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Currently, the list of microorganisms that have a possible connection with the development of rheumatoid arthritis continues to be updated. The role of not only traditional pathogens, but also representatives of conditionally pathogenic microflora is being actively studied. A number of domestic and foreign works demonstrate a high degree of Helicobacter pylori infection in patients with rheumatic diseases, including rheumatoid arthritis.The aim of the present study is to identify the frequency of detection of Helicobacter pylori infection in patients with rheumatoid arthritis and in adult residents of the city of Tula.Material and methods. The study included 3288 residents of Tula who do not have rheumatic diseases, and 119 patients with rheumatoid arthritis. To detect the infection, FEGDS was performed according to the generally accepted method with the taking of biopsies of the mucous membrane of the antrum and the stomach body, followed by verification of Helicobacter pylori using the Helpil-test test system.Results. According to the results of the data on the infection rate of residents of Tula without rheumatic diseases (n=3288), the largest percentage of infected (78.8%) was detected by an invasive method – express diagnosis of urease activity of the biopsy. The detection rate using a respiratory ammonia test and serological method was lower and amounted to 51.1 and 49.3%, respectively. In total, H. pylori was detected in 1692 people, which was 51.46%. Among patients with rheumatoid arthritis, Helicobacter pylori infection was 81.5%. Signs of damage to the mucous membrane of the upper gastrointestinal tract were often detected: superficial and subatrophic gastritis, single erosions.Conclusions. 1. Based on the study, it was found that the infection rate of Helicobacter pylori in patients with rheumatoid arthritis is at a fairly high level, not significantly different from that in residents without rheumatic diseases, when examined by an invasive method – express diagnosis of urease activity of the biopsy (81.5% and 78.8%, respectively). 2. Among patients with rheumatoid arthritis, there was a tendency to increase the frequency of infection with age and peak values in older age groups (r=0.37; p˂ 0.05). 3. The frequency of detection of erosive and ulcerative lesions of the gastrointestinal tract in infected and uninfected Helicobacter pylori patients with rheumatoid arthritis significantly differed (42.2 and 13.6%) (p=0.03).

Dyspepsia still becomes a major challenge in upper gastrointestinal disease in Indonesia. This disease often correlated with Helicobacter pylori infection. However, the prevalence of this bacterium is generally low in Indonesia. Therefore, several considerations should be taken into consideration during the management of dyspepsia and H. pylori infection. "Management of dyspepsia and H. pylori infection in Indonesia: The Indonesian consensus report" comprises information gathered from 22 gastroenterology centers across Indonesia. The experts gathered to evolve a consensus, that consists of the statements, grades of recommendations, evidence levels, and rationales for the dyspepsia and H. pylori infection management for daily clinical practice. The report explains several aspects from the updated epidemiology information to comprehensive management therapy. After the experts worked together on all statements in the recommendations, the results are presented with the final agreement as a consensus to help clinicians in understanding, diagnosing, and treating dyspepsia and H. pylori infection patients in daily clinical practice in Indonesia. [ABSTRACT FROM AUTHOR]

The relief from clinical symptoms of Helicobacter pylori infection caused by Lactobacillus acidophilus treatment was analyzed by a 13C-urea breath test. To this end, 200 patients diagnosed with Helicobacter pylori infection were divided into two equal groups of 100 patients, designated as the control and study groups, respectively. The control group received conventional quadruple therapy that included enteric-coated esomeprazole magnesium tablets, amoxicillin, clarithromycin, and colloidal pectin bismuth for 2 weeks. The study group, in addition to the conventional quadruple therapy, received Lactobacillus acidophilus tablets orally for 2 weeks. The Helicobacter pylori eradication rate (P < 0.05) and total effective rate (P < 0.05) of the study group were higher than the control group. The incidence of adverse reactions including acid reflux, upper abdominal pain, abdominal fullness, and vomiting in the study group was lower (P < 0.05) than the control group. There was no statistically significant difference (P > 0.05) in the levels of tumor nuclear factor-a, high sensitivity C-reaction protein, and interlukin-6 between two groups before treatment. However, the level of these indicators in the study group after treatment was lower than that in the control group. Similarly, there was no statistically significant difference in CD3+, CD4+, CD8+, or CD4+/CD8+ between the two groups before treatment. However, the level of CD3+, CD4+, and CD4+/CD8+ after treatment was significantly higher, while CD8+ was significantly lower in the study group. In conclusion, Lactobacillus acidophilus treatment exhibits a high eradication rate of Helicobacter pylori with good safety and relief from Helicobacter pylori-associated clinical symptoms. [ABSTRACT FROM AUTHOR]

Introduction: High-dose dual therapy (HDDT) can attain acceptable eradication rates provided that the optimal doses, timing and treatment duration are applied. The existing evidence still shows inconsistent reports (< 90%) on HDDT therapy except in some Asian countries. We aimed to assess and compare the efficacy of 14-day HDDT by comparing it to 14-day rabeprazole-containing hybrid therapy (HT) and to investigate the host and bacterial factors predicting the treatment outcomes of eradication therapies. Methods: In this open-label, randomized controlled trial, we recruited 243 naïve Helicobacter pylori-infected patients from September 1, 2018, to November 30, 2021. They were randomly allocated (1:1) to the HDDT group (rabeprazole 20 mg and amoxicillin 750 mg q.i.d for 14 days, n = 122) and the HT group (rabeprazole 20 mg and amoxicillin 1 g b.i.d. for 7 days, followed by rabeprazole 20 mg, amoxicillin 1 g, clarithromycin 500 mg and metronidazole 500 mg b.i.d. for 7 days, n = 121). Twelve patients were absent during follow-up in the HDDT group and 4 in the HT group, resulting in 110 for the HDDT group and 117 for HT group in the per protocol (PP) study. The outcome was determined by urea breath tests 8 weeks later. Results: The eradication rates for the HDDT and HT groups were 77.0% (95% confidence interval [CI]: 68.5% to 84.1%) and 94.2% (95% CI: 88.4% to 97.6%) (P < 0.001) in intention-to-treat analysis; 85.5% (95% CI: 77.5% to 91.5%) and 97.4% [95% CI: 92.6% to 99.5%] (P = 0.001) in per protocol analysis. The adverse event rates were 7.3% in the HDDT group and 14.5% in the HT group (P = 0.081). The habit of coffee drinking was the dependent factor for eradication failure in the HDDT group (88.2% vs. 68.8%, P = 0.040), but had no influence in the HT group (97.9% versus 95.0%, P = 0.449) in the univariate analysis. Conclusion: This study demonstrated that 14-day rabeprazole-containing HDDT did not achieve > 90% eradication rates for first-line H. pylori eradication as 14-day rabeprazole-containing HT did. HDDT is a potentially beneficial combination, which involves only two drugs with mild adverse effects; more precise studies are urged to find answers regarding these failures. This clinical trial was registered retrospectively on 28 November, 2021, as ClinicalTrials.gov identifier: NCT05152004. [ABSTRACT FROM AUTHOR]

Background: The treatment of Helicobacter pylori (H. pylori) infection is a challenge for those who cannot use amoxicillin. Objective: To evaluate the eradication rate and adverse effects of vonoprazan and tetracycline dual therapy as first‐line and rescue treatment regimens used in special populations with penicillin allergy or failed in previous amoxicillin‐containing therapies. Design: Patients enrolled were those who were H. pylori‐positive with selected conditions: (1) allergic to penicillin, either naïve to treatment or had failed before; or (2) failed in previous amoxicillin‐containing therapies. All enrolled patients accepted 14‐day vonoprazan and tetracycline dual therapy (VT dual therapy) as follows: vonoprazan (20 mg b.i.d.) and tetracycline (500 mg t.i.d. [body weight < 70 kg] or 500 mg q.i.d. [body weight ≥ 70 kg]). H. pylori status was evaluated by 13C‐urease breath test 6 weeks after treatment. All adverse effects were recorded. Some patients underwent bacterial culture and antibiotic susceptibility testing. Results: A total of 62 patients were enrolled; 18 of them received VT dual therapy as first‐line treatment, 44 patients received VT dual therapy as rescue treatment. Overall, 58 of 62 patients achieved successful eradication (93.5%), while all involved (100%,18/18) succeeded in the first‐line treatment group and 40 cases (90.9%, 40/44) succeeded in the rescue treatment group. Sixty‐one (61/62, 98.4%) patients completed the whole course of treatment. Adverse events occurred in 6 patients (6/62, 9.7%), while one patient quit because of skin rash. All adverse effects were mild and relieved spontaneously after H. pylori treatment. Five patients achieved successful H. pylori culture, and all strains isolated were sensitive to tetracycline. Conclusions: For the treatment of H. pylori infection in special populations with penicillin allergy or failed in previous amoxicillin‐containing therapies, a 14‐day vonoprazan and tetracycline dual therapy was effective and safe as first‐line and rescue treatment in our study. Further study is warranted to verify its efficacy, especially for those who cannot use amoxicillin. [ABSTRACT FROM AUTHOR]

In adults with immune thrombocytopenic purpura (ITP), the identification of H. pylori infection and its subsequent eradication proved to aid platelet recovery. Similar findings, at a smaller scale, were allegedly reported by some pediatric studies. This review’s objective was to establish the influence of H. pylori infection and its eradication upon platelet count and recovery in pediatric ITP. Three databases, namely Pubmed, Scopus and Web of Science, were searched for pediatric studies which investigated a link between H. pylori infection and thrombocytopenia. The search results retrieved a number of 21 articles which complied to the inclusion and exclusion criteria. Some studies report lower platelet values among children with ITP and documented H. pylori infection, as well as an improve in platelet numbers after H. pylori treatment. However, results are controversial, as multiple authors failed to identify a higher prevalence of H. pylori among children with ITP or a lack of significant change in therapeutic outcome with the addition of an eradication regimen to standard treatment. The main limitations of current pediatric studies remain the small study samples and the short follow-up periods of the included subjects. Hence, the long-term impact of H. pylori in children with ITP is still uncertain.

BackgroundHelicobacter pylori (HP) is a major cause of upper digestive tract diseases. However, the relationship between HP infection and 25-hydroxyvitamin D [25(OH)D] levels in children has not been fully elucidated. This study investigated the levels of 25(OH)D in children of different ages and with varying degrees of HP infection and immunological features as well as the correlations between 25(OH)D levels in children infected with HP and their ages and degrees of infection.Materials and methodsNinety-four children who underwent upper digestive endoscopy were divided into an HP-positive group without peptic ulcers (Group A), an HP-positive group with peptic ulcers (Group B) and an HP-negative control group (Group C). The serum levels of 25(OH)D and immunoglobulin and the percentages of lymphocyte subsets were determined. HP colonization, the degree of inflammation, and the degree of activity were further evaluated by HE staining and immunohistochemical staining in gastric mucosal biopsy.ResultsThe 25(OH)D level of the HP-positive groups (50.93 ± 16.51 nmol/L) was significantly lower than that of the HP-negative group (62.89 ± 19.18 nmol/L). The 25(OH)D level of Group B (47.79 ± 14.79 nmol/L) was lower than that of Group A (51.53 ± 17.05 nmol/L) and was significantly lower than that of Group C (62.89 ± 19.18 nmol/L). The 25(OH)D level decreased with increasing age, and there was a significant difference between Group C subjects who were ≤5 years old and those who were aged 6–9 years and ≥10 years. The 25(OH)D level was negatively correlated with HP colonization (r = −0.411, P

Humans always mount a robust immune response to the bacterial infection caused by Helicobacter pylori, which causes various gastrointestinal tract infections. Calprotectin (CALP) and B-Cell Activating Factor (BAFF) are inflammatory biomarkers having a role in the gastrointestinal neutrophilic response to bacterial infection. The study was designed to assess serum CALP and BAFF as inflammatory biomarkers in H. pylori infection and peptic ulcer patients. The current study comprised 112 people, including 62 H. pylori-infected patients (34 men and 28 women) who were clinically diagnosed with H. pylori infection via testing positive for the H. pylori stool antigen test; they were compared to a control group of 50 healthy people (34 men and 16 women) who were age and gender-matched to H. pylori-infected patients. The serum level of CALP and BAFF were assayed using the ELISA technique. The biochemical parameters were statistically compared between patients and controls by unpaired Man-Whitney U t-test and Receiver Operating Characteristic (ROC) curve analysis. There was a significant elevation of serum CALP in H. pylori-infected patients [116.4(120.7), p=0.0132] in comparison to healthy controls [99.50(115.8)]. Similarly, there was a significant elevation of serum BAFF concentration in H. pylori-infected patients [485.7(367.1), p=0.0014] in comparison to healthy controls [444.5(513.0)]. The ROC curve analysis suggests serum CALP and BAFF as reasonable inflammatory biomarkers for H. pylori infection with statistically significant (p=0.0135, p=0.0015) area under the ROC curve of (0.6361, 0.6748), respectively. CALP and BAFF are potent inflammatory biomarkers involved in the development and etiology of H. pylori infection. Serum CALP and BAFF levels could be used as biomarkers for chronic inflammation induced by H. pylori. CALP and BAFF biomarkers can be combined to diagnose and predict the prognosis of H. pylori infection.

Interleukins (IL) expressed in response to Helicobacter pylori (Hp) infection are involved in the destruction of gastric mucosa and might participate in the formation of polyps made of inflammatory cells. In this study, we aimed to understand the pathogenesis of proliferative polyps in patients with gastric cancer. In particular, we investigated the correlation between the expression levels of IL-6, IL-8, and tumor necrosis factor alpha (TNF-a) in the serum and the development of gastric polyps in the context of Hp infection. The serum levels of IL-4, IL-6, and TNF-a were reduced in gastric cancer patients after polypectomy compared to healthy control subjects. Fatty acids application after polypectomy improved the levels of anti-inflammatory factors in the serum of patients as reduced amounts of the pro-inflammatory factors IL-6 and TNF-a were detected. Fatty acids administration constitutes a promising therapy to explore in the relief of postoperative pain and consequently in the improvement of gastric cancer patient rehabilitation. [ABSTRACT FROM AUTHOR]

Endoscopic assessment of Helicobacter pylori infection is a simple and effective method. Here, we aimed to develop a deep learning-based system named Intelligent Detection Endoscopic Assistant-Helicobacter pylori (IDEA-HP) to assess H. pylori infection by using endoscopic videos in real time. Endoscopic data were retrospectively obtained from Zhejiang Cancer Hospital (ZJCH) for the development, validation, and testing of the system. Stored videos from ZJCH were used for assessing and comparing the performance of IDEA-HP with that of endoscopists. Prospective consecutive patients undergoing esophagogastroduodenoscopy were enrolled to assess the applicability of clinical practice. The urea breath test was used as the gold standard for diagnosing H. pylori infection. In 100 videos, IDEA-HP achieved a similar overall accuracy of assessing H. pylori infection to that of experts (84.0% vs. 83.6% [ P = 0.729]). Nevertheless, the diagnostic accuracy (84.0% vs. 74.0% [ P <0.001]) and sensitivity (82.0% vs. 67.2% [ P <0.001]) of IDEA-HP were significantly higher than those of the beginners. In 191 prospective consecutive patients, IDEA-HP achieved accuracy, sensitivity, and specificity of 85.3% (95% CI: 79.0%–89.3%), 83.3% (95% CI: 72.8%–90.5%), and 85.8% (95% CI: 77.7%–91.4%), respectively. Our results show that IDEA-HP has great potential for assisting endoscopists in assessing H. pylori infection status during actual clinical work. [ABSTRACT FROM AUTHOR]

Helicobacter pylori is one of the most common chronic bacterial infections in humans and responsible for 90% of duodenal ulcers and 70–90% of gastric ulcers. Despite this, many misconceptions regarding the appropriate diagnostic method and treatment strategies still exist in the Malaysian clinical practice. Under the initiative of the steering committee, an expert panel consisting of nine key opinion leaders in the field of gastroenterology convened to develop a set of consensus statements that are relevant to the Malaysian healthcare practice. The panel members reviewed the current evidence on the management of H. pylori infection, focusing on the best practices that are relevant to the Malaysian population based on clinical experience and published clinical evidence. Using the modified Delphi method, the panel achieved consensus in three areas of H. pylori infection management: indications for testing, diagnosis, and treatment. The panel proposed a set of 19 consensus statements, which were synthesized via two rounds of blinded voting and group discussions. The recommendations provided are relevant to the Malaysian population and can be used as a guide by physicians across various healthcare settings to facilitate appropriate diagnostic testing and treatment of H. pylori infection. [ABSTRACT FROM AUTHOR]

Abstract Background and Aim There have been contradictory reports about the association between Helicobacter pylori infection and iron deficiency anemia (IDA). Based on the high frequency of H. pylori infection in Cameroon, we have evaluated the frequency of H. pylori infection as the cause of anemia, and IDA among dyspeptic patients in Cameroon. Methods This cross‐sectional study enrolled 842 dyspeptic patients (472 women and 370 men) in two reference hospitals in Douala‐Cameroon. Each participant gave a written consent, and the study was approved by the National Ethical Committee. Erythroid‐related indices and markers of iron deficiency (ID) measurement were done for each participant as well as H. pylori detection. Data were analyzed using SSPS statistical package. Results The prevalence of anemia, ID, IDA, and H. pylori infection was 65.08%, 31.47%, 25.65%, and 80.88%, respectively. H. pylori infected individuals had a significantly lower mean value of hemoglobin (P = 0.01), hematocrit (P = 0.04), ferritin (P = 0.03) and coefficient of transferrin saturation (CTS) levels (P = 0.04) and a significantly higher mean value of mean corpuscular hemoglobin concentration (MCHC) (P = 0.02). Compared with H. pylori non‐infected participants, H. pylori infected patients were 1.2938 (95% confidence interval [CI]: 0.9087–1.8421), 1.1851 (95% CI: 0.8122–1.7292), and 1.5636 (95% CI: 1.0206–2.3953) times at higher risk to develop anemia, ID, and IDA, respectively. A significant relationship was found between H. pylori infection and IDA (P = 0.04 and 0.04 for crude and age/sex‐adjusted, respectively). Conclusion H. pylori infection seems to be associated with anemia, and IDA among dyspeptic patients in our milieu.

Objective: This study aimed at examining the alterations in metabolomic profiles caused by treatment of H. pylori infection, and the associations between key plasma metabolites and the risk of gastric lesion progression during follow-up after treatment. Methods: An intervention trial was performed in 183 participants, 117 of whom were H. pylori positive participants receiving treatment for H. pylori infection. H. pylori positive participants were prospectively followed for 182 to 1,289 days. Untargeted metabolomics assays were conducted on plasma samples collected at baseline, 6 months after treatment, and during continued follow-up. Results: We identified 59 metabolites with differential posttreatment changes between participants with successful and failed H. pylori eradication, 17 metabolites significantly distinguished participants with successful vs. failed eradication. Two metabolites [PC(18:1(11Z)/14:1(9Z)) and (2S)-6-amino-2-formamidohexanamide] showed posttreatment changes positively associated with successful H. pylori eradication, and were inversely associated with the risk of gastric lesion progression among participants with successful eradication. In contrast, 9-decenoic acid showed posttreatment changes inversely associated with successful eradication: its level was positively associated with the risk of gastric lesion progression among participants with successful eradication. Although the identified metabolites showed a temporary but significant decline after treatment, the trend generally reversed during continued follow-up, and pretreatment levels were restored. Conclusions: Treatment of H. pylori infection significantly altered plasma metabolic profiles in the short term, and key metabolites were capable of distinguishing participants with successful vs. failed eradication, but might not substantially affect metabolic regulation in the long term. Several plasma metabolites were differentially associated with the risk of gastric lesion progression among participants with successful or failed eradication.

Helicobacter pylori infection is a prevalent infectious disease, associated with many gastric diseases, including gastritis, gastric ulcer, and gastric cancer. To reveal the characteristics of the gastric microbiome in patients infected with H. pylori, we performed metagenomic shotgun sequencing of stomach swab samples from 96 patients and then conducted metagenomic association analyses between alterations in the gastric microbiome and H. pylori infection status. The overall composition of the gastric microbiota in H. pylori‐infected individuals was distinctly different from the negative controls; H. pylori became the dominant species after colonizing the human stomach and significantly decreased the α‐diversity of the gastric community (P 0.05, Wilcoxon rank‐sum test). This study revealed alterations in gastric microbial taxa and function associated with HPI in the Chinese population, which provides an insight into gastric microbial interactions and their potential role in the pathological process of gastric diseases.

Gastric cancer is strongly associated with atrophic gastritis associated with Helicobacter pylori infection. The eradication of H. pylori has been reported to improve inflammation of the gastric mucosa, atrophy, and intestinal metaplasia and has also been shown to inhibit the development and growth of gastric cancer. Advanced gastric cancer from H. pylori-negative mucosa without inflammation, atrophy, or intestinal epithelialization is rarely found. We report on two cases of advanced gastric cancer without endoscopic evidence of gastric mucosal atrophy. One case was in the gastric angle 9 years after H. pylori eradication and the other case was in the pylorus of an uninfected stomach. Although gastric cancer is strongly associated with atrophic gastritis caused by H. pylori infection, postoperative histopathological examination of the stomach in both cases showed no inflammation, atrophy, or intestinal metaplasia. Poorly differentiated adenocarcinomas were confirmed at the microscopic level, and both cases were determined to be type 4 using the Borrmann classification. There is a body of evidence showing that H. pylori infection can cause gastric cancer and is the most prevalent infection-induced cancer in the world. The 2 cases here displayed different carcinogenesis than gastric mucosal atrophy caused by H. pylori infection. With the spread of H. pylori eradication treatments and an increasing number of uninfected patients, these case reports can contribute to future strategies for the diagnosis of gastric cancer.

Yumei Wu,1 Hui Zeng,2 Meiping Zhang,1 Chunyan Li,2 Yuanlin Tang,2 Xiufen Li,1 Shanyou Yuan,3 Qifeng Wei,3 Jinghua Wang,4 Xianjia Ning,4 Xiaoyin Zhang1 1Department of Gastroenterology, the Third People’s Hospital of Shenzhen, Shenzhen, Guangdong Province, People’s Republic of China; 2Department of Health Management, the Third People’s Hospital of Shenzhen, Shenzhen, Guangdong Province, People’s Republic of China; 3Department of Orthopedics, the Third People’s Hospital of Shenzhen, Shenzhen, Guangdong Province, People’s Republic of China; 4Centre of Clinical Epidemiology, the Third People’s Hospital of Shenzhen, Shenzhen, Guangdong Province, People’s Republic of ChinaCorrespondence: Xiaoyin Zhang, Department of Gastroenterology, the Third People’s Hospital of Shenzhen, 29 Bulan Road, Longgang District, Shenzhen, Guangdong Province, 518112, People’s Republic of China, Tel +86-755-61222333, Fax +86-755-61238928, Email xhnk_01@163.com Xianjia Ning, Center of Clinical Epidemiology, the Third People’s Hospital of Shenzhen, 29 Bulan Road, Longgang District, Shenzhen, Guangdong Province, 518112, People’s Republic of China, Tel +86-755-61222333, Fax +86-755-61238928, Email xning@tmu.edu.cnPurpose: Helicobacter pylori is one of the most common causes of peptic ulcers, gastritis, and gastric cancers. This study investigated sex-specific differences in the prevalence of H. pylori infection and its associated factors among individuals undergoing hospital-based health examinations in southern China.Methods: This study enrolled consecutive healthy individuals who underwent regular health examinations at a hospital physical examination center between September 2020 and September 2021. Anthropometric characteristics and biochemical profiles were measured. All individuals underwent carbon-13 urea breath tests. Univariate and multivariate analyses were used to evaluate the factors associated with H. pylori infection.Results: A total of 5035 individuals (men, 59.1%; women, 40.9%) were included in the analyses. The total rate of H. pylori infection was 35.0% (men, 35.5%; women, 34.3%). In the multivariate analysis, the risk factors identified for H. pylori infections were high fasting blood glucose levels and blood pressure ≥ 160 mmHg in men and older age, high body mass index, and low albumin levels in women.Conclusion: These findings suggest that physicians must be aware of the metabolic factors associated with H. pylori infections in the Chinese population. Early detection of these factors and timely intervention are expected to reduce H. pylori infections and provide a theoretical basis for the primary prevention of several gastrointestinal diseases.Keywords: Helicobacter pylori infection, gastrointestinal disease, sex differences, prevalence, metabolic factors

Background: Various ways of treating H.pylori infection are reported, such as triple-therapy and quadruple therapy for two weeks. Some side effects have been seen during these treatments, besides Helicobacter pylori becoming resistant to these antibiotics easily. According to some studies, there is a relationship between metformin and reduction in Helicobacter pylori infection. Thus, in this study, we determine the effects of metformin on Helicobacter pylori infection. Methods: We performed this assessment in a randomized, case-controlled way in the diagnosis of Helicobacter pylori infected outpatients and inpatients. In both groups (case group and control group), patients took two tablets for a two-week period. In the case group, the patients were given two metformin tablets (each containing 500mg of metformin (extended release) and in the control group, they were given two placebo tablets (each containing 500mg of white flour). We took h.pylori Ag stool test and rapid urease test to confirm the presence of Helicobacter pylori infection. Results: In this study, at first all the patients had positive h.pylori Ag stool test or positive rapid urease test. At the end of this study, the results of h.pylori Ag stool*- test presented that Helicobacter pylori infection was negative in 82.7% of the case group patients and 76% of control group patients which illustrates suppression of Helicobacter pylori infection. However, comparing to the control group (P=0.36), this difference was not statistically remarkable. Conclusion: According to these findings, it is stated that having metformin along with prescribed antibiotics can help decrease Helicobacter pylori infection.

Background: Iron deficiency anemia (IDA) can result from both physiological and pathological events, the etiology of underlying IDA should be determined. Helicobacter pylori infection in children has mostly been associated with recurrent abdominal pain, gastric dyspepsia, or duodenal-ulcer. Other extra-digestive tract conditions such as iron deficiency or IDA have been recently related to the H. pylori infection. Aims and Objectives: To find out the prevalence of H. pylori infection in children aged 2–18 years with IDA in a tertiary care hospital. Materials and Methods: Across-sectional observational study was carried out in the Department of Paediatrics, Dr. S.N. Medical College, Jodhpur for a period of 1 year. A total of 52 children aged between 2 and 18 years with anemia (as per the WHO criteria of anemia) were evaluated for complete blood count, peripheral blood film and serum ferritin, serum iron, total iron-binding capacity (TIBC), Upper gastrointestinal endoscopy and two biopsy specimen evaluated for H. pylori and histopathological changes. Normally distributed data means were compared using student’s t-test unpaired and paired. Proportions were compared using Chi-square or Fisher’s exact test. Results: The prevalence of H. pylori in our study population was 32.69%. In children with H. pylori infection mean S.iron was 25.78±10.24 μg/dl, mean S.TIBC 544.66±91.68 μg/dl, and mean S.ferritin was 6.07±3.00 μg/dl. There was statistically significant difference in serum iron, S.TIBC and S.ferritin between children having H. pylori infection and without H. pylori infection(P

Little is known about the role of chronic gastritis on weight loss after laparoscopic sleeve gastrectomy (LSG). This study aims to investigate the relationship between histopathologic findings of gastric specimens, excess weight loss (% EWL), and excess BMI loss (% EBL) at 6 and 12 months follow up after LSG. We retrospectively reviewed the clinical records of 95 patients who had undergone LSG between January 2017 and December 2019. Based on the histopathological findings of gastric resection specimens, patients were divided into those with chronic gastritis (CG) and those without chronic gastritis (NoCG) and compared for their % EWL and % EBL at 6 and 12 months. The mean BMI was 44.74 kg/m2 in the CG group and 44.14 kg/m2 in the NoCG group. At 6 months follow up, the CG group had a mean % EWL of 45.7 and % EBL of 40.5, while NoCG had a mean % EWL of 51.1 and % EBL of 46.7. After 1-year follow-up, the CG group had a mean % EWL of 53.1 and a % EBL of 44.8, while the NoCG group had a % EWL of 54.1 and % EBL of 44. This observational study does not support the hypothesis that the occurrence of chronic gastritis can affect postoperative % EWL and % EBL.

Background: The role of preoperative upper gastrointestinal endoscopy before bariatric surgery is still debated, and a consensus among the international scientific community is lacking. The aims of this study, conducted in three different geographic areas, were to analyze data regarding the pathological endoscopic findings and report their impact on the decision-making process and surgical management, in terms of delay in surgical operation, modification of the intended bariatric procedure, or contraindication to surgery. Methods: This is a multicenter cross-sectional study using data obtained from three prospective databases. The preoperative endoscopic reports, patient demographics, Body Mass Index, type of surgery, and Helicobacter pylori status were collected. Endoscopic findings were categorized into four groups: (1) normal endoscopy, (2) abnormal findings not requiring a change in the surgical approach, (3) clinically important lesions that required a change in surgical management or further investigations or therapy prior to surgery, and (4) findings that contraindicated surgery. Results: Between 2006 and 2020, data on 643 patients were analyzed. In all of the enrolled bariatric institutions, preoperative endoscopy was performed routinely. A total of 76.2% patients had normal and/or abnormal findings that did not required a change in surgical management; in 23.8% cases a change or a delay in surgical approach occurred. Helicobacter pylori infection was detected in 15.2% patients. No patient had an endoscopic finding contraindicating surgery. Conclusions: The role of preoperative UGE is to identify a wide range of pathological findings in patients with obesity that could influence the therapeutic approach, including the choice of the proper bariatric procedure. Considering the anatomical modifications, the incidence of asymptomatic pathologies, and the risk of malignancy, we support the decision of performing preoperative endoscopy for all patients eligible for bariatric operation. [ABSTRACT FROM AUTHOR]

Background: Earlier studies have shown that a modified low-dose bismuth quadruple therapy given for 10 to 14 days is highly effective for the treatment of Helicobacter pylori infection in Sardinia. However, bismuth is not universally available. Aim: We aimed to investigate the efficacy of a simplified low-dose 10-day quadruple therapy containing a galenic formulation of bismuth salicylate for H. pylori infection. Patients and Methods: Adult patients positive for H. pylori infection were assigned to a quadruple therapy containing a galenic formulation of bismuth salicylate (200 mg) plus tetracycline 500 mg, metronidazole 500 mg and rabeprazole 20 mg, given twice a day with the midday and evening meals for 10 days. A negative stool antigen test or 13C-Urea Breath Test defined successful eradication. Compliance and adverse events were recorded 30–40 days after the end of treatment. Results: In this open-label pilot study, 42 patients were enrolled (mean age 54.1 ± 12.0 years; 64% female). Among the study participants, 35 were naïve to H. pylori treatment. The treatment regimen was completed by 41 patients, with an overall success rate of 95.1%. More specifically, the eradication rate was 95.1% PP; 95% confidence interval (CI) = 86.6–100 and 92.9% by ITT; 95%CI = 85.1–100%, respectively. For naïve patients, the cure rate was 97.1%. Compliance was excellent. Side effects were absent or mild overall. Conclusions: The modified low-dose 10-day quadruple therapy provided high eradication rates of H. pylori infection, despite the replacement of colloidal bismuth subcitrate with bismuth salicylate. In regions where bismuth is unavailable in the market, the galenic formulation should be a valid option. [ABSTRACT FROM AUTHOR]

Humans always mount a robust immune response to the bacterial infection caused by Helicobacter pylori, which causes various gastrointestinal tract infections. Calprotectin (CALP) and B-Cell Activating Factor (BAFF) are inflammatory biomarkers having a role in the gastrointestinal neutrophilic response to bacterial infection. The study was designed to assess serum CALP and BAFF as inflammatory biomarkers in H. pylori infection and peptic ulcer patients. The current study comprised 112 people, including 62 H. pylori-infected patients (34 men and 28 women) who were clinically diagnosed with H. pylori infection via testing positive for the H. pylori stool antigen test; they were compared to a control group of 50 healthy people (34 men and 16 women) who were age and gender-matched to H. pylori-infected patients. The serum level of CALP and BAFF were assayed using the ELISA technique. The biochemical parameters were statistically compared between patients and controls by unpaired Man-Whitney U t-test and Receiver Operating Characteristic (ROC) curve analysis. There was a significant elevation of serum CALP in H. pylori-infected patients [116.4(120.7), p=0.0132] in comparison to healthy controls [99.50(115.8)]. Similarly, there was a significant elevation of serum BAFF concentration in H. pylori-infected patients [485.7(367.1), p=0.0014] in comparison to healthy controls [444.5(513.0)]. The ROC curve analysis suggests serum CALP and BAFF as reasonable inflammatory biomarkers for H. pylori infection with statistically significant (p=0.0135, p=0.0015) area under the ROC curve of (0.6361, 0.6748), respectively. CALP and BAFF are potent inflammatory biomarkers involved in the development and etiology of H. pylori infection. Serum CALP and BAFF levels could be used as biomarkers for chronic inflammation induced by H. pylori. CALP and BAFF biomarkers can be combined to diagnose and predict the prognosis of H. pylori infection. [ABSTRACT FROM AUTHOR]

Objectives: Helicobacter pylori (H. pylori) and cardiovascular (CV) disease share common symptoms and underlie many general medical complaints. Preliminary studies suggest an association between H. pylori positivity and CV risk, and gastroenterological guidelines recommend eradication of H. pylori in patients with manifest atherosclerosis. Therefore, the aim of this study was to examine the reciprocal association of H. pylori positivity and CV risk for their independence of shared risk factors. Methods: We included 3284 asymptomatic participants of a colorectal cancer screening cohort who were offered and underwent upper gastrointestinal endoscopy. We calculated the 10‐year risk for a CV event using the novel SCORE2 for each patient. We evaluated the association between H. pylori positivity and CV risk assessed by SCORE2 using both multilevel logistic and linear regression. We adjusted for age, sex and the concomitant diagnosis of metabolic syndrome. Lastly, we assessed the association between H. pylori status and mortality using proportional hazard Cox regression. Results: In total, 2659 patients were H. pylori negative and 625 H. pylori positive. Helicobacter pylori positivity was associated with SCORE2 and remained so (r =.33; 95% CI 0.09–0.57; p =.006) after adjustment for age, sex, and the diagnosis of metabolic syndrome. Also, SCORE2 was associated with higher odds for H. pylori positivity (aOR 1.03 95% CI 1.01–1.05; p =.02) even after multivariable adjustment. Helicobacter pylori positivity was associated with neither CV (HR 0.60 95% CI 0.14–2.63; p =.50) nor all‐cause (HR 1.20 95% CI 0.77–1.87; p =.43) mortality during a median follow‐up of 9 years. Conclusions: In our study, H. pylori positivity and CV risk were independently associated. This did not translate into a dissimilar CV mortality between H. pylori positive and H. pylori negative patients. However, the overwhelming majority of our patients underwent H. pylori eradication. We, therefore, think that H. pylori eradication is at least safe from a cardiovascular perspective and warranted from gastrointestinal standpoint. [ABSTRACT FROM AUTHOR]

BackgroundSeveral studies have revealed a positive correlation between a Helicobacter pylori (HP) infection and the risk of non-alcoholic fatty liver disease (NAFLD). This meta-analysis was conducted to explore further the relationship between HP infection and NAFLD in the Asian and non-Asian populations.MethodsRelevant studies published from inception to July 22, 2021, in the following databases: PubMed, EMBASE, the Cochrane library, and Web of Science were comprehensively searched. The odds ratio (OR) and hazard ratio (HR) with a 95% confidence interval (95%CI) were pooled by the random-effects model or fixed-effects model. Additionally, subgroup and sensitivity analyses were performed. The funnel plot and the Egger test were used to estimate publication bias.ResultsThis meta-analysis included 25 studies involving 107,306 participants. Positive associations between HP infection and NAFLD were found both for the Asian (OR = 1.30, 95% CI: 1.13–1.49, P < 0.01; I2 = 94.30%, P < 0.01) and non-Asian populations (OR = 1.42, 95% CI: 1.04–1.94, P = 0.03; I2 = 44.90%, P = 0.09). Moreover, similar results were observed in the Asian female group (OR = 1.31, 95% CI: 1.17–1.46, P < 0.01; I2 = 46.30%, P = 0.07) but not for the Asian male group. Subgroup analyses for the Asian population showed that there were differences in the association among NAFLD diagnosis methods (P < 0.01) and the study design (P < 0.01). However, subgroup and sensitivity analyses results showed that the association for the non-Asian population was not stable enough.ConclusionsThe data obtained in this systematic review and meta-analysis suggested that an HP infection was associated with an increased risk of NAFLD for Asian and non-Asian populations. However, the association was not found for Asian males. Further studies are required to establish the causal association, especially for the non-Asian population.Systematic review registrationIdentifier: CRD42021266871.

Helicobacter pylori infection (HPI) is an important risk factor of gastrointestinal diseases, but factors leading to it are still not fully understood. To investigate the association between short-term exposure to air pollution and HPI during outpatient visits, we collected daily data for HPI outpatient visits and air pollutant concentrations during 2014–2021 in Hefei, Anhui Province, China. A time-stratified case-crossover design was performed to analyze the acute impacts of air pollution on HPI outpatient visits. We also explored potential effect modifiers. A total of 9072 outpatient visits were recorded. We found positive and statistically significant associations of acute exposure to nitrogen dioxide (NO2), sulfur dioxide (SO2), and carbon monoxide (CO) with HPI outpatient visits. Threshold concentrations of the three pollutants with same-day exposure (lag 0 day) for outpatient visits were 37 μg/m3 for NO2, 8 μg/m3 for SO2, and 0.8 mg/m3 for CO. The odds ratios for HPI outpatient visits at the 95th percentile of NO2, SO2, and CO against the thresholds were 1.207 (1.120–1.302), 1.175 (1.052–1.312), and 1.110 (1.019–1.209), respectively. The associations were more evident in patients older than 45 years, females, with health insurance, and in cold seasons. Null associations of exposure to either ozone (O3) or particulate matter (PM) were observed. In summary, short-term exposure to NO2, SO2, and CO above certain concentrations, but not PM or O3, may trigger the increased risk of outpatient visits due to HP infection in Chinese population. [ABSTRACT FROM AUTHOR]

Aim. Evaluation of the efficacy and safety of eradication therapy of infection Helicobacter pylori in patients with H. pylori- associated pathology of the upper gastrointestinal tract and concomitant type 2 diabetes mellitus (DM). Materials and methods. The prospective randomized study involving 180 patients (87 men and 93 women) with H. pylori- associated pathology of the upper gastrointestinal tract was carried out. The patients were divided into four groups of 45 people: 1 patients without diabetes who received the classic triple eradication therapy; 2 patients with type 2 DM who received the classic triple eradication therapy; 3 patients without DM who underwent quadrotherapy with bismuth preparations; 4 patients with type 2 DM who underwent quadrotherapy with bismuth preparations. Eradication therapy was carried out for 14 days. Evaluation of the effectiveness of eradication using a breath test was carried out 4 weeks after completion of the course of treatment. Eradication success was assessed separately for ITT and PP analyzes. Results. The effectiveness of classical triple eradication therapy in patients with concomitant type 2 DM is 64.4% in the ITT group and 69.05% in the PP: quadrotherapy 73.34 and 80.49%, respectively. The effectiveness of first line eradication therapy is higher in patients without DM compared with groups of patients with concomitant type 2 DM: ITT 83.33%, PP 88.23% and ITT 68.89%, PP 74.70%, respectively. The incidence of side effects in patients with type 2 DM: with the use of classical triple therapy 22.23%, quadrotherapy 31.12%. Conclusion. The data of the study of the efficacy and safety of line I eradication therapy make it possible to recommend the four-component therapy based on bismuth for use in clinical practice, especially in patients with DM.

Introduction: Helicobacter pylori infection is a chronic bacterial infection associated with some extragastric diseases as well as gastric involvements that occur most commonly worldwide. In our study, we aimed to investigate the usability of immature granulocytes as a basic indicator that can reflect the severity of helicobacter pylori inflammation, to the best of our knowledge, for the first time. Materials and Methods: Patients who underwent upper gastrointestinal endoscopy between April 2019 and April 2020 and were diagnosed with antral gastritis were included in this study. The relationship between helicobacter infection and its severity detected in gastric biopsies of patients and immature granulocyte count (IGC), immature granulocyte percentage (IG%), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and mean platelet volume (MPV) were investigated. Results: Of the 868 patients, 210 were HP negative, 658 were HP positive (218 mild HP positive, 293 moderate HP positive, and 147 severe HP positive). There were statistically significant differences between the HP negative and HP positive groups in terms of IGC, IG%, NLR, and PLR. However, IG% and IGC were not clinically useful because the median IG% (0.3 vs 0.3) and IGC (0.02 vs 0.02) were the same in the HP negative and total HP positive groups. Conclusion: In our study, IGC and IG% were not found useful to detect H. pylori intensity and severity of inflammation.

ObjectiveCurrent evidence on the associations between plasma thyroid stimulating hormone and Helicobacter pylori infection is conflicting. Therefore, our study aimed to examine TSH in relation to H. pylori infection.MethodsBased on the US National Health and Nutrition Examination Survey (NHANES) 1999-2000, a cross-sectional study was conducted with 948 participants aged 30 to 85 years. The associations between H. pylori seropositivity and TSH were evaluated using binary logistic regression models. A subgroup analysis stratified by sex, age, and body mass index was conducted.ResultsA higher serum TSH level was found in subjects with H. pylori seropositive than in subjects with H. pylori seronegative. A significant positive association was found between H. pylori seropositivity and TSH with increasing quartiles of hormonal levels in univariate regression models (Q4 vs Q1: OR = 1.659; 95% CI, 1.152-2.389) and in multivariate regression models (Q4 vs Q1: OR = 1.604; 95% CI, 1.087-2.367). In stratified analyses, the adjusted association of serum TSH with H. pylori seropositivity was statistically significant in male (Q4 vs Q1: OR = 1.894; 95% CI, 1.109-3.235), normal BMI (Q4 vs Q1: OR = 1.894; 95% CI, 1.109-3.235), overweight (Q4 vs Q1: OR = 2.124; 95% CI, 1.047-4.308);, obese (Q4 vs Q1: OR = 0.429; 95% CI, 0.220-0.837), and age over 60 years (Q4 vs Q1: OR = 1.999; 95% CI, 1.118-3.575).ConclusionHigh TSH levels were associated with H. pylori infection, especially among male, overweight and elderly adults.

BackgroundAntibiotic susceptibility of Helicobacter pylori to antibiotics may vary among different niches of the stomach. The progression of chronic H. pylori gastritis to atrophy changes intragastric physiology that may influence selection of resistant strains.AimTo study the antibiotic resistance of H. pylori taking the severity of atrophic gastritis in antrum and corpus into account.MethodsHelicobacter pylori-positive patients (n = 110, m = 32, mean age 52.6 ± 13.9 years) without prior H. pylori eradication undergoing upper gastrointestinal (GI) endoscopy for dyspeptic symptoms were included in a prospective study. Patients were stratified into three groups depending on the grade of atrophy: no atrophy (OLGA Stage 0), mild atrophy (OLGA Stage I–II) and moderate/severe atrophy (OLGA Stage III–IV). Two biopsies each from the antrum and the corpus and one from the angulus were taken and assessed according to the updated Sydney system. H. pylori strains were isolated from antrum and corpus biopsies and tested for antibiotic susceptibility (AST) for amoxicillin, clarithromycin, metronidazole, levofloxacin, tetracycline, and rifampicin by the agar dilution methods. A Chi-square test of independence with a 95% confidence interval was used to detect differences in the proportion of patients with susceptible and resistant H. pylori strains.ResultsAmong 110 patients, primary clarithromycin resistance (R) was 30.0%, both in the antrum and corpus; metronidazole resistance accounted for 36.4 and 34.5% in the antrum and corpus; and levofloxacin was 19.1 and 22.7% in the antrum and corpus, respectively. Resistance rates to amoxicillin, tetracycline, and rifampicin were below 5%. Dual antibiotic resistance rate was 21.8%, and triple resistance rate was 9.1%. There was a significant difference in the resistance rate distribution in antrum (p

Objective: To analyze the influencing factors of Helicobacter pylori (Hp) infection in health physical examination population, and to further explore the relationship between Hp infection and pepsinogen (PG) and carotid atherosclerosis (CAS) in health physical examination population. Methods: 146 healthy physical examination persons who underwent Hp screening in our hospital from March 2021 to March 2022 were selected, and they were divided into HP-positive group (n=62) and HP-negative group (n=84) according to the results of carbon 13 urea breath test. Univariate and multivariate Logistic regression were used to analyze the influencing factors of HP infection in healthy physical examination population. The serum PG Ⅰ, PG Ⅱ, PGⅠ/PGⅡ levels and the CAS proportion were compared between the two groups. Spearman correlation coefficient was used to analyze the correlation between DOB value of HP-positive group and serum PG Ⅰ, PG Ⅱ, PGⅠ/PGⅡ and carotid intima-media thickness (CIMT). Results: Univariate analysis showed that, compared with the HP-negative group, the HP-positive group was older, had higher proportion family history of Hp infection, smoking, drinking, food tastes spicy, frequent intake salted food, shared tableware, had lower proportion frequent drank teas and frequent intake of fruits/vegetables (all P＜0.05). Multivariate Logistic regression analysis showed that increasing age, family history of Hp infection, smoking, food tastes spicy, frequent intake salted food and shared tableware were independent risk factors for Hp infection in health physical examination population, and frequent drank teas and frequent intake of fruits/vegetables were independent protective factors (all P＜0.05). Serum PGⅠ and PGⅡ levels and CAS proportion in Hp-positive group were higher than those in Hp-negative group, while PGⅠ/PGⅡ was lower than that in Hp-negative group (all P＜0.05). Spearman correlation coefficient showed that DOB value in Hp-positive group was positively correlated with PGⅠ, PGⅡ and CIMT, but negatively correlated with PGⅠ/PGⅡ. Conclusion: Increasing age, family history of HP infection, smoking, food tastes spicy, frequent intake salted food and shared tableware are the risk factors for HP infection in healthy physical examination population, while frequent drank teas and frequent intake of fruits/vegetables are the protective factors for HP infection in healthy physical examination population. HP infection is closely related to changes in serum PG level and CAS. [ABSTRACT FROM AUTHOR]

Background: The currently recommended quadruple regimens as rescue therapy on Helicobacter pylori infection were not as effective as being supposed, especially in those who had failed two or more times. Dual regimen composed of vonoprazan (a potassium‐competitive acid blocker) and amoxicillin might be an option since it's effective in eradication therapy as first‐line treatment. Objective: As a real‐world retrospective study, data were collected to evaluate the efficacy and safety of vonoprazan and amoxicillin dual regimen as rescue therapy in Helicobacter pylori positive patients who had failed one or more times in their previous treatment. Methods: From May 2020 to June 2021, the clinical data of patients who had failed in Helicobacter pylori infection treatment were collected in GI department of Peking University First Hospital, Beijing, China. Patients were given vonoprazan 20 mg or 40 mg per day and amoxicillin 3000 mg per day (VA dual therapy) for 14 days as rescue treatment. Helicobacter pylori status was evaluated by 13C‐urease breath test 6 weeks after treatment. All adverse effects during treatment were recorded. Results: A total of 186 patients were enrolled, including 67 males and 119 females. All of them had failed for 1 ~ 7 times in their previous treatment. Successful eradication was achieved in 172 patients (92.5%, 172/186). The adverse effects (referring to skin rash, abdominal pain, diarrhea, and headache), mainly mild and did not cause quit of treatment, occurred in 14 patients (7.5%, 14/186) and all symptoms relieved spontaneously. Conclusions: Dual regimen composed of vonoprazan and amoxicillin for 14 days was effective and safe as rescue therapy in Helicobacter pylori infection treatment. It could be chosen as a "simplified rescue therapy" with relatively high eradication rate no matter how many times the patients had failed and what regimens they had used previously. [ABSTRACT FROM AUTHOR]

Background: Chronic inflammation has been reported as one of the novel coronary heart disease (CHD) risk factors. Knowing that Helicobacter pylori (H. pylori) provokes a local inflammation, the relationship between H. pylori infection and cardiovascular disease (CVD) has received considerable attention. However, the attempt to demonstrate the association between H. pylori and specific cardiovascular disease risk factors is always a challenging issue due to the conflicting reports in the literatures.Methods: We performed a cross-sectional study of 363 consecutive dyspeptic subjects in three reference health facilities in Cameroon from October 2020 to October 2021. Each participation gave a written consent and the study was approved by the local Ethical Committee. Check-up for cardiovascular disease (CVD) risk factors such as dyslipidemia-related parameters, obesity-related parameter, high blood pressure as well as H. pylori detection was done for each participant. Data was analyzed using SSPS statistical package.Results: Helicobacter pylori infection was significantly associated with higher total cholesterol level (OR: 2.3324, p = 0.0002) and higher LDL cholesterol level (OR: 2.3096, p = 0.0006). The crude OR of H. pylori status on the prevalence of high body mass index (BMI) was 1.0813 (p = 0.7300) and the adjusted OR for confounding factors was 1.1785 (p = 0.5095). The strength of the association between H. pylori infection and blood pressure, shows an OR of 1.3807 (p = 0.2991), 1.0060 (p = 0.9855) and 1.4646 (p = 0.2694) for diastolic pressure, hypertension and high heart rate respectively, while that of systolic pressure was 0.8135 (p = 0.4952). H. pylori infection is associated with dyslipidemia in our milieu. [ABSTRACT FROM AUTHOR]

Mucosal‐associated invariant T (MAIT) cells are innate‐like, unconventional T cells that are present in peripheral blood and mucosal surfaces. A clear understanding of how MAIT cells in the mucosae function and their role in host immunity is still lacking. Therefore, our aim was to investigate MAIT cell distribution and their characteristics in the gastrointestinal (GI) mucosal tissue based on Vα7.2+CD161hi identification. We showed that Vα7.2+CD161hi T cells are present in both intraepithelial layer and lamina propriae of the GI mucosa, but have different abundance at each GI site. Vα7.2+CD161hi T cells were most abundant in the duodenum, but had the lowest reactivity to MR1‐5‐OP‐RU tetramers when compared with Vα7.2+CD161hi T cells at other GI tissue sites. Striking discrepancies between MR1‐5‐OP‐RU tetramer reactive cells and Vα7.2+CD161hi T cells were observed along each GI tissue sites. Vα7.2+CD161hi TCR repertoire was most diverse in the ileum. Similar dominant profiles of TRBV usage were observed among peripheral blood, duodenum, ileum, and colon. Some TRBV chains were detected at certain intestinal sites and not elsewhere. The frequency of peripheral blood Vα7.2+CD161hi T cells correlated with mucosal Vα7.2+CD161hi T cells in lamina propriae ileum and lamina propriae colon. The frequency of peripheral blood Vα7.2+CD161hi T cells in Helicobacter pylori‐infected individuals was significantly lower than uninfected individuals, but this was not observed with gastric Vα7.2+CD161hi T cells. This study illustrates the biology of Vα7.2+CD161hi T cells in the GI mucosa and provides a basis for understanding MAIT cells in the mucosa and MAIT‐related GI diseases. [ABSTRACT FROM AUTHOR]

Helicobacter pylori is a microaerophile Gram-negative bacillus, resistant to the activity of gastric juice. The bacteria may take the vegetative form (spiral shape) or sporulation form. Liver cirrhosis and H.Pylori infection are two common diseases in our population and reducing the incidence of complications in cirrhotic subjects is an important step in current gastroenterology practice. The aim of the present study is to determine incidence of H. Pylori infection among patients with liver cirrhosis secondary to HCV infection and study the correlation between esophageal varices degree and H. Pylori infection. This study involved 50 patients with liver cirrhosis secondary to Hepatitis C Virus infection were selected from gastroenterology and internal medicine clinics at Beni-Suef general hospital and Beni-Suef university hospital. Our results illustrate that the percent of H. pylori infection among studied patients was 68%, our results illustrate that there is statistically significant association between the grade of varices and the detection of H. pylori; p value is less than 0.001. [ABSTRACT FROM AUTHOR]

Background: Antibiotic susceptibility of Helicobacter pylori to antibiotics may vary among different niches of the stomach. The progression of chronic H. pylori gastritis to atrophy changes intragastric physiology that may influence selection of resistant strains. Aim: To study the antibiotic resistance of H. pylori taking the severity of atrophic gastritis in antrum and corpus into account. Methods: Helicobacter pylori-positive patients (n = 110, m = 32, mean age 52.6 ± 13.9 years) without prior H. pylori eradication undergoing upper gastrointestinal (GI) endoscopy for dyspeptic symptoms were included in a prospective study. Patients were stratified into three groups depending on the grade of atrophy: no atrophy (OLGA Stage 0), mild atrophy (OLGA Stage I–II) and moderate/severe atrophy (OLGA Stage III–IV). Two biopsies each from the antrum and the corpus and one from the angulus were taken and assessed according to the updated Sydney system. H. pylori strains were isolated from antrum and corpus biopsies and tested for antibiotic susceptibility (AST) for amoxicillin, clarithromycin, metronidazole, levofloxacin, tetracycline, and rifampicin by the agar dilution methods. A Chi-square test of independence with a 95% confidence interval was used to detect differences in the proportion of patients with susceptible and resistant H. pylori strains. Results: Among 110 patients, primary clarithromycin resistance (R) was 30.0%, both in the antrum and corpus; metronidazole resistance accounted for 36.4 and 34.5% in the antrum and corpus; and levofloxacin was 19.1 and 22.7% in the antrum and corpus, respectively. Resistance rates to amoxicillin, tetracycline, and rifampicin were below 5%. Dual antibiotic resistance rate was 21.8%, and triple resistance rate was 9.1%. There was a significant difference in the resistance rate distribution in antrum (p < 0.0001) and corpus (p < 0.0001). With increasing severity of atrophy according to OLGA stages, there was a significant increase in clarithromycin-R and metronidazole-R. Conclusion: In treatment-naïve patients, antibiotic resistance and heteroresistance were related to the severity of atrophy. The high clarithromycin resistance in atrophic gastritis suggests that H. pylori antibiotic susceptibility testing should always be performed in this condition before selecting the eradication regimen. [ABSTRACT FROM AUTHOR]

Helicobacter pylori is usually acquired during childhood. The reports from the last two decades pointed out a decrease in H. pylori prevalence across geographical areas worldwide compared to previously reported data. Most of the studies performed in America found an overall H. pylori infection prevalence of approximately 50%. The most important risk factors in America include being male, poor adherence or difficult access to treatment, and the lack of in-home water service. Despite the descending trend in prevalence worldwide, the overall prevalence in Africa remains very high (70%). Nevertheless, the prevalence of H. pylori in children without gastrointestinal who underwent screening was reported to be only 14.2%. The main risk factors in Africa are having a traditional pit or no toilet, poverty, birth order, source of drinking water, or being a farmer. Asia seems to have the widest variations in terms of H. pylori prevalence. Several risk factors were reported in Asia to be associated with this infection, such as lower income and educational level, house crowding, rural residence, ethnicity, the use of tanks as water supplies, alcohol drinking, active smoking, eating spicy food or raw uncooked vegetables, poor living conditions and sanitation. The overall prevalence of H. pylori infection in European children is almost 25%. Portugal has the highest prevalence of all European countries at 66.2% in children 13 years of age. The risk factors in European individuals consist of living in rural areas, eating unwashed fruits and vegetables, not washing hands after school, low parental education and unemployment, and short education duration. Further studies are required to identify the precise mechanisms involved in the discrepancies of H. pylori prevalence worldwide. [ABSTRACT FROM AUTHOR]

Helicobacter pylori (Hp) infection is a chronic gram-negative bacterial infection, that infects the epithelium of the stomach. This prevalence is very high and varies depending on factors such as geographical location, ethnicity, age, and socioeconomic. The key management of Hp infection is accurate diagnosis and treatment. The H. pylori diagnostic examination consists of non-invasive and invasive tests, the most common non-invasive tests are serological tests, urea breath tests (UBT), and stool antigen tests, while invasive tests are rapid urease tests, histopathology, culture, and PCR. The goal of H. pylori eradication is to heal peptic ulcers and reduce the risk of gastric cancer. Eradication therapy that is recommended worldwide and used in Indonesia is the triple drug combination therapy consisting of a PPI, clarithromycin and amoxicillin or metronidazole for 14 days. The success of eradication therapy is highly dependent on the choice of therapeutic regimen, patient compliance in taking multi-drugs with possible drug side effects, and the sensitivity of H. pylori strains to the antibiotics consumed.

PurposeCardiac syndrome X (CSX) is a condition with normal coronary angiography but angina pectoris. Chronic inflammation caused by Helicobacter pylori (H. pylori) infection may play a pathogenic role in CSX. Therefore, we conducted a meta-analysis to explore the relationship between H. pylori infection and risk of CSX.MethodsA systematic search in the Web of Science, Medline, Embase and Chinese databases (CNKI and Wanfang) was conducted up to October 2021. Articles on the association between H. pylori infection and the risk of CSX were included and were analyzed by R software (version 4.1.0).ResultsTen case-control studies involving 703 CSX patients and 731 healthy controls were included. H. pylori infection was associated with an increased risk of CSX (OR: 8.29, 95% CI: 4.64–14.82). We also found a significant association in those 25–40 years of age (OR: 1.34, 95% CI: 1.04–1.72), those 40–50 years of age (OR: 11.27, 95% CI: 4.29–29.61), those over 50 years of age (OR: 7.18, 95% CI: 3.59–14.36), those in developing countries [Iran (OR: 12.99, 95% CI: 8.61–19.60) and China (OR: 5.14, 95% CI: 3.09–8.56)]. However, this association was not apparent in a developed country [Italy (OR: 0.93, 95% CI: 0.37–2.33)].ConclusionsOur study suggested a possible association between H. pylori infection and the risk of CSX. Its pathogenicity is stronger in middle-aged individuals and some developing countries. However, more studies are needed to further investigate whether early eradication of H. pylori can reduce the incidence rate of CSX, especially in middle-aged individuals and some developing countries.

Yu Lei,&ast; Xiaoyu Liu,&ast; Jingmei Liu, Min Zhang, Yan Zhou, Wei Yan, Dean Tian, Ping Zhang, Ping Han Department of Gastroenterology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei Province, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Ping Zhang; Ping HanDepartment of Gastroenterology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei Province, People’s Republic of ChinaEmail 845917536@qq.com; hanzhouping@163.comBackground: Isolated terminal ileitis (ITI) is a phenomenon often observed during colonoscopy, but in most cases, the specific etiology of ITI is unclear. Helicobacter pylori (H. pylori) infection has been reported to be associated with a wide variety of diseases, especially gastrointestinal diseases. Here, we conducted a retrospective study to explore a potential correlation between H. pylori infection and unexplained ITI (UITI).Materials and Methods: The retrospective study was conducted at Sino-French New City Branch of Tongji Hospital, Wuhan, China, from April 2017 to October 2020. All subjects underwent total colonoscopy, with the endoscope being inserted more than 10cm into the terminal ileum. Subjects also received a 13C-urea breath test (13C-UBT). Data on the age, gender, endoscopic manifestations, and main clinical symptoms of subjects were collected. The presence of H. pylori infection was defined as a positive 13C-UBT result. Logistic regression models were used to analyze the potential correlation between H. pylori infection and UITI.Results: There were 247 subjects (25.1%) in the H. pylori (+) group and 739 subjects (74.9%) in the H. pylori (-) group. The prevalence of UITI in the H. pylori (+) group was significantly lower than that in the H. pylori (-) group (OR = 0.518; 95% CI 0.281– 0.956; P = 0.035), and there was no difference in other clinical features between groups. Stratification analysis results showed that there was an inverse association between H. pylori infection and UITI in subjects with age < 60 (P = 0.046).Conclusion: These data showed that H. pylori infection was negatively correlated with UITI. Additional studies are needed to validate these findings in a larger cohort as well as to explore the underlying mechanisms.Keywords: Helicobacter pylori infection, unexplained isolated terminal ileitis, colonoscopy, 13C-urea breath test

Background: Very few studies have explored the changes of serum pepsinogen after bariatric surgery and no research has evaluated the feasibility of ABC classification to predict gastric cancer risk after bariatric surgery. Methods: We enrolled 94 obese subjects that received bariatric surgery, including 41 sleeve gastrectomy (SG) and 53 Roux-en-Y gastric bypass (RYGB). The serum pepsinogen I (PGI), pepsinogen II (PGII), PGI/II ratio and seropositivity of Helicobacter pylori ( H. pylori ) were measured before and one year after surgery. Patients were classified according to ABC classification and post-operative change was evaluated. Results: Preoperatively, four (4.2%) patients were classified into high risk group (classification C and D) for gastric cancer. Significant reduction of PGI, PGII and decrease of PGI/II ratio were noted after bariatric surgery. H. pylori seropositive patients had a greater postoperative change of PGI (-38.6μg/L vs -22.1μg/L, p=0.003) and PGII (-8.0μg/L vs -2.5μg/L, p

Given the high prevalence of Helicobacter pylori infection in Iran, eradicating it with an effective, low-cost, and easy diet is one of the challenges ahead The aim of this study was designed to compare the effect of "levofloxacin-based regimen “with” clarithromycin-based regimen” in the treatment of Helicobacter pylori. This quasi-experimental study was performed on 161 patients with Helicobacter pylori infection referred to the gastrointestinal clinic of Vali-asr Hospital in Birjand. Patients were randomly divided into two groups A (levofloxacin, pantoprazole and amoxicillin) and B (amoxicillin, pantoprazole, clarithromycin and bismuth sub citrate) and were treated for 14 days. 4 weeks after the end of treatment, the urease breath test was performed to check for eradication In levofloxacin group, 67 patients (91.8%) and in clarithromycin group 55 patients (70.5%), eradication was performed which was statistically significant. (p=0.001). Also, there was no statistically significant difference between the two groups in terms of complications (p=0.3). The results showed that the levofloxacin-based regimen could be used as an alternative to four clarithromycin-based therapies due to its greater efficacy in eradicating Helicobacter pylori despite the lower number of drugs and similar side effects.

Approximately half of the world's population is infected with Helicobacter pylori, which causes gastric disease. Recent systematic reviews and meta-analyses have reported that H. pylori may also have extragastric manifestations such as hematologic diseases, including chronic immune thrombocytopenia (cITP). However, the molecular mechanisms by which H. pylori induces cITP remain unclear, and may involve the host immune response, bacterial strain diversity, and delivery of bacterial molecules to the host blood vessels. This review discusses the important pathophysiological mechanisms by which H. pylori potentially contributes to the development of cITP in infected patients. [ABSTRACT FROM AUTHOR]

Helicobacter pylori infection results in gastric cancer (GC) with gastric mucosal atrophy (GMA). Some single-nucleotide polymorphisms (SNPs) in the prostate stem cell antigen gene (PSCA) are associated with GC and duodenal ulcers. However, the relationship of other identified SNPs in PSCA with these diseases remains unclear. Herein, the association between PSCA SNPs and GMA among 195 Japanese individuals with H. pylori infection was evaluated. The definition of GMA or non-GMA was based on serum pepsinogen levels or endoscopic findings. Five tag PSCA SNPs were analyzed using PCR high-resolution melting curve analysis with nonlabelled probes. The frequencies of alleles and the genotypes of each tag SNP were compared between the GMA and non-GMA groups. Subsequently, a genetic test was performed using associated SNPs as biomarkers to detect patients developing GMA. Two tag PSCA SNPs (rs2920280 and rs2294008) were related to GMA susceptibility. Individuals with the rs2920280 G/G genotype or the rs2294008 T/T genotype in PSCA had 3.5- and 2.1-fold susceptibility to GMA, respectively. In conclusion, SNP rs2920280 is a possible biomarker for detecting individuals developing GMA. PSCA polymorphisms may be useful biomarkers for predicting GMA linked to GC risk and a screening endoscopy strategy to detect GC related to early stage H. pylori associated GMA. [ABSTRACT FROM AUTHOR]

Objective: To observe the association of Helicobacter Pylori infection with metformin intolerance in type2 diabetic patients. Study Design: Observational, Cross Sectional study. Setting: Out Patients of Shifa Foundation Falahee Clinics. Period: August 2017 to January 2018. Material & Methods: Type 2 diabetes mellitus (DM) patients above 30 years of age taking metformin were recruited according to inclusion criteria. These patients were labelled metformin intolerant or metformin tolerant on the basis of their gastrointestinal (GI) symptoms. Both groups were tested for the presence of Helicobacter Pylori (H. pylori) infection using urea breath test (UBT). SPSS 23 was used for data entry and analysis. Descriptive statistics were analysed for demographic and other variables and cross tabulation performed to link the variables using chi square and Fischer's exact test. Results were expressed as p-value, which when <0.05 with 95% confidence interval, was considered statistically significant. Results: Out of 57 patients, female gender, age above 50 years and residence in Rawalpindi showed higher frequencies. Majority of them were found intolerant to metformin use. Urea breath test were found positive in majority of metformin intolerant patients (p value =0.04). Dyspepsia was most frequent symptom among metformin intolerants. Duration of diabetes mellitus, of metformin use and dose of metformin did not affect the tolerance status of metformin and urea breath test results. Conclusion: The screening for H. pylori should be considered in all Metformin intolerant diabetic patients. It is likely to improve drug compliance. [ABSTRACT FROM AUTHOR]