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PubMed2005

Helicobacter infection, chronic inflammation, and the development of malignancy.

PURPOSE OF REVIEW: Chronic infection with Helicobacter pylori affects approximately half the world and results in malignancy in a small subset of this population. Although the frequency of infection in developed nations is falling with a resultant decline in H. pylori-associated peptic ulcer disease, gastric cancer remains the second major cause of cancer death worldwide, with H. pylori infection being a major attributable factor in the development of gastric cancer. This review provides an update on the pathogenesis of Helicobacter infection, the malignancies associated with infection, and how infection and chronic inflammation may lead to the development of gastric malignancy, emphasizing recent developments in the field, particularly those published in leading journals. RECENT FINDINGS: Recent studies have broadened our understanding of the pathogenesis of chronic inflammation associated with Helicobacter infection, and how chronic inflammation contributes to carcinogenesis. There is also continuing evidence from eradication studies in humans and animal models to support the association of Helicobacter infection with gastric cancer. Although there are some differences in the various human trials, recent studies support the notion that early eradication of infection may prevent the development of malignancy, but once certain events have taken place, the process leading to cancer may not be reversible. Continued research into bacterial and host factors that are associated with an increased risk of the development of gastric cancer have also enhanced our understanding of this field. SUMMARY: The emerging literature has important implications for the understanding of the basic pathophysiology leading to malignancy in chronic H. pylori infection throughout the world. Treatment of infection may be beneficial in preventing the development of cancer in certain settings, and the role of antioxidants and other approaches is promising but requires further study. Findings from the investigation of host and bacterial factors that may predispose to the development of more severe disease manifestations including gastric cancer are also important developments in this area.

Animals↗
PubMed2005

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

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.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed2005

[Helicobacter pylori infection in patients with chronic hives and asthma].

Difficulties in treatment of allergic diseases (ADs) are often determined by the fact that the origin of the illness is impossible to establish. Foreign researchers have demonstrated a correlation between Helicobacter pylori (HP) persistence and such conditions as chronic relapsing urticaria (CRLU), Quincke's edema (QO) and respiratory manifestations of allergy (usually bronchial asthma (BA)). HP may participate in the forming of ADs in three possible ways: 1) the bacteria interact with mast cells, and thus are able to initiate mediator liberation; 2) being full antigens, the bacteria themselves are able to cause allergy; 3) the infection process development impairs the barrier function of the alimentary tract mucosa, thus impairing food processing. This creates conditions for allergic food particles to enter bloodstream, which is facilitated by inflammatory lesions of the intestinal tract, protozoal and helminthic invasion, and dysbacteriosis. The aim of the study was to determine how frequently patients with CRU, QO and BA have HP invasion and develop intestinal microflora disbalance, as well as to find out whether there is a correlation between HP infection and alterations in the IgE-system, and establish anti-HP therapy effects, measuring the levels of anti-helicobacter antibody and IgE before and after the treatment. The study revealed HP invasion in 89.2% of patients with chronic ADs; 96.7% of the subjects had disturbances of microbiocenosis; total IgE level correlated with the allergic process activity and anti-helicobacter antibody level; eradicational therapy was more effective when included proton pump inhibitor, clarithromycin and flemoxin than when de-nol, clarithromycin and flemoxin were administered. According to the results of the study, anti-helicobacter therapy allows more effective treatment of patients with relapsing ADs and HP infection.

Adolescent↗
PubMed2005

[Failure in the eradication of Helicobacter pylori: the role of antibiotic resistance].

The authors discuss in detail the antibiotic resistance playing role in the unsuccessful treatment of Helicobacter pylori eradication. After reviewing the frequency of the antibiotic resistant regimens in Helicobacter pylori they demonstrate the general biological forms in the development of antibiotic resistance, and the molecular-biologic background resistance against antibiotics used in the Helicobacter pylori eradication. The methods of antibiotic sensibility of Helicobacter pylori are also discussed. They summarize the therapeutic recommendations in cases of different drug resistances and underline the newer treatment possibilities.

Anti-Bacterial Agents↗
PubMed2005

[Helicobacter pylori infection and idiopathic thrombocytopenic purpura].

There are increasing data on the association between Helicobacter pylori infection and idiopathic thrombocytopenic purpura and the significant increase in platelet count after bacterial eradication. The aim of this review was to consider the studies so far published on Helicobacter pylori infection and idiopathic thrombocytopenic purpura in order to evaluate a possible correlation between these two conditions. A review of the literature showed that 306 out of the 524 patients investigated (54.8%) were positive for Helicobacter pylori infection and that the bacterium was eradicated in 83% of cases. Eradication therapy was accompanied by a complete or partial platelet response in approximately half the cases. Overall, these data show that Helicobacter pylori eradication in patients with idiopathic thrombocytopenic purpura is effective in increasing platelet count. However, since the studies so far published are few, sometimes controversial and involve small series of patients, further studies on larger numbers of patients with longer followup are needed to confirm these preliminary findings.

Helicobacter Infections↗
PubMed2005

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

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.

Amoxicillin↗
PubMed2005

Diagnostic accuracy of a new rapid urease test (Pronto Dry), before and after treatment of Helicobacter pylori infection.

AIM: The diagnosis of Helicobacter pylori infection can be made easily by the rapid urease test during endoscopy. The mainly commercial rapid urease test available in routine practice, is in liquid phase, need to be stored at 4 degrees C and generally they are not ready to use. Recently a new rapid urease test, the Pronto Dry, has been reported to be faster in the final reading, ready to use, and it can be stored at room temperature. Aim of the study was to evaluate the diagnostic accuracy and the reaction time of Pronto Dry vs liquid phase-rapid urease test, before and after treatment of Helicobacter pylori infections. METHODS: A total of 315 untreated dyspeptic patients and 323 post-treatment patients, were enrolled in this study. At endoscopy, 5 biopsy samples were obtained from the antrum and from the corpus for histology; culture and rapid urease tests (liquid phase and Dry test). Helicobacter pylori status was defined according to European guidelines. Sensitivity and specificity of both rapid urease test were assessed at 5, 15, 30 minutes, and 3 and 24 hours after the endoscopy. RESULTS: One hundred and eleven out of 315 untreated dyspeptic patients were found to be positive for Helicobacter pylori infection, and 56/323 patients were found still positive after treatment. Sensitivity at 5, 15, 30 minutes, and 3 and 24 hours in untreated patients were 45%, 71.2%, 81.1%, 90.1% and 91.9% respectively for the Pronto Dry vs 6.3%, 31.5%, 51.3%, 78.4% and 90.1% for liquid phase rapid urease test. Sensitivity at the same times in not eradicated patients were 33.9%, 66.1%, 85.7%, 92.8 and 92.8% respectively for the Pronto Dry vs 3.6%, 37.5%, 55.3%73.2%, 92.8% for liquid phase rapid urease test. CONCLUSIONS: Pronto Dry showed to have higher sensitivity in pre and post treatment setting compared to liquid phase-rapid urease test within 3 hours of incubation time.

Clinical Enzyme Tests↗
PubMed2005

[Examination of patients with dyspepsia in areas with a low prevalence of Helicobacter pylori infection].

Examination of patients with dyspepsia is quantitatively a major task in gastroenterology. Several strategies have been used. In recent years the "test and treat strategy" has gained wide acceptance, because it is easy and without discomfort to the patient. The primary step in this strategy is a 13C-urea breath test for Helicobacter pylori. If the test is positive, the Helicobacter pylori must be eradicated. Only patients with alarm symptoms or refractory symptoms are offered gastroscopy. This strategy has been found useful in clinical trials performed in areas with a high prevalence of Helicobacter pylori infection. To examine whether these results are valid in clinical practice in a low-prevalence country, we performed a one-year retrospective study of our modified strategy of 666 patients, in which gastroscopy is offered to patients who test negative--an "open access test and scope strategy". In all, 576 patients were referred and examined according to the strategy; 90 patients, of whom 43 had alarm symptoms, were referred erronously. We performed 322 breath tests, of which 66 were positive--49 in patients without alarm symptoms. Of the latter, 39 were improved by Helicobacter pylori eradication therapy. These were the patients who really benefitted from the strategy. Of the 230 patients with a negative breath test, 197 agreed to have a gastroscopy done, and 31 cases of oesophagitis and 3 idiopathic ulcers were found. It is concluded that the strategy is advantageous but complicated in an open-access setting.

Adolescent↗
PubMed2005

[Detection of Helicobacter pylori in nasal polyps specimens using urease test GUT plus].

In patients with nasal polyps the colonisation of nasal polyps tissues by Helicobacter pylori was investigated using urease test (GUT plus). In this prospective clinical trials we enrolled 61 subjects who had undergone endoscopic nasal polyps surgery and 30 subjects who had undergone septoplasty (control group) were questioned and biopsy specimens of the removed polyps or the mucosal part of inferior turbinate were tested by the urease test GUT plus. In result Helicobacter pylori was not found in the nasal polyps and mucosal part of inferior turbinate tissue of any of patients including the 43 of 61 patients with nasal polyps and 7 of 30 patients with septum deviation who had symptoms of gastroesophageal reflux. In our study using the urease test GUT plus we were not able to confirm presence of Helicobacter pylori in the nasal polyps tissue. However, further epidemiologic studies using different diagnostic methods would be necessary to confirm presence of Helicobacter pylori as potential underlying pathogenetic mechanism of nasal polyposis.

Adult↗
PubMed2005

[Children Helicobacter pylori infection: antibiogram results].

UNLABELLED: Helicobacter pylori infection is frequent in children. The eradication rate is variable, it is influenced by resistance of the bacteria to the antibiotics used. The aim of this study was to determine the resistance rate of the most commonly used antibiotics among helicobacter pylori (Hp) strains isolated in infected children. PATIENTS AND METHODS: 60 children (26 males, 34 females), with mean age of 8 years 8 months (3 years and 2 month (2.5-13.5 years) underwent an oesogastroscopy. Forty six of them had helicobacter infection assessed by the presence of Hp on the gastric biopsy and or positivity of urease test. The infected children were treated with three medication; Omeprazole. Clarythromycin, and Amoxicillin. The eradication of Hp was confirmed in 13 patients by the absence of Hp on the gastric biopsy and/or negativation of the urease test; RESULTS: Culture was positive in 13 infected children susceptibility to anti microbial drugs was done in ten children. Nine children had primary metronidazole resistance, three had both clarythromycin and Metronidazole resistance, three had Clarythromycin primary resistance. No case of Amoxicillin primary resistance was detected. Children eradication was achieved in four children among 13 children. This study shows the difficulty of Hp culture. It confirms the absence of Hp resistance to Amoxicilline. the high level of Hp resistance to Metronidazole and the mild level of Clarythromycin resistance. The authors stress the importance of Antibiotic susceptibility assay in helicobacter pylori infections.

Adolescent↗
PubMed2005

[Helicobacter pylori infection in children of developing countries].

A characteristic feature of Helicobacterpylori infection in developing countries is early acquisition of the bacteria during childhood. Recent study has documented the frequency of transient infection in young children in particular during the first year following eradication therapy. Children living in developing countries present several risk factors for acquisition including crowding, young age, and recurrent gastroenteritis. The risk of infection increases significantly in function of the number of infected persons in a child's family. Using molecular biology techniques based on gene sequencing, we have shown that strains in different members of the same family were identical not only between parents and children but also between siblings. The relationship between chronic diarrhoea, retarded growth, iron-deficient anaemia, and Helicobacter pylori infection in children especially from developing countries remains controversial. Gram staining of biopsy smears to detect Helicobacter pylori is an efficient diagnostic method and can be a good alternative when culture is unfeasible. Respiratory testing and detection of antigens in stools are effective and appear to be well suited to diagnosis of Helicobacter pylori infection. In developing countries Helicobacter pylori is a common infectious agent warranting further study to gain insight into clinical presentation, epidemiological features, and treatment requirements including sensitivity to antibiotics

Adolescent↗
PubMed2006

Occurrence of Helicobacter species other than H. hepaticus in laboratory mice and rats in Sweden.

The aim of this study was to determine which Helicobacter species other than H. hepaticus colonize laboratory mice and rats in Sweden. We analyzed 63 intestinal samples from mice and 42 intestinal samples from rats by partial 16S rDNA sequence analysis. Previously these samples had been found positive for Helicobacter species but negative for H. hepaticus in a polymerase chain reaction screening assay at the National Veterinary Institute in Sweden. H. ganmani, H. typhlonius, H. rodentium, an uncharacterized Helicobacter species ('hamster B'), and a possibly novel species were detected in mice. The possibly novel species was most closely related to H. apodemus strain YMRC 000216 (98.3% sequence similarity). Two different Helicobacter species were detected in rats: H. ganmani and H. rodentium. H. ganmani colonization of rats has not previously been reported.

Animals↗
PubMed1991

[Preliminary study of the prevalence of Helicobacter pylori in Tananarive, Madagascar and the antibacterial activity in vitro of 13 Malagasy medicinal plants on this germ].

Helicobacter pylori infection has been studied in 60 patients who were suffering from either a peptic ulcer disease or a gastritis complaint. Helicobacter pylori was searched in antral biopsy specimens using standard bacteriological methods (Gram-staining urea-test, culture) and histological staining techniques (hematoxylin-eosin-saffron, undifferentiated Giemsa). The culture was successful in 40 cases. The antibacterial activity of 13 malagasy medicinal plants has been tested versus Helicobacter pylori using disc method on agar culture. For five extracts, we observed an anti-Helicobacter pylori activity which would deserve further investigations.

Adult↗
PubMed2006

Helicobacter pylori in the dental plaque: is it of diagnostic value for gastric infection?

AIM: The aim of present study was the assessment of association of helicobacter pylori of dental plaque and stomach in a more homogenous population and also to determine the diagnostic value of dental plaque for gastric infection. MATERIALS AND METHODS: Based on the results of Rapid urease test (RUT) on specimens from gastric antrum, 88 patients with symptoms of dyspepsia were assigned into two groups of infected and non-infected with helicobacter pylori. Supragingival plaque samples were collected from mandibular first and second molar area using and sterile curette and were investigated using RUT. Statistical analysis of data was performed using chi-square test and independent t-test. RESULTS: H. pylori was detected in 34.1 % of dental plaque specimens. The prevalence of helicobacter pylori infection in dental was 31.8 % and 36.4 % in patients with and without gastric infection (P=0.6). Also the interaction of age and infection was not significant but the prevalence of H. pylori both in the dental plaque and the stomach of male patients was higher than female patients. CONCLUSION: There is not any significant association between the helicobacter pylori of the dental plaque and the stomach. Also the dental plaque can not be used as a primary diagnostic aid for gastric infection.

Adult↗
PubMedDate not supplied

[Effect of preceding acid-reducing therapy on the Helicobacter pylori eradication rate in patients with ulcerous disease].

32 patients having for the last one or two years an episode of exacerbation of stomach ulcer disease associated with Helicobacter pylory had received 7 days Helicobacter eradicative therapy of the first line according to Maastricht consensus-2, 2002 year. All the patients were divided into 2 groups. 15 persons of the first group have received just after establishing diagnosis antihelicobacter therapy, other 17 patients of the second group preliminarily over the period of 2-3 weeks had been treated with proton pomp's inhibitor. Helicobacter pylori eradication rate in the first and second group was 93,3% and 52,9% respectively. The obtained results enable us to discuss the regimen of rational medical therapy of patients with Helicobacter pylori associated diseases.

Adult↗
PubMed2006

[Helicobacter pylori-associated pathology of oral cavity in children (clinical-laboratory study)].

As the result of the study of stomatological status indices in children with gastroduodenal pathology associated with Helicobacter pylori it was established that caries incidence in children did not depend upon contamination while caries prevalence in examined children unlike caries incidence was associated with HP-status of the oral cavity. Patients with concomitant gastroduodenal pathology had frequently periodontal disease (PD). In children with chronic antral gastritis associated with Helicobacter pylori clinical manifestations were poor and tended towards inflammatory process chronicity. All the patients had chronic catarrhal gingivitis. In children with Helicobacter pylori associated pathology of GIT it proceeded with 100% contamination of gingival mucous membrane by Helicobacter pylori as shown by bacterioscopic study.

Adolescent↗
PubMedDate not supplied

[The role of serology in the diagnosis of Helicobacter (Campylobacter) pylori infection].

The purpose of the communication is to review the different aspects of the Helicobacter (Campylobacter) pylori infection. The first part of the communication is devoted to the description of the different gastric pathologies induced by the Helicobacter pylori infection and to the different methods used for the detection of this infection. Today a consensus assesses a causal role to Helicobacter pylori in the development of chronic active gastritis (or type B gastritis), in the pathogenesis of duodenal ulcer, and a major contributing factor in the development of peptic ulcer disease. The possible role played by this bacterium in the development of non-ulcer dyspepsia is still unclear. H. pylori infections can be detected using different methods including invasive methods--requiring an endoscopy (e.g.: culture of the micro-organism, urease test, microscopy) and non-invasive methods (e.g.: breath test, serology). Each of these methods has advantages but also some disadvantages, and none shows an absolute sensitivity and specificity. The second part of the presentation analyses the results obtained with a serologic method using a specific fractioned and purified antigenic complex extracted from Helicobacter pylori. This report demonstrates a good correlation with the other detection methods. Serology appears also as a useful tool for the therapeutical monitoring of infected patients. Serological results must however be interpreted in the light of the complete clinical examination of the patient.

Antibodies, Bacterial↗
PubMed1991

Use of ampicillin plus ranitidine for Helicobacter pylori gastritis.

1. Helicobacter pylori (formerly Campylobacter pylori) is now recognized as an etiological factor in gastritis and duodenal ulcers and probably also gastric ulcers. Eradication of the bacteria is fundamental to avoid ulcer relapse. Although bismuth salts have been shown to be effective for treatment, they are not commercially available in Brazil. 2. We report an attempt to treat patients with Helicobacter pylori-associated gastritis with ampicillin (1000 mg twice daily for one month) and compare the results with the conventional treatment used in Brazil (ranitidine, 300 mg daily for one month) and with a combination of the two drugs. We studied 44 patients with histologically confirmed gastritis and with Helicobacter pylori, who were examined at the beginning and after one month of treatment. 3. Ampicillin associated with ranitidine was better than ampicillin or ranitidine alone for the treatment of gastritis. Although ampicillin may be more efficient in patients with lower acid output we did not find a statistically significant difference between these two groups (ampicillin vs drug combination), perhaps owing to the small number of patients studied. When ampicillin was combined with ranitidine there was 25% normalization of the histological picture of the gastric mucosa. 4. We conclude that ampicillin in combination with ranitidine may be a useful treatment for Helicobacter pylori-associated gastritis.

Ampicillin↗