Nearly half of the global population are carriers of Helicobacter pylori(H. pylori),a Gram-negative bacterium that persists in the healthy human stomach. H. pylori can be a pathogen and causes development of peptic ul...Nearly half of the global population are carriers of Helicobacter pylori(H. pylori),a Gram-negative bacterium that persists in the healthy human stomach. H. pylori can be a pathogen and causes development of peptic ulcer disease in a certain state of the macroorganism. It is well established that H. pylori infection is the main cause of chronic gastritis and peptic ulcer disease(PUD). Decontamination of the gastric mucosa with various antibiotics leads to H. pylori elimination and longer remission in this disease. However,the reasons for repeated detection of H. pylori in recurrent PUD after its successful eradication remain unclear. The reason for the redetection of H. pylori in recurrent PUD can be either reinfection or ineffective anti-Helicobacter therapy. The administration of antibacterial drugs can lead not only to the emergence of resistant strains of microorganisms,but also contribute to the conversion of H. pylori into the resting(dormant) state. The dormant forms of H. pylori have been shown to play a potential role in the development of relapses of PUD. The paper discusses morphological H. pylori forms,such as S-shaped,C-shaped,U-shaped,and coccoid ones. The authors proposes the classification of H. pylori according to its morphological forms and viability.展开更多
Gastric cancer(GC)has high morbidity and mortality worldwide.Due to the absence of noticeable symptoms,diagnosing GC at an early stage is very difficult,which consequently leads to advanced GC and poor prognosis.Effec...Gastric cancer(GC)has high morbidity and mortality worldwide.Due to the absence of noticeable symptoms,diagnosing GC at an early stage is very difficult,which consequently leads to advanced GC and poor prognosis.Effective biomarkers are essential for prolonging patients’survival.Helicobacter pylori(H.pylori)infection represents the most significant risk factor for GC,with nearly all cases linked to this infection.Many non-coding RNAs(ncRNAs)are dysregulated in H.pylori-infected GC,indicating that ncRNAs may serve as biomarkers of early-stage GC.In this editorial,we discuss the study by Chen et al.Although previous studies have identified roles for miR-136 in gastric cancer proliferation,apoptosis,and invasion,none have specifically explored its relationship with H.pylori-associated gastric carcinogenesis.展开更多
Helicobacter pylori(H.pylori)infection remains a pivotal driver of chronic gastritis,peptic ulcer,gastric mucosa-associated lymphoid tissue lymphoma and gastric cancer,yet its eradication is increasingly frustrated by...Helicobacter pylori(H.pylori)infection remains a pivotal driver of chronic gastritis,peptic ulcer,gastric mucosa-associated lymphoid tissue lymphoma and gastric cancer,yet its eradication is increasingly frustrated by climbing antibiotic resistance and intolerable side-effects of standard triple or quadruple therapies.In recent years,fecal microbiota transplantation(FMT),a strategy that reconstructs the gut ecosystem by introducing a healthy donor microbiome,has emerged as a novel adjunct or alternative.By competitively excluding H.pylori,reinforcing mucosal barrier integrity,modulating host immunity and secreting bacteriocins,FMT can raise eradication rates,relieve dyspeptic symptoms and lower recurrence.This review synthesizes up-to-date pre-clinical,pilot and controlled clinical data,dissects underlying mechanisms,compares delivery routes,donor screening protocols and safety profiles,and discusses regulatory,ethical and standardization hurdles that must be overcome before large-scale clinical application.展开更多
This article aims to deepen the understanding of the role of Helicobacter pylori(H.pylori)infection in the development of cholelithiasis,initiated by the article by Yao et al,who investigated the potential link betwee...This article aims to deepen the understanding of the role of Helicobacter pylori(H.pylori)infection in the development of cholelithiasis,initiated by the article by Yao et al,who investigated the potential link between H.pylori infection and the development of cholelithiasis through a multicenter retrospective study on an Asian population of over 70000 participants.They also performed a compre-hensive analysis of previously published studies on H.pylori and cholelithiasis,finding a positive association therein[odds ratio(OR)=1.103,P=0.049].Patients positive for H.pylori also had lower levels of total and direct bilirubin,but higher levels of total cholesterol and low-density lipoprotein cholesterol compared to uninfected patients(P<0.05).Cohort studies have confirmed that H.pylori is a risk factor for cholelithiasis(P<0.0001),and aggregate analyses of case-control and cross-sectional studies have shown a positive association between H.pylori and cholelithiasis in Asia(OR=1.599,P=0.034),but not in Europe(OR=1.277,P=0.246).Moreover,H.pylori appears to be related to a higher ratio of choledocho-lithiasis/cholecystolithiasis(OR=3.321,P=0.033).The authors conclude that H.pylori infection is positively correlated with cholelithiasis,particularly with the choledocholithiasis phenotype,especially in Asia,and it is potentially related to bilirubin and cholesterol metabolism.展开更多
Helicobacter pylori-associated gastritis(HPAG)is a common condition of the gastrointestinal tract.However,extensive and long-term antibiotic use has resulted in numerous adverse effects,including increased resistance,...Helicobacter pylori-associated gastritis(HPAG)is a common condition of the gastrointestinal tract.However,extensive and long-term antibiotic use has resulted in numerous adverse effects,including increased resistance,gastrointestinal dysfunction,and increased recurrence rates.When these concerns develop,traditional Chinese medicine(TCM)may have advantages.TCM is based on the concept of completeness and aims to eliminate pathogens and strengthen the body.It has the potential to prevent this condition while also boosting the rate of Helicobacter pylori eradication.This review elaborates on the mechanism of TCM treatment for HPAG based on cellular signalling pathways,which reflects the flexibility of TCM in treating diseases and the advantages of multi-level,multipathway,and multi-target treatments for HPAG.展开更多
AIM: To investigate the frequencies of the expression of main protein antigens of Helicobacter pylori (H py/ori) isolates, such as UreB, VacA, CagA1, HpaA, NapA, FlaA and FlaB and the production of specific antibodies...AIM: To investigate the frequencies of the expression of main protein antigens of Helicobacter pylori (H py/ori) isolates, such as UreB, VacA, CagA1, HpaA, NapA, FlaA and FlaB and the production of specific antibodies in sera from H pylori-infected patients, and to understand the correlations among the different clinical types of chronic gastritis and peptic ulcer and the infection and virulence of H pylori. METHODS: H pylori strains in biopsy specimens from 157 patients with chronic gastritis and peptic ulcer were isolated and serum samples from the patients were also collected. The target recombinant proteins rUreB, rVacA, rCagAl, rHpaA, rNapA, rFlaA and rFlaB expressed by the prokaryotic expression systems constructed in our previous studies were collected through Ni-NTA affinity chromatography. Rabbit antisera against rUreB, rVacA, rCagAl, rHpaA, rNapA, rFlaA and rFlaB were prepared by using routine subcutaneous immunization. By using ultrasonic lysates of the isolates as coated antigens, and the self-prepared rabbit antisera as the first antibodies and commercial HRP-labeling sheep anti-rabbit IgG as the second antibody, expression frequencies of the seven antigens in the isolates were detected by ELISA. Another ELISA was established to detect antibodies against the seven antigens in sera of the patients by using the corresponding recombinant proteins as coated antigens, and the sera as the first antibody and HRP-labeling sheep anti-human IgG as the second antibody respectively. Correlations among the different clinical types of chronic gastritis and peptic ulcer and the infection and virulence of H pylori were statistically analysed. RESULTS: In the 125 isolates of H pylori, the positive rates of UreB, VacA, CagAl, HpaA, NapA, FlaA and FlaB were 100%, 65.6%, 92.8%, 100%, 93.6%, 100% and 99.2% respectively. In the 125 serum samples from the H pylori infected patients, the positive rates of antibodies against recombinant UreB, VacA, CagA1, HpaA, NapA, FIaA and FlaB were 100%, 42.4%, 89.6%, 81.6%, 93.6%, 98.4% and 92.8% respectively. H pylori strains were isolated from 79.6% (125/157) of the biopsy specimens, but no close correlations among the H pylori infection frequencies and different types of chronic gastritis and peptic ulcer could be found (P>0.05, x2 = 0.01-0.87). The VacA positive rate (82.40%) in the strains isolated from the specimens of patients with peptic ulcer and the anti-VacA positive rate (54.3%) in the sera from the patients were significantly higher than those (51.5%, 32.3%) from the patients with chronic gastritis (P<0.01, x2= 13.19; P<0.05, x2= 6.13). When analysis was performed in the different types of chronic gastritis, the VacA in the strains isolated from the specimems of patients with active gastritis showed a higher expression frequency (90.0%) than those from superficial (47.9%) and atrophic gastritis (30.0%) (P<0.05, x2 = 5.93; P<0.01,x2 = 7.50). While analysis was carried out in the strains isolated from the specimens with superficial (93.8%) and active gastritis (100%), NapA showed a higher expression frequency compared to that from atrophic gastritis (60.0%) (P<0.01, x2 = 8.88; P<0.05, X2=5.00). CONCLUSION: The types of chronic gastritis and peptic ulcer and their severity are not associated with H pylori infection frequency but closely related to the infection frequency of different virulent H pylori strains. The optimal antigens for developing vaccine and diagnostic kit are UreB, FlaA, HpaA, FlaB, NapA and CagAl, but not VacA.展开更多
BACKGROUND A dual therapy regimen containing amoxicillin is a common treatment option for the eradication of Helicobacter pylori(H.pylori).While substantial research supports the efficacy and safety of vonoprazan and ...BACKGROUND A dual therapy regimen containing amoxicillin is a common treatment option for the eradication of Helicobacter pylori(H.pylori).While substantial research supports the efficacy and safety of vonoprazan and amoxicillin(VA)dual therapy in the general population,there is still a lack of studies specifically focusing on its safety in elderly patients.AIM To evaluate efficacy and safety of VA dual therapy as first-line or rescue treatment for H.pylori in elderly patients.METHODS As a real-world retrospective study,data were collected from elderly patients aged 60 years and above who accepted VA dual therapy(vonoprazan 20 mg twice daily+amoxicillin 1000 mg thrice daily for 14 days)for H.pylori eradication in the Department of Gastroenterology at Peking University First Hospital between June 2020 and January 2024.H.pylori status was evaluated by^(13)C-urease breath test 6 weeks after treatment.All adverse events(AEs)during treatment were recorded.RESULTS In total,401 cases were screened.Twenty-one cases were excluded due to loss to follow-up,lack of re-examination,or unwillingness to take medication.The total of 380 included cases comprised 250 who received VA dual therapy as first-line treatment and 130 who received VA dual therapy as rescue treatment.H.pylori was successfully eradicated in 239 cases(95.6%)in the first-line treatment group and 116 cases(89.2%)in the rescue treatment group.The overall incidence of AEs was 9.5%for both groups.Specifically,9.2%of patients experienced an AE in the first-line treatment group and 10.0%in the rescue treatment group.Five patients discontinued treatment due to AE,with a discontinuation rate of 1.3%.No serious AE occurred.CONCLUSION The VA dual therapy regimen as a first-line treatment and a rescue therapy was effective and safe for elderly patients aged 60 and older.展开更多
BACKGROUND Helicobacter pylori(H.pylori)infection is a prevalent disease encountered in military internal medicine and recognized as the main cause of dyspepsia,gastritis,and peptic ulcer,which are common diseases in ...BACKGROUND Helicobacter pylori(H.pylori)infection is a prevalent disease encountered in military internal medicine and recognized as the main cause of dyspepsia,gastritis,and peptic ulcer,which are common diseases in military personnel.Current guidelines in China state all patients with evidence of active infection with H.pylori are offered treatment.However,the prevalence of H.pylori infection and its regional distribution in the military population remain unclear,which hinders effective prevention and treatment strategies.Understanding the prevalence of H.pylori infection in the military population will aid in the development of customized strategies to better manage this infectious disease.AIM To investigate the prevalence of H.pylori infection in the Chinese military population in different geographic areas.METHODS This multicenter,retrospective study included 22421 individuals from five tertiary hospitals located in north,east,southwest,and northwest cities of China.H.pylori infection was identified using the urea breath test,which had been performed between January 2020 and December 2021.RESULTS Of the 22421 military service members,7416(33.1%)were urea breath test-positive.The highest prevalence of H.pylori was in the 30-39 years age group for military personnel,with an infection rate of 34.9%.The majority of infected subjects were younger than 40-years-old,accounting for 70.4%of the infected population.The individuals serviced in Lanzhou and Chengdu showed a higher infection prevalence than those in Beijing,Nanjing,and Guangzhou,with prevalence rates of 44.3%,37.9%,29.0%,31.1%,and 32.3%,respectively.CONCLUSION H.pylori infection remains a common infectious disease among military personnel in China and has a relatively high prevalence rate in northwest China.展开更多
Helicobacter pylori(H.pylori)infection plays a critical role in gastric diseases,impacting the microbiota structure in gastric and duodenal ulcers.In their study,Jin et al utilized metagenomic sequencing to analyze mu...Helicobacter pylori(H.pylori)infection plays a critical role in gastric diseases,impacting the microbiota structure in gastric and duodenal ulcers.In their study,Jin et al utilized metagenomic sequencing to analyze mucosal samples from patients with ulcers and healthy controls,revealing significant changes in microbial diversity and composition.This article reviews their findings,emphasizing H.pylori’s role in gastric ulcers and the need for further research on its impact on duodenal ulcers.We evaluate the study’s strengths and limitations,suggesting future research directions to enhance our understanding of H.pylori’s contribution to ulcerative diseases.展开更多
BACKGROUND Antibiotic resistance is a key factor influencing the treatment outcomes of Helicobacter pylori(H.pylori)infection.The antibiotic resistance spectrum of H.pylori varies in different regions.We investigated ...BACKGROUND Antibiotic resistance is a key factor influencing the treatment outcomes of Helicobacter pylori(H.pylori)infection.The antibiotic resistance spectrum of H.pylori varies in different regions.We investigated the current status of antibiotic resistance of H.pylori in Hunan Province and analyzed the factors related to such resistance to provide strategies for the accurate clinical treatment of H.pylori infection.AIM To understand the antibiotic resistance of H.pylori in Hunan Province and provide guidance for the clinical treatment of H.pylori infection.METHODS This study selected patients who underwent gastroscopy in five hospitals in Hunan Province from April 2022 to April 2023.The sensitivity of H.pylori to clarithromycin,levofloxacin,metronidazole,amoxicillin,furazolidone,and tetracycline was detected using the Agar dilution method.RESULTS H.pylori strains from a total of 566 patients were isolated and identified.The resistance rates of H.pylori strains to clarithromycin,levofloxacin,metronidazole,amoxicillin,furazolidone,and tetracycline were 49.2%,37.8%,76.1%,2.3%,1.4%,and 0.7%,respectively.The resistance rates to clarithromycin,levofloxacin,and metronidazole were high in the four regions of Hunan Province,and the overall resistance rates in central Hunan Province were higher than those in other regions.The resistance rates of H.pylori strains to clarithromycin and levofloxacin were significantly different among the different age groups(P<0.05),with the elderly group having a higher resistance rate than the young group.The resistance rate of H.pylori strains to clarithromycin was greater in patients with atrophic gastritis,and the resistance rate to levofloxacin was the lowest in patients with peptic ulcers.CONCLUSION The resistance rate of H.pylori to amoxicillin,clarithromycin,and metronidazole is high in Hunan Province.Age,stomach disease,and H.pylori reinfection may affect the antibiotic resistance of H.pylori.展开更多
BACKGROUND MicroRNAs play an important role in gastric cancer(GC)development following Helicobacter pylori(H.pylori)infection.Yet the exact mechanism is still not fully understood.Herein,we investigated the underlying...BACKGROUND MicroRNAs play an important role in gastric cancer(GC)development following Helicobacter pylori(H.pylori)infection.Yet the exact mechanism is still not fully understood.Herein,we investigated the underlying mechanisms of miR-136 during this process.AIM To investigate the role of miR-136 in H.pylori-induced GC progression.METHODS GC and gastric epithelial cells were infected with H.pylori and transfected with miR-136 mimic,inhibitor,mimic plus PDCD11(identified as miR-136 target),or miR-NC(control).Cell proliferation,migration,and invasion were assessed via cell counting kit-8 assay,colony formation,wound healing,and Transwell assays.Nuclear factor kappa-B(NF-κB)/miR-136/PDCD11 interactions were confirmed by luciferase and inhibition assays.For in vivo studies H.pylori-infected BGC-823 cells were injected into nude mice.Reverse transcription PCR,western blot,immunohistochemistry,and immunofluorescent staining assay were used to assess mRNA and protein expression.RESULTS miR-136 expression was significantly upregulated while PDCD11 expression was significantly downregulated in early GC tissues and GC cells infected with H.pylori compared with non-infected tissues or cells(all P<0.01).miR-136 overexpression induced by H.pylori could promote the proliferation and migration of infected GC cells and induce the growth of H.pylori-positive GC tumors in mice while its inhibition could reverse this effect.Mechanistically,upregulation of miR-136 suppressed PDCD11 through NF-κB activation induced by H.pylori infection.CONCLUSION miR-136 is a novel diagnostic biomarker and therapeutic target in H.pylori-associated early-stage gastric carcinogenesis and acts through the NF-κB-miR-136-PDCD11 pathway.展开更多
BACKGROUND Helicobacter pylori(H.pylori)is a Gram-negative bacterium that relies on flagellar motility to colonize the stomach,damaging the gastric mucosa through various mechanisms and leading to various digestive di...BACKGROUND Helicobacter pylori(H.pylori)is a Gram-negative bacterium that relies on flagellar motility to colonize the stomach,damaging the gastric mucosa through various mechanisms and leading to various digestive disorders.Accurate assessment and precise treatment are essential in initial intensive therapy.AIM To investigate the efficacy and safety of a vonoprazan(VPZ)-based triple regimen for first-line eradication of H.pylori in China.METHODS This multicenter noninferior randomized controlled trial(June 2022 to November 2023)involved 524 H.pyloripositive patients across 19 centers in Shandong,China.Participants were randomized to 14-day esomeprazole/bismuth/amoxicillin/clarithromycin(EBAC),14-day VPZ/amoxicillin/clarithromycin(VACa),or 10-day VPZ/amoxicillin/clarithromycin(VACb)-all administered twice daily.Primary outcomes(eradication rates)were assessed via intention-to-treat(ITT)and per-protocol(PP)analyses.Secondary endpoints included adverse events and adherence.Noninferiority testing andχ^(2)tests were used for statistical comparisons.RESULTS A total of 524 patients participated in this study.In ITT analysis,the eradication rates of the EBAC,VACa,and VACb groups were 72.6%(127/175),88.0%(154/175),and 83.3%(145/174),respectively(P=0.001).The difference in the eradication rate between the EBAC and VPCa groups was 15.4%[95%confidence interval(CI):7.3-23.6,P<0.001],and that between the EBAC and VACb groups was 10.8%(95%CI:2.1-19.4,P=0.018).In PP analysis,the eradication rates of the EBAC,VACa,and VACb groups were 81.4%(127/156),93.9%(154/164),and 90.6%(145/160),respectively(P=0.001).There was no significant difference in the incidence of adverse reactions among the three groups,which were 36.6%,33.8%and 29.6%,respectively(P=0.50).CONCLUSION VPZ-based triple therapies demonstrate noninferiority to 14-day bismuth-containing regimens,with the 10-day regimen showing comparable efficacy and similar adverse event rates.展开更多
Recent studies have shown a noticeable increase in global Helicobacter pylori(H.pylori)resistance,with clarithromycin resistance surpassing 15%in various areas.However,inadequate epidemiological monitoring,especially ...Recent studies have shown a noticeable increase in global Helicobacter pylori(H.pylori)resistance,with clarithromycin resistance surpassing 15%in various areas.However,inadequate epidemiological monitoring,especially in developing countries,and the absence of uniform testing methods lead to discrepancies between regions and a possible underestimation of resistance levels.The complexity of treating H.pylori is driven by its highly dynamic genome,which is prone to frequent mutations contributing to phenotypical resistance.The usual course of action in empirical treatment involves using a combination of various drugs simultaneously,leading to significant resistance selection pressure and potential side effects.The emergence of H.pylori strains resistant to multiple drugs is closely tied to failures in first-line treatment,highlighting the need to prevent further resistance by using optimal initial empirical therapy or regimens guided by antibiotic susceptibility testing,requiring a collection of mixed samples and multiple isolates for accurate assessment.The emergence of new treatments like potassium-competitive acid blockers offers a hopeful approach to decrease antimicrobial usage while still ensuring effectiveness in comparison to traditional therapies with proton pump inhibitors.Additionally,the use of probiotics is under investigation to identify specific strains and formulations that may mitigate therapy-associated adverse effects.展开更多
BACKGROUND Each year,more than a million people are diagnosed with gastric cancer(GC)worldwide,and the incidence of this disease is projected to increase.Helicobacter pylori(H.pylori)is the major cause of GC.Managing ...BACKGROUND Each year,more than a million people are diagnosed with gastric cancer(GC)worldwide,and the incidence of this disease is projected to increase.Helicobacter pylori(H.pylori)is the major cause of GC.Managing infections caused by H.pylori and investigating their contribution to GC carcinogenesis are crucial for advancing diagnosis and treatment.Deleted in malignant brain tumors 1(DMBT1)is associated with the development of H.pylori and GC.However,the precise underlying mechanism is unclear.AIM To explore the role of DMBT1,as modulated by H.pylori,in the development,proliferation,and metastasis of GC.METHODS Utilizing human GC cells,DMBT1 gene silencing,and H.pylori treatment,four cell groups(control,H.pylori,si-DMBT1,and H.pylori+si-DMBT1)were subjected to cell counting kit-8,scratch,and Transwell assays.The DMBT1 expression was assessed by quantitative real-time polymerase chain reaction and Western blot.RESULTS In cellular tests,H.pylori+si-DMBT1 showed the greatest ability to proliferate,migration,and invasion capabilities,followed by the si-DMBT1,H.pylori,and control groups.DMBT1 mRNA was found to be the highest in control group,next in si-DMBT1,H.pylori and H.pylori+si-DMBT1,while H.pylori+si-DMBT1 showed the least expression.The results the Western blot assay showed a consistent trend of decreasing DMBT1 protein and mRNA levels.CONCLUSION Through inhibition of DMBT1,H.pylori could enhance GC’s proliferation,metastasis and invasion.Our findings revealed a novel connection between H.pylori infection,inflammation,and GC.展开更多
Objective Helicobacter pylori(HP)infection is associated with non-alcoholic fatty liver disease(NAFLD)and insulin resistance;however,the correlation between HP eradication and NAFLD remains controversial.This systemat...Objective Helicobacter pylori(HP)infection is associated with non-alcoholic fatty liver disease(NAFLD)and insulin resistance;however,the correlation between HP eradication and NAFLD remains controversial.This systematic review and meta-analysis examined the effect of HP treatment on clinical and laboratory parameters in NAFLD patients.Methods We conducted a literature search of the PubMed,Embase,Scopus,and Web of Science databases through Septem-ber 2023 for randomized controlled trials(RCTs)examining the effect of HP treatment on NAFLD patients versus lifestyle changes alone.The primary outcome was the change in steatosis parameters.The secondary endpoints were changes in anthropometric parameters,inflammatory markers(TNF-α),and metabolic parameters(fasting blood glucose,homeostasis model assessment of insulin resistance,AST/ALT,and lipid profile).The random effects model was used to calculate the standardized mean difference(SMD)with associated 95%confidence intervals(CIs)for our desired outcome.Results Four RCTs met our inclusion criteria.A total of 453 patients were included(mean age 42.8 years,58.5%males),228(50.3%)of whom were in the HP eradication group and 225(49.7%)of whom were in the lifestyle modification group.Compared with lifestyle modification alone,HP eradication had a significant effect on reducing liver steatosis and TNF-αlevels(SMD:-0.9;95%CI-14.67,-3.82,I^(2)=0%and SMD:-6.3;95%CI-9.04,-3.56,I^(2)=0%,respectively).No sig-nificant effect on other metabolic parameters was found.Conclusions HP eradication significantly reduced liver steatosis and TNF-αlevels in NAFLD patients.However,HP eradi-cation did not significantly affect other metabolic indices compared to lifestyle changes alone.展开更多
Helicobacter pylori(H.pylori)infection induces pathological changes via chronic inflammation and virulence factors,thereby increasing the risk of gastric cancer development.Compared with invasive examination methods,H...Helicobacter pylori(H.pylori)infection induces pathological changes via chronic inflammation and virulence factors,thereby increasing the risk of gastric cancer development.Compared with invasive examination methods,H.pylori-related serum indicators are cost-effective and valuable for the early detection of gastric cancer(GC);however,large-scale clinical validation and sufficient understanding of the specific molecular mechanisms involved are lacking.Therefore,a comprehensive review and analysis of recent advances in this field is necessary.In this review,we systematically analyze the relationship between H.pylori and GC and discuss the application of new molecular biomarkers in GC screening.We also summarize the screening potential and application of anti-H.pylori immunoglobulin G and virulence factor-related serum antibodies for identifying GC risk.These indicators provide early warning of infection and enhance screening accuracy.Additionally,we discuss the potential combination of multiple screening indicators for the comprehensive analysis and development of emerging testing methods to improve the accuracy and efficiency of GC screening.Although this review may lack sufficient evidence due to limitations in existing studies,including small sample sizes,regional variations,and inconsistent testing methods,it contributes to advancing personalized precision medicine in high-risk populations and developing GC screening strategies.展开更多
BACKGROUND Gastric cancer(GC)is one of the most common malignancies worldwide,and Helicobacter pylori(HP)infection is a well-established risk factor for its development.Programmed death-ligand 1(PD-L1)expression is a ...BACKGROUND Gastric cancer(GC)is one of the most common malignancies worldwide,and Helicobacter pylori(HP)infection is a well-established risk factor for its development.Programmed death-ligand 1(PD-L1)expression is a crucial biomarker for predicting the efficacy of immune checkpoint inhibitors in cancer treatment.While HP infection and PD-L1 expression in GC may be linked,the relationship between them remains unclear,in part because there have been conflicting results reported from various studies.AIM To perform a meta-analysis to assess the relationship between HP and PD-L1 expression in patients with GC.METHODS A systematic literature review was conducted using PubMed,Embase,Cochrane Library,and Web of Science databases.Observational studies that examined the association between HP infection and PD-L1 expression in patients with GC were included.Odds ratios and 95%confidence intervals were calculated to estimate the association.Heterogeneity was assessed using Cochrane’s Q test and I²statistic.A random-effects model was used due to significant heterogeneity across studies.RESULTS Fourteen studies involving a total of 3069 patients with GC were included.The pooled analysis showed a significant association between HP infection and increased PD-L1 expression in GC tissues(odd ratio=1.69,95%confidence interval:1.24-2.29,P<0.001,I^(2)=59%).Sensitivity analyses confirmed the robustness of these findings.Subgroup analyses did not show significant variation based on geographic region,sample size,or method of PD-L1 assessment.Publication bias was minimal,as shown by funnel plots and Egger’s regression test.CONCLUSION HP infection is associated with increased PD-L1 expression in GC,suggesting that HP status may influence the response to programmed cell death protein 1/PD-L1 blockade therapy.展开更多
Helicobacter pylori infection represents a widespread chronic condition with varying prevalence influenced by race, ethnicity, and geography. The severity of H. pylori-associated diseases is determined by an array of ...Helicobacter pylori infection represents a widespread chronic condition with varying prevalence influenced by race, ethnicity, and geography. The severity of H. pylori-associated diseases is determined by an array of virulence factors. Although extensive studies have been conducted globally, data on the distribution of Helicobacter pylori virulence genes in Libya remain limited, constraining insights into the pathogenicity of local strains and hindering the development of targeted interventions. This study aimed to evaluate the prevalence of H. pylori infection, characterize essential virulence genes [vacA variants (s1/s2, m1/m2), cagA, and iceA1], and examine their association with gastroduodenal diseases among Libyan patients. Gastric biopsies from 144 participants were analyzed using polymerase chain reaction (PCR) assays, and risk factor data were collected via questionnaires. H. pylori was detected in 63.2% of samples by PCR. The vacA gene was present in 84.6% of cases, cagA in 58.2%, and iceA1 in 29.7%. Among vacA variants, s1 allele was most common (53.2%), followed by m1 (42.9%), m2 (37.7%), and s2 (13%) alleles. Significant associations were identified between specific virulence genes and the development of gastroduodenal diseases, highlighting their role in pathogenicity. This investigation is one of Libya’s first comprehensive assessments of H. pylori virulence factors, addressing a critical epidemiological gap. The high prevalence of virulence genes suggests their potential as disease biomarkers. These findings contribute to a deeper understanding of H. pylori pathogenicity within the Libyan population and establish a basis for future clinical interventions and public health strategies to manage and prevent H. pylori-associated diseases in Libya and comparable regions.展开更多
BACKGROUND Antibiotic resistance significantly impacts the treatment failure rates of Helicobacter pylori(H.pylori)infections.AIM To investigate the trends in primary antibiotic resistance of H.pylori in Taiwan of Chi...BACKGROUND Antibiotic resistance significantly impacts the treatment failure rates of Helicobacter pylori(H.pylori)infections.AIM To investigate the trends in primary antibiotic resistance of H.pylori in Taiwan of China over the past six years.METHODS We conducted a retrospective analysis of H.pylori isolates from Taiwan residents,China who had not undergone previous treatments(n=1408),collected between January 1,2019 and December 31,2024.Susceptibility of these strains to amoxicillin,clarithromycin,levofloxacin,metronidazole,and tetracycline was tested using the Epsilometer test.We analyzed the trends in single and dual resistance profiles over the study period,and compared antibiotic resistance across different regions(northern,southern and eastern areas)of Taiwan of China.RESULTS The overall resistance rates for H.pylori to amoxicillin,clarithromycin,metronidazole,tetracycline,and levofloxacin in Taiwan of China were 1.3%,18.0%,31.0%,0.8%,and 28.7%,respectively.Tetracycline resistance increased significantly from 0%in 2019 to 3.5%in 2024(P value inχ^(2)test for linear trend:<0.001),while metronidazole resistance declined from 35.5%to 13.0%(P value inχ^(2)test for linear trend:<0.001).No significant changes of amoxicillin,clarithromycin and levofloxacin resistances were observed.The dual resistances to clarithromycin plus tetracycline,and metronidazole plus tetracycline both increased significantly from 0%to 1.7%from 2019 to 2024(P value inχ^(2)test for linear trend:<0.05).Furthermore,no significant regional differences in resistance frequencies except for levofloxacin were detected.CONCLUSION Primary antibiotic resistance to tetracycline in H.pylori has increased in Taiwan of China from 2019 to 2024,while resistance to metronidazole has decreased during the same period.The dual resistance to clarithromycin plus tetracycline and metronidazole plus tetracycline both increased significantly.展开更多
Salvia miltiorrhiza(Danshen)is a traditional Chinese herb that is commonly known for its cardiovascular and hepatoprotective benefits.Recent studies have confirmed that Danshen and its bioactive components can influen...Salvia miltiorrhiza(Danshen)is a traditional Chinese herb that is commonly known for its cardiovascular and hepatoprotective benefits.Recent studies have confirmed that Danshen and its bioactive components can influence gut microbial homeostasis,thereby affecting Helicobacter pylori(HP)colonization in the human stomach.HP is a bacterial pathogen associated with various gastrointestinal diseases.Current HP treatments mainly involve antibiotics and proton pump inhibitors.However,their efficacy is strongly compromised by the rapid emergence of antibiotic resistance in HP and genetic heterogeneity among patients.The interaction between Danshen and gut microbial status provides a novel perspective for HP treatment.Understanding the medical properties of Danshen in altering gut microbiota and eliminating HP,as well as the underlying mechanisms,is important for improving human gastrointestinal healthcare.This review investigates the interaction between Danshen and gut microbiota and its impact on HP infection using databases including Web of Science,PubMed,and Google Scholar.We explored the unconventional intersection between Danshen,gut microbiota,and HP infection,shedding light on their intricate interplay and potential therapeutic implications.A comprehensive understanding of this interaction provides valuable insights into developing novel therapeutic strategies that target the gut microbiota to mitigate HP-associated gastrointestinal disorders.展开更多
文摘Nearly half of the global population are carriers of Helicobacter pylori(H. pylori),a Gram-negative bacterium that persists in the healthy human stomach. H. pylori can be a pathogen and causes development of peptic ulcer disease in a certain state of the macroorganism. It is well established that H. pylori infection is the main cause of chronic gastritis and peptic ulcer disease(PUD). Decontamination of the gastric mucosa with various antibiotics leads to H. pylori elimination and longer remission in this disease. However,the reasons for repeated detection of H. pylori in recurrent PUD after its successful eradication remain unclear. The reason for the redetection of H. pylori in recurrent PUD can be either reinfection or ineffective anti-Helicobacter therapy. The administration of antibacterial drugs can lead not only to the emergence of resistant strains of microorganisms,but also contribute to the conversion of H. pylori into the resting(dormant) state. The dormant forms of H. pylori have been shown to play a potential role in the development of relapses of PUD. The paper discusses morphological H. pylori forms,such as S-shaped,C-shaped,U-shaped,and coccoid ones. The authors proposes the classification of H. pylori according to its morphological forms and viability.
基金Supported by The Joint Fund of Zhejiang Provincial Natural Science Foundation of China,No.LKLY25H160002.
文摘Gastric cancer(GC)has high morbidity and mortality worldwide.Due to the absence of noticeable symptoms,diagnosing GC at an early stage is very difficult,which consequently leads to advanced GC and poor prognosis.Effective biomarkers are essential for prolonging patients’survival.Helicobacter pylori(H.pylori)infection represents the most significant risk factor for GC,with nearly all cases linked to this infection.Many non-coding RNAs(ncRNAs)are dysregulated in H.pylori-infected GC,indicating that ncRNAs may serve as biomarkers of early-stage GC.In this editorial,we discuss the study by Chen et al.Although previous studies have identified roles for miR-136 in gastric cancer proliferation,apoptosis,and invasion,none have specifically explored its relationship with H.pylori-associated gastric carcinogenesis.
基金the 2026 Health Commission Fund of Guizhou Province,China.the freestatistics suite for its technical support.
文摘Helicobacter pylori(H.pylori)infection remains a pivotal driver of chronic gastritis,peptic ulcer,gastric mucosa-associated lymphoid tissue lymphoma and gastric cancer,yet its eradication is increasingly frustrated by climbing antibiotic resistance and intolerable side-effects of standard triple or quadruple therapies.In recent years,fecal microbiota transplantation(FMT),a strategy that reconstructs the gut ecosystem by introducing a healthy donor microbiome,has emerged as a novel adjunct or alternative.By competitively excluding H.pylori,reinforcing mucosal barrier integrity,modulating host immunity and secreting bacteriocins,FMT can raise eradication rates,relieve dyspeptic symptoms and lower recurrence.This review synthesizes up-to-date pre-clinical,pilot and controlled clinical data,dissects underlying mechanisms,compares delivery routes,donor screening protocols and safety profiles,and discusses regulatory,ethical and standardization hurdles that must be overcome before large-scale clinical application.
文摘This article aims to deepen the understanding of the role of Helicobacter pylori(H.pylori)infection in the development of cholelithiasis,initiated by the article by Yao et al,who investigated the potential link between H.pylori infection and the development of cholelithiasis through a multicenter retrospective study on an Asian population of over 70000 participants.They also performed a compre-hensive analysis of previously published studies on H.pylori and cholelithiasis,finding a positive association therein[odds ratio(OR)=1.103,P=0.049].Patients positive for H.pylori also had lower levels of total and direct bilirubin,but higher levels of total cholesterol and low-density lipoprotein cholesterol compared to uninfected patients(P<0.05).Cohort studies have confirmed that H.pylori is a risk factor for cholelithiasis(P<0.0001),and aggregate analyses of case-control and cross-sectional studies have shown a positive association between H.pylori and cholelithiasis in Asia(OR=1.599,P=0.034),but not in Europe(OR=1.277,P=0.246).Moreover,H.pylori appears to be related to a higher ratio of choledocho-lithiasis/cholecystolithiasis(OR=3.321,P=0.033).The authors conclude that H.pylori infection is positively correlated with cholelithiasis,particularly with the choledocholithiasis phenotype,especially in Asia,and it is potentially related to bilirubin and cholesterol metabolism.
基金Supported by National Natural Science Foundation of China,No.82374323and Hunan Graduate Research Innovation Project,No.2023CX15.
文摘Helicobacter pylori-associated gastritis(HPAG)is a common condition of the gastrointestinal tract.However,extensive and long-term antibiotic use has resulted in numerous adverse effects,including increased resistance,gastrointestinal dysfunction,and increased recurrence rates.When these concerns develop,traditional Chinese medicine(TCM)may have advantages.TCM is based on the concept of completeness and aims to eliminate pathogens and strengthen the body.It has the potential to prevent this condition while also boosting the rate of Helicobacter pylori eradication.This review elaborates on the mechanism of TCM treatment for HPAG based on cellular signalling pathways,which reflects the flexibility of TCM in treating diseases and the advantages of multi-level,multipathway,and multi-target treatments for HPAG.
基金Supported by the Excellent Young Teacher Fund of Chinese Education Ministry and the General Science Technology Research Program of Zhejiang Province, No. 001110438
文摘AIM: To investigate the frequencies of the expression of main protein antigens of Helicobacter pylori (H py/ori) isolates, such as UreB, VacA, CagA1, HpaA, NapA, FlaA and FlaB and the production of specific antibodies in sera from H pylori-infected patients, and to understand the correlations among the different clinical types of chronic gastritis and peptic ulcer and the infection and virulence of H pylori. METHODS: H pylori strains in biopsy specimens from 157 patients with chronic gastritis and peptic ulcer were isolated and serum samples from the patients were also collected. The target recombinant proteins rUreB, rVacA, rCagAl, rHpaA, rNapA, rFlaA and rFlaB expressed by the prokaryotic expression systems constructed in our previous studies were collected through Ni-NTA affinity chromatography. Rabbit antisera against rUreB, rVacA, rCagAl, rHpaA, rNapA, rFlaA and rFlaB were prepared by using routine subcutaneous immunization. By using ultrasonic lysates of the isolates as coated antigens, and the self-prepared rabbit antisera as the first antibodies and commercial HRP-labeling sheep anti-rabbit IgG as the second antibody, expression frequencies of the seven antigens in the isolates were detected by ELISA. Another ELISA was established to detect antibodies against the seven antigens in sera of the patients by using the corresponding recombinant proteins as coated antigens, and the sera as the first antibody and HRP-labeling sheep anti-human IgG as the second antibody respectively. Correlations among the different clinical types of chronic gastritis and peptic ulcer and the infection and virulence of H pylori were statistically analysed. RESULTS: In the 125 isolates of H pylori, the positive rates of UreB, VacA, CagAl, HpaA, NapA, FlaA and FlaB were 100%, 65.6%, 92.8%, 100%, 93.6%, 100% and 99.2% respectively. In the 125 serum samples from the H pylori infected patients, the positive rates of antibodies against recombinant UreB, VacA, CagA1, HpaA, NapA, FIaA and FlaB were 100%, 42.4%, 89.6%, 81.6%, 93.6%, 98.4% and 92.8% respectively. H pylori strains were isolated from 79.6% (125/157) of the biopsy specimens, but no close correlations among the H pylori infection frequencies and different types of chronic gastritis and peptic ulcer could be found (P>0.05, x2 = 0.01-0.87). The VacA positive rate (82.40%) in the strains isolated from the specimens of patients with peptic ulcer and the anti-VacA positive rate (54.3%) in the sera from the patients were significantly higher than those (51.5%, 32.3%) from the patients with chronic gastritis (P<0.01, x2= 13.19; P<0.05, x2= 6.13). When analysis was performed in the different types of chronic gastritis, the VacA in the strains isolated from the specimems of patients with active gastritis showed a higher expression frequency (90.0%) than those from superficial (47.9%) and atrophic gastritis (30.0%) (P<0.05, x2 = 5.93; P<0.01,x2 = 7.50). While analysis was carried out in the strains isolated from the specimens with superficial (93.8%) and active gastritis (100%), NapA showed a higher expression frequency compared to that from atrophic gastritis (60.0%) (P<0.01, x2 = 8.88; P<0.05, X2=5.00). CONCLUSION: The types of chronic gastritis and peptic ulcer and their severity are not associated with H pylori infection frequency but closely related to the infection frequency of different virulent H pylori strains. The optimal antigens for developing vaccine and diagnostic kit are UreB, FlaA, HpaA, FlaB, NapA and CagAl, but not VacA.
基金Supported by National High Level Hospital Clinical Research Funding(Youth Clinical Research Project of Peking University First Hospital),No.2023YC27Capital’s Funds for Health Improvement and Research,No.2022-2-40711National High Level Hospital Clinical Research Funding(Interdepartmental Research Project of Peking University First Hospital),No.2024IR20.
文摘BACKGROUND A dual therapy regimen containing amoxicillin is a common treatment option for the eradication of Helicobacter pylori(H.pylori).While substantial research supports the efficacy and safety of vonoprazan and amoxicillin(VA)dual therapy in the general population,there is still a lack of studies specifically focusing on its safety in elderly patients.AIM To evaluate efficacy and safety of VA dual therapy as first-line or rescue treatment for H.pylori in elderly patients.METHODS As a real-world retrospective study,data were collected from elderly patients aged 60 years and above who accepted VA dual therapy(vonoprazan 20 mg twice daily+amoxicillin 1000 mg thrice daily for 14 days)for H.pylori eradication in the Department of Gastroenterology at Peking University First Hospital between June 2020 and January 2024.H.pylori status was evaluated by^(13)C-urease breath test 6 weeks after treatment.All adverse events(AEs)during treatment were recorded.RESULTS In total,401 cases were screened.Twenty-one cases were excluded due to loss to follow-up,lack of re-examination,or unwillingness to take medication.The total of 380 included cases comprised 250 who received VA dual therapy as first-line treatment and 130 who received VA dual therapy as rescue treatment.H.pylori was successfully eradicated in 239 cases(95.6%)in the first-line treatment group and 116 cases(89.2%)in the rescue treatment group.The overall incidence of AEs was 9.5%for both groups.Specifically,9.2%of patients experienced an AE in the first-line treatment group and 10.0%in the rescue treatment group.Five patients discontinued treatment due to AE,with a discontinuation rate of 1.3%.No serious AE occurred.CONCLUSION The VA dual therapy regimen as a first-line treatment and a rescue therapy was effective and safe for elderly patients aged 60 and older.
文摘BACKGROUND Helicobacter pylori(H.pylori)infection is a prevalent disease encountered in military internal medicine and recognized as the main cause of dyspepsia,gastritis,and peptic ulcer,which are common diseases in military personnel.Current guidelines in China state all patients with evidence of active infection with H.pylori are offered treatment.However,the prevalence of H.pylori infection and its regional distribution in the military population remain unclear,which hinders effective prevention and treatment strategies.Understanding the prevalence of H.pylori infection in the military population will aid in the development of customized strategies to better manage this infectious disease.AIM To investigate the prevalence of H.pylori infection in the Chinese military population in different geographic areas.METHODS This multicenter,retrospective study included 22421 individuals from five tertiary hospitals located in north,east,southwest,and northwest cities of China.H.pylori infection was identified using the urea breath test,which had been performed between January 2020 and December 2021.RESULTS Of the 22421 military service members,7416(33.1%)were urea breath test-positive.The highest prevalence of H.pylori was in the 30-39 years age group for military personnel,with an infection rate of 34.9%.The majority of infected subjects were younger than 40-years-old,accounting for 70.4%of the infected population.The individuals serviced in Lanzhou and Chengdu showed a higher infection prevalence than those in Beijing,Nanjing,and Guangzhou,with prevalence rates of 44.3%,37.9%,29.0%,31.1%,and 32.3%,respectively.CONCLUSION H.pylori infection remains a common infectious disease among military personnel in China and has a relatively high prevalence rate in northwest China.
文摘Helicobacter pylori(H.pylori)infection plays a critical role in gastric diseases,impacting the microbiota structure in gastric and duodenal ulcers.In their study,Jin et al utilized metagenomic sequencing to analyze mucosal samples from patients with ulcers and healthy controls,revealing significant changes in microbial diversity and composition.This article reviews their findings,emphasizing H.pylori’s role in gastric ulcers and the need for further research on its impact on duodenal ulcers.We evaluate the study’s strengths and limitations,suggesting future research directions to enhance our understanding of H.pylori’s contribution to ulcerative diseases.
基金Supported by the National Natural Science Foundation of China,No.82270594the Independent Exploration and Innovation Project of Central South University,No.2024ZZTS0966.
文摘BACKGROUND Antibiotic resistance is a key factor influencing the treatment outcomes of Helicobacter pylori(H.pylori)infection.The antibiotic resistance spectrum of H.pylori varies in different regions.We investigated the current status of antibiotic resistance of H.pylori in Hunan Province and analyzed the factors related to such resistance to provide strategies for the accurate clinical treatment of H.pylori infection.AIM To understand the antibiotic resistance of H.pylori in Hunan Province and provide guidance for the clinical treatment of H.pylori infection.METHODS This study selected patients who underwent gastroscopy in five hospitals in Hunan Province from April 2022 to April 2023.The sensitivity of H.pylori to clarithromycin,levofloxacin,metronidazole,amoxicillin,furazolidone,and tetracycline was detected using the Agar dilution method.RESULTS H.pylori strains from a total of 566 patients were isolated and identified.The resistance rates of H.pylori strains to clarithromycin,levofloxacin,metronidazole,amoxicillin,furazolidone,and tetracycline were 49.2%,37.8%,76.1%,2.3%,1.4%,and 0.7%,respectively.The resistance rates to clarithromycin,levofloxacin,and metronidazole were high in the four regions of Hunan Province,and the overall resistance rates in central Hunan Province were higher than those in other regions.The resistance rates of H.pylori strains to clarithromycin and levofloxacin were significantly different among the different age groups(P<0.05),with the elderly group having a higher resistance rate than the young group.The resistance rate of H.pylori strains to clarithromycin was greater in patients with atrophic gastritis,and the resistance rate to levofloxacin was the lowest in patients with peptic ulcers.CONCLUSION The resistance rate of H.pylori to amoxicillin,clarithromycin,and metronidazole is high in Hunan Province.Age,stomach disease,and H.pylori reinfection may affect the antibiotic resistance of H.pylori.
基金Supported by the National Natural Science Foundation of China,No.82470593General Project of the Development Fund of the Affiliated Hospital of Xuzhou Medical University,No.XYFM202334.
文摘BACKGROUND MicroRNAs play an important role in gastric cancer(GC)development following Helicobacter pylori(H.pylori)infection.Yet the exact mechanism is still not fully understood.Herein,we investigated the underlying mechanisms of miR-136 during this process.AIM To investigate the role of miR-136 in H.pylori-induced GC progression.METHODS GC and gastric epithelial cells were infected with H.pylori and transfected with miR-136 mimic,inhibitor,mimic plus PDCD11(identified as miR-136 target),or miR-NC(control).Cell proliferation,migration,and invasion were assessed via cell counting kit-8 assay,colony formation,wound healing,and Transwell assays.Nuclear factor kappa-B(NF-κB)/miR-136/PDCD11 interactions were confirmed by luciferase and inhibition assays.For in vivo studies H.pylori-infected BGC-823 cells were injected into nude mice.Reverse transcription PCR,western blot,immunohistochemistry,and immunofluorescent staining assay were used to assess mRNA and protein expression.RESULTS miR-136 expression was significantly upregulated while PDCD11 expression was significantly downregulated in early GC tissues and GC cells infected with H.pylori compared with non-infected tissues or cells(all P<0.01).miR-136 overexpression induced by H.pylori could promote the proliferation and migration of infected GC cells and induce the growth of H.pylori-positive GC tumors in mice while its inhibition could reverse this effect.Mechanistically,upregulation of miR-136 suppressed PDCD11 through NF-κB activation induced by H.pylori infection.CONCLUSION miR-136 is a novel diagnostic biomarker and therapeutic target in H.pylori-associated early-stage gastric carcinogenesis and acts through the NF-κB-miR-136-PDCD11 pathway.
基金Supported by Qilu Health Outstanding Young Talent Cultivation Project,No.QDFY-3839。
文摘BACKGROUND Helicobacter pylori(H.pylori)is a Gram-negative bacterium that relies on flagellar motility to colonize the stomach,damaging the gastric mucosa through various mechanisms and leading to various digestive disorders.Accurate assessment and precise treatment are essential in initial intensive therapy.AIM To investigate the efficacy and safety of a vonoprazan(VPZ)-based triple regimen for first-line eradication of H.pylori in China.METHODS This multicenter noninferior randomized controlled trial(June 2022 to November 2023)involved 524 H.pyloripositive patients across 19 centers in Shandong,China.Participants were randomized to 14-day esomeprazole/bismuth/amoxicillin/clarithromycin(EBAC),14-day VPZ/amoxicillin/clarithromycin(VACa),or 10-day VPZ/amoxicillin/clarithromycin(VACb)-all administered twice daily.Primary outcomes(eradication rates)were assessed via intention-to-treat(ITT)and per-protocol(PP)analyses.Secondary endpoints included adverse events and adherence.Noninferiority testing andχ^(2)tests were used for statistical comparisons.RESULTS A total of 524 patients participated in this study.In ITT analysis,the eradication rates of the EBAC,VACa,and VACb groups were 72.6%(127/175),88.0%(154/175),and 83.3%(145/174),respectively(P=0.001).The difference in the eradication rate between the EBAC and VPCa groups was 15.4%[95%confidence interval(CI):7.3-23.6,P<0.001],and that between the EBAC and VACb groups was 10.8%(95%CI:2.1-19.4,P=0.018).In PP analysis,the eradication rates of the EBAC,VACa,and VACb groups were 81.4%(127/156),93.9%(154/164),and 90.6%(145/160),respectively(P=0.001).There was no significant difference in the incidence of adverse reactions among the three groups,which were 36.6%,33.8%and 29.6%,respectively(P=0.50).CONCLUSION VPZ-based triple therapies demonstrate noninferiority to 14-day bismuth-containing regimens,with the 10-day regimen showing comparable efficacy and similar adverse event rates.
基金Supported by the Industrial Technological Initiation Scholarship of National Council for Scientific and Technological Development,CNPq,Brazil,No.0932204294929829 and No.7414780530977345the Scientific Initiation Scholarship Programme(PIBIC)of National Council for Scientific and Technological Development,CNPq,Brazil,No.5763023359532159,No.6472982965854452,and No.7340128440641417+2 种基金the Scientific Initiation Scholarship Programme(PIBIC)of Bahia State Research Support Foundation,FAPESB,Brazil,No.19.573.301.5418the PERMANECER Programme of Pro-Rectory of Student Assistance at Federal University of Bahia,No.R8EZ-4V4W-6LQX-5LC8the CNPq Research Productivity Fellow,No.4357511882624145.
文摘Recent studies have shown a noticeable increase in global Helicobacter pylori(H.pylori)resistance,with clarithromycin resistance surpassing 15%in various areas.However,inadequate epidemiological monitoring,especially in developing countries,and the absence of uniform testing methods lead to discrepancies between regions and a possible underestimation of resistance levels.The complexity of treating H.pylori is driven by its highly dynamic genome,which is prone to frequent mutations contributing to phenotypical resistance.The usual course of action in empirical treatment involves using a combination of various drugs simultaneously,leading to significant resistance selection pressure and potential side effects.The emergence of H.pylori strains resistant to multiple drugs is closely tied to failures in first-line treatment,highlighting the need to prevent further resistance by using optimal initial empirical therapy or regimens guided by antibiotic susceptibility testing,requiring a collection of mixed samples and multiple isolates for accurate assessment.The emergence of new treatments like potassium-competitive acid blockers offers a hopeful approach to decrease antimicrobial usage while still ensuring effectiveness in comparison to traditional therapies with proton pump inhibitors.Additionally,the use of probiotics is under investigation to identify specific strains and formulations that may mitigate therapy-associated adverse effects.
文摘BACKGROUND Each year,more than a million people are diagnosed with gastric cancer(GC)worldwide,and the incidence of this disease is projected to increase.Helicobacter pylori(H.pylori)is the major cause of GC.Managing infections caused by H.pylori and investigating their contribution to GC carcinogenesis are crucial for advancing diagnosis and treatment.Deleted in malignant brain tumors 1(DMBT1)is associated with the development of H.pylori and GC.However,the precise underlying mechanism is unclear.AIM To explore the role of DMBT1,as modulated by H.pylori,in the development,proliferation,and metastasis of GC.METHODS Utilizing human GC cells,DMBT1 gene silencing,and H.pylori treatment,four cell groups(control,H.pylori,si-DMBT1,and H.pylori+si-DMBT1)were subjected to cell counting kit-8,scratch,and Transwell assays.The DMBT1 expression was assessed by quantitative real-time polymerase chain reaction and Western blot.RESULTS In cellular tests,H.pylori+si-DMBT1 showed the greatest ability to proliferate,migration,and invasion capabilities,followed by the si-DMBT1,H.pylori,and control groups.DMBT1 mRNA was found to be the highest in control group,next in si-DMBT1,H.pylori and H.pylori+si-DMBT1,while H.pylori+si-DMBT1 showed the least expression.The results the Western blot assay showed a consistent trend of decreasing DMBT1 protein and mRNA levels.CONCLUSION Through inhibition of DMBT1,H.pylori could enhance GC’s proliferation,metastasis and invasion.Our findings revealed a novel connection between H.pylori infection,inflammation,and GC.
文摘Objective Helicobacter pylori(HP)infection is associated with non-alcoholic fatty liver disease(NAFLD)and insulin resistance;however,the correlation between HP eradication and NAFLD remains controversial.This systematic review and meta-analysis examined the effect of HP treatment on clinical and laboratory parameters in NAFLD patients.Methods We conducted a literature search of the PubMed,Embase,Scopus,and Web of Science databases through Septem-ber 2023 for randomized controlled trials(RCTs)examining the effect of HP treatment on NAFLD patients versus lifestyle changes alone.The primary outcome was the change in steatosis parameters.The secondary endpoints were changes in anthropometric parameters,inflammatory markers(TNF-α),and metabolic parameters(fasting blood glucose,homeostasis model assessment of insulin resistance,AST/ALT,and lipid profile).The random effects model was used to calculate the standardized mean difference(SMD)with associated 95%confidence intervals(CIs)for our desired outcome.Results Four RCTs met our inclusion criteria.A total of 453 patients were included(mean age 42.8 years,58.5%males),228(50.3%)of whom were in the HP eradication group and 225(49.7%)of whom were in the lifestyle modification group.Compared with lifestyle modification alone,HP eradication had a significant effect on reducing liver steatosis and TNF-αlevels(SMD:-0.9;95%CI-14.67,-3.82,I^(2)=0%and SMD:-6.3;95%CI-9.04,-3.56,I^(2)=0%,respectively).No sig-nificant effect on other metabolic parameters was found.Conclusions HP eradication significantly reduced liver steatosis and TNF-αlevels in NAFLD patients.However,HP eradi-cation did not significantly affect other metabolic indices compared to lifestyle changes alone.
文摘Helicobacter pylori(H.pylori)infection induces pathological changes via chronic inflammation and virulence factors,thereby increasing the risk of gastric cancer development.Compared with invasive examination methods,H.pylori-related serum indicators are cost-effective and valuable for the early detection of gastric cancer(GC);however,large-scale clinical validation and sufficient understanding of the specific molecular mechanisms involved are lacking.Therefore,a comprehensive review and analysis of recent advances in this field is necessary.In this review,we systematically analyze the relationship between H.pylori and GC and discuss the application of new molecular biomarkers in GC screening.We also summarize the screening potential and application of anti-H.pylori immunoglobulin G and virulence factor-related serum antibodies for identifying GC risk.These indicators provide early warning of infection and enhance screening accuracy.Additionally,we discuss the potential combination of multiple screening indicators for the comprehensive analysis and development of emerging testing methods to improve the accuracy and efficiency of GC screening.Although this review may lack sufficient evidence due to limitations in existing studies,including small sample sizes,regional variations,and inconsistent testing methods,it contributes to advancing personalized precision medicine in high-risk populations and developing GC screening strategies.
文摘BACKGROUND Gastric cancer(GC)is one of the most common malignancies worldwide,and Helicobacter pylori(HP)infection is a well-established risk factor for its development.Programmed death-ligand 1(PD-L1)expression is a crucial biomarker for predicting the efficacy of immune checkpoint inhibitors in cancer treatment.While HP infection and PD-L1 expression in GC may be linked,the relationship between them remains unclear,in part because there have been conflicting results reported from various studies.AIM To perform a meta-analysis to assess the relationship between HP and PD-L1 expression in patients with GC.METHODS A systematic literature review was conducted using PubMed,Embase,Cochrane Library,and Web of Science databases.Observational studies that examined the association between HP infection and PD-L1 expression in patients with GC were included.Odds ratios and 95%confidence intervals were calculated to estimate the association.Heterogeneity was assessed using Cochrane’s Q test and I²statistic.A random-effects model was used due to significant heterogeneity across studies.RESULTS Fourteen studies involving a total of 3069 patients with GC were included.The pooled analysis showed a significant association between HP infection and increased PD-L1 expression in GC tissues(odd ratio=1.69,95%confidence interval:1.24-2.29,P<0.001,I^(2)=59%).Sensitivity analyses confirmed the robustness of these findings.Subgroup analyses did not show significant variation based on geographic region,sample size,or method of PD-L1 assessment.Publication bias was minimal,as shown by funnel plots and Egger’s regression test.CONCLUSION HP infection is associated with increased PD-L1 expression in GC,suggesting that HP status may influence the response to programmed cell death protein 1/PD-L1 blockade therapy.
文摘Helicobacter pylori infection represents a widespread chronic condition with varying prevalence influenced by race, ethnicity, and geography. The severity of H. pylori-associated diseases is determined by an array of virulence factors. Although extensive studies have been conducted globally, data on the distribution of Helicobacter pylori virulence genes in Libya remain limited, constraining insights into the pathogenicity of local strains and hindering the development of targeted interventions. This study aimed to evaluate the prevalence of H. pylori infection, characterize essential virulence genes [vacA variants (s1/s2, m1/m2), cagA, and iceA1], and examine their association with gastroduodenal diseases among Libyan patients. Gastric biopsies from 144 participants were analyzed using polymerase chain reaction (PCR) assays, and risk factor data were collected via questionnaires. H. pylori was detected in 63.2% of samples by PCR. The vacA gene was present in 84.6% of cases, cagA in 58.2%, and iceA1 in 29.7%. Among vacA variants, s1 allele was most common (53.2%), followed by m1 (42.9%), m2 (37.7%), and s2 (13%) alleles. Significant associations were identified between specific virulence genes and the development of gastroduodenal diseases, highlighting their role in pathogenicity. This investigation is one of Libya’s first comprehensive assessments of H. pylori virulence factors, addressing a critical epidemiological gap. The high prevalence of virulence genes suggests their potential as disease biomarkers. These findings contribute to a deeper understanding of H. pylori pathogenicity within the Libyan population and establish a basis for future clinical interventions and public health strategies to manage and prevent H. pylori-associated diseases in Libya and comparable regions.
基金Supported by the An Nan Hospital,China Medical University,No.ANHRF114-20 and No.ANHRF114-21.
文摘BACKGROUND Antibiotic resistance significantly impacts the treatment failure rates of Helicobacter pylori(H.pylori)infections.AIM To investigate the trends in primary antibiotic resistance of H.pylori in Taiwan of China over the past six years.METHODS We conducted a retrospective analysis of H.pylori isolates from Taiwan residents,China who had not undergone previous treatments(n=1408),collected between January 1,2019 and December 31,2024.Susceptibility of these strains to amoxicillin,clarithromycin,levofloxacin,metronidazole,and tetracycline was tested using the Epsilometer test.We analyzed the trends in single and dual resistance profiles over the study period,and compared antibiotic resistance across different regions(northern,southern and eastern areas)of Taiwan of China.RESULTS The overall resistance rates for H.pylori to amoxicillin,clarithromycin,metronidazole,tetracycline,and levofloxacin in Taiwan of China were 1.3%,18.0%,31.0%,0.8%,and 28.7%,respectively.Tetracycline resistance increased significantly from 0%in 2019 to 3.5%in 2024(P value inχ^(2)test for linear trend:<0.001),while metronidazole resistance declined from 35.5%to 13.0%(P value inχ^(2)test for linear trend:<0.001).No significant changes of amoxicillin,clarithromycin and levofloxacin resistances were observed.The dual resistances to clarithromycin plus tetracycline,and metronidazole plus tetracycline both increased significantly from 0%to 1.7%from 2019 to 2024(P value inχ^(2)test for linear trend:<0.05).Furthermore,no significant regional differences in resistance frequencies except for levofloxacin were detected.CONCLUSION Primary antibiotic resistance to tetracycline in H.pylori has increased in Taiwan of China from 2019 to 2024,while resistance to metronidazole has decreased during the same period.The dual resistance to clarithromycin plus tetracycline and metronidazole plus tetracycline both increased significantly.
基金supported by Henan Province Science and Technology Research and Development(No.242102311176)China Agriculture Research System of MOF and MARA(No.CARS-21)+2 种基金Henan Modern Industrial Technology System of Chinese Herbal Medicine(No.HARS-22-11-Z1)Program for Science&Technology Innovation Talents in Universities of Henan Province(No.23HASTIT045)Henan Province Scientific and Technological Project(No.232102311059)。
文摘Salvia miltiorrhiza(Danshen)is a traditional Chinese herb that is commonly known for its cardiovascular and hepatoprotective benefits.Recent studies have confirmed that Danshen and its bioactive components can influence gut microbial homeostasis,thereby affecting Helicobacter pylori(HP)colonization in the human stomach.HP is a bacterial pathogen associated with various gastrointestinal diseases.Current HP treatments mainly involve antibiotics and proton pump inhibitors.However,their efficacy is strongly compromised by the rapid emergence of antibiotic resistance in HP and genetic heterogeneity among patients.The interaction between Danshen and gut microbial status provides a novel perspective for HP treatment.Understanding the medical properties of Danshen in altering gut microbiota and eliminating HP,as well as the underlying mechanisms,is important for improving human gastrointestinal healthcare.This review investigates the interaction between Danshen and gut microbiota and its impact on HP infection using databases including Web of Science,PubMed,and Google Scholar.We explored the unconventional intersection between Danshen,gut microbiota,and HP infection,shedding light on their intricate interplay and potential therapeutic implications.A comprehensive understanding of this interaction provides valuable insights into developing novel therapeutic strategies that target the gut microbiota to mitigate HP-associated gastrointestinal disorders.
