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Aging is a multifactorial biological process characterized by a decline in physiological function and increasing susceptibility to various diseases, including malignancies and gastrointestinal disorders. Helicobacter pylori (H. pylori) infection is highly prevalent among older adults, particularly those in institutionalized settings, contributing to conditions such as atrophic gastritis, peptic ulcer disease, and gastric carcinoma. This review examines the intricate interplay between aging, gastrointestinal changes, and H. pylori pathogenesis. The age-associated decline in immune function, known as immunosenescence, exacerbates the challenges of managing H. pylori infection. Comorbidities and polypharmacy further increase the risk of adverse outcomes in older adults. Current clinical guidelines inadequately address the specific needs of the geriatric population, who are disproportionately affected by antibiotic resistance, heightened side effects, and diagnostic complexities. This review focuses on recent advancements in understanding H. pylori infection among older adults, including epidemiology, diagnostics, therapeutic strategies, and age-related gastric changes. Diagnostic approaches must consider the physiological changes that accompany aging, and treatment regimens need to be carefully tailored to balance efficacy and tolerability. Emerging strategies, such as novel eradication regimens and adjunctive probiotic therapies, show promise for improving treatment outcomes. However, significant knowledge gaps persist regarding the impact of aging on H. pylori pathogenesis and treatment efficacy. A multidisciplinary approach involving gastroenterologists, geriatricians, and other specialists is crucial to providing comprehensive care for this vulnerable population. Future research should focus on refining diagnostic and therapeutic protocols to bridge these gaps, ultimately enhancing clinical outcomes and reducing the burden of H. pylori-associated diseases in the aging population. [ABSTRACT FROM AUTHOR]

Helicobacter pylori has been of interest to scientists and clinicians for many years, often causing diagnostic difficulties, especially in the youngest age group, in children. The presence of this bacterium in the population depends on the geographic region. However, it is assumed that even half of the world's population may be infected with H. pylori. Children infected with H. pylori—the study group (Hp(+)) and control group (Hp(−)), were chosen for further examination. The aim of the study was to analyze the concentrations of selected inflammatory markers in saliva (TNF-α, IL-8) and other markers (neutrophil defensin-1, sICAM-1, calprotectin, metalloproteinase-9, metalloproteinase-2, lactotransferrin, TLR-2) using ELISA technique. We confirmed the increased concentrations of IL-8, ND-1, and TLR-2 in the group of children infected with Helicobacter pylori. Moreover, there was also a positive, significant correlation between the concentration of ND-1 and MMP-2, sICAM-1, and calprotectin as well as MMP-9 and MMP-2 in the group of infected children. The study created new possibilities of insight into the pathogenetic mechanisms of developing inflammation in the mouth. This type of comprehensive research is also used to monitor the current disease process and create new opportunities for better in-depth diagnostics of children infected with H. pylori. [ABSTRACT FROM AUTHOR]

Six solvent fractions isolated from flower bud and leaf ethanolic extracts of Cleistocalyx operculatus were analyzed for their phytochemical contents, including phenolics, flavonoids, saponins, tannins, and alkaloids. Antioxidant activities were measured using the ABTS, DPPH, and FRAP assays. The results showed that the flower bud aqueous fraction (BAF) and the leaf aqueous fraction (LAF) rich in phenolic content (768.18 and 490.74 mg GAE/g dry extract, respectively) exhibited significantly higher antioxidant activities than the other fractions. The flower bud hexane fraction (BHF) had remarkably high flavonoid and saponin contents (134.77 mg QE/g and 153.33 mg OA/g dry extract, respectively), followed by that of the leaf hexane fraction (LHF) (76.54 mg QE/g and 88.25 mg OA/g dry extract, respectively). The BHF and LHF were found to have extremely high antibacterial activity against two H. pylori strains, ATCC 51932 and 43504 (MICs of 125 µg/mL). Interestingly, DMC (2′,4′-Dihydroxy-6′-methoxy-3′,5′-dimethylchalcone) isolated from the BHF displayed greater antibacterial activity against the bacterial strains (MICs of 25–50 µg/mL) than those of the fractions. In addition, DMC presented potent inhibitory effects on H. pylori urease (IC50 of 3.2 µg/mL) and α-amylase (IC50 of 83.80 µg/mL), but no inhibition against α-glucosidase. It was also demonstrated that DMC showed pronounced inhibitory effects on the urease activity and biofilm formation of H. pylori, and could increase the membrane permeability of the bacterial cells. Scanning electron micrographs depicted that the BHF and DMC had strong effects on the cell shape and significantly induced the distortion and damage of the cell membrane. The fractions and DMC showed no significant toxicity to four tested human cell lines. Efforts to reduce antibiotic use indicate the need for further studies of the flower buds and DMC as potential products to prevent or treat gastric H. pylori infections. [ABSTRACT FROM AUTHOR]

Objective To investigate the clinical features of the spectrum of upper gastrointestinal diseases in children and to provide assistance in the prevention, diagnosis and treatment of upper gastrointestinal diseases in children. Methods Clinical data of 424 children aged 2 months to 14 years who were hospitalised for gastroscopy in the paediatrics department of the First People's Hospital of Yunnan Province from January 2018 to June 2023 were collected, and retrospective analyses were performed for the children's clinical presentation, gastroscopy results, and HP infections. Results The symptoms of vomiting and diarrhea in infants were significantly different from those in preschool and school age groups (P < 0.05). The positive rate of lesions under gastroscopy was 96.46%. The main diseases found were non-atrophic gastritis (222 cases), bile reflux gastritis (42 cases), non-atrophic gastritis with erosion (30 cases), duodenitis (25 cases), reflux esophagitis (15 cases) and others (75 cases). Helicobacter pylori (HP) was detected in 300 of the 424 cases, and 105 cases were HP positive, with a detection rate of 35.00%. Conclusion Abdominal pain was the main symptom of upper gastrointestinal diseases in school-age and preschool children. Vomiting and diarrhea were the main symptoms of upper gastrointestinal diseases in infants. There was no gender difference in HP infection, but there was a difference in age. [ABSTRACT FROM AUTHOR]

Most gastric cancers (95%) are related to an initial Helicobacter pylori infection worldwide. Treatments against this pathogen include a mix of antibiotics, antimicrobials, and proton-pump inhibitors. Over time, H. pylori mutated, generating resistance to treatments and making it hard to combat its infection. The purpose of this review is Hibiscus sabdariffa, commonly known as hibiscus, as a potential agent for anti-H. pylori activity. Scientific interest has increased toward plant-derived bioactive compounds, which have the ability to enhance the antibiotic effect and can lead to the development of new drugs, such is the case for H. sabdariffa. In general, studies show that natural products, such as plant-derived bioactive compounds, can be used as alternative treatments from natural origin against the pathogen. The specific action mechanism of these bioactive compounds is still controversial, but it is suggested that they have an anti-inflammatory effect, and they also act as antibiotic coadjutants. Research has been conducted regarding different bioactive compounds such as polyphenols, epicatechins, alkaloids, and caryophyllenes. H. sabdariffa contains several of these compounds; therefore, more studies are needed to establish its effect against H. pylori. [ABSTRACT FROM AUTHOR]

Background: Qurom quenching enzyme have an impact on treatment efficacy and prevent the recurrence of Helicobacter pylori biofilm-related infections, although it has not been thoroughly investigated in vitro and in silico. The current study aims to characterize the N-acyl homoserine lactonase, the quorum quenching AiiA protein of Bacillus licheniformis against H. pylori biofilm. Methods and results: In this study, AiiA protein were screened for their anti-biofilm activity, was found to effectively control biofilm formation of H. pylori with concentrations ranging from 2 to 10 µg/mL. According to CLSM and COMSTAT analysis, the untreated substratum had the robust biofilm biomass of 25–18 µM and biovolume of 3–4 mm3 /mm2. The total biofilm biovolume and average biofilm thickness were considerably reduced by 40% with a single application of 10 µg/mL of AiiA protein. The biofilm treated with AiiA exhibited a lower urease and polysaccharides than to the untreated biofilm. Further, in silico analysis, exhibited a greater interaction of AiiA against the outer membrane proteins of H. pylori compared to virulence factors. The conserved domains in the binding pockets of AiiA proteins showed a highest binding affinity proving the catalytic activity of the protein. Conclusion: In this study, the H. pylori biofilm architecture, exopolysaccharide and urease were significantly controlled by our purified N-acyl homoserine lactonase from B. licheniformis. Furthermore, the molecular docking showed the significant interaction between AiiA and key biofilm forming and virulence proteins proved an excellent antibiofilm activity controlling the infections of H. pylori human pathogen. [ABSTRACT FROM AUTHOR]

Helicobacter pylori is the most common chronic bacterial infection worldwide. Because of the risk for chronic gastritis, peptic ulcer disease, and gastric malignancy, all patients with H. pylori should be treated. Unfortunately, eradication rates remain low, and barriers to successful treatment include inadequate acid suppression, locoregional antibiotic resistance, and patient nonadherence to complicated treatment regimens. Vonoprazan, a new medication for the treatment of H. pylori infections, provides more potent acid suppression and is simpler to dose than proton pump inhibitors. This article provides a data-driven algorithm for incorporating vonoprazan into the treatment of patients with H. pylori infections. [ABSTRACT FROM AUTHOR]

Objective: To study the interobserver agreement for diagnosing Helicobacter pylori gastritis using narrow band imaging (NBI) with magnification. Methods: This prospective study recruited patients who underwent gastroscopy for dyspepsia in the Department of Gastroenterology, Aster MIMS Hospital, Kannur.361 patients were included in the study. The gastroscopy was performed using high‐definition white light endoscopy (WLE) and NBI with magnification. Histopathology and rapid urease test were used to detect HP infection. Endoscopy videos were analyzed by three trained endoscopists who were blinded to each other. NBI patterns were classified into four types (Types 1, 2A, 2B, and 3). Interobserver variability was examined using Kappa Statistics. Results: 164 of 361 patients had HP infection (45.42%). Of 361 people, 199 had Type 1 (55.12%), 54 Type 2a (14.95%), 65 Type 2b (18%), and 43 Type 3 cases (11.91%). There was good interobserver agreement with a kappa value of 0.730 (95% confidence interval (CI) 0.693–0.768). 87% of HP‐negative patients had Type 1 NBI pattern. 79.5% of type 2A and 89.2% of Type 2b pattern were HP positive. The Type 1 pattern identified normal gastric mucosa with 84.75% sensitivity, 88.32% specificity and 87.4% negative predictive value. Type 2 and Type 3 NBI patterns had high positive predictive value and specificity for HP infection. Conclusions: This study demonstrates excellent interobserver agreement among experienced endoscopists in using NBI to identify gastric mucosal patterns associated with HP infection. While biopsies remain essential for comprehensive evaluation of gastric pathologies, our findings suggest that NBI, with appropriate training and validation, may have the potential to reduce the need for biopsies in specific cases where the primary concern is HP infection. The good level of interobserver agreement seen in our study is encouraging and suggests that NBI has the potential to be a reliable tool for diagnosing HP infection. [ABSTRACT FROM AUTHOR]

Background and Aim: Helicobacter pylori infection is a major cause of peptic ulcer disease and gastric cancer. Limited data exist on H. pylori prevalence and risk factors of infection among elderly individuals in Vietnam. This study aimed to determine the prevalence and associated risk factors of H. pylori infection in elderly Vietnamese patients with upper gastrointestinal symptoms. Methods: A cross‐sectional study was conducted on patients aged ≥ 60 years with upper gastrointestinal symptoms who underwent endoscopy. The exclusion criteria included recent antibiotic or proton pump inhibitor use, prior H. pylori eradication, or upper gastrointestinal surgery. Data on demographics, hygiene, diet, and history were collected through structured questionnaires. H. pylori was diagnosed by a rapid urease test. Logistic regression was used to analyze risk factors. Results: Of 406 participants (mean age 65.4 ± 4.5 years, male‐to‐female ratio 1:2), H. pylori prevalence was 55.6%. The risk factors for H. pylori infection included infrequent tooth brushing (OR 18.14, 95% CI 3.94–83.55), overweight/obesity (OR 5.82, 95% CI 3.44–9.88), spicy food consumption (OR 5.18, 95% CI 2.74–9.79), a family history of upper gastrointestinal symptoms (OR 3.15, 95% CI 1.84–5.39), and cat ownership (OR 2.01, 95% CI 1.10–3.68). The vegetarian diet was protective (OR 0.04, 95% CI 0.01–0.18). Conclusions: H. pylori prevalence in elderly Vietnamese is high, with risk factors including poor hygiene, obesity, spicy food, family history, and cat ownership. A vegetarian diet may be protective. [ABSTRACT FROM AUTHOR]

Background and Aim: The treatment for Helicobacter pylori is considered to be a combination of several strict regimens, with patients' dissatisfaction and poor compliance. Probiotics are effective in patients' antibiotic regimens. This study investigated the efficacy of the Pyloshot probiotic in combination with standard four‐drug therapy in patients with H. pylori infection. Methods: This is an interventional study. The study population consisted of patients with H. pylori infection who were selected using the convenience sampling method and were randomly divided into two groups: (i) A or standard four‐drug therapy (amoxicillin‐clarithromycin‐bismuth‐pantoprazole) plus two placebo capsules (80 cases). (ii) B or Pyloshot group (standard four‐drug therapy plus 2 Pyloshot probiotic capsules) (90 cases). Patients were followed up for 1 month after treatment completion. Eradication of H. pylori was also assessed using the stool antigen test. Data were analyzed using SPSS (v.26) statistical software. Results: Based on the results from the present study, the number of negative stool antigen tests in group A was less than that in group B, and no statistically significant relationship was found between H. pylori eradication (based on stool antigen test) and the studied groups (P = 0.20). There was a statistically significant relationship between vomiting (P = 0.03), diarrhea (P = 0.04), constipation (P = 0.01), and headache (P = 0.04); vomiting and constipation were most frequent in the control group. Conclusion: Based on the results of the present study, there was no significant difference between the effectiveness of treatment with Pyloshot probiotic and the standard four‐drug therapy in patients with H. pylori infection. However, the incidence of side effects was lower in the group treated with Pyloshot. [ABSTRACT FROM AUTHOR]

Eugenia uniflora leaves are a source of flavonoids and ellagitannins, and the Brazilian population uses them to treat various diseases, including gastrointestinal disorders. This study aimed to determine if the ethanol extract and other derivatives are effective cytotoxic agents against gastric adenocarcinoma (AGS cells) and anti-H. pylori agent, its chemical composition, and mass spectrometry characterization of the more abundant compounds. The results were compared with the literature. The aqueous fraction, rich in Oenothein B and Gemin D/Hippomanin A, showed anti-H. pylori activity and higher cytotoxicity on AGS cells compared to the other samples analysed. Furthermore, the ESI(-) FT-ICR MS characterized the more abundant phenolic compounds, including Quinic Acid, Myricitrin, Gemin D/Hippomanin A, and Oenothein. Therefore, the activity of the ethanolic extract and aqueous fraction for gastric cancer and against H-pylori seems to originate from the antiproliferative and bacteriostatic effects of tannins and flavonoids. [ABSTRACT FROM AUTHOR]

The management of acid-based disorders was transformed in the 1980s with the advent of proton pump inhibitors (PPIs), which target the hydrogen-potassium adenosine triphosphatase (proton pump) of the parietal cell. Potassium-competitive acid blockers (P-CABs), a newer class of medications, act at the same proton pump through a novel mechanism resulting in profound and sustained acid suppression. Although trials in Asian populations over the past decades have highlighted the potential benefit of P-CABs, clinical trials in Western populations have been initiated more recently. These trials evaluated vonoprazan in patients with Helicobacter pylori infection, erosive esophagitis, and heartburn with nonerosive reflux disease and have demonstrated promising results, culminating in US Food and Drug Administration approval for these indications. Adverse event profiles between PPIs and P-CABs appear comparable thus far, although additional long-term data on P-CABs are needed. While navigating the evolving landscape of acid suppression, it is crucial to identify which patients and diseases are poised to derive the most benefit from this emerging therapeutic option. This article seeks to highlight important pharmacologic properties of PPIs and P-CABs, understand the current literature with a focus on clinical trials in Western populations, and explore potential scenarios for integrating P-CABs into therapeutic regimens. [ABSTRACT FROM AUTHOR]

Background: The complaint of halitosis among patients with gastrointestinal disorders (GD) is considerable. This review aims to bring a halitosis conceptual and etiological approach to clarify its association with GD. Types of Studies Reviewed: A search was conducted in PubMed and Web of Science for papers discussing about any gastrointestinal disorder and its association to halitosis. The original studies regarding this association had its results included in this narrative review and were discussed along the text. Results: Halitosis origin is in the oral cavity in about 85% of the cases, while extra-oral halitosis associated with GD corresponds from 0,5% to 1% of cases. Gastroesophageal Reflux Disease (GERD) and the infection by Helicobacter pylori in gastritis cases are the main GD that brings the halitosis symptom along with other manifestations. Inflammatory Bowel Diseases (IBD) are also related to halitosis. In GERD, the esophagus shows pathologic alterations in its functioning that result in the expelling of gastric gases associated to bad breath through the mouth. The presence of Helicobacter pylori is associated with an increase of the volatile sulfur compounds (VSC) due to its capacity of producing such gases in its metabolism. IBD may alter the bowel permeability, allowing VSC to enter in the bloodstream and be exhaled during breathing. Practical Implications: The biologic plausibility of the halitosis and GD relation is undeniable and deserves a multidisciplinary approach. Despite the limited number of studies, inflammatory bowel diseases are associated with halitosis in the available evidence. [ABSTRACT FROM AUTHOR]

Purpose: Tribal Nations disproportionately lack access to safe drinking water and can be adversely affected by other water quality and environmental concerns. Such conditions could lead to an increase in the transmission of waterborne, environmental and hygiene related infections. We collected saliva samples from attendees at two Tribal Nation annual festivals and tested them for salivary immunoglobulin G (IgG) responses to selected common infections using an in-house multiplex immunoassay. Antibody responses were compared to responses from a previously conducted study in the midwestern United States. Methods: We collected and tested 531 samples from Tribal Nation sites and used data on 453 previously analyzed samples from the Midwest site. Logistic and linear regression models were used to model a binary classification of seropositivity and the intensity of the antibody response, respectively. Results: Seroprevalence of chronic infections (Helicobacter pylori and Toxoplasma gondii) were generally consistent with estimates from population-based studies. Compared to the Midwest site, one of the Tribal Nation sites had consistently higher median antibody responses to several noroviruses. The Tribal Nation sites had a lower seroprevalence of hepatitis E virus antibodies. At the Tribal Nation sites, farm residents had higher antibody responses to Cryptosporidium spp., bottled water consumption was associated with lower responses to Cryptosporidium spp., animal contact was associated with T. gondii seropositivity, and recent diarrhea was associated with higher norovirus antibody responses. Helicobacter pylori seropositivity was associated with reduced odds of reporting allergies. Conclusion: This study demonstrated the application of a multiplex salivary immunoassay in Tribal Nations to provide insights regarding selected common pathogens which are transmitted through different transmission pathways including person-to-person contacts, contaminated food, soil and drinking water. [ABSTRACT FROM AUTHOR]

The WHO has classified Helicobacter pylori as a group 1 carcinogen for stomach cancer since early 1994. However, despite the high prevalence of Helicobacter pylori infection, only about 3% of infected people eventually develop gastric cancer.Biomolecular detections of Helicobacter pylori(HP) were compared using specially modified sensors and fluorine immobilized on a carbon nanotube (HFCNT) electrode, which yielded sensitive results. Handheld voltammetric circuits were used for optimization. An anodic voltammogram of HP molecular oxidation was obtained at 0.0 V ± 0.1 (versus the Ag/AgCl/KCl) in a 0.1 ± 0.2 M NH4H2PO4 electrolyte solution. Under optimized conditions, the analytical working range was 2.98 × 103–22.127 × 10−3 CFU/mL HP using square wave (SW) stripping voltammetry, precision of R2 = 0.9857 ± 0.0005 (SWSV), the detection limit approached to 2.5 × 102 CFU/mL HP (S/N = 3).The developed techniques have been applied to diagnosis of early-stage HP infections using stomach tissue from healthy humans and gastric patients. [ABSTRACT FROM AUTHOR]

Helicobacter pylori (H. pylori), one of the most prevalent pathogenic bacteria worldwide, is the leading cause of gastritis, gastric intestinal metaplasia, and gastric cancer. Antibiotics, the conventional treatment for eliminating H. pylori, often lead to severe bacterial resistance, gut dysbiosis, and hepatic insufficiency and fail to address the inflammatory response or gastric mucosal damage caused by H. pylori infection. In this study, based on 10-week animal experiments, two models of L. salivarius NCUH062003 for the prophylaxis and therapy of H. pylori infection in C57BL/6 mice were established; a comprehensive comparative analysis was performed to investigate the anti-H. pylori effect of probiotics, the reduction in inflammation, and repair of gastric mucosal damage. ELISA, immunohistochemistry, and pathology analyses showed that NCUH062003 decreased the expression of pro-inflammatory cytokine interleukins (IL-1β, IL-6) and myeloperoxidase (MPO) and reduced neutrophil infiltration in the gastric mucosa lamina propria. Immunofluorescence and biochemical analysis showed that NCUH062003 resisted gastric epithelial cell apoptosis, increased the level of superoxide dismutase (SOD) in gastric mucosa, and promoted the expression of tight junction protein ZO1 and Occludin. In addition, through high-throughput sequencing, in the probiotic therapy and prophylactic mode, the diversity and composition of the gut microbiota of HP-infected mice were clarified, the potential functions of the gut microbiota were analyzed, the levels of short-chain fatty acids (SCFAs) were measured, and the effects of L. salivarius NCUH062003 on the gut microbiota and its metabolites in HP-infected mice treated with amoxicillin/metronidazole were revealed. This study provides functional strain resources for the development and application of microbial agents seeking to antagonize H. pylori beyond antibiotics. [ABSTRACT FROM AUTHOR]

Objective: To analyze the association of single nucleotide polymorphisms (SNP) in glutathione peroxidase 4 (GPX4) gene with Helicobacter pylori (H. pylori) infection.Methods: A total of 506 samples were selected to detect H. pylori infection by enzyme-linked immunosorbent assay (ELIS) and 14C Urea breath test(UBT), a positive result of either test was determined as positive; GPX4 rs4807542, rs713041, rs713041 and rs3746162 were genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method; Unconditional logistic regression was used to analyze the association of each SNP with H. pylori infection. SHEsis software was used to constructed Haplotype to analyze its association with H. pylori infection. The relationship between SNP-SNP interaction and H. pylori infection was analyzed by generalized multi-factor dimensionality reduction method.Results: GPX4 rs4807542, rs713041, rs2074451 and rs3746162 were not associated with H. pylori infection in codominant, dominant, recessive, and overdominant models (P>0.05); Haplotypes constructed by rs4807542, rs713041, rs2074451 and rs3746162 were not founded to be associated with H. pylori infection, and these SNPs also did not have interaction in H. pylori infection (P>0.05).Conclusion: GPX4 rs4807542, rs713041, rs2074451 and rs3746162 may not play a major role in the process of H. pylori infection in Baotou Han population. [ABSTRACT FROM AUTHOR]

Piroplasmosis, a disease of domestic and wild animals, is caused by tick-borne protozoa of the genera Babesia and Theileria, while anaplasmosis is caused by tick-borne bacteria of genera Anaplasma. Hyalomma dromedarii is the most dominant tick species infesting camels in Egypt and act as a vector of piroplasms, Anaplasma, Rickettsia and Ehrlichia spp. The available information concerning the detection of these pathogens in H. dromedarii infesting camels is limited. The present study aimed to evaluate the status of these pathogens in H. dromedarii ticks over four seasons of a year, in addition to investigate the infections of piroplasms and Anaplasmataceae besides their genetic diversity starting from June 2021 till April 2022. A total of 275 semi-engorged females of H. dromedarii were collected from different slaughtered camels, Toukh city slaughterhouse then investigated by Polymerase Chain Reaction (PCR) to detect piroplasms (Babesia spp., Theileria spp.) and Anaplasmataceae DNA targeting 18 S rRNA and 16 S rRNA genes, respectively followed by sequencing and phylogenetic analyses. Overall, piroplasms were detected in 38 ticks (13.8%), Babesia spp. was detected in 35 ticks (12.7%), while Theileria spp. was detected in one tick (0.4%). Anaplasmataceae was detected in 57 ticks (20.7%). Mixed infections of piroplasms and Anaplasmataceae were detected in 13 ticks (5%). Single infection either with piroplasms or Anaplasmataceae was detected in 25 (9%) and 44 (16%) ticks, respectively. The highest monthly rate of piroplasms was in April (spring) and Anaplasmataceae was in July (summer). Sequence analysis revealed that Babesia bigemina, Wolbachia spp. and Anaplasma marginale are the most dominant species in the examined tick samples. To the best of our knowledge, this study confirms the presence of B. bigemina, Wolbachia spp. and A. marginale in H. dromedarii in Egypt by sequencing. [ABSTRACT FROM AUTHOR]

Helicobacter pylori (H. pylori) is a Gram-negative, spiral-shaped bacterium that colonizes the gastric epithelium and is associated with a range of gastrointestinal disorders, exhibiting a global prevalence of approximately 50%. Despite the availability of treatment options, H. pylori frequently reemerges and demonstrates increasing antibiotic resistance, which diminishes the efficacy of conventional therapies. Consequently, it is imperative to explore non-antibiotic treatment alternatives to mitigate the inappropriate use of antibiotics. This review examines H. pylori infection, encompassing transmission pathways, treatment modalities, antibiotic resistance, and eradication strategies. Additionally, it discusses alternative therapeutic approaches such as probiotics, anti-biofilm agents, phytotherapy, phototherapy, phage therapy, lactoferrin therapy, and vaccine development. These strategies aim to reduce antimicrobial resistance and enhance treatment outcomes for H. pylori infections. While alternative therapies can maintain low bacterial levels, they do not achieve complete eradication of H. pylori. These therapies are designed to bolster the immune response, minimize side effects, and provide gastroprotective benefits, rendering them suitable for adjunctive use alongside conventional treatments. Probiotics may serve as adjunctive therapy for H. pylori; however, their effectiveness as a monotherapy is limited. Photodynamic and phage therapies exhibit potential in targeting H. pylori infections, including those caused by drug-resistant strains, without the use of antibiotics. The development of a reliable vaccine is also critical for the eradication of H. pylori. This review identifies candidate antigens such as VacA, CagA, and HspA, along with various vaccine formulations, including vector-based and subunit vaccines. Some vaccines have demonstrated efficacy in clinical trials, while others have shown robust immune protection in preclinical studies. Nevertheless, each of the aforementioned alternative therapies requires thorough preclinical and clinical evaluation to ascertain their efficacy, side effects, cost-effectiveness, and patient compliance. [ABSTRACT FROM AUTHOR]

This article introduces a novel risk factor for gastric cancer (GC) by analyzing available epidemiological data from East Asian populations. A significantly higher age-standardized GC rate was observed in Japanese and Korean populations than in Chinese populations, despite nearly identical ethnicity, food habits, obesity rates, and alcohol consumption. Given the pivotal role of environmental factors in GC development, particularly for the intestinal type, a thorough evaluation of the lifestyles of these three populations was conducted to identify commonalities and disparities. It was observed that Japanese and Korean individuals prefer consuming ice water, while Chinese individuals tend to drink warm water, potentially influenced by traditional Chinese medicine disciplines. Considering the key features of GC development, a literature review was conducted to investigate the mechanisms through which the consumption of ice water might contribute to GC initiation and progression. Mechanistically, exposing gastric cells to hypothermia can increase the risk of carcinogenesis through multiple pathways. This includes the promotion of Helicobacter pylori colonization, prolonged gastric inflammation, and mitochondrial dysfunction in gastric cells. Furthermore, drinking ice water can enhance the survival, proliferation, and invasion of GC cells by releasing cold shock proteins, increasing gastric acid secretion, and delaying gastric emptying. Additionally, hypothermia can boost the immune evasion of cancer cells by weakening the antitumor immune system and activating different components of the tumor microenvironment. This paper also explores the association between exposure of GC cells to hypothermia and current insights into cancer hallmarks. These findings may partially elucidate the higher incidence of GC in Japanese and Korean populations and provide a clue for future experimental studies. Graphical abstract available for this article. [ABSTRACT FROM AUTHOR]

Helicobacter pylori is a bacterium that may colonise and proliferate in human stomachs, leading invariably to chronic inflammation and, to a lesser extent, to peptic ulcers and cancer. The main objective of this study is to describe the epidemiology surrounding H. pylori in Nunavik's Inuit population using the 2004 and 2017 Health Surveys. Estimated prevalences were 70.9% for bacterial colonisation using a stool antigens test (SAT), 72.5% for anti-H. pylori antibodies, 12.7% for faecal occult blood in participants aged ≥ 50 and respectively of 28.4%, 11.2% and 2.4% for a prior diagnosis of colonisation, gastritis and peptic ulcer in the medical charts, with under five cases of gastric cancer reported. Variables associated with higher SAT+ prevalence were the number of household members (prevalence ratio [PR] = 1.03) and age (quadratic relationship), whereas mainly drinking municipal (PR = 0.84) and natural water (PR = 0.72) compared to bottled water, and increasing alcohol consumption (PR = 0.96) were associated with reduced prevalence. Despite current regional guidelines targeting high risk individuals in the context of high prevalence, Nunavik's health authorities must remain vigilant by following gastric cancer incidence and the rapid evolution of guidelines, while considering local realities. [ABSTRACT FROM AUTHOR]

Objective: Chronic low-grade inflammation occurs in polycystic ovary syndrome (PCOS), and there are many contributing factors. In this study, we aimed to investigate Helicobacter pylori and Chlamydia trachomatis infections in patients with PCOS and to evaluate the association between these microorganisms and the inflammatory process in the etiology of the disease. Materials and Methods: This comparative cross-sectional clinical study was conducted at Balıkesir University Hospital and included 40 female patients diagnosed with PCOS in the gynecology outpatients clinic and 40 healthy female controls. Demographic data were recorded. Blood hormone profiles and biochemical parameters were analyzed. An enzyme-linked immunosorbent assay test kit was used to measure H. pylori IgG and C. trachomatis IgG. Results: According to the analysis of the study data, there was no significant association between the PCOS and non-PCOS groups with regard to the presence of Helicobacter pylori IgG (p = 0.1) and Chlamydia trachomatis IgG (p = 0.338). CRP levels were significantly higher in the PCOS group (p = 0.001). In the subgroup analyses, the CRP levels were not significantly different between the H. pylori and C. trachomatis antibody-positive and -negative groups. Diabetes mellitus was significantly associated with PCOS (p = 0.005). The smoking rate was significantly higher in the control group than in the PCOS group (p = 0.036). Compared to the control group, the BMI, LH, HOMA-IR, TSH, and TG levels were significantly higher in participants with PCOS (p = 0.000; p = 0.004; p = 0.001; p = 0.001; p = 0.043; p = 0.000). FSH was lower in PCOS patients compared to controls (p = 001). In the subgroup analyses, no significant differences were found between the H. pylori and C. trachomatis antibody-positive and -negative groups. Conclusions: PCOS is characterized by chronic nonspecific low-grade inflammation. The etiopathogenesis of PCOS involves comorbidities that cause a chronic inflammatory process. However, the possible infective causes still seem to be open to investigation. In particular, studies on microbiota and periodontal diseases in PCOS may provide important contributions. [ABSTRACT FROM AUTHOR]

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Helicobacter pylori, a common gastrointestinal bacterial pathogenic isolate infects 50% and 90% of the global and developing nations population respectively. This study aimed at evaluating the bioactive components and therapeutic potential of Bryophyllum pinnatum, Ocimum gratissimum and Vernonia amygdalina plants extracts against Helicobacter pylori infection using standard physicochemical, in-vitro and in-vivo microbiological methods. Five (5) stool samples were collected from patients who presented with symptoms of gastrointestinal distress and diagnosed of ulcer at the University of Benin Teaching Hospital, for the isolation of Helicobacter pylori. Phytochemical screening of ethanol extract of the test plants revealed the presence of bioactive constituents such as flavonoids, tannins, cardiac glycosides, saponin, steroids, phenols, alkaloids and terpenoids. The minimum inhibitory concentration (MIC) of the plant’s extracts were determined at concentrations of 125, 250, 500, and 1000 μg/ml. While the different plants extract demonstrated a better anti-Helicobacter pylori activity as well as MIC when compared to the commonly used antibiotic amoxicillin, and other conventional antibiotics, the anti-Helicobacter pylori activity and MIC of Vernonia amygdalina was higher, followed by Bryophyllum pinnatum and Ocimum gratissimum. The in-vivo study as carried out using Wistar albino rats demonstrated the promising therapeutic effect of the plants extract against Helicobacter pylori infection. This study therefore suggests that Vernonia amygdalina, Bryophyllum pinnatum and Ocimum gratissimum extracts possess anti-Helicobacter pylori properties, offering safe, effective, and cost-effective treatment options for the treatment of ulcer, caused by Helicobacter pylori.

Background Although the immune dysregulation caused by Helicobacter pylori has been linked to the pathogenesis of many dermatological diseases, the link between H. pylori infection and pityriasis versicolor (PVC) has not been largely verified. Objective To study the probable association between active H. pylori infection and PVC prevalence and clinical parameters. Patients and methods The present case control study included 65 male patients with PVC (group A) and 65 dermatologically free patients (group B). Active H. pylori infection was detected in both groups using H. pylori stool antigen test (SAT). In group A, patients who tested SAT positive were subjected to measurement of anti-H. pylori immunoglobulin (Ig)G and IgA and interleukin (IL)-10 serum levels. Results The frequency of H. pylori was equal (61.5%) in both study groups. The various clinical parameters of PVC did not significantly differ between SAT-positive and SAT-negative patients. In group A, H. pylori-infected patients had elevated IgG and IgA serum titer, while IL-10 level was in most cases (65%) low. No significant relation was detected between the H. pylori serological markers and the PVC clinical parameters. Conclusion Active H. pylori infection did not impact the prevalence or clinical features of PVC. Elevated H. pylori IgG and IgA levels did not vary differentially in relation to PVC clinical features. Moreover, serum IL-10 level in active H. pylori-infected patients with PVC was not elevated. Accordingly, its role as a systemic immunosuppressive cytokine predisposing for PVC was unverified in this study.

Abstract Background Children are among the most vulnerable groups for Helicobacter pylori (H. pylori) infection, which was linked with an increased risk of anemia. H. pylori infection may cause the development of anemia through affecting the absorption of different micronutrients and increasing hepcidin production from hepatocytes. This study aimed to assess the effect of H. pylori infection on the occurrence of anemia in children. Methodology Previously published articles were systematically searched on major databases including Science Direct, PubMed, Embase, Scopus, Cochrane Library, and Science Citation Index using search terms. The search results were imported into EndNote X9 to organize and remove duplicates. Then, relevant data was extracted and analyzed using STATA version 16.0. The pooled odds ratio (OR) was calculated to evaluate the associations of H. pylori infection with Anemia. Moreover, pooled standardized mean difference (SMD) of Hemoglobin (Hgb) and Serum ferritin (SF) levels between cases and controls were calculated for group comparisons. Results A total of nine published articles were included in this study. The result showed that H. pylori-infected children had 2.68 times more risk of developing anemia compared to H. pylori-negative children (OR: 2.68:95% CI:1.44–4.99, p = 0.002). Subgroup analyses based on study design showed an increased significant association between H. pylori infection and anemia among case-control studies (OR:3.792:95%CI;1.767, 8.142, p = 0.001). Subgroup analyses based on the H. pylori detection method indicated an increased significant association between H. pylori infection and anemia when the stool antigen test method was used (OR:3.801;95%CI:1.090,13.250, p = 0.036). Moreover, there was a significant decrement of Hgb and SF levels in the H. pylori positive group compared to the negative group with SMD of -0.54(95%CI: -0.65, -0.42, p

Background: Gastritis is commonly caused by Helicobacter pylori, which colonizes the mucosa of the gastric epithelium in more than half the population worldwide. It adheres to the gastric epithelium, with an important aspect of the pathogenicity of the microorganism facilitating the transport of certain proteins such as CagA, BabA, and Hom into that epithelium. Objective: This study aimed to determine the association between the co-expression of LGR5 and CD133 in patients with gastric diseases and assess the distribution of H. pylori outer membrane genes (CagA, BabA, and HomB) with gastrointestinal disease outcomes. Materials and Methods: For the 140 patients enrolled, H. pylori virulence factors including Cag, BabA, and HomB were detected using Multiplex real-time PCR, while LGR5 and CD133 expressions were determined via immunohistochemistry. Results: The expressions of BabA and HomB had a significant difference with gastric disease such as gastric cancer, gastric metaplasia, and gastritis with and without the colonization of H. pylori, while there was no significant difference of CAG gene expression with gastric disease. Co-expression of LGR5 and CD133 had significant association with gastric disease. Conclusion: There was a significant increase in H. pylori Ag (BabA and HomB) expression among patients with gastric disease. However, no significant differences were observed between H. pylori Cag Ag expression among patients with gastric disease, and all the patients were infected with H. pylori having the Cag gene (100%). It is suggested that CD133 and Lgr5 may play an important role in gastric carcinoma.

Abstract Objectives We investigated the clinical significance of serum Helicobacter pylori cytotoxin-associated gene A (CagA) antibody levels in 768 patients with unstable angina (UA). Methods Serum CagA levels were measured using ELISA. Demographic data, serum biomarkers, and SYNTAX scores were collected. Patients were followed up for 1 year for major adverse cardiac events (MACE). Results CagA-positive UA patients had higher total cholesterol and hsCRP levels, and SYNTAX scores. CagA levels correlated positively with TC, hsCRP, and SYNTAX scores. Kaplan–Meier analysis showed shorter MACE-free survival in CagA-positive UA patients. CagA levels predicted MACE occurrence within 1 year, along with SYNTAX scores. Conclusions Serum H. pylori CagA antibody positivity is associated with worse prognosis in UA patients. CagA levels correlate with lipid metabolism and inflammatory markers.

A study conducted at Seoul National University Hospital compared three hematoxylin and eosin (H&E) staining methods for diagnosing gastritis using tissue biopsies from 83 patients who underwent gastro endoscopy. The three methods tested were Mayer H&E, Harris H&E, and a modified five-minute Mayer H&E, with Wright-Giemsa (W-G) staining used as the standard. Two pathologists evaluated the slides for the presence of Helicobacter pylori, nucleus, capillaries, neutrophils, and internal metaplasia. The results were analyzed based on two criteria: stages from negative to severe and positive or negative categories for H. pylori detection. The five-minute Mayer H&E method showed the highest detection rate for H. pylori and the best staining for the nucleus, capillaries, and neutrophils. The highest agreement was observed between pathologists in their evaluations. These findings suggest that the five-minute Mayer H&E method is the most effective for diagnosing gastritis and provides the most accurate and reliable results. As a result, this method is recommended as the standard histological stain for gastritis diagnosis, offering superior diagnostic accuracy compared to other staining techniques.

The prevalence of gastric mucosa-associated lymphoid tissue (MALT) lymphoma in Korea has not been reported largely because, it is a relatively rare disease. Gastric MALT lymphoma is clinically important because of the high prevalence of Helicobacter pylori (H. pylori) in Korea. The endoscopic findings of gastric MALT lymphoma are diverse, and it is often challenging to differentiate from gastric adenocarcinoma. Adequate tissue acquisition and testing for H. pylori are required for diagnosis. Neck, chest, and abdominopelvic CT scans should be performed with detailed patient history taking and a physical examination for accurate disease staging. The treatment for gastric MALT lymphoma depends on the disease stage and include H. pylori eradication therapy, radiation therapy, and chemotherapy. This manuscript summarizes the etiology, clinical characteristics, diagnosis, and treatment of gastric MALT lymphoma in Korea.

Gastric cancer remains a significant global health challenge, causing a substantial number of cancer-related deaths, particularly in China. While the exact causes of gastric cancer are still being investigated, Helicobacter pylori (H. pylori) infection has been identified as the primary risk factor, which triggers chronic inflammation and a multistage progression of gastric lesions that may lead to carcinogenesis over a long latency time. Since the 1990s, numerous efforts have focused on assessing the effectiveness of H. pylori eradication in preventing new cases of gastric cancer among both the general population and patients who have undergone early-stage cancer treatment. This body of work, including several community-based interventions and meta-analyses, has shown a reduction in both the incidence of and mortality from gastric cancer following H. pylori treatment, alongside a decreased risk of metachronous gastric cancer. In this review, we seek to consolidate current knowledge on the effects of H. pylori treatment on gastric cancer prevention, its systemic consequences, cost-effectiveness, and the influence of antibiotic resistance and host characteristics on treatment outcomes. We further discuss the potential for precision primary prevention of H. pylori treatment and comment on the efficient implementation of test-and-treat policies and allocation of health resources towards minimizing the burden of gastric cancer globally.

Objective: Magnetically controlled capsule gastroscopy (MCCG) is an effective method for screening gastric diseases; however, its performance may be affected by gastric cleanliness. We aimed to explore the correlation between Helicobacter pylori infection and the degree of gastric cleanliness in the MCCG. Methods: This retrospective study enrolled 297 participants from October 2020 to April 2024 at Sir Run Run Shaw Hospital, Zhejiang University School of Medicine. Participant characteristics, MCCG examination results, and (13) C-urea breath test (C13-UBT) results were collected. The gastric cleanliness in MCCG examinations was assessed using a gastric cleanliness score. Binary logistic regression was used to analyze the relationships among participant characteristics, H. pylori infection, and gastric cleanliness. Chi-square tests and Fisher's exact tests were used to analyze the relationships among gastric lesions, H. pylori infection, and gastric cleanliness. Results: Among the participants, 24.2% had H. pylori infection, and 17.5% had poor gastric cleanliness. Hypertension (odds ratio [OR]: 2.63; 95% confidence interval [CI]: 1.36–5.09; p = 0.004) was associated with a greater likelihood of H. pylori infection. H. pylori infection (OR: 3.76; 95% CI: 1.99–7.09; p

Prophages can have major clinical implications through their ability to change pathogenic bacterial traits. There is limited understanding of the prophage role in ecological, evolutionary, adaptive processes and pathogenicity of Helicobacter pylori, a widespread bacterium causally associated with gastric cancer. Inferring the exact prophage genomic location and completeness requires complete genomes. The international Helicobacter pylori Genome Project (HpGP) dataset comprises 1011 H. pylori complete clinical genomes enriched with epigenetic data. We thoroughly evaluated the H. pylori prophage genomic content in the HpGP dataset. We investigated population evolutionary dynamics through phylogenetic and pangenome analyses. Additionally, we identified genome rearrangements and assessed the impact of prophage presence on bacterial gene disruption and methylome. We found that 29.5% (298) of the HpGP genomes contain prophages, of which only 32.2% (96) were complete, minimizing the burden of prophage carriage. The prevalence of H. pylori prophage sequences was variable by geography and ancestry, but not by disease status of the human host. Prophage insertion occasionally results in gene disruption that can change the global bacterial epigenome. Gene function prediction allowed the development of the first model for lysogenic-lytic cycle regulation in H. pylori. We have disclosed new prophage inactivation mechanisms that appear to occur by genome rearrangement, merger with other mobile elements, and pseudogene accumulation. Our analysis provides a comprehensive framework for H. pylori prophage biological and genomics, offering insights into lysogeny regulation and bacterial adaptation to prophages.

It is estimated that more than half of the world population has been infected with Helicobacter pylori. Most newly acquired H. pylori infections occur in children before 10 years of age. We hypothesized that early life H. pylori infection could influence the composition of the microbiome at mucosal sites distant to the stomach. To test this hypothesis, we utilized the infant rhesus macaque monkey as an animal model of natural H. pylori colonization to determine the impact of infection on the lung and oral microbiome during a window of postnatal development. From a cohort of 4-7 month-old monkeys, gastric biopsy cultures identified 44% of animals infected by H. pylori. 16S ribosomal RNA gene sequencing of lung washes and buccal swabs from animals showed distinct profiles for the lung and oral microbiome, independent of H. pylori infection. In order of relative abundance, the lung microbiome was dominated by the phyla Proteobacteria, Firmicutes, Bacteroidota, Fusobacteriota, Campilobacterota and Actinobacteriota while the oral microbiome was dominated by Proteobacteria, Firmicutes, Bacteroidota, and Fusobacteriota. In comparison to the oral cavity, the lung was composed of more genera and species that significantly differed by H. pylori status, with a total of 6 genera and species that were increased in H. pylori negative infant monkey lungs. Lung, but not plasma IL-8 concentration was also associated with gastric H. pylori load and lung microbial composition. We found the infant rhesus macaque monkey lung harbors a microbiome signature that is distinct from that of the oral cavity during postnatal development. Gastric H. pylori colonization and IL-8 protein were linked to the composition of microbial communities in the lung and oral cavity. Collectively, these findings provide insight into how H. pylori infection might contribute to the gut-lung axis during early childhood and modulate future respiratory health.

Helicobacter pylori, a dominant member of the gastric microbiota, shares co-evolutionary history with humans. This has led to the development of genetically distinct H. pylori subpopulations associated with the geographic origin of the host and with differential gastric disease risk. Here, we provide insights into H. pylori population structure as a part of the Helicobacter pylori Genome Project (HpGP), a multi-disciplinary initiative aimed at elucidating H. pylori pathogenesis and identifying new therapeutic targets. We collected 1011 well-characterized clinical strains from 50 countries and generated high-quality genome sequences. We analysed core genome diversity and population structure of the HpGP dataset and 255 worldwide reference genomes to outline the ancestral contribution to Eurasian, African, and American populations. We found evidence of substantial contribution of population hpNorthAsia and subpopulation hspUral in Northern European H. pylori. The genomes of H. pylori isolated from northern and southern Indigenous Americans differed in that bacteria isolated in northern Indigenous communities were more similar to North Asian H. pylori while the southern had higher relatedness to hpEastAsia. Notably, we also found a highly clonal yet geographically dispersed North American subpopulation, which is negative for the cag pathogenicity island, and present in 7% of sequenced US genomes. We expect the HpGP dataset and the corresponding strains to become a major asset for H. pylori genomics.

Background & aimsGastric cancer (GC) remains a leading cause of cancer and cancer-related mortality. Recent reports suggest noncardia GC is increasing in certain U.S.PopulationsHowever, whether these trends are driven by gastric adenocarcinoma (GA) or other histologies, including neuroendocrine tumors (NETs), lymphoma, or gastrointestinal stromal tumors (GISTs), is unclear.MethodsWe analyzed the Surveillance, Epidemiology and End Results-18 cancer registry (2000-2018) to determine age-standardized incidence rates (ASIR) and annual percentage change (APC) trends for histologically-confirmed GCs, stratified by anatomic location (noncardia vs cardia), age group (20-49 vs 50+ years), sex, race, and ethnicity. Joinpoint regression modeling estimated the statistical significance of trend comparisons.ResultsOf 74,520 individuals with noncardia GC, most (66.2%) were GA, with the next largest categories being non-mucosa-associated lymphoid tissue (non-MALT) lymphomas (6.9%), GIST (6.7%), NET (6.4%), and MALT lymphoma (5.6%). Noncardia GA ASIR was significantly higher than other histologies and demonstrated the greatest differences by race and ethnicity. APCs for GA and MALT, both Helicobacter pylori-associated cancers, declined significantly over time, which was driven primarily by trends among individuals ≥50 years-old. NET and GIST APCs significantly increased irrespective of age group, with the highest APCs observed among non-Hispanic white individuals. Cardia GC was rarer than noncardia GC and comprised primarily by GA (87.9%). Cardia GC incidence fell during the study period, which was primarily driven by decline in cardia GA.ConclusionsGA was the most common histology. On the basis of our findings, the rise in noncardia GC among certain U.S. populations appears predominantly driven by NET and GIST, not GA. Further studies are needed to clarify underlying etiologies for these findings.

Background: Infection by Helicobacter pylori (H. pylori) is prevalent and linked to many pathological conditions. Numerous studies have explored the association between H. pylori and gastric diseases. However, there are fewer studies on the impact of H. pylori on biochemical and hematological parameters. Furthermore, the role of genetic variations in mediating these hematobiochemical alterations remains poorly unrevealed. Objective: explore the association between Glutathione S-transferase mu1 and theta1 (GST M1, T1) gene polymorphisms and hematobiochemical changes in H. pylori-infected individuals. Subjects and Methods: Thirty H. pylori-infected male patients and thirty healthy uninfected males as control were enrolled in the study. Biochemical profiles, oxidative stress markers, and hematological profile were measured, along with glutathione S-transferase mu1 and theta1genotyping. Statistical analyses: The statistics were conducted using the SPSS program (version 27). Results: H. pylori-infected patients had significantly decreased mean levels of many parameters like hemoglobin. Meanwhile significantly increased levels of other parameters like monocytes in comparison to the non-infected control. Additionally, patients with the null genotype for mu1 and theta1 (double null) had significantly higher levels of monocytes and other parameters. However, they had reduced total glutathione S-transferase enzyme activity compared to the control group. Conclusion: This study offers proof of hematobiochemical alterations related to infection with H. pylori and underscore the modulatory role of GSTM1/GSTT1 genetic variation with a higher susceptibility in null genotypes carriers.

Abstract Helicobacter pylori infection is a major risk factor for gastric adenocarcinomas. In the case of the intestinal subtype, chronic gastritis and intestinal metaplasia are well-known sequential steps in carcinogenesis. H. pylori has high genetic diversity that can modulate virulence and pathogenicity in the human host as a cag Pathogenicity Island (cagPAI). However, bacterial gene combinations do not always explain the clinical presentation of the disease, indicating that other factors associated with H. pylori may play a role in the development of gastric disease. In this context, we characterized the microbial composition of patients with chronic gastritis (inactive and active), intestinal metaplasia, and gastric cancer as well as their potential association with H. pylori. To this end, 16 S rRNA metagenomic analysis was performed on gastric mucosa samples from patients with different types of lesions and normal gastric tissues. Our main finding was that H. pylori virulence status can contribute to significant differences in the constitution of the gastric microbiota between the sequential steps of the carcinogenesis cascade. Differential microbiota was observed in inactive and active gastritis dependent of the H. pylori presence and status (p = 0.000575). Pseudomonades, the most abundant order in the gastritis, was associated the presence of non-virulent H. pylori in the active gastritis. Notably, there are indicator genera according to H. pylori status that are poorly associated with diseases and provide additional evidence that the microbiota, in addition to H. pylori, is relevant to gastric carcinogenesis.

Abstract Background This umbrella review aims to synthesize evidence from previously conducted meta-analyses and review articles to assess the effects of vonoprazan-amoxicillin (VA) in the management of Helicobacter pylori (Hp). Methods While adhering to the PRIOR guidelines, PubMed, Google Scholar, Web of Science, and Scopus were searched from the database inception to May 2024 to identify relevant articles. The outcomes of interest included eradication rate, compliance, and adverse events. The risk ratios for these outcomes were compared across the studies and a corrected covered area (CCA) assessment was performed to determine overlap. Each included review was assessed for its quality and rigor via the AMSTAR-2 tool. Results From 13,743 articles identified during the literature search, 4 meta-analyses were included. A significant overlap was noted across studies with a corrected cover area of 20.8%. VA dual therapy outperformed PPI-based therapies in eradication rates (RR: 1.14–1.15, p 0.05). Compliance was significantly higher with VA dual therapy versus proton pump inhibitors (PPI)-based therapies (RR: 1.14, p = 0.004), but no significant difference was found between VA dual therapy and VAC therapy. Adverse events were reported inconsistently: one review found a higher likelihood with VA dual therapy versus PPI-based therapies (RR: 1.14, p = 0.0004), while others reported lower risk (RR: 0.59–0.80). VA dual therapy has not shown significant adverse events versus VAC therapy. Conclusion VA dual therapy presents as a promising alternative to PPI-based therapies, showcasing better eradication rates and higher compliance. Its performance is comparable to VAC triple therapy, indicating its potential as an effective treatment option for certain conditions.

Abstract Background This study aimed to explore whether cytotoxin-associated gene A (CagA) can inhibit cell cycle progression by activating nuclear factor of activated T cells (NFAT) in lymphoma B cells and contribute to Helicobacter pylori eradication (HPE) responsiveness (complete remission [CR] after HPE) in gastric mucosa-associated lymphoid tissue (MALT) lymphoma. Materials and Methods We co-cultured three B-lymphoma cell lines (MA-1, OCI-Ly3, and OCI-Ly7) with HP strains (derived from HPE-responsive gastric MALT lymphoma) and evaluated the expression patterns of CagA, phosphorylated (p)-CagA (CagAP−Tyr), and CagA-signaling molecules, cell-cycle inhibitors, p-NFATc1 (Ser172), and NFATc1 using western blotting. Furthermore, we evaluated the association between nuclear NFATc1 expression in the tumor cells of 91 patients who received first-line HPE (59 patients with HPE responsiveness and 32 without HPE responsiveness) and HPE responsiveness and CagA expression in tumor cells. Results In HP strains co-cultured with B cell lymphoma cell lines, CagA was translocated to the nucleus through tyrosine phosphorylation (CagAP−Tyr) and simultaneously dephosphorylated NFATc1, subsequently causing nuclear NFATc1 translocation and stimulating the expression of p-SHP-2/p-ERK/Bcl-xL. Activated NFATc1 causes G1 cell cycle retardation in both MA-1 and OCI-Ly3 cells by triggering p21 and p27 production. Nuclear NFATc1 localization was significantly associated with the presence of CagA in gastric MALT lymphomas (80% [41/51] vs. 33% [13/40]; p

Abstract Background Chronic infection by Helicobacter pylori strains expressing cytotoxin-associated gene A (CagA) are the strongest risk factor for gastric cancer. CagA can be classified into East Asian-type and Western-type (CagAE and CagAW), with CagAE being more closely associated with gastric cancer. This study aimed to investigate the impact of CagAE on intracellular signaling pathways to explain its high oncogenicity. Results Mutant H. pylori strains expressing either CagAE or CagAW were generated by transforming CagAE/W-expression plasmid into CagA-deleted G27 strain (G27ΔCagA). In human gastric epithelial cells (GES-1) infection, CagAE induced more severe cytopathic changes, including higher interleukin-8 (IL-8) secretion, reduced cell viability, more pronounced “hummingbird phenotype” alterations, and increased cell migration and invasion compared to CagAW. Transcriptome analysis revealed that CagAE had a stronger effect on the up-regulation of key intracellular processes, including tumor necrosis factor-ɑ (TNF-ɑ) signal pathway via nuclear factor kappa-B (NF-κB), inflammatory response, interferon-γ (IFN-γ) response, hypoxia, ultraviolet (UV) response, and Kirsten Rat Sarcoma Viral Oncogene Homolog (KRAS) signaling. A significant upregulation of hypoxia-related genes was a notable feature of CagAE. GES-1 cells infected with CagAE exhibited more severe intracellular hypoxia and higher levels of reactive oxygen species (ROS) than those infected with CagAW. Inhibition of hypoxia-inducible factor-1α (HIF-1α), which blocks hypoxia signaling, mitigated CagAE-induced cell migration, emphasizing the role of hypoxia in mediating CagAE effects. Conclusions The study provides transcriptome evidence of CagA-associated intracellular regulation during H. pylori infection, demonstrating that CagAE exerts stronger effects on intracellular signaling than CagAW. These findings offer insights into the heightened carcinogenic potential of CagAE in H. pylori-induced gastric cancer.

Abstract Background Helicobacter pylori is a prevalent infection that may complicate pregnancy, but evidence remains limited, controversial and may not apply to all pregnant women. Objective This study aims to evaluate whether Helicobacter pylori is a risk factor for adverse pregnancy outcomes and to identify vulnerable subpopulations. Study design Multiplex serology was utilized to measure blood levels of immunoglobulin G against eight Helicobacter pylori antigens in 1372 pregnant women from three European birth cohorts: BiB (United Kingdom), Rhea (Greece) and INMA (Spain). Outcomes of interest included gestational diabetes mellitus, gestational hypertension, preeclampsia, preterm birth and small for gestational age neonates, as well as prenatal anxiety and depression. Adjusted logistic regression models were used to evaluate the association between Helicobacter pylori seropositivity (overall and by antigen) and antigen specific antibody levels with the outcomes. We examined effect modification of the associations by ethnicity. Results Helicobacter pylori seropositivity was detected in 18.8% (258/1372) of pregnant women. Preeclampsia was the least common outcome (26/830). Helicobacter pylori seropositivity was associated with the development of two or more adverse pregnancy outcomes (gestational hypertension, gestational diabetes, preterm birth, small gestational age and preeclampsia) [OR:1.32 (95% CI: 1.06–1.65), p-value: 0.01], especially in women with high antibody levels to OMP antigen [OR: 2.12 (95% CI: 1.62–2.76), p-value: 0.001]. Women with high antibody levels to Helicobacter pylori antigens GroEL and NapA were more likely to develop preeclampsia [OR: 2.34 (95% CI: 1.10–8.82), p-value: 0.03; OR: 4.09 (95% CI: 1.4-11.93), p-value 0.01)]. Helicobacter pylori seropositivity increased the odds of developing any hypertensive disorder during pregnancy among women of western ethnicity (948/1372) [OR:3.35 (95% CI: 1.29–8.74), p-value 0.03]. Conclusion Our study suggests that Helicobacter pylori seropositivity is a risk factor for multiple adverse pregnancy outcomes and particularly in women of western origin for hypertensive disorders during pregnancy. Moreover, pathogen specific characteristics reflected in the antibody responses against OMP, GroEL and NapA seem to determine disease associations.

Dan Ma,1,&ast; Yunhui Fang,2,&ast; ZiWei Wang,1 Mosang Yu,1 Xin Xin Zhou1 1Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou City, People’s Republic of China; 2State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou City, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xin Xin Zhou, Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou City, 310003, People’s Republic of China, Email zhouxinxin@zju.edu.cnBackground and Aim: Antibiotic resistance of Helicobacter pylori is increasing worldwide, lowering its efficacy in eradication therapy and posing a serious threat to human health. This study evaluated H. pylori resistance to antibiotics in the southeast region of China and explored factors related to eradication failure guided by antimicrobial susceptibility testing (AST).Methods: In this retrospective study, patients who tested positive underwent gastroscopy, and H. pylori infection was confirmed by histological staining and H. pylori culture. We determined the rate of H. pylori antibiotic resistance, success rate of AST-guided eradication therapy, and risk factors associated with treatment failure.Results: Among the 210 enrolled patients, 188 (89.5%) had successful cultures, and 183 (87.1%) underwent AST. The most common antibiotic resistance was to metronidazole and clarithromycin (89.6%), followed by levofloxacin (68.3%), and amoxicillin (14.2%). Furazolidone (3.0%) and tetracycline (0.5%) showed relatively low resistance rates. There were no statistically significant differences in the rates of resistance to MET, LEV, or AMX between naive and non-naive patients. However, CLA resistance rates in non-naive patients were significantly higher than those in naive patients. The overall success rate of AST-guided therapy was high and showed no significant difference between first-line and rescue therapy. Sex, age, prior therapy, and proton pump inhibitors (PPIs) or potassium-competitive acid blockers (P-CABs) use were not significantly associated with an increased risk of eradication failure in AST-guided therapy.Keywords: Antibiotic resistance, Culture, Helicobacter pylori, Eradication therapy.

Objective To explore the effect of quadruple regimen with Lansoprazole in elderly patients with chronic atrophic gastritis and its influence on gastric function. Methods A total of 82 elderly patients with Helicobacter pylori(Hp)-positive chronic atrophic gastritis were enrolled as the research objects between January 2021 and December 2023. They were randomly divided into an observation group and a control group according to random number table, 54 cases in each group. The control group was treated with routine quadruple therapy (Omeprazole+Amoxicillin+Clarithromycin+Colloidal Bismuth Pectin), while the observation group was treated with quadruple regimen containing Lansoprazole (Lansoprazole + Amoxicillin + Clarithromycin + Colloidal Bismuth Pectin). The clinical curative effect, Hp eradication rate, gastric function indexes ［pepsinogen(PG-) Ⅰ, PG-Ⅱ, and gastrin(G)-17］, gastric mucosal recovery indexes ［epidermal growth factor (EGF), nitric oxide (NO)］, inflammatory indexes ［interleukin(IL)-6, IL-12, tumor necrosis factor(TNF)-α］ and adverse reactions were compared between the two groups. Results The total effective rate and Hp eradication rate in the observation group were higher than those in the control group (P0.05). Conclusion The curative effect of quadruple regimen with Lansoprazole is significant in elderly patients with Hp-positive chronic atrophic gastritis, which can effectively accelerate the recovery of gastric mucosa, improve gastric function and reduce inflammatory response.

Background/Aims: Helicobacter pylori eradication can reduce the incidence of metachronous gastric neoplasm (MGN) after endoscopic submucosal dissection (ESD) for early gastric cancer (EGC). This study evaluated the risk of developing MGN after ESD for EGC based on age at H. pylori eradication.Methods: Data of patients who underwent curative ESD for EGC with H. pylori infection between 2005 and 2018 were retrospectively analyzed. The patients were allocated to four groups according to age at H. pylori eradication: group 1 (