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Susceptibility patterns and virulence genotypes of Helicobacter pylori affecting Eradication therapy outcomes among Egyptian patients with gastroduodenal diseases

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World Journal of Gastroenterology 2023年第19期29卷 2950-2960页

作者： Ahmed Morad Asaad Gasser El-Azab Eman Abdelsameea Osama Elbahr Ahmed Kamal Mohamed Abdel-Samiee Ahmed Abdelfattah Heba Abdallah Doha Maher Ahmed El-Refaie Samar Ebrahim Ghanem Shamshul Ansari Samah Mohammed Awad Department of Microbiology College of MedicineZagazig UniversityZagazig 44519Egypt Department of Hepatology and Gastroenterology National Liver InstituteMenoufia UniversityShebin El-Kom 32511Egypt Department of Clinical Pathology National Liver InstituteMenoufia UniversityShebin El-Kom 32511Egypt Department of Pathology National Liver InstituteMenoufia UniversityShebin El-Kom 32511Egypt Department of Clinical Biochemistry and Molecular Diagnostics National Liver InstituteMenoufia UniversityShebin El-Kom 32511Egypt Department of Health Sciences Higher Colleges of TechnologyAbu Dhabi Women's CollegeAbu Dhabi 25026United Arab Emirates Department of Clinical Microbiology and Immunology National Liver InstituteMenoufia UniversityShebin El-Kom 32511Egypt

BACKGROUND Helicobacter pylori(H.pylori)is a significant human pathogen that is responsible for a variety of illnesses,including mucosa-associated lymphoid tissue lymphoma,gastric cancer,peptic ulcers,and gastritis.AIM To investigate the frequency of H.pylori infection and its resistance patterns among Egyptian patients and to determine the influence of H.pylori virulence genetic determinants on the eradication success of 14-d triple therapy regimen.METHODS H.pylori infections were investigated in 72 patients with gastroduodenal complications suggestive of H.pylori infection.The cagA and vacA genotypes of cultured strains were studied using polymerase chain reaction.The patients underwent 14 d of triple-therapy treatment.The treatment response was examined using histology and a rapid urease test 6 wk after therapy discontinuation.RESULTS The intention-to-treat eradication rate was 59.2%(95%CI:48.2%-70.3%).Rates of H.pylori resistance to clarithromycin,amoxicillin,and metronidazole were 52.8%,81.9%,and 100%,respectively.Successful eradication of H.pylori was more significantly associated with vacA s1-positive strains[adjusted odds ratio(aOR)=0.507,95%CI:0.175-0.822].A significant association was found between failed eradication rate and H.pylori strains resistant to clarithromycin(aOR=0.204,95%CI:-0.005 to 0.412)and amoxicillin(aOR=0.223,95%CI:0.026-0.537).CONCLUSION This study’s low H.pylori eradication rate following 14-d triple therapy is concerning and worrying.H.pylori pan-resistance to metronidazole followed by the high resistance to ciprofloxacin,amoxicillin,and clarithromycin in this research is challenging and of great concern.

关键词： Helicobacter pylori Eradication therapy Virulence Clarithromycin resistance cagA gene vacA gene

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Non-improvement of atrophic gastritis in cases of gastric cancer after successful Helicobacter pylori Eradication therapy

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World Journal of Clinical Cases 2024年第14期12卷 2342-2349页

作者： Yuto Suzuki Yasumi Katayama Yo Fujimoto Ikuhiro Kobori Masaya Tamano Department of Gastroenterology Dokkyo medical University Saitama Medical CenterKoshigayaSaitama 343-8555Japan Endoscopy Center Dokkyo Medical University Saitama Medical CenterKoshigayaSaitama 343-8555Japan

BACKGROUND Helicobacter pylori(H.pylori)infection is closely related to the development of gastric cancer(GC).However,GC can develop even after H.pylori eradication.Therefore,it would be extremely useful if GC could be predicted after eradication.The Kyoto classification score for gastritis(GA)is closely related to cancer risk.However,how the score for GC changes after eradication before onset is not well understood.AIM To investigate the characteristics of the progression of Kyoto classification scores for GC after H.pylori eradication.METHODS eradication of H.pylori was confirmed in all patients using either the urea breath test or the stool antigen test.The Kyoto classification score of GC patients was evaluated by endoscopy at the time of event onset and three years earlier.In ad-dition,the modified atrophy score was evaluated and compared between the GC group and the control GA group.RESULTS In total,30 cases of early GC and 30 cases of chronic GA were evaluated.The pathology of the cancer cases was differentiated adenocarcinoma,except for one case of undifferentiated adenocarcinoma.The total score of the Kyoto classifi-cation was significantly higher in the GC group both at the time of cancer onset and three years earlier(4.97 vs 3.73,P=0.0034;4.2 vs 3.1,P=0.0035,respectively).The modified atrophy score was significantly higher in the GC group both at the time of cancer onset and three years earlier and was significantly improved only in the GA group(5.3 vs 5.3,P=0.5;3.73 vs 3.1,P=0.0475,respectively).CONCLUSION The course of the modified atrophy score is useful for predicting the onset of GC after eradication.Patients with severe atrophy after H.pylori eradication require careful monitoring.

关键词： Helicobacter pylori Kyoto classification Gastritis Eradication therapy Gastric cancer

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Disease trends after Helicobacter pylori eradication based on Japanese nationwide claims and the health check-up database

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World Journal of Gastroenterology 2023年第4期29卷 692-705页

作者： Kazuhiro Mizukami Kentaro Sugano Tomomi Takeshima Kazunari Murakami Department of Gastroenterology Oita UniversityOita 8795593Japan Department of Medicine Jichi Medical UniversityTochigi 3290498Japan Milliman Inc. Tokyo 1020083Japan

BACKGROUND Helicobacter pylori(H.pylori)infection is a risk factor for many diseases,including peptic ulcer disease and gastric cancer.While H.pylori Eradication therapy can prevent these diseases,potentially unfavorable effects of Eradication therapy have also been reported in some diseases,such as gastroesophageal reflux disease(GERD),Barrett’s esophagus(BE),inflammatory bowel disease(IBD),allergic diseases,and metabolic diseases.Consequently,both positive and negative impacts should be considered when assessing the effects of H.pylori Eradication therapy.AIM To compare the incidence of these diseases before and after H.pylori eradication and to comprehensively assess its effects.METHODS This retrospective cohort study used a Japanese nationwide health claims database(April 2009-March 2020),developed by the Japanese Ministry of Health,Labour and Welfare.The database contained almost all health insurance claims data issued in Japan,and specific health check-up data for individuals who took the check-ups.Descriptive statistics were used for the analyses.Patients who received primary Eradication therapy were defined as those prescribed medication for H.pylori eradication.New diagnoses,defined as incidence of upper gastrointestinal diseases and IBD,and prevalence of allergic diseases were compared before and after eradication.The incidence and prevalence of each disease were also compared between the 3-year period before eradication(from the 4th to the 2nd year prior to the year of eradication)and the 3-year period after eradication(from the 1st to the 3rd year after the year of eradication)based on the age category and calendar year and month.Changes in body mass index and proportion of patients with metabolic syndrome(MS)were examined before and after eradication.RESULTS We identified 5219731 patients who received primary Eradication therapy.The 65-69 years age group had the greatest number of patients in both sexes.There was no significant increase in the incidence of GERD after eradication when considering the

关键词： Administrative claims Healthcare Allergy Eradication therapy Gastroesophageal reflux disease Helicobacter pylori Inflammatory bowel disease

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Effectiveness of Helicobacter pylori eradication in the treatment of early-stage gastric mucosa-associated lymphoid tissue lymphoma:An up-to-date meta-analysis

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World Journal of Gastroenterology 2023年第14期29卷 2202-2221页

作者： Fabian Fellipe Bueno Lemos Caroline Tianeze de Castro Mariana Santos Calmon Marcel Silva Luz Samuel Luca Rocha Pinheiro Clara Faria Souza Mendes dos Santos Gabriel Lima Correa Santos Hanna Santos Marques Henrique Affonso Delgado Kádima Nayara Teixeira Cláudio Lima Souza Márcio Vasconcelos Oliveira Fabrício Freire de Melo Instituto Multidisciplinar em Saúde Universidade Federal da BahiaVitória da Conquista 45029094BahiaBrazil Instituto de Saúde Coletiva Universidade Federal da BahiaSalvador 40110040BahiaBrazil Campus Vitória da Conquista Universidade Estadual do Sudoeste da BahiaVitória da Conquista 45029094BahiaBrazil Campus Toledo Universidade Federal do ParanáToledo 85919899ParanáBrazil

BACKGROUND Gastric mucosa-associated lymphoid tissue(MALT)lymphoma(GML)is usually a low-grade B-cell neoplasia strongly associated with Helicobacter pylori(H.pylori)-induced chronic gastritis.Clinical practice guidelines currently recommend H.pylori eradication as the preferred initial treatment for early-stage GML.To determine the practical effect of bacterial eradication as the sole initial therapy for early-stage GML,an updated analysis and review of available evidence is imperative.AIM To perform a meta-analysis to assess the rate of complete remission(CR)of H.pylori-positive early-stage GML following bacterial eradication.METHODS We performed independent,computer-assisted literature searches using the PubMed/MEDLINE,Embase,and Cochrane Central databases through September 2022.Prospective and retrospective observational studies evaluating the CR of early-stage GML following bacterial eradication in H.pylori-positive patients.The risk of bias was assessed using Joanna Briggs Institute(JBI)Critical Appraisal Tools.The pooled estimate of the complete histopathological remission rate and respective confidence intervals(95%CI)were calculated following the random-effects model.Heterogeneity and inconsistency were assessed using Cochran’s Q test and I2 statistic,and heterogeneity was defined as P50%,respectively.Subgroup and meta-regression analyses were conducted to explore potential sources of heterogeneity.RESULTS The titles and abstracts of 1576 studies were screened;96 articles were retrieved and selected for full-text reading.Finally,61 studies were included in the proportional meta-analysis(P-MA).Forty-six were prospective and fifteen were retrospective uncontrolled,single-arm,observational studies.The overall risk of bias was low to moderate in all but a single report,with an average critical appraisal score across all studies of 79.02%.A total of 2936 H.pylori-positive early-stage GML patients,in whom H.pylori was successfully eradicated,were included in the analysis.The pooled CR of H.pylori-p

关键词： Lymphoma B-cell Marginal zone Gastric mucosa-associated lymphoid tissue lymphoma Stomach lymphoma Helicobacter pylori Therapeutics Eradication therapy

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Helicobacter pylori eradication:Exploring its impacts on the gastric mucosa

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World Journal of Gastroenterology 2021年第31期27卷 5152-5170页

作者： Chun-Yan Weng Jing-Li Xu Shao-Peng Sun Kai-Jie Wang Bin Lv Department of Gastroenterology The First Clinical Medical College of Zhejiang Chinese Medical UniversityHangzhou 310053Zhejiang ProvinceChina Department of Gastrointestinal Surgery The First Clinical Medical College of Zhejiang Chinese Medical UniversityHangzhou 310053Zhejiang ProvinceChina Department of Gastroenterology The First Affiliated Hospital of Zhejiang Chinese Medical UniversityHangzhou 310006Zhejiang ProvinceChina

Helicobacter pylori(H.pylori)infects approximately 50%of all humans globally.Persistent H.pylori infection causes multiple gastric and extragastric diseases,indicating the importance of early diagnosis and timely treatment.H.pylori eradication produces dramatic changes in the gastric mucosa,resulting in restored function.Consequently,to better understand the importance of H.pylori eradication and clarify the subsequent recovery of gastric mucosal functions after eradication,we summarize histological,endoscopic,and gastric microbiota changes to assess the therapeutic effects on the gastric mucosa.

关键词： Helicobacter pylori Gastric mucosa Histology Endoscopic findings Gastrointestinal microbiota Eradication therapy

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Acquired haemophilia in patients with malignant disease:A case report

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World Journal of Clinical Cases 2021年第10期9卷 2409-2418页

作者： Veronika Krašek Aleša Kotnik Hana Zavrtanik Jasna Klen Samo Zver Medical Faculty University of LjubljanaLjubljana 1000Slovenia Department of Abdominal Surgery University Medical Centre LjubljanaLjubljana 1000Slovenia Department of Hematology University Medical Centre LjubljanaLjubljana 1000Slovenia

BACKGROUND Acquired haemophilia is a rare coagulation disorder characterized by autoantibodies against coagulation factor VIII leading to severe and potentially life-threatening haemorrhages.The underlying disorder causing the development of an autoimmune phenomenon is not always known,but 10%-15%could be linked to malignancies.Patients with cancer who require surgical resection represent a treatment challenge not solely due to increased risk of bleeding but also due to adverse events of immunosuppressive therapy.CASE SUMMARY We present the case of a 67-year-old man with non-metastatic adenocarcinoma of the distal bile duct who developed concomitant acquired haemophilia a month after having been diagnosed with malignant disease.Haemostasis was established with recombinant activated factor VII,and immunosuppressive therapy was started immediately.An extensive surgical procedure was performed in order to remove the cancer and,therefore,eliminate the inhibitory autoantibodies.Due to a complicated postoperative course,relatively short period of treatment and likelihood of micrometastases,no improvement in the patient’s status was observed.Diagnosis and treatment of acquired haemophilia as well as other coagulation disorders in patients with cancer are discussed.CONCLUSION Prompt diagnosis of acquired haemophilia is required in order to start appropriate treatment and reduce mortality.Among patients with cancer,other causes of abnormal bleeding related to malignancy should be considered.

关键词： Malignancy Haemostasis Bleeding diathesis Eradication therapy Case report

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Cap polyposis refractory to Helicobacter pylori eradication treated with endoscopic submucosal dissection

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World Journal of Gastrointestinal Endoscopy 2017年第10期9卷 529-534页

作者： Masaki Murata Mitsushige Sugimoto Hiromitsu Ban Taketo Otsuka Toshiro Nakata Masahide Fukuda Osamu Inatomi Shigeki Bamba Ryoji Kushima Akira Andoh Department of Gastroenterology Shiga University of Medical Science Hospital Division of Digestive Endoscopy Shiga University of Medical Science Hospital Department of Clinical Laboratory Medicine Shiga University of Medical Science Hospital

Cap polyposis is a rare intestinal disorder. Characteristic endoscopic findings are multiple inflammatory polypoid lesions covered by caps of fibrous purulent exudate. Although a specific treatment has not been established, some studies have suggested that Eradication therapy for Helicobacter pylori(H. pylori) is effective. We report a case of a 20-year-old man with cap polyposis presenting with hematochezia. Colonoscopy showed the erythematous polyps with white caps from the sigmoid colon to rectum. Histopathological findings revealed elongated, tortuous, branched crypts lined by hyperplastic epithelium with a mild degree of fibromusculosis in the lamina propria. Although H. pylori eradication was instituted, there was no improvement over six months. We then performed en bloc excision of the polyps by endoscopic submucosal dissection(ESD), which resulted in complete resolution of symptoms. ESD may be a treatment option for cap polyposis refractory to conservative treatments. We review the literature concerning treatment for cap polyposis and clinical outcomes.

关键词： Endoscopic submucosal dissection Cap polyposis Eradication therapy Helicobacter pylori

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Kyoto classification in patients who developed multiple gastric carcinomas after Helicobacter pylori eradication

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World Journal of Gastrointestinal Endoscopy 2020年第9期12卷 276-284页

作者： Kosuke Sakitani Toshihiro Nishizawa Akira Toyoshima Shuntaro Yoshida Tatsuya Matsuno Tomoharu Yamada Masatoshi Irokawa Yoshiyuki Takahashi Yousuke Nakai Osamu Toyoshima Kazuhiko Koike Department of Gastroenterology Toyoshima Endoscopy ClinicTokyo 157-0066Japan Department of Gastroenterology Sakitani Endoscopy ClinicChiba 275-0026Japan Department of Gastroenterology International University of Health and WelfareNarita HospitalChiba286-8520Japan Department of Colorectal Surgery Japanese Red Cross Medical CenterTokyo 150-8935Japan Department of Gastroenterology Graduate School of Medicinethe University of TokyoTokyo 113-8655Japan

BACKGROUND Endoscopic Kyoto classification predicts gastric cancer risk;however,the score in the patients with primary gastric cancer after Helicobacter pylori(H.pylori)Eradication therapy is unknown.AIM To elucidate the Kyoto classification score in patients with both single gastric cancer and multiple gastric cancers developed after H.pylori eradication.METHODS The endoscopist recorded the Kyoto classification at the endoscope and the Kyoto classification score at the time of the first diagnosis of gastric cancer after H.pylori eradication.The score was compared between single gastric cancer group and multiple gastric cancers group.RESULTS The Kyoto score at the time of diagnosis of 45 cases of gastric cancer after H.pylori eradication was 4.0 points in average.The score was 3.8 points in the single gastric cancer group,and 5.1 points in the multiple gastric cancers group.The multiple group had a significantly higher score than the single group(P=0.016).In the multiple gastric cancers group,all the patients(7/7)had 5 or higher Kyoto score,while in single gastric cancer group,the proportion of patients with a score of 5 or higher was less than half,or 44.7%(17/38).CONCLUSION Patients diagnosed with gastric cancer after H.pylori eradication tended to have advanced gastritis.In particular,in cases of multiple gastric cancers developed after H.pylori eradication,the endoscopic Kyoto classification score tended to be 5 or higher in patients with an open type atrophic gastritis and the intestinal metaplasia extended to the corpus.

关键词： Kyoto classification Gastric cancer Helicobacter pylori Eradication therapy Metachronous Intestinal metaplasia

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