradication Therapy: A Case Report.

    Science.gov (United States)

    Chiba, Mitsuro; Tsuji, Tsuyotoshi; Takahashi, Kenichi; Komatsu, Masafumi; Sugawara, Takeshi; Ono, Iwao

    2016-01-01

    In Japan, Helicobacter pylori eradication has been approved since 2013 for treatment of H pylori-induced chronic gastritis, in an attempt to reduce the prevalence of gastric cancer, a leading cancer in Japan. H pylori infection affects more than 50% of the world's population. H pylori eradication therapy is generally safe. To our knowledge, no case of newly diagnosed ulcerative colitis occurring immediately after H pylori eradication therapy has previously been reported.A 63-year-old man received a diagnosis of chronic gastritis and H pylori infection. In early March 2014, primary H pylori eradication therapy was initiated; lansoprazole, amoxicillin, and clarithromycin were administered for 1 week. Beginning on the fourth day, he had watery diarrhea twice a day. From the 11th day, bloody stools and watery diarrhea increased to 6 times a day. Colonoscopy, performed on the 40th day after termination of drug therapy, revealed diffuse inflammation in the distal aspect of the colon, with histologic findings consistent with ulcerative colitis. He was admitted to the hospital and was provided with a semivegetarian diet and metronidazole. He noticed a gradual decrease in the amount of blood in his feces then a disappearance of the blood. A fecal occult blood test on the 11th hospital day recorded 337 ng/mL. Fecal occult blood test is not indicated during macroscopic bloody stool but is indicated after disappearance of bloody stool. Therefore, he achieved clinical remission by the 11th hospital day. He was in remission on discharge.New onset of ulcerative colitis should be added to a list of adverse events of H pylori eradication therapy.

  10. Does emerging Clarithromycin resistance signal an obituary to empirical standard triple therapy for Helicobacter pylori infection?

    Science.gov (United States)

    John, Anil; Al Kaabi, Saad; Doiphode, Sanjay; Chandra, Prem; Sharma, Manik; Babu, Ragesh; Yacoub, Rafie; Derbala, Moutaz

    2015-09-01

    Despite 30 years of its discovery, the ideal therapeutic regimen against Helicobacter pylori is still evasive. Clarithromycin-based standard triple therapy which has been considered the first line empirical therapy has been failing in many parts of the world, due to rising resistance against Clarithromycin, forcing the use of alternate regimens. In this context, we studied the local antibiotic resistance patterns against H. pylori and its impact on standard triple therapy in our region. All patients undergoing diagnostic upper endoscopy during the study period and detected to be positive for rapid urease test (RUT) underwent cultures of gastric mucosal specimens and had their antibiotic resistance patterns mapped out. Standard triple therapy was administered to those tested positive for H. pylori by RUT and eradication rates checked by urea breath test 4 weeks after the completion of treatment. Eradication rates with Clarithromycin-based standard triple therapy were suboptimal with a success of only (71.28%). H. pylori culture and antibiotic susceptibility studies showed high resistance to Clarithromycin (21.2%), Metronidazole (78.1%), and Levofloxacin (15%). However, the resistance to Amoxicillin (2.9%), Tetracycline (0%), and Rifabutin (4.5%) were low. Standard triple therapy is failing in our region due to high Clarithromycin resistance. We need to abandon empirical and blind triple therapy without post-treatment testing and devise alternate effective treatment strategies against H. pylori based on the local resistance patterns observed.

  11. Gastric Carcinogenesis and Underlying Molecular Mechanisms: Helicobacter pylori and Novel Targeted Therapy

    Directory of Open Access Journals (Sweden)

    Toshihiro Nishizawa

    2015-01-01

    Full Text Available The oxygen-derived free radicals that are released from activated neutrophils are one of the cytotoxic factors of Helicobacter pylori-induced gastric mucosal injury. Increased cytidine deaminase activity in H. pylori-infected gastric tissues promotes the accumulation of various mutations and might promote gastric carcinogenesis. Cytotoxin-associated gene A (CagA is delivered into gastric epithelial cells via bacterial type IV secretion system, and it causes inflammation and activation of oncogenic pathways. H. pylori infection induces epigenetic transformations, such as aberrant promoter methylation in tumor-suppressor genes. Aberrant expression of microRNAs is also reportedly linked to gastric tumorogenesis. Moreover, recent advances in molecular targeting therapies provided a new interesting weapon to treat advanced gastric cancer through anti-human epidermal growth factor receptor 2 (HER-2 therapies. This updated review article highlights possible mechanisms of gastric carcinogenesis including H. pylori-associated factors.

  12. Role of Helicobacter pylori Eradication Therapy on Platelet Recovery in Chronic Immune Thrombocytopenic Purpura

    Science.gov (United States)

    Sheema, Khan; Arshi, Naz; Farah, Naz; Imran, Sheikh

    2017-01-01

    Background. Idiopathic thrombocytopenic purpura (ITP) is a bleeding disorder in which the immune system destroys native platelets. In this condition an autoantibody is generated against a platelet antigen. ITP affects women more often than men and is more common in children than adults. Objective. To assess the effect of Helicobacter pylori eradication therapy (HPET) on platelet count in Helicobacter pylori associated chronic immune thrombocytopenic purpura (chronic ITP) in adult. Materials and Methods. It is an interventional prospective study conducted at Liaquat University of Medical and Health Sciences, Jamshoro, from 2014 to 2015. A set of 85 patients diagnosed with chronic ITP were included in the study via convenient sampling. Patients with platelets count 3 months were selected. They were posed to first-line investigations which comprised complete blood count (CBC) and peripheral blood smear examination followed by second-line tests including bone marrow examination and Helicobacter pylori stool specific antigen (HpSA-EIA). Standard H. pylori eradication therapy was offered and the patients were assessed at regular intervals for 6 months. Results. Of the 85 study patients, 32 (37.6%) were male and 53 (62.3%) were female. Mean ages of H. pylori positive and negative subjects were 43.89 ± 7.06 and 44.75 ± 7.91 years, respectively. Bone marrow examination confirmed the diagnosis and excluded other related BM disorders. H. pylori stool antigen (HpSA) was detected in 34 (40%) patients and hence regarded as H. pylori positive; the rest were negative. Treatment with eradication therapy significantly improved the mean platelet counts from 48.56 ± 21.7 × 109/l to 94.2 ± 26.8 × 109/l. Conclusion. We concluded that the anti-H. pylori eradication therapy improves blood platelet counts in chronic immune thrombocytopenia.

  13. Role of Helicobacter pylori Eradication Therapy on Platelet Recovery in Chronic Immune Thrombocytopenic Purpura

    Directory of Open Access Journals (Sweden)

    Khan Sheema

    2017-01-01

    Full Text Available Background. Idiopathic thrombocytopenic purpura (ITP is a bleeding disorder in which the immune system destroys native platelets. In this condition an autoantibody is generated against a platelet antigen. ITP affects women more often than men and is more common in children than adults. Objective. To assess the effect of Helicobacter pylori eradication therapy (HPET on platelet count in Helicobacter pylori associated chronic immune thrombocytopenic purpura (chronic ITP in adult. Materials and Methods. It is an interventional prospective study conducted at Liaquat University of Medical and Health Sciences, Jamshoro, from 2014 to 2015. A set of 85 patients diagnosed with chronic ITP were included in the study via convenient sampling. Patients with platelets count 3 months were selected. They were posed to first-line investigations which comprised complete blood count (CBC and peripheral blood smear examination followed by second-line tests including bone marrow examination and Helicobacter pylori stool specific antigen (HpSA-EIA. Standard H. pylori eradication therapy was offered and the patients were assessed at regular intervals for 6 months. Results. Of the 85 study patients, 32 (37.6% were male and 53 (62.3% were female. Mean ages of H. pylori positive and negative subjects were 43.89 ± 7.06 and 44.75 ± 7.91 years, respectively. Bone marrow examination confirmed the diagnosis and excluded other related BM disorders. H. pylori stool antigen (HpSA was detected in 34 (40% patients and hence regarded as H. pylori positive; the rest were negative. Treatment with eradication therapy significantly improved the mean platelet counts from 48.56±21.7 × 109/l to 94.2±26.8 × 109/l. Conclusion. We concluded that the anti-H. pylori eradication therapy improves blood platelet counts in chronic immune thrombocytopenia.

  14. High efficacy of gemifloxacin-containing therapy in Helicobacter Pylori eradication

    Science.gov (United States)

    Mahmoudi, Laleh; Farshad, Shohreh; Seddigh, Mehrdad; Mahmoudi, Paria; Ejtehadi, Fardad; Niknam, Ramin

    2016-01-01

    Abstract Background: Helicobacter pylori (H pylori) is a common gastric pathogen which is associated with chronic gastritis, peptic ulcer, and gastric cancer. It has worldwide distribution with higher incidence in developing countries. Gemifloxacin is a fluoroquinolone antibiotic with documented in vitro activity against H pylori. Considering that there is no clinical data to verify gemifloxacin efficacy in H pylori eradication, this pilot clinical trial was designed. Methods: This prospective pilot study was performed during February 2014 to February 2015. A regimen of gemifloxacin (320 mg single dose) plus twice daily doses of amoxicillin1g, bismuth 240 mg, and omeprazole 20 mg for 14 days were prescribed for H pylori infected patients in whom a first-line standard quadruple therapy (clarithromycin–amoxicillin–bismuth–omeprazole) had failed. To confirm H pylori eradication a 13C-urea breath test was performed 4 weeks after treatment. Compliance and incidence of adverse effects were evaluated by questionnaires. Results: A total of 120 patients were enrolled consecutively; out of which 106 patients achieved H pylori eradication; per-protocol and intention-to-treat eradication rates were 91.4% (95% CI: 85.5–97.6) and 88.3% (95% CI: 75.4–92.4) respectively. Three patients (2.5%) failed to take at least 80% of the drugs and excluded from the final analysis. Adverse effects were reported in 42% of patients, most commonly including nausea (15%) and diarrhea (13.3%), which was intense in 1 patient and led to the discontinuation of treatment. In total, 96.7% (116/120) of the patients took the medications correctly. Conclusion: This study revealed that gemifloxacin-containing quadruple therapy provides high H pylori eradication rate (≥90% PP cure rate), and this agent can be included in the list of second-line H pylori therapeutic regimens. PMID:27759625

  15. Role of adjuvant therapy in the treatment of helicobacter pylori infection in children

    Directory of Open Access Journals (Sweden)

    Gerasymenko O.N.

    2014-06-01

    Full Text Available The aim was to study the effect of combined probiotic containing Lactobacillus acidophilus, Bifidobacterium infantis, Enterococcus faecium, on H.pylori eradication efficacy in the treatment of children with chronic H.pylori- associated gastroduodenitis in the scheme of "triple" therapy of H.pylori eradication. Determination of total serum Ig M , A, G protein to Ag SagA H. pylori, breathing "Helik" test, rapid urease "Helpil" test ; that of concentration of serum sCD14 was conducted. The study group included 20 children who received standard "triple" eradication therapy for 7 days and 1 caps. of probiotic 3 times a day for 4 weeks, control group (20 children – who received only standard eradication therapy. It is shown that combined use of probiotics in the treatment of Helicobacter pylori infection enhances effectiveness of eradication of H.pylori. In the basis of action of probiotic strains of the drug is an anti-inflammatory effect mediated by the impact on non-specific mechanisms of innate immunity, provided by molecular mechanism responsible for induction of sCD14 synthesis.

  16. Clinical role and importance of fluorescence in situ hybridization method in diagnosis of H pylori infection and determination of clarithromycin resistance in H pylori eradication therapy

    Institute of Scientific and Technical Information of China (English)

    (O)zlem Yilmaz; Ebru Demiray

    2007-01-01

    H pylori is etiologically associated with gastritis, gastric and duodenal ulcers, gastric adenocarcinoma and mucosa-associated lymphoid tissue (MALT) lymphoma.Eradicating H pylori may convert rapidly the outcome of related diseases with the use of more accurate diagnostic molecular tests. Indeed some of the tests cannot give the evidence of current infection; H pylori can be detected by noninvasive and invasive methods,the latter requiring an endoscopy. Eradication failure is a big problem in H pylori infection. Recently, clarithromycin resistance in H pylori strains is increasing and eradication therapy of this bacterium is becoming more difficult.Molecular methods have frequently been applied besides phenotypic methods for susceptibility testing to detect clarithromycin resistance due to mutations in the 2143 and 2144 positions of 23S rRNA gene. Fluorescence in situ hybridization (FISH) method on paraffin embedded tissue is a rapid, accurate and cost-effective method for the detection of H pylori infection and to determine clarithromycin resistance within three hours according to the gold standards as a non-culture method. This method can also be applied to fresh biopsy samples and the isolated colonies from a culture of H pylori, detecting both the culturable bacillary forms and the coccoid forms of H pylori, besides the paraffin embedded tissue sections. This technique is helpful for determining the bacterial density and the results of treatment where clarithromycin has been widely used in populations to increase the efficacy of the treatment and to clarify the treatment failure in vitro.

  17. [Farmacoeconomical estimation of efficiency of different schemes of eradication therapy of Helicobacter pylori infection in children].

    Science.gov (United States)

    Kashnikova, S N; Shcherbakov, P L; Kashnikov, V V; Tatarinov, P A; Shcherbakova, M Iu

    2008-01-01

    In this article farmakoekonomical analysis of efficiency of various, the most common in Russia schemes of eradication therapy disoders, associated with H. pylori infection is given to by authors basis on their private experience. All-round studying of the different economical factors influencing on a cost of used schemes is realized, and result of spent complex efficiency eradication therapy is estimated.

  18. Use of PCR and culture to detect Helicobacter pylori in naturally infected cats following triple antimicrobial therapy.

    Science.gov (United States)

    Perkins, S E; Yan, L L; Shen, Z; Hayward, A; Murphy, J C; Fox, J G

    1996-06-01

    Helicobacter pylori causes gastritis and peptic ulcers and is linked to gastric cancer. Domestic cats from a commercial source were found to be naturally infected with H. pylori, and studies were undertaken to eradicate H. pylori from infected cats by using triple antimicrobial therapy. Eight cats infected with H. pylori were used in the study. Six cats received a 21-day course of oral amoxicillin, metronidazole, and omeprazole, and two cats served as controls. Two weeks and 4 weeks posttreatment (p.t.), all six treated cats were negative at several sites (saliva, gastric juice, and gastric mucosa) for H. pylori by culture. However, as determined by PCR with primers specific for the 26-kDa product, the majority of cats at 2 and 4 weeks p.t. had gastric fluid samples which were positive for H. pylori and three of three cats at 2 weeks p.t. had dental plaque which was positive for H. pylori. At 6 weeks p.t., all six cats had H. pylori-negative cultures for samples from several gastric sites taken at necropsy, and only one cat had H. pylori cultured from gastric juice. PCR analysis revealed that five of six cats had H. pylori DNA amplification products from plaque, saliva, and/or gastric fluid samples. Negative bacterial cultures for cats for which there was demonstrable PCR amplification of H. pylori DNA may reflect the inability of in vitro culture techniques to isolate small numbers of H. pylori organisms, focal colonization at sites not cultured, or a failure of the antibiotics to successfully eradicate H. pylori from extragastric sites which allowed subsequent recolonization of the stomach after cessation of therapy. Alternatively, the treatment strategy may have induced in vivo viable but nonculturable coccoid forms of H. pylori. The H. pylori cat model should allow further studies to test these hypotheses as well as the efficacies of other combined therapeutic regimens. Also, because 100% of these cats were naturally infected with H.pylori, this model should

  19. Recombinant human lactoferrin enhances the efficacy of triple therapy in mice infected with Helicobacter pylori.

    Science.gov (United States)

    Yuan, Yuping; Wu, Qinyi; Cheng, Guoxiang; Liu, Xuefang; Liu, Siguo; Luo, Juan; Zhang, Aimin; Bian, Li; Chen, Jianquan; Lv, Jiajun; Dong, Xiangqian; Yang, Gang; Zhu, Yunzhen; Ma, Lanqing

    2015-08-01

    Helicobacter pylori (H. pylori) is a life-threatening pathogen which causes chronic gastritis, gastric ulcers and even stomach cancer. Treatment normally involves bacterial eradication; however, this type of treatment only has a rate of effectiveness of <80%. Thus, it is a matter of some urgency to develop new therapeutic strategies. Lactoferrin, a member of the transferrin family of iron-binding proteins, has been proven to be effective in removing a vast range of pathogens, including H. pylori. In the present study, we examined the effectiveness of recombinant human lactoferrin (rhLf) isolated from transgenic goats as a treatment for H. pylori in vitro and in vivo. For the in vivo experiments, BALB/c mice received an intragastric administration of 0.1 ml of a suspension of H. pylori. The mice were then divided into 4 groups: group A, treated with saline; group B, treated with 1.5 g of rhLF; group C, treated with the standard triple therapy regimen; and group D, treated with the standard triple therapy regimen plus.5 g of rhLF. Following sacrifice, the stomach tissues of the mice were histologically examined for the presence of bacteria. For the in vitro experiments, the bacteria were cultured in BHI broth and RT-qPCR and western blot analysis were carried out to determine the mRNA and protein levels of virulence factors (CagA and VacA) in the cultures. Our results revealed that rhLf not only inhibited the growth of H. pylori, but also suppressed the expression of two major virulence factors. Moreover, rhLf markedly increased bacterial eradication and effectively reduced the inflammatory response when combined with the standard triple therapy regimen. These results provide evidence supporting the use of rhLF as an adjuvant to traditional therapeutic strategies in the treatment of H. pylori.

  20. Drug therapy for Helicobacter pylori infection: problems and pitfalls.

    Science.gov (United States)

    Glupczynski, Y; Burette, A

    1990-12-01

    Antibacterial chemotherapy against Helicobacter pylori is currently being assessed by open or randomized controlled clinical studies for its efficacy in eradicating this bacterium from the stomach of patients with gastritis or gastroduodenal ulcer. Whereas there is presently no "optimal" agent and treatment scheme, the combination of some antibiotics (metronidazole, tinidazole, amoxicillin) with bismuth salts proves definitely superior in vivo to either of these agents administered alone. Several reasons have been proposed, to explain the clinical failure after treatment: insufficient concentration of active drugs in gastric mucus, instability of some agents at an acidic pH, inappropriate formulation of drug, insufficient duration of treatment, and variable compliance of patients. Recently, it has appeared from several clinical trials that H. pylori may rapidly acquire resistance to some antibiotics, and that this event might also account for clinical failure. A critical review of the literature on H. pylori treatment indicates that association of bismuth and antibiotics or of antibiotics alone both may efficiently reduce the risk of emergence of resistance and improve the therapeutic outcome. Guidelines of treatment are suggested in order to avoid the future misuse of antibiotics that would increase selection of antibiotic-resistant H. pylori and negatively affect the ecology of the gastric microflora. Likewise, an accurate definition of a subset of patients with H. pylori who really will require treatment needs to be rapidly established.

  1. Two stomach-originated lactobacillus strains improve Helicobacter pylori infected murine gastritis

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    AIM:To investigate the potential anti-Helicobacter pylori(H.pylori ) and anti-inflammation in vivo effects of two lactobacillus strains from human stomach.METHODS:Forty H.pylori infected Balb/c mice were randomly divided into 4 groups:proton pump inhibitor and antibiotics triple treated group,Lactobacillus fermenti(L.fermenti ) treated group,Lactobacillus acidophilus treated group and normal saline control group.Ten uninfected mice were also included as blank control group.The infection of H.pylori was dete...

  2. Furazolidone-based triple therapy for H pylori gastritis in children

    Institute of Scientific and Technical Information of China (English)

    Elisabete Kawakami; Rodrigo Strehl Machado; Silvio Kazuo Ogata; Marini Langner; Erika Fukushima; Anna Paula Carelli; Vania Cláudia Guimar(a)es Bonucci; Francy Reis Silva Patrício

    2006-01-01

    AIM: To evaluate the furazolidone-based triple therapy in children with symptomatic H pylori gastritis.METHODS: A prospective and consecutive open trial was carried out. The study included 38 patients withupper digestive symptoms sufficiently severe to warrant endoscopic investigation.H pylori status was defined based both on histology and on positive 13C-urea breath test. Drug regimen was a seven-day course of omeprazole, clarithromycin and furazolidone (100 mg, 200 mg if over 30 kg) twice daily. Eradication of H pylori was assessed two months after treatment by histology and 13C-urea breath test. Further clinical evaluation was performed 7 d, 2 and 6 mo after the treatment. RESULTS: Thirty-eight patients (24 females, 14 males)were included. Their age ranged from 4 to 17.8 (mean 10.9 ± 3.7) years. On intent-to-treat analysis (n = 38),the eradication rate of H pylori was 73.7% (95% CI,65.2%-82%) whereas in per-protocol analysis (n = 33) it was 84.8% (95% CI, 78.5%-91%). All the patients with duodenal ulcer (n = 7) were successfully treated (100% vs 56.2% with antral nodularity). Side effects were reported in 26 patients (68.4%), mainly vomiting (14/26) and abdominal pain (n = 13). Successfully treated dyspeptic patients showed improvement in 78.9% of H pylori-negative patients after six months and in 50% of H pylori-positive patients after six months of treatment.CONCLUSION: Triple therapy with furazolidone achieves moderate efficacy in H pylori treatment. The eradication rate seems to be higher in patients with duodenal ulcer.

  3. Furazolidone versus metronidazole in quadruple therapy for eradication of Helicobacter pylori in duodenal ulcer disease

    NARCIS (Netherlands)

    Malekzadeh, R.; Ansari, R.; Vahedi, H.; Siavoshi, F.; Alizadeh, B.Z.; Eshraghian, M.R.; Vakili, A.; Saghari, M.; Massarrat, S.

    2000-01-01

    Objective: Furazolidone, an old but cheap antibiotic, was shown to be a good alternative to metronidazole in triple therapy for Helicobacter pylori eradication in areas where metronidazole resistant bacteria are common, but randomized studies are lacking. Aim: A randomized controlled trial to determ

  4. Potential mechanism of corpus-predominant gastritis after PPI therapy in Helicobacter pylori-positive patients with GERD.

    Science.gov (United States)

    Mukaisho, Ken-ichi; Hagiwara, Tadashi; Nakayama, Takahisa; Hattori, Takanori; Sugihara, Hiroyuki

    2014-09-14

    The long-term use of proton pump inhibitors (PPIs) exacerbates corpus atrophic gastritis in patients with Helicobacter pylori (H. pylori) infection. To identify a potential mechanism for this change, we discuss interactions between pH, bile acids, and H. pylori. Duodenogastric reflux, which includes bile, occurs in healthy individuals, and bile reflux is increased in patients with gastroesophageal reflux disease (GERD). Diluted human plasma and bile acids have been found to be significant chemoattractants and chemorepellents, respectively, for the bacillus H. pylori. Although only taurine conjugates, with a pKa of 1.8-1.9, are soluble in an acidic environment, glycine conjugates, with a pKa of 4.3-5.2, as well as taurine-conjugated bile acids are soluble in the presence of PPI therapy. Thus, the soluble bile acid concentrations in the gastric contents of patients with GERD after continuous PPI therapy are considerably higher than that in those with intact acid production. In the distal stomach, the high concentration of soluble bile acids is likely to act as a bactericide or chemorepellent for H. pylori. In contrast, the mucous layer in the proximal stomach has an optimal bile concentration that forms chemotactic gradients with plasma components required to direct H. pylori to the epithelial surface. H. pylori may then colonize in the stomach body rather than in the pyloric antrum, which may explain the occurrence of corpus-predominant gastritis after PPI therapy in H. pylori-positive patients with GERD.

  5. Comparative study: Vonoprazan and proton pump inhibitors in Helicobacter pylori eradication therapy

    Science.gov (United States)

    Sakurai, Kouichi; Suda, Hiroko; Ido, Yumi; Takeichi, Takayuki; Okuda, Ayako; Hasuda, Kiwamu; Hattori, Masahiro

    2017-01-01

    AIM To compare the effectiveness and safety of vonoprazan-based therapy with proton pump inhibitor (PPI)-based therapies to treat Helicobacter pylori (H. pylori). METHODS We retrospectively analysed data from first-line (vonoprazan or PPI with 200 mg clarithromycin and 750 mg amoxicillin twice daily for 7 d) (n = 1353) and second-line (vonoprazan or PPI with 250 mg metronidazole and 750 mg amoxicillin twice daily for 7 d) (n = 261) eradication treatments for H. pylori -positive patients with associated gastrointestinal diseases from April 2014 to December 2015 at Hattori Clinic, Japan. The primary endpoint was the eradication rate, which was assessed with a full analysis set. The secondary endpoints were adverse events and related factors. RESULTS After the first-line treatments, the eradication rates for vonoprazan, esomeprazol, rabeprazole, and lansoprazole were 87.9% (95%CI: 84.9%-90.5%), 71.6% (95%CI: 67.5%-75.5%), 62.9% (95%CI: 52.0%-72.9%), and 57.3% (95%CI: 50.4%-64.1%), respectively. The vonoprazan eradication rate was significantly higher than that of the PPIs (P pylori eradication rate in the vonoprazan group (P = 0.34), whereas it decreased the rates in the PPI groups (P = 0.013). The incidence of adverse events in the vonoprazan group was not different from the PPI group (P = 0.054), although the vonoprazan group exhibited a wider range of adverse events. Vonoprazan-based triple therapy was highly effective as a second-line treatment, with an eradication rate similar to that of PPI-based therapy. CONCLUSION Vonoprazan might be superior to PPIs in first-line H. pylori therapy, particularly for smokers. However, caution is required due to possible adverse events. PMID:28216974

  6. Reflux esophagitis triggered after Helicobacter pylori eradication: a noteworthy demerit of eradication therapy among the Japanese?

    Directory of Open Access Journals (Sweden)

    Katsunori eIijima

    2015-06-01

    Full Text Available In the February 2013 Revision of Insured Medical Treatment, bacterial eradication for all Helicobacter pylori-positive individuals in Japan was covered under the insurance scheme. However, reflux esophagitis is believed to occur in approximately 10% of Japanese patients who undergo eradication therapy. Hence, the risk of reflux esophagitis among such cases should be carefully considered, particularly in the treatment for H. pylori-positive patients who are otherwise healthy. The eradication of Helicobacter pylori in cases of H. pylori-positive gastritis markedly suppresses gastric inflammation, and inhibits gastric mucosal atrophy and its progression to intestinal metaplasia. In a long-term follow-up study (10-20 years, eradication treatment was found to reduce the risk of subsequent gastric cancer. However, the fact that eradication-induced reflux esophagitis could increase the long-term risk of Barrett’s esophagus and esophageal adenocarcinoma should also be considered in the Japanese population. Appropriate treatment with proton pump inhibitors should be taken into consideration for patients undergoing eradication therapy in clinical practice.

  7. Levofloxacin/amoxicillin-based schemes vs quadruple therapy for Helicobacter pylori eradication in second-line.

    Science.gov (United States)

    Di Caro, Simona; Fini, Lucia; Daoud, Yayha; Grizzi, Fabio; Gasbarrini, Antonio; De Lorenzo, Antonino; Di Renzo, Laura; McCartney, Sara; Bloom, Stuart

    2012-10-28

    Worldwide prevalence of Helicobacter pylori (H. pylori) infection is approximately 50%, with the highest being in developing countries. We compared cure rates and tolerability (SE) of second-line anti-H. pylori levofloxacin/amoxicillin (LA)-based triple regimens vs standard quadruple therapy (QT). An English language literature search was performed up to October 2010. A meta-analysis was performed including randomized clinical trials comparing 7- or 10-d LA with 7-d QT. In total, 10 articles and four abstracts were identified. Overall eradication rate in LA was 76.5% (95% CI: 64.4%-97.6%). When only 7-d regimens were included, cure rate was 70.6% (95% CI: 40.2%-99.1%), whereas for 10-d combinations, cure rate was significantly higher (88.7%; 95% CI: 56.1%-109.9%; P therapy than QT (OR: 0.39; 95% CI: 0.18-0.85; P = 0.02). A higher rate of side effects was reported in Asian patients who received QT. Our findings support the use of 10-d LA as a simple second-line treatment for H. pylori eradication with an excellent eradication rate and tolerability. The optimal second-line alternative scheme might differ among countries depending on quinolone resistance.

  8. Causal role of Helicobacter pylori infection and eradication therapy in gastric carcinogenesis

    Institute of Scientific and Technical Information of China (English)

    Masanori Ito; Shinji Tanaka; Tomoari Kamada; Ken Haruma; Kazuaki Chayama

    2006-01-01

    Many epidemiological reports indicate that Helicobacter pylori(H pylori) infection plays an important role in gastric carcinogenesis. Several genetic and epigenetic alterations contribute to the initiation, promotion, and progression of the cancer cells in a multi-step manner.H pyloriis known to induce chronic inflammation in the gastric mucosa. Its products, including superoxides,participate in the DNA damage followed by initiation, and the inflammation-derived cytokines and growth factors contribute to the promotion of gastric carcinogenesis.By eradicating H pylori, gastric inflammation can be cured; the therapy diminishes the levels not only of inflammatory cell infiltration, but also atrophyl intestinal metaplasia in part. A randomized controlled trial revealed that the eradication therapy diminished the gastric cancer prevalence in cases without precancerous conditions. In addition, recent epidemiological studies from Japanese groups demonstrated that the development of gastric cancer, especially of the intestinal type, was decreased by successful eradication therapy, although these were designed in a nonrandomized manner. However, it should be mentioned that endoscopic detection is the only way to evaluate the degree of gastric carcinogenesis. We have reported that the endoscopic and histological morphologies could be modified by eradication therapy and it might contribute to the prevalence of gastric cancer development.Considering the biological nature of cancer cell proliferation, it is considered that a sufficiently long-term follow-up would be essential to discuss the anticancer effect of eradication therapy.

  9. Improvement in symptoms after H2-receptor antagonist-based therapy for eradication of H pylori infection

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To investigate the therapeutic effects of triple therapy combining lafutidine with clarithromycin and amoxicillin on H pylori infection and the resolution of gastroesophageal symptoms after eradication.METHODS: We conducted a randomized, multicenter,open-label controlled trial to compare the effectiveness of a triple therapy of lafutidine, clarithromycin, and amoxicillin (lafutidine group) with that of a triple therapy of lansoprazole, clarithromycin, and amoxicillin (lansoprazole group) in patients with H pylori infection. The study group comprised 22 patients with gastric ulcers and 18 patients with duodenal ulcers who had H pylori infection.RESULTS: H pylori eradication rates were similar in the lafutidine group (14/20, 70%) and the lansoprazole group (14/20, 70%). Gastroesophageal reflux and abdominal symptoms improved after eradication therapy in both groups, whereas abdominal discomfort, diarrhea,and constipation were unchanged. H pylori status had no apparent effect on improvement of gastroesophageal reflux or abdominal symptoms after treatment. Adverse events were similar in both groups.CONCLUSION: The triple therapy including lafutidine is equivalent to triple therapy including lansoprazole in terms of H pylori eradication rates and improvement in gastroesophageal reflux and abdominal symptoms.These results are attributed to the fact that lafutidine has strong, continuous antisecretory activity, unaffected by CYP2C19 polymorphisms.

  10. Does Helicobacter pylori eradication therapy for peptic ulcer prevent gastric cancer?

    Institute of Scientific and Technical Information of China (English)

    Katsuhiro Mabe; Mikako Takahashi; Haruhumi Oizumi; Hideaki Tsukuma; Akiko Shibata; Kazutoshi Fukase; Toru Matsuda; Hiroaki Takeda; Sumio Kawata

    2009-01-01

    AIM: To investigate the effects of Helicobacter pylori (H pylori ) eradication therapy for treatment of peptic ulcer on the incidence of gastric cancer. METHODS: A multicenter prospective cohort study was conducted between November 2000 and December 2007 in Yamagata Prefecture, Japan. The study included patients with H pylori -positive peptic ulcer who decided themselves whether to receive H pylori eradication (eradication group) or conventional antacid therapy (non-eradication group). Incidence of gastric cancer in the two groups was determined based on the results of annual endoscopy and questionnaire surveys, as well as Yamagata Prefectural Cancer Registry data, and was compared between the two groups and by results of H pylori therapy. RESULTS: A total of 4133 patients aged between 13 and 91 years (mean 52.9 years) were registered, and 56 cases of gastric cancer were identified over a mean follow-up of 5.6 years. The sex- and age-adjusted incidence ratio of gastric cancer in the eradication group, as compared with the non-eradication group, was 0.58 (95% CI: 0.28-1.19) and ratios by follow-up period (< 1 year, 1-3 years, > 3 years) were 1.16 (0.27-5.00), 0.50 (0.17-1.49), and 0.34 (0.09-1.28), respectively. Longer follow-up tended to be associated with better prevention of gastric cancer, although not to a significant extent. No significant difference in incidence of gastric cancer was observed between patients with successful eradication therapy (32/2451 patients, 1.31%) and those with treatment failure (11/639 patients, 1.72%). Among patients with duodenal ulcer, which is known to be more prevalent in younger individuals, the incidence of gastric cancer was significantly less in those with successful eradication therapy (2/845 patients, 0.24%) than in those with treatment failure (3/216 patients, 1.39%). CONCLUSION: H pylori eradication therapy for peptic ulcer patients with a mean age of 52.9 years at registration did not significantly decrease the

  11. Comparison of Sequential Regimen and Standard Therapy for Helicobacter pylori Eradication in Patients with Dyspepsia

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    Gh. Roshanaei

    2013-10-01

    Full Text Available Introduction & Objective: Some studies have reported successful eradication rates using se-quential therapy but more recent studies performed in Asia did not find a similar benefit. Due to inconsistencies in the comparison of standard triple drugs therapy and sequential regimen, in the previous researches we decided to compare these treatments in Persian patients. Materials & Methods: This study is a randomized clinical trial, performed in one hundred and forty patients suffering from dyspepsia with indication for H. pylori eradication between No-vember 2010 and March 2012.Patients were randomized in two equal groups. The patients in the first group (standard were treated by omeprazole capsule 20 mg BID, amoxicillin cap-sule 1 gr BID, clarithromycin tablet 500mg BID for 14 days; while the patients in the second group (sequential were treated by omeprazole capsule 20 mg for 10 days, amoxicillin cap-sule 1 gr BID for 5 days, then clarithromycin tablet 500 mg and tinidazole tablet 500 mg BID for other 5 days. 4-6 weeks after the treatment, we compared the eradication of H.pylori be-tween the two groups by urease breathe test with C14. Results: H. pylori infection was successfully cured in 57/70 (81.43% with a 10-day sequen-tial therapy, in 60/70 (85.75% with the standard fourteen-day triple therapy, respectively. Conclusion: We detected no significant differences between the 10-day sequential eradication therapy for H. pylori and 14-day standard triple treatment among the patients. (Sci J Hamadan Univ Med Sci 2013; 20 (3:184-193

  12. Quadruple therapy with moxifloxacin and bismuth for first-line treatment of Helicobacter pylori

    Institute of Scientific and Technical Information of China (English)

    Antonio Francesco Ciccaglione; Luigina Cellini; Laurino Grossi; Leonardo Marzio

    2012-01-01

    AIM:To compare triple therapy vs quadruple therapy for 10 d as first-line treatment of Helicobacterpylori (H.pylori) infection.METHODS:Consecutive H.pylori positive patients never treated in the past for this infection were randomly treated with triple therapy of pantoprazole (PAN) 20 mg bid,amoxicillin (AMO) 1 g bid and moxifloxacin (MOX) 400 mg bid for 10 d (PAM) or with quadruple therapy of PAN 20 mg bid,AMO 1 g bid,MOX 400 mg bid and bismuth subcitrate 240 mg bid for 10 d (PAMB).All patients were found positive at 13 C-Urea breath test (UBT) performed within ten days prior to the start of the study.A successful outcome was confirmed with an UBT performed 8 wk after the end of treatment.x2 analysis was used for statistical comparison.Per protocol (PP) and intention-to-treat (ITT) values were also calculated.RESULTS:Fifty-seven patients were enrolled in the PAM group and 50 in the PAMB group.One patient in each group did not return for further assessment.Eradication was higher in the PAMB group (negative:46 and positive:3) vs the PAN group (negative:44 and positive:12).The H.pylori eradication rate was statistically significantly higher in the PAMB group vs the PAM group,both with the PP and ITT analyses (PP:PAMB 93.8%,PAM 78.5%,P < 0.02; ITT:PAMB 92%,PAM 77.1%,P <0.03).CONCLUSION:The addition of bismuth subcitrate can be considered a valuable adjuvant to triple therapy in those areas where H.pylori shows a high resistance to fluoroquinolones.

  13. Trisomy 3 may predict a poor response of gastric MALT lymphoma to Helicobacter pylori eradication therapy

    Institute of Scientific and Technical Information of China (English)

    Sawako Taji; Masuji Morita; Masafumi Taniwaki; Kenichi Nomura; Yosuke Matsumoto; Hideaki Sakabe; Naohisa Yoshida; Shoji Mitsufuji; Kazuhiro Nishida; Shigeo Horiike; Shigeo Nakamura

    2005-01-01

    AIM: To investigate the relation of the response to Helicobacter pylori eradication therapy to the depth of tumor invasion and chromosome abnormalities in patients with mucosaassociated lymphoid tissue (MALT) lymphoma and to determine the clinical value of aneuploidy.METHODS: We studied 13 patients with localized gastric MALT lymphoma of stage E1. Before eradication therapy,the depth of tumor invasion was assessed by endoscopic ultrasonography in 8 patients and by endoscopic examination and gastrointestinal series in the remaining patients. To detect chromosomal abnormalities, paraffin-embedded tissue sections of diagnostic biopsy specimens underwent tissuefluorescence in situ hybridization (FISH), using chromosomespecific α-satellite DNA probes for chromosomes 3,7,12,and 18 and YAC clones for t(11;18)(q21;q21).RESULTS: Seven of the 13 patients had complete regression(CR) in response to H pylori eradication therapy. No patient with CR had submucosal tumor invasion. Trisomy 18 was seen in 1 patient with CR, and both trisomies 12 and 18 were present in another patient with CR. All patients with no response or progressive disease had deep submucosal tumor invasion and showed t(11;18)(q21;q21) or trisomy 3. Trisomy 7 was not detected in this series of patients.CONCLUSION: The depth of tumor invasion is an accurate predictor of the response of stage E1 MALT lymphoma to H pylori eradication therapy and is closely associated with the presence of chromosomal abnormalities. Trisomy 3 may predict the aggressive development of MALT lymphoma.

  14. Five-day bismuth-free triple therapy for the eradication of Helicobacter pylori and reduction of duodenal ulcer relapse

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    Coelho, L.G.; Passos, M.C.; Chausson, Y.; Castro L de, P. (Gastroenterology, Nutrition and Digestive Surgery Unit, University Hospital, Federal University of Minas Gerais (Brazil))

    1991-08-01

    Previous studies have demonstrated that the eradication of Helicobacter pylori (H. pylori) is associated with a significant reduction of the rate of duodenal ulcer (DU) relapse. The aim of this study was to assess the long-term effect of a bismuth-free triple therapy on the eradication of H. pylori and reduction of DU relapse. After informed consent, 61 patients with endoscopically proven DU and H. pylori infection detected on 14C-urea breath test (BT) were included in the study. All patients received a combination of furazolidone, amoxicillin, and metronidazole, three times a day, for 5 days, in addition to eventual classical antiulcer agents prescribed by their attending physicians. BT was repeated after an interval of at least 60 days to evaluate H. pylori eradication. Endoscopy and another BT were performed again at 6.5 months after therapy to detect possible recurrences. Forty-eight patients completed the trial: 26 (54%) patients were negative for H. pylori at 6.5 months after the end of treatment, and 22 (46%) persisted H. pylori positive. Ninety-two percent of the patients in whom the bacteria were eradicated showed endoscopically healed ulcers and were asymptomatic, and two that were symptomatic presented only occasional pain not requiring therapy. Among the 22 patients who persisted H. pylori positive, six (27%) showed endoscopically active ulcers (p = 0.012) and eight (36%) patients continued to be symptomatic (p less than 0.01), and were still using antiulcer drugs (p = 0.002) 6.5 months after treatment. It is concluded that combined treatment with furazolidone, amoxicillin, and metronidazole for 5 days represents a well-tolerated, inexpensive, and effective therapeutic regime for the eradication of H. pylori and abolition of DU relapse in more than 50% of the patients during a follow-up period of 6.5 months.

  15. Stool antigen tests in the diagnosis of Helicobacter pylori infection before and after eradication therapy

    Institute of Scientific and Technical Information of China (English)

    Lea Veijola; Eveliina Myllyluoma; Riitta Korpela; Hilpi Rautelin

    2005-01-01

    Aim: To evaluate two enzyme immunoassay-based stool antigen tests, Premier Platinum HpSA and Amplified IDEIA HpStAR, and one rapid test, ImmunoCard STAT! HpSA, in the primary diagnosis of Helicobacter pylori (H pylori) infection and after eradication therapy.METHODS: Altogether 1 574 adult subjects were screened with a whole-blood H pylori antibody test and positive results were confirmed with locally validated serology and 13C-urea breath test. All 185 subjects,confirmed to be H pylori positive, and 97 H pylorinegative individuals, randomly selected from the screened study population and with negative results in serology and UBT, were enrolled. After eradication therapy the results of 182 subjects were assessed.RESULTS: At baseline, the sensitivity of HpSA and HpStAR was 91.9% and 96.2%, respectively, and specificity was 95.9% for both tests. ImmunoCard had sensitivity of 93.0% but specificity of only 88.7%. After eradication therapy, HpSA and HpStAR had sernsitivity of 81.3% and 100%, and specificity of 97.0% and 97.6%,respectively. ImmunoCard had sensitivity of 93.8% and specificity of 97.0%. HpSA, HpStAR, and ImmunoCard had PPV 77%, 80%, and 75%, and NPV 98%, 100%,and 99%, respectively.CONCLUSION: In primary diagnosis, the EIA-based tests performed well. After eradication therapy, negative results were highly accurate for all the three tests.HpStAR had the best overall performance.

  16. Efficacy of Helicobacter pylori eradication therapies: a single centre observational study

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    Beales Ian LP

    2001-08-01

    Full Text Available Abstract Background Many Helicobacter pylori eradication regimens have been described. There are little data reporting their efficacy or integration in routine clinical practice. The overall results of eradication therapy in a cohort of patients are described and an algorithm for management outlined. Methods 469 patients receiving eradication therapy in routine clinical practice were evaluated. The successes of individual regimes as first, second and third line therapy were determined. Results Overall success after one, two and three courses of therapy were 73% (95% confidence intervals 69–77%, 94% (91–96% and 98% (97–99% respectively. 10 different regimens, including many non-recommended ones were used as primary therapy. Ranitidine bismuth citrate-amoxicillin-clarithromycin triple therapy (94.8%, 90–99% was significantly more effective than any other combination as primary therapy, including all proton pump inhibitor based triple therapies. Quadruple therapy with bismuth chelate-proton pump inhibitor-tetracycline and a nitroimidazole (70%, 52–88% and ranitidine bismuth citrate-based triple therapy (73%, 56–90% where more effective second line combinations than proton pump inhibitor-triple therapies (37.5%, 12–58%. Third line therapy directed by the results of sensitivity testing improved eradication compared to further empirical antibiotics. The use of a proton pump inhibitor with clarithromycin and a nitroimidazole as initial therapy was associated with a significantly worse overall eradication rate than other combinations. Conclusions Helicobacter pylori eradication rates can be maximised by using ranitidine bismuth citrate-clarithromycin-amoxicillin containing triple therapy, followed by bismuth and nitroimidazle containing second-line therapy, with third line combinations directed by sensitivity testing. Proton pump inhibitor-clarithromycin-metronidazole combinations should be avoided.

  17. Effects of killing Helicobacter pylori quadruple therapy on peptic ulcer: A randomized double-blind clinical trial

    Institute of Scientific and Technical Information of China (English)

    Li-Ying Feng; Xi-Xian Yao; Shu-Lin Jiang

    2005-01-01

    AIM: To study the therapeutic efficacy of a Chinese and Western integrated regimen, killing Helicobacter pylori quadruple therapy on H pylori-associated peptic ulcers(PU).METHODS: With prospective and double-blind controlled method, seventy-five active PU patients with H pylori infection were randomized to receive one of the following three regimens: (1) new triple therapy (group A:lansoprazole 30 mg qd, plus clarithromycin 250 mg bid,plus amoxycillin 500 mg tid, each for 10 d); (2) killing Hp quadruple therapy(group B: the three above drugs plus killing H pylori capsule 6 capsules bid for 4 wk) and (3)placebo(group C: gastropine 3 tablets bid for 4 wk).H pylori eradication and ulcer healing quality were evaluated under an endoscope 4 wk after treatment. The patients were followed up for 5 years.RESULTS: Both the healing rate of PU and H pylori eradication rate in group B were significantly higher than those in group C (100% and 96.4% vs 20% and 0%,respectively, P<0.005), but there was no significant difference compared to those in group A (88% and92%, P>0.05). The healing quality of ulcer in group B was superior to that in groups C and A (P<0.05). The recurrence rate of PU in group B (4%) was lower than that in group A (10%) and group C (100%, P<0.01).CONCLUSION: Killing Helicobacter pylori quadruple therapy can not only promote the eradication of H pylori and healing quality of ulcer but also reduce recurrence rate of ulcer.

  18. Triple therapy with ilaprazole,levofloxacin and clarithromycin for the eradication of Helicobacter pylori

    Institute of Scientific and Technical Information of China (English)

    黄伟平

    2014-01-01

    Objective To evaluate the efficacy of triple therapy with ilaprazole,levofloxacin and clarithromycin and standard triple therapy for Helicobacter pylori(Hp)eradication.Methods One hundred and twenty Hp(+)patients were randomized to two groups:the treatment group:60 patients received ilaprazole 5 mg,bid,levofloxacin 0.5 g,qd,and clarithromycin 500 mg,bid,for7 days;60 patients received omeprazole 20 mg,bid,amoxicillin 1 g,and clarithromycin 500 mg,bid,for 7days.Follow-up Hp test was performed at four weeks after the treatment.Results Intention-treatment analysis

  19. Probiotics improve the efficacy of standard triple therapy in the eradication of Helicobacter pylori: a meta-analysis

    Science.gov (United States)

    Lau, Christine S M; Ward, Amanda; Chamberlain, Ronald S

    2016-01-01

    Introduction Helicobacter pylori colonization is present in half of the world’s population and can lead to numerous gastrointestinal diseases if left untreated, including peptic ulcer disease and gastric cancer. Although concurrent triple therapy remains the recommended treatment regimen for H. pylori eradication, its success rate and efficacy have been declining. Recent studies have shown that the addition of probiotics can significantly increase eradication rates by up to 50%. This meta-analysis examines the impact of probiotic supplementation on the efficacy of standard triple therapy in eradicating H. pylori. Methods A comprehensive literature search was conducted using PubMed, Cochrane Central Registry of Controlled Trials, and Google Scholar (time of inception to 2016) to identify all published randomized control trials (RCTs) assessing the use of probiotics in addition to triple therapy for the treatment of H. pylori. Searches were conducted using the keywords “probiotics”, “triple therapy”, and “Helicobacter pylori”. RCTs comparing the use of probiotics and standard triple therapy with standard triple therapy alone for any duration in patients of any age diagnosed with H. pylori infection were included. H. pylori eradication rates (detected using urea breath test or stool antigen) were analyzed as-per-protocol (APP) and intention-to-treat (ITT). Results A total of 30 RCTs involving 4,302 patients APP and 4,515 patients ITT were analyzed. The addition of probiotics significantly increased eradication rates by 12.2% (relative risk [RR] =1.122; 95% confidence interval [CI], 1.091–1.153; PProbiotics were beneficial among children and adults, as well as Asians and non-Asians. No significant difference was observed in efficacy between the various types of probiotics. The risk of diarrhea, nausea, vomiting, and epigastric pain was also reduced. Conclusion The addition of probiotics is associated with improved H. pylori eradication rates in both

  20. Adjuvant probiotics improve the eradication effect of triple therapy for Helicobacter pylori infection

    Institute of Scientific and Technical Information of China (English)

    Yi-Qi Du; Tun Su; Jian-Gao Fan; Yu-Xia Lu; Ping Zheng; Xing-Hua Li; Chuan-Yong Guo

    2012-01-01

    AIM:To investigate whether the addition of probiotics can improve the eradication effect of triple therapy for Helicobacter pylori (H.pylori) infection.METHODS:This open randomized trial recruited 234 H.pylori positive gastritis patients from seven local centers.The patients were randomized to one-week standard triple therapy (omeprazole 20 mg bid,clarithromycin 500 mg bid,and amoxicillin 1000 mg bid; OCA group,n =79); two weeks of pre-treatment with probiotics,containing 3 × 107 Lactobacillus acidophilus per day,prior to one week of triple therapy (POCA group,n =78); or one week of triple therapy followed by two weeks of the same probiotics (OCAP group,n =77).Successful eradication was defined as a negative C13 or C14 urease breath test four weeks after triple therapy.Patients were asked to report associated symptoms at baseline and during follow-up,and side effects related to therapy were recorded.Data were analyzed by both intention-to-treat (ITT) and per-protocol (PP) methods.RESULTS:PP analysis involved 228 patients,78 in the OCA,76 in the POCA and 74 in the OCAP group.Successful eradication was observed in 171 patients; by PP analysis,the eradication rates were significantly higher (P =0.007 each) in the POCA (62/76; 81.6%,95%CI 72.8%-90.4%) and OCAP (61/74; 82.4%,95% CI 73.6%-91.2%) groups than in the OCA group (48/78;61.5%,95% CI 50.6%-72.4%).ITT analysis also showed that eradication rates were significantly higher in the POCA (62/78; 79.5%,95% CI 70.4%-88.6%)and OCAP (61/77; 79.2%,95% CI 70%-88.4%)groups than in the OCA group (48/79; 60.8%,95% CI 49.9%-71.7%),(P =0.014 and P =0.015).The symptom relieving rates in the POCA,OCAP and OCA groups were 85.5%,89.2% and 87.2%,respectively.Only one of the 228 patients experienced an adverse reaction.CONCLUSION:Administration of probiotics before or after standard triple therapy may improve H.pylori eradication rates.

  1. Multiple-antibiotic-resistant Helicobacter pylori infection eradicated with a tailor-made quadruple therapy.

    Science.gov (United States)

    Nakajima, Shigemi; Inoue, Hisayuki; Inoue, Tetsuya; Maruoka, Yuri

    2012-04-01

    In 2008, a 44-year-old woman with mild epigastralgia diagnosed as having Helicobacter pylori-positive chronic gastritis without peptic ulcer underwent eradication therapy with lansoprazole (LPZ), amoxicillin (AMPC) and clarithromycin (CAM) for 7 days, but it failed, so treatment with rabeprazole, AMPC, and metronidazole (MNZ) for another 7 days was given, but it also failed. She was then prescribed a modified, 14-day sequential therapy of LPZ and AMPC with an increased dose of CAM followed by MNZ supplement, but the infection was still not eradicated. The H. pylori was cultured and examined for antibiotic susceptibility with the agar dilution method and was found to be resistant to CAM, MNZ, and levofloxacin, and non-sensitive to AMPC, namely multiple-antibiotic-resistant, although sensitive to minocycline. The CYP2C19 genotype of the patient was an extensive metabolizer (G681A: G/A, G636A: G/G). In 2010, she gave informed consent for a 14-day, tailor-made, modified classical (or modified high-dose PPI + AMPC) quadruple therapy comprising 30 mg LPZ, 500 mg AMPC and 500 mg bismuth subnitrate, qid, and 100 mg minocycline, bid. Two months later, her urea breath test was negative. Histology and bacterial culture were still negative 1 year after the therapy. She did not have any adverse events during or after the novel therapy, nor did she feel any further epigastralgia.

  2. Triple therapy with clarithromycin, amoxicillin and omeprazole for Helicobacter pylori eradication in children and adolescents

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    KAWAKAMI Elisabete

    2001-01-01

    Full Text Available Background - Helicobacter pylori infection presents high prevalence in developing countries, but there are few pediatric assays evaluating antimicrobial treatment. Objective - The aim of this study was to investigate Helicobacter pylori eradication rate using a short regimen (7 and 10 days of triple therapy with clarithromycin, amoxicillin and omeprazole. Patients and methods - Twenty-five Hp positive patients who presented severe epigastralgia, were submitted to antimicrobial treatment with amoxicillin (50 mg/kg/day - maximum dose 1g bid, clarithromycin (30 mg/kg/day - maximum dose 500 mg bid and omeprazole (0.6 mg/kg/day - maximum dose 20 mg bid during 7 or 10 days. After 2 months, clinical symptoms were evaluated and gastric biopsies were taken to test Hp eradication. Results - Overall eradication rate was achieved in 16/25 patients (64% - IC(95% = 45-83%, in 11/15 (73% - IC(95% = 51-95% patients who used 10 days therapy course and in 5/10 (50% - IC(95% = 19-81% who used 7 days therapy course. Eradication drugs were well accepted and adverse effects were reported in two patients (8%. Conclusions - This triple therapy regimen had moderate efficacy (64%. The data suggests that 10 days therapy course achieves better eradication rate (73% than 7 days course (50% to treat Hp infection in our population.

  3. Helicobacter  pylori Eradication Therapies in the Era of Increasing Antibiotic Resistance: A Paradigm Shift to Improved Efficacy

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    Sotirios D. Georgopoulos

    2012-01-01

    Full Text Available With the rising prevalence of antimicrobial resistance, the eradication rates of Helicobacter pylori (H. pylori with standard treatments are decreasing to unacceptable levels (i.e., ≤80% in most countries. After these disappointing results, several authorities have proposed that infection with H. pylori should be approached and treated as any other bacterial infectious disease. This implicates that clinicians should prescribe empirical treatments yielding a per protocol eradication of at least 90%. In recent years several treatments producing ≥90% cure rates have been proposed including sequential therapy, concomitant quadruple therapy, hybrid (dual-concomitant therapy, and bismuth-containing quadruple therapy. These treatments are likely to represent the recommended first-line treatments in the near future. In the present paper, we are considering a series of critical issues regarding currently available means and approaches for the management of H. pylori infection. Clinical needs and realistic endpoints are taken into account. Furthermore, emerging strategies for the eradication of H. pylori and the existing evidence of their clinical validation and widespread applicability are discussed.

  4. A randomized comparison of triple therapy Helicobacter pylori eradication regimens in children with peptic ulcers.

    Science.gov (United States)

    Shcherbakov, P L; Filin, V A; Volkov, I A; Tatarinov, P A; Belousov, Y B

    2001-01-01

    An open, randomized trial was performed to compare the efficacy of three Helicobacter pylori eradication regimens in children with peptic ulcer disease. A total of 106 children (5 - 15 years) were treated for 1 week with metronidazole, 30 - 40 mg/kg per day depending on age, amoxycillin, 750 mg/day, and one of three anti-secretory agents: proprietary omeprazole, 20 - 40 mg/day depending on age; generic omeprazole, 20 - 40 mg/day; or ranitidine, 150 mg twice daily. The H. pylori eradication rate was significantly higher in patients receiving proprietary omeprazole (88.9%) than in those receiving generic omeprazole (80.0%) or ranitidine (74.3%), and this was associated with a trend towards faster ulcer healing. It is concluded that triple therapy consisting of an anti-secretory agent and two antimicrobials produces effective eradication of H. pylori and ulcer healing in children with peptic ulcer disease, and that proprietary omeprazole is more effective than both ranitidine and the generic formulation used in this study.

  5. Azithromycin in a triple therapy for H. pylori eradication in active duodenal ulcer

    Institute of Scientific and Technical Information of China (English)

    Vladimir T. Ivashkin; Tatiana L. Lapina; Oksana Yu. Bondarenko; Olga A. Sklanskaya; Petr Ya. Grigoriev; Yuri V. Vasiliev; Emilia P. Yakovenko; Pavel V. Gulyaev; Valeri I. Fedchenko

    2002-01-01

    AIM: To assess and compare the efficacy and safety of twotriple regimes: A) metronidazole, amoxicillin and omeprazole,which is still widely used in Russia, and B) azithromycin,amoxicillin and omeprazole in healing active duodenal ulcerand H.pylori eradication. METHODS: 100 patients with active duodenal ulcer wereincluded in the open, multicentre, randomized study withcomparative groups. Patients were randomly assigned toone of the following one-week triple regimes: A)metronidazole 500 mg bid, amoxicillin 1 g bid and omeprazole20 mg bid (OAM, n=50) and B) azithromycin 1 g od for thefirst 3 days (total dose 3 g), amoxicillin 1 g bid andomeprazole 20 mg bid (OAA, n=50). Omeprazole 20 mg odwas given after the eradication course as a monotherapyfor three weeks. The control endoscopy was performed 8weeks after the entry. H. pylori infection was determined inthe entry of the study and four weeks after the cessation oftreatment by means of histology and CLO-test.RESULTS: 97 patients completed the study according tothe protocol (1 patient of the OAM group did not come tothe control endoscopy, 2 patients of the OAA group stoppedthe treatment because of mild allergic urticaria). Duodenalulcers were healed in 48 patients of the OAM group (96 %;CI 90.5-100 %) and in 46 patients of the OAA group (92 %;CI 89.5-94.5 %) (p=ns). H. pylori infection was eradicatedin 15 out of 50 patients with OAM (30 %; CI 17-43 %) andin 36 out of 50 patients treated with OAA (72 %; CI 59-85 %)(P<0.001)-ITT analysis.CONCLUSION: The triple therapy with omeprazole,amoxicillin and metronidazole failed to eradicate H. pylori inthe majority of patients, which is an essential argument towithdraw this regimen out of the national recommendations.Macrolide with amoxicillin are preferable to achieve highereradication rates. Azithromycin (1 g od for the first 3 days)can be considered as a successful component of the triplePPI-based regimen.

  6. Modified Sequential Therapy Regimen versus Conventional Triple Therapy for Helicobacter pylori Eradication in Duodenal Ulcer Patients in China: A Multicenter Clinical Comparative Study

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    Ying-Qun Zhou

    2012-01-01

    Full Text Available Objective. Antimicrobial resistance has decreased eradication rates for Helicobacter pylori infection worldwide. To observe the effect of eradicating Helicobacter pylori (H. pylori and the treatment of duodenal ulcer by 2 kinds of modified sequential therapy through comparing with that of 10-day standard triple therapy. Methods. A total of 210 patients who were confirmed in duodenal ulcer active or heal period by gastroscopy and H. pylori positive confirmed by rapid urease test, serum anti-H. pylori antibody (ELASE, or histological examination enrolled in the study. All the patients were randomly divided into three groups: group A (70 cases and group B (70 cases were provided 10-day modified sequential therapy; group C (70 cases was provided 10-day standard triple therapy. Patients of group A received 20 mg of Esomeprazole, 500 mg of Clarithromycin for the first 5 days, followed by 20 mg of Esomeprazole, 500 mg of Clarithromycin, and 1000 mg of Amoxicillin for the remaining 5 days. Group B received 20 mg of Esomeprazole, 1000 mg of Amoxicillin for the first 5 days, followed by 20 mg of Esomeprazole, 500 mg of Clarithromycin, and 1000 mg of Amoxicillin for the remaining 5 days. Group C received 20 mg of Esomeprazole, 500 mg of Clarithromycin, and 1000 mg of Amoxicillin for standard 10-day therapy. All drugs were given twice daily. H. pylori eradication rate was checked four to eight weeks after taking the medicine by using a 13C urea breath test. In the first, second, third, seventh, twenty-first, thirty-fifth days respectively, the symptoms of patients such as epigastric gnawing, burning pain, and acidity were evaluated simultaneously. Results. Overall, 210 patients accomplished all therapy schemes, 9 case patients were excluded. The examination result indicated that the H. pylori eradication rate of each group was as follows: group A 92.5% (62/67, group B 86.8% (59/68, and group C 78.8% (52/66. The H. pylori

  7. Furazolidone-based therapies for Helicobacter pylori infection: A pooled-data analysis

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    Angelo Zullo

    2012-01-01

    Full Text Available Background/Aim: Furazolidone-based therapies are used in developing countries to cure Helicobacter pylori infection due to its low cost. The low bacterial resistance toward furazolidone may render appealing the use of this drug even in developed countries. However, some relevant safety concerns do exist in using furazolidone. Patients and Methods : This was a systematic review with pooled-data analysis of data regarding both eradication rate and safety of furazolidone-based therapies for H. pylori infection. Intention-to-treat (ITT and per-protocol (PP eradication rates were calculated. Results : Following furazolidone-based first-line therapy, H. pylori eradication rates were 75.7% and 79.6% at ITT and PP analysis, respectively (P<0.001. The overall incidence of side effects and severe side effects were 33.2% and 3.8%, respectively. At multivariate analysis, only high-dose furazolidone was associated with increased therapeutic success (OR: 1.5, 95% CI: 1.3-2.7; P<0.001, while occurrence of side effects was relevant following treatment for a long duration (OR: 2.9, 95% CI: 2.2-4.1; P<0.001, high-dose furazolidone (OR: 2.3, 95% CI: 1.7-3.2; P<0.001 and bismuth-containing regimens (OR: 2.1, 95% CI: 1.5-2.8; P<0.001. Conclusions: Furazolidone-based regimens usually achieve low eradication rates. Only a high-dose regimen improves the cure rate, but simultaneously increases the incidence of severe side effects. Therefore, we suggest that patients have to be clearly informed about the possible genotoxic and carcinogenetic effects for which furazolidone use is not approved in developed countries.

  8. Levofloxacin-amoxicillin/clavulanate-rabeprazole versus a standard seven-day triple therapy for eradication of Helicobacter pylori infection.

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    Chen, Ming-Cheh; Lei, Wei-Yi; Lin, Jen-Shung; Yi, Chih-Hsun; Wu, Deng-Chyang; Hu, Chi-Tan

    2014-01-01

    The resistance rates of Helicobacter pylori to amoxicillin and metronidazole therapy are higher in eastern Taiwan as compared to national and worldwide rates. The high resistance rate in this territory justified a search for a better eradication regimen. We conducted an open-labeled, prospective, randomized, and controlled study in a tertiary referral hospital in eastern Taiwan. Between December 2007 and December 2009, a total of 153 Helicobacter pylori-positive, therapy-naïve patients with a positive rapid urease test were recruited for random assignment to two seven-day treatment groups: levofloxacin (500 mg), amoxicillin/clavulanate (875 mg/125 mg), and rabeprazole (20 mg) twice per day (LAcR) or clarithyromicin (500 mg), amoxicillin (1000 mg), and rabeprazole (20 mg) twice per day (CAR). Helicobacter pylori eradication was assessed using the (13)C-urea breath test or rapid urease test performed at least 4 weeks after the end of treatment. After exclusion, 146 patients were enrolled and allocated in the study. The Helicobacter pylori eradication rates analyzed by both intention to treat (78.1% versus 57.5%, P = 0.008) and perprotocol (80.9% versus 61.8%, P = 0.014) were significantly higher for the LAcR group. In conclusion, the seven-day LAcR regimen provided improved Helicobacter pylori eradication efficacy when compared with the standard CAR triple therapy in eastern Taiwan.

  9. Effect of bismuth addition to the triple therapy of Helicobacter pylori eradication

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    Ezel Taşdemir

    2012-03-01

    Full Text Available Objective: Success rates of amoxicillin, clarithromycin, and proton-pump inhibitor therapy in the Helicobacter pylori (Hp eradication have been decreasing. The aim of this study was to investigate the impact of bismuth subcitrate addition to triple therapy.Materials and methods: 148 patients diagnosed Hp infection with both histology and Hp stool antigen (HpSA tests were examined retrospectively. The patients were divided into 3 groups according to the eradication therapy. The first group received triple therapy with claritromycine 2x 500 mg, amoxicilline 2x1 g and PPI 2x1 for 14 days (n=40. The second group had bismuth subcitrate 4x120 mg with triple therapy for 14 days (n=73. The third group received 14 days pretreatment with bismuth subcitrate 4x1 together with PPI 2x1 then had triple therapy for 14 days (n=35. (14C urea breath and HpSA tests were used to detect posttreatment H.pylori status.Results: There were no statistical difference between the groups in terms of gender and age (p > 0.05. In group one 12 patients, in group two 20 patients and in group three 10 patients were identified as Hp positive after treatment. Eradication rates were 70% for group one, 72.6% for group two and 71.4% for group three respectively. There was no statistical difference between the groups in terms of eradication rates of treatment (p > 0.05.Conclusions: The addition of bismuth to conventional triple therapy did not affect treatment success rates.

  10. Effect of Lactobacillus acidophilus and Bifidobacterium bifidum supplementation to standard triple therapy on Helicobacter pylori eradication and dynamic changes in intestinal flora.

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    Wang, Yu-huan; Huang, Ying

    2014-03-01

    To investigate Lactobacillus acidophilus (L. acidophilus) and Bifidobacterium bifidum (B. bifidum) supplementation to triple therapy for Helicobacter pylori (H. pylori) eradication and dynamic changes in intestinal flora in children with H. pylori infection. One hundred H. pylori-infected children were randomly assigned to two groups: treatment group (n = 43), standard triple anti-H. pylori therapy plus probiotics of L. acidophilus and B. bifidum for 2 weeks followed by taking probiotics for another 4 weeks; control group (n = 45), standard triple anti-H. pylori therapy for 6 weeks. After 6-week treatment, ¹³C-urease breath test was performed and side effects were monitored during the observation period. Quantitative PCR with 16S rRNA-gene-targeted species-specific primers was carried out for the analysis of human intestinal B. bifidum, L. acidophilus, and Escherichia coli (E. coli). As expected, treatment group could significantly enhance the H. pylori eradication rate (83.7 vs. 64.4 %, P acidophilus, and E. coli showed no statistical difference before or after therapy in the treatment group. The number of B. bifidum and L. acidophilus was significantly decreased after 2-week treatment in the control group, but after 6-week treatment it significantly increased and nearly returned to the level before treatment. The number of E. coli increased significantly after 2-week treatment, while after 6-week treatment, it nearly decreased to the level before treatment. L. acidophilus and B. bifidum supplementation is effective for H. pylori eradication compared with triple therapy alone.

  11. Effect of Helicobacter pylori eradication therapy in rosacea patients Efecto del tratamiento erradicador frente a Helicobacter pylori en la rosácea

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    D. Boixeda de Miquel

    2006-06-01

    Full Text Available Objective: the causal relation between rosacea and Helicobacter pylori infection is discussed. We evaluated the clinical evolution of rosacea after infection eradication. Patients and methods: we have prospectively studied 44 patients diagnosed with rosacea. Helicobacter pylori infection was determined, and infected patients were treated with eradication therapy. The evolution of dermatological symptoms in a subgroup of 29 infected patients in whom eradication had been achieved was followed during 16.8 (± 17.8 months. Median age was 50.6 (± 14.1 years for 22 women (75.9% and 7 men (24.1%. Clinical response according to gender and clinical subtype of rosacea was evaluated. Results: complete improvement was observed in 10 patients (34.5%; 95% CI: 18.6-54.3%, relevant improvement in 9 (31.1%; 95% CI: 16-51%, poor improvement in 5 (17.2%; 95% CI: 6.5-36.4%, and absence of improvement in 5 cases (17.2%; 95% CI: 6.5-36.4%. No significant differences in dermatological evolution according to sex were observed. Regarding subtype of rosacea there was a relevant improvement in 83.3% (95% CI: 64.1-93.8% of cases with papulopustular type as opposed to 36.5% (95% CI: 20-56.1% of cases with erythematous predominance, p = 0.02. Conclusions: based on these results, the relation between Helicobacter pylori and rosacea is supported, and infection should be investigated in these patients because an appreciable percentage of patients diagnosed with rosacea and Helicobacter pylori infection can benefit from eradication therapy, mainly in the papulopustular subtype.

  12. Expression comparison of azithromycin and clarithromycin in triple-therapy regimens for eradication of Helicobacter pylori in hemodialysis patients

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    Jamshid Vafaeimanesh

    2014-01-01

    Full Text Available To compare a triple-therapy regimen based on change of antibiotic (azithromycin and clarithromycin for the eradication of Helicobacter pylori in hemodialysis (HD patients, we studied in a prospective, randomized, double-blinded clinical trial 39 patients who had dyspepsia and showed two positive results from the diagnostic tests of H. pylori infection including anti-H. pylori serology and stool antigen (HpSAg and urease breath test (UBT. The patients were divided into two groups: Group-A received omeprazol 20 mg, amoxycilin 500 mg and clarithromycin 500 mg twice a day and Group-B received omeprazol 20 mg, amoxicillin 500 mg and azithromycin 250 mg twice a day. The adverse events and compliance with triple therapy were reviewed at one visit per week. Both groups were prescribed their medications for 14 days. Of the 39 patients, only 37 patients completed the treatment schedule (20 men and 19 women, with the mean being 59 years. Two patients died due to myocardial infarction before the start of treatment and were out of the study. The eradication rate of H. pylori, evaluated by negative results of UBT, was 82.4% in Group-A and 80% in Group-B (P-value = 1.0. The results of our study showed no significant difference of azitromycin versus claritromycin in the eradication of H. pylori infection in HD patients.

  13. Expression comparison of azithromycin and clarithromycin in triple-therapy regimens for eradication of Helicobacter pylori in hemodialysis patients.

    Science.gov (United States)

    Vafaeimanesh, Jamshid; Jalalzadeh, Mojgan; Nazarian, Morteza

    2014-01-01

    To compare a triple-therapy regimen based on change of antibiotic (azithromycin and clarithromycin) for the eradication of Helicobacter pylori in hemodialysis (HD) patients, we studied in a prospective, randomized, double-blinded clinical trial 39 patients who had dyspepsia and showed two positive results from the diagnostic tests of H. pylori infection including anti-H. pylori serology and stool antigen (HpSAg) and urease breath test (UBT). The patients were divided into two groups: Group-A received omeprazol 20 mg, amoxycilin 500 mg and clarithromycin 500 mg twice a day and Group-B received omeprazol 20 mg, amoxicillin 500 mg and azithromycin 250 mg twice a day. The adverse events and compliance with triple therapy were reviewed at one visit per week. Both groups were prescribed their medications for 14 days. Of the 39 patients, only 37 patients completed the treatment schedule (20 men and 19 women, with the mean being 59 years). Two patients died due to myocardial infarction before the start of treatment and were out of the study. The eradication rate of H. pylori, evaluated by negative results of UBT, was 82.4% in Group-A and 80% in Group-B (P-value = 1.0). The results of our study showed no significant difference of azitromycin versus claritromycin in the eradication of H. pylori infection in HD patients.

  14. Effect of Clostridium butyricum on fecal flora in Helicobacter pylori eradication therapy

    Institute of Scientific and Technical Information of China (English)

    Izumi Shimbo; Taketo Yamaguchi; Takeo Odaka; Kenichi Nakajima; Akinori Koide; Hidehiko Koyama; Hiromitsu Saisho

    2005-01-01

    AIM: To investigate the effect of probiotic bacterium,Clostridium butyricum MIYAIRI 588 strain (CBM) on the changes of the fecal flora in Helicobacter pylori(H pylori)treatment.METHODS: Thirty-five patients with gastric or duodenal ulcers positive for Hpylori were randomized either to 1 wk amoxicillin, clarithromycin, lansoprazole (Group 1) or to the same regimen supplemented with CBM 7 dahead of the triple therapy (Group 2). Stool samples were collected before and 2, 4, 7, 15, and 22 d after the starting eradication therapy, and were examined intestinal flora. Patients were required to keep a diary record of their condition. RESULTS: Obligate anaerobes decreased significantly on d 2, 4, 8 and 15 in Group 1. On the other hand, they did not decrease significantly in Group 2. The Escherichiacoli was dominant bacterium in Enterobacteriaceae, butthat was replaced by other species such as Klebsiella and Enterobacter after eradication in Group 1. The change was suppressed in Group 2. Abdominal symptoms were less frequent in Group 2 than in Group 1.CONCLUSION: The combined use of CBM reduced the changes in the intestinal flora and decreased the incidence of gastrointestinal side effects.

  15. Inhibition of Helicobacter pylori and Its Associated Urease by Palmatine: Investigation on the Potential Mechanism

    Science.gov (United States)

    Tan, Li-Hua; Xu, Yi-Fei; Liu, Yu-Hong; Mo, Zhi-Zhun; Dou, Yao-Xing; Su, Rui; Su, Zi-Ren; Huang, Ping; Xie, Jian-Hui

    2017-01-01

    In this paper, we evaluated the anti-Helicobacter pylori activity and the possible inhibitory effect on its associated urease by Palmatine (Pal) from Coptis chinensis, and explored the potential underlying mechanism. Results indicated that Pal exerted inhibitory effect on four tested H. pylori strains (ATCC 43504, NCTC 26695, SS1 and ICDC 111001) by the agar dilution test with minimum inhibitory concentration (MIC) values ranging from 100 to 200 μg/mL under neutral environment (pH 7.4), and from 75 to 100 μg/mL under acidic conditions (pH 5.3), respectively. Pal was observed to significantly inhibit both H. pylori urease (HPU) and jack bean urease (JBU) in a dose-dependent manner, with IC50 values of 0.53 ± 0.01 mM and 0.03 ± 0.00 mM, respectively, as compared with acetohydroxamic acid, a well-known urease inhibitor (0.07 ± 0.01 mM for HPU and 0.02 ± 0.00 mM for JBU, respectively). Kinetic analyses showed that the type of urease inhibition by Pal was noncompetitive for both HPU and JBU. Higher effectiveness of thiol protectors against urease inhibition than the competitive Ni2+ binding inhibitors was observed, indicating the essential role of the active-site sulfhydryl group in the urease inhibition by Pal. DTT reactivation assay indicated that the inhibition on the two ureases was reversible, further supporting that sulfhydryl group should be obligatory for urease inhibition by Pal. Furthermore, molecular docking study indicated that Pal interacted with the important sulfhydryl groups and inhibited the active enzymatic conformation through N-H ∙ π interaction, but did not interact with the active site Ni2+. Taken together, Pal was an effective inhibitor of H. pylori and its urease targeting the sulfhydryl groups, representing a promising candidate as novel urease inhibitor. This investigation also gave additional scientific support to the use of C. chinensis to treat H. pylori-related gastrointestinal diseases in traditional Chinese medicine. Pal might be

  16. Levofloxacin/amoxicillin-based schemes vs quadruple therapy for Helicobacter pylori eradication in second-line

    Institute of Scientific and Technical Information of China (English)

    Simona Di Caro; Lucia Fini; Yayha Daoud; Fabio Grizzi; Antonio Gasbarrini; Antonino De Lorenzo; Laura Di Renzo

    2012-01-01

    Worldwide prevalence of Helicobacter pylori (H.pylori)infection is approximately 50%,with the highest being in developing countries.We compared cure rates and tolerability (SE) of second-line anti-H,pylori levofloxacin/amoxicillin (LA)-based triple regimens vs standard quadruple therapy (QT).An English language literature search was performed up to October 2010.A meta-analysis was performed including randomized clinical trials comparing 7-or 10-d LA with 7-d QT.In total,10 articles and four abstracts were identified.Overall eradication rate in LA was 76.5% (95%CI:64.4%-97.6%).When only 7-d regimens were included,cure rate was 70.6% (95% CI:40.2%-99.1%),whereas for 10-d combinations,cure rate was significantly higher (88.7%; 95% CI:56.1%-109.9%;P < 0.05).Main eradication rate for QT was 67.4% (95% CI:49.7%-67.9%).The 7-d LA and QT showed comparable efficacy [odds ratio (OR):1.09; 95% CI:0.63-1.87],whereas the 10-d LA regimen was significantly more effective than QT (OR:5.05; 95% CI:2.74-9.31; P < 0.001;I2 =75%).No differences were reported in QT eradication rates among Asian and European studies,whereas LA regimens were more effective in European populations (78.3% vs 67.7%; P =0.05).Incidence of SE was lower in LA therapy than QT (OR:0.39; 95% CI:0.18-0.85; P =0.02).A higher rate of side effects was reported in Asian patients who received QT.Our findings support the use of 10-d LA as a simple second-line treatment for H.pylori eradication with an excellent eradication rate and tolerability.The optimal second-line alternative scheme might differ among countries depending on quinolone resistance.

  17. Bismuth-Based Quadruple Therapy with Bismuth Subcitrate, Metronidazole, Tetracycline and Omeprazole in the Eradication of Helicobacter pylori

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    Raymond Lahaie

    2001-01-01

    Full Text Available BACKGROUND: A previous study showed that 14 days of qid bismuth-based triple therapy with tetracycline 500 mg, metronidazole 250 mg and colloidal bismuth subcitrate 120 mg resulted in excellent Helicobacter pylori eradication rates (89.5%. The present study looked at a shorter treatment period by adding omeprazole and by reducing the dose of tetracycline.

  18. Sequential versus concomitant therapy for eradication of Helicobacter Pylori in patients with perforated duodenal ulcer: A randomized trial

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    Roby Das

    2016-01-01

    Full Text Available Objectives: Comparison of Helicobacter pylori eradication rates, side effects, compliance, cost, and ulcer recurrence of sequential therapy (ST with that of concomitant therapy (CT in patients with perforated duodenal ulcer following simple omental patch closure. Methods: Sixty-eight patients with perforated duodenal ulcer treated with simple closure and found to be H. pylori positive on three months follow-up were randomized to receive either ST or CT for H. pylori eradication. Urease test and Giemsa stain were used to assess for H. pylori eradication status. Follow-up endoscopies were done after 3 months, 6 months, and 1 year to evaluate the ulcer recurrence. Results: H. pylori eradication rates were similar in ST and CT groups on intention-to-treat (ITT analysis (71.43% vs 81.80%,P = 0.40. Similar eradication rates were also found in per-protocol (PP analysis (86.20% vs 90%,P = 0.71. Ulcer recurrence rate in ST groups and CT groups at 3 months (17.14% vs 6.06%,P = 0.26, 6 months (22.86% vs 9.09%,P = 0.19, and at 1 year (25.71% vs 15.15%,P = 0.37 of follow-up was also similar by ITT analysis. Compliance and side effects to therapies were comparable between the groups. The most common side effects were diarrhoea and metallic taste in ST and CT groups, respectively. A complete course of ST costs Indian Rupees (INR 570.00, whereas CT costs INR 1080.00. Conclusion: H. pylori eradication rates, side effects, compliance, cost, and ulcer recurrences were similar between the two groups. The ST was more economical compared with CT.

  19. Probiotics improve the efficacy of standard triple therapy in the eradication of Helicobacter pylori: a meta-analysis

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    Lau CSM

    2016-12-01

    Full Text Available Christine S M Lau,1,2 Amanda Ward,2 Ronald S Chamberlain1–4 1Department of Surgery, Saint Barnabas Medical Center, Livingston, NJ, USA; 2Saint George’s University School of Medicine, Grenada, West Indies; 3Department of Surgery, Banner MD Anderson Cancer Center, Gilbert, AZ, USA; 4Department of Surgery, New Jersey Medical School, Rutgers University, Newark, NJ, USA Introduction: Helicobacter pylori colonization is present in half of the world’s population and can lead to numerous gastrointestinal diseases if left untreated, including peptic ulcer disease and gastric cancer. Although concurrent triple therapy remains the recommended treatment regimen for H. pylori eradication, its success rate and efficacy have been declining. Recent studies have shown that the addition of probiotics can significantly increase eradication rates by up to 50%. This meta-analysis examines the impact of probiotic supplementation on the efficacy of standard triple therapy in eradicating H. pylori. Methods: A comprehensive literature search was conducted using PubMed, Cochrane Central Registry of Controlled Trials, and Google Scholar (time of inception to 2016 to identify all published randomized control trials (RCTs assessing the use of probiotics in addition to triple therapy for the treatment of H. pylori. Searches were conducted using the keywords “probiotics”, “triple therapy”, and “Helicobacter pylori”. RCTs comparing the use of probiotics and standard triple therapy with standard triple therapy alone for any duration in patients of any age diagnosed with H. pylori infection were included. H. pylori eradication rates (detected using urea breath test or stool antigen were analyzed as-per-protocol (APP and intention-to-treat (ITT. Results: A total of 30 RCTs involving 4,302 patients APP and 4,515 patients ITT were analyzed. The addition of probiotics significantly increased eradication rates by 12.2% (relative risk [RR] =1.122; 95% confidence

  20. Role of concomitant therapy for Helicobacter pylori eradication: A technical note

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    Losurdo, Giuseppe; Giorgio, Floriana; Iannone, Andrea; Principi, Mariabeatrice; Barone, Michele; Di Leo, Alfredo; Ierardi, Enzo

    2016-01-01

    We read with interest the recent meta-analysis by Lin et al who evaluated the effectiveness of concomitant regimen for Helicobacter pylori (H. pylori) in Chinese regions. They found that 7-d concomitant regimen is undoubtedly superior to 7-d triple therapy (91.2% vs 77.9%, P < 0.0001). However, it is a common belief that a triple therapy lasting 7 d should be definitively removed from the clinical practice for its ineffectiveness. Only its prolongation to 14 d may give satisfactory success rate. Thus, the assessment of an old and outdated treatment versus a more recent and successful one does not seem to bring novel and useful information. Moreover, a 7-d duration has not been ascertained for concomitant regimen, as main guidelines recommend a 10-d schedule for this scheme. Therefore, only studies comparing 10-d concomitant versus 14-d triple seem to be appropriate according to current Guidelines and would clarify which regimen is the most suitable worldwide. Additionally, in this meta-analysis concomitant and sequential therapy showed similar performances, despite it is common opinion that sequential is more prone than concomitant therapy to fail when metronidazole resistance occurs, and China is characterized by high rate of resistance to this antibiotic. None of the included studies evaluated a priori antibiotic resistances, and the lack of this detail hampers the unveiling of this apparent contradiction. In conclusion, the lack of the evaluation of the quality of included trials as well as their high heterogeneity constitute a burdensome limit to draw solid conclusions in this meta-analysis. On the bases of these considerations and the low number of examined trials, we believe that further studies and the knowledge of antibiotic resistances will support with high quality evidence which is the best regimen and its optimal duration. PMID:27784977

  1. Effects of H pylori therapy on erythrocytic and iron parameters in iron deficiency anemia patients with H pylori-positive chronic gastristis

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To elucidate the influences of H pylori infection on oral iron treatment for iron deficiency anemia (IDA). METHODS: A total of 86 patients were divided into two groups: group A, receiving ferrous succinate combined with triple therapy for H pylorieradication, and group B (control), treated with ferrous succinate only. During treatment of IDA, dynamic changes in hemoglobin (Hb) level, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), serum iron (SI), and serum ferritin (SF) were compared between the groups. RESULTS: Hb was slightly higher in group A at d 14 after the start of triple therapy for H pylori eradication (P > 0.05). After the therapy, the increase of Hb in group A became significantly faster than that in group B (P < 0.05). At d 56, the mean Hb in group A returned to the normal level, however, in group B, it was lower than that in group A (P < 0.05) although it had also increased compared with that before oral iron treatment. The MCV and MCH in group A recovered to the normal level, and were much higher than those in group B (P < 0.05) at d 21. In Group B, the MCV and MCH remained at lower than normal levels until d 42 after the start of therapy. And then, they reached a plateau in both groups and the differences disappeared (P > 0.05). The SF in group A was higher than that in group B (P < 0.05) 28 d after the treatment and its improvement was quicker in group A (P < 0.05), and the difference between the two groups was even more significant (P < 0.01) at d 56. The SI in group A was higher than that in group B (P < 0.05) at d 14 and this persisted until d 56 when the follow-up of this research was finished. CONCLUSION: Treatment of H pylori can enhance the efficacy of ferrous succinate therapy in IDA patients with H pylori-positive chronic gastritis.

  2. Optimizing clarithromycin-containing therapy for Helicobacter pylori in the era of antibiotic resistance.

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    Molina-Infante, Javier; Gisbert, Javier P

    2014-08-14

    The efficacy of triple therapy for Helicobacter pylori infection has dramatically declined over the last decade, largely related to increasing clarithromycin resistance rates. From a microbiological standpoint, bismuth quadruple therapy is the ideal replacement since it combines drugs for which resistance does not impair its efficacy. Nonetheless, several obstacles such as availability, complexity or tolerance prevent a general implementation of bismuth quadruple therapy, so non-bismuth quadruple regimens remain the best first-line treatment in clinical practice in many geographical areas. We review the rationale and efficacy of several optimization tools (increasing the length of duration, high-dose acid suppression, probiotics), which have been largely evaluated over the last 5 years to increase the effectiveness of standard triple therapy. Then, we update available evidence on the effectiveness of several non-bismuth quadruple therapies (sequential, concomitant, hybrid, miscellaneous therapy), which have gained interest lately. We also revise evidence on the efficacy of the aforementioned optimization tools for non-bismuth quadruples schemes and, finally we provide a novel regionalized therapeutic algorithm, based on novel formulas recently developed for predicting the outcome of non-bismuth quadruple regimens, upon local antibiotic resistance rates.

  3. The efficacy of blueberry and grape seed extract combination on triple therapy for Helicobacter pylori eradication: a randomised controlled trial.

    Science.gov (United States)

    Chua, Chian-Sem; Yang, Kuo-Ching; Chen, Jui-Hao; Liu, Yuh-Hwa; Hsu, Yi-Hsin; Lee, Hsiu-Chuan; Huang, Shih-Yi

    2016-01-01

    Helicobacter pylori is a major risk factor for gastritis, gastric ulcers and gastric cancer. Traditional therapy with proton pump inhibitor and antibiotics is regarded as optimal for H. pylori eradication whereas, the eradication rate is unsatisfactory. Studies have reported that cranberry may inhibit H. pylori adhesion to the human gastric mucus but lack of other berry extracts have been evaluated in clinical study. Thus, a 9-week add-on randomised controlled trial was conducted to explore the impact of blueberry and grape seed extract (BGE) combinations traditional therapy for H. pylori eradication. In results, we found that there was no significant difference of eradication rate between the berry extract group and placebo group in the intention-to-treat analysis and in the per-protocol analysis (94.64% versus 84.62%, p = 0.085). Diarrhoea, constipation and epigastric pain were observed increasing during ingestion of the berry extract in some cases. In conclusion, this study indicated that no significant difference existed between the BGE extract group and placebo group in eradication rate under triple therapy.

  4. The influence of Helicobacter pylori on oesophageal acid exposure in GERD during acid suppressive therapy

    NARCIS (Netherlands)

    Peters, FTM; Kuipers, EJ; Ganesh, S; Sluiter, WJ; Klinkenberg-Knol, EC; Lamers, CBHW; Kleibeuker, JH

    1999-01-01

    Background: Helicobacter pylori exaggerates the effect of acid suppressive drugs on intragastric pH. It is unknown whether this is relevant for the treatment of GERD. Aim: To compare oesophageal acid exposure and symptoms in H. pylori-negative and H. pylori-positive GERD patients during low and prof

  5. H pylori eradication:A randomized prospective study of triple therapy with or without ecabet sodium

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    AIM:To investigate whether adding ecabet sodium to the standard triple therapy for Hpylori infection improve eradication rate.METHODS:Two hundred and fifty-seven H pyloriinfected patients were randomly assigned to standard triple therapy (group A, n=129) or triple therapy plus ecabet sodium(group B, n=128).Successful eradication was defined as a negative 13C-urea breath test 6-8 wk after completion of treatment.RESULTS:After completion of therapy,194/257 patients showed negative 13C-urea breath test results.According to intention-to-treat analysis,the infection was eradicated in 93/129(72.1%)patients in group A and 101/128 (78.9%) in group B (P=0.204).Per-protocol analysis showed successful eradication in 93/118(78.8%)patients from group A and 101/114 (88.6%) from group B (P = 0.044).There were no significant differences in the side effects experienced by the patients in the two treatment groups.CONCLUSION:Our results suggest that the addition of ecabet sodium improves the efficacy of the standard triple therapy for H pylori.

  6. Analysis of Patients with Helicobacter pylori Infection and the Subsequent Risk of Developing Osteoporosis after Eradication Therapy: A Nationwide Population-Based Cohort Study

    Science.gov (United States)

    Shih, Hong-Mo; Hsu, Tai-Yi; Chen, Chih-Yu; Lin, Cheng-Li; Kao, Chia-Hung; Chen, Chao-Hsien

    2016-01-01

    Purpose Previous studies have reported conflicting results on the association between Helicobacter pylori infection and osteoporosis. A few studies have discussed the influence of H. pylori eradication therapy on bone mineral density. Methods We assessed the prevalence of osteoporosis among the H. pylori-infected population in Taiwan and the influence of early and late H. pylori eradication therapy on bone mineral density. Results Using data from Taiwan's National Health Insurance Research Database, we identified 5,447 patients who received H. pylori eradication therapy from 2000 to 2010 and 21,788 controls, frequency-matched according to age, sex, and year of receiving H. pylori eradication therapy. Those who received H. pylori eradication therapy were divided into two groups based on the time interval between the diagnosis of a peptic ulcer and commencement of eradication therapy. The risk of developing osteoporosis was higher in the early H. pylori treatment cohort (hazard ratio [HR] = 1.52, 95% confidence interval [CI] = 1.23–1.89) and late H. pylori treatment cohort (HR = 1.69, 95% CI = 1.39–2.05), compared with the risk in the control cohort. When followed for less than 5 years, both the early and late cohorts had a higher risk of developing osteoporosis (HR = 1.69, 95% CI = 1.32–2.16 and HR = 1.72, 95% CI = 1.38–2.14). However, when the follow-up period was over 5 years, only the late eradication group exhibited a higher incidence of osteoporosis (HR = 1.62, 95% CI = 1.06–2.47). Conclusion The development of osteoporosis is complex and multi-factorial. Via this population-based cohort study and adjustment of possible confounding variables, we found H. pylori infection may be associated with an increased risk of developing osteoporosis in Taiwan. Early eradication could reduce the influence of H. pylori infection on osteoporosis when the follow-up period is greater than 5 years. Further prospective studies are necessary to discover the connection of

  7. Inhibition of Helicobacter pylori and Its Associate Urease by Labdane Diterpenoids Isolated from Andrographis paniculata.

    Science.gov (United States)

    Shaikh, Rafik U; Dawane, Ashwini A; Pawar, Rajendra P; Gond, Dhananjay S; Meshram, Rohan J; Gacche, Rajesh N

    2016-03-01

    The present study was carried out to evaluate anti-Helicobacter pylori and its associated urease activity of labdane diterpenoids isolated from Andrographis paniculata. A molecular docking analysis was performed by using ArgusLab 4.0.1 software. The results obtained indicate that compound A possesses strong inhibition to H. pylori, 28 ± 2.98 (minimum inhibitory concentration, 9 µg/mL), and its urease, 85.54 ± 2.62% (IC50 , 20.2 µg/mL). Compounds B, C, and D also showed moderate inhibition to H. pylori and its urease. The obtained results were in agreement with the molecular docking analysis of compounds. The phytochemicals under investigation were found to be promising antibacterial agents. Moreover, the isolated compounds can be considered as a resource for searching novel anti-H. pylori agents possessing urease inhibition.

  8. Eradication of Helicobacter pylori in Children by Triple Therapy Regimens of Amoxicillin, Omeprazole, and Clarithromycin or Azithromycin

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    Mohammad Reza Esmaeili-Dooki

    2015-12-01

    Full Text Available Background and Objectives: The present study aimed to evaluate the effect of classical and azithromycin-containing triple therapy eradication regimen against H. Pylori in children, and to determine the level of patients’ tolerance. Patients and Methods: This single clinical trial was performed in 2014 on 2 to 15 years old children. All children, in whom H. Pylori infection was confirmed through multiple biopsies of the stomach and required treatment, were enrolled in the study. H. Pylori-positive patients were treated alternately with two different drug regimens; Group OCA received clarithromycin 7.5 mg/kg/day every 12 hours for 10 days, amoxicillin 50 mg/kg/day every 12 hours for 10 days, and omeprazole 1 mg/kg/day every 12 hours for two weeks, and Group OAA received azithromycin 10 mg/kg/day once a day (before meal for 6 days along with amoxicillin and omeprazole. Four to six weeks after completion of treatment, patients’ stool was tested for H. Pylori through the monoclonal method using the Helicobacter antigen quick kit. Results: There were no significant differences between the two groups regarding gender and age of patients. Based on ITT analysis, the therapeutic response in the OAA and OCA groups were 56.2% and 62.5%, respectively (P = 0.40. Drug adverse effects were 15.6% in the OCA and 3.1% in the OAA group (P = 0.19. Conclusions: The therapeutic response was seen in more than half of the patients treated with triple therapy of H. Pylori eradication regimen including azithromycin or clarithromycin, and there was no significant difference between the two treatment groups.

  9. Efficacy of microencapsulated lactic acid bacteria in Helicobater pylori eradication therapy

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    Maha A Khalil

    2015-01-01

    Full Text Available Background: Probiotic delivery systems are widely used nutraceutical products for the supplementation of natural intestinal flora. These delivery systems vary greatly in the effectiveness to exert health benefits for a patient. This study focuses on providing probiotic living cells with a physical barrier against adverse environmental conditions. Materials and Methods: Microencapsulation of the selected lactic acid bacteria (LAB using chitosan and alginate was performed. Physical examination of the formulated LAB microcapsules was observed using phase contrast inverted microscope and scanning electron microscope (SEM. Finally, the survival of microencapsulated and noncapsulated bacteria was cheeked in the simulated human gastric tract (GT. The potential antimicrobial activity of the most potent microencapsulated LAB strain was in vivo evaluated in rabbit models. Results: Microencapsulated L. plantarum, L. acidophilus, and L. bulgaricus DSMZ 20080 were loaded with 1.03 × 10 10 CFU viable bacteria/g, 1.9 × 10 10 CFU viable bacteria/g, and 5.5 × 10 9 CFU viable bacteria/g, respectively. The survival of microencapsulated cells was significantly higher than that of the free cells after exposure to simulated gastric juice (SGJ at pH 2. Additionally, in simulated small intestine juice (SSJ, larger amounts of the selected LAB cells were found, whereas in simulated colon juice (SCJ, the released LAB reached the maximum counts. In vivo results pointed out that an 8-week supplementation with a triple therapy of a microencapsulated L. plantarum, L. acidophilus, and L. bulgaricus DSMZ 20080 might be able to reduce H. pylori. Conclusion: Microencapsulated probiotics could possibly compete with and downregulate H. pylori infection in humans.

  10. Short-term triple therapy with azithromycin for Helicobacter pylori eradication: Low cost, high compliance, but low efficacy

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    Mattar Rejane

    2008-05-01

    Full Text Available Abstract Background The Brazilian consensus recommends a short-term treatment course with clarithromycin, amoxicillin and proton-pump inhibitor for the eradication of Helicobacter pylori (H. pylori. This treatment course has good efficacy, but cannot be afforded by a large part of the population. Azithromycin, amoxicillin and omeprazole are subsidized, for several aims, by the Brazilian federal government. Therefore, a short-term treatment course that uses these drugs is a low-cost one, but its efficacy regarding the bacterium eradication is yet to be demonstrated. The study's purpose was to verify the efficacy of H. pylori eradication in infected patients who presented peptic ulcer disease, using the association of azithromycin, amoxicillin and omeprazole. Methods Sixty patients with peptic ulcer diagnosed by upper digestive endoscopy and H. pylori infection documented by rapid urease test, histological analysis and urea breath test were treated for six days with a combination of azithromycin 500 mg and omeprazole 20 mg, in a single daily dose, associated with amoxicillin 500 mg 3 times a day. The eradication control was carried out 12 weeks after the treatment by means of the same diagnostic tests. The eradication rates were calculated with 95% confidence interval. Results The eradication rate was 38% per intention to treat and 41% per protocol. Few adverse effects were observed and treatment compliance was high. Conclusion Despite its low cost and high compliance, the low eradication rate does not allow the recommendation of the triple therapy with azithromycin as an adequate treatment for H. pylori infection.

  11. Clinical Usefulness between High Dose Radioiodine Therapy and Helicobacter Pylori Infection after Total Thyroidectomy due to Well Differentiated Thyroid Cancer

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    Yun, Kuk No; Lim, Seok Tae; Moon, Eun Ha; Kim, Jin Suk; Jeong, Young Jin; Kim, Dong Wook; Jeong, Hwan Jeong; Sohn, Myung Hee [Chonbuk National University Medical School and Hospital, Jeonju (Korea, Republic of)

    2009-12-15

    Helicobacter (H) pylori infection has been considered the most important cause of gastritis, dyspepsia, and gastroduodenal ulcer. Radioiodine can be accumulated in the remaining thyroid tissue, salivary gland, and stomach. We investigated if the high radiation induced by radioiodine in the stomach after high dose radioiodine therapy (HD-RIT) is effective in the eradication of H. pylori infection. One hundred ninety nine patients (M:F=33:166, age 46.7{+-}12.3 years) who had HD-RIT (dose 159.1{+-}25.9 mCi, range 120-250 mCi) after thyroidectomy due to well differentiated thyroid cancer were enrolled. To detect H. pylori infection, the urea breath tests (UBT) were performed at 1 hour before HD-RIT and at 4 weeks after HD-RIT. The results of UBT were classified as positive ({>=}50 dpm) or negative (<50 dpm), and analyzed its values. Of 199 patients, 103 (51.8%) patients had positive UBT before HD-RIT. Of these, 80 patients had follow-up UBT after HD-RIT. Among them, 76 (95.0%) patients had persistent positive UBT and only 4 (5.0%) patients were changed negative UBT. Among 76 patients with persistent positive UBT, 26 (34.2%) patients had increased the values of follow-up UBT, 49 (64.5%) had decreased them, and 1 (1.3%) had shown the same value. The different values of UBT between before and after HD-RIT were 62{+-}66.1 dpm in increased one of follow-up UBT, and 153.3{+-}157.1 dpm in decreased one of follow-up UBT. We conclude that the radiation induced by HD-RIT is ineffective in the eradication of H. pylori infection. However, it could be influential the degree or distribution of H. pylori infection.

  12. Efficacy of the Therapy of Goiter with Subclinical Hypothyroidism Associated with Helicobacter pylori infection

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    G M Panyushkina

    2008-12-01

    Full Text Available Article presented results of the treatment (150 mcg/day KI of goitre with subclinical hypothyroidism associated with Helicobacter pylori infection in 54 women. In conclusion total eradication of Helicobacter pylori could increase efficacy of goitre treatment up to 90%.

  13. Antigenic proteins of Helicobacter pylori of potential diagnostic value.

    Science.gov (United States)

    Khalilpour, Akbar; Santhanam, Amutha; Wei, Lee Chun; Saadatnia, Geita; Velusamy, Nagarajan; Osman, Sabariah; Mohamad, Ahmad Munir; Noordin, Rahmah

    2013-01-01

    Helicobacter pylori antigen was prepared from an isolate from a patient with a duodenal ulcer. Serum samples were obtained from culture-positive H. pylori infected patients with duodenal ulcers, gastric ulcers and gastritis (n=30). As controls, three kinds of sera without detectable H. pylori IgG antibodies were used: 30 from healthy individuals without history of gastric disorders, 30 from patients who were seen in the endoscopy clinic but were H. pylori culture negative and 30 from people with other diseases. OFF-GEL electrophoresis, SDS-PAGE and Western blots of individual serum samples were used to identify protein bands with good sensitivity and specificity when probed with the above sera and HRP-conjugated anti-human IgG. Four H. pylori protein bands showed good (≥ 70%) sensitivity and high specificity (98-100%) towards anti-Helicobacter IgG antibody in culture- positive patients sera and control sera, respectively. The identities of the antigenic proteins were elucidated by mass spectrometry. The relative molecular weights and the identities of the proteins, based on MALDI TOF/ TOF, were as follows: CagI (25 kDa), urease G accessory protein (25 kDa), UreB (63 kDa) and proline/pyrroline- 5-carboxylate dehydrogenase (118 KDa). These identified proteins, singly and/or in combinations, may be useful for diagnosis of H. pylori infection in patients.

  14. Multicenter evaluation of dual-therapy (omeprazol and amoxycillin) for Helicobacter pylori-associated duodenal and gastric ulcer (two years of the observation).

    Science.gov (United States)

    Gabryelewicz, A; Laszewicz, W; Dzieniszewski, J; Ciok, J; Marlicz, K; Bielecki, D; Popiela, T; Legutko, J; Knapik, Z; Poniewierka, E

    1997-09-01

    Treatment with the proton pump inhibitor (omeprazole) and single antibiotic (amoxycillin), two synergistic compounds, can cure Helicobacter pylori (H. pylori) infection, but this therapy is not as effective as had been expected. However, some studies show promising results. The aim of our study was to evaluate the effect of two weeks dual-therapy with omeprazole (O) and amoxycillin (A) on gastric (GU) and duodenal ulcer (DU) patients: ulcer healing, eradication of the H. pylori and recurrence rate of the ulcer. We studied 216 patients (aged 18-70) endoscopically proven GU (58 patients) and DU (158 patients). Rapid urease test from the two antrum biopses and two antral and two corporeal biopses using Giemsa stain method for confirmation of the H. pylori infection were used. The patients were treated with omeprazole 20 mg BID and amoxycillin 1.0 g BID for 2 weeks and investigated every 4 months during 2 years. Clearance effect of Hp infection was achieved in 65.1% GU and 66.4% DU patients. Eradication ("check point" after 4 months) in 43% DU and 56.6% GU patients was confirmed. Reinfection rate was found in 16% during 2 years. We conclude--dual-therapy (O and A) is not sufficiently effective to be recommended as an anti-H. pylori treatment. H. pylori eradication prevents recurrence of peptic ulcer and is an important issue in attempts to achieve permanent ulcer healing.

  15. First-line eradication of Helicobacter pylori:Are the standard triple therapies obsolete? A different perspective

    Institute of Scientific and Technical Information of China (English)

    Gyrgy; Miklós; Buzás

    2010-01-01

    Studies concerning the eradication of Helicobacter pylori have resulted in a proliferation of meta-analyses. To date, there are 303 meta-analyses cited in PubMed, 113 dealing with the therapy of the infection. A chronological analysis of the results of meta-analyses performed between 1998 and 2010 shows that first-line standard triple therapies achieved eradication rates on an intention-to-treat basis of around 80%; prolonging treatment to 14, but not 10 d should improve the results. The proton pump inhibit...

  16. Helicobacter pylori infection: Is sequential therapy superior to standard triple therapy? A single-centre Italian study in treatment-naive and non-treatment-naive patients

    Science.gov (United States)

    Urgesi, R; Pelecca, G; Cianci, R; Masini, A; Zampaletta, C; Riccioni, ME; Faggiani, R

    2011-01-01

    BACKGROUND: Clarithromycin resistance has decreased the eradication rates of Helicobacter pylori. AIMS: To determine whether a 10-day course of sequential therapy (ST) is more effective at eradicating H pylori infection than triple therapy (TT) in the first or second line, and to assess side effects and compliance with therapy. METHODS: One hundred sixty treatment-naive and 40 non-treatment-naive patients who were positive for H pylori infection by 13C-urea breath test or endoscopy were enrolled. Eighty of 160 patients underwent TT, while 80 of 160 underwent ST with omeprazole (20 mg) plus amoxicillin (1 g) twice/day for five days, followed by omeprazole (20 mg) with tinidazole (500 mg) twice/day and clarithromycin (500 mg) twice/day for five consecutive days. H pylori eradication was evaluated by 13C-urea breath test no sooner than four weeks after the end of treatment. RESULTS: Eradication was achieved in 59 of 80 treatment-naive patients treated with TT (74%), in 74 of 80 patients treated with ST (93%), and in 38 of 40 non-treatment-naive patients (95%). Eradication rates in treatment-naive patients with ST were statistically significantly higher than TT (92.5% versus 73.7%; P=0.0015; OR 4.39 [95% CI 1.66 to 11.58]). Mild adverse effects were reported for both regimens. CONCLUSIONS: ST appears to be a well-tolerated, promising therapy; however, randomized controlled trials with larger and more diverse sample populations are needed before it can be recommended as a first-line treatment. PMID:21766091

  17. [THE EFFECTIVENESS OF A 10-DAY DRUG THERAPY IN CHILDREN WITH CHRONIC GASTRODUODENAL PATHOLOGY ASSOCIATED WITH CAGA-POSITIVE STRAINS OF HELICOBACTER PYLORI].

    Science.gov (United States)

    Dudnyk, V M; Rudenko, G M

    2015-01-01

    The results of triple Helicobacter-therapy (omeprazole, amoxicillin, nifuratel) in the treatment of chronic gastroduodenal pathology in children depending on the duration of it's use. The effectiveness of drug therapy was evaluated in terms of eradication of Helicobacter pylori and dynamics of pain, dyspeptic syndrome and astenovegetative syndrome.

  18. Antibacterial Activity of Twenty Iranian Plant Extracts Against Clinical Isolates of Helicobacter pylori

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    Farahnaz Nariman

    2009-06-01

    Full Text Available Objective(sDue to increasing emergence of drug-resistance in Helicobacter pylori isolates, traditional plants arepotentially valuable sources of novel anti-H. pylori agents. In this research, anti-H. pylori activity of theorganic extracts of twenty native Iranian plants was determined against ten clinical isolates of H. pylori.Materials and MethodsDisc diffusion was used to determine the biological activity of 20 plant extracts as well as 8 antibioticscommonly used to treat H. pylori infections. Minimum inhibitory concentrations were also measured by tubeand agar dilution methods for the biologically active plant extracts.ResultsOf the twenty plant extracts analyzed, sixteen exhibited good anti-H. pylori activity, using disc diffusion.The ten most active extracts were Carum bulbocastanum, Carum carvi, Mentha longifolia, Saliva limbata,Saliva sclarea, Ziziphora clinopodioides, Thymus caramanicus, Glycyrrhiza glabra, Xanthium brasilicumand Trachyspermum copticum. Minimum inhibitory concentrations measured for the 10 biologically activeplant extracts were within the range of 31.25 to 500 μg/ml.ConclusionAmong the ten plant extracts effective against H. pylori clinical isolates, Carum carvi, Xanthium brasilicumand Trachyspermum copticum showed the highest activity.Keywords: Anti-Helicobacter pylori, Iranian plants, Organic extracts

  19. Helicobacter pylori in colorectal neoplasms: is there an aetiological relationship?

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    Tharakan Joseph

    2007-05-01

    Full Text Available Abstract Background This pilot study was carried out to determine whether Helicobacter pylori can be detected in normal colon or in association with colorectal neoplasia. Methods Paraffin processed colonic tissue blocks of normal colonic mucosa (n = 60, and patients diagnosed as adenoma (n = 60, and adenocarcinoma (n = 60 were retrieved from our archive; the adenoma group included tubular (n = 20, tubulovillous (n = 20 and villous adenomas (n = 20. 4 μm sections were stained by immunohistochemical methods using anti-Helicobacter pylori antibodies (polyclonal NCL-HPp and monoclonal NCL-C-jejuni. Results Significant numbers of Helicobacter pylori were identified in tubular adenomas (OR = 11.13; 95%CI = 1.62–76.70, tubulovillous adenomas (OR = 10.45; 95%CI = 1.52–71.52 and adenocarcinomas (OR = 8.13; 95%CI = 1.40–46.99 compared to controls: there was no association in numbers of Helicobacter pylori and villous adenomas (OR = 2.95; 95%CI = 0.29–9.96. Conclusion We conclude that although, in this pilot study, there appears to be an association in the prevalence of Helicobacter pylori with some, but not all, colorectal neoplasms, we can not infer causality from these results. These findings need to be further substantiated with a prospective study and the use of molecular biological techniques to determine a causal association.

  20. Multiple Genetic Analysis System-Based Antibiotic Susceptibility Testing in Helicobacter pylori and High Eradication Rate With Phenotypic Resistance-Guided Quadruple Therapy.

    Science.gov (United States)

    Dong, Fangyuan; Ji, Danian; Huang, Renxiang; Zhang, Fan; Huang, Yiqin; Xiang, Ping; Kong, Mimi; Nan, Li; Zeng, Xianping; Wu, Yong; Bao, Zhijun

    2015-11-01

    Antibiotics resistance in Helicobacter pylori (H. pylori) is the major factor for eradication failure. Molecular tests including fluorescence in situ hybridization, PCR-restriction fragment length polymorphism, and dual priming oligonucleotide-PCR (DPO-PCR) play critical roles in the detection of antibiotic susceptibility; however, limited knowledge is known about application of multiple genetic analysis system (MGAS) in the area of H. pylori identification and antibiotics resistance detection.The aim of this study is to determine the antibiotics resistance using different molecular tests and evaluate the treatment outcomes of E-test-based genotypic resistance.A total of 297 patients with dyspepsia complaint were recruited for gastroscopies. Ninety patients with H. pylori culture positive were randomly divided into 2 groups (test group and control group). E-test, general PCR, and MGAS assay were performed in test group. Patients in control group were treated with empirical therapy (rabeprazole + bismuth potassium citrate + amoxicillin [AMX] + clarithromycin [CLR]), whereas patients in test group received quadruple therapy based on E-test results twice daily for 14 consecutive days. The eradication effect of H. pylori was confirmed by C-urea breath test after at least 4 weeks when treatment was finished.Rapid urease test showed 46.5% (128/297) patients with H. pylori infection, whereas 30.3% (90/297) patients were H. pylori culture positive. E-test showed that H. pylori primary resistance rate to CLR, AMX, metronidazole, tetracycline, and levofloxacin (LVX) was 40.0% (18/45), 4.4% (2/45), 53.3% (24/45), 0% (0/45), and 55.6% (25/45), respectively. In addition, there are many multidrug resistant (MDR) phenotypes, and the MDR strains have higher minimum inhibitory concentration than their single-drug resistant counterparts. Considering E-test as the reference test, the sensitivities of general PCR and MGAS in detecting CLR resistance were 83.3% (15/18) and 94.4% (17

  1. Helicobacter pylori Infection in Pediatrics.

    Science.gov (United States)

    Roma, Eleftheria; Miele, Erasmo

    2015-09-01

    This review includes the main pediatric studies published from April 2014 to March 2015. The host response of Treg cells with increases in FOXP3 and TGF-β1 combined with a reduction in IFN-γ by Teff cells may contribute to Helicobacter pylori susceptibility in children. Genotypic variability in H. pylori strains influences the clinical manifestation of the infection. Helicobacter pylori infection is associated with variables indicative of a crowded environment and poor living conditions, while breast-feeding has a protective effect. Intrafamilial infection, especially from mother to children and from sibling to sibling, is the dominant transmission route. Studies showed conflicting results regarding the association between H. pylori infection and iron deficiency anemia. One study suggests that H. pylori eradication plays a role in the management of chronic immune thrombocytopenic purpura in H. pylori-infected children and adolescents. The prevalence of H. pylori was higher in chronic urticaria patients than in controls and, following H. pylori eradication, urticarial symptoms disappeared. An inverse relationship between H. pylori infection and allergic disease was reported. Antibiotic resistance and insufficient compliance to treatment limit the efficacy of eradication therapy. Sequential therapy had no advantage over standard triple therapy. In countries where H. pylori infection is prevalent, studies focusing on virulence factors and antibiotic susceptibility may provide anticipation of the prognosis and may be helpful to reduce morbidity and mortality.

  2. The efficacy of moxifloxacin-based triple therapy in treatment of Helicobacter pylori infection: a systematic review and meta-analysis of randomized clinical trials

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    G. Zhang

    2013-08-01

    Full Text Available Recent evidence shows that moxifloxacin could exert an antimicrobial effect against Helicobacter pylori in both in vitro and in vivo models. To systematically evaluate whether moxifloxacin-containing triple therapy could improve eradication rates and reduce side effects in first-line or second-line anti-H. pylori treatment, eligible articles were identified by searches of electronic databases. We included all randomized trials comparing moxifloxacin-based triple therapy with standard triple or quadruple therapy during H. pylori eradication treatment. Statistical analysis was performed with Review Manager 5.0.10. Subanalysis/sensitivity analysis was also performed. We identified seven randomized trials (n=1263. Pooled H. pylori eradication rates were 79.03% (95%CI: 75.73-82.07 and 68.33% (95%CI: 64.44-72.04 for patients with moxifloxacin-based triple therapy or with standard triple or quadruple therapy, respectively (intention-to-treat analysis. The odds ratio (OR was 1.82 (95%CI: 1.17-2.81, the occurrence of total side effects was 15.23% (95%CI: 12.58-18.20 and 27.17% (95%CI: 23.64-30.92 for groups with or without moxifloxacin, and the summary OR was 0.45 (95%CI: 0.26-0.77. In subgroup analyses, we noted that the second-line eradication rate in the moxifloxacin group was significantly higher than that in the quadruple therapy group (73.33 vs 60.17%, OR: 1.78, 95%CI: 1.16-2.73, P<0.001. However, there was no difference in first-line eradication treatment. Findings from this meta-analysis suggest that moxifloxacin-based triple therapy is more effective and better tolerated than standard triple or quadruple therapy. Therefore, a moxifloxacin-based triple regimen should be used in the second-line treatment of H. pylori infection.

  3. Effect of Native Gastric Mucus on in vivo Hybridization Therapies Directed at Helicobacter pylori

    DEFF Research Database (Denmark)

    Santos, Rita S; Dakwar, George R; Xiong, Ranhua

    2015-01-01

    Helicobacter pylori infects more than 50% of the worldwide population. It is mostly found deep in the gastric mucus lining of the stomach, being a major cause of peptic ulcers and gastric adenocarcinoma. To face the increasing resistance of H. pylori to antibiotics, antimicrobial nucleic acid...... barriers-the highly viscoelastic gastric mucus and the bacterial cell envelope. We found that LNA/2'OMe is capable of diffusing rapidly through native, undiluted, gastric mucus isolated from porcine stomachs, without degradation. Moreover, although LNA/2'OMe hybridization was still successful without...... permeabilization and fixation of the bacteria, which is normally part of in vitro studies, the ability of LNA/2'OMe to efficiently hybridize with H. pylori was hampered by the presence of mucus. Future research should focus on developing nanocarriers that shield LNA/2'OMe from components in the gastric mucus...

  4. Helicobacter pylori

    Science.gov (United States)

    ... Old Feeding Your 1- to 2-Year-Old Helicobacter pylori KidsHealth > For Parents > Helicobacter pylori Print A A A What's in this article? ... Diagnosis Treatment Prevention When to Call the Doctor Helicobacter pylori ( H. pylori ) bacteria are a common cause of ...

  5. The effect of probiotics supplementation on Helicobacter pylori eradication rates and side effects during eradication therapy: a meta-analysis.

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    Yini Dang

    Full Text Available BACKGROUND: Previous meta-analyses reported that probiotics improve the effectiveness of Helicobacter pylori (H. pylori eradication during antibiotic therapy, while results regarding a possible reduction of side effects remained inconclusive. Moreover, the effectiveness of different strains of probiotics has not been studied so far. It is further conceivable that probiotics will produce additional effects only if antibiotics are relatively ineffective. METHODS: This meta-analysis includes eligible randomized controlled trials examining effects of probiotics supplementation on eradication rates (ER and side effects, published up to May 2014. Sub-group analysis was performed to compare different probiotic strains and antibiotic therapies with different effectiveness in controls (ER 80%. Publication bias was assessed with funnel plots and Harbord's test. The quality of the trials was assessed with the Cochrane risk of bias tool. RESULTS: Thirty-three RCTs involving a total of 4459 patients met the inclusion criteria in case of eradication rates of which 20 assessed total side effects in addition. Overall, the pooled eradication rate in probiotics supplementation groups was significantly higher than in controls (ITT analysis: RR 1.122, 95% CI 1.086-1.159, PP analysis: RR 1.114, 95% CI 1.070-1.159. Sub group-analysis could, however, confirm this finding only for four individual strains (Lactobacillus acidophilus, Lactobacillus casei DN-114001, Lactobacillus gasseri, and Bifidobacterium infantis 2036 and for relatively ineffective antibiotic therapies. There was a significant difference between groups in the overall incidence of side effects (RR 0.735, 95% CI 0.598-0.902. This result was, however, only confirmed for non-blinded trials. CONCLUSIONS: The pooled data suggest that supplementation with specific strains of probiotics compared with eradication therapy may be considered an option for increasing eradication rates, particularly when antibiotic

  6. Risk of Recurrent Helicobacter pylori Infection 1 Year After Initial Eradication Therapy in 7 Latin American Communities

    Science.gov (United States)

    Morgan, Douglas R.; Torres, Javier; Sexton, Rachael; Herrero, Rolando; Salazar-Martínez, Eduardo; Robert Greenberg, E.; Bravo, Luis Eduardo; Dominguez, Ricardo L.; Ferreccio, Catterina; Lazcano-Ponce, Eduardo C.; Meza-Montenegro, Maria Mercedes; Peña, Edgar M.; Peña, Rodolfo; Correa, Pelayo; Martínez, María Elena; Chey, William D.; Valdivieso, Manuel; Anderson, Garnet L.; Goodman, Gary E.; Crowley, John J.; Baker, Laurence H.

    2013-01-01

    Importance The long-term effectiveness of Helicobacter pylori eradication programs for preventing gastric cancer will depend on recurrence risk and individual and community factors. Objective To estimate risk of H pylori recurrence and assess factors associated with successful eradication 1 year after treatment. Design, Setting, and Participants Cohort analysis of 1463 randomized trial participants aged 21 to 65 years from 7 Latin American communities, who were treated for H pylori and observed between September 2009 and July 2011. Interventions Randomization to 1 of 3 treatment groups: 14-day lansoprazole, amoxicillin, and clarithromycin (triple therapy); 5-day lansoprazole and amoxicillin followed by 5-day lansoprazole, clarithromycin, and metronidazole (sequential); or 5-day lansoprazole, amoxicillin, clarithromycin, and metronidazole (concomitant). Participants with a positive (13) C-urea breath test (UBT) 6 to 8 weeks posttreatment were offered voluntary re-treatment with 14-day bismuth-based quadruple therapy. Measurements Recurrent infection after a negative posttreatment UBT and factors associated with successful eradication at 1-year follow-up. Results Among participants with UBT-negative results who had a 1-year follow-up UBT (n=1091), 125 tested UBT positive, a recurrence risk of 11.5% (95% CI, 9.6%–13.5%). Recurrence was significantly associated with study site (P=.03), nonadherence to initial therapy (adjusted odds ratio [AOR], 2.94; 95% CI, 1.31–6.13; P=.01), and children in the household (AOR, 1.17; 95% CI, 1.01–1.35 per child; P=.03). Of the 281 with positive posttreatment UBT results, 138 completed re-treatment, of whom 93 tested UBT negative at 1 year. Among the 1340 who had a 1-year UBT, 80.4% (95% CI, 76.4%–83.9%), 79.8% (95% CI, 75.8%–83.5%), and 77.8% (95% CI, 73.6%–81.6%) had UBT-negative results in the triple, sequential, and concomitant groups, respectively (P=.61), with 79.3% overall effectiveness (95% CI, 77.1%–81.5%). In a

  7. Proton pump inhibitor-amoxicillin-clarithromycin versus proton pump inhibitor-amoxicillin-metronidazole as first-line Helicobacter pylori eradication therapy.

    Science.gov (United States)

    Nishizawa, Toshihiro; Suzuki, Hidekazu; Suzuki, Masayuki; Takahashi, Masahiko; Hibi, Toshifumi

    2012-09-01

    The aim of this study was to compare the efficacy and tolerability of the first-line Helicobacter pylori (H. pylori) eradication regimen composed of proton pump inhibitor, clarithromycin, and amoxicillin, with those of a regimen composed of proton pump inhibitor, metronidazole, and amoxicillin. Data of patients, who were administered the first-line H. pylori eradication regimen at Tokyo Medical Center between 2008 and 2011, were reviewed. All patients had H. pylori gastritis without peptic ulcer disease. The 7-day triple regimen composed of lansoprazole, clarithromycin, and amoxicillin was administered to 55 patients, and that composed of omeprazole, metronidazole, and amoxicillin was administered to 55 patients. Intention-to-treat and per-protocol eradication rates were 74.5 and 80.4%, respectively, for the regimen of lansoprazole, clarithromycin, and amoxicillin, whereas the corresponding rates were 96.4 and 100%, respectively, for the regimen of omeprazole, metronidazole, and amoxicillin. In conclusion, first-line H. pylori eradication therapy composed of omeprazole, metronidazole, and amoxicillin was significantly more effective than that composed of lansoprazole, clarithromycin, and amoxicillin, without differences in tolerability.

  8. 噬菌体治疗耐药性幽门螺杆菌的研究进展%Advances of phage therapy in antibiotic-resistant Helicobacter pylori infection

    Institute of Scientific and Technical Information of China (English)

    熊婧; 白杨

    2011-01-01

    幽门螺杆菌感染是胃癌重要致病因子.目前,幽门螺杆菌对抗生素耐药情况日趋普遍.噬菌体治疗作为一种生物疗法在治疗幽门螺杆菌方面有极大的潜力.本文就噬菌体治疗耐药性幽门螺杆菌的现状及趋势进行综述.%Helicobacter pylori (H. pylori) infection is one of the most important risk factors leading to gastric cancer.To date, it has been more and more popular that H. pylori is resistant to antibiotics. Phage therapy has a great advantages in control of H. pylori infection. In this article, we will review the advance of phage therapy in antibiotic-resistant H.pylori infection.

  9. Optimal length of triple therapy for H pylori eradication in a population with high prevalence of infection in Chile

    Institute of Scientific and Technical Information of China (English)

    Arnoldo Riquelme; Alejandro Pattillo; Douglas Greig; Marco Arrese; Antonio Rollan; Alejandro Soza; Cesar Pedreros; Andrea Bustamante; Felipe Valenzuela; Francisco Otarola; Eduardo Abbott; Narco Arellano; Brenda Medina

    2007-01-01

    AIM: To compare the efficacy of 7-d versus 14-d triple therapy for the treatment of H pylori infection in Chile,with a prevalence of 73% in general population.METHODS: H pylori-infected patients diagnosed by rapid urease test, with non-ulcer dyspepsia or peptic ulcer disease were randomized to receive omeprazole 20 mg bid, amoxicillin 1 g bid, and clarithromycin 500 mg bid for 7 (OAC7) or 14 (OAC14) d. Primary outcome was eradication rate 6 wk after the treatment. Subgroup analysis was carried out considering the eradication rate among patients with or without peptic ulcer disease and eradication rate among smokers or non-smokers.RESULTS: One hundred and thirty-one patients were randomized to OAC7 (n = 69) or OAC14 (n = 62). The overall eradication rate (intention-to-treat) was 78.3% in OAC7 and 85.5% in OAC14 groups, without a significant difference (P =0.37). No significant difference in the eradication rate was found among the patients with peptic ulcer disease (n = 31) between the OAC7 group (85.7%) and OAC14 group (87.5%). However, smokers had an obviously lower eradication rate compared to non-smokers, particularly in the OAC7 group (57.1% in smokers vs 83.6% in non-smokers; P = 0.06). Adverse effects rate were similar between both groups.CONCLUSION: Short-term efficacy of triple therapy with OAC for 7 d is comparable to 14 d in this high-prevalence population. Longer follow-up, and studies focused to some subgroups of patients (smokers and non-ulcer patients) are necessary to support widespread use of 7-d instead of 10-14-d triple therapy in a developing country like Chile.

  10. Simultaneous determination of triple therapy for Helicobacter pylori in human plasma by reversed phase chromatography with online wavelength switching

    Science.gov (United States)

    Ahmed, Sameh; Atia, Noha N.

    2015-02-01

    The infection of gastric mucosa by Helicobacter pylori (HP) is an essential cofactor in the aetiology of gastroduodenal ulcer and gastric carcinoma. Because of the bacterial resistance, combination therapy containing omeprazole (OME), tinidazole (TNZ) and clarithromycin (CLA) is commonly used for eradication of HP. However, the simultaneous determination of the triple therapy in human plasma was not reported. A simple, reproducible, and selective HPLC method was developed for the simultaneous determination of the triple therapy mixture used for management of HP infections in human plasma. An HPLC procedure based on a liquid-liquid extraction, enrichment of the analytes and subsequent reversed-phase chromatography with UV detection was used. To enable sensitive and selective detection, the method involved the use of online wavelength switching detection, with two different detection wavelengths; 280 nm for detection of OME and TNZ and 210 nm for detection of CLA. Separations were performed on C18 analytical column with acetonitrile-10 mM phosphate buffer of pH = 3.0 at flow rate of 1.0 mL min-1. The linear ranges in human plasma were 0.05-10 μg mL-1 with correlation coefficients >0.9990. The detection limits in human plasma were 0.02-0.07 μg mL-1. Validation parameters were assessed in compliance with US-FDA guidelines. The method proved to be valuable for the therapeutic drug monitoring after oral administration of triple therapy tablets.

  11. A furazolidone-based quadruple therapy for Helicobacter pylori retreatment in patients with peptic ulcer disease Esquema quádruplo com furazolidona para retratamento do Helicobacter pylori, em pacientes ulcerosos

    Directory of Open Access Journals (Sweden)

    Jaime Natan Eisig

    2005-12-01

    Full Text Available PURPOSE: Many of the currently used eradication regimens against Helicobacter pylori fail to cure the infection either due to antimicrobial resistance or to poor patient compliance. The infection leads to increased risk of developing potentially severe complications, such as gastric cancer. This study was aimed at assessing the efficacy and safety of a quadruple therapy with furazolidone for H. pylori retreatment. METHODS: Patients who had failed one or more eradication regimens against H. pylori infection underwent upper gastrointestinal endoscopy. Biopsy specimens were taken from the gastric antrum and corpus for histology and for a urease test and. Patients received omeprazole 20 mg, bismuth citrate 240 mg, tetracycline 500 mg, and furazolidone 200 mg, all twice daily for 7 days. Therapeutic success was evaluated by endoscopy and biopsies 8 weeks after the end of treatment. RESULTS: Sixty two patients were enrolled, and 58 completed the study. Under this protocol, H. pylori eradication was achieved in 39/58 patients (67%. Mild adverse events were reported. CONCLUSION: The short quadruple therapy course with furazolidone is well tolerated, inexpensive, and effective in retreatment for H. pylori infection. It is a good option for developing countries.OBJETIVO: Muitos dos esquemas atualmente usados na erradicação do Helicobacter pylori não conseguem curar a infecção, pela resistência bacteriana ou pela baixa adesão do paciente. Esta condição manterá os riscos de desenvolvimento das potenciais complicações graves da infecção. Este estudo procurou determinar a eficácia e segurança de um esquema quádruplo que associou a furazolidona para o retratamento da infecção pelo H. pylori. MÉTODOS: Pacientes que não alcançaram erradicação em um ou mais tratamentos foram submetidos à endoscopia digestiva alta e dois fragmentos do antro e do corpo foram retirados para exame histológico e de urease. Receberam então 20mg de omeprazol

  12. STUDY OF DIAGNOSTIC TESTS FOR HELICOBACTER PYLORI INFECTION

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    Rajeswari

    2015-12-01

    Full Text Available Helicobacter pylori is the causative agent of most cases of gastritis and peptic ulcer. The diagnosis of H. pylori is an essential element in the management of many common gastrointestinal pathologies. AIMS 1. Comparison of invasive and non-invasive tests to choose the appropriate test for the diagnosis of H. pylori infection. 2. Validation of the comparison of the different diagnostic tests. METHOD Blood and antral biopsy specimens from 100 acid peptic disease patients and blood samples from 10 control subjects were collected. Biopsies were used for Rapid Urease Test (RUT, culture and Gram’s stain by conventional method. Serology using Euroimmun Anti Helicobacter pylori IgG ELISA was done. The efficacy of these tests was determined by calculating the sensitivity, specificity, positive predictive value, negative predictive value and accuracy using culture as gold standard. RESULTS Of the 100 cases 14% were culture positive, 18% Gram stain positive, 36% Rapid urease test positive and 42% were positive for Serology IgG antibodies for H. pylori. Maximum percentage of positivity was in peptic ulcer cases (52.9% followed by Gastritis cases (23.6% and Dyspepsia cases (14.2%. Among the 100 cases of study group, 42(42% were positive by serological test IgG ELISA for H. pylori, whereas 3(30% were positive out of 10 in control group. RUT, IgG Serology showed 100% sensitivity and negative predictive value and Gram stain showed highest specificity (90.1%. CONCLUSION RUT+Gram’s stain+IgG Serology showed highest Sensitivity, Specificity, Positive predictive value, Negative predictive value and Accuracy. IgG Serology indicates a marker for infection. It can be used as a primary diagnostic procedure.

  13. Comparison of a monoclonal antigen stool test (Hp StAR) with the 13C-urea breath test in monitoring Helicobacter pylori eradication therapy

    Institute of Scientific and Technical Information of China (English)

    Francesco Perri; Michele Quitadamo; Rosalba Ricciardi; Ada Piepoli; Rosa Cotugno; Annamaria Gentile; Alberto Pilotto; Angelo Andriulli

    2005-01-01

    AIM: To evaluate the agreement between a mAb-based stool test (HP StAR) and the urea breath test (UBT) in monitoring (H pylori) infection after eradication therapy.METHODS: Patients with discordant results on UBT and Hp StAR underwent endoscopy with biopsies for rapid urease test, culture, and histology to confirm H pylori status.RESULTS: Among 250 patients (50±14 years), 240 (96.0%) had concordant UBT and Hp StAR tests with a significant correlation between DOB and A values (R = 0.87; P<0.0001).The remaining 10 (4.0%) patients had discordant tests (positive Hp StAR and negative UBT) with the Hp StAR inaccurate in five cases (false positive) and UBT inaccurate in the other five cases (false negative). The "maximal expected" sensitivity, specificity, +PV, -PV, +LR, and -LR were 91%, 100%, 100%, 97.4%, ∞, and 8.2 respectively,for the UBT, and 100%, 97.4%, 91%, 100%, 38.8, and 0,respectively, for the Hp StAR. Overall accuracy for both tests was 98%.CONCLUSION: Both the UBT and the Hp StAR are equally accurate in monitoring H pylori infection. Nowadays,the choice of the "best" non-invasive H pylori test in the post-treatment setting should be done not only in terms of diagnostic accuracy but also in view of cost and local facilities.

  14. [Evaluation of infection by Helicobacter pylori in HIV positive patients trough enzyme immunoassay and specific amplification of DNA].

    Science.gov (United States)

    Gutiérrez, Sandra; Chacón-Petrola, María; Flores, María; Pinto, Angela; Pacheco, Mariela

    2005-03-01

    The objective of this work was to assess the effectiveness of detection of specific antibodies anti-Helicobacter pylori (H. pylori) by ELISA and amplification of specific DNA by polimerase chain reaction (PCR) as diagnostic methods of infection of H. pylori in HIV positive patients. Twenty two patients with HIV infection were studied, with ages between 26 to 35 years, 17 masculine, 55% with gastrointestinal symptoms, controlled in the Unit of Immunology, CHET. Inclusion approaches: older than 18 years, with confirmed diagnosis of HIV infection (ELISA and WB), lymphocyte subpopulation and good general conditions. Consent in writing was obtained. Exclusion approaches: previous diagnosis of H. pylori infection or treatment with antibiotics in the three previous months to their inclusion. The quantification of IgG anti H. pylori was carried out by Enzyme Immunoassay methods (ELISA). Biopsy of gastric mucosa was obtained by superior endoscopic study. The amplification of DNA for H. pylori was performed by PCR (Wizard SV Genomik and PCR Ready-Promega). In the statistical analysis was used the test of Fisher, with a level of significance of 5% (0.05). In 15 patients of the total group, antibodies anti H. pylori were confirmed, without statistical association with the presence or not of digestives symptoms, neither with the number of lymphocytes CD4 + in peripheral blood. Also 15 patients were positives by PCR for H. pylori DNA, 73.3% of them presented levels of CD4+ above 200 cells. There was not statistical association between the positivity of this method and levels of lymphocytes CD4+. In 12 of the 15 patients with positive results by PCR, antibodies anti H. pylori were evidenced, and among the 7 patients with negative serology to H. pylori, PCR was positive in three of them. In conclusion, serology is an effective method for the diagnose of H. pylori infection in VIH+ patients, but its negativity doesn't discard the infection for this bacillus.

  15. HELICOBACTER PYLORI GROWTH INHIBITION BY SUBSTANCE PRODUCED PSEUDOMONAS BY AEROGINOSA: IN VTRO STUDY

    Directory of Open Access Journals (Sweden)

    A FAZELI

    2003-03-01

    Full Text Available Resistance of H.pylori against metronidazole is increasingly appeared in reports of investigators of gastric infections. So that, seeking to find more effective anti-helicobacter drugs is a necessity. In this study, inhibitory effect of the P. aeroginosa-produced substance on H. pylori growth was determined using two methods, Cross-streak and Well-diffusion Only two out of 37 P. aeroginosa isalates were able to inhibit H. pylori growth which one of them was chosen for further investigation. Its antibacterial activity was tested on 31 isolates of H. pylori consisting 27 metrondazole-sensitive and 4 metronidazole-resistant isolates. The inhibitory substance was enable to kill both metrondazole-sensitive and resistant isolates of H. pylori. The substance could also inhibit the of several other bacteria including E.coli, Salmonella sp., Klebsiella sp., S. aureus and a gram positive bacilli. While the inhibitory effect of the substance had no change at 40c for 30 days, its effect substantially reduced by treating at 600c for 15 minutes. Treatment of substance at 600c (30 min. 80?c and 100?c (15 & 30min, and freezing (-20?c and melting (37?c inactivated its inhibitory effect completely. Treatment with trips in also could inactivate it. Thus P. aeroginosa-produced substance, probably is a protein and may be classified in bacteriocin group.

  16. Treatment of Helicobacter pylori in surgical practice: A randomised trial of triple versus quadruple therapy in a rural district general hospital

    Institute of Scientific and Technical Information of China (English)

    Siok Siong Ching; Sivakumaran Sabanathan; Uoyd R Jenldnson

    2008-01-01

    AIM: To compare a lansoprazole-based triple versus quadruple therapy for Helicobacter pylori (H pylori)eradication with emphasis on side effect profile,patient compliance and eradication rate at a rural district general hospital in Wales,United Kingdom.METHODS= One hundred one patients with H pylori infection were included in the study.Patients were randomised to receive triple therapy comprising of lansoprazole 30 mg,amoxycillin 1 g,clarithromycin 500 mg,all b.d.(LAC),or quadruple therapy comprising of lansoprazole 30 mg b.d.,metronidazole 500 mg t.d.s.,bismuth subcitrate 240 mg b.d.,and tetracycline chloride 500 mg q.d.s.(LMBT).Cure was defined as a negative 13C urea breath test 2 mo after treatment.RESULTS: Seven patients were withdrawn after randomisation.Fifty patients were assigned to LAC group and 44 to LMBT group.The intention-to-treat cure rates were 92% and 91%,whereas the perprotocol cure rates were 92% and 97%,respectively.Side effects were common,with 56% experiencing moderate to severe symptoms in the LAC group and 59% in the LHBT group.Symptoms of vomiting,diarrhoea and black stools were significantly more common in the LMBT group.Patient compliance was 100% for triple therapy and 86% for quadruple therapy (P<0.01).One-third of patients in both groups were still taking acid-reducing medications at six-month follow-up.CONCLUSION: One-week triple and quadruple therapies have similar intention-to-treat eradication rates.Certain side effects are more common with quadruple therapy,which can compromise patient compliance.Patient education or modifications to the regimen are alternative options to improve compliance of the quadruple regimen.

  17. Helicobacter Pylori Infection: Diagnostic Strategies in Primary Diagnosis and After Therapy.

    Science.gov (United States)

    Atkinson, Nathan S S; Braden, Barbara

    2016-01-01

    Accurate diagnosis of Helicobacter pylori infection pre- and post-treatment is mandatory in the current era of decreasing prevalence and increasing antibiotic resistance. The diagnostic performance of most tests is poorer in clinical situations with low bacterial density which is seen in conditions such as atrophic gastritis or intake of antisecretory and antibiotic medications. Noninvasive tests require less cost and resource but provide excellent accuracy; however, endoscopy with testing of gastric biopsy specimens is indicated where alarming symptoms are present or antibiotic susceptibility testing by culture is desired. Newer modalities such as polymerase chain reaction testing provide additional virulence and antibiotic sensitivity profiling. This article outlines new developments and the key parameters of each test, as careful selection of test modality within the clinical context is required for adequate management of infected symptomatic patients.

  18. Efficacy of rifabutin-based triple therapy as second-line treatment to eradicate helicobacter pylori infection

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    Méndez Isabel

    2007-07-01

    Full Text Available Abstract Background Rifabutin has been found to be effective in multi-resistant patients after various treatment cycles for Helicobacter pylori (HP infection, but it has not been analysed as a second-line treatment. Therefore, we seek to compare the effectiveness of a treatment regimen including rifabutin versus conventional quadruple therapy (QT. Methods Open clinical trial, randomised and multi-centre, of two treatment protocols: A Conventional regime -QT- (omeprazole 20 mg bid, bismuth citrate 120 mg qid, tetracycline 500 mg qid and metronidazole 500 mg tid; B Experimental one -OAR- (omeprazole 20 mg bid, amoxicillin 1 gr bid, and rifabutin 150 mg bid, both taken orally for 7 days, in patients with HP infection for whom first-line treatment had failed. Eradication was determined by Urea Breath Test (UBT. Safety was determined by the adverse events. Results 99 patients were randomised, QT, n = 54; OAR, n = 45. The two groups were homogeneous. In 8 cases, treatment was suspended (6 in QT and 2 in OAR. The eradication achieved, analysed by ITT, was for QT, 38 cases (70.4%, and for OAR, 20 cases (44.4%; p = 0.009, OR = 1.58. Of the cases analysed PP, QT were 77.1%; OAR, 46.5%; p = 0.002. Adverse effects were described in 64% of the QT patients and in 44% of the OAR patients (p = 0.04. Conclusion A 7-day rifabutin-based triple therapy associated to amoxicillin and omeprazole at standard dose was not found to be effective as a second-line rescue therapy. The problem with quadruple therapy lies in the adverse side effects it provokes. We believe the search should continue for alternatives that are more comfortably administered and that are at least as effective, but with fewer adverse side effects. Trial Registration Current Controlled Trials ISRCTN81058036

  19. A Randomized Controlled Trial Comparing Sequential with Triple Therapy for Helicobacter pylori in an Aboriginal Community in the Canadian North

    Directory of Open Access Journals (Sweden)

    Amy L Morse

    2013-01-01

    Full Text Available BACKGROUND: Helicobacter pylori infection occurs more frequently in Arctic Aboriginal settings than elsewhere in North America and Europe. Research aimed at reducing health risks from H pylori infection has been conducted in the Aboriginal community of Aklavik, Northwest Territories.

  20. Six-year follow-up after successful triple therapy for Helicobacter pylori infection in patients with peptic ulcer disease

    NARCIS (Netherlands)

    van der Wouden, EJ; Thijs, JC; van Zwet, AA; Kleibeuker, JH

    2001-01-01

    Objective & Design We question whether Helicobacter pylori eradication in peptic ulcer disease patients leads to a decrease in symptoms and reduced use of anti-dyspeptic drugs. Therefore, the recurrence rate of H. pylori, upper abdominal symptoms and the use of acid-suppressive drugs were determined

  1. Probiotics for the treatment of Helicobacter pylori infection in children

    OpenAIRE

    Pacifico, Lucia; Osborn, John Frederick; Bonci, Enea; Romaggioli, Sara; Baldini, Rossella; Chiesa, Claudio

    2014-01-01

    The combination of a proton pump inhibitor and two antibiotics (clarithromycin plus amoxicillin or metronidazole) has been the recommended first-line therapy since the first guidelines for Helicobacter pylori (H. pylori) infection in children were published. In recent years, the success of eradication therapies has declined, in part due to the development of H. pylori resistant strains. Alternative anti-H. pylori treatments are currently becoming more popular than the traditional eradication ...

  2. Coenzyme Q10 in combination with triple therapy regimens ameliorates oxidative stress and lipid peroxidation in chronic gastritis associated with H. pylori infection.

    Science.gov (United States)

    Rahmani, Asghar; Abangah, Ghobad; Moradkhani, Atefeh; Hafezi Ahmadi, Mohammad Reza; Asadollahi, Khairollah

    2015-08-01

    Chronic gastritis associated with H. pylori infection causes oxidative stress in the stomach. This study aimed to evaluate the therapeutic effects of coenzyme q10 among gastric patients infected by H. pylori. By a clinical trial, chronic gastric patients infected by H. pylori were randomly divided into 2 groups: intervention and placebo. The placebo group received a standard triple therapy regimen, and the intervention group received the triple regimen + coenzyme Q10 (CoQ10). Mean inflammation score; serum levels of 3 serum markers were then compared. A total of 100 participants of whom 67% were female were evaluated. The mean age of participants was 59.4 ± 11.4 years. The mean inflammation score was considerably decreased at the end of the study, in the intervention group. The mean levels of total antioxidant capacity (TAC) and glutathione peroxidase (GPx) at the end of the study were reduced among the triple therapy group (P gastritis.

  3. Diagnostic accuracy of a rapid fecal test to confirm H pylori eradication after therapy: Prospective comparison with a laboratory stool test

    Institute of Scientific and Technical Information of China (English)

    Lucio Trevisani; Viviana Cifalà; Nadia Fusetti; Giuseppe Gilli; Paola Tombesi; Marco Torchiaro; Sergio Boccia; Vincenzo Abbasciano

    2007-01-01

    AIM: To investigate the clinical performances of rapid stool test (ImmunoCard STAT HpSA, Meridian Diagnostic Inc.) in the evaluation of eradication therapy of H pylori and to compare it with a well-known and validated laboratory stool test (Amplified IDEA Hp StAR, Dako).METHODS: Stool samples of 122 patients were evaluated after eradication therapy of H pylori. H pyloristatus was assessed by 13C-urea breath test (UBT).Stool specimens were tested using either the rapid immunoassay kit or the laboratory immunoassay kit.RESULTS: Forty-three patients were infected and 79 non-infected. Sensitivity and specificity of ImmunoCard STAT and Hp StAR were 58.14% and 76.4%, and 97.47% and 98.73%, respectively (P > 0.05). Overall agreement between the two tests was 92.6% (113 of 122 cases).CONCLUSION: ImmunoCard STAT seems to have rather low performances, and it cannot be regarded as a reliable tool in the post-treatment setting. Also Hp StAR cannot be recommended to confirm H pylori eradication after treatment.

  4. Helicobacter pylori and Nonmalignant Diseases.

    Science.gov (United States)

    Potamitis, Georgios S; Axon, Anthony T R

    2015-09-01

    Helicobacter pylori is responsible for most peptic ulcers, plays a role in functional dyspepsia and is thought by some to influence the course of gastroesophageal reflux disease. This article addresses recent studies that have been published in connection with these diseases. H. pylori-associated peptic ulcer is declining in prevalence but the incidence of perforation and bleeding remains high especially in the elderly. All H. pylori associated peptic ulcers should be treated by eradication of the infection. Dyspepsia is a common disorder that affects up to 25% of the population. About 8% of cases that are infected with H. pylori will respond to treatment of the infection. The association between H. pylori and gastroesophageal reflux disease continues to be debated, a number of studies have shown that there is a negative association between H. pylori infection and Gastroesophageal reflux disease but treatment of H. pylori has not been shown to induce reflux or to affect the response to medication. Gastric atrophy is known to extend when acid suppression is used in infected patients implying that H. pylori treatment should be used in infected patients who are to undergo long-term Proton Pump Inhibitor therapy.

  5. Evaluation of clinico-pathological features and Helicobacter pylori infection in gastric inflammatory fibroid polyps.

    Science.gov (United States)

    Albuquerque, Andreia; Rios, Elisabete; Carneiro, Fátima; Macedo, Guilherme

    2014-12-01

    Inflammatory fibroid polyps are rare mesenchymal lesions. The frequency of Helicobacter pylori infection in the gastric mucosa overlying inflammatory fibroid polyps and its relation with the histologic features of the polyps are undetermined. The clinico-pathological features of inflammatory fibroid polyps, the frequency of Helicobacter pylori infection in the overlying gastric mucosa, and its putative impact on the phenotype of the polyps were evaluated. Gastric inflammatory fibroid polyps diagnosed in our Hospital from 1998 to 2012 were reviewed and the histological. The histological sections were stained with hematoxylin and eosin and modified Giemsa for the evaluation of Helicobacter pylori infection. Inconclusive cases were further analyzed by immunohistochemistry with anti-Helicobacter pylori antibody. Diagnosis was confirmed in 54 polyps, 85 % developed in females, mean age 63 ± 11 years. Most polyps were sessile (74 %), with a mean size of 15 ± 12 mm, 96 % were located in the antrum and 85 % were removed by snare polypectomy. Helicobacter pylori infection was identified in 48 % of the polyps. Most inflammatory fibroid polyps developed in the submucosa, and mucosal extension was observed in 96 % of the cases. Chronic gastritis was observed in all cases (63 % with activity, 31 % with intestinal metaplasia, and 61 % with foveolar hyperplasia). Erosion and ulceration of the overlying gastric mucosa was observed in 48 % and 11 % of the polyps, respectively. Onion skin features were present in 52 % of the polyps and were more frequently observed in cases without evidence of Helicobacter pylori infection. Background changes in gastric mucosa were not distinctive according to Helicobacter pylori infection. Chronic atrophic gastritis with intestinal metaplasia was associated with the presence of perivascular onion skin lesions. To our knowledge, this is the second largest series of gastric inflammatory fibroid polyps. Helicobacter pylori infection was

  6. Research Progress on Helicobacter Pylori Resistance Mechanisms and Sequential Therapy%幽门螺杆菌耐药机制及序贯疗法的研究进展

    Institute of Scientific and Technical Information of China (English)

    孟颖; 王启之

    2011-01-01

    Objective:To provide references for the clinical therapeutics, the resistance mechanism of H. Pylori and sequential therapy research of H. Pylori were reviewed in the paper. Methods: To summarize the resistance mechanisms and the treatment progression of H. Pylori, the literatures in recent years related to H. Pylori in Wanfang ,Weipu and PubMed database have been researched. Results :H. Pylori resistance is mainly related to its gene mutation. The latest H. Pylori eradication program - sequential therapy with fewer adverse reactions, good patients compliance, higher eradication rate and so on have been confirmed in the clinical trials. Conclusions: Different molecular basis of H. Pylori antibiotic resistance remains to be further studied; the latest treatments - sequential therapy is a highly effective eradication program, and has broad prospects for treatment.%目的:总结幽门螺杆菌(H.pylori)耐药机制以及序贯疗法的研究进展,为临床治疗提供参考.方法:在万方、维普、pubmed数据库检索近年内H.pylori耐药机制和序贯疗法的相关文献,总结其耐药机制和治疗进展.结果:H.pylori耐药主要与其发生基因突变有关.而临床试验证实,最新的H.pylori根除方案-序贯疗法具有不良反应少、患者的依从性好、根除率高等特点.结论:H.pylori对不同抗生素耐药的分子基础还有待进一步研究;其最新的治疗方法-序贯疗法是一个高效的根除方案,具有广阔的治疗前景.

  7. Determination of metronidazole in a rat stomach by HPLC for obtaining basic data of the eradication therapy of Helicobacter pylori

    Institute of Scientific and Technical Information of China (English)

    Mai Kubodera; Tadakazu Tokumura; Yoshiharu Machida

    2012-01-01

    In the eradication therapy of Helicobacter pylori changes of antibiotics as these concentrations or amount in the stomach after oral administration were not clear. A simple and accurate method for determining the concentration of metronidazole (MTZ) in homogenate of rat stomach was developed in order to obtain basic data to design a pharmaceutical preparation having targeting ability to the surface of gastric-mucosa. This method included a deproteinization process by methanol, separation with reversed-phase high-performance liquid chromatography, and detection with an ultraviolet wavelength of 370 nm. Regression analysis showed that the method was linear over a standard curve nmge from 5 ug/mL to 2000 g/mL. The inter-day precision and accuracy values between thc ranges were 5.0% or better and -7.5 to 5.2%, respectively. The newly developed method was applied to an analysis of gastric samples after oral administration of MTZ at a dose of 5 mg/kg. It was found that the residual MTZ in the stomach was determined within 5 h after dosing. This method is useful for monitoring MTZ in stomach after its oral administration to rats.

  8. Elderly women who received Helicobacter pylori-eradicating therapy have reduced risk of low skeletal muscle mass

    Directory of Open Access Journals (Sweden)

    Baeg MK

    2015-10-01

    Full Text Available Myong Ki Baeg, Myung-Gyu Choi, Sun-Hye Ko, Chul-Hyun Lim, Jin Su Kim, Yu Kyung Cho, Jae Myung Park, Young-Seok Cho, Bo-In Lee, In-Seok LeeDepartment of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Republic of KoreaBackground: Sarcopenia is associated with adverse outcomes such as physical disability, poorer quality of life, and death. Helicobacter pylori (HP eradication increases ghrelin secretion, which may be a possible treatment for sarcopenia. We investigated whether HP eradication reduces the risk of low muscle mass (LMM, which is an integral component of sarcopenia.Materials and methods: Healthy, asymptomatic women aged ≥60 years who participated in a health screening program were enrolled. Subjects with a history of HP eradication were compared with those who were HP IgG+, but had not received HP-eradicating therapy. Body composition was measured by multifrequency bioelectrical impedance analysis. LMM was defined as body muscle mass 2 standard deviations below the mean muscle mass of healthy women aged 20–39 years from the same program. Multivariable analysis was used to identify sarcopenia risk factors.Results: Three hundred seventy-two women had received HP eradication, while 689 HP IgG+ women had not. The prevalence of LMM was significantly lower in those who received HP eradication (13.7% vs 21.6%, P=0.002. Multivariable analysis identified risk factors for LMM as age, white blood cell count, serum total protein concentration, and the metabolic syndrome. HP eradication (odds ratio: 0.632, 95% confidence interval: 0.440–0.824, P=0.013 was a significant preventive factor, and exercise (odds ratio: 0.710, 95% confidence interval: 0.504–1.002, P=0.051 had a preventive tendency.Conclusion: HP eradication might reduce LMM risk. This finding should be confirmed in prospective longitudinal studies to determine the long-term effects of HP eradication on sarcopenia.Keywords: sarcopenia, Helicobacter

  9. Helicobacter pylori

    OpenAIRE

    BATESON, M

    2000-01-01

    Helicobacter pylori infection is a major cause of peptic ulcer disease, and its detection and eradication are now an important part of gastroenterology. Effective regimes are available which will eliminate the organism in about 90% of cases in developed countries.


Keywords: Helicobacter pylori

  10. One-week dual therapy with ranitidine bismuth citrate and clarithromycin for the treatment of Helicobacter pylori infection in Brazilian patients with peptic ulcer

    Institute of Scientific and Technical Information of China (English)

    Maria Aparecida Mesquita; S(o)nia Letícia Silva Lorena; Jazon Romilson Souza Almeida; Ciro Garcia Montes; Fábio Guerrazzi; Luciana T Campos; José Murilo Rubiota Zeitune

    2005-01-01

    AIM: To assess the efficacy and safety of ranitidine bismuth citrate plus clarithromycin given for 1 wk in Brazilian patients with peptic ulcer.METHODS: One hundred and twenty patients with peptic ulcer were randomized in two treatment groups: (1) 1-wk regimen consisting of ranitidine bismuth citrate 400 mg b.i.d. with clarithromycin 500 mg b.i.d. or (2) 2-wk regimen of the same treatment. Eradication of the infection was considered when both the histologic examination and the urease test were negative for the infection 3 mo after treatment.RESULTS: By intention to treat analysis, Helicobacter pylori (H pylori) was eradicated in 73% and 76% of patients, respectively treated for 1 or 2 wk (P>0.05). By per protocol analysis, the eradication rates were 80% and 83%,respectively, in patients treated for 1 or 2 wk (P>0.05). Nine patients (8.2%) reported minor side effects. CONCLUSION: One-week therapy with ranitidine bismuth citrate and clarithromycin is safe, well tolerated and effective for treatment of H pylori infection, andappears to be comparable to the 2-wk regimen in terms of efficacy.

  11. Omeprazole-based triple therapy with low-versus high-dose of clarithromycin plus amoxicillin for H pylori eradication in Iranian population

    Institute of Scientific and Technical Information of China (English)

    Ali Asghar Keshavarz; Homayoon Bashiri; Mahtab Rahbar

    2007-01-01

    AIM: To investigate the efficacy and tolerability of Hpylori eradication in an omeprazole-based triple therapy with high- and low-dose of clarithromycin and amoxicillin.METHODS: One hundred and sixty H pylori positive patients were randomly assigned to two groups based on the following 2 wk investigation; (1) group A or low-dose regimen received omeprazole 20 mg b.i.d, clarithromycin 250 mg b.i.d and amoxicillin 500 mg b.i.d; and (2) group B or high-dose regimen received omeprazole 20 mg b.i.d, clarithromycin 500 mg b.i.d and amoxicillin 1000 mg b.i.d. During the study H pylori status was assessed by histology and rapid urease test prior and by 13C-urea breath test 6 wk after the therapy. Standard questionnaires were administered to determine the compliance to treatment and possible adverse events of therapy. Data were subject to % to compare the eradication rates in the two groups. The significant level of 95% (P≤0.05) was considered statistically different.RESULTS: We found that the per-protocol eradication rate was 88% (68/77) in group A, and 89% (67/75) in group B. The intension-to-treat eradication rate was 85% (68/80) in group A and 83.75% (67/80) in group B. Overall adverse events were 26% in group A and 31% in group B. The adverse events were generally mild in nature and tolerated well in both groups with a compliance of 98% in group A vs 96% in group B.CONCLUSION: The omeprazole-based low dose regimen of clarithromycin and amoxicillin for two weeks in H pylori eradication is as effective as high dose regimen in Iranian population.

  12. Catechin-based procyanidins from Peumus boldus Mol. aqueous extract inhibit Helicobacter pylori urease and adherence to adenocarcinoma gastric cells.

    Science.gov (United States)

    Pastene, Edgar; Parada, Víctor; Avello, Marcia; Ruiz, Antonieta; García, Apolinaria

    2014-11-01

    In this work, the anti-Helicobacter pylori effect of an aqueous extract from dried leaves of Peumus boldus Mol. (Monimiaceae) was evaluated. This extract displayed high inhibitory activity against H. pylori urease. Therefore, in order to clarify the type of substances responsible for such effect, a bioassay-guided fractionation strategy was carried out. The active compounds in the fractions were characterized through different chromatographic methods (RP-HPLC; HILIC-HPLC). The fraction named F5 (mDP = 7.8) from aqueous extract was the most active against H. pylori urease with an IC50  = 15.9 µg gallic acid equivalents (GAE)/mL. HPLC analysis evidenced that F5 was composed mainly by catechin-derived proanthocyanidins (LC-MS and phloroglucinolysis). The anti-adherent effect of boldo was assessed by co-culture of H. pylori and AGS cells. Both the aqueous extract and F5 showed an anti-adherent effect in a concentration-dependent manner. An 89.3% of inhibition was reached at 2.0 mg GAE/mL of boldo extract. In conjunction, our results suggest that boldo extract has a potent anti-urease activity and anti-adherent effect against H. pylori, properties directly linked with the presence of catechin-derived proanthocyanidins.

  13. Low eradication rate of Helicobacter pylori with triple 7-14 days and quadriple therapy in Turkey

    Institute of Scientific and Technical Information of China (English)

    Yuksel Gumurdulu; Sedat Boyacioglu; Ender Serin; Birol Ozer; Fazilet Kayaselcuk; Kursat Ozsahin; Arif Mansur Cosar; Mlurat Gursoy; Gurden Gur; Ugur Yilmaz

    2004-01-01

    AIM: The eradication rate of Helicobacter pylori(H pylorl)shows variation among countries and regimens of treatment.We aimed to study the eradication rates of different regimens in our region and some factors affecting the rate of eradication.METHODS: One hundred and sixty- four H pylori positive patients (68 males, 96 females; mean age: 48±12 years)with duodenal or gastric ulcer without a smoking history were included in the study. The patients were divided into three groups according to the treatment regimens. Omeprazole 20 mg, clarithromycin 500 mg, amoxicillin 1 g were given twice daily for 1 week (Group I) and 2 weeks (Group II).Patients in Group III Received bismuth subsitrate 300 mg,tetracyline 500 mg and metronidazole 500 mg four times daily in addition to Omeprazole 20 mg twice daily. Two biopsies each before and after treatment were obtained from antrum and corpus, and histopathologically evaluated.Eradication was assumed to be successful if no H pylorus was detected from four biopsy specimens taken after treatment. The effects of factors like age, sex, H pylori density on antrum and corpus before treatment, the total H pylori density, and the inflammation scores on the rate of H pylori eradication were evaluated.RESULTS: The overall eradication rate was 42%. The rates in groups II and III were statistically higher than that in group I (P<0.05). The rates of eradication were 24.5%,40.7% and 61.5% in groups I, II and III, respectively. The eradication rate was negatively related to either corpus H pylori density or total H pylori density (P<0.05). The median age was older in the group in which the eradication failed in comparison to that with successful eradication (55 yr vs 39 yr, P<0.001). No correlation between sex and H pylori eradication was found.CONCLUSION: Our rates of eradication were significantly lower when compared to those reported in literature. We believe that advanced age and high H pylori density are negative predictive factors for

  14. Comparison of Ciprofloxacin-Based Triple Therapy with Conventional Triple Regimen for Helicobacter pylori Eradication in Children.

    Science.gov (United States)

    Farahmand, Fatemeh; Mohammadi, Tayebeh; Najafi, Mehri; Fallahi, Gholamhosein; Khodadad, Ahmad; Motamed, Farzaneh; Mahdi Marashi, Sayed; Shoaran, Maryam; Nabavizadeh Rafsanjani, Raheleh

    2016-06-01

    Helicobacter pylori infection is a prevalent disease among Iranian children. The purpose of this study was to compare the effect of ciprofloxacin and furazolidone on eradicating helicobacter pylori in Iranian children in combination with amoxicillin and omeprazole. In this cohort study, helicobacter pylori infection was confirmed by gastroscopy, rapid urease test or pathologic assessments. A total of 66 children were randomly enrolled; based on the random number table, and were divided into two groups; first, a combination regimen consisting of ciprofloxacin, amoxicillin, and omeprazole; second, a three-medication regimen consisting of amoxicillin, furazolidone, and omeprazole. The effect of both medical regimens on the successful eradication of helicobacter pylori infection was assessed and compared. Chi-square test was used for evaluating the association between quantitative variables. All comparisons were made at the significance of Phelicobacter pylori infection was reported 87.9% (29/33) in the first group (CAO) and 60.6% (20.33) in the second group (FAO) (P=0.011). It appears that a major advantage of our proposed regimen over others is a lack of wide use of fluoroquinolones for treating children's diseases. Given FDA's recommendation about the possibility of prescribing ciprofloxacin for infected patients with multidrug resistance, we can use the regimen proposed in this study in patients with resistance to standard treatments.

  15. HELICOBACTER PYLORI

    Science.gov (United States)

    Helicobacter pylori is a pathogenic bacteria which inhabits the human stomach and upper gastrointestinal tract. This encyclopedic entry summarizes the potential role of this organism as a waterborne pathogen. Information is provided on the physiology and morphology of this bacter...

  16. Helicobacter pylori infection in Chile.

    Science.gov (United States)

    Figueroa, G; Acuña, R; Troncoso, M; Portell, D P; Toledo, M S; Valenzuela, J

    1997-11-01

    This article summarizes studies designed to evaluate the role of Helicobacter pylori infection in Chile, described in 21 reports from nine centers in various Chilean regions published between 1985 and 1995. According to their data, H. pylori infection is quite frequent among patients with a variety of gastric conditions, including adults (43%-92%) and children (6%-100%). Levels of specific IgG antibodies to H. pylori are also elevated among patients with duodenal ulcers (100%) and gastritis (86%) as well as asymptomatic adults (75%). Combination therapy with three (but not two) drugs has been proved effective, with clinical improvement, ulcer cure, and H. pylori eradication occurring in well-controlled studies. Available evidence suggests that antibiotic resistance is not a major problem in treatment. The H. pylori reinfection rate is low (4.2% per year), suggesting that combination therapy with three drugs constitutes a cost-effective alternative for treating colonized symptomatic patients. Concurrent preliminary studies revealed that antibodies to VacA but not CagA proteins correlate with disease severity in Chilean patients. It can be concluded that local research assists local administrators of health resources to implement adequate policies to prevent, control, and treat H. pylori-related pathologies.

  17. Dual therapy for third-line Helicobacter pylori eradication and urea breath test prediction

    Institute of Scientific and Technical Information of China (English)

    Toshihiro Nishizawa; Hidekazu Suzuki; Takama Maekawa; Naohiko Harada; Tatsuya Toyokawa; Toshio Kuwai; Masanori Ohara

    2012-01-01

    We evaluated the efficacy and tolerability of a dual therapy with rabeprazole and amoxicillin (AMX) as an empiric third-line rescue therapy.In patients with failure of first-line treatment with a proton pump inhibitor (PPI)-AMX-clarithromycin regimen and second-line treatment with the PPI-AMX-metronidazole regimen,a third-line eradication regimen with mbeprazole (10 mg q.i.d.) and AMX (500 mg q.i.d.) was prescribed for 2 wk.Eradication was confirmed by the results of the 13C-urea breath test (UBT) at 12 wk after the therapy.A total of 46 patients were included; however,two were lost to followup.The eradication rates as determined by per-protocol and intention-to-treat analyses were 65.9% and 63.0%,respectively.The pretreatment UBT results in the subjects showing eradication failure; those patients showing successful eradication comprised 32.9 ± 28.8 permil and 14.8 ± 12.8 permil,respectively.The pretreatment UBT results in the subjects with eradication failure were significantly higher than those in the patients with successful eradication (P =0.019).A low pretreatment UBT result (≤ 28.5 permil) predicted the success of the eradication therapy with a positive predictive value of 81.3% and a sensitivity of 89.7%.Adverse effects were reported in 18.2% of the patients,mainly diarrhea and stomatitis.Dual therapy with rabeprazole and AMX appears to serve as a potential empirical third-line strategy for patients with low values on pretreatment UBT.

  18. Varioliform gastritis: comparative therapy between patients with and without eradication of Helicobacter pylori%根除幽门螺杆菌前后对痘疹样胃炎治疗效果的比较

    Institute of Scientific and Technical Information of China (English)

    张彦敏; 姜葵; 王邦茂; 章明放; 王锐

    2011-01-01

    目的:评价痘疹样胃炎根除幽门螺杆菌(H.pylori)后的治疗效果以及病理变化情况,明确根除H.pylori对痘疹样胃炎的治疗意义.方法:325例痘疹样胃炎患者根据H.pylori检测结果分为阳性组(标准三联或四联疗法)与阴性组(单纯抑酸),比较治疗效果;阳性组根据复查胃镜H.pylori的结果再分为两组,比较病理情况的改善.结果:H.pylori阳性组总有效率(73.68%)与H.pylori阴性组总有效率(72.50%)差异无统计学意义(P>0.05);H.pylori根除后痘疹样胃炎治疗总有效率优于未根除者,差异有统计学意义(89.02% vs 37.84%,P<0.05);根除H.pylori与否对萎缩性炎症、肠化生、不典型增生的病理改善情况差异有统计学意义(均P<0.05).结论:根除H.pylori对痘疹样胃炎的治疗有显著意义,且能部分逆转肠化生、不典型增生等病理改变.%AIM: To compare the efficacy of therapy of varioliform gastritis between patients with and without eradication of Helicobacter pylori (H.pylon).METHODS: Three hundred and twenty-five patients with varioliform gastritis were divided into two groups: patients with and without H.pylori infection. Patients with H.pylori infection were treated by standard triple or quadruple therapy and simultaneously with H2-recetor blockers or proton pump inhibitors, while those without H.pylori infection were treated simply with H2-recetor blockers or proton pump inhibitors. Treatment efficacy and pathological alterations were compared between patients received H. pylori therapy and those who did not as well as between H.pylori-infected patients with and without eradication of H.pylori.RESULTS: There was no significant difference in the total response rate between patients with and without H.pylori infection (73.68% vs 72.50%,P > 0.05). The total response rate was significantly higher in H. pylori-infected patients with H.pylori eradication than those without H.pylori eradication (89.02% vs 37.84%, P < 0

  19. Pre-treatment urea breath test results predict the efficacy of Helicobacter pylori eradication therapy in patients with active duodenal ulcers

    Institute of Scientific and Technical Information of China (English)

    Yung-Chih Lai; Jyh-Chin Yang; Shih-Hung Huang

    2004-01-01

    AIM: To evaluate the association of pre-treatment 13C-urea breath test (UBT) results with H pyloridensity and efficacy of eradication therapy in patients with active duodenal ulcers.METHODS: One hundred and seventeen consecutive outpatients with active duodenal ulcer and H pyloriinfection were recruited. H pylori density was histologically graded according to the Sydney system. Each patient received lansoprazole (30 mg b.i.d.), clarithromycin (500 mg b.i.d.) and amoxicillin (1 g b.i.d.) for 1 week. According to pre-treatment UBT values, patients were allocated into low (<16%o),intermediate (16-35%o), and high (>35%o) UBT groups.RESULTS: A significant correlation was found between pre-treatment UBT results andHpyloridensity (P<0.001).H pylorieradication rates were 94.9%, 94.4% and 81.6%in the low, intermediate and high UBT groups, respectively (per protocol analysis, P=0.11). When patients were assigned into two groups (UBT results ≤35%o and >35%o),the eradication rates were 94.7% and 81.6%, respectively (P=0.04).CONCLUSION: The intragastric bacterial load of H pylori can be evaluated by UBT, and high pre-treatment UBT results can predict an adverse outcome of eradication therapy.

  20. Lactobacillus plantarum B7 inhibits Helicobacter pylori growth and attenuates gastric inflammation

    Institute of Scientific and Technical Information of China (English)

    Chompoonut Sunanliganon; Duangporn Thong-Ngam; Somying Tumwasorn; Naruemon Klaikeaw

    2012-01-01

    AIM:To determine the anti-Helicobacter property of Lactobacillus plantarum B7 (L.plantarum) B7 supernatants in vitro and the protective effects of L.plantarum B7 on serum tumor necrosis factor-alpha (TNF-α),gastric malondialdehyde (MDA) level,apoptosis,and histopathology in Helicobacter pylori (H.pylorl)-induced gastric inflammation in rats.METHODS:In vitro,the inhibition of H,pylori growth was examined using L.plantarum B7 supernatants at pH 4 and pH 7 and at the concentration of 1×,5× and 10× on plates inoculated with H.pylori.The inhibitory effect of H.pylori was interpreted by the size of the inhibition zone.In vitro,male Sprague-Dawley rats were randomly divided into four groups including group 1 (control group),group 2 (H.pylori infected group),group 3 (H.pylori infected with L.plantarum B7 10é CFUs/mL treated group) and group 4 (H.pylori infected with L.plantarum B7 1010 CFUs/mL treated group).One week after H.pylori inoculation,L.plantarum B7 106 CFUs/mL or 1010 CFUs/mL were fed once daily to group 3 and group 4,respectively,for one week.Blood and gastric samples were collected at the end of the study.RESULTS:In vitro,at intact pH 4,mean inhibitory zone diameters of 8.5 mm and 13 mm were noted at concentrations of 5× and 10× of L.plantarum B7supernatant disks,respectively.At adjusted pH 7,L.plantarum B7 supernatants at concentrations of 5 × and 10× yielded mean inhibitory zone diameters of 6.5 mm and 11 mm,respectively.In the in vitro study,in group 2,stomach histopathology revealed mild to moderate H.pylori colonization and inflammation.The level of gastric MDA and epithelial cell apoptosis were significantly increased compared with group 1.The serum TNF-α level was significant decreased in group 3compared with group 2 (P < 0.05).In addition,L.plantarum B7 treatments resulted in a significant improvement in stomach pathology,and decreased gastric MDA level and apoptotic epithelial cells.CONCLUSION:L.plantarum B7 supernatant inhibits H.pylori

  1. [Helicobacter pylori and Arteriosclerosis].

    Science.gov (United States)

    Matsui, Teruaki

    2011-03-01

    Helicobacter pylori (H. pylori) infection-related diseases are known to include gastritis, gastric and duodenal ulcer, gastric cancer, gastric MALT lymphoma, idiopathic thrombocytopenic purpura, iron-deficient anemia, urticaria, reflux esophagitis, and some lifestyle-related diseases. It is indicated that homocysteine involved with arteriosclerosis induces lifestyle-related diseases. Homocysteine is decomposed to methionine and cysteine (useful substances) in the liver, through the involvement of vitamin B₁₂ (VB₁₂) and folic acid. However, deficiency of VB₁₂ and folic acid induces an increase in unmetabolized homocysteine stimulating active oxygen and promoting arteriosclerosis. VB₁₂ and folic acid are activated by the intrinsic factors of gastric parietal cells and gastric acid. The question of whether homocysteine, as a trigger of arteriosclerosis, was influenced by H. pylori infection was investigated. H. pylori infection induces atrophy of the gastric mucosa, and the function of parietal cells decreases with the atrophy to inactivate its intrinsic factor. The inactivation of the intrinsic factor causes a deficiency of VB₁₂ and folic acid to increase homocysteine's chances of triggering arteriosclerosis. The significance and usefulness of H. pylori eradication therapy was evaluated for its ability to prevent arteriosclerosis that induces lifestyle-related diseases. Persons with positive and negative results of H. pylori infection were divided into a group of those aged 65 years or more (early and late elderly) and a group of those under 65 years of age, and assessed for gastric juice. For twenty-five persons from each group who underwent gastrointestinal endoscopy, the degree of atrophy of the gastric mucosa was observed. Blood homocysteine was measured as a novel index of arteriosclerosis, as well as VB₁₂ and folic acid that affect the metabolism of homocysteine, and then activated by gastric acid and intrinsic factors. Their

  2. Antibacterial activity of Tabebuia impetiginosa Martius ex DC (Taheebo) against Helicobacter pylori.

    Science.gov (United States)

    Park, Byeoung-Soo; Lee, Hyun-Kyung; Lee, Sung-Eun; Piao, Xiang-Lan; Takeoka, Gary R; Wong, Rosalind Y; Ahn, Young-Joon; Kim, Jeong-Han

    2006-04-21

    The growth-inhibiting activity of Tabebuia impetiginosa Martius ex DC dried inner bark-derived constituents against Helicobacter pylori ATCC 43504 was examined using paper disc diffusion and minimum inhibitory concentration (MIC) bioassays. The activity of the isolated compounds was compared to that of the commercially available anti-Helicobacter pylori agents, amoxicillin, metronidazole, and tetracycline. The biologically active components of Tabebuia impetiginosa dried inner bark (taheebo) were characterized by spectroscopic analysis as 2-(hydroxymethyl)anthraquinone, anthraquinone-2-carboxylic acid, and 2-hydroxy-3-(3-methyl-2-butenyl)-1,4-naphthoquinone (lapachol). With the paper disc diffusion assay 2-(hydroxymethyl)anthraquinone exhibited strong activity against Helicobacter pylori ATCC 43504 at 0.01 mg/disc. Anthraquinone-2-carboxylic acid, lapachol and metronidazole were less effective, exhibiting moderate anti-Helicobacter pylori activity at 0.1 mg/disc. Amoxicillin and tetracycline were the most potent compounds tested, displaying very strong activity at 0.005 mg/disc. 2-(Hydroxymethyl)anthraquinone exhibited moderate activity at this dose. Tetracycline still had strong activity at 0.001 mg/disc while amoxicillin had little activity at this dose. In the MIC bioassay, 2-(hydroxymethyl)anthraquinone (2 microg/mL), anthraquinone-2-carboxylic acid (8 microg/mL), and lapachol (4 microg/mL) were more active than metronidazole (32 microg/mL) but less effective than amoxicillin (0.063 microg/mL) and tetracycline (0.5 microg/mL). The anti-Helicobacter pylori activity of seven 1,4-naphthoquinone derivatives (structurally related to lapachol), 1,4-naphthoquinone, 5,8-dihydroxy-1,4-naphthoquinone (naphthazarin), 2-methyl-1,4-naphthoquinone (menadione), 2-hydroxy-1,4-naphthoquinone (lawsone), 5-hydroxy-2-methyl-1,4-naphthoquinone (plumbagin), 5-hydroxy-1,4-naphthoquinone (juglone), and 2,3-dichloro-1,4-naphthoquinone (dichlone) was also evaluated using the paper disc

  3. Helicobacter pylori: Basic Mechanisms to Clinical Cure

    Directory of Open Access Journals (Sweden)

    ABR Thomson

    1995-01-01

    Full Text Available Since its rediscovery 10 years ago, Helicobacter pylori has 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 of H pylori include gastritis, gastric cancer and possible maltomas. Therapy of H pylori infection 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 against H pylori is on the far horizon.

  4. Helicobacter pylori: From Infection to Cure

    Directory of Open Access Journals (Sweden)

    ABR Thomson

    1996-01-01

    Full Text Available Over 380 abstracts, presentations and posters of recent advances were highlighted at the European and International Helicobacter pylori meeting held July 7 to 9, 1995 in Edinburgh, Scotland. New advances abound, with major interest focusing on the simple, safe, inexpensive new `gold standard’ for H pylori eradication therapy: a single week of tid omeprazole 20 mg, metronidazole 400 mg and clarithromycin 250 mg, or omeprazole 20 mg, amoxicillin 1000 mg and clarithromycin 500 mg. To avoid false negative results, two biopsies must be taken from the antrum and two from the gastric body at least four weeks after completion of eradication therapy, and ideally should be supplemented with at least one further H pylori test such as a biopsy for urease activity or culture, or a urea breath test. While most patients with a gastric or duodenal ulcer (DU who do not consume nonsteroidal anti-inflammatory drugs are infected with H pylori, the association is much less apparent in those with a DU who present with an upper gastrointestinal hemorrhage. H pylori eradication for nonulcer dyspepsia is not widely recommended, and the patient with a DU given effective H pylori eradication who presents with dyspepsia likely has erosive esophagitis rather than recurrent DU or H pylori. Gastroenterologists are at increased risk of H pylori infection, particularly older gastroenterologists who are very busy endoscopists.

  5. Helicobacter pylori Test

    Science.gov (United States)

    ... urease test (RUT) for H. pylori Formal name: Helicobacter pylori Related tests: Gastrin At a Glance Test Sample ... else I should know? How is it used? Helicobacter pylori testing is used to diagnose an infection due ...

  6. Age-dependent eradication of Helicobacter pylori in Japanese patients

    Institute of Scientific and Technical Information of China (English)

    Satoshi; Mamori; Akihiro; Higashida; Fumiaki; Kawara; Katsuhiro; Ohnishi; Akihiko; Takeda; Eri; Senda; Cho; Ashida; Hajime; Yamada

    2010-01-01

    AIM:To determine the general risk factors affecting the failure rate of first-line eradication therapy in Japanese patients with Helicobacter pylori(H.pylori)infection.METHODS:The present study enrolled 253 patients who had an H.pylori infection,underwent gastroendoscopy,and were treated with H.pylori eradication therapy.Eradication therapy consisted of 30 mg lansoprazole plus 750 mg amoxicillin and 400 mg clarithromycin twice daily for 7 d.All of the patients underwent a 13 C urea breath test at least 1 mo...

  7. Development of Probiotics Adjuvant Therapy on Infection of Helicobacter Pylori%微生态制剂辅助治疗幽门螺杆菌感染的研究进展

    Institute of Scientific and Technical Information of China (English)

    吕志发; 谢勇

    2013-01-01

    幽门螺杆菌与多种胃肠道疾病相关,如消化性溃疡、慢性胃炎、胃黏膜相关淋巴瘤、胃癌等.目前随着传统三联方案及其他方案的广泛使用,幽门螺杆菌的耐药率越来越高,根除率日益下降.微生态制剂可以通过同幽门螺杆菌竞争结合位点、抑制幽门螺杆菌所致炎症反应、提高黏膜的免疫能力、产生抑制幽门螺杆菌物质、加强黏膜屏障功能等,抑制幽门螺杆菌的生长;同时可以减轻抗幽门螺杆菌治疗方案引起的不良反应,因此可安全地用于幽门螺杆菌感染的辅助治疗.%Helicobacter pylori are closely associated with various gastrointestinal diseases, such as peptic ulcer, chronic gastritis, gastric mucosal - associated lymphatic tissue lymphoma and gastric cancer. Recently, with triple therapy and other eradication regimens being widely used, the Helicobacter pylori resistance rates to antibiotics are getting higher, and the eradication efficacy is decreasing. Probiotics can inhibit the growth of Helicobacter pylori through binding the site in epithelial cells and restraining inflammation reaction induced by Helicobacter pylori, and it can improve the immune ability and barrier of mucosa, and can produce some substances that can inhibit Helicobacter pylori. Probiotics can also decrease the side effects of eradication regimens. Therefore, it can be safely used to adjuvant therapy for eradicating Helicobacter pylori.

  8. Improved Helicobacter pylori Eradication Rate of Tailored Triple Therapy by Adding Lactobacillus delbrueckii and Streptococcus thermophilus in Northeast Region of Thailand: A Prospective Randomized Controlled Clinical Trial

    Directory of Open Access Journals (Sweden)

    Taweesak Tongtawee

    2015-01-01

    Full Text Available Background and Aim. To evaluate the effect of Lactobacillus delbrueckii subsp. bulgaricus and Streptococcus thermophilus to Helicobacter pylori eradication in different periods of therapeutic protocol. Methods. Infected patients were randomized to one-week tailored triple therapy (esomeprazole 20 mg bid, clarithromycin 500 mg bid/metronidazole 400 mg tid if clarithromycin resistant, and amoxicillin 1000 mg bid with placebo (group 1, n=100; one week of pretreatment with probiotics (group 2, n=100; and one week of pretreatment with probiotic followed by one week of the same probiotics after treatment (group 3, n=100. Result. PP analysis involved 292 patients, 98 in group 1, 97 in group 2, and 97 in group 3. Successful eradication was observed in 229 patients; by PP analysis, the eradication rates were significantly higher (P<0.01, 95% CI; 0.71–0.97 in group 2 and group 3 than group 1. ITT analysis eradication rates were significantly higher in group 2 and group 3 than group 1 (P<0.01 95% CI; 0.72–0.87, and there is no significant difference between the three groups (P=0.32 in terms of adverse events. Conclusion. Adding probiotics before or before and after tailored treatment can improve Helicobacter pylori eradication rates. This trial is registered with Thai Clinical Trials Registry number: TCTR20141209001.

  9. Vonoprazan, a novel potassium-competitive acid blocker, as a component of first-line and second-line triple therapy for Helicobacter pylori eradication: a phase III, randomised, double-blind study

    Science.gov (United States)

    Murakami, Kazunari; Sakurai, Yuuichi; Shiino, Madoka; Funao, Nobuo; Nishimura, Akira; Asaka, Masahiro

    2016-01-01

    Objective The objective of this study was to assess the efficacy, safety and tolerability of vonoprazan, a novel potassium-competitive acid blocker, as a component of Helicobacter pylori eradication therapy. Design A randomised, double-blind, multicentre, parallel-group study was conducted to verify the non-inferiority of vonoprazan 20 mg to lansoprazole 30 mg as part of first-line triple therapy (with amoxicillin 750 mg and clarithromycin 200 or 400 mg) in H pylori-positive patients with gastric or duodenal ulcer history. The first 50 patients failing first-line therapy with good compliance also received second-line vonoprazan-based triple therapy (with amoxicillin 750 mg and metronidazole 250 mg) as an open-label treatment. Results Of the 650 subjects randomly allocated to either first-line triple therapy, 641 subjects completed first-line therapy and 50 subjects completed second-line therapy. The first-line eradication rate (primary end point) was 92.6% (95% CI 89.2% to 95.2%) with vonoprazan versus 75.9% (95% CI 70.9% to 80.5%) with lansoprazole, with the difference being 16.7% (95% CI 11.2% to 22.1%) in favour of vonoprazan, thus confirming the non-inferiority of vonoprazan (p<0.0001). The second-line eradication rate (secondary end point) was also high (98.0%; 95% CI 89.4% to 99.9%) in those who received second-line therapy (n=50). Both first-line triple therapies were well tolerated with no notable differences. Second-line triple therapy was also well tolerated. Conclusion Vonoprazan is effective as part of first-line triple therapy and as part of second-line triple therapy in H pylori-positive patients with a history of gastric or duodenal ulcer. Trial registration number NCT01505127. PMID:26935876

  10. The impact of Helicobacter pylori resistance on the efficacy of a short course pantoprazole based triple therapy O impacto da resistência do Helicobacter pylori na eficácia de um esquema tríplice a curto prazo com pantoprazol

    Directory of Open Access Journals (Sweden)

    Jaime Natan Eisig

    2003-03-01

    Full Text Available BACKGROUND: Many of the currently used Helicobacter pylori eradication regimens fail to cure the infection due to either antimicrobial resistance or poor patient compliance. Those patients will remain at risk of developing potentially severe complications of peptic ulcer disease. AIM: We studied the impact of the antimicrobial resistance on the efficacy of a short course pantoprazole based triple therapy in a single-center pilot study. METHODS: Forty previously untreated adult patients (age range 20 to 75 years, 14 males infected with Helicobacter pylori and with inactive or healing duodenal ulcer disease were assigned in this open cohort study to 1 week twice daily treatment with pantoprazole 40 mg, plus clarithromycin 250 mg and metronidazole 400 mg. Helicobacter pylori was assessed at entry and 50 ± 3 days after the end of treatment by rapid urease test, culture and histology of gastric biopsies. The criteria for eradication was a negative result in the tests. Susceptibility of Helicobacter pylori to clarithromycin and metronidazole was determined before treatment with the disk diffusion test. RESULTS: One week treatment and follow up were complete in all patients. Eradication of Helicobacter pylori was achieved in 35/40 patients (87.5% and was higher in patients with nitroimidazole-susceptible strains [susceptible: 20/20 (100%, resistant: 10/15 (67%]. There were six (15% mild adverse events reports. CONCLUSIONS: A short course of pantoprazole-based triple therapy is well tolerated and effective in eradicating Helicobacter pylori. The baseline metronidazole resistance may be a significant limiting factor in treatment success.OBJETIVO: Vários esquemas utilizados na erradicação do Helicobacter pylori falham por resistência ao antibiótico ou por pouca aderência ao tratamento pelo paciente. Esses pacientes permanecerão com alto risco de desenvolver complicações decorrentes da úlcera péptica. Assim, estudou-se o impacto da resist

  11. Clinical Significance of Helicobacter Pylori in Children with Idiopathic Thrombocytopenic Purpura%幽门螺杆菌在儿童特发性血小板减少性紫癜中的临床意义

    Institute of Scientific and Technical Information of China (English)

    唐瑛; 王书春; 王鲁娟; 刘永; 王海英; 王占聚

    2013-01-01

    This study was aimed to investigate the clinic significance of helicobacter pylori (HP) in children with idiopathic thrombocytopenic purpura( ITP). The infection of HP in 92 ITP children was determined by 13C-Urea Breath Test, the same test was also performed on 66 healthy children. The 68 children infected with HP were randomly divided into 2 groups: single drug group treated only with corticosteroid and; combined drug group treated with corticosteroid and anti-helicobacter pylori treatment. The results showed that 68 patients infected with HP were found in 92 ITP children(74. 7% ), 26 patients infected with HP were observed in 66 healthy children (39.4% ), which was lower than that in ITP children (74.7% , P<0.05). After anti-helicobacterpylori therapy, the total effective rate and cure rate of ITP patients increased respectively from 73.5% to 94.1 % , and the total recurrence rate( 17.0% ) was much lower than single drug group( 47. 1% , P < 0. 05). Otherwise, after therapy the platelet count in both two groups increased continuously, and at the same time point, the platelet count in snti-helicobacterium pylori group was higher than that in the single drug group(P < 0. 05). It is concluded that the ITP children have a higher infection rate of HP, which may be involved in the pathogenesis of ITP. Anti-helicobacterium pylori therapy would help to improve the therapeutic efficacy and reduce the recurrence of ITP children.%本研究旨在探讨幽门螺杆菌(helicobacter pylori,HP)在儿童特发性血小板减少性紫癜(ITP)中的临床意义.用13C尿素呼气试验检测92例ITP儿童患者的感染情况,并检测66名健康儿童作为对照组.将ITP患儿中68例阳性者随机分为2组:复合用药治疗组34例,应用糖皮质激素+抗菌治疗;单药治疗组34例,用糖皮质激素治疗.结果表明:ITP患儿HP的感染率为74.7%,明显高于对照组(39.4%)(P<0.05).ITP患儿经治疗后,单药治疗组的总有效率(73.5

  12. Helicobacter pylori and non-malignant diseases.

    Science.gov (United States)

    Furuta, Takahisa; Delchier, Jean-Charles

    2009-09-01

    It is well known that Helicobacter pylori infection is associated with many nonmalignant disorders such as gastritis, peptic ulcer, gastroesophageal reflux disease (GERD), gastric polyp, nonsteroidal anti-inflammatory drug (NSAID)/aspirin-induced gastric injury, and functional dyspepsia. In 2008, interesting articles on the association of H. pylori infection with these disorders were presented, some of which intended to reveal the mechanisms of inter-individual differences in response to H. pylori infection, and have demonstrated that genetic differences in host and bacterial factors as well as environmental factors account for these differences. A decline in the occurrence of peptic ulcer related to H. pylori was confirmed. An inverse relationship between H. pylori infection and GERD was also confirmed but the impact of gastric atrophy on the prevention of GERD remained debatable. For NSAID-induced gastric injury, eradication of H. pylori infection has been recommended. During this year, eradication of H. pylori infection was recommended for patients treated with antiplatelet therapy as well as aspirin and NSAID. It was also reported that for patients with functional dyspepsia, eradication of H. pylori offers a modest but significant benefit.

  13. Helicobacter Pylori and Gastric Cancer: Clinical Aspects

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    Zhi-Qiang Song

    2015-01-01

    Full Text Available Objective: Although Helicobacter pylori (H. pylori is considered as the main etiological factor for gastric cancer, the strategy of screening and treating the oncogenic bacterium is still controversial. The objective was to evaluate the status and progress of the cognition about the relationship between H. pylori infection and gastric cancer from a clinical aspect. Data Sources: The data used in this review were mainly from the PubMed articles published in English from 1984 to 2015. Study Selection: Clinical research articles were selected mainly according to their level of relevance to this topic. Results: Gastric cancer is the fifth most common malignancy and the third leading cause of cancer deaths worldwide. The main etiological factor for gastric cancer is H. pylori infection. About 74.7-89.0% gastric cancer was related to H. pylori infection. Up to date, some regional gastric cancer prevention programs including the detection and treatment of H. pylori infection are under way. Current data obtained from the randomized controlled trials suggest that population-based H. pylori screening and treatment is feasible and cost-effective in preventing gastric cancer; however, a population-based H. pylori eradication campaign would potentially lead to bacterial resistance to the corresponding antibiotics, as well as a negative impact on the normal flora. Conclusions: The important questions of feasibility, program costs, appropriate target groups for intervention, and the potential harm of mass therapy with antibiotics must first be answered before implementing any large-scale program.

  14. Early Development of Refl ux Esophagitis after Successful Helicobacter Pylori Eradication in Superfi cial Gastritis

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    H H Jeon

    2011-10-01

    Full Text Available The relationship between gastroesophageal refl ux disease (GERD and Helicobacter pylori (H. pylori eradication is still debated. Recently, we had a patient of GERD who had developed it shortly after H. pylori eradication therapy. A 72-year-old man was diagnosed by endoscopy as suffering from severe superfi cial gastritis in the stomach body. A rapid urease test showed H. pylori infection. He was then started on proton pump inhibitor (PPI based therapy for two weeks eradicating H.pylori. After completion of H. pylori eradication, he complained of a heart-burn sensation. Follow-up endoscopy showed refl ux esophagitis, of grade B according to the Los Angeles classifi cation. Since the patient had developed GERD after completion of the triple therapy, their suggests that H. pylori eradication must have triggered the development of de novo GERD after a short period of time. Keywords: GERD, Helicobacter pylori, PPI.

  15. Infecciones por helicobacter pylori Helicobacter pylori infections

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    Liliam Alvarez Gil

    1994-02-01

    Full Text Available

    Se revisan los conocimientos sobre el papel de Helicobacter pylori en varias enfermedades gastroduodenales como la gastritis crónica (GC, úlcera gástrica (UG, úlcera duodenal (UD y dispepsia no ulcerosa (DNU. La revisión abarca aspectos históricos, microbiológicos, clínicos, epidemiológicos, diagnósticos de laboratorio, terapéuticos y de patogénesis.

    The current knowledge of the role of Helicobacter Pylori in several gastroduodenal  diseases is reviewed. It includes chronic gastritis, gastric and duodenal ulcers and nonulcerous dyspepsia. The following aspects are treated in this paper: history, microbiology. Clinical presentation, epidemiology, laboratory diagnosis, therapy and pathogenesis.

  16. Eradication of Helicobacter pylori infection.

    Science.gov (United States)

    Wu, Tzung-Shiun; Hu, Huang-Ming; Kuo, Fu-Chen; Kuo, Chao-Hung

    2014-04-01

    Eradication of Helicobacter pylori infection has become an important issue recently, because this bacterial species cluster can cause many gastrointestinal diseases. Elevated antibiotic resistance is related to an increasing failure rate of H. pylori eradication. Standard triple therapy is still the first-line therapy; however, according to the Maastricht IV Consensus Report, it should be abandoned in areas of high clarithromycin resistance. Alternative first-line therapies include bismuth-containing quadruple therapy, sequential, concomitant, and hybrid therapies. Quinolone-based triple therapy may be considered as first-line therapy in areas of clarithromycin resistance >15-20% and quinolone resistance <10%. Unique second-line therapy is still unclear, and bismuth-containing quadruple therapy or levofloxacin-based triple therapy can be used as rescue treatment. Third-line therapy should be under culture guidance to select the most effective regimens (such as levofloxacin-based, rifabutin-based, or furazolidone-based therapies). Antibiotics resistance, patient compliance, and CYP 2C19 genotypes could influence the outcome. Clinicians should use antibiotics according to local reports.

  17. 四联方案和序贯方案根除幽门螺杆菌的临床疗效观察%Observation of Clinical Effect of Quadruple Therapy Versus Sequential Therapy for Helicobacter Pylori Eradication

    Institute of Scientific and Technical Information of China (English)

    伊丽萍

    2015-01-01

    目的比较四联疗法和序贯疗法根除幽门螺杆菌(H.pylori)的疗效及安全性。方法102例幽门螺杆菌阳性的初治患者随机分为两组,四联疗法A组及序贯疗法B组,四联疗法组给予埃索美拉唑20mg+克拉霉素500mg+阿莫西林1000mg+枸橼酸铋钾220mg,均为2次/d,共10d。序贯疗法组前5d给予埃索美拉唑20 mg和阿莫西林1000mg,后5d给予埃索美拉唑20 mg、克拉霉素500 mg和甲硝唑400 mg,均为2次/d口服。根除治疗结束至少4w后复查13C-尿素呼气试验或胃镜,确定H.pylori感染是否根除成功。对H.pylori根除率进行意向治疗(ITT)分析和符合方案(PP)分析比较。结果意向性分析显示四联疗法组及序贯疗法组的Hp根除率分别是86.3%(44/51)、76.4%(39/51)。符合方案分析显示四联疗法组及序贯疗法组的Hp根除率分别是91.7%(44/48)及82.9%(39/47)。意向性分析及符合方案分析表明四联疗法组HP根除率高于序贯疗法组,差异有统计学意义(<0.05)。结论含铋剂四联方案为临床根治Hp的一线治疗方案,序贯方案并未得到更好的根除疗效。%Objective To compare the ef ect and safety of quadruple therapy and sequential therapy for Helicobacter pylori eradication. Methods 102 Helicobacter pylori infected patients were randomized divided into 2 groups. Patients in group A were treated with quadruple regimen, esomeprazole 20mg, clarithromycin 500mg, amoxicil in 1000mg and bismuth potassium citrate 220mg, for 10 days. Patients in group B received sequential regimen, esomeprazole 20mg plus amoxicil in 1000mg for the first 5 days, and fol owed by esomeprazole 20mg, clarithromycin 500mg and metronidazole 400mg for the last 5days.Al drugs were given twice daily. Helicobacter pylori was rechecked by 13C-Urea breath test or endoscopy at least 4 weeks after the eradicative treatment. H.pylori eradication rates were compared with the intention-to-treat(ITT)and per protocol

  18. Treatment of Helicobacter Pylori in Children

    Directory of Open Access Journals (Sweden)

    F Famouri

    2014-04-01

    Full Text Available Childrenwith Helicobacter infection need treatment. The aim of treatment is elimination of H.Pylori. Most patients with this infection are asymptomatic and without peptic disease. Treatment and management of these patients are controversy. Conventional Treatment: The best treatment for H. pylori eradication regimens should have cure rates of at least 80%, be without major side effects, and induce minimal bacterial resistance. Antibiotics alone have not achieved this. Luminal acidity influences both the effectiveness of some antimicrobial agents and the survival of the bacteri; thus antibiotics have been combined with acid suppression such as proton pump inhibitors (PPIs, bismuth, or H2 antagonists. The “classic” regimen is treatment twice daily for 7 days with a PPI and clarithromycin plus either amoxicillin or metronidazole Bismuth has been used in the treatment of peptic ulcer disease and 1 part o quadruple therapy for H.Pylori but compliance of children for it is low.   Sequential Therapy  Sequential therapyinvolves dual therapy with a PPI and amoxicillin for 5 days followed sequentially by clarithromycin, Tinidazole and omeperazole for 5 days or other triple therapy for 7 days. This treatment has had 97% efficacy.   Adjunctive Therapies A number of studies have showed the potential benefits of probiotic therapy in H. pylori treatment regimens.Consumption of these drugs accompanied with other medications increase H.Pylori eradication.    

  19. H pylori: Treatment for the patient only or the whole family?

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    AIM: To compare the effects of treatment of H pyIori infected individuals with the effects of treatment of individuals as well as all HpyIori-infected family members. METHODS: H pylori-positive patients with similar demographic specifications were prospectively randomized with respect to treatment, with a triple regimen of either patients and all H pylori-positive family members living together (group) or patients only (group ).Nine months after treatment, all patients were assessed for H pylori positivity. RESULTS: There were 70 H pylori-positive patients in each group; patients in groups and lived with 175and 190 H pylori-positive relatives, respectively. Age, sex and H pylori positivity rate were similar in both groups of relatives. Nine months after 14 d standard triple therapy, H pylori positivity was 7.1% in group patients and 38.6% in group patients [P < 0.01,OR = 8.61 95%confidence interval (CI):2.91-22.84=. CONCLUSION: The present results indicate bad environmental hygienic conditions and close intra-familial relationships are important in H pylori contamination. These findings indicate all family members of H pylori positive individuals should be assessed for H pylori positivity, particularly in developing countries where H pylori prevalence is high; they also suggest patients, their spouses and all H pylori-positive family members of H pylori-positive individuals should be treated for H pylori infection.

  20. Treatment of Helicobacter pylori infection 2011.

    LENUS (Irish Health Repository)

    O'Connor, Anthony

    2012-02-01

    This article reviews the literature published pertaining to Helicobacter pylori eradication over the last year. The general perception among clinicians and academics engaged in research on H. pylori has been that eradication rates for first-line therapies are falling, although some data published this year have cast doubt on this. The studies published this year have therefore focussed on developing alternative strategies for the first-line eradication of H. pylori. In this regard, clear evidence now exists that both levofloxacin and bismuth are viable options for first-line therapy. The sequential and "concomitant" regimes have also been studied in new settings and may have a role in future algorithms also. In addition, data have emerged that the probiotic Saccharomyces boulardii may be a useful adjunct to antibiotic therapy. Other studies promote individualized therapies based on host polymorphisms, age, and other such demographic factors.

  1. Cost Effectiveness Analysis of the Treatment of Helicobacter Pylori Infection by Triple Therapy%拉唑类三联疗法治疗幽门螺杆菌感染的成本-效果分析

    Institute of Scientific and Technical Information of China (English)

    孙洁; 鲁逊艳

    2015-01-01

    目的:探讨拉唑类三联疗法治疗幽门螺杆菌感染的成本-效果。方法选择我院收治的196例Hp感染消化道溃疡患者随机分为RAC组、OAC组和LAC组,对比三组临床疗效。结果三组Hp根除率和临床症状改善情况对比无明显的统计学差异(P>0.05)。结论幽门螺杆菌感染患者接受拉唑类三联疗法治疗效果显著。%Objective To explore the cost-effectiveness of triple therapy for helicobacter pylori infection. Methods 196 patients with Hp infection in our hospital were randomly divided into RAC group, OAC group and LAC group, the clinical efficacy of the three groups were compared.Results There was no signiifcant difference between the three groups in Hp eradication rate and clinical symptom improvement (P>0.05). Conclusion The treatment effect of the triple therapy combined with helicobacter pylori infection in patients with helicobacter pylori infection can be promoted signiifcantly.

  2. H. pylori Infection

    Science.gov (United States)

    ... think you may have a high risk of stomach cancer, talk to your doctor. Together you can decide whether you may benefit from H. pylori screening. References H. pylori and peptic ulcers. National Institute ...

  3. Helicobacter pylori and Gastrointestinal Malignancies.

    Science.gov (United States)

    Venerito, Marino; Vasapolli, Riccardo; Rokkas, Theodoros; Malfertheiner, Peter

    2015-09-01

    Helicobacter pylori infection is the principal trigger of gastric carcinogenesis and gastric cancer (GC) and remains the third leading cause of cancer-related death in both sexes worldwide. In a big Japanese study, the risk of developing GC in patients with peptic ulcer disease who received H. pylori eradication therapy and annual endoscopic surveillance for a mean of 9.9 years was significantly lower after successful eradication therapy compared to the group with persistent infection (0.21%/year and 0.45%/year, respectively, p = .049). According to a recent meta-analysis, H. pylori eradication is insufficient in GC risk reduction in subjects with advanced precancerous conditions (i.e., intestinal metaplasia and dysplasia). A microsimulation model suggested screening smokers over the age of 50 in the U.S. for serum pepsinogens. This would allow to detect advanced gastric atrophy with endoscopic follow-up of subjects testing positive as a cost-effective strategy to reduce GC mortality. In a Taiwanese study, the anti-H. pylori IgG-based test-and-treat program had lower incremental cost-effectiveness ratios than that with (13)C-urea breath test in both sexes to prevent GC whereas expected years of life lost for GC were higher and the incremental cost-effectiveness ratios of test-and-treat programs were more cost-effective in young adults (30-69 years old) than in elders (>70 years old). With respect to gastrointestinal malignancies other than GC, a meta-analysis confirmed the inverse association between H. pylori infection and esophageal adenocarcinoma. In a Finnish study, H. pylori seropositivity was associated with an increased risk of biliary tract cancers (multivariate adjusted OR 2.63; 95% CI: 1.08-6.37), another meta-analysis showed a slightly increased rate of pancreatic cancer in patients with CagA-negative strains (OR: 1.30; 95% CI: 1.02-1.65), whereas current data suggest that the association between H. pylori and colorectal neoplasms may be population

  4. [Expanded indication of National Health Insurance for H. pylori associated gastritis].

    Science.gov (United States)

    Kato, Mototsugu

    2014-05-01

    Since National Health Insurance covered eradication therapy for H. pylori infected gastritis, all patients with H. pylori infection could be received eradication under insurance. Cure of H. pylori infection improves histological gastritis, also atrophic change, and intestinal metaplasia. Prevention of H. pylori associated diseases such as gastric cancer is expected. According to Insurance instruction, it is carried out in order of endoscopic diagnosis of chronic gastritis, diagnosis of H. pylori infection, and eradication treatment. Endoscopic examination prior to H. pylori diagnosis is necessary for screening of gastric cancer. Endoscopic finding of RAC (regular arrangement of collecting venules) in the angle of stomach suggests lack of infection with H. pylori, disappearance of RAC suspects H. pylori infection.

  5. Helicobacter pylori and non-malignant upper gastrointestinal diseases.

    Science.gov (United States)

    Vasapolli, Riccardo; Malfertheiner, Peter; Kandulski, Arne

    2016-09-01

    Peptic ulcer disease (PUD) has been further decreased over the last decades along with decreasing prevalence of Helicobacter pylori-associated PUD. A delayed H. pylori eradication has been associated with an increased risk of rehospitalization for complicated recurrent peptic ulcer and reemphasized the importance of eradication especially in patients with peptic ulcer bleeding (PUB). PUB associated with NSAID/aspirin intake and H. pylori revealed an additive interaction in gastric pathophysiology which favors the "test-and-treat" strategy for H. pylori in patients with specific risk factors. The H. pylori-negative and NSAID-negative "idiopathic PUD" have been increasingly observed and associated with slower healing tendency, higher risk of recurrence, and greater mortality. Helicobacter pylori-associated dyspepsia has been further investigated and finally defined by the Kyoto consensus. Helicobacter pylori eradication therapy is advised as first option in this group of patients. Only in the case of symptom persistence or recurrence after eradication therapy, dyspeptic patients should be classified as functional dyspepsia (FD). There were few new data in 2015 on the role of H. pylori infection in gastroesophageal reflux disease (GERD), and in particular Barrett's esophagus. A lower prevalence of gastric atrophy with less acid output in patients with erosive esophagitis confirmed previous findings. In patients with erosive esophagitis, no difference was observed in healing rates neither between H. pylori-positive and H. pylori-negative patients nor between patients that underwent eradication therapy compared to patients without eradication. These findings are in line with the current consensus guidelines concluding that H. pylori eradication has no effects on symptoms and does not aggravate preexisting GERD.

  6. Helicobacter Pylori Infections

    Science.gov (United States)

    Helicobacter pylori (H. pylori) is a type of bacteria that causes infection in the stomach. It is found in about two-thirds of ... or stool to see if it contains H. pylori. The best treatment is a combination of antibiotics ...

  7. Gene expression of ornithine decarboxylase, cyclooxygenase-2, and gastrin in atrophic gastric mucosa infected with Helicobacter pylori before and after eradication therapy.

    Science.gov (United States)

    Konturek, Peter C; Rembiasz, Kazimierz; Konturek, Stanislaw J; Stachura, Jerzy; Bielanski, Wladyslaw; Galuschka, K; Karcz, Danuta; Hahn, Eckhart G

    2003-01-01

    H. pylori (Hp) -induced atrophic gastritis is a well-known risk factor for the development of gastric cancer. Whether Hp eradication can prevent or retard the progress of atrophy and metaplasia has been the topic of numerous studies but the subject remains controversial. Recently, the increased expression of ornithine decarboxylase (ODC), gastrin and cyclooxygenase (COX)-2 has been shown to be increased in premalignant lesions in gastric mucosa and to play an essential role in the malignant transformation. The aim of the study is to assess the effect of eradication therapy on atrophic gastritis and analyze the gene expression for ODC, COX-2 and gastrin in gastric mucosa after succesful eradication in patients with atrophic gastritis. Twenty patients with chronic atrophic gastritis including both corpus and antrum of the stomach were included in this study. Four antral mucosal biopsy specimens were obtained from antrum and four from corpus. The histopathologic evaluation of gastritis was based on Sydney classification of gastritis. All patients were Hp positive based on the [13C] urea breath test (UBT) and the presence of anti-Hp IgG and anti-CagA-antibodies detected by ELISA. The patients were then eradicated with triple therapy consiting of omeprazol (2 x 20 mg), amoxycillin (2 x 1 g) and clarithromycin (2 x 500 mg) for seven days and vitamin C 1 g/day for three months. In gastric mucosal samples obtained from the antrum and corpus before and after eradication, the mRNA expression for ODC, COX-2, and gastrin was assessed by reverse-transcription polymerase chain reaction (RT-PCR). In all patients the gastric secretory analysis was performed by measuring gastric acid output and serum gastrin levels. After triple therapy the successful eradication assessed by UBT was observed in 95% of patients. In 45% of patients the infection with CagA-positive Hp strain was observed. Three months after eradication a significant reduction in the gastric activity (neutrophilic

  8. Efficacy of 1st-line bismuth-containing quadruple therapies with levofloxacin or clarithromycin for the eradication of Helicobacter pylori infection

    Science.gov (United States)

    Su, Jing; Zhou, Xiaoying; Chen, Han; Hao, Bo; Zhang, Weifeng; Zhang, Guoxin

    2017-01-01

    Abstract Background: The aim of the present open-label, randomized control trial was to determine the clinical efficacy and safety of two 1-week bismuth-containing quadruple regimens and 1 levofloxacin-based triple regimen for the eradication of Helicobacter pylori infection in treatment-naive patients. The influence of susceptibility and host CYP2C19 polymorphisms on the efficacy was also evaluated. Methods: Eligible patients were randomly to receive esomeprazole and colloidal bismuth pectin along with clarithromycin and amoxicillin (EBCA), esomeprazole and colloidal bismuth pectin along with levofloxacin and amoxicillin (EBLA), or esomeprazole along levofloxacin and amoxicillin (ELA) for 1 week. The primary outcome was the eradication rate in the intention-to-treat (ITT) and per-protocol (PP) analyses. Results: Overall, 270 patients were randomized. The eradication rates in the above 3 groups were 80.25%, 89.66%, and 81.93% in PP analysis and 72.22%, 86.66%, and 75.56% in ITT analysis, respectively. The eradication rate of EBLA was significantly higher than that of EBCA (P = 0.016) in ITT analysis. No significant differences were found among these groups in terms of adverse effects and compliance. The efficacy was significantly affected by levofloxacin resistance for EBLA (P = 0.01) and ELA (P = 0.04), but not by polymorphisms of CYP2C19 gene for any of the 3 groups. Conclusion: All 1-week bismuth-containing quadruple therapies and levofloxacin-based triple therapy can obtain an acceptable eradication rate, and levofloxacin-based quadruple regimen exhibits the highest eradication rate. The antibiotic resistant rate of levofloxacin was associated with the eradication rate. PMID:28207505

  9. A randomized controlled comparison of three quadruple therapy regimens in a population with low Helicobacter pylori eradication rates

    NARCIS (Netherlands)

    Sotudehmanesh, Rasool; Malekzadeh, Reza; Fazel, Ali; Massarrat, Sadegh; Ziad-Alizadeh, Behrooz; Eshraghian, Mohammed Reza

    2001-01-01

    Background and Aim: We sought to compare the efficacy and tolerability of an omeprazole/clarithromycin/bismuth/tetracycline-based quadruple therapy to that of a ranitidine/metronidazole/bismuth/tetracycline-based quadruple therapy of 2 or 3 weeks duration in a population with a high prevalence of me

  10. Recombinant Helicobacter pylori catalase

    Institute of Scientific and Technical Information of China (English)

    Yang Bai; Ya-Li Zhang; Jian-Feng Jin; Ji-De Wang; Zhao-Shan Zhang

    2003-01-01

    AIM: To construct a recombinant strain which highly expresses catalase of Helicobacter pylori(H.pylori) and assay the activity of H. pylori catalase.METHODS: The catalase DNA was amplified from H. pylori chromosomal DNA with PCR techniques and inserted into the prokaryotie expression vector pET-22b (+), and then was transformed into the BL21 (DE3) E. coli strain which expressed catalase recombinant protein. The activity of H.pylori catalase was assayed by the Beers & Sizers.RESULTS: DNA sequence analysis showed that the sequence of catalase DNA was the same as GenBank's research. The catalase recombinant protein amounted to 24.4 % of the total bacterial protein after induced with IPTG for 3 hours at 37 ℃ and the activity of H. pylori catalase was high in the BL21 (DE3) E. coli strain.CONCLUSION: A clone expressing high activity H. pylori catalase is obtained, laying a good foundation for further studies.

  11. Antibiotic treatment for Helicobacter pylori : Is the end coming?

    Institute of Scientific and Technical Information of China (English)

    Su; Young; Kim; Duck; Joo; Choi; Jun-Won; Chung

    2015-01-01

    Infection with the Gram-negative pathogen Helicobacter pylori(H. pylori) has been associated with gastroduodenal disease and the importance of H. pylori eradication is underscored by its designation as a groupI carcinogen. The standard triple therapy consists of a proton pump inhibitor, amoxicillin and clarithromycin, although many other regimens are used, including quadruple, sequential and concomitant therapy regimens supplemented with metronidazole, clarithromycin and levofloxacin. Despite these efforts, current therapeutic regimens lack efficacy in eradication due to antibiotic resistance, drug compliance and antibiotic degradation by the acidic stomach environment. Antibiotic resistance to clarithromycin and metronidazole is particularly problematic and several approaches have been proposed to overcome this issue, such as complementary probiotic therapy with Lactobacil us. Other studies have identified novel molecules with an anti-H. pylori effect, as well as tailored therapy and nanotechnology as viable alternative eradication strategies. This review discusses current antibiotic therapy for H. pylori infections, limitations of this type of therapy and predicts the availability of newly developed therapies for H. pylori eradication.

  12. Clinical relevance of Helicobacter pylori vacA and cagA genotypes in gastric carcinoma.

    Science.gov (United States)

    Ferreira, Rui M; Machado, José C; Figueiredo, Ceu

    2014-12-01

    Helicobacter pylori infection is the major etiological factor of gastric carcinoma. This disease is the result of a long, multistep, and multifactorial process, which occurs only in a small proportion of patients infected with H. pylori. Gastric carcinoma development is influenced by host genetic susceptibility factors, environmental factors, and H. pylori virulence. H. pylori is genetically highly variable, and variability that affects H. pylori virulence factors may be useful to identify strains with different degrees of pathogenicity. This review will focus on VacA and CagA that have polymorphic regions that impact their functional properties. The characterization of H. pylori vacA and cagA-associated could be useful for identifying patients at highest risk of disease, who could be offered H. pylori eradication therapy and who could be included in programs of more intensive surveillance in an attempt to reduce gastric carcinoma incidence.

  13. Helicobacter pylori:Effect of coexisting diseases and update on treatment regimens

    Institute of Scientific and Technical Information of China (English)

    Shen-Shong; Chang; Hsiao-Yun; Hu

    2015-01-01

    The presence of concomitant diseases is an independentpredictive factor for non-Helicobacter pylori(H. pylori) peptic ulcers. Patients contracting concomitant diseases have an increased risk of developing ulcer disease through pathogenic mechanisms distinct from those of H. pylori infections. Factors other than H. pylori seem critical in peptic ulcer recurrence in end stage renal disease(ESRD) and cirrhotic patients. However, early H. pylori eradication is associated with a reduced risk of recurrent complicated peptic ulcers in patients with ESRD and liver cirrhosis. Resistances to triple therapy are currently detected using culture-based and molecular methods. Culture susceptibility testing before first- or second-line therapy is unadvisable. Using highly effective empiric first-line and rescue regimens can yield acceptable results. Sequential therapy has been included in a recent consensus report as a valid first-line option for eradicating H. pylori in geographic regions with high clarithromycin resistance. Two novel eradication regimens, namely concomitant and hybrid therapy, have proven more effective in patients with dual-(clarithromycin- and metronidazole-) resistant H. pylori strains. We aim to review the prevalence of and eradication therapy for H. pylori infection in patients with ESRD and cirrhosis. Moreover, we summarized the updated H. pylori eradication regimens.

  14. Helicobacter Pylori and Gastric Cancer: Clinical Aspects

    Institute of Scientific and Technical Information of China (English)

    Zhi-Qiang Song; Li-Ya Zhou

    2015-01-01

    Objective: Although Helicobacterpylori (H.pylori) is considered as the main etiological factor for gastric cancer, the strategy of screening and treating the oncogenic bacterium is still controversial.The objective was to evaluate the status and progress of the cognition about the relationship between H.pylori infection and gastric cancer from a clinical aspect.Data Sources: The data used in this review were mainly from the PubMed articles published in English from 1984 to 2015.Study Selection: Clinical research articles were selected mainly according to their level of relevance to this topic.Results: Gastric cancer is the fifth most common malignancy and the third leading cause of cancer deaths worldwide.The main etiological factor for gastric cancer is H.pylori infection.About 74.7-89.0% gastric cancer was related to H.pylori infection.Up to date, some regional gastric cancer prevention programs including the detection and treatment of H.pylori infection are under way.Current data obtained from the randomized controlled trials suggest that population-based H.pylori screening and treatment is feasible and cost-effective in preventing gastric cancer;however, a population-based H.pylori eradication campaign would potentially lead to bacterial resistance to the corresponding antibiotics, as well as a negative impact on the normal flora.Conclusions: The important questions of feasibility, program costs, appropriate target groups for intervention, and the potential harm of mass therapy with antibiotics must first be answered before implementing any large-scale program.

  15. Differences in the Antigens of Helicobacter pylori Strains Influence on the Innate Immune Response in the In Vitro Experiments

    Directory of Open Access Journals (Sweden)

    Miha Skvarc

    2014-01-01

    Full Text Available The immune response to Helicobacter pylori importantly determines the pathogenesis of infection as well as the success of antibiotic eradication of the bacteria. Strains of H. pylori were gathered from 14 patients who failed to eradicate H. pylori infection with antibiotics—therapy resistant strains (TRS—or from patients who were able to eradicate H. pylori infection—therapy susceptible strains (TSS. The THP-1 cells were stimulated with H. pylori antigens. Cathepsin X expression on THP-1 cells and concentration of cytokines in the supernatant of THP-1 cells were measured with a flow cytometer. TSS H. pylori antigens increased the proportion of cathepsin X positive cells compared to TRS H. pylori antigens. TSS H. pylori antigens induced higher secretion of IL-12 and IL-6 compared to TRS H. pylori antigens (P<0.001; 0.02. Polymyxin B, a lipid A inhibitor, lowered the secretion of IL-12 and IL-6 in TRS and TSS. We demonstrated a H. pylori strain-dependent cathepsin X and cytokine expression that can be associated with H. pylori resistance to eradication due to lack of effective immune response. Differences in lipid A of H. pylori might have an influence on the insufficient immune response, especially on phagocytosis.

  16. Efficacy of triple therapy with a proton pump inhibitor, levofloxacin, and amoxicillin as first-line treatment to eradicate Helicobacter pylori Eficacia de una triple terapia con un inhibidor de la bomba de protones, levofloxacino y amoxicilina, como primer tratamiento, en la erradicación de Helicobacter pylori

    Directory of Open Access Journals (Sweden)

    M. Castro-Fernández

    2009-06-01

    Full Text Available Background: triple therapy including a proton pump inhibitor, clarithromycin, and amoxicillin (PPI-CA is the first-choice treatment used for H. pylori eradication. The efficacy of this treatment is declining of late, and alternative therapies are currently under evaluation. Objectives: to evaluate the efficacy, safety and compliance of a triple therapy with a PPI, amoxicillin and levofloxacin (PPI-LA - replacing clarithromycin - for the eradication of H. pylori. Methods: the study included 135 patients (65% women, mean age 53 years, with dyspeptic symptoms and H. pylori infection proven by a positive urease rapid test, histological analysis, or C13-urea breath test. Diagnosis: non-investigated dyspepsia 48.9%, functional dyspepsia 36.3%, and ulcerative dyspepsia 14.8%. Treatment was indicated with a proton pump inhibitor at usual doses, amoxicillin 1 g, and levofloxacin 500 mg, administered jointly during breakfast and dinner for 10 days. We studied the performance of this triple therapy and its effects using a questionnaire, and effectiveness by the negativity of the C13-urea breath test after 6-8 weeks after treatment discontinuation. Per protocol, we compared the effectiveness of PPI-LA with a control group of 270 patients treated with PPI-CA for 10 days. Results: 130 patients (96.2% could complete the treatment and follow-up protocol. Effectiveness (intention to treat was 71.8% (97/135 and 74.6% (per protocol (97/130. Sixteen patients (11.8% had well-tolerated adverse effects, except for 5 subjects (3.7% who dropped out. PPI-CA was effective (per protocol in 204 patients out of 270 (75.5% in the control group. Conclusions: triple therapy with a PPI, amoxicillin and levofloxacin for 10 days is a well-tolerated treatment that is easy to comply with; however it has low efficiency - less than 80% - and is not recommended as a first-choice treatment for H. pylori eradication. Similar results were obtained with the classic triple therapy using a

  17. Clarithromycin vs. furazolidone in quadruple therapy regimens for the treatment of Helicobacter pylori in a population with a high metronidazole resistance rate

    NARCIS (Netherlands)

    Fakheri, H; Malekzadeh, R; Merat, S; Khatibian, M; Fazel, A; Alizadeh, BZ; Massarrat, S

    2001-01-01

    Background: The eradication of Helicobacter pylori plays a pivotal role in the treatment of peptic ulcer disease. Metronidazole resistance, common in Iran, is claimed to be a major reason for the failure of metronidazole-containing regimens. Both clarithromycin and furazolidone are potential alterna

  18. Role of gastritis pattern on Helicobacter pylori eradication.

    Science.gov (United States)

    Zullo, Angelo; Severi, Carola; Vannella, Lucy; Hassan, Cesare; Sbrozzi-Vanni, Andrea; Annibale, Bruno

    2012-12-01

    Helicobacter pylori eradication rate following standard triple therapy is decreasing. Identification of predictive factors of therapy success would be useful for H. pylori management in clinical practice. This study aimed to evaluate the role of different gastritis patterns on the efficacy of the currently suggested 14-day triple therapy regimen. One-hundred and seventeen, consecutive, non-ulcer dyspeptic patients, with H. pylori infection diagnosed at endoscopy, were enrolled. All patients received a 14-day, triple therapy with lansoprazole 30 mg, clarithromycin 500 mg and amoxicillin 1 g, all given twice daily. Bacterial eradication was assessed with (13)C-urea breath test 4-6 weeks after completion of therapy. H. pylori infection was cured in 70.1% at ITT analysis and 83.7% at PP analysis. The eradication rate tended to be lower in patients with corpus-predominant gastritis as compared to those with antral-predominant gastritis at both ITT (66.1 vs 74.5%) and PP (80.4 vs 87.2%) analyses. The multivariate analysis failed to identify factors associated with therapy success. However, 14-day triple therapy does not achieve acceptable H. pylori cure rate in Italy, and should be not recommended in clinical practice.

  19. Treatment of Helicobacter pylori

    Institute of Scientific and Technical Information of China (English)

    Adam Harris

    2001-01-01

    @@ INTRODUCTION Using an evidence-based approach this review discusses the current treatment of Helicobacter pylori infection in patients with peptic ulcer disease, functional (non-ulcer)dyspepsia or gastro-oesophageal reflux disease (GORD).It also briefly addresses the potential role of eradication of H . pylori in preventing gastric cancer .

  20. Treatment of Helicobacter pylori infection.

    LENUS (Irish Health Repository)

    O'Connor, Anthony

    2012-02-01

    This article aims to examine current best practice in the field reference to first-line, second-line, rescue and emerging treatment regimens for Helicobacter pylori eradication. The recommended first-line treatment in published guidelines in Europe and North American is proton pump inhibitor combined with amoxicillin and clarithromycin being the favoured regimen. Rates of eradication with this regimen however are falling alarmingly due to a combination of antibiotic resistance and poor compliance with therapy. Bismuth based quadruple therapies and levofloxacin based regimes have been shown to be effective second line regimens. Third-line options include regimes based on rifabutin or furazolidone, but susceptibility testing is the most rational option here, but is currently not used widely enough. Sequential therapy is promising but needs further study and validation outside of Italy. Although the success of first line treatments is falling, if compliance is good and a clear treatment paradigm adhered to, almost universal eradication rates can still be achieved. If compliance is not achievable, the problem of antibiotic resistance will continue to beset any combination of drugs used for H. pylori eradication.

  1. 三种抗幽门螺杆菌法治疗复发性口腔溃疡的疗效观察%Effects of three anti-Helicobacter pyloritreatments to recurrent oral ulcer

    Institute of Scientific and Technical Information of China (English)

    唐金菊; 杨永进; 李广

    2014-01-01

    目的:探讨三种抗幽门螺杆菌法治疗复发性口腔溃疡(ROU)的疗效。方法选择幽门螺杆菌唾液测试板(HPS)检测阳性的ROU患者159例,分为A、B、C三组,各组处理措施为:A组:复方氯己定含漱液含漱;B组:A组处理方法+牙周洁治;C组:B组处理方法+三联药物(枸橼酸泌钾颗粒、克拉霉素片、替硝唑片);观察三组患者的治疗期疗效和治疗后3个月疗效。结果三组患者平均溃疡期、疼痛指数和间歇期均有统计学差异(P<0.05),其中C组改善最明显;总溃疡数组间无统计学差异(P>0.05)。结论联合使用含漱液、牙周洁治和三联药物治疗HPS阳性ROU有明显疗效,提示ROU和幽门螺杆菌可能有关。%ObjectiveTo investigate the effects of three anti-H.pylori treatments to recurrent oral ulcer(ROU).Methods159 ROU patients tested positive using H.pylori Saliva Test Cassette (HPS) were collected and divided into group A, B, C. Treatment measures were as follows: group A: compound chlorhexidine gargle; group B: A+periodontal scaling; group C: B+triple-drug (potassium citrate secretion granules, clarithromycin tablets, tinidazole tablets).Results The duration, pain and interval of ulcers of three groups' patients were different (P0.05).Conclusion The combined treatment effect of gargle, periodontal scaling and triple drug therapy for HPS positive ROU patients is significant effect, suggesting ROU and H. pylori may have a relationship.

  2. Factors affecting Helicobacter pylori eradication using a seven-day triple therapy with a proton pump inhibitor, tinidazole and clarithromycin, in brazilian patients with peptic ulcer Fatores que afetam a erradicação do Helicobacter pylori usando um tratamento triplo de sete dias com um inibidor de bomba de prótons associado ao tinidazol e a claritromicina, em pacientes brasileiros com úlcera péptica

    Directory of Open Access Journals (Sweden)

    Fernando Marcuz Silva

    2001-01-01

    Full Text Available Triple therapy is accepted as the treatment of choice for H. pylori eradication. In industrialized countries, a proton pump inhibitor plus clarithromycin and amoxicillin or nitroimidazole have shown the best results. Our aims were: 1. To study the eradication rate of the association of a proton pump inhibitor plus tinidazole and clarithromycin on H. pylori infection in our population. 2. To determine if previous treatments, gender, age, tobacco, alcohol use, and non-steroidal anti-inflammatory drugs (NSAIDs change the response to therapy. METHODS: Two hundred patients with peptic ulcer (upper endoscopy and H. pylori infection (histology and rapid urease test - RUT were included. A proton pump inhibitor (lansoprazole 30 mg or omeprazole 20 mg, tinidazole 500 mg, and clarithromycin 250 mg were dispensed twice a day for a seven-day period. Eradication was assessed after 10 to 12 weeks of treatment through histology and RUT. RESULTS: The eradication rate of H. pylori per protocol was 65% (128/196 patients. This rate was 53% for previously treated patients, rising to 76% for not previously treated patients, with a statistical difference pO esquema tríplice tem sido demonstrado como sendo o melhor tratamento para a erradicação do Helicobacter pylori. Nos países industrializados o uso de um inibidor de bomba de prótons associado a claritromicina e a amoxicilina ou a um nitroimidazólico, tem proporcionado os melhores resultados. Objetivamos estudar na nossa população a taxa de erradicação do H. pylori para a associação de um inibidor de bomba de prótons com o tinidazol e a claritromicina e determinar se a resposta ao tratamento é influenciada pelo tratamento prévio, sexo, tabagismo, alcoolismo, idade e uso de anti-inflamatórios não esteroidais (AINEs. PACIENTES E PROCEDIMENTOS: Duzentos pacientes com diagnóstico endoscópico de úlcera péptica e com infecção pelo H. pylori, confirmada pelo exame histológico e pelo teste rápido da

  3. Comparison of clinical effect of different triple therapy for helicobacter pylori infection gastric ulcer%不同三联疗法根除幽门螺杆菌感染胃溃疡的临床效果比较

    Institute of Scientific and Technical Information of China (English)

    王惠德

    2015-01-01

    目的:探讨不同的三联疗法根除幽门螺杆菌感染胃溃疡的临床疗效。方法:收治幽门螺杆菌感染胃溃疡患者126例,分作观察组和对照组各63例,观察组给予奥美拉唑、克拉霉素、阿莫西林治疗,对照组给予奥美拉唑、甲硝唑、阿莫西林治疗,比较两组临床疗效。结果:观察组治愈总有效率95.23%,明显高于对照组的71.42%(P<0.05);观察组幽门螺杆菌根除率93.65%,高于对照组的76.19%(P<0.05)。结论:奥美拉唑、克拉霉素、阿莫西林根除幽门螺杆菌感染胃溃疡效果显著。%Objective:To explore the clinical effect of different triple therapy for helicobacter pylori infection gastric ulcer. Methods:126 patients with helicobacter pylori infection gastric ulcer were selected.They were divided into the observation group and the control group with 63 cases in each.The observation group were given omeprazole,clarithromycin and amoxicillin,and the control group were given omeprazole,metronidazole,amoxicillin,then we compared two groups of clinical curative effect.Results:In the observation group,the total effective rate of 95.23% was significantly higher than 71.42% in the control group(P>0.05),and the eradication rate of helicobacter pylori of 93.65% was higher than 76.19% in the control group(P<0.05).Conclusion:The clinical effect of omeprazole,clarithromycin and amoxicillin for helicobacter pylori infection gastric ulcer was significant.

  4. Influence of H pylori on plasma ghrelin in patients without atrophic gastritis

    Institute of Scientific and Technical Information of China (English)

    Mehmet Cindoruk; Ilhan Yetkin; Serpil Muge Deger; Tarkan Karakan; Erdal Kan; Selahattin Unal

    2007-01-01

    AIM: To determine the association between H pylori infection and serum ghrelin levels in patients without atrophic gastritis.METHODS: Fifty consecutive patients (24 males and 26 females) with either H pylori-positive gastritis (n = 34) or H pylori-negative gastritis (n = 16) with normal gastric acid secretion determined by 24-h pHmetry and without atrophic gastritis in histopathology were enrolled in this study. Thirty-four H pylori-infected patients were treated with triple therapy consisting of a daily regimen of 30 mg lansoprazole bid, 1 g amoxicillin bid and 500 mg clarithromycin bid for 14 d, followed by an additional 4 wk of 30 mg lansoprazol treatment. H pylori infection was eradicated in 23 of 34 (67.6%) patients. H pylori-positive patients were given eradication therapy. Gastric acidity was determined via intragastric pH catethers. Serum ghrelin was measured by radioimmunoassay (RIA).RESULTS: There was no significant difference in plasma ghrelin levels between H pylori -positive and H pylori-negative groups (81.10 ± 162.66 ng/L vs 76.51 ± 122.94 ng/L). In addition, there was no significant difference in plasma ghrelin levels and gastric acidity levels measured before and 3 mo after the eradication therapy.CONCLUSION: H pylori infection does not influence ghrelin secretion in patients with chronic gastritis without atrophic gastritis.

  5. Use of probiotics in the fight against Helicobacter pylori

    Institute of Scientific and Technical Information of China (English)

    Paolo; Ruggiero

    2014-01-01

    After the discovery of Helicobacter pylori(H. pylori), and the evidence of its relationship with gastric diseas-es, antibiotic-based therapies were developed, which efficacy was however limited by antibiotic resistance and lack of patient compliance. A vaccine would over-come these drawbacks, but currently there is not any H. pylori vaccine licensed. In the frame of the studies aimed at finding alternative therapies or at increasing the efficacy of the current ones and/or reducing their side effects, the investigation on the use of probiotics plays an interesting role. In vitro and preclinical stud-ies have shown the feasibility of this approach. Several clinical trials indicated that administration of probiot-ics can reduce the side effects of H. pylori eradication treatment, increasing tolerability, and often increases the overall efficacy. The results of these trials vary, likely reflecting the variety of probiotics assessed and that of the eradication treatment, as well as the differ-ences in the geographic area that imply different H. py-lori strains distribution, host susceptibility, and therapy efficacy. In conclusion, the use of probiotics appears promising as an adjuvant for the current H. pylori erad-ication treatment, though it still requires optimization.

  6. Treatment of Helicobacter pylori infection: Past, present and future

    Institute of Scientific and Technical Information of China (English)

    Vasilios; Papastergiou; Sotirios; D; Georgopoulos; Stylianos; Karatapanis

    2014-01-01

    Helicobacter pylori(H. pylori) is a major human patho-gen associated with significant morbidity and mortal-ity. However, after decades of efforts, treatment of H. pylori remains a challenge for physicians, as there is no universally effective regimen. Due to the rising prevalence of antimicrobial resistance, mainly to clar-ithromycin, efficacy of standard triple therapies has declined to unacceptably low levels in most parts of the world. Novel regimens, specifically experimented to improve the therapeutic outcome against antibiotic-resistant H. pylori strains, are now recommended as first-line empirical treatment options providing high ef-ficacy(reportedly > 90% in intention to treat analysis) even in high clarithromycin resistance settings. These include the bismuth quadruple, concomitant, sequential and hybrid therapies. Due to the rapid development of quinolone resistance, levofloxacin-based regimens should be reserved as second-line/rescue options. Adjunct use of probiotics has been proposed in order to boost eradication rates and decrease occurrence of treatment-related side effects. Molecular testing meth-ods are currently available for the characterization of H. pylori therapeutic susceptibility, including genotypic detection of macrolide resistance and evaluation of the cytochrome P450 2C19 status known to affect the me-tabolism of proton pump inhibitors. In the future, use of these techniques may allow for culture-free, non-invasive tailoring of therapy for H. pylori infection.

  7. Helicobacter pylori infection - recent developments in diagnosis.

    Science.gov (United States)

    Lopes, Ana Isabel; Vale, Filipa F; Oleastro, Mónica

    2014-07-28

    Considering the recommended indications for Helicobacter pylori (H. pylori) eradication therapy and the broad spectrum of available diagnostic methods, a reliable diagnosis is mandatory both before and after eradication therapy. Only highly accurate tests should be used in clinical practice, and the sensitivity and specificity of an adequate test should exceed 90%. The choice of tests should take into account clinical circumstances, the likelihood ratio of positive and negative tests, the cost-effectiveness of the testing strategy and the availability of the tests. This review concerns some of the most recent developments in diagnostic methods of H. pylori infection, namely the contribution of novel endoscopic evaluation methodologies for the diagnosis of H. pylori infection, such as magnifying endoscopy techniques and chromoendoscopy. In addition, the diagnostic contribution of histology and the urea breath test was explored recently in specific clinical settings and patient groups. Recent studies recommend enhancing the number of biopsy fragments for the rapid urease test. Bacterial culture from the gastric biopsy is the gold standard technique, and is recommended for antibiotic susceptibility test. Serology is used for initial screening and the stool antigen test is particularly used when the urea breath test is not available, while molecular methods have gained attention mostly for detecting antibiotic resistance.

  8. Association of NOD1 and NOD2 genes polymorphisms with Helicobacter pylori related gastric cancer in a Chinese population

    Institute of Scientific and Technical Information of China (English)

    Peng Wang; Zhao-Shan Zhang; Chun-Jie Liu; Li Zhang; Jian-Ming Jiang; Dan Ma; Hao-Xia Tao; Sheng-Ling Yuan; Yan-Chun Wang; Ling-Chun Wang; Hao Liang

    2012-01-01

    AIM:To investigate the association between the tag single nucleotide polymorphisms (TagSNPs) of NOD1 and NOD2 and the risk of developing gastric cancer.METHODS:We conducted a hospital-based case-control study including 296 incident gastric cancer patients and 160 gastritis controls.Eight TagSNPs in the NOD1 and NOD2 genes were selected from the Hapmap database using the haploview software and genotyped by the Sequenom MassArray system.The serum levels of anti-Helicobacter pylori (H.pylori) IgG were measured by enzyme-linked immunosorbent assay to indicate H.pylori infection.The odds ratios (OR) and 95% confidence intervals (CI) were calculated by unconditional logistic regression,including sex and age as confounding factors.RESULTS:The NOD1 rs2907749 GG genotype showed a decreased risk for gastric cancer (OR 0.50,95% CI:0.26-0.95,P =0.04) while the rs7789045 TT genotype showed an increased risk (OR 2.14,95% CI:1.20-3.82,P =0.01).An elevated susceptibility to gastric cancer was observed in the subjects with H.pylori infection and the NaOD1 rs7789045 TT genotype (OR 2.05,95% CI:1.07-3.94,P =0.03) or the NOD2 rs7205423 GC genotype (OR 2.52,95% CI:1.05-6.04,P =0.04).Haplotype analysis suggested that the distribution of AGT (rs2907749,rs2075820 and rs7789045) in NOD1 between the cases and control groups was significantly different (P corrected:0.04),and the diplotype AGT/AGT was associated with an elevated gastric cancer risk (OR 1.98,95%CI:1.04-3.79,P =0.04).The association of the NOD1 rs7789045 Tr genotype and the diplotype AGT/AGT was significant with H.pylori-related diffuse-type gastric cancer (OR 3.00,95% CI:1.38-6.53,P =0.01; OR 4.02,95% CI:1.61-10.05,P < 0.01,respectively).CONCLUSION:Genetic polymorphisms in NOD1 and NOD2 may interact with H.pylori infection and may play important roles in promoting the development of gastric cancer in the Chinese population.

  9. An Overview of the Relationship Between Helicobacter Pylori Infection and Otolaryngology Head and Neck Surgery Diseases%幽门螺旋杆菌感染与耳鼻咽喉头颈外科疾病关系研究综述

    Institute of Scientific and Technical Information of China (English)

    杜芬

    2012-01-01

    Helicobacter pylori is closely related to diseases like chronic gastritis and peptic ulcer, but recent studies show that there is also some connection with certain diseases concerning otolaryngology head and neck surgery. This paper begins with the de scription about helicobacter pylori biology, diagnosis, epidemiology and anti helicobacter pylori treatment and comprehensively states the relationship between helicobacter pylori and diseases concerning otolaryngology head and neck surgery in the hope providing a new perspective for the research of diseases connected with otolaryngology head and neck surgery.%幽门螺旋杆菌与慢性胃炎及消化性溃疡密切相关,但最近研究发现与某些耳鼻咽喉头颈外科疾病亦有一定关系。本文从阐述幽门螺旋杆菌的生物学性状、诊断技术、流行病学及抗幽门螺旋杆菌治疗入手,综述了幽门螺旋杆菌与耳鼻咽喉头颈外科疾病的关系,为从系统因素出发研究耳鼻咽喉头颈外科疾病提供新思路。

  10. Helicobacter pylori: From Bench to Bedside

    Directory of Open Access Journals (Sweden)

    N Chiba

    1997-01-01

    Full Text Available With the exponential increase in research in the field of Helicobacter pylori a paradigm shift has occurred. It is now recognized that H pylori is 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 of H pylori in contributing to nonulcer dyspepsia or nonsteroidal anti-inflammatory drug gastropathy remains controversial. An effective vaccine against H pylori is 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 of H 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 eradicating H pylori will 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.

  11. Helicobacter pylori and Antibiotic Resistance, A Continuing and Intractable Problem.

    Science.gov (United States)

    Hu, Yue; Zhang, Meng; Lu, Bin; Dai, Jinfeng

    2016-10-01

    Helicobacter pylori, a human pathogen with a high global prevalence, is the causative pathogen for multiple gastrointestinal diseases, especially chronic gastritis, peptic ulcers, gastric mucosa-associated lymphoid tissue lymphoma, and gastric malignancies. Antibiotic therapies remain the mainstay for H. pylori eradication; however, this strategy is hampered by the emergence and spread of H. pylori antibiotic resistance. Exploring the mechanistic basis of this resistance is becoming one of the major research questions in contemporary biomedical research, as such knowledge could be exploited to devise novel rational avenues for counteracting the existing resistance and devising strategies to avoid the development of a novel anti-H. pylori medication. Encouragingly, important progress in this field has been made recently. Here, we attempt to review the current state and progress with respect to the molecular mechanism of antibiotic resistance for H. pylori. A picture is emerging in which mutations of various genes in H. pylori, resulting in decreased membrane permeability, altered oxidation-reduction potential, and a more efficient efflux pump system. The increased knowledge on these mechanisms produces hope that antibiotic resistance in H. pylori can ultimately be countered.

  12. Could gastric histology be a useful marker for making decision on Helicobacter pylori eradication therapy in patients with dyspepsia? É a histologia gástrica um marcador útil na decisão de erradicar o Helicobacter pylori nos pacientes com dispepsia?

    Directory of Open Access Journals (Sweden)

    Severino Marcos Borba de Arruda

    2009-09-01

    Full Text Available CONTEXT: It still remains an open debate whether Helicobacter pylori eradication is beneficial or not for the improvement of symptoms in functional dyspepsia. Differences in geographic distribution, the worldwide H. pylori genetic variability and the fact that the outcome of infection is strongly related to the virulence of the infecting strain are factors that might be driving ongoing controversies. OBJECTIVE: To study the correlation between gastric histology and H. pylori serology status in patients with dyspepsia. METHODS: This is a cross-sectional study where 40 consecutive dyspeptic patients (28 women and 12 men, mean age 48.5 years with endoscopically normal stomachs were selected from the endoscopy unit at a university hospital in Recife, PE, Northeast of Brazil, between March 1998 and July 1999. Patients underwent gastric mucosal biopsy and serological tests (anti-Hp and anti-CagA antibodies. Gastric biopsies were examined using H-E and Giemsa stains and gastritis was classified and graded (mild, moderate or severe according to "the updated Sydney System - Houston, 1994". RESULTS: Among 40 patients with dyspepsia the gastric histology revealed that about ¼ had moderate (25% or severe (2.5% gastritis. This subgroup of patients also had a greater positive frequency of anti-Hp (100% vs 41%; P = 0.0005 and anti-CagA (91% vs 58%; P = 0.09 antibodies when compared with those with normal histology (27.5% or mild gastritis (45%. CONCLUSION: Since upper gastrointestinal endoscopy is part of the functional dyspepsia investigation and serology for anti-CagA antibody is not available in daily clinical practice, by biopsying gastric mucosa we would only be able to selectively apply H. pylori eradication therapy for those with histology that best correlate with virulent infecting strains (moderate or severe gastritis - around ¼ of our study patients with dyspepsia.CONTEXTO: O benefício da terapia de erradicação do H. pylori como parte do

  13. Effect of quadruple therapy on peptic ulcer curative with Helicobacter pylori infection%四联疗法治疗幽门螺杆菌阳性消化性溃疡疗效观察

    Institute of Scientific and Technical Information of China (English)

    陈亚松; 汪文渊; 蔡晓林

    2012-01-01

    Objective To observe the effect and eradication rate of quadruple therapy in the healing of duodenal ulcer and gastric ulcer with Helicobacter pylori infection. Methods Altogether 247 patients of duodenal ulcer or gastric ulcer with Helicobacter pylori infection which were proven by gastroscope and rapid urease method were given rabeprazole( 20 mg,bid ),colloidal bismuth pectin( 0. 2 g,bid ), clarithromycin( 0. 5 g, bid )and metronidazole( 0. 4 g, bid ). After a week, only rabeprazole was given for 5 weeks( 20 mg, qd ). At the end of the treatment, the eradication rate of Helicobacter pylori and the healing rate of ulcer were evaluated by the second endoscopey and rapid urease method. Results A total of 196 patients completed the trial. The eradication rates of H. Pylori in duodenal ulcer and gastric ulcer were 86% and 67. 4% ,respectively. The total eradication rate was 81. 6%. The ulcer healing rates in duodenal ulcer and gastric ulcer were 89. 3% and 84. 8% ,respectively. The total healing rates was 88. 3%. There was significant difference in the eradication rate and healing rate between the duodenal ulcer and gastric ulcer ( P < 0. 01 ). Conclusion The quadruple therapy which includes rabeprazole showed more effect and H. Pylori eradication rate in duodenal ulcer patients than gastric ulcer patients.%目的 观察四联疗法治疗HP阳性的十二指肠溃疡、胃溃疡HP根除率及疗效.方法 经胃镜和快速尿素酶方法确诊的HP阳性十二指肠溃疡和胃溃疡共247例.予雷贝拉唑20 mg,2次/日+胶体果胶铋0.2,2次/日+克拉霉素0.5,2次/日+甲硝唑0.4,2次/日,口服一周,继而连服雷贝拉唑20 mg,一次/日共5周.疗程结束四周后胃镜及快速尿素酶试验复查.结果 随访成功196例,HP总根除率81.6%,其中十二指肠溃疡根除率86%,胃溃疡根除率67.4%,溃疡病总有效率88.3%,其中十二指肠溃疡有效率89.3%,胃溃疡有效率84.8%,两组比较差异显著(P<0.01).结论 含雷贝拉唑的四

  14. Antibacterial effects of Bismuth compounds and it synergy with Tetracycline and Metronidazole on Helicobacter Pylori

    Directory of Open Access Journals (Sweden)

    Rajabie A

    1997-04-01

    Full Text Available Bismuth salts and different antimicrobials including Metonidazole & Tetracyclines were used in the assessment of inhibition zone of Helicobacter pylori cultures on solid media. Antibiotics were used or in combined in order to find out their possible synergistic effects. It was showed that: only Bismuth substrate and not then salts have antibacterial effects on Helicobacter pylori and also on the other bacteria such as staphylococci; salmonella and brulla. In addition, only Bismuth substrances showed remarkable synergistic effects with antimicrobial drugs against Helicobacter pylori. Therefore the data obtained from this investigation confirm previously known effect of combination antibiotic therapy including Bismuth compounds in eradicating Helicobacter pylori.

  15. Gastric carcinoid in a patient infected with Helicobacter pylori : A new entity?

    Institute of Scientific and Technical Information of China (English)

    Pantelis Antonodimitrakis; Apostolos Tsolakis; Staffan Welin; Gordana Kozlovacki; Kjell (O)berg; Dan Granberg

    2011-01-01

    There are four types of gastric carcinoid tumors, classified according to their histology and malignant potential. Only a few cases of carcinoid tumors in patients infected with Helicobacter pylori (H. pylori ) have been reported so far. We report a patient infected with H. pylori presenting with a small solitary gastric carcinoid tumor with very low proliferative rate and normal gastrin levels. The tumor was endoscopically removed and the patient received an eradication therapy against H. pylori . No signs of metastatic disease have been found so far during more than 3 year of follow-up. Infection with H. pylori may cause chronic gastritis with normal or elevated gastrin levels, leading to the development of gastric carcinoids by mechanisms unrelated to gastrin. Enterochromaffin-like cell tumors related to a chronic H. pylori infection may be considered as a distinct type of gastric carcinoid tumors.

  16. EXTRAGASTRIC AND ORODENTAL MANIFESTATIONS IN PEDIATRIC INFECTION WITH HELICOBACTER PYLORI. A REVIEW

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    Smaranda DIACONESCU

    2015-12-01

    Full Text Available Helicobacter pylori is a worlwide spread infection mostly manifested in childhood. Many - both invasive and non-invasive diagnostic tests - are now available,. The colonisation effect of gastric mucosa and its consequences are well known and studied. H. pylori can also induce extra-gastric manifestations, like iron-deficiency anemia. The role of oral cavity colonisation is not clearly defined, several studies stating that the oral cavity represents a reservoir for H. pyloris. The presence of this rod in the dental plaque may lead to periodontitis, dental caries, dental calculus and tooth loos. Dental treatment associated with eradication therapy decreases the prevalence of oral H. pylori and improves the eradication rate of gastric H. pylori. Dental treatment in H. pylori infection management should be taken into consideration, especially in children and teens.

  17. Prevalence of primary Helicobacter pylori resistance to metronidazole and clarithromycin in Singapore

    Institute of Scientific and Technical Information of China (English)

    Jie Song Hua; Ho Bow; Peng Yuan Zheng; Yeoh Khay Guan

    2000-01-01

    @@ INTRODUCTION Eradication of Helicobacter pylori, a bacterium residing in stomach and causing peptic ulcer disease,can be achieved by using combination therapies consisting of one or two antibiotics with a proton pump inhibitor (PPI). The major antibiotics widely used in the regimens to eradicate H. Pylori are metronidazole and clarithromycin[1-3].

  18. Antimicrobial susceptibility testing for Helicobacter pylori in times of increasing antibiotic resistance.

    Science.gov (United States)

    Smith, Sinéad M; O'Morain, Colm; McNamara, Deirdre

    2014-08-07

    The gram-negative bacterium Helicobacter pylori (H. pylori) causes chronic gastritis, gastric and duodenal ulcers, gastric cancer and mucosa-associated lymphoid tissue lymphoma. Treatment is recommended in all symptomatic patients. The current treatment options for H. pylori infection are outlined in this review in light of the recent challenges in eradication success, largely due to the rapid emergence of antibiotic resistant strains of H. pylori. Antibiotic resistance is a constantly evolving process and numerous studies have shown that the prevalence of H. pylori antibiotic resistance varies significantly from country to country, and even between regions within the same country. In addition, recent data has shown that previous antibiotic use is associated with harbouring antibiotic resistant H. pylori. Local surveillance of antibiotic resistance is warranted to guide clinicians in their choice of therapy. Antimicrobial resistance is assessed by H. pylori culture and antimicrobial susceptibility testing. Recently developed molecular tests offer an attractive alternative to culture and allow for the rapid molecular genetic identification of H. pylori and resistance-associated mutations directly from biopsy samples or bacterial culture material. Accumulating evidence indicates that surveillance of antimicrobial resistance by susceptibility testing is feasible and necessary to inform clinicians in their choice of therapy for management of H. pylori infection.

  19. Helicobacter pylori in pediatrics.

    Science.gov (United States)

    Homan, Matjaž; Hojsak, Iva; Kolaček, Sanja

    2012-09-01

    This review summarizes important pediatric studies published from April 2011 up to March 2012. Proteomics profile of ulcerogenic Helicobacter pylori strains was defined in the most interesting study of the last year. The antigen stool test is becoming the "gold standard" in prevalence studies, and according to the last epidemiologic studies, the prevalence of H. pylori infection in childhood is not decreasing any more in the developed world. The resistance rate of H. pylori strains is high in children. Therefore, among other important issues concerning H. pylori in pediatrics, guidelines published by ESPGHAN and NASPGHAN last year also recommended culture and susceptibility testing before first-line treatment in areas with high or unknown antibiotic resistance rates.

  20. Potential implications of Helicobacter pylori-related neutrophil-activating protein

    Institute of Scientific and Technical Information of China (English)

    Jannis Kountouras; Ioannis Venizelos; Christos Zavos; Georgia Deretzi; Emmanuel Gavalas; Dimitrios Chatzopoulos; Panagiotis Katsinelos; Elena Tsiaousi; Stergios Gagalis; Stergios A Polyzos

    2012-01-01

    Helicobacter pylori (H. pylori) virulence factors promote the release of various chemoattractants/inflammatory mediators, including mainly the neutrophilattractant chemokine interleukin-8 and neutrophilactivating protein (NAP), involved in H. pylori-induced gastric pathologies. Co-administration of Chios mastic gum (CMG), which inhibits H. pylori NAP, with an H. pylori eradication regimen might add clinical benefits against H. pylori-related gastric pathologies, but possibly not CMG as main therapy. Although H. pylori NAP and other H. pylori-related cytotoxins [i.e., vaculating cytotoxin (VacA)] appear to play a major role in generating and maintaining the H. pylori-associated gastric inflammatory response and H. pylori NAP is a promising vaccine candidate against H. pylori infection (H. pylori-I), concerns regarding its potential drawbacks, particularly neurogenic ones, due to possible crossmimicry, should be considered. Possible cross-mimicry between H. pylori NAP and/or bacterial aquaporin (AQP) and neural tissues may be associated with the anti-AQP-4 antibody-related neural damage in multiple sclerosis (MS)/neuromyelitis optica patients. Moreover, the sequence homology found between H. pylori VacA and human Na+/K+-ATPase A subunit suggests that antibodies to VacA involve ion channels in abaxonal Schwann cell plasmalemma resulting in demyelination in some patients. A series of factors have been implicated in inducing blood-brain barrier (BBB) disruption, including inflammatory mediators (e.g., cytokines and chemokines induced by H. pylori-I) and oxidative stress. BBB disruption permits access of AQP4-specific antibodies and T lymphocytes to the central nervous system, thereby playing a major role in multiple sclerosis pathogenesis. Relative studies show a strong association between H. pylori-I and MS. H. pylori-I induces humoral and cellular immune responses that, owing to the sharing of homologous epitopes (molecular mimicry), cross-react with components of

  1. Helicobacter pylori and nonmalignant diseases.

    LENUS (Irish Health Repository)

    Alakkari, Alaa

    2012-02-01

    Research published over the past year has documented the continued decline of Helicobacter pylori-related peptic ulcer disease and increased recognition of non-H. pylori, non-steroidal anti-inflammatory drugs ulcer disease--idiopathic ulcers. Despite reduced prevalence of uncomplicated PUD, rates of ulcer complications and associated mortality remain stubbornly high. The role of H. pylori in functional dyspepsia is unclear, with some authors considering H. pylori-associated nonulcer dyspepsia a distinct organic entity. There is increasing acceptance of an inverse relationship between H. pylori and gastroesophageal reflux disease (GERD), but little understanding of how GERD might be more common\\/severe in H. pylori-negative subjects. Research has focused on factors such as different H. pylori phenotypes, weight gain after H. pylori eradication, and effects on hormones such as ghrelin that control appetite.

  2. 清除幽门螺杆菌感染在帕金森病治疗中的作用%Efficacy of anti-helicobacter pylori in treatment of parkinson disease

    Institute of Scientific and Technical Information of China (English)

    许文芳; 陈育华; 马博; 时鹏; 陈齐鸣; 屈洪党

    2014-01-01

    目的 观察清除幽门螺杆菌(Hp)感染在帕金森病(PD)治疗中的作用.方法 选择60例年龄在40~69岁之间的早期PD患者,病史1~3年,UPDRS评分小于20分,且其血清HP抗体阳性,随机分成2组,对照组30例,男性20人,女性10人,从小剂量开始给予美多芭治疗,每次美多芭0.0625 g,每日2次,逐渐增加剂量,最高量为每次0.25 g,每日3次;观察组30例,男性19人,女性11人,在此基础上加用清除Hp治疗(雷尼替丁0.15g+阿莫西林1.0g+克拉霉素0.5g,每天2次,共7d).采用UPDRS评分量表比较2组患者治疗1个月、3个月后的疗效.结果 对照组患者治疗1个月和3个月后UPDRS评分从11.77分别降至9.43分(P<0.01)和8.73分(P<0.01),治疗3个月UPDRS评分较治疗1个月UPDRS评分差异无统计学意义(P=0.214).观察组患者治疗1个月和3个月后UPDRS评分从12.67分别降至10.30分(P<0.01)和7.77分(P<0.01),治疗3个月UPDRS评分优于治疗1个月UPDRS评分(P<0.01).治疗1个月UPDRS评分观察组较对照组无明显改善(P=0.140);治疗3个月后UPDRS评分观察组较对照组有明显改善(P =0.018).结论 清除Hp感染可提高治疗PD的疗效.

  3. Antibiotic resistance among Helicobacter pylori clinical isolates in Lima, Peru

    Science.gov (United States)

    Boehnke, Kevin F; Valdivieso, Manuel; Bussalleu, Alejandro; Sexton, Rachael; Thompson, Kathryn C; Osorio, Soledad; Reyes, Italo Novoa; Crowley, John J; Baker, Laurence H; Xi, Chuanwu

    2017-01-01

    Objectives Gastric carcinoma is the most common cancer and cause of cancer mortality in Peru. Helicobacter pylori, a bacterium that colonizes the human stomach, is a Group 1 carcinogen due to its causal relationship to gastric carcinoma. While eradication of H. pylori can help prevent gastric cancer, characterizing regional antibiotic resistance patterns is necessary to determine targeted treatment for each region. Thus, we examined primary antibiotic resistance in clinical isolates of H. pylori in Lima, Peru. Materials and methods H. pylori strains were isolated from gastric biopsies of patients with histologically proven H. pylori infection. Primary antibiotic resistance among isolates was examined using E-test strips. Isolates were examined for the presence of the cagA pathogenicity island and the vacA m1/m2 alleles via polymerase chain reaction. Results Seventy-six isolates were recovered from gastric biopsies. Clinical isolates showed evidence of antibiotic resistance to 1 (27.6%, n=21/76), 2 (28.9%, n=22/76), or ≥3 antibiotics (40.8%). Of 76 isolates, eight (10.5%) were resistant to amoxicillin and clarithromycin, which are part of the standard triple therapy for H. pylori infection. No trends were seen between the presence of cagA, vacA m1, or vacA m2 and antibiotic resistance. Conclusion The rate of antibiotic resistance among H. pylori isolates in Lima, Peru, is higher than expected and presents cause for concern. To develop more targeted eradication therapies for H. pylori in Peru, more research is needed to better characterize antibiotic resistance among a larger number of clinical isolates prospectively. PMID:28331349

  4. Role of Probiotics in the Management of Helicobacter Pylori Infection

    Directory of Open Access Journals (Sweden)

    A Zare Javid

    2014-04-01

    Full Text Available Helicobacter pylori is a gram-negative, spiral-shaped, microaerophilic organism that colonizes the stomach of humans and causes chronic-active gastritis, peptic ulcer disease, and gastric cancers, including adenocarcinoma of the stomach and MALT (mucosal-associated lymphoid tumor lymphomas. H. pylori colonizes the stomach of over 50 % the world’s human population, primarily those who reside in developing nations. Infection is generally first acquired in children, who may be entirely asymptomatic, and then persists for life, unless specific eradication therapy is initiated. All infected individuals have mucosal inflammation in the stomach in response to the organism, but only a subset will develop disease complications, such as an ulcer in the stomach or proximal duodenum and cancer in either the body or the antrum of the stomach. It is estimated that the lifetime risk of developing peptic ulceration is roughly 15%. However, this is an exceedingly important disease, because it has serious morbidity and mortality. Eradication of H. pylori infection is not successful when using antibiotics as monotherapy or dual therapy using combinations of an acid-suppressing agent and an antibiotic or two antibiotics without acid blockage. Multiple studies show that some probiotic strains can inhibit the growth of H. pylori. To date, probiotics do not appear to have a role as sole therapy for use in the prevention or treatment of H. pylori infection. However, there is increasing evidence that a variety of probiotic agents are useful as adjunctive therapy, which can both enhance the success of eradicating the gastric pathogen while, reduce the frequency and severity of adverse effects arising from the other agents that are employed in current combination treatment regimens. Future studies should assess the role of prebiotics and synbiotics and products derived from probiotics as additional options for use in the prevention and treatment of H. pylori infection

  5. Indications, diagnostic tests and Helicobacter pylori eradication therapy: Recommendations by the 2nd Spanish Consensus Conference Indicaciones, métodos diagnósticos y tratamiento erradicador de Helicobacter pylori: Recomendaciones de la II Conferencia Española de Consenso

    Directory of Open Access Journals (Sweden)

    J. Monés

    2005-05-01

    Full Text Available The results of the 2nd Spanish Consensus Conference for appropriate practice regarding indications for eradication, diagnostic tests, and therapy regimens for Helicobacter pylori infection are summarized. The Conference was based on literature searches in Medline, abstracts from three international meetings, and abstracts from national meetings. Results were agreed upon and approved by the whole group. Results are supplemented by evidence grades and recommendation levels according to the classification used in the Clinical Practice Guidelines issued by Cochrane Collaboration. Convincing indications (peptic ulcer, duodenal erosions with no history of ASA or NSAIDs, MALT lymphoma, and not so convincing indications (functional dyspepsia, patients receiving low-dose ASA for platelet aggregation, gastrectomy stump in patients operated on for gastric cancer, first-degree relatives of patients with gastric cancer, lymphocytic gastritis, and Ménétrier's disease for H. pylori eradication are discussed. Diagnostic recommendations for various clinical conditions (peptic ulcer, digestive hemorrhage secondary to ulcer, eradication control, patients currently or recently receiving antibiotic or antisecretory therapy, as well as diagnostic tests requiring biopsy collection (histology, urease fast test, and culture when endoscopy is needed for clinical diagnosis, and non-invasive tests requiring no biopsy collection (13C-urea breath test, serologic tests, and fecal antigen tests when endoscopy is not needed are also discussed. As regards treatment, first-choice therapies (triple therapy using a PPI and two antibiotics, therapy length, quadruple therapy, and a number of novel antibiotic options as "rescue" therapy are prioritized, the fact that prolonging PPI therapy following effective eradication is unnecessary for patients with duodenal ulcer but not for all gastric ulcers is documented, the fact that cultures and antibiograms are not needed for all

  6. Halitosis and Helicobacter pylori infection

    NARCIS (Netherlands)

    Tangerman, A.; Winkel, E. G.; de Laat, L.; van Oijen, A. H.; de Boer, W. A.

    2012-01-01

    There is disagreement about a possible relationship between Helicobacter pylori (H. pylori) infection and objective halitosis, as established by volatile sulfur compounds (VSCs) in the breath. Many studies related to H. pylori used self-reported halitosis, a subjective and unreliable method to detec

  7. "Rescue" regimens after Helicobacter pylori treatment failure

    Institute of Scientific and Technical Information of China (English)

    Javier P Gisbert

    2008-01-01

    Helicobacter pylori (H pylori)infection is the main cause of gastritis,gastroduodenal ulcer disease,and gastric cancer.After more than 20 years of experience in Hpylori treatment,in my opinion,the ideal regimen to treat this infection is still to be found.Currently,apart from having to know first-line eradication regimens well,we must also be prepared to face lyeatment failures.Therefore,in designing a treatment strategy we should not focus on the results of primary therapy alone,but also on the final (overall) eradication rate.The choice of a "rescue" treatment depends on which treatment is used initially.If a clarithromycinbased regimen was used initially,a subsequent metronidazole-based treatment (quadruple therapy)may be used afterwards,and then a levofloxacinbased combination would be a third "rescue" option.Alternatively,it has recently been suggested that levofloxacin-based rescue therapy constitutes an encouraging second-line strategy,representing an alternative to quadruple therapy in patients with previous PPI-clarithromycin-amoxicillin failure,with the advantage of efficacy,simplicity and safety.In this case,a quadruple regimen may be reserved as a third-line rescue option.Finally,rifabutin-based rescue therapy constitutes an encouraging empirical fourthline strategy after multiple previous eradication failures with key antibiotics such as amoxicillin,clarithromycin,metronidazole,tetracycline,and levofloxacin.Even after two consecutive failures,several studies have demonstrated that H pylor/eradication can finally be achieved in almost all patients if several rescue therapies are consecutively given.Therefore,the attitude in H pylori eradication therapy failure,even after two or more unsuccessful attempts,should be to fight and not to surrender.

  8. The Clinical Correlations of Helicobacter pylori Virulence Factors and Chronic Spontaneous Urticaria

    Directory of Open Access Journals (Sweden)

    Yi-Chun Chiu

    2013-01-01

    Full Text Available Background and Study Aims. The association between Helicobacter pylori (H. pylori and chronic spontaneous urticaria (CSU remains controversial. This study explored the role of H. pylori in CSU among different virulent genotypes patients. Patients and Methods. Patients infected by H. pylori were sorted into two groups as group A (with CSU and group B (without CSU. The tissue materials were taken via endoscopy for polymerase chain reaction study to determine virulence factors. After H. pylori eradication therapy, the eradication rate and response of urticaria were evaluated by using C13-UBT and a three-point scale (complete remission, partial remission, or no improvement. Results. The results were comparable between patients of groups A and B in terms of H. pylori infection rates and eradication rate. Longitudinal follow-up of 23.5 months showed complete remission of urticaria in 63.6% but no improvement in 36.4% of the patients after H. pylori eradication. H. pylori infected patients with different virulence factors such as cytotoxin-associated gene A, vacuolating cytotoxin gene A signal region and middle region have similar remission rates for CSU. Conclusions. Current study suggests that H. pylori may play a role in the development and disease course of CSU but may be irrelevant to different virulent genotypes.

  9. Bactericidal and anti-adhesive properties of culinary and medicinal plants against Helicobacter pylori

    Institute of Scientific and Technical Information of China (English)

    Rachel O'Mahony; Huda Al-Khtheeri; Deepeka Weerasekera; Neluka Fernando; Dino Vaira; John Holton; Christelle Basset

    2005-01-01

    AIM: To investigate the bactericidal and anti-adhesive properties of 25 plants against Helicobacter pylori (H pylori).METHODS: Twenty-five plants were boiled in water to produce aqueous extracts that simulate the effect of cooking. The bactericidal activity of the extracts was assessed by a standard kill-curve with seven strains of H pylori. The anti-adhesive property was assessed by the inhibition of binding of four strains of FITC-labeled H pylori to stomach sections. RESULTS: Of all the plants tested, eight plants, including Bengal quince, nightshade, garlic, dill, black pepper, coriander, fenugreek and black tea, were found to have no bactericidal effect on any of the isolates. Columbo weed, long pepper, parsley, tarragon, nutmeg, yellow-berried nightshade, threadstem carpetweed, sage and cinnamon had bactericidal activities against H pylori, but total inhibition of growth was not achieved in this study. Among the plants that killed H pylori, turmeric was the most efficient, followed by cumin, ginger, chilli, borage, black caraway, oregano and liquorice. Moreover, extracts of turmeric; borage and parsley were able to inhibit the adhesion of H pylori strains to the stomach sections.CONCLUSION: Several plants that were tested in our study had bactericidal and/or anti-adhesive effects on H pylori. Ingestion of the plants with anti-adhesive properties could therefore provide a potent alternative therapy for H pylori infection, which overcomes the problem of resistance associated with current antibiotic treatment.

  10. Role of dental plaque, saliva and periodontal disease in Helicobacter pylori infection.

    Science.gov (United States)

    Anand, Pradeep S; Kamath, Kavitha P; Anil, Sukumaran

    2014-05-21

    Helicobacter pylori (H. pylori) infection is one of the most common bacterial infections in humans. Although H. pylori may be detected in the stomach of approximately half of the world's population, the mechanisms of transmission of the microorganism from individual to individual are not yet clear. Transmission of H. pylori could occur through iatrogenic, fecal-oral, and oral-oral routes, and through food and water. The microorganism may be transmitted orally and has been detected in dental plaque and saliva. However, the role of the oral cavity in the transmission and recurrence of H. pylori infection has been the subject of debate. A large number of studies investigating the role of oral hygiene and periodontal disease in H. pylori infection have varied significantly in terms of their methodology and sample population, resulting in a wide variation in the reported results. Nevertheless, recent studies have not only shown that the microorganism can be detected fairly consistently from the oral cavity but also demonstrated that the chances of recurrence of H. pylori infection is more likely among patients who harbor the organism in the oral cavity. Furthermore, initial results from clinical trials have shown that H. pylori-positive dyspeptic patients may benefit from periodontal therapy. This paper attempts to review the current body of evidence regarding the role of dental plaque, saliva, and periodontal disease in H. pylori infection.

  11. [The diagnostic of chronic infection Helicobacter pylori in children].

    Science.gov (United States)

    Tereschenko, S Yu; Olkhovskiy, I A

    2014-02-01

    The epidemiological studies testify an extremely high prevalence of chronic infection of children with Helicobacter pylori in Russia. The affection consists from 50% to 80% depending on region and age of examined children. The currently in force recommendations "Maastricht IV" concerning diagnostic and treatment of Helicobacter pylori infection adult patients are applied not in its fullness to children adolescent population. At the same time recently published joint conciliatory document of the European and North American associations of pediatric gastroenterologists is oriented to populations with low prevalence of Helicobacter pylori infection and particular profile of drug resistance. Hence, an urgent need exists to develop modern local algorithm concerning diagnostic, treatment and control of eradication of Helicobacter pylori infection among children and adolescents in Russia. The review presents analysis of admissibility of application in Russia's conditions of the international conciliatory documents concerning diagnostic of Helicobacter pylori infection in children. The data from conciliatory document of the European (ESPGHAN) and North American (NASPGHAN) associations of pediatric gastroenterologists, particular orginal research studies and one's own clinical experience were used. The advantages and shortcomings of actual methods of laboratory diagnostic of Helicobacter pylori infection are discussed. The approaches to application of particular diagnostic methods are considered. The enhanced indications to detection of infection and implementation of eradication therapy are proposed.

  12. Evaluation of Salivary Antibodies to Detect Infection with Helicobacter pylori

    Directory of Open Access Journals (Sweden)

    Mark B Loeb

    1997-01-01

    Full Text Available 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.

  13. Insulin resistance in H pylori infection and its association with oxidative stress

    Institute of Scientific and Technical Information of China (English)

    Mehmet Aslan; Mehmet Horoz; Yasar Nazligul; Cengiz Bolukbas; F Fusun Bolukbas; Sahbettin Selek; Hakim Celik; Ozcan Erel

    2006-01-01

    AIM:To determine the insulin resistance (IR) and oxidative status in H pylori infection and to find out if there is any relationship between these parameters and insulin resistance.METHODS:Fifty-five H pylori positive and 48 H pylori negative patients were enrolled. The homeostasis model assessment (HOMA) was used to assess insulin resistance. Serum total antioxidant capacity (TAC), total oxidant status (TOS) and oxidative stress index (OSI) were determined in all subjects.RESULTS:The total antioxidant capacity was significantly lower in H pylori positive group than in H pylori negative group (1.36 ± 0.33 and 1.70 ± 0.50,respectively; P < 0.001), while the total oxidant status and oxidative stress index were significantly higher in H pylori positive group than in H pylori negative group (6.79 ± 3.40 and 5.08 ± 0.95, and 5.42 ± 3.40 and 3.10± 0.92, respectively; P < 0.001). Insulin resistance was significantly higher in H pylori positive group than in H pylori negative group (6.92 ± 3.86 and 3.61 ± 1.67, respectively; P < 0.001). Insulin resistance was found to be significantly correlated with total antioxidant capacity (r= -0.251, P < 0.05), total oxidant status (r = 0.365, P <0.05), and oxidative stress index (r = 0.267, P < 0.05).CONCLUSION: Insulin resistance seems to be associated with increased oxidative stress in H pylori infection.Further studies are needed to clarify the mechanisms underlying this association and elucidate the effect of adding antioxidant vitamins to H pylori eradication therapy on insulin resistance during H pylori infection.

  14. Influence of Helicobacter pylori infection on ghrelin levels in children

    Institute of Scientific and Technical Information of China (English)

    Zhao-Hui Deng; Bo Chu; Ya-Zhen Xu; Bin Zhang; Li-Rong Jiang

    2012-01-01

    AIM:To compare ghrelin levels in plasma and gastric mucosa before and after Helicobacter pylori (H.pylori)treatment in children with H.pylori-associated functional dyspepsia.METHODS:Children with H.pylori-associated functional dyspepsia were enrolled in this study.H.pylori infection was confirmed by positive bacterial culture results.All of the children received triple H.pylori eradication therapy (a 2 wk course of omeprazole,amoxicillin,and clarithromycin).The children were divided into two groups based on the success of the H.pylori treatment:group 1 (eradicated)-patients who had a negative 13C-urea breath test 2 mo after the end of therapy; and group 2 (non-eradicated)-patients who had a positive 13C-urea breath test.Plasma ghrelin,gastric ghrelin mRNA,and the body mass index were evaluated in both groups before and after the H.pylori treatment.The plasma ghrelin levels were measured by a radioimmunoassay.The expression of gastric gnrelin mRNA was determined by real-time reverse transcription polymerase chain reaction.RESULTS:A total of 50 children with H.pylori-associated functional dyspepsia were treated with triple H.pylori eradication therapy.The mean age of the children was 5.52 ± 0.83 years,and there were 28 males and 22 females.Among the 50H.pylori-positive children,30 successfully achieved eradication,and 20 did not.The mean plasma ghrelin levels of group 1 were 22.17 ± 1.73 ng/L and 26.59 ± 2.05 ng/L before and after the treatment,respectively,which was a significant increase (P =0.001).However,the mean plasma ghrelin level of group 2 before and after the H.pylori treatment was 21.34 ± 2.40 ng/L and 22.24 ± 2.10ng/L (P =0.785).The plasma ghrelin levels increased substantially after treatment in group 1 but showed only minor changes in group 2.Similarly,the gastric ghrelin mRNA expression in group 1 before treatment was 2.84 ± 0.08.After treatment,the level was 3.11± 0.65,which was significantly different (P =0.023).The gastric ghrelin m

  15. Potentiation of the action of metronidazole on Helicobacter pylori by omeprazole and bismuth subcitrate

    DEFF Research Database (Denmark)

    Andersen, L P; Colding, H; Kristiansen, J E

    2000-01-01

    Treatment failures using triple therapy that include metronidazole, are common in patients infected with metronidazole-resistant Helicobacter pylori in the gastric mucosa. Higher eradication rates in such patients have been described when treatment regimens include bismuth salts compared...

  16. Saliva Secretion and Efficacy of Helicobacter Pylori Eradication in Peptic Ulcer Patients

    Directory of Open Access Journals (Sweden)

    Sh. Abdollahzadeh

    2011-12-01

    Full Text Available Objective: It has been noted that the presence of Helicobacter pylori (H. pyloriin the oral cavity may affect the outcome of eradication therapy. This condition is associated with the recurrence of gastric infection. The optimum secretion of salivapromotes oral health consequently influencing H. pylori eradication. The purpose of this study was to investigate the relation between salivary secretion and the efficacy of H. pylori eradication from the stomach.Materials and Methods: Forty five patients with gastric H. pylori infection were enrolled in this study. Diagnosis of H. pylori infection was confirmed by endoscopy,biopsy, urease test and histological examination. Salivary secretion of all participants was determined under standard condition before the beginning of antibacterial treatment. Then the patients were treated with a 14-day course anti-H. pylori regimen consisting of amoxicillin, omeprazole, metronidazole and bismuth. The efficacy of eradication therapy was evaluated 4 weeks after the end of the treatment course. Mann-Whitney U test was used to analyze the variables.Results: The median of salivary secretion among successful and unsuccessful H. pylori eradication groups was 0.48 ml/min and 0.24 ml/min, respectively (p=0.005.Conclusion: Although the type of drug regimens is challenging, the efficacy of H. pylori eradication from the stomach might be reduced by lower salivary secretion.

  17. The results of Helicobacter pylori eradication on repeated bleeding in patients with stomach ulcer.

    Science.gov (United States)

    Horvat, Darko; Vcev, Aleksandar; Soldo, Ivan; Timarac, Jasna; Dmitrović, Branko; Misević, Tonci; Ivezić, Zdravko; Kraljik, Nikola

    2005-06-01

    The triple therapy of Helicobacter pylori eradication prevents repeated bleeding from stomach ulcer. The aim of this one-way blind prospective study was to evaluate the efficiency of the two-week triple therapy for Helicobacter pylori eradication in preventing renewed bleeding in patients with stomach ulcer within one year. This research included 60 hospitalized patients with bleeding stomach ulcer and positive Helicobacter pylori infection, 34 men and 26 women (average age 59.7 years). The patients were given therapeutic scheme of omeprazol--amoxicilin--metrodinazol (OAM) eradication for 14 days. Eradication of H. pylori infection was defined as lack of proof of the infection one month or several months after therapy suspension. By applying triple OAM therapy within two weeks the eradication was successful in 72%. In the group of 17 H. pylori positive patients there were 8 patients (47.6%) with repeated stomach ulcer and 3 patients (18%) with bleeding. Within the group of 43 H. pylori negative patients there were only 2 patients (4.65%) with repeated stomach ulcer and 1 patient (2%) with bleeding, during the observed period of 12 months. This research confirms the hypothesis about the necessity of eradication of Helicobacter pylori infection in patients with bleeding stomach ulcer as prevention of repeated bleeding.

  18. A review of Helicobacter pylori diagnosis, treatment, and methods to detect eradication.

    Science.gov (United States)

    Garza-González, Elvira; Perez-Perez, Guillermo Ignacio; Maldonado-Garza, Héctor Jesús; Bosques-Padilla, Francisco Javier

    2014-02-14

    Helicobacter pylori (H. pylori) affects nearly half of the world's population and, thus, is one of the most frequent and persistent bacterial infections worldwide. H. pylori is associated with peptic ulcer disease, gastric ulcers, mucosa-associated lymphoid tissue lymphoma, and gastric cancer. Various diagnostic methods exist to detect infection, and the choice of one method or another depends on several factors, such as accessibility, advantages and disadvantages of each method, cost, and the age of patients. Once H. pylori infection is diagnosed, the clinician decides whether treatment is necessity, according to the patient's clinical condition. Typically, eradication of H. pylori is recommended for treatment and prevention of the infection. Cure rates with the standard triple therapy are acceptable, and effective quadruple therapies, sequential therapies, and concomitant therapies have been introduced as key alternatives to treat H. pylori infection. In this work, we review the main diagnostic methods used to identify H. pylori infection and to confirm eradication of infection. In addition, key factors related to treatment are reviewed.

  19. Treatment of Helicobacter pylori Infection 2013.

    LENUS (Irish Health Repository)

    O'Connor, Anthony

    2013-09-01

    This review summarizes important studies regarding Helicobacter pylori therapy published from April 2012 up to March 2013. To begin with, the updated European Consensus Guidelines were published last year, highlighting the role of bismuth and nonbismuth quadruple regimen as first-line treatments. Cure rates for standard triple therapy remain acceptable in quite a few settings nowadays, and some reports on innovative triple therapies look promising. One study evaluating bismuth quadruple therapy as first-line therapy was reported. Regarding nonbismuth quadruple regimens, there is a trend of superiority emerging for the "concomitant" therapy over the "sequential" regimen. "Hybrid" therapy, a combination of sequential and concomitant therapy, has also shown advantage over sequential therapy. Levofloxacin-based therapies appear to be useful and versatile in second- and third-line therapies, with interesting results for newer generation quinolones, which may partially overcome antibiotic resistance. Some promising works have been reported for bismuth-based rescue therapy, using individualized therapies upon antimicrobial information, as well as for rifabutin fourth-line therapy. Probiotics appear to have an effect in terms of reducing side effects and improving compliance, but data on improvement of eradication rates remain controversial.

  20. H pylori infection in patients with Behcet's disease

    Institute of Scientific and Technical Information of China (English)

    Osman Ersoy; Reyhan Ersoy; Ozlem Yayar; Huseyin Demirci; Semih Tatlican

    2007-01-01

    AIM: To evaluate endoscopic findings and the prevalence of H pylori in patients with Behcet's disease (BD) who have upper gastrointestinal symptoms.METHODS: The patients with BD diagnosed according to the International Study Group and followed up in the Department of Dermatology and other related departments and who had any upper gastrointestinal complaints, were included in this study. Forty-five patients with BD and 40 patients in the control group were evaluated by upper gastrointestinal endoscopy and two biopsied specimens were taken during endoscopy for H pylori. A two-week triple therapy for H pylori eradication was administered to H pylori positive patients. Two months after the treatment, the patients were evaluated by urea-breath test for eradication control.RESULTS: Patients with BD had a mean age of 36.2 ± 11.4 years (18-67 years). The mean follow-up time was 35 ± 14 mo (16-84 mo). Aphthous or deep ulcer in esophagus, stomach and duodenum had never been confirmed by endoscopic examination. Most gastric lesions were gastric erosion (40%) and the most duodenal lesions were duodenitis (17.5%) in two groups.H pylori was positive in 33 patients (73.3%) with BD.The two-week triple eradication therapy was successful in 75% of the patients. There was no difference between the groups in respect to prevalence of H pylori(73.3% vs 75%, P > 0.05), and eradication rate (75% vs 70%, P > 0.05).CONCLUSION: Endoscopic findings, eradication rate and prevalence of H pylori were similar in patients with BD and control group.

  1. Bismuth-containing quadruple therapy for peptic ulcer complicated with helicobacter pylori infection%含铋剂四联疗法治疗消化性溃疡幽门螺杆菌感染的疗效分析

    Institute of Scientific and Technical Information of China (English)

    毛从俊

    2016-01-01

    Objective To investigate the clinical curative effect of bismuth-containing quadruple therapy for peptic ulcer complicated with helicobacter pylori infection.Methods 208 patients with peptic ulcer complicated with helicobacter pylori infection admitted into our hospital from July,2013 to April,2015 were selected for prospective study and were randomly divided into an experimental group and a control group,104 cases for each group.The experimental group was treated with quadruple therapy of amoxicillin,pantoprazole,furazolidone,and colloidal bismuth pectin and the control group with triple therapy of amoxicillin,pantoprazole,and clarithromycin.The treatment effectiveness evaluation of gastric ulcer,andduodenal ulcer,helicobacter pylori eradicated rate,conditions of drug adverse reactions,etc.of these two groups were compared.Results The significance of thetreatment effectiveness evaluation of gastric ulcer and duodenal ulcerwas better in the experimental group (95.00% and 98.44%) than in the control group(75% and 83.33%),with statistical differences(P<0.01).The helicobacter pylori eradicated rates of gastric ulcer and duodenal ulcer were better in the experimental group (90.00% and 95.31%) than in the control group(68.18% and 71.67%),with statistical differences(P>0.01).There was no statistical difference in the incidence of drug adverse reactions bwtween these two groups(6.72% vs.3.84%,P>0.05).Conclusions Bismuth-containing quadruple therapy in the treatment of peptic ulcer with helicobacter pylori infection has significant clinical curative effect and better safety.It is of reference.%目的 探讨含铋剂四联疗法治疗消化性溃疡幽门螺杆菌感染的临床疗效.方法 收集本院2013年7月至2015年4月收治的消化性溃疡幽门螺杆菌感染患者208例前瞻性研究且随机分为两组,每组104例,实验组患者给予阿莫西林+泮托拉唑+呋喃唑酮+胶体果胶铋四联疗法治疗,对照组患者则给

  2. Consequences of Helicobacter pylori infection in children

    Institute of Scientific and Technical Information of China (English)

    Lucia; Pacifico; Caterina; Anania; John; F; Osborn; Flavia; Ferraro; Claudio; Chiesa

    2010-01-01

    Although evidence is emerging that the prevalence of Helicobacter pylori (H. pylori) is declining in all age groups, the understanding of its disease spectrum continues to evolve. If untreated, H. pylori infection is lifelong. Although H. pylori typically colonizes the hu-man stomach for many decades without adverse con-sequences, children infected with H. pylori can manifest gastrointestinal diseases. Controversy persists regarding testing (and treating) for H. pylori infection in children with recurrent a...

  3. Consequences of Helicobacter pylori infection in children

    OpenAIRE

    Pacifico, Lucia; Anania, Caterina; Osborn, John F.; Ferraro, Flavia; Chiesa, Claudio

    2010-01-01

    Although evidence is emerging that the prevalence of Helicobacter pylori (H. pylori) is declining in all age groups, the understanding of its disease spectrum continues to evolve. If untreated, H. pylori infection is lifelong. Although H. pylori typically colonizes the human stomach for many decades without adverse consequences, children infected with H. pylori can manifest gastrointestinal diseases. Controversy persists regarding testing (and treating) for H. pylori infection in children wit...

  4. Recent Insights into Antibiotic Resistance in Helicobacter pylori Eradication

    Directory of Open Access Journals (Sweden)

    Wenming Wu

    2012-01-01

    Full Text Available Antibiotics have been useful in the treatment of H. pylori-related benign and malignant gastroduodenal diseases. However, emergence of antibiotic resistance often decreases the eradication rates of H. pylori infections. Many factors have been implicated as causes of treatment failure, but the main antibiotic resistance mechanisms described to date are due to point mutations on the bacterial chromosome, a consequence of a significantly phenotypic variation in H. pylori. The prevalence of antibiotic (e.g., clarithromycin, metronidazole, tetracycline, amoxicillin, and furazolidone resistance varies among different countries; it appears to be partly determined by geographical factors. Since the worldwide increase in the rate of antibiotic resistance represents a problem of relevance, some studies have been performed in order to identify highly active and well-tolerated anti-H. pylori therapies including sequential, concomitant quadruple, hybrid, and quadruple therapy. These represent a promising alternatives in the effort to overcome the problem of resistance. The aim of this paper is to review the current status of antibiotic resistance in H. pylori eradication, highlighting the evolutionary processes in detail at alternative approaches to treatment in the past decade. The underlying resistance mechanisms will be also followed.

  5. Curative effect analysis of 10 days sequential therapy and quadruple therapy in treatment of helicobacter pylori infection%10日序贯疗法与四联疗法治疗幽门螺杆菌感染疗效对比分析

    Institute of Scientific and Technical Information of China (English)

    王宏彦; 徐宝宏; 吴海波

    2013-01-01

    目的探讨10日序贯疗法与四联疗法治疗幽门螺杆菌感染疗效对比。方法随机选择对照组42例,采用四联疗法进行治疗:阿莫西林1000mg+克拉霉素500mg+奥美拉唑20mg+枸橼酸铋钾220mg,Bid,治疗10d;治疗组43例,应用10日序贯疗法治疗:前5d给予阿莫西林1000mg+奥美拉唑20mg,Bid;后5d给予甲硝唑400mg+克拉霉素500mg+奥美拉唑20mg,Bid。结果两组经10d治疗后,停PPI及抗生素满4周,经13C-UBT试验阴性者为幽门螺杆菌(H.pylori)根治成功。实验结果显示:对照组根治成功33例,根除率达78.6%(33/42);治疗组根治成功40例,根除率达93.0%(40/43)。应用统计学分析,两组比较差异具有统计学意义(P<0.05)。结论本实验结果显示,两组治疗方法对治疗幽门螺杆菌感染均有效,同比治疗组疗效更佳,具有重要的临床意义。%Objective To investigate the curative effect comparison of 10 days sequential therapy and quadruple therapy in treatment of helicobacter pylori infection. Methods 42 cases of helicobacter pylori infection were randomly selected as control group,and were given quadruple therapy:1000mg amoxicillin + 500mg clarithromycin+ 20mg omeprazole + 220mg bismuth potassium citrate, Bid, for 10 days; 43 cases of helicobacter pylori infection were randomly selected as treatment group, and were given 10 days sequential therapy:1000mg amoxicillin+20mg omeprazole for the first 5 days,Bid,and 400mg metronidazole+500mg clarithromycin+omeprazole 20 mg for the next 5 days,Bid. Results After treatment for 10 days, stop PPI and antibiotics for 4 weeks, negative 13C-UBT test means helicobacter pylori (H.p ylori) was cured successfully. Experiment results showed that 33 cases of the control group were cured successfully, eradication rate was 78.6%(33/42);40 cases of the treatment group were cured successfully, eradication rate was 93.0% (40/43). Differences of two groups was

  6. Primary Antimicrobial Susceptibility Changes in Children with Helicobacter pylori Infection over 13 Years in Northern Italy

    Science.gov (United States)

    Gismondi, Pierpacifico; Maffini, Valentina; Bizzarri, Barbara; Fornaroli, Fabiola; Madia, Carmen; Salerno, Antonino; Cangelosi, A. Marta; de'Angelis, Gian Luigi

    2015-01-01

    The eradication therapy of Helicobacter pylori (H. pylori) infection is still a challenge for gastroenterologists. One of the main causes of failure in H. pylori eradication is the antibiotic resistance mainly to clarithromycin. Culture from biopsies is maybe the most used method among the antimicrobial susceptibility techniques. In this study, we compared the antimicrobial susceptibility changes in children with H. pylori infection over 13 years and we confirmed that clarithromycin resistance has been increased (16% versus 26%) though with no statistically signficant value. Therefore, clarithromycin should not be used in empiric treatment of H. pylori eradication therapy in children, but its use should be limited only to children with known antimicrobial susceptibility. On the other hand, metronidazole resistance has decreased over this time period in statistically significant manner (56% versus 33%, p = 0.014). Furthermore, ampicillin resistance has been confirmed to be very rare (3% versus 0%) in children with H. pylori infection. In conclusion, in H. pylori infection, if we do not know the antibiotic susceptibility of patients, we should recommend an eradication therapy based on the local distribution of antibiotic resistance rates trying to limit the therapeutic failures. PMID:26064096

  7. Biopatologia do Helicobacter pylori

    Directory of Open Access Journals (Sweden)

    Ladeira Marcelo Sady Plácido

    2003-01-01

    Full Text Available A infecção pelo Helicobacter pylori (H. pylori induz inflamação persistente na mucosa gástrica com diferentes lesões orgânicas em humanos, tais como gastrite crônica, úlcera péptica e câncer gástrico. Os fatores determinantes desses diferentes resultados incluem a intensidade e a distribuição da inflamação induzida pelo H. pylori na mucosa gástrica. Evidências recentes demonstram que cepas do H. pylori apresentam diversidade genotípica, cujos produtos acionam o processo inflamatório por meio de mediadores e citocinas, que podem levar a diferentes graus de resposta inflamatória do hospedeiro, resultando em diferentes destinos patológicos. Cepas H. pylori com a ilha de patogenicidade cag induzem resposta inflamatória mais grave, através da ativação da transcrição de genes, aumentando o risco para desenvolvimento de úlcera péptica e câncer gástrico. O estresse oxidativo e nitrosativo induzido pela inflamação desempenha importante papel na carcinogênese gástrica como mediador da formação ou ativação de cancerígenos, danos no DNA, bem como de alterações da proliferação celular e da apoptose.

  8. Cost-effectiveness analysis on three different therapies for helicobacter pylori infection%幽门螺旋杆菌三种药物治疗方案的成本-效果分析

    Institute of Scientific and Technical Information of China (English)

    潘志浩; 李莉

    2010-01-01

    目的 评价不同药物组合方案治疗幽门螺旋杆菌感染所产生的经济效果.方法 运用药物经济学成本-效果分析法对抗幽门螺旋杆菌3种治疗方案进行分析评价.结果 A、B、C三种方案的成本-效果比分别是2.03、2.51和2.53.无论是从成本-效果比分析,还是从增量成本-效果比分析,均得出A方案为抗幽门螺旋杆菌感染的最佳方案.结论 药物经济学的成本-效果分析可为临床医生和患者治疗幽门螺旋杆菌感染提供合理和经济的治疗方案.%Objective To evaluate the cost-effectiveness analysis (CE) of three therapies for helicobacter pylori (Hp) infection. Methods The CE of three therapies for Hp infection was analyzed by the methods of pharmacoeconomics. Results The CE ratios of three therapies in group A, group B and group C were 1.41, 1.43 and 2.24 respectively. From CE analysis and increasing CE analysis, the therapeutic scheme in group A is the best one. Conclusion The rational and economic therapeutic scheme for Hp infection can he acquired by cliniciansand patients using CE analysis of pharmacoeconomics.

  9. Exopolysaccharide production by Helicobacter pylori

    OpenAIRE

    2006-01-01

    Helicobacter pylori is a widespread Gram-negative bacterium that infects the stomach of humans leading to the onset of several gastric disorders, such as, gastritis, gastric ulcers, and cancers. Studies from developing countries with low socioeconomic status and poor management of the drinking water suggest that it may serve as an environmental reservoir of H. pylori and therefore contribute to human infection. It has been reported that H. pylori has the ability to form microbi...

  10. Helicobacter pylori and pancreatic diseases

    Institute of Scientific and Technical Information of China (English)

    Milutin; Bulajic; Nikola; Panic; Johannes; Matthias; L?hr

    2014-01-01

    A possible role for Helicobacter pylori(H. pylori) infec-tion in pancreatic diseases remains controversial. H. pylori infection with antral predomination leading to an increase in pancreatic bicarbonate output and induc-ing ductal epithelial cell proliferation could contribute to the development of pancreatic cancer via complex interactions with the ABO genotype, dietary and smok-ing habits and N-nitrosamine exposure of the host. Although the individual study data available so far is inconsistent, several meta-analyses have reported an increased risk for pancreatic cancer among H. pylori seropositive individuals. It has been suggested that H. pylori causes autoimmune pancreatitis due to molecu-lar mimicry between H. pylori a-carbonic anhydrase(a-CA) and human CA type Ⅱ, and between H. pylori plasminogen-binding protein and human ubiquitin-protein ligase E3 component n-recognin 2, enzymes that are highly expressed in the pancreatic ductal andacinar cells, respectively. Future studies involving large numbers of cases are needed in order to examine the role of H. pylori in autoimmune pancreatitis more fully. Considering the worldwide pancreatic cancer burden, as well as the association between autoimmune pan-creatitis and other autoimmune conditions, a complete elucidation of the role played by H. pylori in the gen-esis of such conditions could have a substantial impact on healthcare.

  11. Helicobacter pylori infection and dementia: can actual data reinforce the hypothesis of a causal association?

    Science.gov (United States)

    Adriani, A; Fagoonee, S; De Angelis, C; Altruda, F; Pellicano, R

    2014-09-01

    Helicobacter pylori (H. pylori) is involved in the development of several gastroduodenal diseases. Since the latest decade, several studies have reported on the link between chronic H. pylori infection and a variety of extragastric manifestations, including dementia. To identify the publications on the association between H. pylori and dementia, a MEDLINE search was conducted. Although case-control studies reported controversial data, a recent longitudinal population-based cohort study found that after 20 years of follow-up, 28.9% of H. pylori-positive versus 21.1% of H. pylori-negative subjects developed dementia. After correction for confounding factors, the infection was significantly associated with higher risk of developing dementia (P=0.04). Moreover, in another study evaluating the effect of H. pylori eradication on the progression of dementia in Alzheimer's disease patients with peptic ulcer, the cure of the bacterium was associated with a decreased risk of dementia progression compared to persistent infection. To date, defining H. pylori as a target for prevention or treatment of dementia remains a topic with much controversy but of essence, as any relationship would reduce, due to the cost-effectiveness of the therapy, a burden on the National Health Care budget. The need for extensive studies with appropriate epidemiological and clinical approaches is crucial to investigate a potential causal relationship.

  12. Does Helicobacter pylori play a role in the pathogenesis of childhood chronic idiopathic thrombocytopenic purpura?

    Science.gov (United States)

    Maghbool, Maryam; Maghbool, Masood; Shahriari, Mehdi; Karimi, Mehran

    2009-06-08

    Idiopathic thrombocytopenic purpura (ITP) is an acute self-limited bleeding disorder that can progress to chronic form in 10-15% of the cases. Helicobacter pylori (H. pylori) infection is a possible cause of chronic ITP. We studied 30 children with resistant chronic ITP for H. pylori infection based on the detection of H. pylori fecal antigen. This retrospective study was based on data obtained from medical records of 30 children aged between five and 17 years (median age at ITP diagnosis was ten years). A specially-designed data sheet was used to record information on age, sex, duration of disease, family history of bleeding disorders, previous treatments and median platelet count. In patients with H. pylori infection, antimicrobial treatment consisted of amoxicillin, metronidazol and omeprazol. Response was assessed every month for one year and defined as complete (platelet count >150×10(9)/L) or partial (platelet count between 50 and 150×10(9)/L). We detected H. pylori infection in 5 patients. In 4 of them increased platelet count was seen during one year of follow-up and in one patient the platelet count was acceptable during six months. Although the pathological mechanism of H. pylori-induced thrombocytopenia was unclear in our patient sample, the assessment of H. pylori infection and use of eradication therapy should be attempted in chronic and resistant ITP patients.

  13. In vitro inhibition of Helicobacter pylori growth and adherence to gastric mucosal cells by Pycnogenol.

    Science.gov (United States)

    Rohdewald, Peter; Beil, Winfried

    2008-05-01

    The emergence of antibiotic resistant H. pylori strains has necessitated the identification of alternative additive therapies for the treatment of this infection. The study tested whether a specific pine bark extract (Pycnogenol is effective in inhibiting the growth and adherence of H. pylori in vitro. Inhibition of H. pylori growth by Pycnogenol was tested in liquid medium as well as in an in vitro model by using sessile bacteria attached to AGS cells. Adherence was determined by co-incubation of gastric cells with Pycnogenol and H. pylori in vitro. Pycnogenol inhibited H. pylori growth in suspension with an MIC(50) of 12.5 microg/mL. Growth of H. pylori in infected cells was reduced to 10% of the control value by 125 microg/mL Pycnogenol. Adherence of H. pylori to gastric cells was reduced by 70% after 3 h incubation with 125 microg/mL Pycnogenol. The results show a significant, yet limited inhibition of growth and adherence of H. pylori to gastric cells by Pycnogenol. In vivo studies have to demonstrate the clinical relevance of these findings.

  14. Does Helicobacter pylori play a role in the pathogenesis of childhood chronic idiopathic thrombocytopenic purpura?

    Directory of Open Access Journals (Sweden)

    Maryam Maghbool

    2009-07-01

    Full Text Available Idiopathic thrombocytopenic purpura (ITP is an acute self-limited bleeding disorder that can progress to chronic form in 10-15% of the cases. Helicobacter pylori (H. pylori infection is a possible cause of chronic ITP. We studied 30 children with resistant chronic ITP for H. pylori infection based on the detection of H. pylori fecal antigen. This retrospective study was based on data obtained from medical records of 30 children aged between five and 17 years (median age at ITP diagnosis was ten years. A specially-designed data sheet was used to record information on age, sex, duration of disease, family history of bleeding disorders, previous treatments and median platelet count. In patients with H. pylori infection, antimicrobial treatment consisted of amoxicillin, metronidazol and omeprazol. Response was assessed every month for one year and defined as complete (platelet count >150x109/L or partial (platelet count between 50 and 150x109/L. We detected H. pylori infection in 5 patients. In 4 of them increased platelet count was seen during one year of follow-up and in one patient the platelet count was acceptable during six months. Although the pathological mechanism of H. pylori-induced thrombocytopenia was unclear in our patient sample, the assessment of H. pylori infection and use of eradication therapy should be attempted in chronic and resistant ITP patients.

  15. Role of Toll-like receptors in Helicobacter pylori infection and immunity

    Institute of Scientific and Technical Information of China (English)

    Sinéad; M; Smith

    2014-01-01

    The gram-negative bacterium Helicobacter pylori(H. pylori) infects the stomachs of approximately half of the world’s population. Although infection induces an immune response that contributes to chronic gastric inflammation, the response is not sufficient to eliminate the bacterium. H. pylori infection causes peptic ulcers, gastric cancer and mucosa-associated lymphoid tissue lymphoma. Disease outcome is linked to the severity of the host inflammatory response. Gastric epithelial cells represent the first line of innate immune defence against H. pylori, and respond to infection by initiating numerous cell signalling cascades, resulting in cytokine induction and the subsequent recruitment of inflamma-tory cells to the gastric mucosa. Pathogen recognition receptors of the toll-like receptor(TLR) family mediate many of these cell signalling events. This review dis-cusses recent findings on the role of various TLRs in the recognition of H. pylori in distinct cell types, describes the TLRs responsible for the recognition of individual H. pylori components and outlines the influence of innate immune activation on the subsequent development of the adaptive immune response. The mechanistic iden-tification of host mediators of H. pylori-induced patho-genesis has the potential to reveal drug targets and opportunities for therapeutic intervention or prevention of H. pylori-associated disease by means of vaccines or immunomodulatory therapy.

  16. Low prevalence of H. pylori Infection in HIV-Positive Patients in the Northeast of Brazil

    Directory of Open Access Journals (Sweden)

    Silva Cícero IS

    2011-02-01

    Full Text Available Abstract Background This study conducted in Northeastern Brazil, evaluated the prevalence of H. pylori infection and the presence of gastritis in HIV-infected patients. Methods There were included 113 HIV-positive and 141 age-matched HIV-negative patients, who underwent upper gastrointestinal endoscopy for dyspeptic symptoms. H. pylori status was evaluated by urease test and histology. Results The prevalence of H. pylori infection was significantly lower (p H. pylori status and gender, age, HIV viral load, antiretroviral therapy and the use of antibiotics. A lower prevalence of H. pylori was observed among patients with T CD4 cell count below 200/mm3; however, it was not significant. Chronic active antral gastritis was observed in 87.6% of the HIV-infected patients and in 780.4% of the control group (p = 0.11. H. pylori infection was significantly associated with chronic active gastritis in the antrum in both groups, but it was not associated with corpus chronic active gastritis in the HIV-infected patients. Conclusion We demonstrated that the prevalence of H. pylori was significantly lower in HIV-positive patients compared with HIV-negative ones. However, corpus gastritis was frequently observed in the HIV-positive patients, pointing to different mechanisms than H. pylori infection in the genesis of the lesion.

  17. Genetic determinants and clinico-pathological outcomes of helicobacter pylori infection.

    Science.gov (United States)

    Oluwasola, A O

    2014-06-01

    Helicobacter pylori is a spiral Gram-negative bacterium with a relatively small genome and is known to be the most common human bacterial infection worldwide, infecting about half of the world's population. The bacterium represents one of the most successful human pathogens, inducing severe clinical symptoms only in a small subset of individuals, thus signifying a highly balanced degree of co-evolution of H. pylori and humans. The prevalence of Helicobacter pylori infection varies greatly among countries and among population groups within the same country, but is falling in most developed countries. The clinical course of H. pylori infection is highly variable and is influenced by both microbial and host factors including genetic susceptibility while the pattern and distribution of inflammation correlate strongly with the risk of clinical sequelae, namely duodenal or gastric ulcers, mucosal atrophy, gastric carcinoma, or gastric lymphoma. Cytokine gene polymorphisms directly influence inter-individual variation in the magnitude of cytokine response, and this clearly contributes to an individual's ultimate clinical outcome. Polymorphisms in genes coding for innate immune factors have also been incriminated in the pathogenesis of H. pylori related disease, while promoter hypermethylation of tumor suppressor genes is considered an important factor in carcinogenesis and known to be present in H. pylori associated gastric tumors. Functional genomics may fill many of the gaps in our understanding of the pathogenesis of H. pylori infection and accelerate the development of novel therapies, including H. pylori specific antimicrobial agents.

  18. Reliability of Diagnostic Tests for Helicobacter pylori Infection

    Directory of Open Access Journals (Sweden)

    S. Redéen

    2011-01-01

    Full Text Available Introduction. Helicobacter pylori (H. pylori infection is very common worldwide. A reliable diagnosis is crucial for patients with H. pylori-related diseases. At followup, it is important to confirm that eradication therapy has been successful. There is no established gold standard for the diagnosis of H. pylori infection. Material and Methods. A sample of 304 volunteers from the general population was screened for H. pylori infection with serology, 13C-urea breath test (UBT, rapid urease test (RUT on fresh biopsy, culture from biopsy, and histological examination. Culture was used as gold standard. Results. The sensitivity was 0.99 for serology, 0.90 for UBT, 0.90 for RUT, and 0.90 for histological examination. Corresponding specificities were 0.82, 0.99, 0.98, and 0.97, respectively. The accuracy was 0.86 for serology, 0.96 for UBT, 0.95 for RUT, 0.93 for culture, and 0.95 for histology. There was a strong correlation between the results of UBT and the histological scores of H. pylori colonisation as well as between the results of UBT and the scores of RUT. Conclusion. There were only minor differences in accuracy between the three invasive tests for H. pylori infection in this population. RUT may be recommended as the first choice since a result is obtained within hours. The accuracy of UBT was comparable to the invasive tests, and it is recommended for situations when endoscopy is not needed.

  19. Susceptibility of helicobacter pylori to metronidazole and its bioactive derivatives

    Directory of Open Access Journals (Sweden)

    Bannatyne Robert

    1998-01-01

    Full Text Available The hydroxy derivative of metronidazole can exhibit equal or greater activity to the parent drug against several bacteria. The susceptibility status of 22 H. pylori strains to these breakdown compounds was determined in order to determine their possible role in the therapy of H. pylori associated peptic ulcer disease. The susceptibility was determined using the agar dilution method and substantial activity (MIC90 = 0.33 .tg/ml for the hydroxy metabolite of metronidazole versus H. pylori was observed. The findings define a role for the hydroxy derivative of metronidazole in peptic ulcer disease and support the limited data on the possibility of cooperative interactions between the parent compound, its main derivatives and related companion drugs in this condition.

  20. Does Helicobacter pylori Eradication Reduce the Risk of Open Angle Glaucoma in Patients With Peptic Ulcer Disease?

    Science.gov (United States)

    Chen, Hsin-Yi; Lin, Cheng-Li; Chen, Wen-Chi; Kao, Chia-Hung

    2015-09-01

    To investigate whether Helicobacter pylori (H pylori) eradication would influence the risk of primary open angle glaucoma (POAG) in patients with peptic ulcer disease. From the Longitudinal Health Insurance Database 2000, 6061 patients with peptic ulcer and receiving H pylori eradication therapy were recruited. The study cohort was subdivided into early (within 1 year) and late (after 1 year) eradication cohorts. The 24,244 control cohort subjects were those who without peptic ulcer and without receiving H pylori eradication therapy and were frequency-matched with the H pylori eradication cohort by age, sex, and the year of receiving H pylori eradication therapy. The higher incidence of POAG was observed in late H pylori eradication cohort and in early H pylori eradication cohort than in control cohort (1.57, 1.32, and 0.95, per 1000 person-year, respectively). However, overall risk of glaucoma was not significantly higher in the late eradication than in the early eradication (adjusted hazard ratio = 0.85, 95% confidence interval = 0.48-1.53). The POAG incidence was greater in the late H pylori eradication cohort when follow-up duration ≤ 5 years (1.59, per 1000 person-years). However, when follow-up duration >5 years, the incidence of POAG was greater in the early H pylori eradication cohort (1.68, per 1000 person-years). These relationships were not associated with a significantly increased or decreased risk of POAG in multivariable analyses. Either early or late H pylori eradication does not significantly reduce the risk of glaucoma in patients with peptic ulcer disease compared with normal control.

  1. Inactivation of Helicobacter pylori by Chloramination

    Science.gov (United States)

    Three strains of Helicobacter pylori (H. pylori) were studied to determine their resistance to chloramination. H. pylori is an organism listed on the U.S. Environmental Protection Agency’s (USEPA) Contaminant Control List (CCL). H. pylori was exposed to 2ppm of pre-formed monoc...

  2. Chinese Helicobacter pylori vaccine: Solution for an old challenge?

    Institute of Scientific and Technical Information of China (English)

    Amin Talebi Bezmin Abadi; Yeong Yeh Lee

    2016-01-01

    Helicobacter pylori(H. pylori) is an important cause for gastric cancer in high risk individuals. H. pylori colonizes more than 50% of the world’s population and associated peptic ulcer disease and gastric malignancy have important public health implications. It has been classified as a class Ⅰ carcinogen in 1994 by the World Health Organization. Clinicians are often prompted to eliminate the infection the moment it is detected. This also, unfortunately, led to reckless use of antibiotics and reports of increasing resistance are now worldwide. Each year, many of people die from gastric cancer; thus application of effective vaccine can reduce this relatively high mortality worldwide. H. pylori can be eliminated by antibiotics but efficacy is sharply decreasing. Moreover, current therapy is also expensive and with side effects. Vaccine may be the best solution to the above problem but there are many challenges in producing such an effective therapeutic vaccine. Recently, the Chinese group published in Lancet, a single-center, randomized, phase Ⅲ study of an oral recombinant vaccine(Urease B subunit fused with heat-labile enterotoxin B derived from Escherichia coli) prescribed in the Chinese children(6-15 years) without a history of H. pylori infection. This review provides an insight into this new solution for an old challenge.

  3. Review of Helicobacter pylori infection and chronic renal failure.

    Science.gov (United States)

    Sugimoto, Mitsushige; Yamaoka, Yoshio

    2011-02-01

    Chronic renal failure patients receiving hemodialysis and continuous ambulatory peritoneal dialysis often encounter gastrointestinal troubles over their long treatment period. Helicobacter pylori infection has close association with development of peptic ulcer, gastric cancer and gastric lymphoma, and is thought to be one of the major risk factors for gastrointestinal troubles in dialysis patients. However, it is unclear whether H. pylori infection is directly associated with progression of renal dysfunction and prognosis of chronic renal failure patients. Recent consensus shows that the prevalence of H. pylori infection in chronic renal failure patients is significantly lower than in subjects with normal renal function. In the natural history of H. pylori infection in hemodialysis patients, the prevalence of infection decreases as dialysis periods progressed, in particular within the first four years after the start of treatment. However, the chance of natural eradication becomes rare for patients receiving dialysis treatment for a long time. Moreover, chronic renal failure patients with H. pylori infection have a higher incidence of gastroduodenal diseases, and therefore, are recommended to receive eradication therapies, especially for those receiving treatment for a long time and with higher risks of complication. Intensive endoscopic check-ups for the prevention of gastrointestinal events and the discovery of peptic ulcer and neoplastic diseases at an early phase may be required.

  4. Halitosis and Helicobacter pylori infection.

    Science.gov (United States)

    Tangerman, A; Winkel, E G; de Laat, L; van Oijen, A H; de Boer, W A

    2012-03-01

    There is disagreement about a possible relationship between Helicobacter pylori (H. pylori) infection and objective halitosis, as established by volatile sulfur compounds (VSCs) in the breath. Many studies related to H. pylori used self-reported halitosis, a subjective and unreliable method to detect halitosis. In this study a possible relation between H. pylori and halitosis was evaluated, using an objective method (gas chromatography, GC) to detect the VSCs, responsible for the halitosis. The levels of the VSCs hydrogen sulfide (H(2)S), methyl mercaptan (MM) and dimethyl sulfide (DMS) were measured in mouth breath and in stomach air of 11 H. pylori positive patients and of 38 H. pylori negative patients, all with gastric pathology. Halitosis was also established by organoleptic scoring (OLS) of mouth-breath. The levels of H(2)S, MM and DMS in the mouth-breath and stomach air of the H. pylori positive patients did not differ significantly from those of the H. pylori negative patients. OLS of the mouth-breath resulted in 9 patients with halitosis, 1 out of the H. pylori positive group and 8 out of the H. pylori negative group, which is not statistically different. The concentrations of the VSCs in stomach air were in nearly all cases below the thresholds of objectionability of the various VSCs, indicating that halitosis does not originate in the stomach. The patients with gastric pathology were also compared with control patients without gastric pathology and with normal volunteers. No significant differences in VSCs in mouth breath were observed between these groups. Thus, in this study no association between halitosis and H. pylori infection was found. Halitosis, as established by GC and OLS, nearly always originates within the oral cavity and seldom or never within the stomach.

  5. Role of Helicobacter pylori eradication in aspirin or non-steroidal anti-inflammatory drug users

    Institute of Scientific and Technical Information of China (English)

    George V. Papatheodoridis; Athanasios J. Archimandritis

    2005-01-01

    Helicobacter pylori (H pylori) infection and the use of nonsteroidal anti-inflammatory drugs (NSAIDs) including aspirin at any dosage and formulation represent well-established risk factors for the development of uncomplicated and complicated peptic ulcer disease accounting for the majority of such cases. Although the interaction between H pylori and NSAID/aspirin use in the same individuals was questioned in some epidemiological studies, it has now become widely accepted that they are at least independent risk factors for peptic ulcer disease. According to data from randomized intervention trials, naive NSAID users certainly benefit from testing for H pylori infection and, if positive,H pylori eradication therapy prior to the initiation of NSAID. A similar strategy is also suggested for naive aspirin users, although the efficacy of such an approach has not been evaluated yet. Strong data also support that chronic aspirin users with a recent ulcer complication should be tested for H pyloriinfection and, if positive, receive H pylori eradication therapy after ulcer healing, while they appear to benefit from additional long-term therapy with a proton pump inhibitor (PPI).A similar approach is often recommended to chronic aspirin users at a high risk of ulcer complication. H pylori eradication alone does not efficiently protect chronic NSAID users with a recent ulcer complication or those at a high-risk, who certainly should be treated with long-term PPI therapy, but H pylori eradication may be additionally offered even in this setting. In contrast, testing for H pylorior PPI therapy is not recommended for chronic NSAID/aspirin users with no ulcer complications or those at a low risk of complications.

  6. First case of Helicobacter pylori infection resistant to seven antibiotics in Iran

    Directory of Open Access Journals (Sweden)

    Amin Talebi Bezmin Abadi

    2014-10-01

    Full Text Available Treatment of Helicobacter pylori infection with common antibiotics is typically recommended for several digestive conditions, including peptic ulcers. However, reports of resistant H. pylori isolates are increasing, and unfortunately, these do not respond to currently available therapeutic regimens. We report the case of a 31-year-old woman with two peptic ulcers in the duodenal antrum. An H. pylori strain was isolated, and tested for antibiotic resistance using agar dilution and disk diffusion. The isolated strain was found to be resistant to all seven antibiotics that were tested. Therefore, constant monitoring for antibiotic resistance should be performed prior to initiating antibiotic therapy.

  7. Helicobacter pylori infection

    Institute of Scientific and Technical Information of China (English)

    Yvan Vandenplas

    2000-01-01

    @@ IS THERE ANYTHING NEW? Helicobacter pylori has been for many years a forgotten bacterium, since the first report on this spiral organism dated from the 19th century[1]. As early as in 1906, an association between a spiral organism and gastric carcinoma was suggested[2].Doenges reported in 1938 that on autopsy not less than 40% of human stomachs were found to be invaded by spiral organisms[3].

  8. Typical and atypical symptoms of gastro esophageal reflux disease: Does Helicobacter pylori infection matter?

    Institute of Scientific and Technical Information of China (English)

    Laurino; Grossi; Antonio; Francesco; Ciccaglione; Leonardo; Marzio

    2015-01-01

    AIM: To analyze whether the presence of Helicobacter pylori(H. pylori) infection could affect the quality of symptoms in gastro-esophageal reflux disease(GERD) patients. METHODS: one hundred and forty-four consecutive patients referred to our Unit for suspected GERD were recruited for the study. All patients underwent esophageal p H-metric recording. For those with a positive test, C13 urea breath test was then performed to assess the H. pylori status. GERD patients were stratified according to the quality of their symptoms and classified as typical, if affected by heartburn and regurgitation, and atypical if complaining of chest pain, respiratory and ears, nose, and throat features. H. pylori-negative patients were also asked whether they had a previous diagnosis of H. pylori infection. If a positive response was given, on the basis of the time period after successful eradication, patients were considered as "eradicated"(E) if H. pylori eradication occurred more than six months earlier or "recently eradicated" if the therapy had been administered within the last six months. Patients without history of infection were identified as "negative"(N). χ2 test was performed by combining the clinical aspects with the H. pylori status.RESULTS: one hundred and twenty-nine of the 144 patients, including 44 H. pylori-positive and 85 H. pylori-negative(41 negative, 21 recently eradicated, 23 eradicated more than 6 mo before), were eligible for the analysis. No difference has been found between H. pylori status and either the number of reflux episodes(138 ± 23 vs 146 ± 36, respectively, P = 0.2, not significant) or the percentage of time with pH values < 4(6.8 ± 1.2 vs 7.4 ± 2.1, respectively, P = 0.3, not significant). The distribution of symptoms was as follows: 13 typical(30%) and 31 atypical(70%) among the 44 H. pylori-positive cases; 44 typical(52%) and 41 atypical(48%) among the 85 H. pylori-negative cases,(P = 0.017 vs H. pylori +; OR = 2.55, 95%CI: 1

  9. Chronic urticaria and Helicobacter pylori

    Directory of Open Access Journals (Sweden)

    Yadav Mukesh

    2008-04-01

    Full Text Available Background: Helicobacter pylori (HP have recently emerged as a novel eliciting factor for chronic urticaria (CU. The possible association between HP and CU has enormous potential, as eradicating HP could cure CU. Aims and Objectives: We conducted a study to assess the prevalence of HP infection and effect of bacterium eradication on skin lesions in patients of chronic idiopathic urticaria (CIU. Settings and Design: Four hundred sixty patients of CU attending the allergy clinic, SMS hospital, Jaipur during the period February 6, 2004, to February 6, 2006, were screened for possible eliciting factors. Patients with CIU were enrolled and others were excluded. Materials and Methods: Sixty-eight patients of CIU and similar number of age and sex matched controls, attending the allergy clinic, SMS Hospital, Jaipur were enrolled in the study. All patients underwent endoscopy with antral biopsy for urease and histopathology to identify HP-associated gastritis. Infected patients were given HP eradication therapy. Eradication of bacterium was confirmed by fecal antigen assay. Subjective response to treatment was judged using chronic urticaria quality-of-life questionnaire (CU-Q 2 oL while objective response to treatment was judged by need for ′rescue medication′ (antihistaminics. Statistical Analysis: Data were analyzed using Chi square and paired′t′ test for their level of significance. Results: HP associated gastritis was present in 48 (70.58% patients, out of which 39 (81.25% patients responded to eradication therapy. Ten (50.00% patients without HP associated gastritis showed response to symptomatic therapy. Overall 49 (72.05% patients responded and 19 (27.94% showed no response. The value of χ2 was 28.571 (P = 0.003, which showed significant association between presence of HP and response to eradication regimen. Conclusion: The response of HP eradication therapy in infected patients of CIU is significant. HP should be included in diagnostic

  10. An analysis of the curative effect of saccharomyces boulardii combined with a standard triple therapy in the treatment of 55 cases of helicobacter pylori-induced peptic ulcer%布拉酵母菌联合标准三联疗法治疗幽门螺杆菌消化性溃疡55例效果分析

    Institute of Scientific and Technical Information of China (English)

    朱路平; 肖飞

    2014-01-01

    目的:分析布拉酵母菌联合标准三联疗法治疗幽门螺杆菌消化性溃疡的临床疗效和安全性。方法随机将109例确诊幽门螺杆菌消化性溃疡进行分组,对照组54例予标准三联疗法治疗,实验组55例予布拉氏酵母菌联合标准三联疗法治疗,观察两组溃疡愈合效果、幽门螺杆菌清除率和不良反应情况。结果实验组溃疡愈合总有效率92.73%明显高于对照组79.63%(P0.05)。结论布拉氏酵母菌联合标准三联疗法能够通过快速恢复幽门螺杆菌消化性溃疡患者肠道菌群的动态平衡、抑制幽门螺杆菌在胃黏膜上皮定值和成长等作用提高幽门螺杆菌清除率。%Objective To analyze the clinical effect and safety of saccharomyces boulardii combined with a standard triple therapy in the treatment of helicobacter pylori-induced peptic ulcer. Methods A total of 109 patients who were diagnosed as helicobacter pylori-induced peptic ulcer were randomly assigned to control group and experimental group. The control group of 54 patients received a standard triple therapy, and the experimental group of 55 patients received saccharomyces boulardii combined with a standard triple therapy. Ulcer recovery, clearance rate of helicobacter pylori and adverse events were observed between the two groups. Results The total effective rate of ulcer recovery in the ex-perimental group was 92.73%, significantly higher than that of 79.63%in the control group(P<0.05); The clearance rate of helicobacter pylori in the experimental group was 90.91%, significantly higher than that of 75.93% in the control group (P<0.05); The incidence of adverse events in the experimental group was 12.73%, and P value was over 0.05 compared to that of 11.11% in the control group. Conclusion The saccharomyces boulardii combined with a standard triple therapy in the treatment of helicobacter pylori-induced peptic ulcer has a significantly effect, and is able to en-hance the

  11. Helicobacter pylori and gastric or duodenal ulcer.

    Science.gov (United States)

    2016-01-01

    In patients with gastric or duodenal ulcer associated with Helicobacter pylori, treatment of the infection improves healing and prevents complications and recurrences. The drug regimen generally consists of a high-dose proton-pump inhibitor (PPI) such as omeprazole plus antibiotics. Using the standard Prescrire methodology, we conducted a review of the literature in order to determine the standard empirical antibiotic regimen for H. pylori infection in adults with gastric or duodenal ulcer in France. In 2015, due to an increase in H. pylori resistance to clarithromycin, a 7-day course of the PPI + clarithromycin + amoxicillin combination is effective in only about 70% of cases. A Cochrane systematic review and meta-analysis of trials involving thousands of patients suggests that prolonging treatment with a PPI + amoxicillin + clarithromycin or a PPI + amoxicillin + metronidazole to 10 or 14 days improves the rate of H. pylori eradication by 5% to 10%. A metanalysis of seven trials including a total of about 1000 patients showed that combination therapy with a PPI + amoxicillin + clarithromycin + metronidazole for 5 days eradicates H. pylori in about 90% of cases, compared to about 80% of cases with a PPI + amoxicillin + clarithromycin given for 7 days. Sequential treatment with amoxicillin for 5 days, followed by clarithromycin + metronidazole for 5 days, has also been tested in thousands of patients. Efficacy and adverse effects were similar to those observed when the same antibiotics were taken simultaneously for 5 days. In randomised trials, replacing clarithromycin or amoxicillin with a fluoroquinolone yielded conflicting results. In 2009, nearly 20% of H. pylori isolates were resistant to levofloxacin in France. Tetracycline has only been evaluated in combination with bismuth. The few available data on doxycycline suggest that its efficacy is similar to that of tetracycline. A fixed-dose combination of bismuth subcitrate potassium + metronidazole

  12. Nitroimidazole resistance in Helicobacter pylori

    NARCIS (Netherlands)

    Van der Wouden, EJ; Thijs, JC; Van Zwet, AA; Kleibeuker, JH

    2000-01-01

    The efficacy of a nitroimidazole-containing regimen for the treatment of Helicobacter pylori infection is decreased by nitroimidazole resistance. Nitroimidazoles are metabolized by H. pylori by several nitro-reductases of which an oxygen-insensitive NADPH nitroreductase encoded by the rdxA gene is t

  13. Helicobacter pylori infection in pediatrics

    DEFF Research Database (Denmark)

    Wewer, Anne Vibeke; Kalach, Nicolas

    2003-01-01

    in gastric manifestations is the subject of conflicting reports. Extra-digestive manifestations are also reported in the course of this infection. The treatment of H. pylori infection is influenced by resistance of the bacteria to the antibiotics used. We suggest that eradication of H. pylori should take...

  14. Epidemiology of Helicobacter pylori infection.

    Science.gov (United States)

    Eusebi, Leonardo H; Zagari, Rocco M; Bazzoli, Franco

    2014-09-01

    Medline and PubMed databases were searched on epidemiology of Helicobacter pylori for the period of April 2013-March 2014. Several studies have shown that the prevalence of H. pylori is still high in most countries. In north European and North American populations, about one-third of adults are still infected, whereas in south and east Europe, South America, and Asia, the prevalence of H. pylori is often higher than 50%. H. pylori remains highly prevalent in immigrants coming from countries with high prevalence of H. pylori. However, the lower prevalence of infection in the younger generations suggests a further decline of H. pylori prevalence in the coming decades. Low socioeconomic conditions in childhood are confirmed to be the most important risk factors for H. pylori infection. Although the way the infection is transmitted is still unclear, interpersonal transmission appears to be the main route. Finally, H. pylori recurrence after successful eradication can still occur, but seems to be an infrequent event.

  15. Pathogenesis of Helicobacter pylori infection

    NARCIS (Netherlands)

    J.G. Kusters (Johannes); A.H.M. van Vliet (Arnoud); E.J. Kuipers (Ernst)

    2006-01-01

    textabstractHelicobacter pylori is the first formally recognized bacterial carcinogen and is one of the most successful human pathogens, as over half of the world's population is colonized with this gram-negative bacterium. Unless treated, colonization usually persists lifelong. H. pylori infection

  16. The role of acid inhibition in Helicobacter pylori eradication [version 1; referees: 3 approved

    Directory of Open Access Journals (Sweden)

    David R. Scott

    2016-07-01

    Full Text Available 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.

  17. Genetic fine structure analysis of helicobacter pylori isolates before and after treatment

    Directory of Open Access Journals (Sweden)

    Rekha T

    2003-01-01

    Full Text Available BACKGROUND: Eradication of H. pylori infection cures peptic ulcer disease and conversely, relapse is associated with reappearance of H. pylori infection. However, it is not clear whether the recurrence of ulcers following H. pylori eradication is due to recrudescence (identical strain of the previous infection or as a result of exogenous reinfection (different strain by another strain. The aim of the present study was to analyze the FAFLP patterns of pre and post treatment H. pylori samples to check if the recurrence was due to recrudescence or reinfection. MATERIALS AND METHODS: 24 of 30 duodenal ulcer (DU subjects screened for H. pylori infection were positive for H. pylori infection. The treatment regime included pantoprazole, ciprofloxacin and amoxicillin. The patients were called for a repeat endoscopy after one month and screened for H. pylori infection. FAFLP analysis and PCR for the cagA and vacA gene was performed for the pre and post treatment samples. RESULTS: Of the 24 positive H.pylori patients, only 6 were negative after treatment and the remaining 18 were positive for H.pylori infection. The analysis of the pre and post treatment samples of the 18 patients showed that the FAFLP profiles of the initial and follow-up pools were similar to one another. CONCLUSION: It can be concluded that in the present series of patients, reinfection was due to recrudescence of infection due to incomplete eradication. The study also suggests that DNA fingerprinting by FAFLP provides discriminatory and complementary data for identifying strains of H. pylori while monitoring therapy.

  18. Effect of pretreatment with Ethanol or Ammonium Hydroxide on Helicobacter Pylori colonization in the stomach of rats

    Directory of Open Access Journals (Sweden)

    Fahimi F

    2002-05-01

    Full Text Available Animal models for H.pylori infection have been developed to clarify the pathogenesis, testing new therapies and developing vaccines against human H.pylori infection. Although rats have been used extensively for gastric ulceration and acid secretion studies, the animal is not normally infected with H.pylori.Several chemicals such as ethanol and ammonium hydroxide can induce gastric erosion and interact with gastric mucosal defense mechanisms. The aim of the present study was to investigate the effects of pretreatment with the gastroinvasive agents on colonization of H. pylori with the gastroinvasive agents on colonization of H. pylori in not germ-free rats in order to overcome the resistance against H. pylori in rats. After 24 h fasting, the rats were divided into three major groups. Animals in the first group were not pretreated with any chemicals. The two other groups were pretreated with ethanol (60% or ammonium hydroxide (1% before inoculation of 1 mL H. pylori suspension (3×108 cfu/ml. The results showed that H. pylori could not colonize in rats, even with ethanol or ammonium hydroxide pretreatment. An understanding of the mechanism of this resistance can help researchers to develop new therapeutic or preventive drugs against H. pylori and it is recommended to perform more investigation to clarify the reason of this resistance

  19. Helicobacter pylori in gastroduodenal perforation

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    Bharat B Dogra

    2014-01-01

    Full Text Available Background:peptic ulcers were earlier believed to be caused by dietary factors, gastric acid, and stress. However, in 1983, Warren and Marshall identified the correlation between Helicobacter pylori (H. pylori and peptic ulcers. It is now well established that most of the peptic ulcers occur as a result of H. pylori infection. But the co-relation between perforated peptic ulcer and H. pylori infection is not yet fully established. Aims and objectives : to study the prevalence of H. pylori infection in patients with perforated peptic ulcer. Materials and methods: this was a prospective study carried out in all cases of perforated peptic ulcer reporting in surgical wards of a medical college during 2008-2010. A total of 50 cases, presenting as acute perforation of duodenum and stomach during this period, formed the study group. After resuscitation, all the cases were subjected to emergency exploratory laparotomy. The exact site of perforation was identified, biopsy was taken from the ulcer margin from 2-3 sites and the tissue was sent for H. pylori culture and histopathological examination. Simple closure of perforation, omentoplasty, thorough peritoneal lavage and drainage was carried out. Results: out of the 50 cases of perforated peptic ulcer, 38 happened to be males, and only 12 were females. The age of the patients ranged from 20 to 70 years. All the patients underwent only emergency laparotomy. As many as 46 cases (92% turned out to be positive for H. pylori and only four cases (8% were negative for this infection. Postoperatively, patients who were found to be positive for H. pylori were put on anti-H. pylori treatment. Conclusion: there was a high prevalence of H. pylori infection in patients with perforated gastroduodenal ulcers.

  20. Study of the Role of Garlic Consumption in Helicobacter Pylori Eradication

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    M Ghobeh

    2010-09-01

    Full Text Available Introduction: There are various ways to treat H.pylori infection, such as triple-therapy and quadruple therapy for two weeks. However, these treatments have some side effects and Helicobacter pylori easily become resistant to these antibiotics. Some studies have confirmed a relationship between consumption of garlic and reduction in Helicobacter pylori infection, whereas some others have rejected this relationship. Therefore, this present study was performed to determine the effects of garlic on Helicobacter pylori infection. Methods: This trial was performed in a randomized, case-controlled design on outpatients diagnosed with Helicobacter pylori infection. The patients in the case group took four grams of garlic powder daily (two tablets each containing two grams of garlic powder whereas the patients in the control group took two placebo tablets (each containing two grams of white flour. In order to confirm the presence of Helicobacter pylori infection, urea breath test was taken, and in order to examine the presence of inflammation and/or ulcer in stomach, esophagus and duodenum, upper endoscopy was performed at the beginning and the end of the study. Results: At the beginning of this study, all the patients had positive urea breath test. At the end of this study, the results of urea breat*- test showed that Helicobacter pylori infection was negative in 87% of the case group and 73% of control group showing eradication of Helicobacter pylori infection. However, this difference was not significant statistically when compared to the control group (P= 0.36. Conclusion: These findings suggest that taking garlic powder along with prescribed antibiotics can help in reducing Helicobacter pylori infection.

  1. Low efficacy of an ultra-short term, once-daily dose triple therapy with omeprazole, azithromycin, and secnidazole for Helicobacter pylori eradication in peptic ulcer Baixa eficácia de um tratamento tríplice de curta duração, em dose única diária, para erradicação do Helicobacter pylori em pacientes ulcerosos com Omeprazol, Azitromicina e Secnidazol

    Directory of Open Access Journals (Sweden)

    Fernando Marcuz Silva

    2002-02-01

    Full Text Available PURPOSE: To determine the eradication rate of an ultra-short treatment schedule for Helicobacter pylori infection in a population with peptic ulcers, using omeprazole, secnidazole, and azithromycin in a once-daily dose for 3 days. METHODS: Thirty patients with peptic ulcer diagnosed by upper endoscopy and for Helicobacter pylori infection by rapid urease test and histologic examination received omeprazole 40 mg, secnidazole 1000 mg, and azithromycin 500 mg, administered once daily for 3 days. A follow-up exam was performed 12 weeks after the end of the treatment. Patients who were negative for Helicobacter pylori infection by rapid urease test and histologic examination were considered cured. RESULTS: Patients were predominantly female, and the mean age was 50 years. Duodenal peptic ulcer was found in 73% of the patients. Eradication was achieved in 9 of the 28 (32% patients as determined from the follow-up endoscopic exam. The eradication rate by intention to treat was 30%. Side effects were present in 3% of the patients, and compliance to treatment was total. CONCLUSIONS: In spite of the low rate of side effects and good compliance, the eradication index was low. A possible drawback of this therapy is that it reduces the efficacy of macrolide and nitroimidazole compounds in subsequent treatments.OBJETIVO: Testar a eficácia de um esquema ultra-curto de erradicação do H. pylori em uma população de ulcerosos, usando Omeprazol, Secnidazol e Azitromicina em dose única diária por três dias. PACIENTES E MÉTODOS: Trinta doentes portadores de úlcera péptica, documentada por exame endoscópico e com infecção pelo H. pylori confirmada pelo teste da urease e exame histológico, foram tratados com Omeprazol 40mg, Secnidazol 1000 mg e Azitromicina 500mg dados em dose única diária por três dias. Em controle endoscópico realizado 12 semanas após o término do tratamento, foram considerados curados da infecção os pacientes que apresentaram

  2. Helicobacter pylori treatment: Still a work in progress.

    Science.gov (United States)

    Senatore, Frank J; Wilmot, Jonathan; Birk, John W

    2016-01-01

    Helicobacter pylori is a common worldwide bacterium, possessing adaptability that has created difficulty achieving eradication. While the standard treatment was thought to be triple therapy with a proton pump inhibitor, amoxicillin, and clarithromycin, growing rates of treatment failure and antibiotic resistance have stimulated research into novel regimens. Quadruple therapy with bismuth has been compared for both first- and second-line treatments, but eradication still has not reached expected goals. Innovative regimens including sequential and concomitant therapy, as well as the introduction of new antibiotics into previous treatment schedules, have shown promising improvements in eradication rates. We discuss and compare these unique regimens, reviewing the current literature to deduce those which are most likely to provide the highest success in curing H. pylori infection.

  3. Investigation of the effect of esomeprazole triple therapy for eradicating helicobacter pylori on peptic ulcer%埃索美拉唑三联疗法根除幽门螺杆菌对消化性溃疡的疗效探讨

    Institute of Scientific and Technical Information of China (English)

    覃洪

    2015-01-01

    Objective:To explore the effect of esomeprazole triple therapy for eradicating helicobacter pylori on peptic ulcer. Methods:110 peptic ulcer patients with positive helicobacter pylori were selected.They were randomly divided into the control group and the observation group with 55 cases in each group.The control group was treated with lansoprazole triple therapy.The observation group was treated with esomeprazole triple therapy.We compared the clinical efficacy of two groups.Results:In the observation group the efficiency of 95.55% was significantly higher than 81.82% of the control group(P<0.05).Helicobacter pylori eradication rate of 92.73% was significantly higher than 72.73% in the control group(P<0.05).Conclusion:Taking esomeprazole triple therapy,helicobacter pylori eradication rate was increased.The clinical symptoms were significantly improved.%目的:分析埃索美拉唑三联疗法根除幽门螺杆菌对于消化性溃疡的疗效。方法:收治幽门螺杆菌阳性消化性溃疡患者110例,随机分为对照组和观察组,各55例,对照组采取兰索拉唑三联疗法,观察组采取埃索美拉唑三联疗法,对比两组临床疗效。结果:观察组有效率95.55%明显高于对照组的81.82%(P<0.05),幽门螺杆菌根除率92.73%明显高于对照组的72.73%(P<0.05)。结论:采取埃索美拉唑三联疗法,幽门螺杆菌根除率提高,临床症状得到明显改善。

  4. Gastrin and antral G cells in course of Helicobacter pylori eradication: Six months follow up study

    Institute of Scientific and Technical Information of China (English)

    Aleksandra Sokic-Milutinovic; Vera Todorovic; Tomica Milosavljevic; Marjan Micev; Neda Drndarevic; Olivera Mitrovic

    2005-01-01

    AIM: To assess long-term effects of Helicobacter pylori (H pylori) eradication on antral G cell morphology and function in patients with and without duodenal ulcer (DU).METHODS: Consecutive dyspeptic patients referred to the endoscopy entered the study. Out of 39 H pylori positive patients, 8 had DU (H pylori+DU) and 31 gastritis (H pylori +G). Control groups consisted of 11 uninfected dyspeptic patients (CG1) and 7 healthy volunteers (CG2). Basal plasma gastrin (PGL), antral tissue gastrin concentrations (ATGC), immunohistochemical and electron microscopic characteristics of G cells were determined, prior to and 6 mo after therapy.RESULTS: We demonstrated elevated PGL in infected patients compared to uninfected controls prior to therapy.Elevated PGL were registered in all H pylori+patients (H pylori +DU: 106.78±22.72 pg/mL, H pylori+G: 74.95±15.63,CG1: 68.59±17.97, CG2:39.24±5.59 pg/mL, P<0.01).Successful eradication (e) therapy in H pylori+patients lead to significant decrease in PGL (H pylori+DU: 59.93±9.40and H pylori+Ge: 42.36±10.28 pg/mL, P<0.001). ATGC at the beginning of the study were similar in infected and uninfected patients and eradication therapy lead to significant decrease in ATGC in H pylori+gastritis, but not in DU patients. In the H pylori+DU patients, the mean number of antral G cells was significantly lower in comparison with all other groups (P<0.01), but after successful eradication was close to normal values found in controls. By contrast, G cell number and volume density were significantly decreased (P<0.01) in H pylori+Ge group after successful eradication therapy (294±32 and 0.31±0.02,respectively), in comparison to values before eradication (416±40 and 0.48±0.09). No significant change of the G cell/total endocrine cell ratio was observed during the 6 mo of follow up in any of the groups. A reversible increase in G cell secretory function was seen in all infected individuals, demonstrated by a more prominent secretory

  5. Pylera for the eradication of Helicobacter pylori infection.

    LENUS (Irish Health Repository)

    Saleem, Aamir

    2012-02-01

    An ideal antibiotic regimen for Helicobacter pylori should achieve eradication rates of approximately 90%. Current 7-day triple therapy is successful in about two-thirds of patients. A novel treatment is required to achieve higher eradication with minimal induction of bacterial resistance. The aim of this article is to evaluate the safety and efficacy of a single triple capsule (Pylera) containing bismuth, metronidazole and tetracycline, given with omeprazole for the eradication of H. pylori infection. Extensive literature searches were conducted using PubMed data from 1982 to 2007. This search included headings of H. pylori, bismuth and eradication therapy. The triple capsule Pylera, when given with omeprazole, achieved eradication rates ranging between 84 and 97%. Eradication rates were similar for clarithromycin- and metronidazole-resistant strains. Eradication rates with an omeprazole, bismuth, metronidazole and tetracycline regimen appeared comparable for metronidazole-resistant and -sensitive strains. This effect is not seen with the use of triple therapy in cases of clarithromycin resistance. Clinical trials did not report any serious side effects from bismuth-based regimens and compliance was similar to standard triple therapy. Bismuth-based triple therapy using Pylera is a simplified, effective and well-tolerated regimen achieving cure rates of above 90%.

  6. Comparison of three diagnostic methods to confirm Helicobacter pylori infection

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    Opavski Nataša

    2007-01-01

    Full Text Available Introduction: Helicobacter pylori induces gastric inflammation in host and such gastritis increases the risk of gastric and duodenal ulceration as well as adenocarcinoma. Because peptic ulcer disease is the major cause of morbidity, accurate diagnosis of H. pylori infection is very important. Unfortunately, there is no gold standard among diagnostic tests for Helicobacter infections. If gastroscopy is performed, histopathology and urease test are the most often used. Still, culturing of this bacterium is essential for drug susceptibility testing and analysis of virulence factors. Objective The aim of this study was to compare three diagnostic procedures - histopathology, urease test and culture, which are used to verify H. pylori infection. Method Three pairs of gastric mucosal biopsy specimens were collected from each of 28 dyspeptic patients undergoing endoscopy. Nineteen patients were not pretreated with antibiotics, while nine had received eradication therapy earlier. One pair of biopsy specimens was used for histopathologic examination, the second for urease test and the third was simultaneously cultured on nonselective and selective solid media. Isolate was identified as H. pylori on the basis of colony morphology, morphological properties and biochemical tests. Results In 14 out of 28 patients, H. pylori infection was confirmed on the basis of results of all diagnostic procedures. The concordance of these three methods was very good, because the results of histopathology, urease test and culture corresponded in 26 from 28 patients. Conclusion The conclusion of our study is that culture, as the method with high degree of concordance with other two procedures and the only that can give information on drug susceptibility of Helicobacter, is recommended for diagnosis of Helicobacter pylori infection along with histopathology and urease test.

  7. The Relationship between H. pylori Infection and Osteoporosis in Japan

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    Daisuke Asaoka

    2014-01-01

    Full Text Available Background and Objective. H. pylori infection causes a chronic inflammation in the gastric mucosa. However, this local inflammation may result in extra-digestive conditions. Our aim is to investigate the relationship between H. pylori infection and osteoporosis in Japan. Methods. This cross-sectional study was conducted among outpatients at the Juntendo University Hospital between 2008 and 2014. Participants for patient profile, H. pylori infection status, comorbidity, internal medical therapies, lumbar dual-energy X-ray absorptiometry (DXA, and bone turnover marker were collected and upper gastrointestinal endoscopy for reflux esophagitis, hiatal hernia, peptic ulcer disease (PUD, and endoscopic gastric mucosal atrophy (EGA was performed. The diagnosis of osteoporosis was performed in accordance with the Japanese criteria. We investigated risk factors of osteoporosis. Results. Of the eligible 200 study subjects, 41 cases were of osteoporosis. Bivariate analysis showed that age, being female, BMI, alcohol, smoking, H. pylori, bone-specific ALP, PUD, and EGA were related to osteoporosis. Multivariate analysis showed that age (OR 1.13; 95%CI 1.07–1.20, being female (OR 4.77; 95%CI 1.78–12.77, BMI (OR 0.79; 95%CI 0.68–0.92, H. pylori (OR 5.33; 95%CI 1.73–16.42, and PUD (OR 4.98; 95%CI 1.51–16.45 were related to osteoporosis. Conclusions. H. pylori infection may be a risk factor of osteoporosis in Japan.

  8. 胃肠道微生态与幽门螺杆菌根除治疗的相关性%Relevance between Gastrointestinal Microbiota and Helicobacter pylori Eradication Therapy

    Institute of Scientific and Technical Information of China (English)

    关月; 张振玉

    2015-01-01

    Gastrointestinal microbiota is a huge and complex system that has multiple influential factors. As an exogenous pathogen,Helicobacter pylori(Hp)may interact with gastrointestinal microbiota. It has been revealed that Hp infection led to an increase in Lactobacillus acidophilus in intestinal tract and a decrease in Actinobacteria,Bacteroidetes and Firmacutes in stomach. Proton pump inhibitors and antibiotics,the major components of eradication regimens for Hp infection,may also have an impact on gastrointestinal microbiota. On the other hand,gastrointestinal microbiota interferes with Hp’s attachment into gastric mucosa. Probiotics combined with eradication therapy could benefit the eradication rate of Hp infection and reduce adverse events.%胃肠道微生态系统庞大而复杂,影响因素众多,其中幽门螺杆菌(Hp)作为外源性细菌,可与胃肠道微生态产生相互影响。研究发现 Hp 感染可致肠道内嗜酸乳杆菌数量增多,胃内放线菌门、拟杆菌门和厚壁菌门数量减少。Hp 根除治疗方案中的质子泵抑制剂和抗菌药物亦可影响胃肠道微生态。同时,胃肠道微生态可影响 Hp 在胃黏膜的定植,在根除 Hp 时联合使用益生菌可有效提高根除率,减少不良反应。

  9. Analysis on Curative Effect of Sequential Therapy in Treatment of Children with Helicobacter Pylori Infection%序贯疗法治疗儿童幽门螺杆菌感染的效果分析

    Institute of Scientific and Technical Information of China (English)

    荣海芹

    2012-01-01

    Objective To explore on curative effect of sequential therapy in treatment of children with Helicobacter pylori. Methods 200 children with Hp who fitted in radical indication were randomly divided into four groups (n =50) and were radically treated with different methods for 10 d. In sequential therapy group, the therapy method was Omeprazole + Amoxicillin for the first five days and Omeprazole + Clarithromycin + Metronidazole for the last five days; while in PAC group, the treatment was Omeprazole + Amoxicillin + Clarithromycin for ten days; in PAM group, the treatment was Omeprazole + Amoxicillin + Metronidazole for ten days; in quadruple therapy group the method wasOmeprazole + colloid ranitidine bismuth citrate + Clarithromycin + Amoxicillin for ten days. The Hp eradication rates of the four groups were compared. Results The eradication rate of sequential therapy group, PAC group, PAM group and quadruple therapy group was 90% , 72% , 70% and 94% respectively, the differences in the 4 groups were statistically significant (P 0.05); the differences between quadruple therapy group and the PAC group or PAM group were statistically significant (χ2=8.5755, χ2=9.7561, average P 0.05). The different incidence rates in the 4 groups were not statistically significant (P >0.05). Conclusion The sequential therapy has a higher eradication rate of Helico-bacter pylori with less adverse reaction. It may be a new first-line solution in treatment of children with Hp infection with good effect.%目的 探讨序贯疗法对儿童幽门螺杆菌(Hp)感染的效果.方法 选择明确诊断Hp感染的符合根治适应证的儿童患者200例,随机分为4组,每组50例,按照不同方法进行Hp根治,疗程均为10 d.序贯治疗组前5d予奥美拉唑+阿莫西林,后5d予奥美拉唑+克拉霉素+甲硝唑;PAC组予奥美拉唑+阿莫西林+克拉霉素;PAM组予奥美拉唑+阿莫西林+甲硝唑;四联疗法组予奥美拉唑+胶体枸橼酸铋+克拉霉素+

  10. Curcumin Inhibits Gastric Inflammation Induced by Helicobacter Pylori Infection in a Mouse Model

    Directory of Open Access Journals (Sweden)

    António M. Santos

    2015-01-01

    Full Text Available Helicobacter pylori (H. pylori infection triggers a sequence of gastric alterations starting with an inflammation of the gastric mucosa that, in some cases, evolves to gastric cancer. Efficient vaccination has not been achieved, thus it is essential to find alternative therapies, particularly in the nutritional field. The current study evaluated whether curcumin could attenuate inflammation of the gastric mucosa due to H. pylori infection. Twenty-eight C57BL/6 mice, were inoculated with the H. pylori SS1 strain; ten non-infected mice were used as controls. H. pylori infection in live mice was followed-up using a modified 13C-Urea Breath Test (13C-UBT and quantitative real-time polymerase chain reaction (PCR. Histologically confirmed, gastritis was observed in 42% of infected non-treated mice at both 6 and 18 weeks post-infection. These mice showed an up-regulation of the expression of inflammatory cytokines and chemokines, as well as of toll-like receptors (TLRs and MyD88, at both time points. Treatment with curcumin decreased the expression of all these mediators. No inflammation was observed by histology in this group. Curcumin treatment exerted a significant anti-inflammatory effect in H. pylori-infected mucosa, pointing to the promising role of a nutritional approach in the prevention of H. pylori induced deleterious inflammation while the eradication or prevention of colonization by effective vaccine is not available.

  11. Symptomatic infantile Helicobacter pylori gastritis infection in indigenous African infants: a case series.

    Science.gov (United States)

    Malande, Oliver Ombeva

    2014-01-01

    Helicobacter pylori gastritis infection rate increases with age. Higher rates have however been reported among young people in the developing countries of the world. The infection however has rarely been reported in infants, especially in Africa. This case series describes three cases of Helicobacter pylori gastritis infection as diagnosed in three infants. The goal is to raise the suspicion index of medical practitioners about the possibility of this this infection among infants who present with suggestive symptoms. On three separate occasions in 2012 and 2013, three ill, indigenous, black African female infants aged 4, 6 and 7 months, were brought to hospital with symptoms ranging from fever, refusal to feed, diarrhoea, restlessness, vomiting and irritability. In each case, systemic examination findings were unremarkable. After several laboratory investigations, each infant was found to have Helicobacter pylori infection following positive blood antibody (using Tell Me Fast H. Pylori antibody serum and Plasma test manufactured by Biocan Diagnostics Canada) and fecal HpSA ImmunoCardSTAT antigen tests. Repeat stool antigen test was negative in each case after completion of the recommended triple therapy. Helicobacter pylori infection has been rarely reported among infants. This case series highlights the need for health care providers to have a high index of suspicion so that infants with suggestive symptoms, especially in settings with high Helicobacter pylori colonization prevalence can be evaluated for Helicobacter pylori gastritis infection.

  12. Patients with Helicobacter pylori positive and negative duodenal ulcers have distinct clinical characteristics

    Institute of Scientific and Technical Information of China (English)

    Kent-Man Chu; Ka-Fai Kwok; Simon Law; Kam-Ho Wong

    2005-01-01

    AIM: To assess the clinical characteristics of Helicobacterpylori(H pylori) negative duodenal ulcer.METHODS: Patients with an endoscopic diagnosis of duodenal ulcer between 1996 and 2002 were included in the present study. Patients were considered to be negative for Hpylori, if both histological examination and rapid urease test of biopsy specimens were negative. A comparison was made between patients with H pyloripositive and negative duodenal ulcers.RESULTS: A total of 1 343 patients were studied. Their mean age was 54.7±0.5 years. There was a male preponderance (M:F = 2.5:1). Three hundred and ninetyeight patients (29.6%) did not have H pylori infection. The annual proportion of patients with H pylori negative duodenal ulcers increased progressively from 1996 to2002. On multivariate analysis, patients with H pylorinegative duodenal ulcer were more likely to be older, have concomitant medical problem, pre-existing malignancy, recent surgery, underlying sepsis, or taken non-steroidal anti-inflammatory drugs. In terms of clinical presentations, patients with H pylori negative duodenal ulcer were more likely to present with bleeding, multiple ulcers and larger ulcers.CONCLUSION: The proportion of patients with H pylori negative duodenal ulcers is on the rise because of a continued drop in incidence of H pylori positive duodenalulcers in recent years. Such patients have distinct clinical characteristics and it is important to ascertain the H pylori status before starting eradication therapy.

  13. Helicobacter pylori in lacrimal secretions.

    Science.gov (United States)

    Batioglu-Karaaltin, Aysegul; Saatci, Ozlem; Akpinar, Meltem; Celik, Melih Ozgür; Develioglu, Omer; Yigit, Ozgur; Külekçi, Mehmet; Akarsubaşı, Alper Tunga

    2016-03-01

    The aim of this study was to investigate the presence of Helicobacter pylori in human lacrimal and nasal secretions. Eighty patients with complaints of dyspepsia who had undergone endoscopies and gastric antrum biopsies were included in the study. A total of five specimens, including 2 lacrimal secretion samples, 2 nasal mucosal swab samples, and 1 gastric antrum biopsy, were collected from each patient and investigated with polymerase chain reaction (PCR) methods consisting of the urease enzyme coding gene GlmM (UreC) and the H pylori-specific 16S rRNA coding gene. The Reflux Symptom Index and ophthalmologic complaints of the patients were recorded. The detected positivity rates of the H pylori 16S rRNA coding gene in gastric biopsies and nasal mucous and lacrimal secretions were 55, 11.2, and 20%, respectively. The patients were grouped as gastric-antrum-biopsy-negative (Group I [n = 36]) and -positive (Group II [n = 44). In Group II, H pylori positivity in the lacrimal and nasal mucous secretions was 36.3 and 18%, respectively. A comparison between the groups in terms of H pylori presence in nasal mucous and lacrimal secretions yielded statistically significant differences (p = 0.0001, p = 0.003). The simultaneous presence of H pylori in nasal mucous and lacrimal secretions was 13.6% in Group II. H pylori positivity in nasal mucous and lacrimal secretions had a positive moderate correlation (r = 0.40; p = 0.0003). The present study is the first report on the presence of H pylori in lacrimal secretions through nested PCR, which suggested the presence of a number of mechanisms for H pylori transmission to lacrimal secretions.

  14. From Bench to Bedside to Bug: An Update of Clinically Relevant Advances in the Care of Persons with Helicobacter pylori Associated Diseases

    Directory of Open Access Journals (Sweden)

    N Chiba

    2000-01-01

    Full Text Available In-depth meetings of the XIth International Workshop on Gastroduodenal Pathology and Helicobacter pylori led to the presentation and discussion of extensive new data on H pylori and its diseases. The mode of transmission of H pylori remains unclear, and it remains unknown why only a small proportion of infected individuals develop duodenal or gastric ulcer disease and even fewer develop gastric cancer. The role of H pylori eradication in persons with uninvestigated dyspepsia remains controversial. New clinical trials of H pylori treatment show symptom relief and improvement in the quality of life of persons with functional dyspepsia, especially in those with ulcer-like or reflux-like dyspepsia. Clearly the move is toward symptom-based management of persons with dyspepsia, with fewer endoscopies being needed in the otherwise healthy young dyspeptic patients. It remains controversial whether eradicating H pylori in duodenal ulcer or functional dyspepsia increases the risk of subsequent development of gastroesophageal reflux disease. The one-week proton pump inhibitor-based triple regimens remain the gold standard of H pylori therapy, but some of the ranitidine bismuth citrate plus two antibiotic regimens also achieve an 80% H pylori eradication rate on an intention-to-treat basis. While the urea breath test remains the noninvasive test of choice, interesting new data are available on the use of stool antigen testing to diagnose H pylori infection. The number of H pylori-associated gastroduodenal diseases grows to include possible liver, vascular, immune and skin conditions.

  15. Helicobacter pylori infection: approach of primary care physicians in a developing country

    Directory of Open Access Journals (Sweden)

    Ali Shah Hasnain

    2009-04-01

    Full Text Available Abstract Background The aim of the study was to assess the knowledge and practices of primary care physicians in diagnosis and management of Helicobacter pylori (H. pylori infection in developing country. Methods This convenient sample based, cross sectional study was conducted in primary care physicians of Karachi, Pakistan from March 2008 to August 2008 through a pretested self-designed questionnaire, which contained 11 items pertaining to H. pylori route of transmission, diagnosis, indication for testing, treatment options, follow up and source of information. Results Out of 509 primary care physicians, 451 consented to participate with the response rate of 88.6%. Responses of 426 primary care physicians were analyzed after excluding 19 physicians. 78% of the physicians thought that contaminated water was the source of spread of infection, dyspepsia was the most frequent indication for investigating H. pylori infection (67% of the physicians, while 43% physicians were of the view that serology was the most appropriate test to diagnose active H. pylori infection. 77% of physicians thought that gastric ulcer was the most compelling indication for treatment, 61% physicians preferred Clarithromycin based triple therapy for 7–14 days. 57% of the physicians would confirm H. pylori eradication after treatment in selected patients and 47% physicians preferred serological testing for follow-up. In case of treatment failure, only 36% of the physicians were in favor of gastroenterologist referral. Conclusion The primary care physicians in this study lacked in knowledge regarding management of H. pylori infection. Internationally published guidelines and World gastroenterology organization (WGO practice guideline on H. pylori for developing countries have little impact on current practices of primary care physicians. We recommend more teaching programs, continuous medical education activities regarding H. pylori infection.

  16. Early or late antibiotic intervention prevents Helicobacter pylori-induced gastric cancer in a mouse model.

    Science.gov (United States)

    Zhang, Songhua; Lee, Dong Soo; Morrissey, Rhiannon; Aponte-Pieras, Jose R; Rogers, Arlin B; Moss, Steven F

    2014-12-01

    H. pylori infection causes gastritis, peptic ulcers and gastric cancer. Eradicating H. pylori prevents ulcers, but to what extent this prevents cancer remains unknown, especially if given after intestinal metaplasia has developed. H. pylori infected wild-type (WT) mice do not develop cancer, but mice lacking the tumor suppressor p27 do so, thus providing an experimental model of H. pylori-induced cancer. We infected p27-deficient mice with H. pylori strain SS1 at 6-8 weeks of age. Persistently H. pylori-infected WT C57BL/6 mice served as controls. Mice in the eradication arms received antimicrobial therapy (omeprazole, metronidazole and clarithromycin) either "early" (at 15 weeks post infection, WPI) or "late" at 45 WPI. At 70 WPI, mice were euthanized for H. pylori determination, histopathology and cytokine/chemokine expression. Persistently infected mice developed premalignant lesions including high-grade dysplasia, whereas those given antibiotics did not. Histologic activity scores in the eradication groups were similar to each other, and were significantly decreased compared with controls for inflammation, epithelial defects, hyperplasia, metaplasia, atrophy and dysplasia. IP-10 and MIG levels in groups that received antibiotics were significantly lower than controls. There were no significant differences in expression of IFN-γ, TNF-α, IL-1β, RANTES, MCP-1, MIP-1α or MIP-1β among the three groups. Thus, H. pylori eradication given either early or late after infection significantly attenuated gastric inflammation, gastric atrophy, hyperplasia, and dysplasia in the p27-deficient mice model of H. pylori-induced gastric cancer, irrespective of the timing of antibiotic administration. This was associated with reduced expression of IP-10 and MIG.

  17. Effects of Helicobacter pylori infection on gastric emptying rate in patients with non-ulcer dyspepsia

    Institute of Scientific and Technical Information of China (English)

    Grigoris I Leontiadis; George I Minopoulos; Efstratios Maltezos; Stamatia Kotsiou; Konstantinos I Manolas; Konstantinos Simopoulos; Dimitrios Hatseras

    2004-01-01

    AIM: The pathogenesis of delayed gastric emptying in patients with non-ulcer dyspepsia (NUD) remains unclear.We aimed to examine whether gastric emptying rate in NUD patients was associated with Helicobacter pylori(H pylori)infection and whether it was affected by eradication of the infection.METHODS: Gastric emptying rate of a mixed solid-liquid meal was assessed by the paracetamol absorption method in NUD patients and asymptomatic controls (n=17). H pylori status was assessed by serology and biopsy urease test.H pylori-positive NUD patients (n=23) received 10-day triple eradication therapy. H pylori status was re-assessed by biopsy urease test four weeks later, and if eradication was confirmed, gastric emptying rate was re-evaluated.RESULTS: Thirty-three NUD patients and 17 controls were evaluated. NUD patients had significantly delayed gastric emptying compared with controls. The mean maximum plasma paracetamol concentration divided by body mass (P=0.02), the mean area under plasma paracetamol concentration-time curve divided by body mass (AUC/BM)Gastric emptying rate did not differ significantly between H pylori-positive and H pylori-negative NUD patients. The were initially H pylori-positive, confirmed eradication of the infection did not significantly alter gastric emptying rate.and after Hp eradication, respectively (P=0.64), the mean eradication, respectively (P=0.93).CONCLUSION: Although gastdc emptying is delayed in NUD patients compared with controls, gastric emptying rate is not associated with H pylori status nor it is affected by eradication of the infection.

  18. Linked color imaging improves endoscopic diagnosis of active Helicobacter pylori infection

    Science.gov (United States)

    Dohi, Osamu; Yagi, Nobuaki; Onozawa, Yuriko; Kimura-Tsuchiya, Reiko; Majima, Atsushi; Kitaichi, Tomoko; Horii, Yusuke; Suzuki, Kentaro; Tomie, Akira; Okayama, Tetsuya; Yoshida, Naohisa; Kamada, Kazuhiro; Katada, Kazuhiro; Uchiyama, Kazuhiko; Ishikawa, Takeshi; Takagi, Tomohisa; Handa, Osamu; Konishi, Hideyuki; Naito, Yuji; Itoh, Yoshito

    2016-01-01

    Background and study aims: Linked color imaging (LCI) is a new image-enhanced endoscopy technique using a laser light source to enhance slight differences in mucosal color. The aim of this study was to compare the usefulness of LCI and conventional white light imaging (WLI) endoscopy for diagnosing Helicobacter pylori (H. pylori). Patients and methods: We retrospectively analyzed images from 60 patients examined with WLI and LCI endoscopy between October 2013 and May 2014. Thirty patients had H. pylori infections, and other thirty patients tested negative for H. pylori after eradication therapy. Four endoscopists evaluated the 2 types of images to determine which was better at facilitating a diagnosis of H. pylori infection. Results: H. pylori infection was identified with LCI by enhancing the red appearance of the fundic gland mucosa. The accuracy, sensitivity, and specificity for diagnosing H. pylori infection using WLI were 74.2 %, 81.7 %, and 66.7 %, respectively, while those for LCI were 85.8 %, 93.3 %, and 78.3 %, respectively. Thus, the accuracy and sensitivity for LCI were significantly higher than those for WLI (P = 0.002 and P = 0.011, respectively). The kappa values for the inter- and intraobserver variability among the 4 endoscopists were higher for LCI than for WLI. Conclusions: H. pylori infection can be identified by enhancing endoscopic images of the diffuse redness of the fundic gland using LCI. LCI is a novel image-enhanced endoscopy and is more useful for diagnosing H. pylori infection than is WLI. PMID:27556101

  19. [Helicobacter pylori -- 2014].

    Science.gov (United States)

    Buzás, György Miklós

    2015-02-08

    The author reviews the main achievements in Helicobacter pylori research in the past 2 years. Of the more than 1000 microRNAs described thus far, sets of over- and underexpressed samples were identified that are associated with either gastric cancer or precancerous lesions, and some of them could be either markers or therapeutic targets in the near future. Meta-analyses involved 95 new publications: the association between infection and oesophageal, colorectal, pancreatic and liver carcinomas is supported by the increased odds ratios, but the results do not reach the strength seen in gastric carcinoma. Epstein-Barr virus is an emerging pathogen: 10% of gastric cancers are virus-associated; the prevalence of the virus in normal mucosa, chronic gastritis and peptic ulcer are currently being studied. Current Helicobacter pylori eradication regimens frequently achieve suboptimal results: a few optimisation methods are presented, although not all are supported by the meta-analyses. In 2013, the European Helicobacter Study Group proposed the development of a pan-European registry; data from 5792 patients registered so far indicated that many therapeutic regimens resulted in a low eradication rate. In 2013, the Healthy Stomach Initiative was started with the aim of supporting and disseminating research performed in the field of healthy and diseased stomachs.

  20. 序贯疗法治疗幽门螺杆菌阳性十二指肠溃疡疗效观察%Sequential therapy for duodenal ulcer complicated with Helicobacter pylori

    Institute of Scientific and Technical Information of China (English)

    谭瑞明

    2011-01-01

    目的 评估序贯疗法治疗幽门螺杆菌(Hp)阳性十二指肠溃疡的疗效与安全性.方法 选取70例经胃镜检查确诊且1个月内14C尿素呼气试验阳性的十二指肠溃疡患者,随机分为两组:治疗组前5 d给予雷贝拉唑、阿莫西林,后 5 d给予雷贝拉唑、替硝唑、克拉霉素治疗;对照组予雷贝拉唑加阿莫西林、克拉霉素治疗7 d.两组均继续予雷贝拉唑治疗3周,记录用药后患者症状缓解情况.疗程结束1个月后复查胃镜并行14C尿素呼气试验检测.结果 治疗组Hp根除率为94.1%,对照组根除率为77.8%,两组比较差异有统计学意义(P0.05).两组不良反应发生率比较差异无统计学意义(P>0.05).结论 序贯疗法治疗Hp阳性十二指肠溃疡具有疗效高、耐受性和依从性好等优点.%Objective To evaluate the efficacy and safety of sequential therapy in the treatment of duodenal ulcer complicated with Helicobacter pylori(Hp). Methods Seventy patients with Hp positive duodenal ulcer were randomly divided into two groups. The treatment group were treated with rabeprazole,amoxillin at first five days; rabeprazole, clarithromycin and tinidazole at the second five days. The control group were treated with rabeprazole,amoxillin and clarithromycin for seven days. Two groups were treated with rabeprazole for 3 weeks sequentially. Gastroscopy and Hp test were performed in the fourth week after the end of the treatment. Results The Hp eradication rate was 94.1%in treatment group,while it was 77.8% in control group. There was significant difference between the two groups(P0.05). Conclusions Sequential therapy is more effective, well tolerated and with higher rate of eradication.

  1. Helicobacter pylori infection in pediatrics

    DEFF Research Database (Denmark)

    Wewer, Anne Vibeke; Kalach, Nicolas

    2003-01-01

    A high prevalence and early colonization of Helicobacter pylori infection in childhood was described again this year in developing countries in contrast to developed ones. Upper gastrointestinal endoscopy including gastric biopsies remains the diagnostic gold standard method for this infection...

  2. Management of Helicobacter pylori infections

    NARCIS (Netherlands)

    Abadi, Amin Talebi Bezmin; Kusters, Johannes G

    2016-01-01

    BACKGROUND: Infection with Helicobacter pylori is associated with severe digestive diseases including chronic gastritis, peptic ulcer disease, and gastric cancer. Successful eradication of this common gastric pathogen in individual patients is known to prevent the occurrence of peptic ulcer disease

  3. Mucoadhesive and muco-penetrating delivery systems for eradication of helicobacter pylori

    Directory of Open Access Journals (Sweden)

    Saahil Arora

    2012-01-01

    Full Text Available Helicobacter pylori (H. pylori, the major culprit for peptic ulcer, has a unique way of survival in harsh acidic environment of the stomach by colonizing deep in the gastric mucosal layer. Failure of conventional therapies against H. pylori for complete eradication has major limitations like low residence time of delivery system in stomach, poor penetration of drug in gastric mucosa, acidic degradation of antibiotics, and development of antibiotics resistance. The poor penetration of antibiotics through thick viscoelastic mucosal gel results in incomplete eradication of H. pylori. Various investigators have formulated novel gastro-retentive drug delivery systems such as floating systems, mucoadhesive systems, pH-sensitive gel systems, and muco-penetrating delivery systems for increasing the concentration of antibiotic in close proximity to the site of H. pylori infection. This review summarizes the novel drug delivery approaches investigated during the last few years and suggests that a high eradication rate can be achieved by therapy comprising of muco-penetrating delivery systems of antibiotics against H. pylori.

  4. Tnfluence of various proton pump inhibitors on intestinal metaplasia in noneradicated Helicobacter pylori patients

    Institute of Scientific and Technical Information of China (English)

    Marinko Marusic; Zarko Babic; Mirjana Nesanovic; Mira Lucijanic-Mlinac,; Vesna Stajcar

    2005-01-01

    AIM: Intestinal metaplasia (IM) is more often found in patients with Helicobacter pylori(H pylori) infection, while eradication of H pylori results in significant reduction in the severity and activity of chronic gastritis. We aimed to determine in patients with unsuccessful eradication of H pylori the role of various proton pump inhibitors (PPIs)having different mechanisms in the resolution of IM.METHODS: We confirmed endoscopically and pathohistologically (Sydney classification) the IM in 335 patients with gastritis before and after medication for eradication of H pylori(Maastricht Protocol 2002). H pylori infection was determined by using histology, urease test and culture. Control endoscopy and histology were done after 30 d and thereafter (within 1 year). Unsuccessful eradication was considered if only one of the three tests (histology, urease and culture) was negative after therapy protocol. We used omeprazole, pantoprazole,lansoprazole in therapy protocols (in combination with two antibiotics).RESULTS: We found no significant difference in resolution of IM by using different PPI between the groups of eradicated and noneradicated patients (P<0.4821 and P<0.4388,respectively).CONCLUSION: There is no significant difference in resolution of intestinal metaplasia by different proton pump inhibitors.

  5. Effects of fucosylated milk of goat and mouse on Helicobacter pylori binding to Lewis b antigen

    Institute of Scientific and Technical Information of China (English)

    Hong-Tao Xu; Ning Li; Lennart Hammarstr(o)m; Thomas Borén; Rolf Sj(o)str(o)m; Yao-Feng Zhao; Zheng-Xing Lian; Bao-Liang Fan; Zhi-Hui Zhao; Shu-Yang Yu; Yun-Ping Dai; Li-Li Wang; Hui-Ling Niu

    2004-01-01

    AIM: To evaluate the effects of animal milk containing fucosylated antigens on Helicobacter pylori (Hpylori) binding to Lewis b antigen.METHODS: A mammary gland expression vector containing human α1-3/4-fucosyltransferase cDNA sequences was constructed. Transient expression of human α1-3/4-fucosyltransferase cDNA in goat mammary cell and establishment of transgenic mice were performed. The adhesion inhibitory properties of milk samples were analyzed by using H pylori RESULTS: Goat milk samples were found to inhibit bacterial binding to Lewis b antigen. The highest inhibition was observed 42 h after injection of the plasmid. The binding activity of Hpylori to Lewis b antigen reduced mostly, by 83%, however milk samples from transgenic mice did not inhibit H pylori binding to Lewis b antigen.CONCLUSION: The use of "humanized" animal milk produced by the transgenic introduction of fucosylated antigen can perhaps provide an alternative therapy and preventive measure for H pylori infection.

  6. Antimicrobial susceptibility testing of 230 Helicobacter pylori strains: importance of medium, inoculum, and incubation time

    DEFF Research Database (Denmark)

    Hartzen, S H; Andersen, L P; Bremmelgaard, A;

    1997-01-01

    No standardized method of susceptibility testing for Helicobacter pylori is currently available, so before a large agar dilution study comprising 230 H. pylori strains belonging to more than 80 genetically different groups was initiated, we performed a relatively small preliminary study....../spot) as the inoculum and 72 h as the incubation time. A modest inoculum effect was noted for amoxicillin and metronidazole. By the methodology derived from our preliminary study, the susceptibilities of 230 H. pylori strains to six antibiotics were subsequently determined. The results were generally in accord...... with those of others, and apart from metronidazole, the MIC of which for approximately 25% of the strains tested was >8 microg/ml, resistance was low in Denmark. The situation might, however, quickly change when and if the number of indications for antibiotic therapy for H. pylori infections increase...

  7. Direct measurement of gastric H + / K +-ATPase activities in patients with or without Helicobacter pylori-associated chronic gastritis

    Institute of Scientific and Technical Information of China (English)

    Duangporn Thong-Ngam; Pisit Tangkijvanich; Pichet Sampatanukul; Paungpayom Prichakas; Varocha Mahachai; Piyaratana Tosukowong

    2005-01-01

    AIM: The role of Helicobacter pylori (H pylori) infection in gastric acid secretion of patients with chronic gastritisremains controversial. This study was designed to elucidate the effect of H pylori on H+/K+-ATPase activities in gastric biopsy specimens.METHODS: Eighty-two patients with chronic gastritis who had undergone upper endoscopy were included in this study. H pylori infection was confirmed by rapid urease test and histology. Gastric H+/K+-ATPase activities and serum gastrin concentrations were measured by an enzymatic method and radioimmunoassay, respectively. For those patients who received triple therapy for eradicating H pylori, changes in the activity of gastric H+/K+-ATPase and serum gastrin levels were also measured. RESULTS: The mean gastric H+/K+-ATPase activity in H pyloripositive group (42 patients) was slightly higher than thatin H pylori-negative group (29 patients) (169.65±52.9 and eradication of H pylori, the gastric H+/K+-ATPase activities slightly decreased compared to prior therapy (165.03±59.50 The mean basal gastrin concentration was slightly higher in H pylori-positive patients than in H pylori-negative patients (87.92±39.65 pg/mL vs75.04± 42.57 pg/mL, P= 0.228). The gastrin levels fell significantly after the eradication of Hpylori. (Before treatment 87.00±30.78 pg/mL, aftertreatment 64.73±18.96 pg/mL, P = 0.015).CONCLUSION: Gastric H+/K+-ATPase activities are not associated with H pylori status in patients with chronicgastritis.

  8. Pathogenesis of Helicobacter pylori infection.

    Science.gov (United States)

    Hofman, Paul; Waidner, Barbara; Hofman, Véronique; Bereswill, Stefan; Brest, Patrick; Kist, Manfred

    2004-01-01

    Research in the last year has provided new insights into the function of the the cag-associated type IV secretion system and the vacuolating toxin VacA. A quite new aspect was disclosed by the finding that Helicobacter pylori in Mongolian gerbils colonizes a very distinct topology in the gastric mucous layer, obviously providing optimal conditions for long-term survival. Further research activities focused on H. pylori ammonia and metal metabolism as well as on bacterial stress defence mechanisms. Differential expression of approximately 7% of the bacterial genome was found at low pH suggesting that H. pylori has evolved a multitude of acid-adaptive mechanisms. VacA was shown to interrupt phagosome maturation in macrophage cell lines as well as to modulate and interfere with T lymphocyte immunological functions. Gastric mucosa as well as the H. pylori-infected epithelial cell line AGS strongly express IL-8 receptor A and B, which might contribute to the augmentation of the inflammatory response. Accumulating evidence implicates genetic variation in the inflammatory response to H. pylori in the etiology of the increased risk of gastric cancer after H. pylori infection. The chronic imbalance between apoptosis and cell proliferation is the first step of gastric carcinogenesis. In this regard, it was demonstrated that coexpression of two H. pylori proteins, CagA and HspB, in AGS cells, caused an increase in E2F transcription factor, cyclin D3, and phosphorylated retinoblastoma protein. Taken together, we now have a better understanding of the role of different virulence factors of H. pylori. There is still a lot to be learned, but the promising discoveries summarized here, demonstrate that the investigation of the bacterial survival strategies will give novel insights into pathogenesis and disease development.

  9. Helicobacter pylori in gastric carcinogenesis

    Institute of Scientific and Technical Information of China (English)

    Hyo; Jun; Ahn; Dong; Soo; Lee

    2015-01-01

    Gastric cancer still is a major concern as the third most common cancer worldwide, despite declining rates of incidence in many Western countries. Helicobacter pylori(H. pylori) is the major cause of gastric carcinogenesis, and its infection insults gastric mucosa leading to theoccurrence of atrophic gastritis which progress to intestinal metaplasia, dysplasia, early gastric cancer, and advanced gastric cancer consequently. This review focuses on multiple factors including microbial virulence factors, host genetic factors, and environmental factors, which can heighten the chance of occurrence of gastric adenocarcinoma due to H. pylori infection. Bacterial virulence factors are key components in controlling the immune response associated with the induction of carcinogenesis, and cag A and vac A are the most well-known pathogenic factors. Host genetic polymorphisms contribute to regulating the inflammatory response to H. pylori and will become increasingly important with advancing techniques. Environmental factors such as high salt and smoking may also play a role in gastric carcinogenesis. It is important to understand the virulence factors, host genetic factors, and environmental factors interacting in the multistep process of gastric carcinogenesis. To conclude, prevention via H. pylori eradication and controlling environmental factors such as diet, smoking, and alcohol is an important strategy to avoid H. pylori-associated gastric carcinogenesis.

  10. Comparative genomics of Helicobacter pylori

    Institute of Scientific and Technical Information of China (English)

    Quan-Jiang Dong; Qing Wang; Ying-Nin Xin; Ni Li; Shi-Ying Xuan

    2009-01-01

    Genomic sequences have been determined for a number of strains of Helicobacter pylori (H pylori) and related bacteria.With the development of microarray analysis and the wide use of subtractive hybridization techniques,comparative studies have been carried out with respect to the interstrain differences between H pylori and inter-species differences in the genome of related bacteria.It was found that the core genome of H pylori constitutes 1111 genes that are determinants of the species properties.A great pool of auxillary genes are mainly from the categories of cag pathogenicity islands,outer membrane proteins,restriction-modification system and hypothetical proteins of unknown function.Persistence of H pylori in the human stomach leads to the diversification of the genome.Comparative genomics suggest that a host jump has occurs from humans to felines.Candidate genes specific for the development of the gastric diseases were identified.With the aid of proteomics,population genetics and other molecular methods,future comparative genomic studies would dramatically promote our understanding of the evolution,pathogenesis and microbiology of H pylori.

  11. Does Helicobacter pylori affect portal hypertensive gastropathy?

    Directory of Open Access Journals (Sweden)

    Al Mofleh Ibrahim

    2007-01-01

    Full Text Available Helicobacter pylori (H. pylori is a major etiological factor of peptic ulcer disease (PUD. It is supposed to be a risk factor for the more frequently encountered PUD in patients with liver cirrhosis. Several investigators have evaluated the effect of H. pylori on liver cirrhosis, portal hypertensive gastropathy (PHG and encephalopathy with controversial results. Some reports have shown a higher seroprevalence and suggested a synergistic effect of H. pylori on liver cirrhosis and PHG. However, this increased prevalence is associated with a negative histology and is not influenced by the cause of cirrhosis, PHG, Child class or gender. Most studies have not found any correlation between H. pylori and PHG. In contrast, other studies have reported a markedly lower prevalence of H. pylori in cirrhotics with duodenal ulcer compared to controls. The aim of this article is to review the relationship between H. pylori infection and portal hypertensive gastropathy and the role of H. pylori eradication in cirrhotic patients.

  12. Current consensus on the diagnosis and treatment of H. pylori-associated gastroduodenal disease.

    Science.gov (United States)

    Suzuki, Hidekazu; Masaoka, Tatsuhiro; Nomura, Sachiko; Hoshino, Yoshinori; Kurabayashi, Kumiko; Minegishi, Yuriko; Suzuki, Masayuki; Ishii, Hiromasa

    2003-09-01

    Helicobacter pylori (H. pylori) is a spiral shaped bacterium that resides in the stomach mucosa. Isolation of H. pylori from the stomach mucosa changed the erstwhile widely held belief that the stomach contains no bacteria and is actually sterile. Once H. pylori is safely ensconced in the mucus, it is able to neutralize the acid in the stomach by elaborating an enzyme called urease. Urease converts urea, of which there is an abundant supply in the stomach (derived from saliva and the gastric juice), into bicarbonate and ammonia, which are strong bases. These bases form a cloud of acid-neutralizing chemicals in the vicinity of the organisms, protecting them from the acid in the stomach. This urea hydrolysis reaction is utilized for the diagnosis of H. pylori infection in the urea breath test (UBT) and the rapid urease test (RUT). In Japan, both invasive tests, such as bacterial culture, histopathology and RUT, and non-invasive tests such as UBT and serology are conducted for the diagnosis of H. pylori infection. For confirming the results of eradication therapy, UBT is considered to be the most sensitive and specific. In order to treat H. pylori infection, a new one-week triple therapy regimen (lansoprazole or omeprazole + amoxicillin + clarithromycin) has been approved for use in patients with peptic ulcer disease in Japan. As for H. pylori eradication in the case of other diseases in which the bacterium has been implicated (e.g., chronic atrophic gastritis, gastric MALT lymphoma, gastric cancer, non-ulcer dyspepsia, chronic urticaria, idiopathic thrombocytopenic purpura (ITP)), further basic and clinical investigation is required.

  13. Structural Insights into Polymorphic ABO Glycan Binding by Helicobacter pylori.

    Science.gov (United States)

    Moonens, Kristof; Gideonsson, Pär; Subedi, Suresh; Bugaytsova, Jeanna; Romaõ, Ema; Mendez, Melissa; Nordén, Jenny; Fallah, Mahsa; Rakhimova, Lena; Shevtsova, Anna; Lahmann, Martina; Castaldo, Gaetano; Brännström, Kristoffer; Coppens, Fanny; Lo, Alvin W; Ny, Tor; Solnick, Jay V; Vandenbussche, Guy; Oscarson, Stefan; Hammarström, Lennart; Arnqvist, Anna; Berg, Douglas E; Muyldermans, Serge; Borén, Thomas; Remaut, Han

    2016-01-13

    The Helicobacter pylori adhesin BabA binds mucosal ABO/Le(b) blood group (bg) carbohydrates. BabA facilitates bacterial attachment to gastric surfaces, increasing strain virulence and forming a recognized risk factor for peptic ulcers and gastric cancer. High sequence variation causes BabA functional diversity, but the underlying structural-molecular determinants are unknown. We generated X-ray structures of representative BabA isoforms that reveal a polymorphic, three-pronged Le(b) binding site. Two diversity loops, DL1 and DL2, provide adaptive control to binding affinity, notably ABO versus O bg preference. H. pylori strains can switch bg preference with single DL1 amino acid substitutions, and can coexpress functionally divergent BabA isoforms. The anchor point for receptor binding is the embrace of an ABO fucose residue by a disulfide-clasped loop, which is inactivated by reduction. Treatment with the redox-active pharmaceutic N-acetylcysteine lowers gastric mucosal neutrophil infiltration in H. pylori-infected Le(b)-expressing mice, providing perspectives on possible H. pylori eradication therapies.

  14. Motion – Helicobacter pylori Causes or Worsens GERD: Arguments for the Motion

    Directory of Open Access Journals (Sweden)

    Colm A O’Morain

    2002-01-01

    Full Text Available There are several reasons for eradicating Helicobacter pylori in patients with chronic gastroesophageal reflux disease (GERD. Perhaps the most compelling is the evidence that chronic acid suppression therapy can lead to the development of atrophic gastritis, a premalignant condition, in patients with H pylori infection. Epidemiological data that suggest that H pylori is less prevalent in GERD patients than in control subjects may be susceptible to publication bias, and confounding social and environmental factors may also be involved. Although it has been thought that eradication of the organism might lead to increased esophageal acid exposure, this has not been demonstrated in practice. Studies that appeared to show that GERD could be provoked by antimicrobial therapy of duodenal ulcers also have methodological weaknesses. Underlying GERD symptoms might be unmasked after withdrawal of acid-suppression therapy, for reasons that are unrelated to H pylori. In fact, eradication of the organism has been shown to decrease heartburn in patients with peptic ulcer disease. When H pylori is successfully eradicated in patients with GERD, relapse rates are not increased, and the disease- free interval seems to be prolonged. Eradication of the organism is a wise policy in patients who face long term acid-suppression therapy for GERD.

  15. What Do We Do about Helicobacter pylori?

    Directory of Open Access Journals (Sweden)

    CJ Hawkey

    1999-01-01

    Full Text Available Heliobacter pylori and nonsteroidal anti-inflammatory drugs (NSAIDs cause ulcers by different mechanisms. Under some circumstances, patients infected with H pylori may be less prone to NSAID-associated ulcers than those who are H pylori-negative. Eradication trials have yielded differing results. However, those who have studied patients who have a past history of ulcer disease and are already established on NSAIDs have shown no benefit from H pylori eradication.

  16. Helicobacter pylori in duodenal ulcer disease and its eradication

    Directory of Open Access Journals (Sweden)

    Sengupta S

    2002-01-01

    Full Text Available Antral biopsy specimens were processed for Helicobacter pylori by Gram staining, rapid urease test (RUT and culture from 25 patients with symptoms of duodenal ulcer, amongst whom the positivity rate was 84%. Follow up of 16 patients after appropriate therapy showed complete regression of the disease in 87.5% of cases whereas in 12.5% of cases a decrease in the extent of duodenal ulceration was noted.

  17. Helicobacter pylori Seropositivity in Children With Asthma

    OpenAIRE

    Yousefichaijan; Mosayebi; Sharafkhah; Kahbazi; Heydarbagi; Rafiei

    2016-01-01

    Background Some studies have reported an association between Helicobacter pylori (H. pylori) colonization and the occurrence of asthma or other allergies. However, data are inconsistent, and few studies have been performed in children. Objectives The current study aimed to investigate H. pylori seropositivity in children with and without asthma. Patients and Methods This cross-sect...

  18. Gastric cancer development after the successful eradication of Helicobacter pylori

    Institute of Scientific and Technical Information of China (English)

    Kaname Uno; Katsunori Iijima; Tooru Shimosegawa

    2016-01-01

    Gastric cancer(GC) develops as a result of inflammationassociated carcinogenesis due to Helicobacter pylori(H. pylori) infection and subsequent defects in genetic/epigenetic events. Although the indication for eradication therapy has become widespread, clinical studies have revealed its limited effects in decreasing the incidence of GC. Moreover, research on biopsy specimens obtained by conventional endoscopy has demonstrated the feasibility of the restoration of some genetic/epigenetic alterations in the gastric mucosa. Practically, the number of sporadic cases of primary/metachronous GC that emerge after successful eradication has increased, while on-going guidelines recommend eradication therapy for patients with chronic gastritis and those with background mucosa after endoscopic resection for GC. Accordingly, regular surveillance of numerous individuals who have received eradication therapy is recommended despite the lack of biomarkers. Recently, the focus has been on functional reversibility after successful eradication as another cue to elucidate the mechanisms of restoration as well as those of carcinogenesis in the gastric mucosa after H. pylori eradication. We demonstrated that Congo-red chromoendoscopy enabled the identification of the multifocal distribution of functionally irreversible mucosa compared with that of restored mucosa after successful eradication in individuals at extremely high risk for GC. Further research that uses functional imaging may provide new insights into the mechanisms of regeneration and carcinogenesis in the gastric mucosa post-eradication and may allow for the development of useful biomarkers.

  19. Gastric cancer development after the successful eradication of Helicobacter pylori.

    Science.gov (United States)

    Uno, Kaname; Iijima, Katsunori; Shimosegawa, Tooru

    2016-03-15

    Gastric cancer (GC) develops as a result of inflammation-associated carcinogenesis due to Helicobacter pylori (H. pylori) infection and subsequent defects in genetic/epigenetic events. Although the indication for eradication therapy has become widespread, clinical studies have revealed its limited effects in decreasing the incidence of GC. Moreover, research on biopsy specimens obtained by conventional endoscopy has demonstrated the feasibility of the restoration of some genetic/epigenetic alterations in the gastric mucosa. Practically, the number of sporadic cases of primary/metachronous GC that emerge after successful eradication has increased, while on-going guidelines recommend eradication therapy for patients with chronic gastritis and those with background mucosa after endoscopic resection for GC. Accordingly, regular surveillance of numerous individuals who have received eradication therapy is recommended despite the lack of biomarkers. Recently, the focus has been on functional reversibility after successful eradication as another cue to elucidate the mechanisms of restoration as well as those of carcinogenesis in the gastric mucosa after H. pylori eradication. We demonstrated that Congo-red chromoendoscopy enabled the identification of the multi-focal distribution of functionally irreversible mucosa compared with that of restored mucosa after successful eradication in individuals at extremely high risk for GC. Further research that uses functional imaging may provide new insights into the mechanisms of regeneration and carcinogenesis in the gastric mucosa post-eradication and may allow for the development of useful biomarkers.

  20. High-Level Primary Clarithromycin Resistance of Helicobacter pylori in Algiers, Algeria: A Prospective Multicenter Molecular Study.

    Science.gov (United States)

    Djennane-Hadibi, Fazia; Bachtarzi, Mohamed; Layaida, Karim; Ali Arous, Nassima; Nakmouche, Mhamed; Saadi, Berkane; Tazir, Mohamed; Ramdani-Bouguessa, Nadjia; Burucoa, Christophe

    2016-04-01

    Knowledge of local antibiotic resistance is crucial to adaptation for the choice of the optimal first-line treatment for Helicobacter pylori infection. Clarithromycin is a key component of the standard triple therapy largely used worldwide and, more particularly, in Algeria. Clarithromycin resistance is the main risk factor for treatment failure. The aim of this study was to evaluate, for the first time in Algeria, the prevalence of the primary resistance of H. pylori to clarithromycin. We conducted a prospective study (2008-2014) that included 195 Algerian patients referred for gastroduodenal endoscopy to two University Hospitals, one General Hospital, and several private gastroenterologists in Algiers (Algeria). One gastric biopsy was collected for the molecular detection of H. pylori and the mutations in 23S rRNA genes that confer resistance to clarithromycin with a quadruplex real-time PCR using Scorpion primers. The Scorpion PCR detected H. pylori DNA in 91 biopsies (47%). A mutation conferring resistance to clarithromycin was detected in 32 of the 91 positive patients (35%) and in 29 of the 88 positive patients never previously treated for an H. pylori infection (33%). The prevalence of primary resistance of H. pylori to clarithromycin was 33% in the Algerian population being studied. The high level of primary clarithromycin resistance in the H. pylori strains infecting the Algerian population that we report leads us to recommend the abandonment of the standard clarithromycin-based triple therapy as a first-line treatment in Algeria.

  1. Clinical observation of Weichang'an Pills combined with quadruple therapy in treatment of helicobacter pylori infection in children%胃肠安丸联合四联疗法治疗儿童幽门螺杆菌感染的疗效观察

    Institute of Scientific and Technical Information of China (English)

    李哲

    2015-01-01

    目的观察胃肠安丸联合四联疗法治疗儿童幽门螺杆菌感染的临床疗效.方法 2013年1月—2014年8月沈阳市儿童医院收治的幽门螺杆菌感染患儿98例,随机分为对照组和治疗组,每组49例.对照组给予四联疗法治疗,治疗组在四联疗法的基础上口服胃肠安丸.两组均连续治疗14 d.比较两组患儿腹痛、食欲不振、恶心呕吐等临床表现的持续时间、幽门螺杆菌根除率、抗生素相关性腹泻发生率.结果 治疗后,治疗组腹痛、食欲不振、恶心呕吐持续时间显著短于对照组,两组比较差异有统计学意义(P<0.05).对照组和治疗组幽门螺杆菌根除率分别为 91.83%、95.91%,两组比较差异无统计学意义.对照组和治疗组抗生素相关性腹泻发病率分别为18.3%、8.1%,两组比较差异有统计学意义(P<0.05).结论 胃肠安丸联合四联疗法治疗儿童幽门螺杆菌感染具有较好的临床疗效,可缓解临床症状,减少抗生素相关性腹泻的发生.%Objective To observe the therapeutic effect of Weichang'an Pills combined with quadruple therapy in treatment of helicobacter pylori infection in children.Methods Patients (98 cases) with helicobacter pylori infection in Shenyang Children's Hospital from January 2013 to August 2014 were randomly divided into control and treatment groups, and each group had 49 cases. The patients in the control group were given quadruple therapy. The patients in the treatment group were po administered with Weichang'an Pills at the basis of quadruple therapy. Both groups were treated for 14 d. The duration of abdominal pain, loss of appetite, nausea, vomiting, eradication rates of helicobacter pylori, and incidence of antibiotic associated diarrhea in two groups were compared.Results After treatment, durations of abdominal pain, loss of appetite, nausea, and vomiting were shorter than those in the control group, and there were differences between two groups (P< 0.05). The

  2. Ghrelin and Helicobacter pylori infection

    Institute of Scientific and Technical Information of China (English)

    Hiroyuki Osawa

    2008-01-01

    Ghrelin is primarily secreted from the stomach and has been implicated in the coordination of eating behavior and weight regulation. Ghrelin also plays an essential role in the mechanism of gastric mucosal defense. Thus, it is important to clarify which diseases primar-ily influence changes in plasma ghrelin concentrations. Helicobacter pylori(H pylori infection is involved in the pathogenesis of gastritis, gastric and duodenal ulcer, gastric carcinoma, and mucosa-associated lym-phoid tissue lymphorna. H pylori eradication is related to body weight change. Compared, H pylori infected and negative subjects with normal body mass index, plasma ghrelin concentration, gastric ghrelin mRNA, and the number of ghrelin producing cells in gastric mucosa are significantly lower in Hpylori injected sub-jects than in H pylori-negative controls. Plasma ghrelin concentration decreases with the progression of gastric atrophy. Impaired gastric ghrelin production in associa-tion with atrophic gastritis induced by Hpylori infection accounts for the decrease in plasma ghrelin concentra-tion. However, the ratio of plasma acylated ghrelin to total ghrelin levels is higher in patients with chronic atrophic gastritis than in healthy subjects. This may re-sult from the compensatory increase in plasma active ghrelin concentration in response to gastric atrophy. After H pylori eradication, gastric preproghrelin mRNA expression is increased nearly 4-fold in most cases. However, changes in plasma ghrelin concentrations be-fore and after H pylori cure are not associated with the gastric ghrelin production. Plasma ghrelin changes are inversely correlated with both body weight change and initial plasma ghrelin levels.

  3. Early Attempts to Eradicate Helicobacter pylori after Endoscopic Resection of Gastric Neoplasm Significantly Improve Eradication Success Rates

    Science.gov (United States)

    Huh, Cheal Wung; Youn, Young Hoon; Jung, Da Hyun; Park, Jae Jun; Kim, Jie-Hyun; Park, Hyojin

    2016-01-01

    Purpose After endoscopic resection (ER) of gastric tumors, eradication of Helicobacter pylori (H. pylori) infection is advised to reduce metachronous recurrence. Optimal timing of such therapy (yet to be established) was investigated herein, examining early active and late scarring stages of post-ER iatrogenic ulcers. Materials and Methods Analysis included 514 patients who received proton-pump inhibitor (PPI)-based triple therapy for H. pylori eradication after ER for gastric neoplasms between January 2008 and June 2015. Clinicopathologic characteristics, particularly the timing of triple therapy, were used to compare eradication rates, assigning patients to early- (≤2 weeks), intermediate- (2–8 weeks), and late-phase (≥8 weeks) treatment groups. Results H. pylori eradication rates differed significantly by timing of triple therapy after ER (early, 90.0%; intermediate, 76.2%, late, 72.4%; p ulcer, and duration of therapeutic regimen. Early initiation of H. pylori eradication was also identified as a significant independent predictor of eradication success in multivariate analysis (Odds ratio = 3.67, 95% CI 2.18–6.16; p <.001). Conclusion In patients undergoing ER of gastric tumors, early post-ER attempts at eradication of H. pylori offer the best chance of eradication success. PMID:27588679

  4. [Helicobacter pylori infection as additional risk factor of the development of NSAID-gastropatia effects at the patients with osteoarthritis].

    Science.gov (United States)

    Maev, I V; Samsonov, A A; Lezhneva, Iu A; Andreev, N G; Salova, L M

    2009-01-01

    Prevalence of osteoartrosis disease is high among the population. The main places in treatment of this pathology occupy NSAID. Intake of NSAID is lead to the development of NSAID-gastropatia. During last years H. pylori infection was numbered with risk factors of the NSAID-gastropatia development. In this review considered researches which are devoted to studying ties between H. pylori and NSAID. Data of the using eradication therapy with purpose of prevention and treatment of NSAID-gastropatia associated with H. pylori are shown in this review.

  5. 三联疗法治疗幽门螺杆菌相关性胃炎的临床分析%Clinical Analysis of Triple Therapy in the Treatment of Helicobacter Pylori-related Gastritis

    Institute of Scientific and Technical Information of China (English)

    邹庆伟

    2015-01-01

    Objective:To observe the curative effect of Omeprazole and Esomeprazole triple therapy for Helicobacter pylori(Hp) associated gastritis. Method:280 Hp positive patients with chronic gastritis in our hospital from June 2013 to May 2014 were selected,they were divided into the Omeprazole group and the Esomeprazole group according to the random number table method,140 cases in each group.The Omeprazole group was taken with Omeprazole, Amoxicillin and Levofloxacin for treatment.The Esomeprazole group was taken with Esomeprazole,Amoxicillin and Levofloxacin for treatment.The Hp cure rates and differences in clinical symptoms and histological improvement between the two groups were observed and compared.Result:Hp eradication rate of the Esomeprazole group was 81.43%(114/140),which was significantly higher than 69.29%(97/140) of the Omeprazole group,the clinical control rate and total effective rate of clinical symptoms improvement in the Esomeprazole group were 22.86%and 92.14%,which were significantly higher than 14.29%and 76.43%in the Omeprazole group,the clinical control rate and total effective rate of histological improvement in the Esomeprazole group were 29.29%and 65.00%,which were significantly higher than 17.86%and 50.71%in the Omeprazole group,the differences were statistically significant(P<0.05).Conclusion:The Esomeprazole triple therapy in the treatment of Helicobacter pylori-associated gastritis can effectively improve the Hp eradication rate,promote the improvement of clinical symptoms and pathological histology,and its curative effect is better than that of omeprazole triple therapy,is worthy of clinical promotion.%目的:观察奥美拉唑和埃索美拉唑三联疗法治疗幽门螺杆菌(Hp)相关性胃炎的疗效。方法:选取笔者所在医院2013年6月-2014年5月收治的280例Hp阳性的慢性胃炎患者,按照随机数字表法将其分为奥美拉唑组和埃索美拉唑组,各140例。奥美拉唑组采用奥美拉唑、左氧氟

  6. Treatment of Helicobacter pylori infection 2010.

    LENUS (Irish Health Repository)

    O'Connor, Anthony

    2012-02-01

    It is accepted that the success of Helicobacter pylori eradication treatment using standard triple therapy is declining. Resistance, particularly to clarithromycin, has been shown in numerous countries to be rising to a level where the use of standard triple therapy in its current form may no longer be justified. The two major factors influencing resistance are prior exposure to the antibiotic and compliance with therapy. Regimes based on bismuth and levofloxacin, which had previously been mainly second-line options, are now emerging as superior first-line options. Trials of sequential and concomitant therapies are also showing the usefulness of these treatments in different populations. Options for third and subsequent line therapies include furazolidone and rifabutin-based regimes. Susceptibility testing should be performed to maintain accurate data on resistance levels, and has also clinical utility in difficult to eradicate cases. None of these, however, will be successful unless compliance is improved upon. If compliance is assured and eradication confirmation pursued, it has been repeatedly illustrated that near full eradication is achievable.

  7. Five methods for detection of Helicobacter pylori in the Turkish population

    Institute of Scientific and Technical Information of China (English)

    Orhan Cem Aktepe; (I)san Hakki (C)ift(c)i; Birol (S)afak; (I)hsan Uslan; H(u)sniye Dilek

    2011-01-01

    AIM: To compare culture analysis, Helicobacter pylori (H. Pylori) stool antigen (HpSA) test, polymerase chain reaction (PCR) and fluorescence in situ hybridization (FISH) for H. Pylori detection. METHODS: One hundred and thirty-two consecutive adult dyspeptic patients receiving diagnostic endoscopy at the department of gastroenterology were enrolled in this study. Culture and histological examination were performed on biopsy specimens. PCR and FISH tests were applied to histopathological samples. Stool samples that were simultaneously collected were tested for the H. Pylori antigen using the HpSA test and bacterial DNA using stool PCR. RESULTS: H. Pylori was positively identified by histological examination in 85/132 (64.4%) of the patients, while positive samples were found in 56 (42.4%), 64 (48.5%), 98 (74.2%), 28 (21.2%) and 81 (61.4%) of the patients by culture, HpSA, PCR, stool PCR and FISH methods, respectively. The results of the culture, biopsy PCR, HpSA and FISH tests, with the exception of the stool PCR, were found to correlate with the histological examination as a gold standard. CONCLUSION: The HpSA test is a rapid, simple, and noninvasive test for monitoring therapy. FISH is an accurate, rapid, cost-effective, and easy-to-use test for H. Pylori detection.

  8. Resistance pattern of Helicobacter pylori strains to clarithromycin, metronidazole, and amoxicillin in Isfahan, Iran

    Directory of Open Access Journals (Sweden)

    Farzad Khademi

    2013-01-01

    Full Text Available Background: Helicobacter pylori (H. pylori resistance to antibiotics has become a global problem and is an important factor in determining the outcome of treatment of infected patients. The purpose of this study was to determine the H. pylori resistance to clarithromycin, metronidazole, and amoxicillin in gastrointestinal disorders patients. Materials and Methods: In this study, a total of 260 gastric antrum biopsy specimens were collected from patients with gastrointestinal disorders who referred to Endoscopy Section of the Isfahan Hospitals. The E-test and Modified Disk Diffusion Method (MDDM were used to verify the prevalence of antibiotic resistance in 78 H. pylori isolates to the clarithromycin, metronidazole, and amoxicillin. Results: H. pylori resistance to clarithromycin, metronidazole, and amoxicillin were 15.3, 55.1, and 6.4%, respectively. In this studyΈ we had one multidrug resistance (MDR isolates from patient with gastritis and peptic ulcer disease. Conclusion: Information on antibiotic susceptibility profile plays an important role in empiric antibiotic treatment and management of refractive cases. According to the results obtained in this study, H. pylori resistance to clarithromycin and metronidazole was relatively high. MDR strains are emerging and will have an effect on the combination therapy.

  9. Refractory iron deficiency anemia and Helicobacter Pylori Infection in pediatrics: A review

    Science.gov (United States)

    Gheibi, Sh; Farrokh-Eslamlou, HR; Noroozi, M; Pakniyat, A

    2015-01-01

    Background Since the discovery of Helicobacter pylori, several clinical reports have demonstrated that H. Pylori infection has emerged as a new cause of refractory iron stores in children. We carried out a systematic literature review to primarily evaluate the existing evidence on the association between childhood H. Pylori infection and iron deficiency anemia (IDA) and secondly, to investigate the beneficial effects of bacterium elimination. Material and Methods This review concerns important pediatric studies published from January 1991 to October 2014. Fourteen case reports and series of cases, 24 observational epidemiologic studies, seven uncontrolled trials, and 16 randomized clinical trials were included in the review. Results Although there are a few observational epidemiologic studies and some randomized trials mostly due to the potential confounders, most studies reported a positive association linking between H. Pylori infection and iron deficiency or iron deficiency anemia among children. In addition, it seems that elimination of H. Pylori infection induces beneficial effects on iron deficiency. Conclusions Since the evidence for the association of H. pylori eradication therapy and refractory childhood IDA is not enough and there are contrasting data about such association, future high quality and cohort researches are needed to determine the causal association. PMID:25914802

  10. Diagnosis and Treatment of Peptic Ulcer Disease and H. pylori Infection.

    Science.gov (United States)

    Fashner, Julia; Gitu, Alfred C

    2015-02-15

    The most common causes of peptic ulcer disease (PUD) are Helicobacter pylori infection and use of nonsteroidal anti-inflammatory drugs (NSAIDs). The test-and-treat strategy for detecting H. pylori is appropriate in situations where the risk of gastric cancer is low based on age younger than 55 years and the absence of alarm symptoms. Most other patients should undergo upper endoscopy to rule out malignancy and other serious causes of dyspepsia. Urea breath tests and stool antigen tests are most accurate for identifying H. pylori infection and can be used to confirm cure; serologic tests are a convenient but less accurate alternative and cannot be used to confirm cure. Treatment choices include standard triple therapy, sequential therapy, quadruple therapy, and levofloxacin-based triple therapy. Standard triple therapy is only recommended when resistance to clarithromycin is low. Chronic use of NSAIDs in patients with H. pylori infection increases the risk of PUD. Recommended therapies for preventing PUD in these patients include misoprostol and proton pump inhibitors. Complications of PUD include bleeding, perforation, gastric outlet obstruction, and gastric cancer. Older persons are at higher risk of PUD because of high-risk medication use, including antiplatelet drugs, warfarin, selective serotonin reuptake inhibitors, and bisphosphonates.

  11. Epidemiology of Helicobacter pylori infection.

    Science.gov (United States)

    Leja, Mārcis; Axon, Anthony; Brenner, Hermann

    2016-09-01

    This review of recent publications related to the epidemiology of Helicobacter pylori highlights the origin of the infection, its changing prevalence, transmission, and outcome. A number of studies have addressed the ancestor roots of the bacteria, and the first genomewide analysis of bacterial strains suggests that its coexistence with humans is more ancient than previously thought. As opposed to the generally declining prevalence of H. pylori (including China and Japan), in Sweden, the prevalence of atrophic gastritis in the young population has risen. The prevalence of the infection remains high in the indigenous populations of the Arctic regions, and reinfection rates are high. A high prevalence is permanently found in the Siberian regions of Russia as well. Several studies, some of which used multiplex serology, addressed prevalence of and risks associated with various H. pylori serotypes, thereby enabling more precise risk assessment. Transmission of H. pylori was discussed, specifically fecal-oral transmission and the use of well-water and other unpurified water. Finally, the long-term course of H. pylori infection was considered, with an estimated 89% of noncardia gastric cancer cases being attributable to the infection.

  12. Correlation of Helicobacter pylori and gastric carcinoma.

    Directory of Open Access Journals (Sweden)

    Khanna A

    2002-01-01

    Full Text Available BACKGROUND: Difference of opinion about the prevalence of H. pylori association with gastric cancer exists in the literature. AIMS: To study the correlation of Helicobacter pylori (H. pylori to gastric carcinoma. METHODS: 50 proved cases of gastric cancer were studied by rapid urease test, culture, histopathology and ELISA test for H. pylori IgG. RESULTS: 68% of cases of gastric cancer were found to be positive for H. pylori infection as compared to 74% of healthy controls. CONCLUSIONS: The prevalence rate of H. pylori infection in our patients of gastric cancer was lower than in the control population though statistically not significant, suggesting that H. pylori may not be responsible for gastric carcinogenesis in this population.

  13. Effect of the Vacuolation of Helicobacter Pylori

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Cytotoxic test in vitro combined with cytochemical stain, fluorescent stain, transmission electronmicrograph was used to study the vacuolated effect by helicobacter pylori (H.pylori) (Toxin+) and its pathological mechanism. 78.26 % patients with peptic ulcer associated with H.pylori was infected with H.pylori (Toxin+), while 42.86 % patients with gastritis was infected with H.pylori (Toxin+). It was positive in vacuole with acridine orange and acid phosphatase stain. Transmission electronmicrograph of vacuole revealed the presence of abounding membrane. There was a closed relationship between infection with H.pylori (Toxin+) and peptic ulcer disease. The vacuole induced by H.pylori (Toxin+) was autophagosome, which was pathological phenomenon induced by toxin.

  14. Helicobacter pylori infection and skin disorders.

    Science.gov (United States)

    Kutlubay, Zekayi; Zara, Tuba; Engin, Burhan; Serdaroğlu, Server; Tüzün, Yalçin; Yilmaz, Erkan; Eren, Bülent

    2014-08-01

    Helicobacter pylori is a Gram-negative bacterium that has been linked to peptic ulcer disease, gastric lymphoma, and gastric carcinoma. Apart from its well-demonstrated role in gastroduodenal diseases, some authors have suggested a potential role of Helicobacter pylori infection in several extra-intestinal pathologies including haematological, cardiovascular, neurological, metabolic, autoimmune, and dermatological diseases. Some studies suggest an association between Helicobacter pylori infection and skin diseases such as chronic idiopathic urticaria and rosacea. There have also been few case reports documenting association between Helicobacter pylori and psoriasis vulgaris, Behçet's disease, alopecia areata, Henoch-Schönlein purpura, and Sweet's syndrome. However, more systematic studies are required to clarify the proposed association between Helicobacter pylori and skin diseases; most of the studies do not show relevant relationships of these diseases with Helicobacter pylori infections. This review discusses skin diseases that are believed to be associated with Helicobacter pylori.

  15. Mechanism of antibacterial activity of liposomal linolenic acid against Helicobacter pylori.

    Directory of Open Access Journals (Sweden)

    Sung Woo Jung

    Full Text Available Helicobacter pylori infects approximately half of the world population and is a major cause of gastritis, peptic ulcer, and gastric cancer. Moreover, this bacterium has quickly developed resistance to all major antibiotics. Recently, we developed a novel liposomal linolenic acid (LipoLLA formulation, which showed potent bactericidal activity against several clinical isolated antibiotic-resistant strains of H. pylori including both the spiral and coccoid form. In addition, LipoLLA had superior in vivo efficacy compared to the standard triple therapy. Our data showed that LipoLLA associated with H. pylori cell membrane. Therefore, in this study, we investigated the possible antibacterial mechanism of LipoLLA against H. pylori. The antibacterial activity of LipoLLA (C18:3 was compared to that of liposomal stearic acid (LipoSA, C18:0 and oleic acid (LipoOA, C18:1. LipoLLA showed the most potent bactericidal effect and completely killed H. pylori within 5 min. The permeability of the outer membrane of H. pylori increased when treated with LipoOA and LipoLLA. Moreover, by detecting released adenosine triphosphate (ATP from bacteria, we found that bacterial plasma membrane of H. pylori treated with LipoLLA exhibited significantly higher permeability than those treated with LipoOA, resulting in bacteria cell death. Furthermore, LipoLLA caused structural changes in the bacterial membrane within 5 min affecting membrane integrity and leading to leakage of cytoplasmic contents, observed by both transmission electron microscopy (TEM and scanning electron microscopy (SEM. Our findings showing rapid bactericidal effect of LipoLLA suggest it is a very promising new, effective anti-H. pylori agent.

  16. Evaluation on antibiotic resistance of helicobacter pylori isolated from patients admitted to tooba medical center, Sari

    Directory of Open Access Journals (Sweden)

    Amin Talebi BezminAbadi

    2009-01-01

    Full Text Available (Received 17 March, 2009; Accepted 8 July, 2009AbstractBackground and purpose: Helicobacter pylori, which infect approximately one half of the world’s population, are an important risk factor in chronic gastritis, peptic ulcer disease, and gastric cancer. H. pylori eradication is now widely recommended as the most effective treatment of peptic ulcer disease. One of the most important reasons for treatment failure is H. pylori resistance to the antimicrobials usage in therapy. The aim of this study was to determine susceptibility patterns of H. pylori isolates in 6 routine anti-microbial agents in Northern Iran.Materials and methods: 125 patients from Tooba Medical Center in Sari with endoscopic evidence of dyspepsia complaints were used for obtaining gastric biopsies specimens. Biopsies were sent to the laboratory in thioglycolate broth (transport medium. Bacteria were primarily cultured on Columbia agar supplemented with 7% horse blood, 7% fetal calf serum. Urease, Catalase and Oxidase activities were used for H. pylori identification. Bacterial suspensions equivalent to 3 Mc. Farlands were spread on plates, along with antibiotic disks and placed in the diameter zone. Inhibition was measured after 3 days of incubation in micro-aerophilic condition.Results: H. pylori were isolated from 116(92.8% subjects, a total of 125 biopsy specimens. Resistance to metronidazole, amoxicillin, clarithromycin, tetracycline, furazolidone and ciprofloxacin were 71%, 35%, 25%, 9%, 24% and 25%, respectively. Multiple resistance (amoxicillin-clarithromycin-metronidazole were found in (65% of the isolates.Conclusion: Comparison of our data with previous results showed that prevalence of H. pylori resistance to clarithromycin, furazolidone and metronidazole has increased in Iran considerably. Resistance to amoxicillin in our study was too high in comparison with foreign studies. The present study demonstrates the need for continuous monitoring of the antimicrobial

  17. Symptom-based tendencies of Helicobacter pylori eradication in patients with functional dyspepsia

    Institute of Scientific and Technical Information of China (English)

    Ling Lan; Jing Yu; Yu-Long Chen; Ya-Li Zhong; Hao Zhang; Chang-He Jia; Yuan Yuan; Bo-Wei Liu

    2011-01-01

    AIM: To investigate whether there were symptombased tendencies in the Helicobacter pylori (H. pylori ) eradication in functional dyspepsia (FD) patients. METHODS: A randomized, single-blind, placebo-controlled study of H. pylori eradication for FD was conducted. A total of 195 FD patients with H. pylori infection were divided into two groups: 98 patients in the treatment group were treated with rabeprazole 10 mg twice daily for 2 wk, amoxicillin 1.0 g and clarithromycin 0.5 g twice daily for 1 wk; 97 patients in the placebo group were given placebos as control. Symptoms of FD, such as postprandial fullness, early satiety, nausea, belching, epigastric pain and epigastric burning, were assessed 3 mo after H. pylori eradication. RESULTS: By per-protocol analysis in patients with successful H. pylori eradication, higher effective rates of 77.2% and 82% were achieved in the patients with epigastric pain and epigastric burning than those in the placebo group (P 0.05). In 84 patients who received H. pylori eradication therapy, the effective rates for epigastric pain (73.8%) and epigastric burning (80.7%) were higher than those in the placebo group (P 0.05). By intention-to-treat analysis, patients with epigastric pain and epigastric burning in the treatment group achieved higher effective rates of 60.8% and 65.7% than the placebo group (33.3% and 31.8%) (P 0.05). CONCLUSION: The efficacy of H. pylori eradication has symptom-based tendencies in FD patients. It may be effective in the subgroup of FD patients with epigastric pain syndrome.

  18. Interaction between inflammatory mediators and miRNAs in Helicobacter pylori infection.

    Science.gov (United States)

    Rossi, Ana Flávia Teixeira; Cadamuro, Aline Cristina Targa; Biselli-Périco, Joice Matos; Leite, Kátia Ramos Moreira; Severino, Fábio Eduardo; Reis, Patricia P; Cordeiro, José Antonio; Silva, Ana Elizabete

    2016-10-01

    Helicobacter pylori cause chronic inflammation favouring gastric carcinogenesis, and its eradication may prevent malignant transformation. We evaluated whether H. pylori infection and its eradication modify the expression of inflammatory mediators in patients with chronic gastritis. Furthermore, we assessed whether microRNAs modulate inflammatory pathways induced by H. pylori and identified miRNA-gene interaction networks. mRNA and protein expression of TNFA, IL6, IL1B, IL12A, IL2 and TGFBRII and miRNAs miR-103a-3p, miR-181c-5p, miR-370-3p, miR-375 and miR-223-3p were evaluated in tissue samples from 20 patients with chronic gastritis H. pylori negative (Hp-) and 31 H. pylori positive (Hp+), before and three months after bacterium eradication therapy, in comparison with a pool of Hp- normal gastric mucosa. Our results showed that H. pylori infection leads to up-regulation of TNFA, IL6, IL12A and IL2 and down-regulation of miRNAs. Bacterium eradication reduces the expression of TNFA and IL6 and up-regulates TGFBRII and all investigated miRNAs, except miR-223-3p. Moreover, transcriptional profiles of inflammatory mediators and miRNAs after eradication are different from the non-infected group. Deregulated miRNA-mRNA interaction networks were observed in the Hp+ group before and after eradication. Therefore, miRNAs modulated cytokine expression in the presence of H. pylori and after its eradication, suggesting that miRNAs participate in the pathological process triggered by H. pylori in the gastric mucosa.

  19. HELICOBACTER PYLORI-RELATED GASTRITIS AND LYMPHOID TISSUE HYPERPLASIA IN THE AGED

    Institute of Scientific and Technical Information of China (English)

    高天; 陈晓宇; 胡梅洁

    2003-01-01

    Objective To examine the relationship between Helicobacter pylori-related gastritis and the development of lymphoid tissue hyperplasia in the antral mucosa and to pursue its evolution after eradication of H.pylori in the aged. Methods Gastric antral mucosa biopsy specimens for microscopic study were obtained from 101 chronic gastritis patients over 60 years old with H.pylori-positive in the period from 2000 to 2001, and meanwhile those from 124 H.pylori-positive chronic gastritis patients under the age of 60 served as controls. Four to six weeks after a course of anti-H.pylori therapy, biopsy specimens were again obtained. Lym-phoid follicles and aggregates were counted and other pathologic features were scored according to the updated Sydney System for classification of chronic gastritis. Results The prevalence and density of lymphoid follicles and aggregates were significantly lower in the aged as compared with those in the control group, being 36. 6%(37/101) and 0. 41 vs. 72. 5%(90/124) and 0. 81, respectively(P<0.0001). The prevalence and density of lymphoid follicles and aggregates correlated strongly with the activity and severity of gastric antral mucosal inflammation in both groups. Eradication of H.pylori resulted in a decrease in the prevalence and density of lymphoid follicles and aggregates in both groups, especially in the aged group. Conclusion The prevalence and density of lymphoid follicles and aggregates in gastric antral mucosal biopsies correlated closely with H.phlori infection in the aged, therefore, anti-H.pylori treatment would be of importance to the aged patients infected with H.pylori.

  20. Difluoromethylornithine is a novel inhibitor of Helicobacter pylori growth, CagA translocation, and interleukin-8 induction.

    Directory of Open Access Journals (Sweden)

    Daniel P Barry

    Full Text Available Helicobacter pylori infects half the world's population, and carriage is lifelong without antibiotic therapy. Current regimens prescribed to prevent infection-associated diseases such as gastroduodenal ulcers and gastric cancer can be thwarted by antibiotic resistance. We reported that administration of 1% D,L-α-difluoromethylornithine (DFMO to mice infected with H. pylori reduces gastritis and colonization, which we attributed to enhanced host immune response due to inhibition of macrophage ornithine decarboxylase (ODC, the rate-limiting enzyme in polyamine biosynthesis. Although no ODC has been identified in any H. pylori genome, we sought to determine if DFMO has direct effects on the bacterium. We found that DFMO significantly reduced the growth rate of H. pylori in a polyamine-independent manner. Two other gram-negative pathogens possessing ODC, Escherichia coli and Citrobacter rodentium, were resistant to the DFMO effect. The effect of DFMO on H. pylori required continuous exposure to the drug and was reversible when removed, with recovery of growth rate in vitro and the ability to colonize mice. H. pylori exposed to DFMO were significantly shorter in length than those untreated and they contained greater internal levels of ATP, suggesting severe effects on bacterial metabolism. DFMO inhibited expression of the H. pylori virulence factor cytotoxin associated gene A, and its translocation and phosphorylation in gastric epithelial cells, which was associated with a reduction in interleukin-8 expression. These findings suggest that DFMO has effects on H. pylori that may contribute to its effectiveness in reducing gastritis and colonization and may be a useful addition to anti-H. pylori therapies.

  1. Difluoromethylornithine Is a Novel Inhibitor of Helicobacter pylori Growth, CagA Translocation, and Interleukin-8 Induction

    Science.gov (United States)

    Barry, Daniel P.; Asim, Mohammad; Leiman, David A.; de Sablet, Thibaut; Singh, Kshipra; Casero, Robert A.; Chaturvedi, Rupesh; Wilson, Keith T.

    2011-01-01

    Helicobacter pylori infects half the world's population, and carriage is lifelong without antibiotic therapy. Current regimens prescribed to prevent infection-associated diseases such as gastroduodenal ulcers and gastric cancer can be thwarted by antibiotic resistance. We reported that administration of 1% d,l-α-difluoromethylornithine (DFMO) to mice infected with H. pylori reduces gastritis and colonization, which we attributed to enhanced host immune response due to inhibition of macrophage ornithine decarboxylase (ODC), the rate-limiting enzyme in polyamine biosynthesis. Although no ODC has been identified in any H. pylori genome, we sought to determine if DFMO has direct effects on the bacterium. We found that DFMO significantly reduced the growth rate of H. pylori in a polyamine-independent manner. Two other Gram-negative pathogens possessing ODC, Escherichia coli and Citrobacter rodentium, were resistant to the DFMO effect. The effect of DFMO on H. pylori required continuous exposure to the drug and was reversible when removed, with recovery of growth rate in vitro and the ability to colonize mice. H. pylori exposed to DFMO were significantly shorter in length than those untreated and they contained greater internal levels of ATP, suggesting severe effects on bacterial metabolism. DFMO inhibited expression of the H. pylori virulence factor cytotoxin associated gene A, and its translocation and phosphorylation in gastric epithelial cells, which was associated with a reduction in interleukin-8 expression. These findings suggest that DFMO has effects on H. pylori that may contribute to its effectiveness in reducing gastritis and colonization and may be a useful addition to anti-H. pylori therapies. PMID:21386987

  2. Current knowledge on alleviating Helicobacter pylori infections through the use of some commonly known natural products: bench to bedside

    Directory of Open Access Journals (Sweden)

    Malliga Raman Murali

    2014-09-01

    Full Text Available Helicobacter pylori, a spiral-shaped Gram-negative bacterium, has been classified as a class I carcinogen by the World Health Organization and recognized as the causative agent for peptic ulcers, duodenal ulcer, gastritis, mucosa-associated lymphoid tissue lymphomas, and gastric cancer. Owing to their alarming rate of drug resistance, eradication of H. pylori remains a global challenge. Triple therapy consisting of a proton pump inhibitor, clarithromycin, and either amoxicillin or metronidazole, is generally the recommended standard for the treatment of H. pylori infection. Complementary and alternative medicines have a long history in the treatment of gastrointestinal ailments and various compounds has been tested for anti-H. pylori activity both in vitro and in vivo; however, their successful use in human clinical trials is sporadic. Hence, the aim of this review is to analyze the role of some well-known natural products that have been tested in clinical trials in preventing, altering, or treating H. pylori infections. Whereas some in vitro and in vivo studies in the literature have demonstrated the successful use of a few potential natural products for the treatment of H. pylori-related infections, others indicate a need to consider natural products, with or without triple therapy, as a useful alternative in treating H. pylori-related infections. Thus, the reported mechanisms include killing of H. pylori urease inhibition, induction of bacterial cell damage, and immunomodulatory effect on the host immune system. Furthermore, both in vitro and in vivo studies have demonstrated the successful use of some potential natural products for the treatment of H. pylori-related infections. Nevertheless, the routine prescription of potential complementary and alternative medicines continues to be restrained, and evidence on the safety and efficacy of the active compounds remains a subject of ongoing debate.

  3. Diagnosis of Helicobacter pylori Infection.

    Science.gov (United States)

    Tongtawee, Taweesak; Kaewpitoon, Soraya; Kaewpitoon, Natthawut; Dechsukhum, Chavaboon; Leeanansaksiri, Wilairat; Loyd, Ryan A; Matrakool, Likit; Panpimanmas, Sukij

    2016-01-01

    Helicobacter pylori infection plays an important role in the pathogenesis of chronic gastritis, peptic ulcer disease and gastric malignancy. A diagnosis of infection is thus an important part of a treatment strategy of many gastrointestinal tract diseases. Many diagnostic tests are available but all have some limitations in different clinical situations and laboratory settings. A single gold standard cannot available, but be used for diagnosis of Helicobacter pylori infection in daily clinical practice in all areas, so several techniques have been developed to give reliable results, especially focusing on real time endoscopic features. The narrow band imaging system (NBI) and high resolution endoscopy are imaging techniques for enhanced visualization of infected mucosa and premalignant gastric lesions. The aim of this article is to review the current diagnostic options and possible future developments detection of Helicobacter pylori infection.

  4. One-week triple therapy with ranitidine bismuth citrate, clarithromycin and metronidazole versus two-week dual therapy with ranitidine bismuth citrate and clarithromycin for Helicobacter pylori infection : A randomized, clinical trial

    NARCIS (Netherlands)

    van der Wouden, EJ; Thijs, JC; van Zwet, AA; Kooy, A; Kleibeuker, JH

    1998-01-01

    Objective: The aim of this study was to compare the efficacy and side effects of l-wk triple therapy with ranitidine bismuth citrate (RBC) 400 mg b.i.d., clarithromycin 500 mg b.i.d., and metronidazole 500 mg b.i.d., to 2-wk dual therapy with RBC 400 mg b.i.d. and clarithromycin 500 mg b.i.d. for H.

  5. Rapid recurrence of Helicobacter pylori infection in Peruvian patients after successful eradication. Gastrointestinal Physiology Working Group of the Universidad Peruana Cayetano Heredia and The Johns Hopkins University.

    Science.gov (United States)

    Ramirez-Ramos, A; Gilman, R H; Leon-Barua, R; Recavarren-Arce, S; Watanabe, J; Salazar, G; Checkley, W; McDonald, J; Valdez, Y; Cordero, L; Carrazco, J

    1997-11-01

    Helicobacter pylori is associated with gastritis, peptic ulcer disease, and gastric cancer. Since gastric cancer is common in Peru, eradication of H. pylori may help to reduce the occurrence of gastric cancer. This study involved three randomized trials to determine the efficacy of four different triple-drug therapy regimens. The most successful regimen was furazolidone combined with bismuth subsalicylate and amoxicillin, which eradicated infection in 82% of patients. Patients successfully treated were followed every 2-3 months to determine the recurrence rate of H. pylori infection. Of 105 patients with H. pylori eradication documented by pathology and culture, 52% (55) returned for follow-up endoscopy, and in 73% (40) of these 55 the infection recurred during the 8-month follow-up period. Thirty-five patients from whom H. pylori was eradicated and who were tested for antibodies to H. pylori remained consistently seropositive. Rapid recurrence of H. pylori infection after successful eradication suggests that measures other than antimicrobial therapy are needed to fight H. pylori in developing countries.

  6. Implications of Helicobacter pylori infection for stomach cancer prevention

    Directory of Open Access Journals (Sweden)

    Goodman Karen J.

    1997-01-01

    Full Text Available Accumulating evidence has implicated Helicobacter pylori, an established cause of chronic gastritis and peptic ulcer, in the etiology of gastric cancer. Control of this infection would reduce the occurrence of chronic gastritis and peptic ulcer and might substantially lower the risk of stomach cancer as well. The public health impact of this infectious agent warrants efforts to identify preventive measures. This paper reviews the evidence linking H. pylori infection to gastric cancer and evaluates the potential for control in high-risk populations. Current obstacles to H. pylori control are discussed, including the link to poor socioeconomic conditions, difficulty in identifying incident cases, lack of natural immunity to reinfection, limited effectiveness of antibiotic therapy in high-prevalence populations, and incomplete knowledge regarding the reservoir of infection, mode of transmission, host susceptibility factors, and the potential for developing an effective vaccine. Worthwhile avenues of research include studies designed to identify modifiable risk factors for acquisition of the infection, modifiable host factors that may increase resistance to chronic infection, more effective antibiotic therapies, and effective vaccines.

  7. Esophageal Adenocarcinoma Developing after Eradication of Helicobacter pylori

    Directory of Open Access Journals (Sweden)

    Yasuhiko Abe

    2011-07-01

    Full Text Available A 75-year-old man underwent endoscopic hemostatic therapy for hemorrhagic gastric ulcer in September 2002. After healing of the gastric ulcer, he underwent Helicobacter pylori eradication therapy in February 2003. In August 2007, an irregular tumor was detected in the lower esophagus at annual checkup for gastric cancer screening using X-ray. Endoscopic examination showed that the lower margin of the tumor almost coincided with the esophagogastric junction and that a short segment of Barrett’s epithelium existed near the tumor. Biopsies of the tumor showed moderately to poorly differentiated adenocarcinoma. Mild reflux esophagitis and minor hiatal hernia was also observed, and the previously treated gastric ulcer was not recurrent. Absence of H. pylori was confirmed by serum antibody and urea breath test. Surgical resection of the lower esophagus and proximal stomach was performed. The tumor invaded into the muscularis propria of the esophageal wall but had no evidence of lymph node metastasis. Based on macroscopic and pathological findings, the tumor was recognized as esophageal adenocarcinoma. Previous endoscopic examination did not detect any apparent signs of tumor in the esophagogastric junction. As far as we know, this is the first report documenting a newly developed esophageal adenocarcinoma after the successful eradication of H. pylori.

  8. [Dyspepsia, Ulcer Disease – Helicobacter pylori, Gastroesophageal Reflux Disease].

    Science.gov (United States)

    Wirth, Hans-Peter

    2016-06-01

    Prevalence of H. pylori (HP) is declining, whereas reflux disease and the proportion of non-steroidal antiinflammatory drugs (NSAR) to HP-induced ulcers increase. Eradication heals HP-ulcer disease, interrupts cancerous progression and can improve dyspeptic symptoms. NSAR-ulcers heal under proton pump inhibitor (PPI) therapy but tend to recur after reexposition. Anticoagulants and antiplatlet agents increase the risk additionally. PPI reduces NSAR-ulcer recurrence. Reflux patients with severe inflammation and complications often need long-term therapy. Barrett’s esophagus patients are at risk of esophageal adenocarcinoma.

  9. 中西医结合提高幽门螺杆菌根除率的探讨%Investigations on a New Combined Therapy of Traditional Chinese and Western Medicine in the Treatment of Helicobacter Pylori Infection

    Institute of Scientific and Technical Information of China (English)

    张万岱

    2012-01-01

    The article aims to investigate a new approach of Traditional Chinese Medicine and Western Medicine(TCM -WM)which can improve the eradication rate of Helicobacter pylori infection or not,and briefly introduce the researching process and the main achievements by national scholars. Firstly,trying to find effective Chinese medicine to treat Helicobacter pylori infection in vitro anti— bacterial tests. Secondly,conducting randomized control clinical observations to confirm the effect of the Traditional Chinese Medical prescription. Thirdly,particularly emphasizing a new pathway of TCM- WM in the treatment of Helicobacter pylori infection efficiently and evaluating the curative mechanism of the Chinese medicine. Finally, summarizing the advantages of the TCM — WM in the treatment of Helicobacter pylori infection. Some exiting problems and the corresponding countermeasures are also been presented.%本文旨在探讨中西医结合治疗能否提高幽门螺杆菌根除率,简介国内学者对此的探索过程和主要成果.首先通过体外抑菌试验寻找具有杀抑Hp作用的中药;再进行随机对照临床观察,以确认中药复方治疗Hp感染的疗效;重点讨论实行中西医结合探索高效治疗Hp感染的新路径,同时探讨中药的疗效机理;最后概括中西医结合治疗Hp感染的优势,同时提出存在的问题和努力方向.

  10. Dispepsia ed Helicobacter pylori

    Directory of Open Access Journals (Sweden)

    Giovanni Fornaciari

    2003-09-01

    Full Text Available The effect of Helicobacter pylori (HP eradication on functional dyspepsia has been analysed in several clinical trials, including large, controlled and well-designed studies as well as small, flowed studies. The results of these studies indicate that HP infection does not play a major role in the aetiology of this disease and that HP eradication improves dyspeptic symptoms in no more than 15% of patients as compared to placebo. From a practical point of view 15 patients need to be treated for one to benefit while, in duodenal ulcer, 1.4 patient need to be treated for one to benefit. It remains to be elucidated if HP eradication in functional dyspepsia is useful to reduce the risk of developing organic dyspepsia (namely peptic ulcer in functional dyspepsia. In uninvestigated dyspepsia the management of HP infection in primary care has been fully debated.Two therapeutics strategies have been proposed: test and scope and test and treat. The value of test and treat strategy over alternative strategies has been demonstrated in several decision analyses. HP test and scope increases costs in primary care without improving symptoms and saves only 15% of endoscopies.

  11. A five-year follow-up study on the pathological changes of gastric mucosa after H.pylori eradication

    Institute of Scientific and Technical Information of China (English)

    周丽雅; 沈祖尧; 林三仁; 金珠; 丁士刚; 黄雪彪; 夏志伟; 郭慧兰; 刘建军; 曹世植

    2003-01-01

    Objectives To investigate the relationship between H.pylori infection, gastric cancer and other gastric diseases through the changes in gastric mucosa and the status of different gastric diseases within 5 years after H.pylori eradication in H.pylori-positive subjects in a high incidence region of gastric cancer. Methods One thousand and six adults were selected from the general population in Yantai, Shandong province, a high incidence region for gastric cancer in China. Gastroscopy and Campylobacter-like organism (CLO) testing were performed on all subjects. Biopsy samples from the gastric antrum and body were obtained for histology and assessment of H.pylori infection. All H.pylori-positive subjects were then randomly divided into two groups: treatment group receiving Omeprazole Amoxicillin Clarythromycin (OAC) triple therapy and placebo as controls. These subjects were endoscopically followed up in the second and fifth year. We compared the endoscopic appearance and histology of the biopsy specimens from the same site obtained at the first and last visits. Conclusions H.pylori eradication results in remarkable reduction in the severity and activity of chronic gastritis, marked resolution of intestinal metaplasia in the antrum. On the other hand, continuous H.pylori infection leads to progressive aggravation of atrophy and intestinal metaplasia.

  12. RESISTANCE TO AMOXICILLIN, CLARITHROMYCIN AND CIPROFLOXACIN OF Helicobacter pylori ISOLATED FROM SOUTHERN BRAZIL PATIENTS

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    Simone Ulrich Picoli

    2014-06-01

    Full Text Available Introduction: Helicobacter pylori is a bacteria which infects half the world population and is an important cause of gastric cancer. The eradication therapy is not always effective because resistance to antimicrobials may occur. The aim of this study was to determine the susceptibility profile of H. pylori to amoxicillin, clarithromycin and ciprofloxacin in the population of Southern Brazil. Material and methods: Fifty four samples of H. pylori were evaluated. The antibiotics susceptibility was determined according to the guidelines of the British Society for Antimicrobial Chemotherapy and the Comité de l'Antibiogramme de la Société Française de Microbiologie. Results: Six (11.1% H. pylori isolates were resistant to clarithromycin, one (1.9% to amoxicillin and three (5.5% to ciprofloxacin. These indices of resistance are considered satisfactory and show that all of these antibiotics can be used in the empirical therapy. Conclusion: The antibiotics amoxicillin and clarithromycin are still a good option for first line anti-H. pylori treatment in the population of Southern Brazil.

  13. Efficacy of omeprazole and amoxicillin with either clarithromycin or metronidazole on eradication of Helicobacter pylori in Chinese peptic ulcer patients

    Institute of Scientific and Technical Information of China (English)

    Wei-Hao Sun; Han Su; Xi-Long Ou; Da-Zhong Cao; Qian Yu; Ting Yu; Jin-Ming Hu; Feng Zhu; Yun-Liang Sun; Xi-Ling Fu

    2005-01-01

    AIM: One-week triple therapy with proton pump inhibitors, clarithromycin and amoxicillin has recently been proposed as the first-line treatment for Helicobacter pylori(H pylori) infection; however, data regarding the effects of this regimen in China are scarce. The aim of this prospective and randomized study was to compare the efficacy of clarithromycin and metronidazole when they were combined with omeprazole and amoxicillin on eradication of H pylori and ulcer healing in Chinese peptic ulcer patients.METHODS: A total of 103 subjects with H pylori-positive peptic ulcer were randomly divided into two groups, and accepted triple therapy with omeprazole 20 mg, amoxicillin 1 000 mg and either clarithromycin 500 mg (OAC group,n = 58) or metronidazole 400 mg (OAM group, n = 45).All drugs were given twice daily for 7 d. Patients with active peptic ulcer were treated with omeprazole 20 mg daily for 2-4 wk after anti-H pylori therapy. Six to eight weeks after omeprazole therapy, all patients underwent endoscopies and four biopsies (two from the antrum and two others from the corpus of stomach) were taken for rapid urease test and histological analysis (with modified Giemsa staining) to examine H pylori. Successful eradication was defined as negative results from both examination methods.RESULTS: One hundred patients completed the entire course of therapy and returned for follow-up. The eradication rate of H pylori for the per-protocol analysis was 89.3% (50/56) in OAC group and 84.1% (37/44) in OAM group. Based on the intention-to-treat analysis, the eradication rate of H pylori was 86.2% (50/58) in OAC group and 82.2% (37/45) in OAM group. There were no significant differences in eradication rates between the two groups on either analysis. The active ulcer-healing rate was 96.7% (29/30) in OAC group and 100% (21/21)in OAM group (per-protocol analysis, P>0.05). Six patients in OAC group (10.3%) and five in OAM group (11.1%)reported adverse events (P>0.05).CONCLUSION

  14. Serum hepcidin levels in Helicobacter pylori-infected children with iron-deficiency anemia: a case-control study.

    Science.gov (United States)

    Azab, Seham F A; Esh, Asmaa M H

    2013-11-01

    Recently, hepcidin, an antimicrobial-like peptide hormone, has evolved as the master regulator of systemic iron homeostasis. Hepcidin integrates signals from diverse physiological inputs, forming a key connection between iron trafficking and response to infection. In this study, we aimed to investigate whether Helicobacter pylori infection modulates serum hepcidin level and response to oral iron therapy in children with iron-deficiency anemia. This was a case-control study including 60 children with iron-deficiency anemia (IDA; 30 H. pylori infected and 30 H. pylori noninfected) and 30 healthy children with comparable age and gender as the control group. Iron parameters including serum iron, ferritin, transferrin, total iron binding capacity, and transferrin saturation and serum hepcidin levels were assessed initially and after 3 months of oral iron therapy for IDA. Compared to the control group, serum hepcidin was significantly lower in H. pylori-noninfected children with IDA (P iron therapy (P iron therapy (P > 0.05). Although hepcidin showed significant positive correlations with serum ferritin, hemoglobin (Hb), iron, and transferrin saturation in noninfected children with IDA (P iron, and transferrin saturation in H. pylori-infected children with IDA (P iron therapy in children with iron-deficiency anemia.

  15. Helicobacter pylori and Peptic Ulcers

    Centers for Disease Control (CDC) Podcasts

    2010-08-17

    In this podcast, CDC's Dr. David Swerdlow discusses the relationship between Helicobacter pylori and peptic ulcer disease and trends in hospitalization rates for peptic ulcer disease in the United States between 1998 and 2005.  Created: 8/17/2010 by National Center for Emerging and Zoonotic Infectious Diseases.   Date Released: 8/17/2010.

  16. The Moxifloxacin-Based Triple Therapies to Treat Helicobacter Pylori Eradication Failure%莫西沙星三联疗法治疗根治失败的幽门螺杆菌感染

    Institute of Scientific and Technical Information of China (English)

    郝玲; 李智

    2011-01-01

    目的 观察莫西沙星三联疗法治疗根治失败的幽门螺杆菌(Hp)感染的临床疗效及药物的不良反应.方法 选取常规Hp根治失败的患者125例随机分成A、B两组,A组64例给予莫西沙星0.4g qd+泮托拉唑0.4g bid+阿莫西林1.0g bid;B组61例给子泮托拉唑0.4g bid+枸盐酸铋钾0.22g bid+呋喃唑酮0.2g bid+阿莫西林1.0g bid,A、B两组均服药1周.两组停服质子泵抑制剂及抗菌素4周后行14C-BUT呼气试验检测Hp感染是否根治.结果 A、B两组的根治率分别为90.5%和75.4%(P<0.05);不良反应发生率分别为9.4%和22.8%(P<0.05).A组比B组多支付医疗费用137.9元.结论 莫西沙星三联疗法治疗根治失败的Hp感染是一种有效,安全的治疗方案.%Objective To investigate the efficacy and the associated symptoms of moxifioxacin-based readicate helicobacter pylori (Hp) after treatment failure.Methods 125 patients with initial treatment failure were randomly divided into 2 groups; group A ( n = 64) took moxifloxacin 0.4 g qd + pantoloc 0.4 g bid + amoxillin 1.0 g bid; group B ( n = 61 ) took pantoloc 0.4 g bid + amoxillin 1.0 g bid + bismuth potassium citrate 0.22 g bid + furazolidone 0.2 g bid.The patients in both groups were treated for one-week.Hp status was assessed four-weeks after the end of treatment by 14C-UBT breath test.Results The treatment was completed in all the 125 patients.The rates of Hp readication in goups A and B were 90.5% and 75.4% ( P < 0.05), The rates of the associated symptoms in groups A and B were 9.4% and 22.8% ( P < 0.05 ).The group A than group B was more 137.9 yuan for the medical fee.Conclusion The moxifloxacin-based triple therapies is an effective, safechoice after the eradication failure for Hp infection.

  17. H pylori are associated with chronic cholecystitis

    Institute of Scientific and Technical Information of China (English)

    Dong-Feng Chen; Lu Hu; Ping Yi; Wei-Wen Liu; Dian-Chun Fang; Hong Cao

    2007-01-01

    AIM:To study whether H pylori are associated with chronic cholecystitis.METHODS:The subjects were divided into three groups:H pylori-infected cholecystitis group,H pylorinegative cholecystitis group and control group.Pathologic changes of the gallbladder were observed by optic and electronic microscopes and the levels of interleukin-1,6 and 8(IL-1,6 and 8)were detected by radioimmunoassay.RESULTS:Histological evidence of chronic cholecystitis including degeneration,necrosis,inflammatory cell infiltration,were found in the region where H pylori-colonized.Levels of IL-1,6 and 8 in gallbladder mucosa homogenates were significantly higher in H pylori-infected cholecystitis group than those in H pylori-negative cholecystitis group and control group.CONCLUSION:H pylori infection may be related to cholecystitis.

  18. Interaction or relationship between Helicobacter pylori and non-steroidal anti-inflammatory drugs in upper gastrointestinal diseases

    Institute of Scientific and Technical Information of China (English)

    Kai-Yu Ji; Fu-Lian Hu

    2006-01-01

    According to a meta-analysis, H pylori and non-steroidal anti-inflammatory drugs (NSAID) independently and significantly increase the risk of gastroduodenal ulcer and ulcer bleeding. Their coincidence is frequent,demonstration of a possible relationship and consequent attitude is of important implications. But unfortunately,no consensus has been approved in the past years and their interactions are still controversial. H pylori and NSAID are known to share a number of pathogenic mechanisms, but there is no evidence for the significant synergic action between these two risk factors. Their relationship is independent, additive, synergistic or antagonistic without considering the influence of other factors because studies on this subject are different in almost all aspects of their methodology, including the definition of a NSAID user as well as the types,doses, duration and their indications for NSAID use,as well as their end-points, definition of dyspepsia and regimes used for eradication of H pylori. These might contribute to the conflicting results and opinions. H pylori infection in humans does not act synergistically with NSAID on ulcer healing, and there is no need to eradicate it. This notion is supported by the finding that the eradication of H pylori does not affect NSAIDinduced gastropathy treated with omeprazole and that H pylori infection induces a strong cyclooxygenase-2(COX-2) expression resulting in excessive biosynthesis of gastroprotective prostaglandin which in turn counteracts NSAID-induced gastropathy and heals the existing ulcer.Other investigators claimed that H pylori infection acts synergistically with NSAID on ulcer development, and H pylori should be eradicated, particularly at the start of long-term NSAID therapy. Eradication of H pylori prior to NSAID treatment does not appear to accelerate ulcer healing or to prevent recurrent ulcers in NSAID users.However, some recommendations can be drawn from the results of clinical trails.

  19. Antibacterial activities of almond skins on cagA-positive and-negative clinical isolates of Helicobacter pylori

    Science.gov (United States)

    2013-01-01

    Background Helicobacter pylori is known to be a gastric pathogen of humans. Eradication regimens for H. pylori infection have some side effects, compliance problems, relapses, and antibiotic resistance. Therefore, the need for alternative therapies for H. pylori infections is of special interest. We have previously shown that polyphenols from almond skins are active against a range of food-borne pathogens. The aim of this study was to evaluate the antibacterial effects of natural almond skins before and after simulated human digestion and the pure flavonoid compounds epicatechin, naringenin and protocatechuic acid against H. pylori. Results H. pylori strains were isolated from gastric biopsy samples following standard microbiology procedures. Also, cagA and vacA genes were identified using PCR. Susceptibility studies on 34 strains of H. pylori, including two reference strains (ATCC 43504, ATCC 49503), were performed by the standard agar dilution method. Natural almond skin was the most effective compound against H. pylori (MIC range, 64 to 128 μg/ml), followed by natural skin post gastric digestion (MIC range, 128 to 512 μg/ml), and natural almond skin post gastric plus duodenal digestion (MIC range, 256 to 512 μg/ml). Amongst the pure flavonoid compounds, protocatechuic acid showed the greatest activity (MIC range, 128 to 512 μg/ml) against H. pylori strains. Conclusions Polyphenols from almond skins were effective in vitro against H. pylori, irrespective of genotype status and could therefore be used in combination with antibiotics as a novel strategy for antibiotic resistance. PMID:23659287

  20. Helicobacter pylori antibiotic resistance in a Dutch region: trends over time.

    NARCIS (Netherlands)

    Janssen, M.J.R.; Hendrikse, L.; Boer, S.Y. de; Bosboom, R.; Boer, W.A. de; Laheij, R.J.F.; Jansen, J.B.M.J.

    2006-01-01

    AIM: Most patients treated for H. pylori infection receive empirical therapy based on epidemiological data of antibiotic resistance. However, previous European studies indicate that resistance patterns may be changing. Therefore, the aim of this study was to investigate the prevalence of primary cla

  1. Effects of Helicobacter pylori eradication on atrophic gastritis and intestinal metaplasia: A 3-year follow-up study

    Institute of Scientific and Technical Information of China (English)

    Bin Lu; Ming-Tao Chen; Yi-Hong Fan; Yan Liu; Li-Na Meng

    2005-01-01

    AIM: To investigate the effect of H pylori eradication on atrophic gastritis and intestinal metaplasia (IM).METHODS: Two hundred and fifty-nine patients with atrophic gastritis in the antrum were included in the study, 154 patients were selected for H pylori eradication therapy and the remaining 105 patients served as untreated group. Gastroscopy and biopsies were performed both at the beginning and at the end of a 3-year follow-up study. Gastritis was graded according to the updated Sydney system.RESULTS: One hundred and seventy-nine patients completed the follow-up, 92 of them received H pylori eradication therapy and the remaining 87 H pyloriinfected patients were in the untreated group. Chronic gastritis, active gastritis and the grade of atrophy significantly decreased in H pylori eradication group (P<0.01). However, the grade of IM increased in H pylori -infected group (P<0.05).CONCLUSION: H pylori eradication may improve gastric mucosal inflammation, atrophy and prevent the progression of IM.

  2. Efficacy of a therapeutic strategy for eradication of Helicobacter pylori infection

    Institute of Scientific and Technical Information of China (English)

    Giuliana Sereni; Francesco Azzolini; Lorenzo Camellini; Debora Formisano; Francesco Decembrino; Veronica Iori; Cristiana Tioli

    2012-01-01

    AIM:To determine the efficacy of our therapeutic strategy for Helicobacter pylori (H.pylori) eradication and to identify predictive factors for successful eradication.METHODS:From April 2006 to June 2010,we retrospectively assessed 2428 consecutive patients (1025 men,1403 women; mean age 55 years,age range 18-92 years) with gastric histology positive for H.pylori infection referred to our unit for 13-C urea breath test (UBT),after first-line therapy with proton pump inhibitor (PPI) b.i.d.+ amoxicillin 1 g b.i.d.+ clarithromycin 500 mg b.i.d.for 7 d.Patients who were still positive to UBT were recommended a second-line therapy (PPI b.i.d.+amoxicillin 1 g b.i.d.+ tinidazole 500 mg b.i.d.for 14 d).Third choice treatment was empirical with PPI b.i.d.+amoxicillin 1 g b.i.d.+ levofloxacin 250 mg b.i.d.for 14 d.RESULTS:Out of 614 patients,still H.pylori-positive after first-line therapy,only 326 and 19 patients respectively rechecked their H.pylori status by UBT after the suggested second and third-line regimens."Per protocol" eradication rates for first,second and thirdline therapy were 74.7% (95% CI:72.7%-76.4%),85.3% (95% CI:81.1%-89.1%) and 89.5% (95% CI:74.9%-103%) respectively.The overall percentage of patients with H.pylori eradicated after two treatments was 97.8% (95% CI:97.1%-98.4%),vs 99.9% (95%CI:99.8%-100%) after three treatments.The study found that eradication therapy was most effective in patients with ulcer disease (P < 0.05,P =0.028),especially in those with duodenal ulcer.Smoking habits did not significantly affect the eradication rate.CONCLUSION:First-line therapy with amoxicillin and clarithromycin produces an H.pylori eradication rate comparable or superior to other studies and secondline treatment can still be triple therapy with amoxicillin and tinidazole.

  3. 3rd Brazilian Consensus on Helicobacter pylori.

    Science.gov (United States)

    Coelho, Luiz Gonzaga; Maguinilk, Ismael; Zaterka, Schlioma; Parente, José Miguel; do Carmo Friche Passos, Maria; Moraes-Filho, Joaquim Prado P

    2013-04-01

    Signicant progress has been obtained since the Second Brazilian Consensus Conference on Helicobacter pylori Infection held in 2004, in São Paulo, SP, Brazil, and justify a third meeting to establish updated guidelines on the current management of H. pylori infection. The Third Brazilian Consensus Conference on H pylori Infection was organized by the Brazilian Nucleus for the Study of Helicobacter, a Department of the Brazilian Federation of Gastroenterology and took place on April 12-15, 2011, in Bento Gonçalves, RS, Brazil. Thirty-one delegates coming from the five Brazilian regions and one international guest, including gastroenterologists, pathologists, epidemiologists, and pediatricians undertook the meeting. The participants were allocated in one of the five main topics of the meeting: H pylori, functional dyspepsia and diagnosis; H pylori and gastric cancer; H pylori and other associated disorders; H pylori treatment and retreatment; and, epidemiology of H pylori infection in Brazil. The results of each subgroup were submitted to a final consensus voting to all participants. Relevant data were presented, and the quality of evidence, strength of recommendation, and level of consensus were graded. Seventy per cent and more votes were considered as acceptance for the final statement. This article presents the main recommendations and conclusions to guide Brazilian doctors involved in the management of H pylori infection.

  4. 3rd BRAZILIAN CONSENSUS ON Helicobacter pylori

    Directory of Open Access Journals (Sweden)

    Luiz Gonzaga Coelho

    2013-04-01

    Full Text Available Significant progress has been obtained since the Second Brazilian Consensus Conference on Helicobacter pylori Infection held in 2004, in São Paulo, SP, Brazil, and justify a third meeting to establish updated guidelines on the current management of H. pylori infection. The Third Brazilian Consensus Conference on H pylori Infection was organized by the Brazilian Nucleus for the Study of Helicobacter, a Department of the Brazilian Federation of Gastroenterology and took place on April 12-15, 2011, in Bento Gonçalves, RS, Brazil. Thirty-one delegates coming from the five Brazilian regions and one international guest, including gastroenterologists, pathologists, epidemiologists, and pediatricians undertook the meeting. The participants were allocated in one of the five main topics of the meeting: H pylori, functional dyspepsia and diagnosis; H pylori and gastric cancer; H pylori and other associated disorders; H pylori treatment and retreatment; and, epidemiology of H pylori infection in Brazil. The results of each subgroup were submitted to a final consensus voting to all participants. Relevant data were presented, and the quality of evidence, strength of recommendation, and level of consensus were graded. Seventy per cent and more votes were considered as acceptance for the final statement. This article presents the main recommendations and conclusions to guide Brazilian doctors involved in the management of H pylori infection.

  5. Helicobacter Pylori Seropostivity of Colon Cancer

    Directory of Open Access Journals (Sweden)

    F. Tugba Kos

    2014-03-01

    Full Text Available Aim: Until now many researches have showed that Helicobacter pylori infection may be etiological factor of colorectal cancer. The aim of current study was to investigate the frequency of H.pylori infection seropositivity of colorectal cancer patients and compare the clinicopathological features of H.pylori positive patients with negative ones. Material and Method: Seventy four colorectal patients were included in study. Retrospectively, patients clinical features, surgery history and pathological characteristics were screened. Patients group serum samples were collected. H.pylori Ig G level were quantitatively measured with ELISA method and levels above 5 arbU/ml were accepted as seropositive. Results: Patients median age was 60.5 ( range 26-83 and 56.8% (n=42 were male. H.pylori Ig G was positive in 37.8% (n=28 and negative in 62.2% (n=46 of patient group. H.pylori serpositive and negative patients median age of diagnosis were 56 and 64 respectively (p=0.01. There were no significant difference between H.pylori seropositive group when compared with negative group according to age, level of CEA and Ca 19-9, stage, lymph node involvement, perineural and vascular invasion, presence of polyps, differantion, localisation of tumours. Discussion: H.pylori seropositive patients were diagnosed at younger age. Association of this finding with etiology was confusing. Further studies with healthy controls may provide detailed information about whether H.pylori seropositivity is associated with colorectal cancer etiology.

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

    Directory of Open Access Journals (Sweden)

    Nicola L Jones

    2005-01-01

    Full Text Available 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

  7. Antimicrobial resistance of Helicobacter pylori strains to five antibiotics, including levofloxacin, in Northwestern Turkey

    Directory of Open Access Journals (Sweden)

    Reyhan Caliskan

    2015-06-01

    Full Text Available INTRODUCTION: Antibiotic resistance is the main factor that affects the efficacy of current therapeutic regimens against Helicobacter pylori. This study aimed to determine the rates of resistance to efficacy clarithromycin, amoxicillin, tetracycline, levofloxacin and metronidazole among H. pylori strains isolated from Turkish patients with dyspepsia. METHODS: H. pylori was cultured from corpus and antrum biopsies that were collected from patients with dyspeptic symptoms, and the antimicrobial susceptibility of H. pylori was determined using the E-test (clarithromycin, amoxicillin, tetracycline, metronidazole and levofloxacin according to the EUCAST breakpoints. Point mutations in the 23S rRNA gene of clarithromycin-resistant strains were investigated using real-time PCR. RESULTS: A total of 98 H. pylori strains were isolated, all of which were susceptible to amoxicillin and tetracycline. Of these strains, 36.7% (36/98 were resistant to clarithromycin, 35.5% (34/98 were resistant to metronidazole, and 29.5% (29/98 were resistant to levofloxacin. Multiple resistance was detected in 19.3% of the isolates. The A2143G and A2144G point mutations in the 23S rRNA-encoding gene were found in all 36 (100% of the clarithromycin-resistant strains. Additionally, the levofloxacin MIC values increased to 32 mg/L in our H. pylori strains. Finally, among the clarithromycin-resistant strains, 27.2% were resistant to levofloxacin, and 45.4% were resistant to metronidazole. CONCLUSIONS: We conclude that treatment failure after clarithromycin- or levofloxacin-based triple therapy is not surprising and that metronidazole is not a reliable agent for the eradication of H. pylori infection in Turkey.

  8. Successful culture techniques for Helicobacter species: general culture techniques for Helicobacter pylori.

    Science.gov (United States)

    Whitmire, Jeannette M; Merrell, D Scott

    2012-01-01

    Half of the world's population is persistently infected with Helicobacter pylori. The chronicity of this infection ultimately elicits clinical manifestations ranging from gastritis and peptic ulcers to adenocarcinoma and MALT lymphoma. Laboratory research following the initial observations of Helicobacter species was greatly hindered by an inability to isolate and culture the bacteria. Thus, the ability to culture bacterial species from this genus is an extremely important step in expanding clinical knowledge and development of therapies. This chapter describes successful techniques for culturing H. pylori on selective horse blood agar media and in Brucella broth liquid media. Additionally, the specific growth requirements of other Helicobacter species are noted.

  9. Helicobacter pylori neutrophil activating protein as target for new drugs against H.pylori inflammation

    Institute of Scientific and Technical Information of China (English)

    Theodora Choli-Papadopoulou; Filippos Kottakis; Georgios Papadopoulos; Stefanos Pendas

    2011-01-01

    Helicobacter pylori (H. pylori ) infection is among the most common human infections and the major risk factor for peptic ulcer disease and gastric cancer. Within this work we present the implication of C-terminal region of H. pylori neutrophil activating protein in the stimulation of neutrophil activation as well as the evidence that the C-terminal region of H. pylori activating protein is indispensable for neutrophil adhesion to endothelial cells, a step necessary to H. pylori inflammation. In addition we show that arabino galactan proteins derived from chios mastic gum, the natural resin of the plant Pistacia lentiscus var. Chia inhibit neutrophil activation in vitro .

  10. Logistic Regression Analysis on Influencing Factors of Helicobacter Pylori Infection Eradication with Triple Therapy%幽门螺杆菌三联根除疗法影响因素的Logistic回归分析

    Institute of Scientific and Technical Information of China (English)

    吴蓉; 周刚

    2011-01-01

    目的 探讨幽门螺杆菌(H.pylori)的耐药性、患者的性别、年龄、烟酒史、疾病类型及组织学改变等对H.pylori根除率的影响.方法 选取78例十二指肠溃疡(DU)或非溃疡性消化不良(NUD)患者,所有患者接受7 d的H.pylori根除治疗.治疗结束后,采用14C-尿素呼气试验评估H.pylori根除情况.H.pylori药敏试验采用纸片法和二倍平皿稀释法.结果 78例患者均分离出78株革兰阴性弯曲海鸥状弧形杆菌,其中14.1%对克拉霉素原发性耐药,69.2%对甲硝唑耐药,1.3%对阿莫西林耐药.Loginstic回归分析显示,患者性别、克拉霉素耐药的OR值分别为5.649[95%CI(1.3,24.6)]和8.520[95%CI(1.62,44.7)],与H.pylori根除呈正相关(P<0.05);DU的OR=0.119[95%CI (0.018,0.072)],与H.pylori根除呈负相关(P<0.05).结论 克拉霉素耐药、DU、患者的性别是影响H.pylori根除的相关独立因素.%Objective To investigate the impact of drug resistance, sex, age, smoking and drinking habit, disease types, and histological changes on eradication rate of Helicobacter pylori ( H.pylori ) . Methods A total of 78 patients with duodenal ulcer and non - ulcer dyspepsia were recruited and treated with a 7 - day eradication plan. 14C test was employed to evaluate effects of H. pylori eradication. For drug sensitive test of H. pylori we adopted paper disk method and double plating dilution method. Results A total of 78 G - Campylobacter strains were isolated from all the 78 patients. of which 14.1% were resistant to Clarithromycin, 69.2% were resistant to metronidazole, and 1.3% were resistant to amoxicillin. Univariate analysis revealed that eradication effects were positively related with Clarithromycin resistance [ 8.520; 95%CI ( 1.62 , 44.7 ) ], sex [ 5.649 ;95% CI ( 1.3, 24.6 ) ] and negatively related with duodenal ulcer [ 0.119; 95% CI ( 0.018, 0.072 ) ] . Conclusion Our dato suggest that Clarithromycin resistance , sex , and duodenal ulcer are among

  11. 含益生菌四联疗法根治顽固性幽门螺杆菌感染的疗效观察%Radical curative efficacy of quadruple therapy containing probiotics on persistent Helicobacter pylori infection: an efficacy observation

    Institute of Scientific and Technical Information of China (English)

    黎莉; 杨卫文; 杨景林; 何天兰; 汪琪

    2013-01-01

    目的 探讨含益生菌四联疗法根治顽固性幽门螺杆菌感染(H.pylori)的疗效.方法 经标准三联疗法根治失败的顽固性幽门螺杆菌感染患者180例,随机分为6组:A组(含双歧杆菌乳杆菌三联活菌片四联疗法):雷贝拉唑+阿莫西林+克拉霉素+双歧杆菌乳杆菌三联活菌片;B组(伴同疗法):雷贝拉唑+阿莫西林+克拉霉素+呋喃唑酮;C组(标准四联疗法):雷贝拉唑+阿莫西林+克拉霉素+胶体果胶铋.疗程均为7d.同样分组方案A1组、B1组、C1组,疗程14d.治疗前后查肝肾功及三大常规,观察药物不良反应.1个月后复查胃镜并作快速尿素酶实验及14C呼吸实验(14C-UBT),观察H.pylori根除情况.结果 含双歧杆菌乳杆菌三联活菌片四联疗法根除率7d为76.7%,与其他两组比较差异无统计学意义(P>0.05),无任何不良反应发生;14 d为90.0%,与其他两组比较差异也无统计学意义(P>0.05),各组均优于7天组(P <0.05);14天组不良反应发生率为6.67%,7天及14天组不良反应均低于其他相应各组.结论 含双歧杆菌乳杆菌三联活菌片四联疗法根治顽固性幽门螺杆菌感染的疗效与标准四联及伴同疗法相当,但不良反应较少,可以值得推广.%Objective To Discuss the radical curative efficacy of probiotic-containing quadruple therapy on persistent Helicobacter pylori infection.Methods 180 patients with intractable Helicobacter pylori infection after failure of triple therapy were randomly divided into 6 groups:Group A (Quadruple therapy of Live Combined Bifidobacterium and Lactobacillus Tablets) was given Rabeprazole + Amoxicillin + Clarithromycin + Live Combined Bifidobacterium and Lactobacillus Tablets; Group B (Concomitant therapy) was given Rabeprazole + Amoxicillin + Clarithromycin + Furazolidone ; Group C (Standard quadruple therapy) was given Rabeprazole + Amoxi-cillin + Clarithromycin + Colloidal Bismuth Pectin.The course of treatment was 7 days.The same

  12. Is a 7-day Helicobater pylori treatment enough for eradication and inactivation of gastric inflammatory activity?

    Institute of Scientific and Technical Information of China (English)

    Carlos Robles-lara; Carlos Robles-Medranda; Manuel Moncayo; Byron Landivar; Johnny Parrales

    2008-01-01

    AIM- To compare the efficacy of a 7-d vs 10-d triple therapy regarding H pylori eradication, endoscopic findings and histological gastric inflammatory inactivation in the Ecuadorian population. METHODS: 136 patients with dyspepsia and H pylori infection were randomized in 2 groups (68 per group): group 1, 7-d therapy; group 2, t0-d therapy. Both groups received the same medication and daily dosage: omeprazole 20 mg bid, clarithromycin 500 mg bid and amoxicillin I g bid. Endoscopy was performed for histological assessment and H pylori infection status before and 8 wk after treatment. RESULTS: H pylori was eradicated in 68% of group 1 vs 83. 8% of group 2 for the intention-to-treat analysis (ITT) (P = 0. 03; OR = 2. 48; 95% CI, 1. 1-5. 8), and 68% in group 1 vs 88% in group 2 for the per-protocol analysis (PP) (P = 0. 008; OR = 3. 66; 95% CI, 1. 4-10). Endoscopic gastric mucosa normalization was observed in 56. 9% in group 1 vs 61. 2% in group 2 for ITT, with similar results for the PP, the difference being statistically not significant. The rate of inflammatory inactivation was 69% in group 1 vs 88. 7% in group 2 for ITT (P = 0. 007;OR = 3. 00; 95% CI, 1. 2-7. 5), and 69% in group 1 vs96% in group 2 for PP (P = 0. 0002; OR = 7. 25; 95% CI, 2-26). CONCLUSION: In this Ecuadorian population, the 10-d therapy was more effective than the 7-d therapy for H pylori eradication as well as for gastric mucosa inflammatory inactivation.

  13. Helicobacter pylori: epidemiology and routes of transmission.

    Science.gov (United States)

    Brown, L M

    2000-01-01

    H. pylori is a common bacterium, and approximately 50 percent of the world's population has been estimated to be infected (198). Humans are the principal reservoir. The prevalence of H. pylori infection varies widely by geographic area, age, race, ethnicity, and SES. Rates appear to be higher in developing than in developed countries, with most of the infections occurring during childhood, and they seem to be decreasing with improvements in hygiene practices. H. pylori causes chronic gastritis and has been associated with several serious diseases of the gastrointestinal tract, including duodenal ulcer and gastric cancer. Since its "discovery" in 1982 by Warren and Marshall (1), H. pylori has been the topic of extensive research. A number of studies have used questionnaire components to investigate factors possibly related to the etiology of H. pylori infection. The majority of recent studies have not found tobacco use or alcohol consumption to be risk factors for H. pylori infection. Adequate nutritional status, especially frequent consumption of fruits and vegetables and of vitamin C, appears to protect against infection with H. pylori. In contrast, food prepared under less than ideal conditions or exposed to contaminated water or soil may increase the risk. Overall, inadequate sanitation practices, low social class, and crowded or high-density living conditions seem to be related to a higher prevalence of H. pylori infection. This finding suggests that poor hygiene and crowded conditions may facilitate transmission of infection among family members and is consistent with data on intrafamilial and institutional clustering of H. pylori infection. Understanding the route of H. pylori transmission is important if public health measures to prevent its spread are to be implemented. Iatrogenic transmission of H. pylori following endoscopy is the only proven mode. For the general population, the most likely mode of transmission is from person to person, by either the

  14. Effect of H pylori infection and its eradication on hyperammo-nemia and hepatic encephalopathy in cirrhotic patients

    Institute of Scientific and Technical Information of China (English)

    Shu-Jie Chen; Liang-Jing Wang; Qin Zhu; Jian-Ting Cai; Tao Chen; Jian-Min Si

    2008-01-01

    AIM: To investigate the relationship between H pylori infection, blood ammonia concentration and hepatic encephalopathy (HE), and the effect of H pylori eradication in cirrhotic patients.METHODS: From July 2003 to January 2005, 457 cirrhotic patients in five regions of Zhejiang Province were enrolled. Patients were evaluated for demographics, number connection test, H pylori infection, liver impairment, blood ammonia concentration and HE. Patients with H pylori infection were given 1 wk therapy with omeprazole plus clarithromycin and tinidazole. 14C urea breath test was performed and mental symptoms and blood ammonia level were reassessed after bacterium eradication.RESULTS: Overall H pylori infection rate was 60.6%, and HE occurred in 47.5% of cirrhotic patients. Subclinical HE (SHE) was detected in 55 of 117 cirrhotic patients. Blood ammonia concentration in H pylori negative (n = 180) and positive (n = 277) cirrhotic patients was 53.8 ± 51.4 and 78.4 ± 63.6 nmol/L, respectively (P < 0.01), which was significantly reduced to 53.5 ± 37.7 nmol/L after bacterium eradication (n = 126) (P < 0.01). Blood ammonia was 97.5 ± 81.0 nmol/L in H py/ori-positive cirrhotic patients, and this did not significantly change in those with persistent infection after H pylori eradication (n = 11). HE was more frequently observed in patients with H pylori infection than in those without (58.5% vs 30.6%, P < 0.01). HE rate significantly dropped to 34.1% after H pylori eradiation (P < 0.01). H pylori prevalence significantly differed among cirrhotic patients with HE (74.4%), SHE (69.1%), and those without HE (53.2%) (P < 0.05). Blood ammonia level was significantly different among cirrhotic patients with HE (94.5 ± 75.6 nmol/L), SHE (59.9 ± 49.2 nmol/L), and without HE (47.3 ± 33.5 nmol/L) (P < 0.05). Logistic regression analysis showed that blood ammonia concentration, Child-Pugh stage, upper gastrointestinal bleeding, electrolyte disturbance, and urea nitrogen were risk factors

  15. Spontaneous Regression of Polyposis following Abdominal Colectomy and Helicobacter pylori Eradication for Cronkhite-Canada Syndrome

    Directory of Open Access Journals (Sweden)

    Kimitoshi Kato

    2013-03-01

    Full Text Available The etiology of Cronkhite-Canada syndrome (CCS remains unknown and many cases are refractory to treatment. Therefore, new therapies are urgently needed. Furthermore, a number of CCS cases with gastrointestinal carcinoma have been reported. Our patient had rapid onset of CCS and early development of colon carcinoma associated with adenomas. High anterior resection of the sigmoid colon and ileostomy were performed, and her symptoms and endoscopic and histological findings improved. Helicobacter pylori eradication was carried out 2 years later, surgical closure of an ileal fistula the following year. After 4 months, upper gastrointestinal endoscopy and colonoscopy showed that the CCS lesions had completely disappeared, and biopsies confirmed a normal stomach, duodenum, ileum and colon histologically. The patient has maintained remission for 2 years. The clinical course of this case, showing complete regression of CCS lesions following abdominal colectomy and H. pylori eradication, suggests the significance of H. pylori infection in the treatment of CCS.

  16. Recombinant Bacillus subtilis spores expressing cholera toxin B subunit and Helicobacter pylori urease B confer protection against H. pylori in mice.

    Science.gov (United States)

    Zhou, Zhenwen; Dong, Hui; Huang, Yanmei; Yao, Shuwen; Liang, Bingshao; Xie, Yongqiang; Long, Yan; Mai, Jialiang; Gong, Sitang

    2017-01-01

    Helicobacter pylori infection is associated with chronic gastritis, peptic ulcers, gastric cancer and mucosa-associated lymphoid tissue lymphoma. The limitations of current therapies for H. pylori infection include poor compliance and antibiotic resistance. Therefore, an effective anti-H. pylori vaccine would be an alternative or complement to antibiotic treatment. Urease B (UreB) is considered an ideal vaccine antigen against H. pylori infection. In this study, cholera toxin B subunit (CTB), a mucosal adjuvant, was used to enhance the immunogenicity of a novel Bacillus subtilis spore vaccine expressing CTB-UreB, along with the B. subtilis spore coat protein CotC as a fusion protein. Oral administration of B. subtilis spores expressing CotC-UreB or CotC-CTB-UreB led to increased levels of UreB-specific IgG in serum and UreB-specific IgA in faeces, as well as elevated levels of IL-10 and IFN-γ in splenocytes. In addition, oral administration of CotC-UreB or CotC-CTB-UreB spores induced significant reductions (80.0 and 90.5 %, respectively) in gastric H. pylori bacterial load (1.11±0.36×105 and 0.53±0.21×105 c.f.u., respectively) compared to that of the CotC control group (5.56±1.64×105 c.f.u., P<0.01). Moreover, CotC-CTB-UreB spores were significantly more effective at reducing the bacterial load than CotC-UreB spores (P<0.05). These results indicate that CotC-CTB-UreB-expressing B. subtilis spores are a potential vaccine candidate for the control of H. pylori infection.

  17. Antralization at the edge of proximal gastric ulcers: Does Helicobacter pylori infection play a role?

    Institute of Scientific and Technical Information of China (English)

    Harry Hua-Xinag Xia; Benjamin Chun-Yu Wong; Shiu Kum Lam; Wai Man Wong; Wayne Hsing Cheng Hu; Kam Chuen Lai; Sau Hing Wong; Suet Yi Leung; Siu Tsan Yuen; Nicholas A.Wright

    2003-01-01

    AIM: To determine the prevalence of antralization at the edge of proximal gastric ulcers, and the effect ofH. pylori eradication on the mucosal appearances. METHODS: Biopsies were taken from the antrum, body and the ulcer edge of patients with benign proximal gastric ulcers before and one year after treatment. Gastric mucosa was classified as antral, transitional or body type.H. pylori positive patients receivedeither triple therapy, or omeprazole. RESULTS: Patients with index ulcers in the incisura, body or fundus (n=116) were analyzed. Antral-type mucosa was more prevalent at the ulcer edge inH. pylori-positive patients thanH.pylori-negative patients (93% vs 60%, OR=8.95,95%CI: 2.47-32.4, P=0.001). At one year, there was a significant reduction in the prevalence of antralization (from 93 % to 61%, P=0.004) at the ulcer edge in patients with H. pyloribeing eradicated. However, there was no difference in the prevalence of antralization at the ulcer edge in those with persistent infection. CONCLUSION: H. pylori infection is associated with antralization at the edge of proximal gastric ulcers, which may be reversible in some patients after eradication of the infection.

  18. Prevalence of antibiotic resistance in Helicobacter pylori: A recent literature review

    Science.gov (United States)

    Ghotaslou, Reza; Leylabadlo, Hamed Ebrahimzadeh; Asl, Yalda Mohammadzadeh

    2015-01-01

    AIM: To review previous studies (the last 6 years) about the Helicobacter pylori (H. pylori) antibiotic resistance in order to evaluate the trend in antibiotic resistance. METHODS: In this study, the PubMed, MEDLINE, Science Direct, Google Scholar and Scielo manuscripts were reviewed from 2009 to 2014. RESULTS: On the whole rates of H. pylori antibiotic resistance were 47.22% (30.5%-75.02%) for metronidazole, 19.74% (5.46%-30.8%) for clarithromycin, 18.94% (14.19%-25.28%) for levofloxacin, and 14.67% (2%-40.87%) for amoxicillin, 11.70% (0%-50%) for tetracycline, 11.5% (0%-23%) for furazolidon and 6.75% (1%-12.45%) for rifabutin. The frequency of tetracycline, metronidazole and amoxicillin resistance was higher in Africa, while clarithromycin and levofloxacin resistance was higher in North America and Asian, respectively. CONCLUSION: The most sensitive drug is rifabutin and the lowest sensitive drug is metronidazole in the world. The worldwide H. pylori antibiotic resistance to clarithromycin and levofloxacin has increased during the last 6 years. The present systematic review show alarming results and a novel plan is needed for eradication therapy of H. pylori infections. PMID:26413490

  19. Carbon-14 urea breath test for the diagnosis of Campylobacter pylori associated gastritis

    Energy Technology Data Exchange (ETDEWEB)

    Marshall, B.J.; Surveyor, I.

    1988-01-01

    Urease in the human gastric mucosa is a marker for infection with Campylobacter pylori (CP), an organism suspected of causing chronic gastritis and peptic ulceration. To detect gastric urease, we examined 32 patients who were being evaluated for possible peptic ulcer disease. Fasting patients were given 10 microCi (370 kBq) of /sup 14/C-labeled urea. Breath samples were collected in hyamine at intervals between 1 and 30 min. The amount of /sup 14/C collected at these times was expressed as: body weight X (% of administered dose of /sup 14/C in sample)/(mmol of CO/sub 2/ collected). The presence of C. pylori colonization was also determined by examination of multiple endoscopic gastric biopsy specimens. On average, patients who were proven to have C. pylori infection exhaled 20 times more labeled CO/sub 2/ than patients who were not infected. The difference between infected patients and C. pylori negative control patients was highly significant at all time points between 2 and 30 min after ingestion of the radionuclide (p less than 0.0001). The noninvasive urea breath is less expensive than endoscopic biopsy of the stomach and more accurate than serology as a means of detecting Campylobacter pylori infection. Because the test detects actual viable CP organisms, it can be used to confirm eradication of the bacterium after antibacterial therapy.

  20. Epidemiology of Helicobacter pylori and gastric cancer.

    Science.gov (United States)

    Kikuchi, Shogo

    2002-01-01

    Findings in epidemiological studies of the relationship between Helicobacter pylori and gastric cancer have been inconsistent: many studies have yielded a positive relationship, whereas several studies have shown no relationship. The inconsistency arises because of the occurrence of seroreversion during the period between the time that H. pylori exerts a carcinogenic effect and the time of blood sampling. When this seroreversion is taken into account, there is an epidemiologically positive association between H. pylori status and the risk for gastric cancer. In addition to the epidemiological evidence, experimental studies using Mongolian gerbils have shown that H. pylori infection elevates the risk for gastric cancer. It is concluded that H. pylori is a causal factor for gastric cancer. In the creation of preventive strategies against gastric cancer by the eradication of H. pylori, determination of the time at which H. pylori plays a role as a carcinogen is important. Three hypotheses have been proposed in regard to this timing: that H. pylori infection in childhood or the teenage years acts as a factor that produces precancerous lesions with irreversible damage in the gastric mucosa, that in adulthood it acts as an initiator, and also in adulthood, that it acts as a promoter. As these hypotheses are not mutually exclusive, the extent to which each hypothesis plays a part in explaining gastric carcinogenesis should be evaluated. Only a small proportion of subjects infected with H. pylori have gastric cancer during their lifetime. Interleukin-1 polymorphism, a host factor, and CagA, a virulence factor of H. pylori, are suspected to be risk factors for gastric cancer in subjects with H. pylori infection. Dietary factors, especially vitamin C, and patterns of precancerous lesions also seem to influence the relationship between H. pylori and gastric cancer. H. pylori seems to reduce the risk for esophageal and for some gastric cardia adenocarcinomas. This finding, as

  1. Treatment of low-grade gastric malt lymphoma using Helicobacter pylori eradication

    Directory of Open Access Journals (Sweden)

    Grgov Saša

    2015-01-01

    Full Text Available Background/Aim. Lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma of the stomach usually occurs as a consequence of Helicobacter pylori (H. pylori infection. The aim of this study was to investigate the long-term effect of treatment of low-grade gastric MALT lymphoma with the H. pylori eradication method. Methods. In the period 2002-2012 in 20 patients with dyspepsia, mean age 55.1 years, the endoscopic and histologic diagnosis of gastric MALT lymphoma in the early stages were made. Histological preparations of endoscopic biopsy specimens were stained with hematoxyllineosin (HE, histochemical and immunohistochemical methods. Results. Endoscopic findings of gastritis were documented in 25% of the patients, and 75% of the patients had hypertrophic folds, severe mucosal hyperemia, fragility, nodularity, exulcerations and rigidity. Histopathologically, pathognomonic diagnostic criterion were infiltration and destruction of glandular epithelium with neoplastic lymphoid cells, the so-called lymphoepithelial lesions. In all 20 patients H. pylori was verified by rapid urease test and Giemsa stain. After the triple eradication therapy complete remission of MALT lymphoma was achieved in 85% of the patients, with no recurrence of lymphoma and H. pylori infection in the average follow-up period of 48 months. In 3 (15% of the patients, there was no remission of MALT lymphoma 12 months after the eradication therapy. Of these 3 patients 2 had progression of MALT lymphoma to diffuse large-cell lymphoma. Conclusion. Durable complete re-mission of low-grade gastric MALT lymphoma is achieved in a high percentage after eradication of H. pylori infection, thus preventing the formation of diffuse large-cell lymphoma and gastric adenocarcinoma.

  2. Standard triple versus levofloxacin based regimen for eradication ofHelicobacter pylori

    Institute of Scientific and Technical Information of China (English)

    Raj; Gopal; Thirthar; Palanivelu; Elamurugan; Vikram; Kate; Sadasivan; Jagdish; Debdatta; Basu

    2013-01-01

    AIM:To compare the eradication rates for Helicobacter pylori(H.pylori) and ulcer recurrence of standard triple therapy(STT) and levofloxacin based therapy(LBT).METHODS:Seventy-four patients with perforated duodenal ulcer treated with simple closure and found to be H.pylori infected on 3 mo follow up were randomized to receive either the STT group comprising of amoxicillin 1 g bid,clarithromycin 500 mg bid and omeprazole 20 mg bid or the LBT group comprising of amoxicillin 1 g bid,levofloxacin 500 mg bid and omeprazole 20 mg bid for 10 d each.The H.pylori eradication rates,side effects,compliance and the recurrence of ulcer were assessed in the two groups at 3 mo follow up.RESULTS:Thirty-four patients in the STT group and 32 patients in the levofloxacin group presented at 3 mo follow up.H.pylori eradication rates were similar with STT and the LBT groups on intention-to-treat(ITT) analysis(69% vs 80%,P = 0.425) and(79% vs 87%,P = 0.513) by per-protocol(PP) analysis respectively.Ulcer recurrence in the STT and LBT groups on ITT analysis was(20% vs 14%,P = 0.551) and(9% vs 6%,P = 1.00) by PP analysis.Compliance and side effects were also comparable between the groups.A complete course of STT costs Indian Rupees(INR) 1060.00,while LBT costs only INR 360.00.CONCLUSION:H.pylori eradication rates and the rate of ulcer recurrence were similar between the STT and LBT.The LBT is a more economical option compared to STT.

  3. Helicobacter pylori colonization of the oral cavity: A milestone discovery.

    Science.gov (United States)

    Yee, John K C

    2016-01-14

    Over the past several years, the severity of Helicobacter pylori (H. pylori) infections has not significantly diminished. After successful eradication, the annual H. pylori recurrence rate is approximately 13% due to oral H. pylori infection. Established clinical diagnostic techniques do not identify an oral etiologic basis of H. pylori prior to gastric infection. There has been disagreement as to whether oral infection of H. pylori exists or not, with no definite conclusion. In medical practice, negative results with the urea breath test suggest that the stomach infection of H. pylori is cured in these patients. In fact, patients can present negative urea breath test results and yet exhibit H. pylori infection due to oral infection. The present paper provides evidence that H. pylori oral infection is nonetheless present, and the oral cavity represents a secondary site for H. pylori colonization.

  4. Immune response to H pylori

    Institute of Scientific and Technical Information of China (English)

    Giovanni Suarez; Victor E Reyes; Ellen J Beswick

    2006-01-01

    The gastric mucosa separates the underlying tissue from the vast array of antigens that traffic through the stomach lumen. While the extreme pH of this environment is essential in aiding the activation of enzymes and food digestion, it also renders the gastric epithelium free from bacterial colonization, with the exception of one important human pathogen, H pylori. This bacterium has developed mechanisms to survive the harsh environment of the stomach, actively move through the mucosal layer,attach to the epithelium, evade immune responses, and achieve persistent colonization. While a hallmark of this infection is a marked inflammatory response with the infiltration of various immune cells into the infected gastric mucosa, the host immune response is unable to clear the infection and may actually contribute to the associated pathogenesis. Here, we review the host responses involved during infection with H pylori and how they are influenced by this bacterium.

  5. Helicobacter pylori infection and serum ferritin

    DEFF Research Database (Denmark)

    Berg, Gabriele; Bode, G; Blettner, M

    2001-01-01

    OBJECTIVE: Helicobacter pylori may possibly affect the iron metabolism by occult bleeding, impaired absorption of non-hem iron, and by scavenging hem iron or ferritin, as some studies have suggested. The aim of this study was to analyze the association between H. pylori infection and serum ferrit...

  6. Inflammation, immunity, and vaccines for Helicobacter pylori

    DEFF Research Database (Denmark)

    D'Elios, Mario M; Andersen, Leif P

    2009-01-01

    Helicobacter pylori infects almost half of the population worldwide and represents the major cause of gastroduodenal diseases, such as duodenal and gastric ulcer, gastric adenocarcinoma, autoimmune gastritis, and B-cell lymphoma of mucosa-associated lymphoid tissue. Helicobacter pylori induces...

  7. Helicobacter pylori eradication for preventing gastric cancer.

    Science.gov (United States)

    Lu, Bin; Li, Meng

    2014-05-21

    Helicobacter pylori (H. pylori) infection is a major risk factor for gastric cancer (GC) development, which is one of the most challenging malignant diseases worldwide with limited treatments. In the multistep pathogenesis of GC, H. pylori infection slowly induces chronic active gastritis, which progresses through the premalignant stages of atrophic gastritis, intestinal metaplasia, and dysplasia, and then finally to GC. Although eradication of H. pylori is a reasonable approach for the prevention of GC, there have been some contradictory reports, with only some long-term follow-up data showing efficacy of this approach. The inconsistencies are likely due to the insufficient number of participants, relatively short follow-up periods, poor quality of study designs, and the degree and extent of preneoplastic changes at the time of H. pylori eradication. This review analyzes recent high-quality studies to resolve the discrepancies regarding the eradication of H. pylori for GC prevention. The relationship between H. pylori eradication and GC/precancerous lesions/metachronous GC is examined, and the cost-effectiveness of this strategy in the prevention of GC is assessed. Although it is assumed that eradication of H. pylori has the potential to prevent GC, the feasibility and appropriate timing of this strategy for cancer prevention remain to be determined. As a result, additional well-designed trials with longer follow-up periods are needed to clarify this issue.

  8. Role of Helicobacter pylori in functional dyspepsia

    Institute of Scientific and Technical Information of China (English)

    Colm O'Morain

    2006-01-01

    The aetiology of dyspepsia is unknown in the majority of patients. Helicobacter pylori(H pylori) is the cause in a subset of patients. A non invasive test to assess the presence of H pylori is recommended in the management of patients under the age of 50 presenting to a family practitioner with dyspepsia. A urea breath test or a stool antigen test are the most reliable non invasive tests. Eradication of H pylori will reduce the risk to the patient with dyspepsia of developing a peptic ulcer, reduce the complication rate if prescribed nonsteroid anti-inflammatory drugs and later reduce the risk of gastric cancer. The recommended treatment for non ulcer dyspepsia associated with a H pylori infection should be a 10-d course of treatment with a PPI and two antibiotics. Treatment efficacy should be assessed four weeks after completing treatment with a urea breath test or a stool antigen test.

  9. Helicobacter pylori, Cancer, and the Gastric Microbiota.

    Science.gov (United States)

    Wroblewski, Lydia E; Peek, Richard M

    Gastric adenocarcinoma is one of the leading causes of cancer-related death worldwide and Helicobacter pylori infection is the strongest known risk factor for this disease. Although the stomach was once thought to be a sterile environment, it is now known to house many bacterial species leading to a complex interplay between H. pylori and other residents of the gastric microbiota. In addition to the role of H. pylori virulence factors, host genetic polymorphisms, and diet, it is now becoming clear that components of the gastrointestinal microbiota may also influence H. pylori-induced pathogenesis. In this chapter, we discuss emerging data regarding the gastric microbiota in humans and animal models and alterations that occur to the composition of the gastric microbiota in the presence of H. pylori infection that may augment the risk of developing gastric cancer.

  10. 幽门螺杆菌感染与特发性血小板减少性紫癜关系的荟萃分析%Relationship between Helicobacter pylori infection and idiopathic thrombocytopenic purpura: a meta-analysis

    Institute of Scientific and Technical Information of China (English)

    谭勇; 施瑞华; 赵福军

    2009-01-01

    目的:评价特发性血小板减少性紫癜(ITP)与幽门螺杆菌(H pylori )感染的相关性.方法:检索PubMed、EMBase和CNKI数据库,获取ITP与H pylori 感染的病例-对照研究, 将入选的病例分成4组:H pylori 阳性并成功清除组; H pylori 阳性但清除不成功组; H pylori 阳性未清除治疗组; H pylori 阴性组. 每组均记录进入实验时各患者的基础血小板计数和随访时的血小板计数, 并在组内行荟萃分析.结果:检索文献中纳入21篇病例-对照研究, 其中国外17篇, 国内4篇. 在随访前后, H pylori阳性并成功清除组P LT计数有统计学意义(WMD 61.70, 95%CI:47.58-75.81); H pylori阳性但清除不成功组PLT计数无统计学意义(WMD 11.41, 95%CI:-0.07-22.88); H pylori阳性未清除治疗组P LT计数无统计学意义(WMD 15.77, 95%CI:-7.99-39.54); H pylori阴性组PLT计数有统计学意义(WMD 24.24,95%CI:8.54-39.93).结论:H pylor i 阳性的ITP患者在成功清除H pylori 后PLT计数上升, 但H pylori 感染并不是ITP发生的唯一因素.%AIM: To investigate the relationship between Helicobacter pylori (H pylori) infection and idiopathic thrombocytopenic purpura (ITP). METHODS: The databases of PubMed, EMBase and CNKI were searched for published case-control studies on association between H pylori infection and ITP. We focused on the difference in the platelet count between the experimental arm (H pylori-infected patients who responded to eradication therapy) and each control arm (H pylori-infected patients who failed to respond to eradication therapy; H pylori-infected patients without eradication therapy and H pylori-negative patients). Data were extracted using a standardized form and the meta-analysis was performed. RESULTS: Twenty-one eligible studies, including 17 studies carried by foreigners, and 4 by Chinese researchers, were included in the metaanalysis. There was a statistically significant difference in platelet count between patients who responded

  11. Twenty five years since the first prospective study by Forman et al. (1991) on Helicobacter pylori and stomach cancer risk.

    Science.gov (United States)

    Sitas, Freddy

    2016-04-01

    Stomach cancer is one of the leading causes of cancer death worldwide, despite its incidence and mortality falling in many places. The discovery in 1984 that a bacterial infection with Helicobacter pylori could cause stomach and duodenal ulcers prompted work in its role in causing gastritis, and led to the first prospective study in 1991 by Forman et al., showing that infection with H.pylori increased the risk of stomach cancer in those infected by almost three-fold. Prior to then, it was hypothesized that stomach was caused by poor diets. While diets may still play a role, the falls in stomach cancer incidence have been associated with reductions in population prevalence of H. pylori. Discovery of the link was accelerated by the use of stored sera from other unrelated studies, and the use of serological assays. Since those discoveries the treatment landscape of gastric disorders has changed significantly, with a rapid uptake of antibiotic and proton pump inhibitors (triple) therapies in those who are H. pylori positive. Over time we have seen falls in gastric cancer, peptic and duodenal ulcers and in many of the procedures previously used to cure peptic ulcer disease, such as vagotomies and gastrectomies. Further still, an oral vaccine against H. pylori, first trialled in China, holds much promise of being the third vaccine against a cancer causing infection. If successful this would lead to a further reduction in H. pylori related conditions, and ultimately gastric cancer, an otherwise lethal disease.

  12. Mechanisms linking metabolism of Helicobacter pylori to (18)O and (13)C-isotopes of human breath CO2.

    Science.gov (United States)

    Som, Suman; De, Anulekha; Banik, Gourab Dutta; Maity, Abhijit; Ghosh, Chiranjit; Pal, Mithun; Daschakraborty, Sunil B; Chaudhuri, Sujit; Jana, Subhra; Pradhan, Manik

    2015-06-03

    The gastric pathogen Helicobacter pylori utilize glucose during metabolism, but the underlying mechanisms linking to oxygen-18 ((18)O) and carbon-13 ((13)C)-isotopic fractionations of breath CO2 during glucose metabolism are poorly understood. Using the excretion dynamics of (18)O/(16)O and (13)C/(12)C-isotope ratios of breath CO2, we found that individuals with Helicobacter pylori infections exhibited significantly higher isotopic enrichments of (18)O in breath CO2 during the 2h-glucose metabolism regardless of the isotopic nature of the substrate, while no significant enrichments of (18)O in breath CO2 were manifested in individuals without the infections. In contrast, the (13)C-isotopic enrichments of breath CO2 were significantly higher in individuals with Helicobacter pylori compared to individuals without infections in response to (13)C-enriched glucose uptake, whereas a distinguishable change of breath (13)C/(12)C-isotope ratios was also evident when Helicobacter pylori utilize natural glucose. Moreover, monitoring the (18)O and (13)C-isotopic exchange in breath CO2 successfully diagnosed the eradications of Helicobacter pylori infections following a standard therapy. Our findings suggest that breath (12)C(18)O(16)O and (13)C(16)O(16)O can be used as potential molecular biomarkers to distinctively track the pathogenesis of Helicobacter pylori and also for eradication purposes and thus may open new perspectives into the pathogen's physiology along with isotope-specific non-invasive diagnosis of the infection.

  13. Design and evaluation of novel pH-sensitive ureido-conjugated chitosan/TPP nanoparticles targeted to Helicobacter pylori.

    Science.gov (United States)

    Jing, Zi-Wei; Jia, Yi-Yang; Wan, Ning; Luo, Min; Huan, Meng-Lei; Kang, Tai-Bin; Zhou, Si-Yuan; Zhang, Bang-Le

    2016-04-01

    The covalently modified ureido-conjugated chitosan/TPP multifunctional nanoparticles have been developed as targeted nanomedicine delivery system for eradication of Helicobacter pylori. H. pylori can specifically express the urea transport protein on its membrane to transport urea into cytoplasm for urease to produce ammonia, which protects the bacterium in the acid milieu of stomach. The clinical applicability of topical antimicrobial agent is needed to eradicate H. pylori in the infected fundal area. In this study, we designed and synthesized two ureido-conjugated chitosan derivatives UCCs-1 and UCCs-2 for preparation of multifunctional nanoparticles. The process was optimized in order to prepare UCCs/TPP nanoparticles for encapsulation of amoxicillin. The results showed that the amoxicillin-UCCs/TPP nanoparticles exhibited favorable pH-sensitive characteristics, which could procrastinate the release of amoxicillin at gastric acids and enable the drug to deliver and target to H. pylori at its survival region effectively. Compared with unmodified amoxicillin-chitosan/TPP nanoparticles, a more specific and effective H. pylori growth inhibition was observed for amoxicillin-UCCs/TPP nanoparticles. Drug uptake analysis tested by flow cytometry and confocal laser scanning microscopy verified that the uptake of FITC-UCCs-2/TPP nanoparticles was associated with urea transport protein on the membrane of H. pylori and reduced with the addition of urea as competitive transport substrate. These findings suggest that the multifunctional amoxicillin-loaded nanoparticles have great potential for effective therapy of H. pylori infection. They may also serve as pharmacologically effective nanocarriers for oral targeted delivery of other therapeutic drugs to treat H. pylori.

  14. Observation of the Curative Effect of the Triad Therapy in Addition to Helicobacter Pylori%三联疗法根除幽门螺杆菌的疗效观察

    Institute of Scientific and Technical Information of China (English)

    廖肇发

    2009-01-01

    目的:评估左氧氟沙星为基础的三联治疗方案治疗幽门螺杆菌(helicobacter pylori,HP)感染的疗效及安全性.方法:对264例经胃镜检查和病理诊断慢性胃炎、胃溃疡的患者,随机分为治疗组和对照组各132例,治疗组给予左氧氟沙星、奥美拉唑、阿莫西林治疗;对照组给予奥美拉唑、克拉霉素、阿莫西林治疗,疗程均为10 d.结果:治疗组HP根除率为91.67%,对照组HP根除率为83.33%,两组治愈率差异均无统计学意义(P>0.05).结论:左氧氟沙星联合奥美拉唑、阿莫西林是一种安全、疗效高、耐受性好,也是当前根除幽门螺杆菌首选的一线治疗方案.%Objective:Be based on Levofloxacin,to evaluate the curative effect and security of treating helicobacter pylori with the treatment of trigeminy.Methods:Check-up 264 patients with gastroscopy and pathological diagnosis of chronic gastritis,gastric ulcer patients were randomly divided into treatment and control groups with 132 cases respectively,the treatment of levofloxacin group,omeprazole,amoxicillin treatment.In the control group given omeprazole,clarithromycin and amoxicillin treatment,treatment of 10d.Results:Hp eradication rate was 91.67% in the treatment group,83.33% in the control group,the rate difference between the two groups were not significant (P>0.05).Conclusions:the Joint omeprazole and amoxicillin are safe,high effective,with good tolerance,and the eradication of Helicobacter pylori is the current preferred first-line treatment.

  15. Evaluation of Helicobacter pylory colonization by serologic test (IgG and dyspepsia in volunteers from the countryside of Monte Negro, in the Brazilian western Amazon region Avaliação da colonização por Helicobacter pylori através de teste sorológico (IgG e de dispepsia em voluntários da população rural de Monte Negro (RO, região da Amazônia ocidental

    Directory of Open Access Journals (Sweden)

    Rafael Bernardon Ribeiro

    2010-08-01

    Full Text Available The present study intended to analyze the seroprevalence of Helicobacter pylori, IgG, and its relation to dyspepsia in a population from the western Amazon region. During the "Projeto Bandeira Científica", a University of São Paulo Medical School program, in Monte Negro's rural areas, state of Rondônia, 266 blood samples were collected from volunteers. The material was tested for IgG antibodies anti-Helicobacter pylori by ELISA method and the participants were also interviewed on dyspepsia, hygiene and social aspects. Participants aged between five and 81 years old (34 years on average, 149 (56% were female and 117 (44% male. We found 210 (78.9% positive, 50 (18.8% negative and six (2.3% undetermined samples. Dyspeptic complaints were found in 226 cases (85.2%. There was no statistical association between dyspepsia and positive serology for H. pylori. We concluded that the seroprevalence in all age categories is similar to results found in other studies conducted in developing countries, including those from Brazil. On the other hand, the seroprevalence found in Monte Negro was higher than that reported in developed countries. As expected, there was a progressive increase in the positivity for H. pylori in older age groups.Este trabalho tem por objetivo analisar a soroprevalência do Helicobacter pylori, IgG, em população rural da Amazônia, e sua correlação com queixa dispéptica. No Projeto Bandeira Científica da FMUSP, em Monte Negro - RO, foram coletadas 266 amostras sangüíneas nos assentamentos rurais do município. Foram pesquisados anticorpos da classe IgG dirigidos contra Helicobacter pylori pelo método ELISA e aplicados questionários sobre dispepsia, aspectos sociais e epidemiológicos. Os pacientes tinham idades entre cinco e 81 anos (média de 34 anos; 149 (56% do sexo feminino e 117 (44% do sexo masculino. Foram encontradas 210 (78.9% amostras positivas, 50 negativas (18.8% e seis indeterminadas (2.3%. A queixa de

  16. Helicobacter pylori resistance to metronidazole and clarithromycin in Ireland.

    LENUS (Irish Health Repository)

    O'connor, Anthony

    2012-02-01

    INTRODUCTION: Helicobacter pylori eradication rates have fallen considerably in recent years. Antibiotic resistance is thought to be rising. OBJECTIVES: To examine the levels of resistance to metronidazole (MTZ) and clarithromycin (CLA) in H. pylori, isolates were taken in a reference centre in Ireland from 2007 to 2008 and were compared to a similar cohort from a study in 1997. METHOD: Antimicrobial susceptibilities were tested by E-test. Frequencies of spontaneous metronidazole and clarithromycin resistance were measured on an agar plate containing the antibiotics at concentrations of 2x and 4x minimum inhibition concentration values. Clinical data were obtained from charts, laboratory and endoscopy reports. RESULTS: Two hundred and twenty-two patients were analyzed, 98 were females. Colonies amenable to culture were grown in 219 patients. Thirty-seven had prior attempts at eradication therapy (all with amoxicillin-CLA-proton pump inhibitor. A total of 31.5% of the patients had strains resistant to MTZ and 13.2% of the patients were noted to have strains resistant to CLA. About 8.6% of the patients had strains resistant to both the agents. CLA resistance was 9.3% in those who had no prior eradication therapy compared with 32.4% of those who had. CLA resistance increased from 3.9%, among treatment-naive patients in 1997, to 9.3% in our study. MTZ resistance was 29.1% in the treatment-naive population. In 1997, MTZ resistance in the treatment-naive cohort was 27.1%. MTZ resistance was more likely to occur in females (35.4 vs. 28.5%) than in males. CONCLUSION: This study shows that resistance to CLA among Irish patients infected with H. pylori has increased since 1997. The future of treatment may well lie in the widespread use of sensitivity testing before the treatment. This would promote an accurate treatment.

  17. Efecto del tratamiento erradicador para Helicobacter pylori en pacientes con dispepsia funcional Effect to Helicobacter pylori eradication on patients with functional dyspepsia

    Directory of Open Access Journals (Sweden)

    T. de Artaza Varasa

    2008-09-01

    Full Text Available Objetivo: este estudio ha tenido un doble objetivo: por un lado, evaluar el efecto del tratamiento erradicador para Helicobacter pylori en la respuesta sintomática de pacientes diagnosticados de dispepsia funcional y, por otro, determinar si los hallazgos histológicos podían servir como predictor de la efectividad de la terapia. En particular, se trató de averiguar si la presencia de gastritis antral (la que se asocia a la enfermedad ulcerosa péptica podría predecir una mayor respuesta sintomática al tratamiento erradicador en los pacientes con dispepsia funcional e infección por Helicobacter pylori. Pacientes y métodos: estudio prospectivo, monocéntrico y aleatorizado, que incluyó a 48 pacientes con dispepsia funcional e infección por Helicobacter pylori (27 mujeres y 21 hombres, con edad media de 37 ± 13,5 años. Veintisiete pacientes recibieron el tratamiento erradicador (rabeprazol, claritromicina y amoxicilina durante 10 días, seguido de 20 mg/día de rabeprazol 3 meses y 21 el tratamiento control (20 mg/día de rabeprazol 3 meses. Los pacientes fueron seguidos durante un año. Todos rellenaron el Cuestionario de calidad de vida asociada a dispepsia, que evalúa cuatro apartados: intensidad de los síntomas habituales, intensidad del dolor de estómago, incapacidad debida al dolor y satisfacción con la salud. Resultados: existió una mejoría significativa (p Objective: this study evaluated Helicobacter pylori eradication therapy in terms of symptomatic response in patients with functional dyspepsia. On the other hand, we analyzed the importance of histologic findings as a predictor of treatment response. In particular, we studied whether antral gastritis (which is associated with peptic ulcer may predict a greater symptomatic response to Helicobacter pylori eradication in functional dyspepsia. Patients and methods: this prospective, randomized, single-center trial included 48 patients with functional dyspepsia and

  18. Evaluation of the benefit of addition of clidinium C to a Helicobacter pylori eradication regimen

    Science.gov (United States)

    Chorami, Maryam; Naderi, Nosratollah; Moghimi-Dehkordi, Bijan; Mirsattari, Dariush; Shalmani, Hamid Mohaghegh

    2013-01-01

    Aim This study aimed to evaluate the success of H.pylori eradication therapy in patients with dyspepsia by therapeutics regimes with and without clidinium C. Background Helicobacter pylori infections are reported in all parts of the world. Appropriate antibiotic therapy can treat infection. The ideal treatment regimen has not been specified. Patients and methods In a randomized, double blind clinical trials study, 250 patients with dyspepsia were enrolled. All patients were treated by Omeprazole, Metronidazole, Amoxicillin and Bismuth (OMAB) for two weeks. One tablet clidinium C before each meal was added to this regimen in the intervention group (A). Urea Breath Test (UBT) was carried out after 8-12 weeks after treatment for evaluation of H.pylori eradication. Results 132 patients in the intervention group (A) and 118 patients in the control group (B) were enrolled to the study. The rate of eradication in group A was significantly higher than group B (62.1% vs. 50%, p=0.04). Conclusion The results supported the effect of clidinium C for increasing of helicobacter pylori eradication, but further studies need to be performed. PMID:24834261

  19. Study of serum Helicobacter pylori soluble antigen

    Institute of Scientific and Technical Information of China (English)

    吴勤动; 朱永良

    2002-01-01

    Objective:to explore a new serological method for detecting Helicobacter pylori(H.pylori) infection.Methods:Serum soluble antigen of H.pylori was detected by using avidin-biotin ELISA technique to evaluate the status of H.pylori infection and for comparison with rapid urease test(RUT).histologic examination and serology,Results:The sensitivity,specificity,positive predictive value and negative predictive value were 77.46% ,91.07%,91.67% and 76.12%,respectively.The prevalence rate of werum H. pylori soluble antigen in 138 patients undergong endoscopy was similar to the rate obtained by 14 C-UBT methods(P>0.05).Conclusions:The detection of serum H.pylori soluble antigen(HpSAg) could be used as a new serological method which is accurate,and convenient,not affected by the memorizing raction of serum antibody;is more sensitive,more specific and suitable for dinical diagriosis,and evaluation of eradication and for follow-up of H.pylori as well as for detection in children and pregnant women.

  20. ASSESSMENT OF PATTERN OF ANTIMICROBIAL RESISTANCE OF HELICOBACTER PYLORI IN PATIENTS OF DYSPEPSIA OF RURAL AREA

    Directory of Open Access Journals (Sweden)

    Yogendra

    2015-08-01

    Full Text Available BACKGROUND : Helicobacter Pylori is a gastric pathogen that chronically infects more than half of the world's population. Unless treated, colonization usually persists lifelong. H. pylori infection represents a key factor in the etiology of various gastrointestinal diseases, ranging from chronic active gastritis without clinical symptoms to peptic ulceration, gastric adenocarcinoma, and gastric mucosa - associated lymphoid tissue lymphoma. Helicobacter pylori eradication rate varies in different parts of the world. This may be related to the regional difference in anti - microbial resistance that affects the outcome of therapy, genetic difference in the metabolism of the proton pump inhibitor, which can also alter the availability of anti - microbial in the stomach. The pattern of antimicrobial resistant of Helicobacter pylori has not been tested in this part of central India. In present study we have assessed the pattern of anti - microbial resistance of Helicobacter Pylori in patients of dyspepsia attending medicine opd , Department of Medicine, Dr. BRAM Hospital, Raipur (Chhattisgarh, India. METHODS: The present study was conducted in the Department of Medicine, Pt . J. N. M. Medical College, and Dr . BRAM Hospital Raipur (C.G. 60 patients attending medicine opd were subjected to upper gastrointestinal endoscopy. Multiple biopsy specimens taken from the gastric antrum. Rapid urease test were done. The biopsy specimen was inoculated in to culture media. The strains were subjected to antibiotic sensitivity test by disk diffusion method for metronidazole, tinidazole, Ornidazole, Clarithromycin, amoxicillin, tetracycline, furazolidone, ofloxacin and ciprofl oxacin. RESULT : The antibiotic resistance of H. Pylori in culture positive cases in our study showed 84.6%o of cases were resistant to Metronidazole, 38.5% to Tinidazole, 7.6%o to Ornidazole, 32.8% to Amoxicillin, 3.8% to Tetracycline, 19.2% to Clarithromycin, 11.5% to furazolidone, and 3

  1. Helicobacter pylori as a potential target for the treatment of central serous chorioretinopathy

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    Antonio Marcelo Barbante Casella

    2012-09-01

    Full Text Available OBJECTIVES: The objective of this study was to evaluate the relationship between the treatment of Helicobacter pylori gastric infection and changes in best-corrected visual acuity and macular detachment in patients with chronic central serous chorioretinopathy. METHODS: Seventeen patients diagnosed with central serous chorioretinopathy were examined for gastric infection with Helicobacter pylori using the urease test and gastric biopsy. Helicobacter pylory-positive patients were treated with the appropriate medication. The response to therapy was monitored by evaluating the best-corrected visual acuity and optical coherence tomography. The data were analyzed using Student's t-test before and after treatment. RESULTS: Fourteen patients (15 eyes aged 30-56 years (mean 43.4 ± 8.3 years were positive for Helicobacter pylori. Most of the positive patients had gastric symptoms (78.5%; one had bilateral central serous chorioretinopathy. The mean baseline best-corrected visual acuity was 20/98 (logMAR = 0.53 ± 0.28. Three months after starting treatment with antibiotics, the serous detachment had resolved in 14 of 15 eyes, but two cases required laser treatment. The follow-up period ranged from 6 to 27 months. The mean final best-corrected visual acuity differed significantly from baseline. CONCLUSION: Our findings suggest that Helicobacter pylori infection may be present in many chronic central serous chorioretinopathy patients and that treatment for the infection may have a favorable effect on the outcome of chronic central serous chorioretinopathy. Due to the possibility of the spontaneous regression of chronic central serous chorioretinopathy and the high prevalence of the infection in the general population, prospective and masked clinical trials are necessary to confirm that treatment for Helicobacter pylori infection may benefit patients with chronic central serous chorioretinopathy.

  2. Nitazoxanide Use as Part of an Empiric Multi-Drug Regimen in Treating Children with Suspected Helicobacter pylori Infection

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    Asuncion G. Ramos-Soriano

    2015-01-01

    Full Text Available Helicobacter pylori, a Gram-negative bacterium found in the human stomach, is often present in patients with chronic gastritis. Traditional treatment for H. pylori infection includes metronidazole or clarithromycin, both being associated with development of resistance. In this retrospective report, we describe our clinical experience using a multi-drug treatment regimen for pediatric H. pylori that included nitazoxanide, a newer nitrothiazole benzamide compound used in treating intestinal protozoa infections. Charts were identified for patients who were treated between January 1, 2008 and December 31, 2013 with an ICD-9-CM code 041.86 (H. pylori and who underwent elective endoscopy. All patients were exposed to nitazoxanide for 3 days plus azithromycin, and cefixime (or another 3rd-generation oral cephalosporin for 7-10 days, plus a proton pump inhibitor for 30 days. The clinical cure criteria were predefined. There were 127 individual occurrences or cases identified for inclusion in the review, with 111 occurrences meeting the inclusion criteria. The success rate or clinical cure for the new therapy combination prescribed as defined prior to the chart review was 99 out of 111 cases (89.2%. There were no serious adverse events observed or reported during the treatment of any patient. Approximately 10% of patient charts reflected minor complaints of nausea, vomiting or abdominal cramps during the time of active drug therapy. Nitazoxanide appears to be an effective and well-tolerated option for use in combination with other agents to treat H. pylori-induced gastritis.

  3. Helicobacter pylori VacA suppresses Lactobacillus acidophilus-induced interferon beta signaling in macrophages via alterations in the endocytic pathway.

    Science.gov (United States)

    Weiss, Gudrun; Forster, Sam; Irving, Aaron; Tate, Michelle; Ferrero, Richard L; Hertzog, Paul; Frøkiær, Hanne; Kaparakis-Liaskos, Maria

    2013-06-11

    Helicobacter pylori causes chronic gastritis and avoids elimination by the immune system of the infected host. The commensal bacterium Lactobacillus acidophilus has been suggested to exert beneficial effects as a supplement during H. pylori eradication therapy. In the present study, we applied whole-genome microarray analysis to compare the immune responses induced in murine bone marrow-derived macrophages (BMDMs) stimulated with L. acidophilus, H. pylori, or both bacteria in combination. While L. acidophilus induced a Th1-polarizing response characterized by high expression of interferon beta (IFN-β) and interleukin 12 (IL-12), H. pylori strongly induced the innate cytokines IL-1β and IL-1α. In BMDMs prestimulated with L. acidophilus, H. pylori blocked the expression of L. acidophilus-induced IFN-β and IL-12 and suppressed the expression of key regulators of the Rho, Rac, and Cdc42 GTPases. The inhibition of L. acidophilus-induced IFN-β was independent of H. pylori viability and the virulence factor CagPAI; however, a vacuolating cytotoxin (vacA) mutant was unable to block IFN-β. Confocal microscopy demonstrated that the addition of H. pylori to L. acidophilus-stimulated BMDMs redirects intracellular processing, leading to an accumulation of L. acidophilus in the endosomal and lysosomal compartments. Thus, our findings indicate that H. pylori inhibits the development of a strong Th1-polarizing response in BMDMs stimulated with L. acidophilus by blocking the production of IFN-β in a VacA-dependent manner. We suggest that this abrogation is caused by a redirection of the endocytotic pathway in the processing of L. acidophilus. IMPORTANCE Approximately half of the world's population is infected with Helicobacter pylori. The factors that allow this pathogen to persist in the stomach and cause chronic infections have not yet been fully elucidated. In particular, how H. pylori avoids killing by macrophages, one of the main types of immune cell underlying the

  4. Adherence of Helicobacter pylori to the Gastric Mucosa

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    Marguerite Clyne

    1997-01-01

    Full Text Available Bacterial adhesion to the intestinal epithelium is a critical initial step in the pathogenesis of many enteric diseases. Helicobacter pylori is a duodenal pathogen that adheres to the gastric epithelium and causes gastritis and peptic ulceration. The mechanism by which H pylori causes disease has not yet been elucidated but adherence to the gastric mucosa is thought to be an important virulence determinant of the organism. What is known about adherence of H pylori to the gastric mucosa is summarized. Topics discussed are the mechanism of H pylori adherence; in vitro and in vivo models of H pylori infection; and adherence and potential adhesins and receptors for H pylori.

  5. 克拉霉素联合三联疗法治疗幽门螺杆菌感染相关胃炎的疗效观察%Clinical Observation on Clarithromycin Combined with Triple Therapy in Treatment of Helicobacter Pylori Related Gastritis

    Institute of Scientific and Technical Information of China (English)

    李新建

    2013-01-01

    Objective:The paper is to conduct an clinical observation on ef icacy of clarithromycin combined with triple therapy in treatment of helicobacter pylori related gastritis.Methods:200 admit ed gastritis cases with helicobacter pylori infection were randomly divided into A(n=65),B(n=62),C(n=73)groups,group B was given lansoprazole+clarithromycin therapeutic scheme,group C was applied omeprazole+amoxicil in+furazolidone treatment,while,A groups was given clarithromycin combined with lansoprazole+omeprazole+furazolidone scheme,7 days was 1 course of treatment,and clinical ef icacy were compared between 3 groups after 3 therapeutic courses.Results:Abdominal swel ing symptoms of group B&C had seen no obvious improvement,but the other symptoms after treatment compared with before treatment were significantly improved;clinical symptoms of group A after treatment were significantly improved compared with pretreatment,ef icacy composition,overal ef iciency and cure rate of group A were both superior to that of group B&C,and the former dif erence was statistical y significant(P<0.05).Conclusion:Clarithromycin combined with triple therapy therapeutic scheme in treatment of chronic gastritis with helicobacter pylori infection has good clinical ef ect,and it is worthy of clinical promotion.%  目的:观察并探讨克拉霉素联合三联疗法治疗幽门螺杆菌感染性胃炎的临床疗效。方法:将2009年2月-2012年4月收治的200例幽门螺杆菌感染性胃炎患者随机单盲分为A(n=65)、B(n=62)、C(n=73)三组,B组患者给予克拉霉素+兰索拉唑治疗方案,C组患者给予阿莫西林+奥美拉唑+呋喃唑酮三联治疗方案,A组患者给予克拉霉素联合兰索拉唑片+奥美拉唑+呋喃唑酮方案,以上3组均7 d为一疗程,服药3个疗程后对比临床治疗效果。结果:B、C两组患者治疗后上腹肿胀症状与治疗前无明显改善,其余症状在治疗后相比治疗前均有明显改善;A组患者

  6. Clinical Comparison of Sequential Scheme and Standard Triple Therapy in Treatment of Initial Patients with Infection of Helicobacter Pylori%序贯方案和标准三联方案治疗初始幽门螺旋菌感染患者的临床比较

    Institute of Scientific and Technical Information of China (English)

    张磊

    2015-01-01

    Objective To study the clinical effect of sequential scheme and standard triple therapy in treatment of initial patients with infection of Helicobacter pylori. Methods From 2012 March to 2014 September were treuted 106 cases who meet the re-quirements of initial Helicobacter in our hospital were divided into two groups. The control group took the triple therapy, observa-tion group adopted sequential therapy, comparison of two clinical symptom score, Hp eradication rate and the incidence of adverse reactions. Results The observation group after treatment, review the symptom scores were significantly lower than those in control group (P0.05). Conclusion Sequential scheme of Hp eradication rate, low recurrence rate, it has clinical value.%目的:比较序贯方案和标准三联方案治疗初始幽门螺旋菌感染临床疗效。方法以该院于2012年3月-2014年9月共收治106例符合要求初始幽门螺旋菌感染患者进行研究,分为两组。对照组采取三联疗法,观察组采取序贯疗法,比较两组临床症状评分、Hp根除率及不良反应发生率。结果观察组治疗结束、复查时的症状评分均显著低于对照组(P0.05)。结论序贯方案Hp根除率高,复发率低,有临床推广价值。

  7. Importance of Helicobacter pylori eradcation for maintenance of remission of drug associated peptic ulcer disease

    Directory of Open Access Journals (Sweden)

    Dajani A

    2006-01-01

    Full Text Available Background: The role of Helicobacter pylori (H. pylori eradication in non-steroidal anti inflammatory drug (NSAID users with peptic ulcer disease is controversial especially in countries with a high prevalence of the infection. Furthermore the value of low dose omeprazole for maintenance of remission is not yet known. Patients and methods: 138 symptomatic out-patients receiving continuous COX 1 NSAID therapy, were treated with omeprazole 40mg/day upon endoscopic confirmation of gastro-duodenal ulceration or erosions while those infected with H. pylori received in addition clarithromycin 500 mg and amoxycillin 1000 mg twice daily during the first week of treatment. After endoscopic confirmation of healing at the end of week 5, the patients were randomized to receive omeprazole 10 mg (n=50 or 20 mg once daily (n=66 and endoscopy repeated after 20 weeks. Results: The overall healing rate (per protocol at five weeks (116/128 was 90.6% while in 85.5% (65/76 eradication was successful. The healing rate for the H. pylori eradicated patients (58/65 was 89.2%. For those who failed eradication (8/11 it was 72.7% (NS, while for patients not infected with H. pylori at entry to the study (50/52 it was 96.2% (NS. An intention to treat analysis showed that after 20 weeks of omeprazole prophylaxis with the 10mg dose 86% (43/50 had maintained healing while for the 20mg dose a similar figure was observed (87.9; 58/66. Only three patients in the two groups (pp had persistent H. pylori infection, all of whom relapsed. No patients discontinued treatment because of adverse effects of the drugs. Conclusion: H. pylori eradication was not associated with impaired ulcer healing in a Middle Eastern population with symptomatic NSAID induced gastro/duodenal lesions, when a high healing dose of omeprazole (40 mg was used. After eradication, omeprazole 10 or 20 mg per day were highly and equally effective for maintenance of gastroduodenal mucosal integrity during continued

  8. Adverse events with bismuth salts for Helicobacter pylori eradication:Systematic review and meta-analysis

    Institute of Scientific and Technical Information of China (English)

    Alexander C Ford; Peter Malfertheiner; Monique Giguére; José Santana; Mostafizur Khan; Paul Moayyedi

    2008-01-01

    AIM:To assess the safety of bismuth used in Helicobacter pylori (H pylori) eradication therapy regimens.METHODS:We conducted a systematic review and meta-analysis.MEDLINE and EMBASE were searched (up to October 2007) to identify randomised controlled trials comparing bismuth with placebo or no treatment,or bismuth salts in combination with antibiotics as part of eradication therapy with the same dose and duration of antibiotics alone or,in combination,with acid suppression.Total numbers of adverse events were recorded.Data were pooled and expressed as relative risks with 95% confidence intervals (CI).RESULTS:We identified 35 randomised controlled trials containing 4763 patients.There were no serious adverse events occurring with bismuth therapy.There was no statistically significant difference detected in total adverse events with bismuth [relative risk (RR)=1.01;95% CI:0.87-1.16],specific individual adverse events,with the exception of dark stools (RR = 5.06;95% CI:1.59-16.12),or adverse events leading to withdrawal of therapy (RR = 0.86;95% CI:0.54-1.37).CONCLUSION:Bismuth for the treatment of H pylori is safe and well-tolerated.The only adverse event occurring significantly more commonly was dark stools.

  9. Helicobacter pylori infection in patients with autoimmune thrombocytopenic purpura

    Institute of Scientific and Technical Information of China (English)

    Erdal Kurtoglu; Ertugrul Kayacetin; Aysegul Ugur

    2004-01-01

    AIM: To compare the prevalence of Helicobacter pylori (Hpylori) infection in autoimmune thrombocytopenic purpura (AITP) patients with that of nonthrombocytopenic controls,and to evaluate the efficacy of the treatment in H pylori(+)and H pylori(-) AITP patients.METHODS: The prevalence of gastric H pylori infection in 38 adult AITP patients (29 female and 9 male; median age 27 years; range 18-39 years) who consecutively admitted to our clinic was investagated.RESULTS: H pylori infection was found in 26 of 38 AITP patients (68.5%). H pylori infection was found in 15 of 23control subjects (65.2%). The difference in H pylori infection between the 2 groups was not significant. Thrombocyte count of H pylori-positive AITP patients was significantly lower than that of H pylori-negative AITP patients (P<0.05).Thrombocyte recovery of H pylori-positive group was less than that of H pylori-negative group (P<0.05).CONCLUSION: H pylori infection should be considerecd in the treatment of AITP patients with H pylori infection.

  10. Transmission of Helicobacter pylori Infection

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    Giuseppina Oderda

    1999-01-01

    Full Text Available Helicobacter pylori infection is one of the most common bacterial infections worldwide. It is accepted as the major cause of chronic gastritis, peptic ulcer, carcinoma of the distal part of the stomach and gastric lymphoma. However, how and when the infection is acquired remain largely unknown. Identification of mode of transmission is vital for developing preventive measures to interrupt its spread, but studies focused on this issue are difficult to implement. From epidemiological studies, it is known that there are great differences in the prevalence of infection in different populations and in ethnic groups originating from high prevalence regions. This is likely related to inferior hygienic conditions and sanitation. In developing countries, infection occurs at a much earlier age. In developed countries, the prevalence of infection is related to poor socioeconomic conditions, particularly density of living. Humans seem to be the only reservoir of H pylori, which spread from person to person by oral-oral, fecal-oral or gastro-oral routes. Most infections are acquired in childhood, possibly from parents or other children living as close contacts. Infection from the environment or from animals cannot be entirely excluded.

  11. Helicobacter Pylori Bacteremia: An Unusual Finding

    Science.gov (United States)

    De Luca, Concetta; Mancin, Annalisa; Calabrò, Maria; Daleno, Cristina; Ferrario, Antonella; Renzulli, Raffaella; Scuderi, Cristina; Casari, Erminia

    2016-01-01

    We report a case of Helicobacter pylori transient bacteremia in a woman with ulcerated antral gastric cancer. The patient was hospitalized for laparoscopy and subtotal gastrectomy. After surgery she developed fever (39°C) and was empirically treated with levofloxacin. Blood cultures, collected and sent immediately to Laboratory, were positive for a spiral Gram-negative bacterium. This isolate was identified as H. pylori and the specific susceptibility test was performed. One day after the fever was decreased but antibiotic treatment with levofloxacin was continued and it was maintained until discharge. In summary, H. pylori transient bacteremia may occur as a rare complication after stomach surgery. Further studies are necessary to elucidate the potential role of Helicobacter pylori presence in blood.

  12. Distribution of Helicobacter pylori in north China

    Institute of Scientific and Technical Information of China (English)

    Yue-Hua Gong; Ying Wang; Yuan Yuan

    2005-01-01

    AIM: To compare the distribution of virulence-associatedgenotypes of Helicobacter pylori(H pylori) in two areas of north China with different gastric cancer risk and furthermore probe into the pathogenicity of the bacterium. METHODS: Gastric biopsies were taken from 355 subjects from Zhuanghe, a high risk area of gastric cancer, and 136 subjects from Shenyang, a low risk area of gastric cancer. A total of 149 H pylori strains isolated from these patients were studied by PCR for differences in the genotypes of cagA, vac A, and iceA.RESULTS: In patients with high risk for gastric cancer, higher frequencies of vacA s1 or s1m1b genotypes were found as compared to those from the low risk area. CONCLUSION: There is significantly different distribution of H pylori genotypes between Zhuanghe and Shenyang areas in north China.

  13. Enzymic colorimetry-based DNA chip: a rapid and accurate assay for detecting mutations for clarithromycin resistance in the 23S rRNA gene of Helicobacter pylori.

    Science.gov (United States)

    Xuan, Shi-Hai; Zhou, Yu-Gui; Shao, Bo; Cui, Ya-Lin; Li, Jian; Yin, Hong-Bo; Song, Xiao-Ping; Cong, Hui; Jing, Feng-Xiang; Jin, Qing-Hui; Wang, Hui-Min; Zhou, Jie

    2009-11-01

    Macrolide drugs, such as clarithromycin (CAM), are a key component of many combination therapies used to eradicate Helicobacter pylori. However, resistance to CAM is increasing in H. pylori and is becoming a serious problem in H. pylori eradication therapy. CAM resistance in H. pylori is mostly due to point mutations (A2142G/C, A2143G) in the peptidyltransferase-encoding region of the 23S rRNA gene. In this study an enzymic colorimetry-based DNA chip was developed to analyse single-nucleotide polymorphisms of the 23S rRNA gene to determine the prevalence of mutations in CAM-related resistance in H. pylori-positive patients. The results of the colorimetric DNA chip were confirmed by direct DNA sequencing. In 63 samples, the incidence of the A2143G mutation was 17.46 % (11/63). The results of the colorimetric DNA chip were concordant with DNA sequencing in 96.83 % of results (61/63). The colorimetric DNA chip could detect wild-type and mutant signals at every site, even at a DNA concentration of 1.53 x 10(2) copies microl(-1). Thus, the colorimetric DNA chip is a reliable assay for rapid and accurate detection of mutations in the 23S rRNA gene of H. pylori that lead to CAM-related resistance, directly from gastric tissues.

  14. Detection of Helicobacter pylori in Oral Lesions

    OpenAIRE

    Irani, Soussan; Monsef Esfahani, Alireza; Bidari Zerehpoush, Farahnaz

    2013-01-01

    Background and aims. Helicobacter pylori is a microaerophilic gram-negative spiral organism. It is recognized as the etiologic factor for peptic ulcers, gastric adenocarcinoma and gastric lymphoma. Recently, it has been isolated from dental plaque and the dorsum of the tongue. This study was designed to assess the association between H. pylori and oral lesions such as ulcerative/inflammatory lesions, squamous cell carcinoma (SCC) and primary lymphoma. Materials and methods. A total of 228 bio...

  15. Helicobacter pylori : migrations humaines et cancer gastrique

    OpenAIRE

    Breurec, Sébastien

    2011-01-01

    Helicobacter pylori is associated with severe gastroduodenal disorders but is also a bacterial genetic marker of human migrations. First, we provide evidence that distinct H. pylori genetic populations accompanied at least four ancient human migrations into Oceania and Southeast Asia: i) an expansion of Austronesian speaking people about 5000 years ago from Taiwan into Oceania, ii) a migration from India into Southeast Asia within the last 2000 years, iii) a migration of Austro-Asiatic speaki...

  16. 含铋剂及奥硝唑的序贯疗法补救治疗幽门螺杆菌初治失败的研究%The study of helicobacter pylori infection after initial treatment failure remedied by sequential therapy which containing bismuth and ornidazole

    Institute of Scientific and Technical Information of China (English)

    张亚辉; 欧阳义; 张丽艳; 吕致斌; 胡丽

    2014-01-01

    目的:评价由雷贝拉唑、果胶铋、阿莫西林克拉维酸钾、左氧氟沙星、奥硝唑组成的10 d序贯疗法与10 d标准四联疗法对幽门螺杆菌(Hp)初治失败患者补救治疗的疗效及安全性。方法选取2012年4月至2014年2月永州市中心医院收治的Hp初次根除失败患者136例,随机均分为治疗组和对照组。治疗组前5 d予雷贝拉唑20 mg、果胶铋300 mg、阿莫西林克拉维酸钾1142.5 mg,口服2次/d,后5 d予雷贝拉唑20 mg、果胶铋300 mg、左氧氟沙星200 mg、奥硝唑500 mg,口服2次/d。对照组予雷贝拉唑20 mg、果胶铋300 mg、阿莫西林克拉维酸钾1142.5 mg、奥硝唑500 mg,口服2次/d,疗程10 d。观察药物不良反应发生率,停药治疗4周后行14 C呼气试验测定Hp。结果治疗组ITT根除率(91.18%)、PP根除率(93.94%)均较对照组(分别为79.41%和83.08%)高,差异有统计学意义(P0.05)。结论由雷贝拉唑、果胶铋、阿莫西林克拉维酸钾、左氧氟沙星、奥硝唑组成的10 d序贯疗法是一种Hp初治失败后安全而有效的补救治疗方案。%Objective To evaluate the curative effect and security between 10-day sequential therapy including rabeprazole, colloidal Bismuth Pectin, amoxicillin and clavulanate potassium, levofloxacin and ornidazole and 10-day standard quadruple therapy for patients who fail on first-line Helicobacter pylori( H.pylori) eradication. Methods 136 Hp-positive patients with treatment failure of initial eradication were randomly divided into treatment group which included 68 patients and control group which included 68 patients.The treatment group was treated with rabeprazole 20 mg,colloidal Bismuth Pectin 300mg and amoxicillin and clavulanate potassium 1142.5 mg at first five days,orally two times a day at first five days and rabeprazole 20 mg,colloidal Bismuth Pectin 300 mg,levofloxacin 200 mg,and ornidazole 500 mg, orally two times a day at the second five

  17. Changing epidemiology of Helicobacter pylori in Japan.

    Science.gov (United States)

    Inoue, Manami

    2017-03-01

    Helicobacter pylori (H. Pylori) is known as the most important cause of gastric cancer. The prevalence of H. pylori infection varies widely by geographic area, age, and socioeconomic status. In Japan, H. pylori infection has been highly correlated with the incidence rate of gastric cancer, and a reduction in H. pylori infection is therefore crucial for decreasing the incidence of gastric cancer, especially at the population level. Infection occurs during childhood, commonly before 5 years of age. In Japan, where gastric cancer has ranked as the most common cancer by incidence and mortality for the last several decades, the prevalence of H. pylori infection has dramatically declined by birth cohort effect, mainly due to improvements in the general hygiene environment in childhood. Older generations born before around 1950 show a high prevalence of around 80-90 %, decreasing with age to reach around 10 % or less in those born around the 1990s, and less than 2 % for children born after the year 2000. This change will have generational effects on gastric cancer prevention strategies, both primary and secondary. The risk-stratified approach to gastric cancer prevention should be considered in Japan and other countries which have similarly experienced rapid economic development.

  18. Study of serum Helicobacter pylori soluble antigen

    Institute of Scientific and Technical Information of China (English)

    吴勤动; 朱永良

    2002-01-01

    Objective: to explore a new serological method for detecting Helicobac ter pylori ( H. pylori ) infection. Methods: Serum soluble antigen of H. p ylor i was detected by using avidin-biotin ELISA technique to evaluate the status of H. pylori infection and for comparison with rapid urease test ( RUT ), histo logi c examination and serology. Results: The sensitivity, specificity, positive pred ictive value and negative predictive value were 77.46%, 91.07%, 91.67% a nd 76.12 %, respectively. The prevalence rate of serum H. pylori soluble antigen in 138 patients undergoing endoscopy was similar to the rate obtained by 14 C-UBT met hods ( P>0.05 ). Conclusions: The detection of serum H. pylori solub le antigen( HpSAg) could be used as a new serological method which is accurate, and convenie nt, not affected by the memorizing reaction of serum antibody; is more sensitive , m ore specific and suitable for clinical diagnosis, and evaluation of eradication and for follow-up of H. pylori as well as for detection in children and pre gnant women.

  19. Helicobacter pylori CagA: from pathogenic mechanisms to its use as an anti-cancer vaccine

    Directory of Open Access Journals (Sweden)

    Markus eStein

    2013-10-01

    Full Text Available Helicobacter pylori colonizes the gastric mucosa of more than 50% of the human population, causing chronic inflammation, which however is largely asymptomatic. Nevertheless, H. pylori-infected subjects can develop chronic gastritis, peptic ulcer, gastric mucosa-associated lymphoid tissue (MALT lymphoma, and gastric cancer. Chronic exposure to the pathogen and its ability to induce epithelial-to-mesenchymal transition (EMT through the injection of CagA into gastric epithelial cells may be key triggers of carcinogenesis. By deregulating cell-cell and cell-matrix interactions as well as DNA methylation, histone modifications, expression of micro RNAs, and resistance to apoptosis, EMT can actively contribute to early stages of the cancer formation. Host response to the infection significantly contributes to disease development and the concomitance of particular genotypes of both pathogen and host may turn into the most severe outcomes. T regulatory cells (Treg have been recently demonstrated to play an important role in H. pylori-related disease development and at the same time the Treg-induced tolerance has been proposed as a possible mechanism that leads to less severe disease. Efficacy of antibiotic therapies of H. pylori infection has significantly dropped. Unfortunately, no vaccine against H. pylori is currently licensed, and protective immunity mechanisms against H. pylori are only partially understood. In spite of promising results obtained in animal models of infection with a number of vaccine candidates, few clinical trials have been conducted so far and with no satisfactory outcomes. However, prophylactic vaccination may be the only means to efficiently prevent H. pylori-associated cancers.

  20. DPO multiplex PCR as an alternative to culture and susceptibility testing to detect Helicobacter pylori and its resistance to clarithromycin

    Directory of Open Access Journals (Sweden)

    Siffré Elodie

    2011-10-01

    Full Text Available Abstract Background Macrolide resistance in Helicobacter pylori is the major risk factor for treatment failure when using a proton pump inhibitor-clarithromycin containing therapy. Macrolide resistance is due to a few mutations on the 23S ribomosal subunit encoded by the 23S rRNA gene. The present study aimed at investigating the performance of the dual priming oligonucleotide (DPO-PCR kit named Seeplex® ClaR-H. pylori ACE detection designed to detect H. pylori and two types of point mutations causing clarithromycin resistance in H. pylori. Methods The performance of Seeplex® ClaR-H. pylori ACE detection was evaluated on 127 gastric biopsies in comparison to conventional bacterial culture followed by the determination of susceptibility to clarithromycin by E-test, as well as by an in-house real-time PCR using a fluorescence resonance energy transfer (FRET technology. Results Considering culture as the reference test, the sensitivity of DPO-PCR and real-time FRET-PCR was 97.7% and 100% while specificity was 83.1% and 80.7%, respectively. However, both PCR were concordant in detecting 14 H. pylori positive cases which were negative by culture. Globally, E-test and DPO-PCR were concordant with regard to clarithromycin susceptibility in 95.3% of the cases (41/43, while real-time FRET-PCR and DPO-PCR were concordant in 95% (57/60. Conclusion The DPO-PCR is an interesting tool to detect H. pylori on gastric biopsies and to study its susceptibility to clarithromycin in laboratories that cannot perform real-time PCR assays.

  1. Epithelial cell proliferation and glandular atrophy in lymphocytic gastritis: Effect of H pylori treatment

    Institute of Scientific and Technical Information of China (English)

    Johanna M. Makinen; Seppo Niemela; Tuomo Kerola; Juhani Lehtola; Tuomo J. Karttunen

    2003-01-01

    AIM: Lymphocytic gastritis is commonly ass ociated with Helicobacter pylori infection. The presence of glandular atrophy and foveolar hyperplasia in lymphocytic gastritis suggests abnormalities in cell proliferation and differentiation,forming a potential link with the suspected association with gastric cancer. Our aim was to compare epithelial cell proliferation and morphology in H pylori associated lymphocytic gastritis and H pylori gastritis without features of lymphocytic gastritis,and to evaluate the effect of H pylori treatment.METHODS: We studied 14 lymphocytic gastritis patients with H pylori infection. For controls, we selected 14 matched dyspeptic patients participating in another treatment trial whose H pylori infection had successfully been eradicated.Both groups were treated with a triple therapy and followed up with biopsies for 6-18 months (patients) or 3 months (controls). Blinded evaluation for histopathological features was carried out. To determine the cell proliferation index,the sections were labeled with Ki-67 antibody.RESULTS: Before treatment, lymphocytic gastritis was characterized by foveolar hyperplasia (P=0.001) and glandular atrophy in the body (P=0.008), and increased proliferation in both the body (P=0.001) and antrum (P=0.002). Proliferation correlated with foveolar hyperplasia and inflammation activity. After eradication therapy, the number of intraepithelial lymphocytes decreased in the body (P=0.004)and antrum (P=0.065), remaining higher than in controls (P<0.001). Simultaneously, the proliferation index decreased in the body from 0.38 to 0.15 (P=0.043), and in the antrum from 0.34 to 0.20 (P=0.069), the antral index still being higher in lymphocytic gastritis than in controls (P=0.010).Foveolar hyperplasia and glandular atrophy in the body improved (P=0.021), reaching the non-LG level.CONCLUSION: In lymphocytic gastritis, excessive epithelial cell proliferation is predominantly present in the body, where it associates with

  2. Maastricht Ⅱ treatment scheme and efficacy of different proton pump inhibitors in eradicating Helicobacter pylori

    Institute of Scientific and Technical Information of China (English)

    Engin Altintas; Orhan Sezgin; Oguz Ulu; Ozlem Aydin; Handan Camdeviren

    2004-01-01

    AIM: The Maastricht Ⅱ criteria suggest the use of amoxicillin and clarithromycin in addition to a proton pump inhibitor over 7-10 d as a first line therapy in the eradication of Helicobacter pylori(H pylori). For each proton pump inhibitor, various rates of eradication have been reported. The present study was to compare the efficacy of different proton pump inhibitors like omeprazole, lansoprazole and pantoprazole in combination with amoxicillin and clarithromycin in the first line eradication of H pylori and to investigate the success of H pylori eradication in our district.METHODS: A total of 139 patients were included having a Helicobacter pylori(+) gastroduodenal disorders diagnosed by means of histology and urease test. Besides amoxicillin (1 000 mg twice a day) and clarithro