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helicobacter pylori isolates from ethnic minority patients in Guangxi:Resistance rates,mechanisms,and genotype

World Journal of Gastroenterology 2014年第16期20卷 4761-4770页

作者： Li-Juan Zhao Yan-Qiang Huang Bing-Pu Chen Xiao-Qiang Mo Zan-Song Huang Xiao-Feng Huang Lian-Deng Wei Hong-Yu Wei Yuan-Hong Chen Hua-Ying Tang Gan-Rong Huang Yan-Chun Qin Xiao-Hua Li Lu-Yao Wang Department of Medical Microbiology and Immunology You Jiang Medical College for Nationalities

AIM:To investigate the rate of helicobacter pylori(H.pylori)resistance to clarithromycin among ethnic minority patients in Guangxi,explore the underlyingmechanisms,and analyze factors influencing genotype distribution of H.pylori isolates.METHODS:H.pylori strains were isolated,cultured and subjected to drug sensitivity testing.The 23S rRNA gene of H.pylori isolates was amplified by PCR and analyzed by PCR-RFLP and direct sequencing to detect point mutations.REP-PCR was used for genotyping of H.pylori isolates,and NTsys_2 software was used for clustering analysis based on REP-PCR DNA fingerprints.Factors potentially influencing genotype distribution of H.pylori isolates were analyzed.RESULTS:The rate of clarithromycin resistance was31.3%.A2143G and A2144G mutations were detected in the 23S rRNA gene of all clarithromycin-resistant H.pylori isolates.At a genetic distance of 78%,clarithromycin-resistant H.pylori isolates could be divided into six groups.Significant clustering was noted among H.pylori isolates from patients with peptic ulcer or gastritis.CONCLUSION:The rate of clarithromycin resistance is relatively high in ethnic minority patients in Guangxi.Main mechanisms of clarithromycin resistance are A2143G and A2144G mutations in the 23S rRNA gene.Clarithromycin-resistant H.pylori isolates can be divided into six groups based on REP-PCR DNA fingerprints.Several factors such as disease type may influence the genotype distribution of H.pylori isolates.

关键词： helicobacter pylori Antibiotic resistance Mechanis

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helicobacter pylori infection: New pathogenetic and clinical aspects

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World Journal of Gastroenterology 2014年第21期20卷 6386-6399页

作者： Krisztina Hagymási Zsolt Tulassay 2~(nd) Department of Internal Medicine Semmelweis UniversityH-1088 BudapestHungary

helicobacter pylori(H.pylori)infects more than half of the world’s human population,but only 1%to3%of infected people consequently develop gastric adenocarcinomas.The clinical outcome of the infection is determined by host genetic predisposition,bacterial virulence factors,and environmental factors.The association between H.pylori infection and chronic active gastritis,peptic ulcer disease,gastric cell carcinoma,and B cell mucosa-associated lymphoid tissue lymphoma has been well established.With the exception of unexplained iron deficiency anemia and idiopathic thrombocytopenic purpura,H.pylori infection has no proven role in extraintestinal diseases.On the other hand,there is data showing that H.pylori infection could be beneficial for some human diseases.The unpredictability of the long-term consequences of H.pylori infection and the economic challenge in eradicating it is why identification of high-risk individuals is crucial.

关键词： helicobacter pylori virulence factor Host factors

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helicobacter pylori infection is not associated with nonalcoholic fatty liver disease

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World Journal of Gastroenterology 2016年第8期22卷 2592-2600页

作者： Myong Ki Baeg Seung Kew Yoon Sun-Hye Ko Yong-Sun Noh In-Seok Lee Myung-Gyu Choi Department of Internal Medicine The Catholic University of Korea College of Medicine

AIM: To determine whether helicobacter pylori(H. pylori) infection confers a higher risk of Nonalcoholic fatty liver disease(NAFLD).METHODS: Healthy people who underwent health screening were analyzed retrospectively. Inclusion criteria were age ≥ 20 years, history of H. pylori infection, and recorded insulin level. Participants were classified as H. pylori positive or negative according to 13 C urea breath tests. NAFLD was defined using the hepatic steatosis index(HSI) and NAFLD liver fat score(NAFLD-LFS). Those with an HSI > 36 or NAFLD-LFS >-0.640 were considered to have NAFLD. Multivariable logistic regression was performed to identify risk factors for NAFLD.RESULTS: Three thousand six hundred and sixtythree people were analyzed and 1636(44.7%) were H. pylori positive. H. pylori infection was associated with older age, male gender, hypertension, higher body mass index, and a dyslipidemic profile. HSI differed significantly between H. pylori positive and negative subjects(median 33.2, interquartile range(IQR) 30.0-36.2 for H. pylori-positive vs median 32.6, IQR 29.8-36.0 for negative participants, P = 0.005), but NAFLD-LSF did not [median-1.7, IQR-2.4--0.7 vs median-1.8, IQR-2.4-(-0.7), respectively, P = 0.122]. The percentage of people with NAFLD did not differbetween infected and uninfected groups: HIS, 26.9% vs 27.1%, P = 0.173; NAFLD-LFS, 23.5% vs 23.1%, P = 0.778. H. pylori infection was not a risk factor, but C-reactive protein concentration and smoking were significant risk factors for NAFLD.CONCLUSION: H. pylori infection is not a risk factor for NAFLD as indicated by HSI or NAFLD-LFS. Prospective, large-scale studies involving liver biopsies should be considered.

关键词： helicobacter pylori Nonalcoholic fatty liver disease Hepatic steatosis index Nonalcoholic fatty live

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helicobacter pylori eradication with moxifloxacin-containing therapy following failed first-line therapies in South korea

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World Journal of Gastroenterology 2014年第22期20卷 6932-6938页

作者： Kyu Keun Kang Dong Ho Lee Dong Hyun Oh Hyuk Yoon Cheol Min Shin Young Soo Park Nayoung Kim Hyun Chae Jung Department of Internal Medicine Seoul National University Bundang HospitalSeongnamGyeongi-do 463-707South Korea Department of Internal Medicine Seoul National University College of MedicineSeoul 100-744South Korea

AIM:To investigate moxifloxacin-containing triple therapy as second-line treatment for helicobacter pylori(H.pylori)infection following failed first-line treatment.METHODS:The sample included 312 patients for whom first-line treatment failed between January 2008and May 2013;27 patients were excluded,and a total of 285 patients received 7-or 14-d moxifloxacincontaining triple therapy as second-line treatment for H.pylori infection.First line regimens included 7-d standard triple(n=172),10-d bismuth-containing quadruple(n=28),14-d concomitant(n=37),or14-d sequential(n=48)therapy.H.pylori status was evaluated using 13C-urea breath testing 4 wk later,aftercompletion of the treatment.The primary outcome was the H.pylori eradication rate analyzed using intentionto-treat(ITT)and per protocol(PP)analyses.The secondary outcome was the occurrence of serious adverse events.Demographic and clinical factors were analyzed using Student’s t-tests and Pearson’sχ2 tests according to first-and second-line regimens.A P value of less than 0.05 was considered statistically significant.RESULTS:The eradication rate of moxifloxacincontaining triple therapy was 68.4%(ITT;95%CI:62.8-73.5)and 73.9%(PP;95%CI:68.3-78.8).The eradication rate was significantly higher with 14 d compared to 7 d of treatment(77.5%vs 62.5%,P=0.017).Peptic ulcer patients had a higher eradication rate than the patients without ulcers(82.9%vs 70.6%,P=0.046).The demographic and clinical characteristics were not significantly different between the groups according to first-line therapies.ITT and PP analyses of the moxifloxacin-containing triple therapy indicated the following eradication rates:70.9%(95%CI:63.8-77.2)and 77.2%(95%CI:70.1-83.1)for standard triple;67.9%(95%CI:51.5-84.2)and 67.9%(95%CI:51.5-84.2)for bismuth-containing quadruple;60.4%(95%CI:46.3-73.0)and 70.7%(95%CI:54.0-80.9)for sequential;and 67.6%(95%CI:51.5-80.4)and67.6%(95%CI:51.5-80.4)for concomitant therapy.There were no statistically significant differences in the efficacy of the first-line regimens(

关键词： Fluoroquinolones helicobacter pylori Dis-ease erad

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helicobacter pylori and pregnancy-related disorders

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World Journal of Gastroenterology 2014年第3期20卷 654-664页

作者： Simona Cardaropoli Alessandro Rolfo Tullia Todros Department of Surgical Sciences University of Turin

helicobacter pylori(H.pylori)infection is investigated in gastric diseases even during pregnancy.In particular,this Gram-negative bacterium seems to be associated with hyperemesis gravidarum,a severe form of nausea and vomiting during pregnancy.During the last decade,the relationship among H.pylori and several extra-gastric diseases strongly emerged in literature.The correlation among H.pylori infection and pregnancy-related disorders was mainly focused on iron deficiency anemia,thrombocytopenia,fetal malformations,miscarriage,pre-eclampsia and fetal growth restriction.H.pylori infection may have a role in the pathogenesis of various pregnancy-related disorders through different mechanisms:depletion of micronutrients(iron and vitamin B12)in maternal anemia and fetal neural tube defects;local or systemic induction of pro-inflammatory cytokines release and oxidative stress in gastrointestinal disorders and pre-eclampsia;cross-reaction between specific anti-H.pylori antibodies and antigens localized in placental tissue and endothelial cells(preeclampsia,fetal growth restriction,miscarriage).Since H.pylori infection is most likely acquired before pregnancy,it is widely believed that hormonal and immunological changes occurring during pregnancy could activate latent H.pylori with a negative impact not only on maternal health(nutritional deficiency,organ injury,death),but also on the fetus(insufficient growth,malformation,death)and sometime consequences can be observed later in life.Another important issue addressed by investigators was to determine whether it is possible to transmit H.pylori infection from mother to child and whether maternal anti-H.pylori antibodies could prevent infant’s infection.Studies on novel diagnostic and therapeutic methods for H.pylori are no less important,since these are particularly sensitive topics in pregnancy conditions.It could be interesting to study the possible correlation between H.pylori infection and other pregnancy-related diseases of unknown etiology,such as gestational diabe

关键词： helicobacter pylori Pregnancy Hypereme-sis gravida

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Seroprevalence of helicobacter pylori infection among students of a Nigerian University

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Asian Pacific Journal of Tropical Medicine 2010年第7期3卷 584-585页

作者： Ishaleku David Ihiabe Hope A Microbiology Unit Department of Biological SciencesNasarawa State University.P.M.B.1022Keffi.Nigeria

Objective:To investigate the seroprevalence of helicobacter pylori(H.pylori) infection among the undergraduate students of Nasarawa state University,Keffi,Nigeria.Methods:A total of 200 serum samples were collected from undergraduate students of Nasarawa State University, Keffi,and 100μL of each serum was aseptically transferred to the specimen well of an H.pylori antigen kit(Clinotech USA).The 2 distinctive red lines apearing in the control and test regions of the kit after 10 minufes indicated positive reaction.Results:Of the 200 students sampled, 108(54%) were seropositive.Analysis of seroprevalence of H.pylori revealed the correlation between infection prevalence and age.The infection prevalence was 45.5%among students aged 18-20,rose to the peak of 85.7%adults aged 31-40,dropped to 66.7%among those 41-50 years old,and continuously went down to 28.6%in the 51-year-old and above populaion.There was a statistically significant difference(using Chi-square) with respects to gender,age and type of infection(symptomatic or asymptomatic seropositive infection)(P<0.0S).Conclucions: Community Health Personnel should be aware of this microorganism as a potential cause of illness in children.Furthermore,the mode of transmission and possible means of controlling the bacterial infection among students or a community is of public health concern and requires further study.

关键词： Nasarawa State University Undergraduate students Prevalence helicobacter pylori Seropositive

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helicobacter pylori:Management in 2013

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World Journal of Gastroenterology 2014年第18期20卷 5302-5307页

作者： Yesim Ozen Alahdab Cem Kalayci Department of Gastroenterology and Hepatology Fatih Sultan Mehmet Education and Research Hospital34752 IstanbulTurkey Department of Gastroenterology and Hepatology Feneryolu Mh Kadikoy34724 IstanbulTurkey

helicobacter pylori(H.pylori)is a prevalent,worldwide,chronic infection.Choice of treatment can be modified according to antibiotic-resistance rates of H.pylori.The ideal therapeutic regimen for H.pylori infection should achieve an eradication rate of≥80%.In some countries,triple therapy with a proton-pump inhibitor(PPI),clarithromycin,and amoxicillin or metronidazole is still the best option.Bismuth-containing quadruple therapy consisting of bismuth salts,tetracycline,metronidazole and PPI,may be the preferred option in countries with clarithromycin resistance>20%.Sequential therapy including a PPI and amoxicillin given for the first 5 d,followed by triple therapy including a PPI,clarithromycin,and nitroimidazole antimicrobial(all twice daily)for the remaining 5 d,can be another option for the first-line treatment of H.pylori.Recent data suggest that treatment with PPI,levofloxacin,and amoxicillin for 10 d is a good choice for second-line therapy.Concomitant therapy consisting of PPI,amoxicillin,clarithromycin and metronidazole is another option for second-line treatment.If second-line treatment also fails,it is recommended to culture H.pylori from biopsy specimens and perform antimicrobial susceptibility testing.Rescue treatment should be based on antimicrobial susceptibility.

关键词： helicobacter pylori First-line therapy Second-line

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helicobacter pylori and gastric mucin expression: A systematic review and meta-analysis

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World Journal of Gastroenterology 2015年第31期21卷 9430-9436页

作者： Yaron Niv Department of Gastroenterology Rabin MedicalCenterTel Aviv University

AIM: To investigate the relationship between helicobacter pylori(H. pylori) and mucin expression in gastric mucosa.METHODS: English Medical literature searches were conducted for gastric mucin expression in H. pylori infected people vs uninfected people. Searches wereperformed up to December 31 th 2014,using MEDLINE,Pub Med,EMBASE,Scopus,and CENTRAL. Studies comparing mucin expression in the gastric mucosa in patients positive and negative for H. pylori infection,were included. Meta-analysis was performed by using Comprehensive meta-analysis software(Version 3,Biostat Inc.,Englewood,NJ,United States). Pooled odds ratios(ORs) and 95% confidence intervals(CIs) were calculated compared mucin expression in individual studies by using the random effects model. Heterogeneity between studies was evaluated using the Cochran Q-test,and it was considered to be present if the Q-test P value was less than 0.10. I2 statistic was used to measure the proportion of inconsistency in individual studies,with I2 > 50% representing substantial heterogeneity. We also calculated a potential publication bias.RESULTS: Eleven studies,which represent 53 substudies of 15 different kinds of mucin expression,were selected according to the inclusion criteria. Every kind of mucin has been considered as one study. When a specific mucin has been studied in more than one paper,we combined the results in a nested metaanalysis of this particular mucin: MUC2,MUC6,STn,Paradoxical con A,Tn,T,Type 1 chain mucin,Le A,SLe A,Le B,AB-PAS,MUC1,and MUC5 AC. The odds ratio of mucin expression in random analysis was 2.33,95%CI: 1.230-4.411,P = 0.009,higher expression in H. pylori infected patients. Odds ratio for mucin expression in H. pylori positive patients was higher for MUC6(9.244,95%CI: 1.567-54.515,P = 0.014),and significantly lower for MUC5AC(0.447,95%CI: 0.211-0.949,P = 0.036). Thus,H. pylori infection may increase MUC6 expression and decrease MUC5 AC expression by 924% and 52%,respectively.CONCLUSION: H. pylori inhibits MUC5 AC expression in the gastr

关键词： helicobacter pylori Gastric mucin Stomach Secretio

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helicobacter pylori gamma-glutamyl transpeptidase and its pathogenic role

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World Journal of Gastroenterology 2014年第3期20卷 630-638页

作者： Vittorio Ricci Maria Giannouli Marco Romano Raffaele Zarrilli Department of Molecular Medicine Human Physiology SectionUniversity of Pavia Medical School Department of Public Health Hygiene SectionUniversity of Naples "Federico Ⅱ" Department of Clinical and Experimental Medicine Chair of GastroenterologySecond University of Naples CEINGE Biotecnologie Avanzate

helicobacter pylori(H.pylori)gamma-glutamyl transpeptidase(GGT)is a bacterial virulence factor that converts glutamine into glutamate and ammonia,and converts glutathione into glutamate and cysteinylglycine.H.pylori GGT causes glutamine and glutathione consumption in the host cells,ammonia production and reactive oxygen species generation.These products induce cell-cycle arrest,apoptosis,and necrosis in gastric epithelial cells.H.pylori GGT may also inhibit apoptosis and induce gastric epithelial cell proliferation through the induction of cyclooxygenase-2,epidermal growth factor-related peptides,inducible nitric oxide synthase and interleukin-8.H.pylori GGT induces immune tolerance through the inhibition of T cell-mediated immunity and dendritic cell differentiation.The effect of GGT on H.pylori colonization and gastric persistence are also discussed.

关键词： helicobacter pylori Gamma-glutamyl transpeptidase

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helicobacter pylori-negative,non-steroidal anti-inflammatory drug:Negative idiopathic ulcers in Asia

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World Journal of Gastroenterology 2014年第3期20卷 706-713页

作者： Katsunori Iijima Takeshi Kanno Tomoyuki Koike Tooru Shimosegawa Division of Gastroenterology Tohoku University Graduate School of Medicine

Since the discovery of helicobacter pylori(H.pylori)infection in the stomach,the bacteria infection and non-steroidal anti-inflammatory drugs(NSAIDs)use had been considered to be the 2 main causes of peptic ulcers.However,there have been recent reports of an increase in the proportion of peptic ulcers without these known risk factors;these are termed idiopathic peptic ulcers.Such trend was firstly indicated in 1990s from some reports in North America.In Asia,numerous studies reported that idiopathic ulcers accounted for a small percentage of all ulcers in the 1990s,but in the2000s,multiple studies reported that the proportion of idiopathic ulcers had reached 10%-30%,indicating that the incidence of idiopathic ulcers in Asia has also been rising in recent years.While a decline in H.pylori infection rates of general population in Asia is seen as the main reason for the increased incidence of idiopathic ulcers,it is also possible that the absolute number of idiopathic ulcer cases has increased.Advanced age,serious systemic complication,and psychological stress are considered to be the potential risk factors for idiopathic ulcers.Management of idiopathic ulcers is challenging,at present,because there is no effective preventative measure against recurrence in contrast with cases of H.pylori-positive ulcers and NSAIDs-induced ulcers.As it is expected that H.pylori infection rates in Asia will decline further in the future,measures to treat idiopathic ulcers will also likely become more important.

关键词： helicobacter pylori Non-steroidal antiinflammatory

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