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Mărginean CO, Meliț LE, Săsăran MO. Traditional and Modern Diagnostic Approaches in Diagnosing Pediatric Helicobacter pylori Infection. CHILDREN 2022; 9:children9070994. [PMID: 35883980 PMCID: PMC9316053 DOI: 10.3390/children9070994] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 06/24/2022] [Accepted: 06/29/2022] [Indexed: 01/10/2023]
Abstract
Helicobacter pylori (H. pylori) is the most common bacterial infection worldwide, is usually acquired during childhood and is related to gastric carcinogenesis during adulthood. Therefore, its early proper diagnosis and subsequent successful eradication represent the cornerstones of gastric cancer prevention. The aim of this narrative review was to assess traditional and modern diagnostic methods in terms of H. pylori diagnosis. Several invasive and non-invasive methods were described, each with its pros and cons. The invasive diagnostic methods comprise endoscopy with biopsy, rapid urease tests, histopathological exams, cultures and biopsy-based molecular tests. Among these, probably the most available, accurate and cost-effective test remains histology, albeit molecular tests definitely remain the most accurate despite their high costs. The non-invasive tests consist of urea breath tests, serology, stool antigens and non-invasive molecular tests. Urea breath tests and stool antigens are the most useful in clinical practice both for the diagnosis of H. pylori infection and for monitoring the eradication of this infection after therapy. The challenges related to accurate diagnosis lead to a choice that must be based on H. pylori virulence, environmental factors and host peculiarities.
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Affiliation(s)
- Cristina Oana Mărginean
- Department of Pediatrics I, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, Gheorghe Marinescu Street No. 38, 540136 Targu Mures, Romania;
| | - Lorena Elena Meliț
- Department of Pediatrics I, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, Gheorghe Marinescu Street No. 38, 540136 Targu Mures, Romania;
- Correspondence:
| | - Maria Oana Săsăran
- Department of Pediatrics III, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, Gheorghe Marinescu Street No. 38, 540136 Targu Mures, Romania;
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Dai B, Xiang A, Qu D, Chen G, Wang L, Wang W, Zhai D, Wang L, Lu Z. Rapid and Sensitive Assay of Helicobacter pylori With One-Tube RPA-CRISPR/Cas12 by Portable Array Detector for Visible Analysis of Thermostatic Nucleic Acid Amplification. Front Microbiol 2022; 13:858247. [PMID: 35586866 PMCID: PMC9108776 DOI: 10.3389/fmicb.2022.858247] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 03/31/2022] [Indexed: 11/20/2022] Open
Abstract
Helicobacter pylori (H. pylori) has infected more than half of the world’s population and is still a threat to human health. The urea breath test, despite being widely used in clinical diagnosis, still faces huge challenges in the immediate detection of H. pylori. Thus, a rapid, sensitive, and highly specific point of care diagnosis is particularly important for preventing the further transmission of H. pylori and for real-time monitoring of the disease in a given population. Recently, the clustered regularly interspaced short palindromic repeats (CRISPR)-based diagnostics have been applied to various types of nucleic acid testing; however, there are often shortcomings of complex operation and high signal transmission background. In this study, we proposed a new platform for the assay of H. pylori using one-tube-based CRISPR/Cas12a diagnostic methods and designed a detector for this platform, which is a portable array detector for visible analysis of thermostatic nucleic acid amplification (Pad-VATA). By incorporating isothermal recombinase polymerase amplification, our platform could detect the conserved gene fragments of H. pylori with a constant low as 2 copies/μl. The assay process can be performed at a single temperature in about 30 min and integrated into the reactor in the palm-sized Pad-VATA to facilitate rapid diagnosis of H. pylori. We also verified the accuracy of our platform using 10 clinical samples and found that the platform can quickly detect H. pylori infection in a given population. We believe that this fast, convenient, efficient, and inexpensive screening and diagnostic platform can be widely used in various settings, including homes and clinics.
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Affiliation(s)
- Bing Dai
- The College of Life Sciences, Northwest University, Xi’an, China
- Department of Biopharmaceutics, State Key Laboratory of Cancer Biology, Air Force Medical University, Xi’an, China
| | - An Xiang
- Department of Biopharmaceutics, State Key Laboratory of Cancer Biology, Air Force Medical University, Xi’an, China
| | - Di Qu
- The College of Life Sciences, Northwest University, Xi’an, China
- Department of Biopharmaceutics, State Key Laboratory of Cancer Biology, Air Force Medical University, Xi’an, China
| | - Guo Chen
- Department of Biopharmaceutics, State Key Laboratory of Cancer Biology, Air Force Medical University, Xi’an, China
| | - Li Wang
- Department of Biopharmaceutics, State Key Laboratory of Cancer Biology, Air Force Medical University, Xi’an, China
| | - Wenwen Wang
- Department of Biopharmaceutics, State Key Laboratory of Cancer Biology, Air Force Medical University, Xi’an, China
| | - Dongsheng Zhai
- Department of Biopharmaceutics, State Key Laboratory of Cancer Biology, Air Force Medical University, Xi’an, China
| | - Lei Wang
- Department of Gastrointestinal Surgery, General Hospital of Ningxia Medical University, Ningxia, China
- *Correspondence: Lei Wang,
| | - Zifan Lu
- Department of Biopharmaceutics, State Key Laboratory of Cancer Biology, Air Force Medical University, Xi’an, China
- Zifan Lu,
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3
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Zhang C, Zhou W, Wang J, Zhang J, Zhang C. Investigation of the quantitative detection of serum Helicobacter pylori antibody in clinical laboratories in China. J Clin Lab Anal 2021; 36:e24069. [PMID: 34783398 PMCID: PMC8761440 DOI: 10.1002/jcla.24069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 10/10/2021] [Accepted: 10/12/2021] [Indexed: 11/09/2022] Open
Abstract
Background This study aimed to investigate the implementation and quality control of the quantitative detection of serum Helicobacter pylori (H. pylori) antibody in clinical laboratories in China. Methods Online external quality assessment (EQA) questionnaires were distributed to the clinical laboratories by National Center for Clinical Laboratories (NCCL) of China. We collected information on the quantitative detection procedures of serum H. pylori antibody in clinical laboratories, including detection reagents, methods, instruments, calibrators, and internal quality control (IQC). We distributed quality control products to some select laboratories that conducted quantitative detection and analyzed the obtained test data. We evaluated the quantitative detection procedure based on the standard evaluation criteria set at a target value of ±30%. Results 70.9% (146/206) of the laboratories conducted quantitative detection of H. pylori antibody; 29.1% (60/206) of the laboratories performed qualitative detection. Domestic reagents and matching calibrators accounted for more than 97.1% (200/206) of all reagents. Latex‐enhanced immunoturbidimetry was used in 89.7% (131/146) of the laboratories for quantitative determination, while the colloidal gold method was used in 66.7% (40/60) of the laboratories for qualitative determination. A total of 130 laboratories participated in the EQA; 123 completed the assessment, and the pass rate was 75.6% (93/123). Conclusion Clinical quantitative detection of serum H. pylori antibody is performed at a high rate in China. Thus, further studies on the specificity of commercial detection reagents are needed. EQAs are useful to monitor and improve the detection quality of H. pylori antibodies.
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Affiliation(s)
- Chao Zhang
- National Center for Clinical Laboratories, National Center of Gerontology, Institute of Geriatric Medicine, Beijing Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Weiyan Zhou
- National Center for Clinical Laboratories, National Center of Gerontology, Institute of Geriatric Medicine, Beijing Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Jing Wang
- National Center for Clinical Laboratories, National Center of Gerontology, Institute of Geriatric Medicine, Beijing Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Jiangtao Zhang
- National Center for Clinical Laboratories, National Center of Gerontology, Institute of Geriatric Medicine, Beijing Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Chuanbao Zhang
- National Center for Clinical Laboratories, National Center of Gerontology, Institute of Geriatric Medicine, Beijing Hospital, Chinese Academy of Medical Sciences, Beijing, China
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Gong L, El-Omar EM. Application of molecular techniques in Helicobacter pylori detection: limitations and improvements. Helicobacter 2021; 26:e12841. [PMID: 34333819 DOI: 10.1111/hel.12841] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/02/2021] [Accepted: 07/02/2021] [Indexed: 12/13/2022]
Affiliation(s)
- Lan Gong
- Microbiome Research Centre, St George and Sutherland Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Emad M El-Omar
- Microbiome Research Centre, St George and Sutherland Clinical School, University of New South Wales, Sydney, NSW, Australia
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Bordin DS, Voynovan IN, Andreev DN, Maev IV. Current Helicobacter pylori Diagnostics. Diagnostics (Basel) 2021; 11:diagnostics11081458. [PMID: 34441392 PMCID: PMC8393410 DOI: 10.3390/diagnostics11081458] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/27/2021] [Accepted: 08/09/2021] [Indexed: 12/18/2022] Open
Abstract
The high prevalence of Helicobacter pylori and the variety of gastroduodenal diseases caused by this pathogen necessitate the use of only accurate methods both for the primary diagnosis and for monitoring the eradication effectiveness. There is a broad spectrum of diagnostic methods available for detecting H. pylori. All methods can be classified as invasive or non-invasive. The need for upper endoscopy, different clinical circumstances, sensitivity and specificity, and accessibility defines the method chosen. This article reviews the advantages and disadvantages of the current options and novel developments in diagnostic tests for H. pylori detection. The progress in endoscopic modalities has made it possible not only to diagnose precancerous lesions and early gastric cancer but also to predict H. pylori infection in real time. The contribution of novel endoscopic evaluation technologies in the diagnosis of H. pylori such as visual endoscopy using blue laser imaging (BLI), linked color imaging (LCI), and magnifying endoscopy is discussed. Recent studies have demonstrated the capability of artificial intelligence to predict H. pylori status based on endoscopic images. Non-invasive diagnostic tests such as the urea breathing test and stool antigen test are recommended for primary diagnosis of H. pylori infection. Serology can be used for initial screening and epidemiological studies. The histology showed its value in detecting H. pylori and provided more information about the degree of gastric mucosa inflammation and precancerous lesions. Molecular methods are mainly used in detecting antibiotic resistance of H. pylori. Cultures from gastric biopsies are the gold standard and recommended for antibiotic susceptibility tests.
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Affiliation(s)
- Dmitry S. Bordin
- A.S. Loginov Moscow Clinical Scientific Center, 111123 Moscow, Russia;
- A.I. Yevdokimov Moscow State University of Medicine and Dentistry, 127473 Moscow, Russia; (D.N.A.); (I.V.M.)
- Tver State Medical University, 170100 Tver, Russia
- Correspondence:
| | - Irina N. Voynovan
- A.S. Loginov Moscow Clinical Scientific Center, 111123 Moscow, Russia;
| | - Dmitrii N. Andreev
- A.I. Yevdokimov Moscow State University of Medicine and Dentistry, 127473 Moscow, Russia; (D.N.A.); (I.V.M.)
| | - Igor V. Maev
- A.I. Yevdokimov Moscow State University of Medicine and Dentistry, 127473 Moscow, Russia; (D.N.A.); (I.V.M.)
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Doohan D, Fauzia KA, Rathnayake J, Lamawansa MD, Waskito LA, Tuan VP, Dashdorj A, Kabamba ET, Phuc BH, Ansari S, Akada J, Matsumoto T, Uchida T, Matsuhisa T, Yamaoka Y. Pepsinogen and Serum IgG Detection Is a Valuable Diagnostic Method for Helicobacter pylori Infection in a Low-Prevalence Country: A Report from Sri Lanka. Diagnostics (Basel) 2021; 11:diagnostics11081364. [PMID: 34441303 PMCID: PMC8391933 DOI: 10.3390/diagnostics11081364] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/24/2021] [Accepted: 07/26/2021] [Indexed: 12/28/2022] Open
Abstract
The use of serum anti-Helicobacter pylori IgG and pepsinogen (PG) detection as a diagnostic method was evaluated in Sri Lanka. Gastric biopsies were performed (353 patients), and the prevalence of H. pylori infection was 1.7% (culture) and 2.0% (histology). IgG serology testing showed an area under the curve (AUC) of 0.922 (cut-off, 2.95 U/mL; specificity, 91.56%; sensitivity, 88.89%). Histological evaluation showed mild atrophy (34.3%), moderate atrophy (1.7%), metaplasia (1.7%), chronic gastritis (6.2%), and normal tissue (56%). The PGI/PGII ratio was significantly higher in H. pylori-negative patients (p < 0.01). PGII and PGI/PGII levels were lower in patients with metaplasia than in those with normal mucosa (p = 0.049 and p < 0.001, respectively). The PGI/PGII ratio best discriminated metaplasia and moderate atrophy (AUC 0.88 and 0.76, respectively). PGI and PGII alone showed poor discriminative ability, especially in mild atrophy (0.55 and 0.53, respectively) and chronic gastritis (0.55 and 0.53, respectively). The best cut-off to discriminate metaplasia was 3.25 U/mL (95.19% specificity, 83.33% sensitivity). Anti-H. pylori IgG and PG assessment (ABC method) was performed (group B, 2.0%; group A, 92.1%). The new cut-off more accurately identified patients with metaplasia requiring follow-up (group B, 5.4%). Assessment of anti-H. pylori IgG and PG is valuable in countries with a low prevalence of H. pylori infection.
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Affiliation(s)
- Dalla Doohan
- Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Yufu 879-5593, Japan; (D.D.); (K.A.F.); (L.A.W.); (V.P.T.); (A.D.); (E.T.K.); (B.H.P.); (S.A.); (J.A.); (T.M.)
- Institute of Tropical Disease, Universitas Airlangga, Surabaya 60115, Indonesia
| | - Kartika Afrida Fauzia
- Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Yufu 879-5593, Japan; (D.D.); (K.A.F.); (L.A.W.); (V.P.T.); (A.D.); (E.T.K.); (B.H.P.); (S.A.); (J.A.); (T.M.)
- Institute of Tropical Disease, Universitas Airlangga, Surabaya 60115, Indonesia
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya 60115, Indonesia
| | - Jeewantha Rathnayake
- Department of Surgery, Teaching Hospital Peradeniya, University of Peradeniya, Kandy 20404, Sri Lanka; (J.R.); (M.D.L.)
| | - Meegahalande Durage Lamawansa
- Department of Surgery, Teaching Hospital Peradeniya, University of Peradeniya, Kandy 20404, Sri Lanka; (J.R.); (M.D.L.)
| | - Langgeng Agung Waskito
- Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Yufu 879-5593, Japan; (D.D.); (K.A.F.); (L.A.W.); (V.P.T.); (A.D.); (E.T.K.); (B.H.P.); (S.A.); (J.A.); (T.M.)
- Institute of Tropical Disease, Universitas Airlangga, Surabaya 60115, Indonesia
| | - Vo Phuoc Tuan
- Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Yufu 879-5593, Japan; (D.D.); (K.A.F.); (L.A.W.); (V.P.T.); (A.D.); (E.T.K.); (B.H.P.); (S.A.); (J.A.); (T.M.)
- Department of Endoscopy, Cho Ray Hospital, Ho Chi Minh 749000, Vietnam
| | - Azzaya Dashdorj
- Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Yufu 879-5593, Japan; (D.D.); (K.A.F.); (L.A.W.); (V.P.T.); (A.D.); (E.T.K.); (B.H.P.); (S.A.); (J.A.); (T.M.)
| | - Evariste Tshibangu Kabamba
- Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Yufu 879-5593, Japan; (D.D.); (K.A.F.); (L.A.W.); (V.P.T.); (A.D.); (E.T.K.); (B.H.P.); (S.A.); (J.A.); (T.M.)
- Research Center for Infectious Sciences, Department of Parasitology, Graduate School of Medicine, Osaka City University, Osaka 545-8585, Japan
| | - Bui Hoang Phuc
- Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Yufu 879-5593, Japan; (D.D.); (K.A.F.); (L.A.W.); (V.P.T.); (A.D.); (E.T.K.); (B.H.P.); (S.A.); (J.A.); (T.M.)
| | - Shamshul Ansari
- Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Yufu 879-5593, Japan; (D.D.); (K.A.F.); (L.A.W.); (V.P.T.); (A.D.); (E.T.K.); (B.H.P.); (S.A.); (J.A.); (T.M.)
- Department of Microbiology, Teaching Hospital, Chitwan Medical College, Bharatpur 44200, Nepal
| | - Junko Akada
- Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Yufu 879-5593, Japan; (D.D.); (K.A.F.); (L.A.W.); (V.P.T.); (A.D.); (E.T.K.); (B.H.P.); (S.A.); (J.A.); (T.M.)
| | - Takashi Matsumoto
- Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Yufu 879-5593, Japan; (D.D.); (K.A.F.); (L.A.W.); (V.P.T.); (A.D.); (E.T.K.); (B.H.P.); (S.A.); (J.A.); (T.M.)
| | - Tomohisa Uchida
- Department of Molecular Pathology, Faculty of Medicine, Oita University, Yufu 879-5593, Japan;
| | - Takeshi Matsuhisa
- Department of Gastroenterology, Tama Nagayama University Hospital, Nippon Medical School, Tokyo 206-8512, Japan;
| | - Yoshio Yamaoka
- Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Yufu 879-5593, Japan; (D.D.); (K.A.F.); (L.A.W.); (V.P.T.); (A.D.); (E.T.K.); (B.H.P.); (S.A.); (J.A.); (T.M.)
- Department of Medicine, Gastroenterology and Hepatology Section, Baylor College of Medicine, Houston, TX 77030, USA
- Global Oita Medical Advanced Research Center for Health (GO-MARCH), Faculty of Medicine, Oita University, Yufu 879-5593, Japan
- Division of Gastroentero-Hepatology, Department of Internal Medicine, Faculty of Medicine, Dr. Soetomo Teaching Hospital, Universitas Airlangga, Surabaya 60115, Indonesia
- Correspondence: ; Tel.: +81-97-586-5740
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Bosch DE, Krumm N, Wener MH, Yeh MM, Truong CD, Reddi DM, Liu Y, Swanson PE, Schmidt RA, Bryan A. Serology Is More Sensitive Than Urea Breath Test or Stool Antigen for the Initial Diagnosis of Helicobacter pylori Gastritis When Compared With Histopathology. Am J Clin Pathol 2020; 154:255-265. [PMID: 32445464 DOI: 10.1093/ajcp/aqaa043] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES To assess the concordance and performance characteristics of Helicobacter pylori laboratory tests compared with histopathology and to propose algorithms for the diagnosis of H pylori that minimize diagnostic error. METHODS H pylori diagnostics were reviewed from a 12-year period within a health system (2,560 cases). Analyses were performed to adjust diagnostic performance based on treatment and consensus histopathologic diagnoses among pathologists. Markers of access to care, including test cancellation frequency and turnaround time, were assessed. Costs and performance of candidate noninvasive testing algorithms were modeled as a function of disease prevalence. RESULTS Serum H pylori IgG demonstrated a higher sensitivity (0.94) than urea breath and stool antigen tests (0.64 and 0.61, respectively). Evidence of an advantage in access to care for serology included a lower cancellation rate. Interobserver variability was higher (κ = 0.34) among pathologists for cases with a discordant laboratory test than concordant cases (κ = 0.56). A model testing algorithm utilizing serology for first-time diagnoses minimizes diagnostic error. CONCLUSIONS Although H pylori serology has modestly lower specificity than other noninvasive tests, the superior sensitivity and negative predictive value in our population support its use as a noninvasive test to rule out H pylori infection. Reflexive testing with positive serology followed by either stool antigen or urea breath test may optimize diagnostic accuracy in low-prevalence populations.
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Affiliation(s)
- Dustin E Bosch
- Department of Laboratory Medicine, University of Washington, Seattle
- Department of Pathology, University of Washington, Seattle
| | - Niklas Krumm
- Department of Laboratory Medicine, University of Washington, Seattle
| | - Mark H Wener
- Department of Laboratory Medicine, University of Washington, Seattle
| | - Matthew M Yeh
- Department of Pathology, University of Washington, Seattle
| | - Camtu D Truong
- Department of Pathology, University of Washington, Seattle
| | - Deepti M Reddi
- Department of Pathology, University of Washington, Seattle
| | - Yongjun Liu
- Department of Pathology, University of Washington, Seattle
| | - Paul E Swanson
- Department of Pathology, University of Washington, Seattle
| | | | - Andrew Bryan
- Department of Laboratory Medicine, University of Washington, Seattle
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Nakagawa K, Hara K, Fikree A, Siddiqi S, Woodland P, Masamune A, Aziz Q, Sifrim D, Yazaki E. Patients with dyspepsia have impaired mucosal integrity both in the duodenum and jejunum: in vivo assessment of small bowel mucosal integrity using baseline impedance. J Gastroenterol 2020; 55:273-280. [PMID: 31468184 PMCID: PMC7026227 DOI: 10.1007/s00535-019-01614-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 08/09/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND Recent studies reported that impaired proximal duodenal mucosa, assessed by duodenal biopsy, could play an important role in the development of dyspeptic symptoms. The aims of this study were (a) to develop a method to measure "in vivo" duodenal and jejunal baseline impedance (BI) and (b) to assess small bowel mucosal integrity in patients with functional dyspepsia (FD) and healthy controls (HC). METHODS We recruited 16 patients with FD and 15 HC. All subjects underwent ambulatory duodeno-jejunal manometry combined with impedance (HRM/Z), BI were determined by measuring impedance immediately after the passage of nocturnal migrating motor complex (MMC) phase IIIs. RESULTS The number of MMC phase IIIs in FD was significantly lower than that in HC (2.6 ± 1.4 vs 4.8 ± 1.7, p < 0.001). The BI in patients was significantly lower than that in HC in D1(164.2 ± 59.8 Ω in FD and 243.1 ± 40.5 Ω in HC, p = 0.0061), D2 (191.2 ± 34.1 and 256.5 ± 91.4 Ω, p = 0.01), D3 (214.0 ± 76.9 and 278.1 ± 45.3 Ω, p = 0.009), D4 (270.8 ± 54.2 and 351.8 ± 50.2 Ω, p < 0.001), and J1 (312.2 ± 55.4 and 379.3 ± 38.3 Ω, p = 0.001). CONCLUSIONS This is the first study reporting the duodenal and jejunal BI in vivo. The results have shown significantly lowered BI in the proximal small intestine in patients with FD compared to HC. Furthermore it suggests that measurements of small bowel BI could be used as a biomarker for diagnosis and follow up of patients with FD.
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Affiliation(s)
- Kenichiro Nakagawa
- Wingate Institute of Neurogastroenterology, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, 26 Ashfield Street, Whitechapel, London, E1 AJ UK
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aobaku, Sendai, 980-8574 Japan
| | - Ken Hara
- Wingate Institute of Neurogastroenterology, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, 26 Ashfield Street, Whitechapel, London, E1 AJ UK
- Division of Gastroenterology, Hyogo College of Medicine, 1-1 Mukogawacho, Nishinomiya, 663-8501 Hyogo Japan
| | - Asma Fikree
- Wingate Institute of Neurogastroenterology, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, 26 Ashfield Street, Whitechapel, London, E1 AJ UK
| | - Shahab Siddiqi
- Division of General Surgery, Broomfield Hospital, Court Rd, Broomfield, Chelmsford, CM1 7ET UK
| | - Philip Woodland
- Wingate Institute of Neurogastroenterology, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, 26 Ashfield Street, Whitechapel, London, E1 AJ UK
| | - Atsushi Masamune
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aobaku, Sendai, 980-8574 Japan
| | - Qasim Aziz
- Wingate Institute of Neurogastroenterology, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, 26 Ashfield Street, Whitechapel, London, E1 AJ UK
| | - Daniel Sifrim
- Wingate Institute of Neurogastroenterology, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, 26 Ashfield Street, Whitechapel, London, E1 AJ UK
| | - Etsuro Yazaki
- Wingate Institute of Neurogastroenterology, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, 26 Ashfield Street, Whitechapel, London, E1 AJ UK
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Is breath testing without 13C-labelled external urea able to detect Helicobacter pylori infection? Anal Bioanal Chem 2019; 411:5641-5645. [PMID: 31201459 DOI: 10.1007/s00216-019-01961-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 05/23/2019] [Accepted: 06/04/2019] [Indexed: 10/26/2022]
Abstract
Helicobacter pylori (H. pylori) infection is the main cause of gastric inflammation and peptic ulcer disease. Diagnosis and treatment are important to prevent these outcomes. The diagnosis of H. pylori infection can be performed by non-invasive methods, such as 13C-urea breath test (13C-UBT). As endogenous urea is normally released to body cavities, we sought to investigate the usefulness of UBT without 13C-labelled external urea to detect H. pylori infection. The analysis was performed in a series of adult patients just before upper gastrointestinal endoscopy and biopsy to investigate dyspeptic symptoms. Breath samples were analyzed using isotope ratio mass spectrometry (IRMS). The natural variation of 13C and 18O isotopic abundance in the breath samples was also investigated. The results of the isotopic analysis were compared with the findings of the histopathological evaluation of gastric biopsies, which is the gold standard to detect H. pylori infection. No differences between patients with or without H. pylori infection could be detected by the isotope analysis of breath tests without 13C-urea. Therefore, our results showed that UBT without 13C-urea, analyzed by IRMS, was not useful to detect H. pylori infection in the study population.
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Ignatius R, Berg C, Weiland C, Darmer A, Wenzel T, Lorenz M, Fuhrmann J, Müller M. Accurate Detection of Helicobacter pylori Antigen in Human Stool Specimens by Two Novel Immunoassays. Eur J Microbiol Immunol (Bp) 2019; 9:29-31. [PMID: 31223492 PMCID: PMC6563681 DOI: 10.1556/1886.2019.00008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 05/02/2019] [Indexed: 12/28/2022] Open
Abstract
Stool antigen tests are recommended for the diagnosis of Helicobacter pylori infection. Here, we compared two novel assays, i.e., one enzyme immunoassay (EIA) and one immunochromatography assay (ICA), with a chemiluminescence immunoassay (CLIA) that had previously been compared with rapid urease test, histology, and urea breath test. Two hundred sixty-six frozen stool samples with defined CLIA results (42 positives, 219 negatives, and 5 samples with borderline results) collected between January and May 2018 were thawed and immediately tested by EIA, ICA, and CLIA. In 248 samples with repeatedly positive/negative CLIA results, EIA and ICA were positive for 40 and 37 of 41 CLIA-positive samples and yielded negative results for 206 and 201 of 207 CLIA-negative samples, respectively. There was a high positive percent agreement (EIA, 97.6%; 95% confidence interval (95% CI), 86.3-100%; ICA, 90.2%; 95% CI, 76.9-96.7%), as well as a negative percent agreement between the assays (EIA, 99.5%; 95% CI, 97.0-100%; ICA, 97.1%; 95% CI, 93.7-98.8%). This was further supported by kappa values indicating very good agreement (CLIA vs. EIA, 0.971; CLIA vs. ICA, 0.857). In conclusion, both EIA and ICA comprise valuable assays for the detection of H. pylori antigen in stool samples.
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Affiliation(s)
- Ralf Ignatius
- MVZ Labor 28, Mecklenburgische Str. 28, 14197 Berlin, Germany.,Department of Microbiology and Infection Immunology, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12200 Berlin, Germany
| | - Christiane Berg
- MVZ Labor 28, Mecklenburgische Str. 28, 14197 Berlin, Germany
| | - Chris Weiland
- MVZ Labor 28, Mecklenburgische Str. 28, 14197 Berlin, Germany
| | - Angela Darmer
- MVZ Labor 28, Mecklenburgische Str. 28, 14197 Berlin, Germany
| | - Thilo Wenzel
- MVZ Labor 28, Mecklenburgische Str. 28, 14197 Berlin, Germany
| | - Marion Lorenz
- R-Biopharm, An der neuen Bergstraße 17, 64297 Darmstadt, Germany
| | - Jörg Fuhrmann
- MVZ Labor 28, Mecklenburgische Str. 28, 14197 Berlin, Germany
| | - Michael Müller
- MVZ Labor 28, Mecklenburgische Str. 28, 14197 Berlin, Germany
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Mohammadian T, Ganji L. The Diagnostic Tests for Detection of Helicobacter pylori Infection. Monoclon Antib Immunodiagn Immunother 2019; 38:1-7. [PMID: 30648911 DOI: 10.1089/mab.2018.0032] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Helicobacter pylori causes one of the most common infections in human populations. The role of this bacterium in chronic gastritis, gastric ulcer, gastric cancer, as well as extra-digestive diseases such as ischemic heart disease and chronic obstructive pulmonary diseases, is well known. Prevention and control of these diseases can occur by early diagnosis and eradication of H. pylori infection. At present, different methods have been established to detect H. pylori infection. The biopsy-based tests, which are known as invasive methods, such as rapid urease test and histology, have the highest specificity among the others. Similarly, culture of biopsy samples is used for diagnosis of H. pylori infection. It has a high specificity value, and also allows us to perform antibiotic sensitivity testing. On the contrary, polymerase chain reaction and other molecular methods have good sensitivity and specificity, and can be used for detection of H. pylori infection, its virulence factors, and eradication success after treatment. While serological tests are more appropriate for epidemiological studies, their main weakness for clinical use is low specificity. Overall, specificity and sensitivity, cost, usefulness, and limitation of tests should be considered for selection of detection methods of H. pylori in each country.
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Affiliation(s)
- Taher Mohammadian
- 1 Department of Microbiology, Shahr-e-Qods-Branch, Islamic Azad University, Tehran, Iran
| | - Leila Ganji
- 1 Department of Microbiology, Shahr-e-Qods-Branch, Islamic Azad University, Tehran, Iran.,2 Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Science, Tehran, Iran
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12
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Talebi Bezmin Abadi A. Diagnosis of Helicobacter pylori Using Invasive and Noninvasive Approaches. J Pathog 2018; 2018:9064952. [PMID: 29951318 PMCID: PMC5987299 DOI: 10.1155/2018/9064952] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 04/12/2018] [Indexed: 01/06/2023] Open
Abstract
Helicobacter pylori (H. pylori) as gram-negative and spiral microorganism is responsible for colonization in the gastric microniche for more than 50% of world population. Recent studies have shown a critical role of H. pylori in the development of peptic ulcers, gastric mucosa-associated lymphoid tissue (MALT) lymphoma, and gastric cancer. Over the past decade, there has been a sharp interest to use noninvasive tests in diagnosis of the H. pylori infection. During the years after discovery by Marshall and Warren, it has been frequently declared that the rapid urease test (RUT) is one of the cheapest and rapid diagnostic approaches used in detecting the infection. Although the specificity and sensitivity are durable for this test, clinical experiences had shown that the ideal results are only achieved only if we take biopsies from both corpus and antrum at the same time. Given the diagnosis of the H. pylori in clinical samples, gastroenterologists are facing a long list of various molecular and nonmolecular tests. We need more in-depth researches and investigations to correctly generalize rapid and accurate molecular tests determining both bacterial identity and antibiotic resistance profile.
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Affiliation(s)
- Amin Talebi Bezmin Abadi
- Department of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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COELHO LGV, MARINHO JR, GENTA R, RIBEIRO LT, PASSOS MDCF, ZATERKA S, ASSUMPÇÃO PP, BARBOSA AJA, BARBUTI R, BRAGA LL, BREYER H, CARVALHAES A, CHINZON D, CURY M, DOMINGUES G, JORGE JL, MAGUILNIK I, MARINHO FP, MORAES-FILHO JPD, PARENTE JML, PAULA-E-SILVA CMD, PEDRAZZOLI-JÚNIOR J, RAMOS AFP, SEIDLER H, SPINELLI JN, ZIR JV. IVTH BRAZILIAN CONSENSUS CONFERENCE ON HELICOBACTER PYLORI INFECTION. ARQUIVOS DE GASTROENTEROLOGIA 2018; 55:97-121. [DOI: 10.1590/s0004-2803.201800000-20] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 02/22/2018] [Indexed: 02/06/2023]
Abstract
ABSTRACT Significant progress has been obtained since the III Brazilian Consensus Conference on H. pylori infection held in 2012, in Bento Gonçalves, Brazil, and justify a fourth meeting to establish updated guidelines on the current management of H. pylori infection. Therefore, the Núcleo Brasileiro para Estudo do Helicobacter pylori e Microbiota (NBEHPM), association linked to Brazilian Federation of Gastroenterology (FBG) held its fourth meeting again in Bento Gonçalves, RS, Brazil, on August 25-27, 2017. Twenty-six delegates, including gastroenterologists, endoscopists, and pathologists from the five regions of Brazil as well as one international guest from the United States, participated in the meeting. The participants were invited based on their knowledge and contribution to the study of H. pylori infection. The meeting sought to review different aspects of treatment for infection; establish a correlation between infection, dyspepsia, intestinal microbiota changes, and other disorders with a special emphasis on gastric cancer; and reassess the epidemiological and diagnostic aspects of H. pylori infection. Participants were allocated into four groups as follows: 1) Epidemiology and Diagnosis, 2) Dyspepsia, intestinal microbiota and other afections, 3) Gastric Cancer, and, 4) Treatment. Before the consensus meeting, participants received a topic to be discussed and prepared a document containing a recent literature review and statements that should be discussed and eventually modified during the face-to-face meeting. All statements were evaluated in two rounds of voting. Initially, each participant discussed the document and statements with his group for possible modifications and voting. Subsequently, during a second voting in a plenary session in the presence of all participants, the statements were voted upon and eventually modified. The participants could vote using five alternatives: 1) strongly agree; 2) partially agree; 3) undecided; 4) disagree; and 5) strongly disagree. The adopted consensus index was that 80% of the participants responded that they strongly or partially agreed with each statement. The recommendations reported are intended to provide the most current and relevant evidences to management of H. pylori infection in adult population in Brazil.
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