Association of Helicobacter pylori with Gastritis, Duodenitis and Peptic Ulcer Diseases

Antibacterial effect of Kampo herbal formulation Hochu-ekki-to (Bu-Zhong-Yi-Qi-Tang) on Helicobacter pylori infection in mice

Because Helicobacter pylori (H. pylori) infection is a major cause of gastroduodenal diseases in humans, the eradication of H. pylori using antibiotics is very effective for the treatment of gastroduodenal diseases. However, it has recently been reported that resistance to these antibiotics is developing. In the present study, the antibacterial effect of a Kampo (traditional Japanese medicine) herbal formulation, Hochu-ekki-to (RET; Formula repletionis animalis et supletionis medii), against H. pylori was examined in vitro and in vivo. HET inhibited the growth of antibiotic-resistant strains of H. pylori as well as antibiotic-sensitive strains at a dose of 2.5 mg/ml in vitro. When 1,000 mg/kg of HET was administered orally to C57BL/6 mice for 7 days before or after inoculation with H. pylori, H. pylori in the stomach was significantly reduced in the HET-pre-treatment group compared with the control group. Furthermore, HET in combination with antibiotics completely eradicated the bacteria in mice. The expression of interferon (IFN)-gamma was induced in the gastric mucosa of the mice pre-treated with HET. There were no significant differences between the colonization of H. pylori in the control and HET treatment groups in IFN-gamma gene-deficient mice. These results suggest that the antibacterial effect of HET may be partly due to IFN-gamma induction, and that HET may be clinically useful for treatment of H. pylori infection.

Heat shock protein 60 (HSP60) immunoreactivity in gastric epithelium associated with Helicobacter pylori infection: a pitfall in immunohistochemically interpreting HSP60-mediated autoimmune responses

Previous studies have suggested that heat shock proteins (HSP) of Helicobacter pylori (H. pylori) are involved in the induction of autoimmunity mediated gastritis. In the present report, the cross-reactivity between H. pylori-related HSP60 and gastric epithelial cells was investigated by the indirect immunoperoxidase method using two monoclonal antibodies (mAb) against H. pylori-derived HSP60, H9 and H20. H9 is reactive with an epitope common to bacterial HSP60, while H20 is specific to H. pylori HSP60. A total of 70 paraffin-embedded gastric biopsy specimens were analyzed after heat-induced epitope retrieval. Both mAb were cross-reactive with the gastric epithelial cells, with a higher frequency seen for the H9-reactive epitope. The frequency of positive epithelial decoration was not significantly different between H. pylori-positive and H. pylori-negative gastric mucosae. A variety of epithelial and non-epithelial cells were immunostained with mAb H9, while mAb H20 was cross-reactive only with small intestinal epithelia. Reactivity was mainly located in the Golgi area and rarely in the cytoplasm. These results suggest a noteworthy pitfall in immunohistochemical interpretations of HSP60-associated autoimmune reactions in the gastric mucosa.

Biometric evaluation of gastric urease activity in man

The 14C-urea breath test is claimed to be the best test for detection of Helicobacter pylori infection. We present a procedure for estimating its cutoff value on the basis of biometric evaluation only, without involving other diagnostic methods. Cumulative gastric urease activity (CA) was determined during the first 30 min after oral administration of 14C-urea (92.5 kBq) in 56 random volunteers and 49 consecutive patients with peptic ulcer disease. The distribution of CA in random volunteers was positively skewed. Logarithmic transformation yielded two separate populations, each normally distributed. Their normal probability density functions intercepted at log cutoff value. A bimodal distribution of log CA was confirmed in patients with peptic ulcer disease before and after treatment aimed at H. pylori eradication. Cutoff values were determined for both random volunteers and patients with peptic ulcer disease. By application of the present procedure for determination of cutoff value, the 14C-urea breath test distinguishes between individuals who have an increased gastric urease activity and individuals who do not, with the smallest possible arbitrariness.