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Yao M, Cao J, Zhang L, Wang K, Lin H, Qin L, Zhang Q, Qu C, Miao J, Xue C. Indole-3-Lactic Acid Derived from Lacticaseibacillus paracasei Inhibits Helicobacter pylori Infection via Destruction of Bacteria Cells, Protection of Gastric Mucosa Epithelial Cells, and Alleviation of Inflammation. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2024; 72:15725-15739. [PMID: 38973111 DOI: 10.1021/acs.jafc.4c02868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/09/2024]
Abstract
Indole-3-lactic acid (ILA) has exhibited antimicrobial properties. However, its role in inhibiting Helicobacter pylori infection remains elusive. This study investigated the inhibitory effect of ILA produced by Lacticaseibacillus paracasei on H. pylori, which was further confirmed by cell and animal experiments. 5 mg/mL ILA was sufficient to directly inhibit the growth of H. pylori in vitro, with a urease inhibitory activity reaching 60.94 ± 1.03%, and the cell morphology and structure were destroyed. ILA inhibited 56.5% adhesion of H. pylori to GES-1 and significantly reduced the number of apoptotic cells. Furthermore, ILA suppresses H. pylori colonization by approximately 38% to 63%, reduced inflammation and oxidative stress in H. pylori-infected mice, and enhanced the enrichment and variety of gut microbiota, notably fostering the growth of beneficial bacteria such as Lactobacillus and Bifidobacterium strains. The results support that ILA derived from Lactobacillus can be applicated as a novel prebiotic in anti-H. pylori functional foods.
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Affiliation(s)
- Mengke Yao
- College of Food Science and Engineering, Ocean University of China, Qingdao 266003, China
- Key Laboratory of Marine Eco-Environmental Science and Technology, First Institute of Oceanography, Ministry of Natural Resources, Qingdao 266061, China
| | - Junhan Cao
- College of Food Science and Engineering, Ocean University of China, Qingdao 266003, China
- Key Laboratory of Marine Eco-Environmental Science and Technology, First Institute of Oceanography, Ministry of Natural Resources, Qingdao 266061, China
| | - Liping Zhang
- Key Laboratory of Marine Eco-Environmental Science and Technology, First Institute of Oceanography, Ministry of Natural Resources, Qingdao 266061, China
| | - Kai Wang
- Key Laboratory of Marine Eco-Environmental Science and Technology, First Institute of Oceanography, Ministry of Natural Resources, Qingdao 266061, China
| | - Huan Lin
- College of Food Science and Engineering, Ocean University of China, Qingdao 266003, China
- Key Laboratory of Marine Eco-Environmental Science and Technology, First Institute of Oceanography, Ministry of Natural Resources, Qingdao 266061, China
| | - Ling Qin
- Key Laboratory of Marine Eco-Environmental Science and Technology, First Institute of Oceanography, Ministry of Natural Resources, Qingdao 266061, China
| | - Qing Zhang
- Key Laboratory of Marine Eco-Environmental Science and Technology, First Institute of Oceanography, Ministry of Natural Resources, Qingdao 266061, China
| | - Changfeng Qu
- Key Laboratory of Marine Eco-Environmental Science and Technology, First Institute of Oceanography, Ministry of Natural Resources, Qingdao 266061, China
- Laboratory for Marine Drugs and Bioproducts, Qingdao Pilot National Laboratory for Marine Science and Technology, Qingdao 266237, China
- Marine Natural Products R&D Laboratory, Qingdao Key Laboratory, Qingdao 266061, China
| | - Jinlai Miao
- Key Laboratory of Marine Eco-Environmental Science and Technology, First Institute of Oceanography, Ministry of Natural Resources, Qingdao 266061, China
- Laboratory for Marine Drugs and Bioproducts, Qingdao Pilot National Laboratory for Marine Science and Technology, Qingdao 266237, China
- Marine Natural Products R&D Laboratory, Qingdao Key Laboratory, Qingdao 266061, China
| | - Changhu Xue
- College of Food Science and Engineering, Ocean University of China, Qingdao 266003, China
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Lai Y, Zhang T, Yin X, Zhu C, Du Y, Li Z, Gao J. An antibiotic-free platform for eliminating persistent Helicobacter pylori infection without disrupting gut microbiota. Acta Pharm Sin B 2024; 14:3184-3204. [PMID: 39027245 PMCID: PMC11252519 DOI: 10.1016/j.apsb.2024.03.014] [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: 12/25/2023] [Revised: 02/18/2024] [Accepted: 02/20/2024] [Indexed: 07/20/2024] Open
Abstract
Helicobacter pylori (H. pylori) infection remains the leading cause of gastric adenocarcinoma, and its eradication primarily relies on the prolonged and intensive use of two antibiotics. However, antibiotic resistance has become a compelling health issue, leading to H. pylori eradication treatment failure worldwide. Additionally, the powerlessness of antibiotics against biofilms, as well as intracellular H. pylori and the long-term damage of antibiotics to the intestinal microbiota, have also created an urgent demand for antibiotic-free approaches. Herein, we describe an antibiotic-free, multifunctional copper-organic framework (HKUST-1) platform encased in a lipid layer comprising phosphatidic acid (PA), rhamnolipid (RHL), and cholesterol (CHOL), enveloped in chitosan (CS), and loaded in an ascorbyl palmitate (AP) hydrogel: AP@CS@Lip@HKUST-1. This platform targets inflammatory sites where H. pylori aggregates through electrostatic attraction. Then, hydrolysis by matrix metalloproteinases (MMPs) releases CS-encased nanoparticles, disrupting bacterial urease activity and membrane integrity. Additionally, RHL disperses biofilms, while PA promotes lysosomal acidification and activates host autophagy, enabling clearance of intracellular H. pylori. Furthermore, AP@CS@Lip@HKUST-1 alleviates inflammation and enhances mucosal repair through delayed Cu2+ release while preserving the intestinal microbiota. Collectively, this platform presents an advanced therapeutic strategy for eradicating persistent H. pylori infection without inducing drug resistance.
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Affiliation(s)
- Yongkang Lai
- Department of Gastroenterology, Shanghai Changhai Hospital, Naval Medical University, Shanghai 200433, China
- Department of Gastroenterology, Ganzhou People's Hospital Affiliated to Nanchang University, Ganzhou 341000, China
| | - Tinglin Zhang
- Changhai Clinical Research Unit, Shanghai Changhai Hospital, Naval Medical University, Shanghai 200433, China
- National Key Laboratory of Immunity and Inflammation, Naval Medical University, Shanghai 200433, China
| | - Xiaojing Yin
- Department of Gastroenterology, Shanghai Changhai Hospital, Naval Medical University, Shanghai 200433, China
| | - Chunping Zhu
- Department of Gastroenterology, Ganzhou People's Hospital Affiliated to Nanchang University, Ganzhou 341000, China
| | - Yiqi Du
- Department of Gastroenterology, Shanghai Changhai Hospital, Naval Medical University, Shanghai 200433, China
- Changhai Clinical Research Unit, Shanghai Changhai Hospital, Naval Medical University, Shanghai 200433, China
- National Key Laboratory of Immunity and Inflammation, Naval Medical University, Shanghai 200433, China
- Shanghai Key Laboratory of Nautical Medicine and Translation of Drugs and Medical Devices, Shanghai 200433, China
| | - Zhaoshen Li
- Department of Gastroenterology, Shanghai Changhai Hospital, Naval Medical University, Shanghai 200433, China
- Changhai Clinical Research Unit, Shanghai Changhai Hospital, Naval Medical University, Shanghai 200433, China
- Department of Gastroenterology, Ganzhou People's Hospital Affiliated to Nanchang University, Ganzhou 341000, China
- National Key Laboratory of Immunity and Inflammation, Naval Medical University, Shanghai 200433, China
- Shanghai Key Laboratory of Nautical Medicine and Translation of Drugs and Medical Devices, Shanghai 200433, China
| | - Jie Gao
- Changhai Clinical Research Unit, Shanghai Changhai Hospital, Naval Medical University, Shanghai 200433, China
- National Key Laboratory of Immunity and Inflammation, Naval Medical University, Shanghai 200433, China
- Shanghai Key Laboratory of Nautical Medicine and Translation of Drugs and Medical Devices, Shanghai 200433, China
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Li XT, Xu L, Zhang C, Qi YB, Hu RB, Abdun MA, Yu XC, Li K, Liu TT, Ma J, Xiao W, Lan L, Wang XM, Cao MB, Li J, Han SY, Li XL, Ding SZ. Improved Patient Adherence to Family-Based Helicobacter pylori Infection Control and Management Strategy in Central China and Its Influencing Factors. Helicobacter 2024; 29:e13114. [PMID: 39031966 DOI: 10.1111/hel.13114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 07/02/2024] [Accepted: 07/03/2024] [Indexed: 07/22/2024]
Abstract
BACKGROUND Patient adherence status to the newly introduced family-based Helicobacter pylori (H. pylori) infection control and management strategy remains unclear, so are its influencing factors. We aim to investigate family members' adherence and its influencing factors during the family-based H. pylori infection management practice for related disease prevention. MATERIALS AND METHODS Based on our previously family-based H. pylori survey in 2021, 282 families including 772 individuals were followed up 2 years after the initial survey to compare if the investigation and education might improve family member's adherence. The participant's adherence to H. pylori infection awareness, retest, treatment, publicity, gastroscopy, and hygiene habits were followed up, and their influencing factors were also analyzed. RESULTS The overall participant's adherence to recommendations on H. pylori awareness, retest, treatment, publicity, gastroscopy, and hygiene habits were 77% (187/243), 67.3% (138/205), 60.1% (211/351), 46.5% (107/230), 45.6% (159/349), and 39.1% (213/545), respectively; and all showed improvements compared with their prior survey stages. The top reasons for rejection to treatment, retest, and gastroscopy were forgetting or unaware of H. pylori infection (30.3%), busy (32.8%), and asymptomatic (67.9%), respectively. Independent risk factor for low adherence to treatment was occupation (e.g., staff: OR 4.49, 95% CI 1.34-15.10). Independent favorable factors for treatment adherence were individuals at the ages of 18-44 years (OR 0.19, 95% CI 0.04-0.89) and had a large family size (e.g., four family members: OR 0.15, 95% CI 0.06-0.41); for retest adherence, it was individuals at the ages of 60-69 years (OR 0.23, 95% CI 0.06-0.97); for gastroscopy adherence, it was individuals at the age of 60-69 years (OR 0.46, 95% CI 0.28-0.75), and with gastrointestinal symptoms (OR 0.57, 95% CI 0.36-0.90). CONCLUSIONS Family-based H. pylori management increases individual adherence to treatment, retest, and awareness, and there are also improved adherence to gastroscopy, publicity, and personal hygiene recommendations; further efforts are required to enhance the individual adherence rate for related disease prevention.
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Affiliation(s)
- Xiao-Ting Li
- Department of Gastroenterology and Hepatology, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Lu Xu
- Department of Gastroenterology and Hepatology, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Chen Zhang
- Department of Gastroenterology and Hepatology, Henan University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Ya-Bin Qi
- Department of Gastroenterology and Hepatology, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Ruo-Bing Hu
- Department of Gastroenterology and Hepatology, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Mohammed Awadh Abdun
- Department of Gastroenterology and Hepatology, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Xue-Chun Yu
- Department of Gastroenterology and Hepatology, Xinyang People's Hospital, Xinyang, Henan, China
| | - Kuan Li
- Department of Infectious Disease, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Ting-Ting Liu
- Department of Endocrinology, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Jing Ma
- Department of Gastroenterology and Hepatology, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Wei Xiao
- Department of Gastroenterology and Hepatology, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Ling Lan
- Department of Gastroenterology and Hepatology, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Xue-Mei Wang
- Department of Traditional Chinese Medicine, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Ming-Bo Cao
- Department of Gastroenterology and Hepatology, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Jian Li
- Department of Gastroenterology and Hepatology, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Shuang-Yin Han
- Department of Gastroenterology and Hepatology, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Xiu-Ling Li
- Department of Gastroenterology and Hepatology, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Song-Ze Ding
- Department of Gastroenterology and Hepatology, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Zhengzhou, Henan, China
- Department of Gastroenterology and Hepatology, Henan University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, Henan, China
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Lai Y, Dong X, Song Y, Zhao J, Du Y, Li Z. Novel MAXPOWER biological antibacterial liquid for eradicating oral Helicobacter pylori. BMC Infect Dis 2024; 24:540. [PMID: 38811871 PMCID: PMC11137934 DOI: 10.1186/s12879-024-09424-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 05/21/2024] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND Eradication of oral Helicobacter pylori (H. pylori) not only reduces the infection rate from the transmission route but also improves the success rate of intragastric eradication. MAXPOWER Biological Bacteriostatic Liquid, developed in our previous work, is a composite biological preparation with strong antibacterial ability and unique antibacterial mechanism. The present study evaluated the efficacy of the MAXPOWER biocontrol solution on H. pylori and its success rate in eradicating oral H. pylori in clinical patients. METHODS Live-dead cell staining and hemolysis test were used to evaluate the cellular safety of MAXPOWER biocontrol solution; plate spreading, live-dead bacterial staining, and scanning electron microscopy methods were used to evaluate its antimicrobial effect against H. pylori. Transcriptomics was used to analyze the changes in H. pylori genes before and after treatment. After seven days of gavage treatment, H&E staining and mice feces were collected for 16SrDNA sequencing to evaluate the animals' safety. Oral H. pylori-positive patients were randomized to be given a placebo and MAXPOWER Bio-Bacteriostatic Liquid gargle for seven days to evaluate the effect on oral H. pylori eradication. RESULTS In vitro tests demonstrated that this product has excellent biocompatibility and hemocompatibility and can effectively eradicate oral H. pylori. In vivo tests further showed that it has good biosafety and virtually no adverse effect on intestinal microflora. Transcriptomics analysis revealed that it kills H. pylori cells mainly by disrupting their cell membranes and metabolism. Additionally, the results of randomized controlled trials on humans disclosed that the oral H. pylori eradication rates achieved by MAXPOWER Biological Antibacterial Liquid were 71.4% and 78.9% according to the intention-to-treat and the per-protocol analysis, respectively. CONCLUSION MAXPOWER Biological Antibacterial Liquid is both safe and efficacious in the eradication of oral H. pylori. TRIAL REGISTRATION This study was retrospectively registered in the ClinicalTrials.gov Trial Registry on 21/09/2023 (NCT06045832).
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Affiliation(s)
- Yongkang Lai
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, 168 Changhai Road, Yangp u District, Shanghai, 200433, China
- Department of Gastroenterology, Ganzhou People's Hospital Affiliated to Nanchang University, Ganzhou, 341000, China
| | - Xiaoyang Dong
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, 168 Changhai Road, Yangp u District, Shanghai, 200433, China
| | - Yingxiao Song
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, 168 Changhai Road, Yangp u District, Shanghai, 200433, China
| | - Jiulong Zhao
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, 168 Changhai Road, Yangp u District, Shanghai, 200433, China.
- National Clinical Research Center for Digestive Diseases, Changhai Hospital, Naval Medical University, Shanghai, China.
- National key laboratory of Immunity and inflammation, Naval Medical University, Shanghai, China.
- Changhai Clinical Research Unit, Changhai hospital, Naval Medical University, Shanghai, China.
| | - Yiqi Du
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, 168 Changhai Road, Yangp u District, Shanghai, 200433, China.
- National Clinical Research Center for Digestive Diseases, Changhai Hospital, Naval Medical University, Shanghai, China.
- National key laboratory of Immunity and inflammation, Naval Medical University, Shanghai, China.
- Changhai Clinical Research Unit, Changhai hospital, Naval Medical University, Shanghai, China.
| | - Zhaoshen Li
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, 168 Changhai Road, Yangp u District, Shanghai, 200433, China
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Lai Y, Liao F, Zhao J, Zhu C, Hu Y, Li Z. Exploring the capacities of ChatGPT: A comprehensive evaluation of its accuracy and repeatability in addressing helicobacter pylori-related queries. Helicobacter 2024; 29:e13078. [PMID: 38867649 DOI: 10.1111/hel.13078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 04/01/2024] [Accepted: 04/03/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND Educational initiatives on Helicobacter pylori (H. pylori) constitute a highly effective approach for preventing its infection and establishing standardized protocols for its eradication. ChatGPT, a large language model, is a potentially patient-friendly online tool capable of providing health-related knowledge. This study aims to assess the accuracy and repeatability of ChatGPT in responding to questions related to H. pylori. MATERIALS AND METHODS Twenty-one common questions about H. pylori were collected and categorized into four domains: basic knowledge, diagnosis, treatment, and prevention. ChatGPT was utilized to individually answer the aforementioned 21 questions. Its responses were independently assessed by two experts on H. pylori. Questions with divergent ratings were resolved by a third reviewer. Cohen's kappa coefficient was calculated to assess the consistency between the scores of the two reviewers. RESULTS The responses of ChatGPT on H. pylori-related questions were generally satisfactory, with 61.9% marked as "completely correct" and 33.33% as "correct but inadequate." The repeatability of the responses of ChatGPT to H. pylori-related questions was 95.23%. Among the responses, those related to prevention (comprehensive: 75%) had the best response, followed by those on treatment (comprehensive: 66.7%), basic knowledge (comprehensive: 60%), and diagnosis (comprehensive: 50%). In the "treatment" domain, 16.6% of the ChatGPT responses were categorized as "mixed with correct or incorrect/outdated data." However, ChatGPT still lacks relevant knowledge regarding H. pylori resistance and the use of sensitive antibiotics. CONCLUSIONS ChatGPT can provide correct answers to the majority of H. pylori-related queries. It exhibited good reproducibility and delivered responses that were easily comprehensible to patients. Further enhancement of real-time information updates and correction of inaccurate information will make ChatGPT an essential auxiliary tool for providing accurate H. pylori-related health information to patients.
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Affiliation(s)
- Yongkang Lai
- Department of Gastroenterology, Ganzhou People's Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
- Department of Gastroenterology, Shanghai Changhai Hospital, Naval Medical University, Shanghai, China
| | - Foqiang Liao
- Department of Gastroenterology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Jiulong Zhao
- Department of Gastroenterology, Shanghai Changhai Hospital, Naval Medical University, Shanghai, China
| | - Chunping Zhu
- Department of Gastroenterology, Ganzhou People's Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Yi Hu
- Department of Gastroenterology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Zhaoshen Li
- Department of Gastroenterology, Ganzhou People's Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
- Department of Gastroenterology, Shanghai Changhai Hospital, Naval Medical University, Shanghai, China
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Gu Y, Xu Y, Wang P, Zhao Y, Wan C. Research progress on molecular mechanism of pyroptosis caused by Helicobacter pylori in gastric cancer. Ann Med Surg (Lond) 2024; 86:2016-2022. [PMID: 38576917 PMCID: PMC10990316 DOI: 10.1097/ms9.0000000000001802] [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: 11/07/2023] [Accepted: 01/29/2024] [Indexed: 04/06/2024] Open
Abstract
Gastric cancer (GC) is a prevalent malignancy worldwide. Helicobacter pylori (H. pylori), a Gram-negative spiral bacterium, has the ability to colonize and persist in the human gastric mucosa. Persistent H. pylori infection has been identified as a major risk factor for ~80% of GC cases. The interplay between H. pylori pathogenicity, genetic background, and environmental factors collectively contribute to GC transformation. Eradicating H. pylori infection is beneficial in reducing the recurrence of gastric cancer and residual cancer. However, the underlying molecular mechanisms involved in GC remain incompletely understood. Additionally, H. pylori reshapes the immune microenvironment within the stomach which may compromise immunotherapy efficacy in infected individuals. Clinical eradication of H. pylori infection still faces numerous challenges. In this review, the authors summarize recent research progress on elucidating the molecular mechanisms underlying H. pylori infection in GC development. Notably, CagA protein-a carcinogenic virulence factor predominantly expressed by Asian strains of H. pylori-induces inflammation and excessive ROS production within gastric mucosa cells. Dysregulation of multiple pyroptosis signalling pathways can lead to malignant transformation of these cells. MiRNA-1290 plays a crucial role in GC initiation and progression while serving as an indicator for disease progression dynamics. Pyroptosis exhibits dual roles both promoting carcinogenesis and inhibiting tumour growth; thus it holds potential clinical applications for drug-resistant GC treatment strategies. Furthermore, pyroptosis may play a regulatory role within the immune system during gastric cancer development. Lastly, the authors provide an overview on current concepts regarding pyroptosis as well as insights into miRNA-1290's pathogenicity and clinical value within immune mechanisms associated with GC, aiming to serve as reference material for researchers.
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Affiliation(s)
- Yulan Gu
- Department of Oncology, Affiliated Changshu Hospital of Nantong University
| | - Yeqiong Xu
- General Medical research center of Changshu Medicine Examination Institute, Changshu
| | - Ping Wang
- School of Preclinical Medicine, Wannan Medical College, Wuhu
| | - Yu Zhao
- Department of Clinical Medicine, Qixiu Campus Medical College of Nantong University, Nantong, China
| | - Chuandan Wan
- General Medical research center of Changshu Medicine Examination Institute, Changshu
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Shao Y, Lin Y, Fang Z, Yan J, Zheng T, Ye G. Analysis of Helicobacter pylori resistance in patients with different gastric diseases. Sci Rep 2024; 14:4912. [PMID: 38418852 PMCID: PMC10901771 DOI: 10.1038/s41598-024-55589-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 02/26/2024] [Indexed: 03/02/2024] Open
Abstract
Helicobacter pylori (H. pylori) resistance is the most important risk factor for eradication failure. However, in most regions, antibiotic resistance rates of H. pylori in patients with different types of gastric mucosal lesions are still unclear. An 8-year clinical retrospective cohort study involving 2847 patients was performed. In this study, we first summarized and compared the resistance status of H. pylori in different years, ages, sexes, and gastric diseases. The resistance profiles of amoxicillin (AMX), clarithromycin (CLR), levofloxacin (LVX) and furazolidone (FR) and their changing trends in the clinic were described. Then, multiple antibiotic resistance in different gastric diseases and years were described and compared. The relationship between proton pump inhibitor (PPI) medication history and antibiotic resistance in H. pylori was also explored. Finally, an antibiotic resistance risk model was constructed for clinical resistance risk prediction. The overall resistance rates of AMX, CLR, LVX and FR in gastric diseases were 8.18%, 38.11%, 43.98%, and 13.73%, respectively. The mono resistance, double resistance, triple resistance, and quadruple resistance rates were 30.17%, 25.96%, 6.46%, and 0.63%, respectively. Compared with the period from 2014 to 2016, the rates of mono-resistance and multiple resistance all showed relatively downward trends in the past 5 years. Factors including age, sex, type of gastric lesions and recent PPI treatment history are associated with the antibiotic resistance rate of H. pylori. Atrophic gastritis is an important clinical feature of high-risk antibiotic resistance in H. pylori-infected patients. Patients with atrophic gastritis have higher risk of resistant strains infection. In this study, our data provide the association between antibiotic resistance of H. pylori and gastritis pattern, which indicate the higher risk of resistant strain infection if the patients with atrophic gastritis, PPI history and older age.
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Affiliation(s)
- Yongfu Shao
- Health Science Center, Ningbo University, Ningbo, 315211, China
- Department of Gastroenterology, The First Affiliated Hospital of Ningbo University, Ningbo, 315020, China
| | - Yifan Lin
- Department of Gastroenterology, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, 318000, China
| | - Ziyi Fang
- Health Science Center, Ningbo University, Ningbo, 315211, China
- Department of Gastroenterology, The First Affiliated Hospital of Ningbo University, Ningbo, 315020, China
| | - Jianing Yan
- Department of Gastroenterology, The First Affiliated Hospital of Ningbo University, Ningbo, 315020, China
| | - Tuo Zheng
- Department of Gastroenterology, The First Affiliated Hospital of Ningbo University, Ningbo, 315020, China.
| | - Guoliang Ye
- Department of Gastroenterology, The First Affiliated Hospital of Ningbo University, Ningbo, 315020, China.
- Institute of Digestive Disease of Ningbo University, Ningbo, 315020, China.
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Lai Y, Liao F, He Z, Lai W, Zhu C, Du Y, Li Z. The status quo of short videos as a health information source of Helicobacter pylori: a cross-sectional study. Front Public Health 2024; 11:1344212. [PMID: 38259733 PMCID: PMC10800962 DOI: 10.3389/fpubh.2023.1344212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 12/28/2023] [Indexed: 01/24/2024] Open
Abstract
Background Health education about Helicobacter pylori (H. pylori) is one of the most effective methods to prevent H. pylori infection and standardize H. pylori eradication treatment. Short videos enable people to absorb and remember information more easily and are an important source of health education. This study aimed to assess the information quality of H. pylori-related videos on Chinese short video-sharing platforms. Methods A total of 242 H. pylori-related videos from three Chinese short video-sharing platforms with the most users, TikTok, Bilibili, and Kwai, were retrieved. The Global Quality Score (GQS) and the modified DISCERN tool were used to assess the quality and content of videos, respectively. Additionally, comparative analyzes of videos based on different sources and common H. pylori issues were also conducted. Results The median GQS score and DISCERN score was 2 for H. pylori-related videos analyzed in this study. Non-gastroenterologists posted the most H. pylori-related videos (136/242, 56.2%). Videos from gastroenterologists (51/242, 21.0%) had the highest GQS and DISCERN scores, with a median of 3. Few videos had content on family-based H. pylori infection control and management (5.8%), whether all H. pylori-positive patients need to undergo eradication treatment (27.7%), and the adverse effects of H. pylori eradication therapy (16.1%). Conclusion Generally, the content and quality of the information in H. pylori-related videos were unsatisfactory, and the quality of the video correlated with the source of the video. Videos from gastroenterologists provided more correct guidance with higher-quality information on the prevention and treatment of H. pylori infection.
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Affiliation(s)
- Yongkang Lai
- Department of Gastroenterology, Ganzhou People’s Hospital, Jiangxi Medical College, Nanchang University, Ganzhou, China
- Department of Gastroenterology, Shanghai Changhai Hospital, Naval Medical University, Shanghai, China
| | - Foqiang Liao
- Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Zixuan He
- Department of Gastroenterology, Shanghai Changhai Hospital, Naval Medical University, Shanghai, China
| | - Weiguo Lai
- Department of Gastroenterology, Ganzhou People’s Hospital, Jiangxi Medical College, Nanchang University, Ganzhou, China
| | - Chunping Zhu
- Department of Gastroenterology, Ganzhou People’s Hospital, Jiangxi Medical College, Nanchang University, Ganzhou, China
| | - Yiqi Du
- Department of Gastroenterology, Shanghai Changhai Hospital, Naval Medical University, Shanghai, China
| | - Zhaoshen Li
- Department of Gastroenterology, Ganzhou People’s Hospital, Jiangxi Medical College, Nanchang University, Ganzhou, China
- Department of Gastroenterology, Shanghai Changhai Hospital, Naval Medical University, Shanghai, China
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9
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Li J, Shi H, Zhou F, Xie L, Lin R. The Efficacy and Safety of Regimens for Helicobacter pylori Eradication Treatment in China: A Systemic Review and Network Meta-Analysis. J Clin Gastroenterol 2024; 58:12-23. [PMID: 38084866 DOI: 10.1097/mcg.0000000000001902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
BACKGROUND With Helicobacter pylori's increasing antibiotic resistance, evidence of more effective treatments is lacking in China, where H. pylori prevalence is nearly 50%. Thus, we performed a network meta-analysis to compare therapeutic regimens. METHODS Data extracted from eligible randomized controlled trials from January 2000 to September 2021 were entered into a Bayesian hierarchical random-effects model to evaluate the efficacy and safety of H. pylori eradication regimens. RESULTS This study included 101 trials involving 21,745 patients. Vonoprazan-bismuth-containing quadruple therapy (VBQT) ranked the highest [surfaces under cumulative ranking curve (SUCRA), 83.64%], followed by high-dose amoxicillin dual therapy (HDDT) [SUCRA, 79.70%, odds ratio (OR)=1.31, 95% credible interval (CrI) (0.36, 4.72)] and proton pump inhibitor-based bismuth-containing quadruple therapy (BQT) [SUCRA, 63.59%, OR=1.59, 95% CrI (0.48, 5.24)]. HDDT [OR=2.47, 95% CrI (1.51, 4.06)], BQT [OR=2.04, 95% CrI (1.69, 2.47)], concomitant quadruple nonbismuth therapy (CT) [OR=1.93, 95% CrI (1.19, 3.15)], and sequential therapy (ST) [OR=1.86, 95% CrI (1.50, 2.32)] had higher eradication rates than standard triple therapy (TT). ST (SUCRA, 82.52%) and VBQT (SUCRA, 83.89%) had the highest eradication rate before and after 2010 in the effectiveness ranking, respectively. Furthermore, the H. pylori eradication rate of patients receiving 14-day BQT treatment was higher than that of 10-day BQT regimen [OR=2.55, 95% CI (1.84, 3.53)] and 7-day BQT regimen [OR=3.64, 95% CI (2.64, 5.01)]. CONCLUSIONS The TT regimen was not an optimal choice in China for H. pylori eradication; VBQT, HDDT, and BQT showed better efficacy. After 2010, there is a trend toward significance that VBQT provided a higher H. pylori eradication rate in China, but with only 1 randomized controlled trial. Thus, more supportive real-world data are needed to confirm its effectiveness.
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Affiliation(s)
- Jing Li
- Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan
| | - Huiying Shi
- Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan
| | - Fang Zhou
- Takeda Pharmaceutical Company Ltd., Shanghai
| | - Li Xie
- Takeda Pharmaceutical Company Ltd., Beijing, China
| | - Rong Lin
- Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan
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10
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Zou JC, Wen MY, Huang Y, Chen XZ, Hu JK. Helicobacter pylori infection prevalence declined among an urban health check-up population in Chengdu, China: a longitudinal analysis of multiple cross-sectional studies. Front Public Health 2023; 11:1128765. [PMID: 38089026 PMCID: PMC10711608 DOI: 10.3389/fpubh.2023.1128765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 10/11/2023] [Indexed: 12/18/2023] Open
Abstract
Objectives The efficacy of updated health policy in improving the generalization of Helicobacter pylori screening and eradication in southwest China was assessed in a longitudinal analysis of multiple cross-sectional studies from an institution. Methods In the periods 2009-2010, 2013-2014, and 2019-2021, 8,365, 16,914, and 18,281 urban observations from health check-ups at West China Hospital were analyzed, respectively. The 14C-urea or 13C-urea breath test was consistently used for H. pylori detection. The protocol has been reported elsewhere (PROSPERO Registration number: CRD42019120764). Results The overall prevalence of H. pylori dramatically decreased from 53.1% to 30.7% over the past decade (OR = 0.39, 95% CI 0.37-0.41), with a similar decline in all sex-specific and age-specific subgroups. The age-specific prevalence consistently increased before 40 years of age and always peaked at 50-59 years. Longitudinal clearance increased along with aging, and prevalence dropped to 22.6%, 25.1%, and 23.6% in the 40-49, 50-59, and 60-69 years initial age groups, respectively. Conclusion The generalization of H. pylori screening and eradication could greatly contribute to the control of H. pylori infection among urban health check-up populations and lower gastric cancer incidence.
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Affiliation(s)
- Jin-Chen Zou
- Gastric Cancer Center & Gastric Cancer Laboratory, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
- Department of General Surgery, Second People’s Hospital of Yibin City – West China Yibin Hospital, Sichuan University, Yibin, China
| | - Mao-Yao Wen
- Health Management Center, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yan Huang
- Health Management Center, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xin-Zu Chen
- Gastric Cancer Center & Gastric Cancer Laboratory, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
- Department of Gastrointestinal Surgery, People’s Hospital of Ya’an City – West China Ya’an Hospital, Sichuan University, Ya’an, China
- Yibin Cancer Prevention and Control Center, Second People’s Hospital of Yibin City – West China Yibin Hospital, Sichuan University, Yibin, China
| | - Jian-Kun Hu
- Gastric Cancer Center & Gastric Cancer Laboratory, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
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11
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Feng JH, Cheng J, Lao YJ, Huang K, Mou JL, Hu F, Lin ML, Lin J. The efficacy and safety of vonoprazan-amoxicillin dual therapy in eradicating Helicobacter pylori: a systematic review and meta-analysis. Eur J Med Res 2023; 28:272. [PMID: 37550781 PMCID: PMC10405488 DOI: 10.1186/s40001-023-01249-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 07/27/2023] [Indexed: 08/09/2023] Open
Abstract
AIM To evaluate the efficacy and safety of vonoprazan-amoxicillin (VA) dual therapy for radically eradicating Helicobacter pylori (H. pylori). METHODS The PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI) and Wanfang databases were searched up to July 7, 2022, to identify clinical trials comparing the efficacy of VA dual therapy and triple therapy for H. pylori eradication. After evaluating the quality of the included studies, random effects models were conducted, and risk ratios (RRs) with 95% confidence intervals (CIs) were calculated to estimate the efficacy and safety of each approach. RESULTS Six publications (including four randomized controlled trials) involving 2019 patients were included in this meta-analysis. Overall, the eradication rate for VA dual therapy was 89.9%, while it was 85.2% for triple therapy based on other acid inhibitors. The eradication rate of H. pylori in the VA dual regimen group was higher than that in the PPI-based (omeprazole or lansoprazole) triple therapy group (RR = 1.15, 95% CI 1.07-1.23, p < 0.0001). However, the efficacy of VA dual therapy was comparable with VA-Clarithromycin (VAC) triple therapy (RR = 0.97, 95% CI 0.93-1.02). Besides, the incidence of adverse reactions in VA dual therapy was also lower than that in triple therapy (RR = 0.80, 95% CI 0.70-0.91, p = 0.0009). CONCLUSION Compared with PPI-based triple therapy, VA dual therapy showed a better therapeutic effect, safety and patient compliance rate for eradicating H. pylori, which should be used as a novel curative strategy in the future.
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Affiliation(s)
- Jia-Hui Feng
- Department of Gastroenterology/Hepatology, Zhongnan Hospital of Wuhan University, Wuhan, China
- The Hubei Clinical Center & Key Laboratory of Intestinal & Colorectal Diseases, Wuhan, China
| | - Jie Cheng
- Department of Gastroenterology/Hepatology, Zhongnan Hospital of Wuhan University, Wuhan, China
- The Hubei Clinical Center & Key Laboratory of Intestinal & Colorectal Diseases, Wuhan, China
| | - Yao-Jia Lao
- Department of Gastroenterology/Hepatology, Zhongnan Hospital of Wuhan University, Wuhan, China
- The Hubei Clinical Center & Key Laboratory of Intestinal & Colorectal Diseases, Wuhan, China
| | - Kai Huang
- Department of Gastroenterology/Hepatology, Zhongnan Hospital of Wuhan University, Wuhan, China
- The Hubei Clinical Center & Key Laboratory of Intestinal & Colorectal Diseases, Wuhan, China
| | - Juan-Li Mou
- Department of Gastroenterology/Hepatology, Zhongnan Hospital of Wuhan University, Wuhan, China
- The Hubei Clinical Center & Key Laboratory of Intestinal & Colorectal Diseases, Wuhan, China
| | - Fan Hu
- Department of Gastroenterology/Hepatology, Zhongnan Hospital of Wuhan University, Wuhan, China
- The Hubei Clinical Center & Key Laboratory of Intestinal & Colorectal Diseases, Wuhan, China
| | - Meng-Lu Lin
- Department of Gastroenterology/Hepatology, Zhongnan Hospital of Wuhan University, Wuhan, China
- The Hubei Clinical Center & Key Laboratory of Intestinal & Colorectal Diseases, Wuhan, China
| | - Jun Lin
- Department of Gastroenterology/Hepatology, Zhongnan Hospital of Wuhan University, Wuhan, China.
- The Hubei Clinical Center & Key Laboratory of Intestinal & Colorectal Diseases, Wuhan, China.
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12
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Liu DN, Wang QY, Li PY, Wu DH, Pan J, Chen ZY, Li YQ, Han XY, Lan C, Tang J, Tan Y, Mo CY, Yang WZ, Han JL, Huang XX. Comparing high-dose dual therapy with bismuth-containing quadruple therapy for the initial eradication of Helicobacter pylori infection on Hainan Island: a randomized, multicenter clinical trial. Clin Res Hepatol Gastroenterol 2023; 47:102125. [PMID: 37062356 DOI: 10.1016/j.clinre.2023.102125] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 04/06/2023] [Accepted: 04/14/2023] [Indexed: 04/18/2023]
Abstract
BACKGROUND Traditional bismuth-containing quadruple therapy, as a first-line eradication treatment for Helicobacter pylori (H. pylori), has several disadvantages, including drug side effects, low medication adherence, and high costs. Trials of high-dose dual treatment have demonstrated its advantages, which include good safety and adherence profiles. In this study, we investigated the efficacy, safety, and compliance of a high-dose dual therapy when compared with bismuth-based quadruple treatment for the initial eradication of H. pylori infection on Hainan Island, China. METHODS We randomized 846 H. pylori-infected patients into two groups. A bismuth-containing quadruple therapy group was administered the following: esomeprazole 20 mg, amoxicillin 1000 mg, and clarithromycin 500 mg twice daily, and colloidal bismuth pectin in suspension 150 mg three times/day for 2 weeks. A high-dose dual therapy group was administered the following: esomeprazole 20 mg four times/day and amoxicillin 1000 mg three times/day for 2 weeks. Patients were given a 13C urea breath test at 4 weeks at treatment end. Adverse effects and compliance were evaluated at follow-up visits. RESULTS Eradication rates in the high-dose dual therapy group were: 90.3% (381/422, 95% confidence interval [CI]: 87.1%-92.9%) in intention-to-treat (ITT) and 93.6% (381/407, 95% CI: 90.8%-95.8%) in per-protocol (PP) analyses. Eradication rates were 87.3% in ITT (370/424, 95% CI: 83.7%-90.3%) and 91.8% in PP analyses (370/403, 95% CI: 88.7%-94.3%) for quadruple therapy, with no statistical differences (P = 0.164 in ITT and P = 0.324 in PP analyses). Adverse effects were 13.5% (55/407) in the dual group and 17.4% (70/403) in the quadruple group (P = 0.129). Compliance was 92.4% (376/407) in the dual group and 86.6% (349/403) in the quadruple group (P = 0.007). CONCLUSIONS High-dose dual therapy had high eradication rates comparable with bismuth-based quadruple treatment, with no differences in adverse effects, however higher adherence rates were recorded.
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Affiliation(s)
- Dan-Ni Liu
- Department of Gastroenterology, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou, China
| | - Qiu-Yan Wang
- Department of Gastroenterology, Tongji Wenchang Hospital of Huazhong University of Science and Technology, Wenchang, China
| | - Pei-Yuan Li
- Department of Gastroenterology, Tongji Wenchang Hospital of Huazhong University of Science and Technology, Wenchang, China
| | - Dong-Han Wu
- Department of Gastroenterology, Sanya Municipal People's Hospital, Sanya, China
| | - Jing Pan
- Department of Gastroenterology, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou, China
| | - Zheng-Yi Chen
- Department of Gastroenterology, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou, China
| | - Yan-Qiang Li
- Department of Gastroenterology, Wanning Municipal People's Hospital, Wanning, China
| | - Xiang-Yang Han
- Department of Gastroenterology, Hainan Provincial People's Hospital, Haikou, China
| | - Cheng Lan
- Department of Gastroenterology, Hainan Provincial People's Hospital, Haikou, China
| | - Jing Tang
- Department of Gastroenterology, The First Affiliated Hospital of Hainan Medical College, Haikou, China
| | - Yan Tan
- Department of Gastroenterology, The First Affiliated Hospital of Hainan Medical College, Haikou, China
| | - Cui-Yi Mo
- Department of Gastroenterology, Qionghai Municipal People's Hospital, Qionghai, China
| | - Wei-Zhong Yang
- Department of Gastroenterology, The Second Affiliated Hospital of Hainan Medical College, Haikou, China
| | - Jun-Ling Han
- Department of Gastroenterology, 928th Hospital of Joint service support force of the Chinese People's Liberation Army, Haikou, China
| | - Xiao-Xi Huang
- Department of Gastroenterology, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou, China.
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Zou JC, Yang Y, Chen XZ. Active Eradication of Helicobacter pylori Within Organized Massive Screening Might Improve Survival of Gastric Cancer Patients. Gastroenterology 2023; 164:162-163. [PMID: 35550142 DOI: 10.1053/j.gastro.2022.05.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/05/2022] [Accepted: 05/07/2022] [Indexed: 02/03/2023]
Affiliation(s)
- Jin-Chen Zou
- Department of Gastrointestinal Surgery and Gastric Cancer Laboratory, West China Hospital, Sichuan University, Chengdu, China; Department of General Surgery, Second People's Hospital of Yibin City-West China Yibin Hospital, Sichuan University, Yibin, China
| | - Yuan Yang
- Department of Gastrointestinal Surgery and Gastric Cancer Laboratory, West China Hospital, Sichuan University, Chengdu, China; Department of Gastrointestinal and Hernia Surgery, Second People's Hospital of Yibin City-West China Yibin Hospital, Sichuan University, Yibin, China
| | - Xin-Zu Chen
- Department of Gastrointestinal Surgery and Gastric Cancer Laboratory, West China Hospital, Sichuan University, Chengdu, China; Department of Gastrointestinal and Hernia Surgery, Second People's Hospital of Yibin City-West China Yibin Hospital, Sichuan University, Yibin, China; Cancer Prevention and Control Center of Yibin, Second People's Hospital of Yibin City-West China Yibin Hospital, Sichuan University, Yibin, China
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14
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Wang Z, Han W, Xue F, Zhao Y, Wu P, Chen Y, Yang C, Gu W, Jiang J. Nationwide gastric cancer prevention in China, 2021-2035: a decision analysis on effect, affordability and cost-effectiveness optimisation. Gut 2022; 71:2391-2400. [PMID: 35902213 DOI: 10.1136/gutjnl-2021-325948] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 07/08/2022] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To project future trajectories of the gastric cancer (GC) burden in China under different scenarios of GC prevention and identify strategies to improve affordability and cost-effectiveness. DESIGN Using a cohort of Chinese men and women born during 1951-1980, we assumed that different prevention strategies were conducted, including eradication of Helicobacter pylori (Hp) and endoscopy screening (one-time, annual, biennial, triennial or stratified according to personal risk). We performed a literature search to identify up-to-date data and populate a Markov model to project the number of new GC cases and deaths during 2021-2035, as well as resource requirements and quality-adjusted life-years (QALYs). We examined the impacts of general (among the whole population) and targeted (high-risk population) prevention. RESULTS During 2021-2035, 10.0 million new GC cases and 5.6 million GC deaths would occur, with 7.6%-35.5% and 6.9%-44.5%, respectively, being avoidable through various prevention strategies. Relative to the status quo, Hp eradication was a cost-saving strategy. General annual screening dominated other screening strategies, but cost more than CNY 70 000 per QALY gained (willingness-to-pay) compared with Hp eradication. Among endoscopy strategies, targeted screening resulted in 44%-49% lower cost per QALY gained over the status quo than general screening. Among high-risk population, tailoring the screening frequency according to personal risk could reduce endoscopy-related resources by 22% compared with biennial screening and by 55% compared with annual screening, CONCLUSION: Our findings provide important input for future decision-making and investment, highlighting the need and feasibility for China to include GC prevention in its national health plans.
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Affiliation(s)
- Zixing Wang
- Department of Epidemiology and Biostatistics, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Basic Medical Sciences, Beijing, China
| | - Wei Han
- Department of Epidemiology and Biostatistics, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Basic Medical Sciences, Beijing, China
| | - Fang Xue
- Department of Epidemiology and Biostatistics, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Basic Medical Sciences, Beijing, China
| | - Yujie Zhao
- Department of Epidemiology and Biostatistics, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Basic Medical Sciences, Beijing, China
| | - Peng Wu
- Department of Epidemiology and Biostatistics, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Basic Medical Sciences, Beijing, China
| | - Yali Chen
- Department of Epidemiology and Biostatistics, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Basic Medical Sciences, Beijing, China
| | - Cuihong Yang
- Department of Epidemiology and Biostatistics, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Basic Medical Sciences, Beijing, China
| | - Wentao Gu
- Department of Epidemiology and Biostatistics, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Basic Medical Sciences, Beijing, China
| | - Jingmei Jiang
- Department of Epidemiology and Biostatistics, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Basic Medical Sciences, Beijing, China
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15
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Hu Y, Zhu Y, Lu NH. The management of Helicobacter pylori infection and prevention and control of gastric cancer in China. Front Cell Infect Microbiol 2022; 12:1049279. [PMID: 36530421 PMCID: PMC9751207 DOI: 10.3389/fcimb.2022.1049279] [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: 09/20/2022] [Accepted: 11/14/2022] [Indexed: 12/04/2022] Open
Abstract
Helicobacter pylori (H. pylori) infection, a type-1 carcinogen, was closely associated with gastric cancer (GC). Successfully eradicating H. pylori infection could reduce the incidence of GC. China was a country with high incidence of GC and high prevalence of H. pylori infection. Nearly half of worldwide GC new cases and deaths attributed to H. pylori infection occurred in China. H. pylori prevalence varied over time with the improvement of socioeconomic status and sanitary conditions. The knowledge of antibiotic resistance rate in time was important to guide the clinical choice of antibiotics use in the regimens. With the publication of five Chinese consensus reports on the management of H. pylori infection and the effort of public preach of H. pylori-related knowledge, the standardization of H. pylori diagnosis and treatment by clinicians was improved. Bismuth-containing quadruple therapy was widely applied in clinical practice of H. pylori eradication because of high efficacy and safety. High-dose Proton Pump Inhibitor-amoxicillin dual therapy or vonoprazan-amoxicillin dual therapy showed comparable efficacy and lower side effects than bismuth-containing quadruple therapy, which were the alternative choice. The diagnosis rate of early GC was low and distinguishing Chinese GC risk population for the further endoscopy screening was important. Efforts have been done to establish prediction models to stratify GC risk in the Chinese GC risk population. We reviewed the current situation of the management of H. pylori infection and prevention and control of GC in China here.
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Affiliation(s)
- Yi Hu
- Department Of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China,JiangXi Clinical Research Center for Gastroenterology, Nanchang, Jiangxi, China
| | - Yin Zhu
- Department Of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China,JiangXi Clinical Research Center for Gastroenterology, Nanchang, Jiangxi, China,*Correspondence: Nong-Hua Lu, ; Yin Zhu,
| | - Nong-Hua Lu
- Department Of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China,JiangXi Clinical Research Center for Gastroenterology, Nanchang, Jiangxi, China,*Correspondence: Nong-Hua Lu, ; Yin Zhu,
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16
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He C, Xie Y, Zhu Y, Zhuang K, Huo L, Yu Y, Guo Q, Shu X, Xiong Z, Zhang Z, Lyu B, Lu N. Probiotics modulate gastrointestinal microbiota after Helicobacter pylori eradication: A multicenter randomized double-blind placebo-controlled trial. Front Immunol 2022; 13:1033063. [PMID: 36426355 PMCID: PMC9679295 DOI: 10.3389/fimmu.2022.1033063] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 10/21/2022] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Helicobacter pylori (H. pylori) eradication has been reported to cause short-term disruption of gut microbiota. It is acknowledged that probiotics supplementation mitigates side effects induced by H. pylori eradication, yet its role on alleviating dysbiosis of microbiota is obscure. OBJECTIVES To evaluate the impact of probiotics on gastrointestinal microbiota after eradication therapy. METHODS This was a multicenter, double-blinded, randomized trial done at seven centers in China. A total of 276 treatment-naïve H. pylori-positive patients were randomly assigned to receive 14-day bismuth-containing quadruple therapy (esomeprazole, bismuth, amoxicillin, furazolidone) combined with probiotics (Bifidobacterium Tetragenous viable Bacteria Tablets) (n=140) or placebo (n=136) for 28 days. Saliva, gastric mucosa and fecal samples were collected before and after therapy for 16S rRNA gene sequencing. RESULTS The incidence of gastrointestinal adverse events was lower in probiotics group compared to placebo group (23.6% vs 37.7%, p=0.016), while there was no significant difference in eradication rate. We found dramatic perturbations of gut microbiota immediately following eradication, with the predominance of Proteobacteria in replacement of commensal Firmicutes and Bacteroidetes, and gradually restored after two weeks. The reduction of gut Bacteroidetes caused by eradication drugs was neutralized with probiotics supplementation. The gastric microbiota was completely reconstituted with H. pylori depleted and other taxa flourished. Of note, patients treated with probiotics showed smaller fluctuations of gastric microbiota compared to those with placebo. We also observed changes of saliva microbiota after H. pylori eradication, illustrated by the overgrowth of Neisseria and depletion of Streptococcus. The expansion of some pathogenic genera, including Porphyromonas, Leptotrichia, in the mouth was suppressed by probiotics. CONCLUSION This study not only demonstrated the beneficial effect of probiotics implementation on side events during H. pylori eradication but also provided a comprehensive profile of microbiome alterations along gastrointestinal tract that modulated by probiotics.
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Affiliation(s)
- Cong He
- Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital of Nanchang University, Jiangxi, China
- Jiangxi Clinical Research Center for Gastroenterology, Nanchang, China
| | - Yong Xie
- Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital of Nanchang University, Jiangxi, China
- Jiangxi Clinical Research Center for Gastroenterology, Nanchang, China
| | - Yin Zhu
- Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital of Nanchang University, Jiangxi, China
- Jiangxi Clinical Research Center for Gastroenterology, Nanchang, China
| | - Kun Zhuang
- Department of Gastroenterology, Xi’an Central Hospital, Shaanxi, China
| | - Lijuan Huo
- Department of Gastroenterology, First Affiliated Hospital of Shanxi Medical University, Taiyuan, China
| | - Yong Yu
- Department of Gastroenterology, Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Qiang Guo
- Department of Gastroenterology, First People’s Hospital of Yunnan Province, Kunming, China
| | - Xu Shu
- Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital of Nanchang University, Jiangxi, China
- Jiangxi Clinical Research Center for Gastroenterology, Nanchang, China
| | - Zhijuan Xiong
- Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital of Nanchang University, Jiangxi, China
- Jiangxi Clinical Research Center for Gastroenterology, Nanchang, China
| | - Zhenyu Zhang
- Department of Gastroenterology, Nanjing First Hospital, Nanjing Medical University, Jiangsu, China
| | - Bin Lyu
- Department of Gastroenterology, First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Nonghua Lu
- Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital of Nanchang University, Jiangxi, China
- Jiangxi Clinical Research Center for Gastroenterology, Nanchang, China
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17
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Alarming antibiotics resistance of Helicobacter pylori from children in Southeast China over 6 years. Sci Rep 2022; 12:17754. [PMID: 36272980 PMCID: PMC9588048 DOI: 10.1038/s41598-022-21661-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 09/29/2022] [Indexed: 01/19/2023] Open
Abstract
The increasing rates of antibiotic resistance in Helicobacter pylori (H. pylori) are a major concern of the decreasing eradication rate. Large-scale and long-period studies on antimicrobial susceptibility of H. pylori in children are limited. This study aimed to describe the temporal changes of antibiotic resistance among children in southeast China. Gastric biopsies obtained from children were cultured for H. pylori from 2015 to 2020. Susceptibility to clarithromycin (CLA), amoxicillin (AML), metronidazole (MTZ), furazolidone (FZD), tetracycline (TET) and levofloxacin (LEV) was tested. Data from 2012 to 2014 reported previously were obtained for comparing the change in temporal trends of antibiotic resistance. A total of 1638 (52.7%) H. pylori strains were isolated from 3111 children recruited. The resistance rates to CLA, MTZ and LEV were 32.8%, 81.7% and 22.8%, respectively. There were 52.9% strains resistant to single resistance, 28.7% to double resistance, and 9.0% to triple resistance. The total resistance rate and resistance rates to CLA, MTZ, LEV, CLA + LEV and CLA + MTZ + LEV increased annually in a linear manner. All resistant patterns except single resistance increased obviously from 2015 to 2017 and 2018 to 2020 compared to that from 2012 to 2014. Double resistance to CLA + MTZ increased significantly with age. The resistance rate to CLA and triple resistance to CLA, MTZ and LEV increased in children with prior H. pylori treatment than that from children without prior treatment. The antibiotic resistance rates of H. pylori were high in a large pediatric population in southeast China from 2015 to 2020. Individual treatment based on susceptibility test is imperative and optimal regimens should be chosen in H. pylori eradication therapy.
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Chen XX, Chen YX, Bi HX, Zhao X, Zhang LF, Liu JY, Shi YQ. Efficacy and safety of triple therapy containing berberine hydrochloride, amoxicillin, and rabeprazole in the eradication of Helicobacter pylori. J Dig Dis 2022; 23:568-576. [PMID: 36415112 PMCID: PMC10107123 DOI: 10.1111/1751-2980.13146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 11/02/2022] [Accepted: 11/21/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To estimate the effectiveness and safety of triple therapy containing berberine, amoxicillin, and rabeprazole in the eradication of Helicobacter pylori (H. pylori). METHODS This prospective, randomized controlled, open-label, noninferiority trial included treatment-naive patients with H. pylori infection who were randomly allocated at a ratio of 1:1 into the berberine triple therapy group (berberine hydrochloride 300 mg thrice daily, amoxicillin 1 g twice daily, and rabeprazole 10 mg twice daily) or standard bismuth-containing quadruple therapy group (amoxicillin 1 g twice daily, rabeprazole 10 mg twice daily, clarithromycin 500 mg twice daily, and bismuth tartrate 200 mg twice daily) for 14 days. Negative 13 C/14 C-urea breath test at 4 weeks after completion of the therapy was regarded as successful eradication. RESULTS Altogether 262 and 262 patients received berberine triple therapy and bismuth-containing quadruple therapy, respectively. Both intention-to-treat (79.8% vs 80.9%, P = 0.742) and per-protocol analyses (83.6% and 85.1%, P = 0.636) showed comparable eradication rate between the two groups, indicating a noninferior eradication rate (the lower limit of the 95% confidence interval over -10% [-7.9% and -7.87%, respectively]). Adverse events more commonly occurred in the bismuth-containing quadruple-therapy group (8.8% vs 16.0%, P = 0.012), while patient compliance and symptom improvement of the two regimens were comparable. CONCLUSION Triple therapy containing berberine, amoxicillin and rabeprazole is noninferior to bismuth-containing quadruple therapy in the initial treatment for H. pylori eradication.
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Affiliation(s)
- Xing Xing Chen
- Xi'an Medical University, Xi'an, Shaanxi Province, China.,State Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases and Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi Province, China.,The Second Affiliated Hospital of Xi'an Medical College, Xi'an, Shaanxi Province, China
| | - Yu Xin Chen
- Xi'an Medical University, Xi'an, Shaanxi Province, China.,State Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases and Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi Province, China
| | - Han Xin Bi
- Xi'an Medical University, Xi'an, Shaanxi Province, China.,State Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases and Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi Province, China
| | - Xin Zhao
- Xi'an Medical University, Xi'an, Shaanxi Province, China.,State Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases and Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi Province, China
| | - Li Feng Zhang
- State Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases and Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi Province, China
| | - Jun Ye Liu
- Department of Radiation Protective Medicine, Air Force Medical University, Xi'an, Shaanxi Province, China
| | - Yong Quan Shi
- Xi'an Medical University, Xi'an, Shaanxi Province, China.,State Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases and Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi Province, China
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Li H, Zhao G, Guo Y, Fang Y, Wang K, Ma Y, Feng C, Zhou X, Chen Q, Liu X, Wang W, Xiong S, Chen G, Zheng M, Fei S. Feasibility and reproducibility of a plasma-based multiplex DNA methylation assay for early detection of gastric cancer. Pathol Res Pract 2022; 238:154086. [PMID: 36031696 DOI: 10.1016/j.prp.2022.154086] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/10/2022] [Accepted: 08/18/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Gastric cancer (GC) is a leading cause of cancer death and an important barrier to increasing life expectancy in China. Early detection of GC can significantly reduce its mortality rate. METHODS A new plasma-based multiplex DNA methylation assay combining simultaneous detection of three biomarkers (KCNQ5, C9orf50 and CLIP4) and one control gene (ACTB) was developed. It was used to examine 12 paired tissue samples and a training cohort of 151 plasma samples. Its performance was subsequently confirmed in validation cohort 1 (n = 105) and validation cohort 2 (n = 139). RESULTS Three methylation markers showed significantly higher methylation levels in GC tissues than in paired adjacent tissues. The assay showed a sensitivity of 67.9 % with a specificity of 86.6 % for GC detection in the training cohort, and the AUC was 0.786 (95 % CI: 0.701-0.855). The methylation levels in GC patients were significantly higher than those in benign gastric tumors and in control group. Meanwhile, the assay achieved a sensitivity of 65.5 % with a specificity of 90.0 % in the validation cohort 1, and the AUC was 0.805 (95 % CI: 0.716-0.876). In the validation cohort 2, its sensitivity and specificity were 73.7 % and 84.1 %, respectively, and the AUC was 0.851 (95 % CI: 0.776-0.909). CONCLUSION The plasma-based multiplex DNA methylation assay was highly specific for GC early detection. It has the potential to become an alternative approach to improve diagnosis of GC in the clinics.
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Affiliation(s)
- Hui Li
- Department of Gastroenterology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221002, China; Department of Gastroenterology, The First People's Hospital of Xuzhou, Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University, Xuzhou, Jiangsu 221002, China
| | - Guodong Zhao
- Department of R&D, Suzhou VersaBio Technologies Co. Ltd., Kunshan, Jiangsu 215300, China; Zhejiang University Kunshan Biotechnology Laboratory, Zhejiang University Kunshan Innovation Institute, Kunshan, Jiangsu 215300, China; State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, Nanjing 210009, China
| | - Yahui Guo
- Department of Gastroenterology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221002, China
| | - Yu Fang
- Department of Gastroenterology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221002, China
| | - Kai Wang
- Department of R&D, Suzhou VersaBio Technologies Co. Ltd., Kunshan, Jiangsu 215300, China
| | - Yong Ma
- Zhejiang University Kunshan Biotechnology Laboratory, Zhejiang University Kunshan Innovation Institute, Kunshan, Jiangsu 215300, China; Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, Jiangsu 215163, China
| | - Chenxi Feng
- Department of Gastroenterology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221002, China
| | - Xilang Zhou
- Department of Gastroenterology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221002, China
| | - Qi Chen
- Department of Gastroenterology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221002, China
| | - Xin Liu
- Department of Gastroenterology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221002, China
| | - Weifeng Wang
- Department of R&D, Suzhou VersaBio Technologies Co. Ltd., Kunshan, Jiangsu 215300, China
| | - Shangmin Xiong
- Department of R&D, Suzhou VersaBio Technologies Co. Ltd., Kunshan, Jiangsu 215300, China; Zhejiang University Kunshan Biotechnology Laboratory, Zhejiang University Kunshan Innovation Institute, Kunshan, Jiangsu 215300, China
| | - Guangxia Chen
- Department of Gastroenterology, The First People's Hospital of Xuzhou, Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University, Xuzhou, Jiangsu 221002, China.
| | - Minxue Zheng
- Zhejiang University Kunshan Biotechnology Laboratory, Zhejiang University Kunshan Innovation Institute, Kunshan, Jiangsu 215300, China; Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, Jiangsu 215163, China.
| | - Sujuan Fei
- Department of Gastroenterology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221002, China.
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20
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Ouyang Y, Wang M, Xu YL, Zhu Y, Lu NH, Hu Y. Amoxicillin-vonoprazan dual therapy for Helicobacter pylori eradication: A systematic review and meta-analysis. J Gastroenterol Hepatol 2022; 37:1666-1672. [PMID: 35716370 DOI: 10.1111/jgh.15917] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 06/09/2022] [Accepted: 06/14/2022] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND AIM The efficacy and safety of amoxicillin-vonoprazan (VA) dual therapy remained unclear. METHODS This systematic review was conducted in accordance with the PRISMA 2009 guidelines. A systematic search of the Pubmed, Embase, and Cochrane database was conducted using the combination of "Helicobacter pylori or H. pylori or Hp," "amoxicillin or penicillin," and "Vonoprazan or TAK-438 or Takecab or (potassium AND competitive) or potassium-competitive." The initial and secondary outcome of this meta-analysis was to evaluate the efficacy and safety of VA dual therapy. RESULTS Three studies and 668 H. pylori infected patients were included in this meta-analysis. The crude eradication rate of VA dual therapy was 87.5% and 89.6% by ITT and PP analysis, respectively. No significant differences were observed regarding the VA dual therapy and vonoprazan-amoxicillin-clarithromycin (VAC) triple therapy according to ITT (RR = 0.99, 95% CI, 0.93-1.05, P = 0.65) and PP (RR = 0.99, 95% CI, 0.94-1.05, P = 0.82) analysis. The side effect of VA dual therapy was 19.1% (95% CI, 5.9-32.4), which was lower than that of VAC triple therapy but there was no statistical significance (RR = 0.75, 95% CI, 0.59-1.06, P = 0.12). CONCLUSION VA dual therapy shows acceptable efficacy, good safety and avoid unnecessary antibiotic use in the first-line treatment for H. pylori infection. However, its application in other regions need to be further explored.
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Affiliation(s)
- Yaobin Ouyang
- Department Of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Minghui Wang
- Medical College of Nanchang University, Nanchang, China
| | - Yu-Ling Xu
- Medical College of Nanchang University, Nanchang, China
| | - Yin Zhu
- Department Of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Nong-Hua Lu
- Department Of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yi Hu
- Department Of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, China
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21
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Qin S, Wang X, Li S, Tan C, Zeng X, Wu M, Peng Y, Wang L, Wan X. Benefit-to-harm ratio and cost-effectiveness of government-recommended gastric cancer screening in China: A modeling study. Front Public Health 2022; 10:955120. [PMID: 36033760 PMCID: PMC9399635 DOI: 10.3389/fpubh.2022.955120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 07/18/2022] [Indexed: 01/24/2023] Open
Abstract
Objective Current guidelines recommend the gastric cancer risk score scale (GCRSS) for screening in gastric cancer (GC) high-risk populations in China. This study aimed to estimate the clinical benefits, harms, cost, and cost-effectiveness of the GCRSS screening strategy from a Chinese healthcare system perspective. Materials and methods Using a microsimulation model, we evaluated 7 screening scenarios of the GCRSS with varying starting ages. We simulated 100,000 individuals from the age of 20 for each screening scenario. The main outcomes included GC incidence reduction, number of cause-specific deaths, costs, quality-adjusted life year (QALY), incremental cost-effectiveness ratio (ICER), and benefit-to-harm ratio. Deterministic and probabilistic sensitivity analyses were done to explore the robustness of model findings. Results Screening with the GCRSS strategy at the age of 40 years (40-GCRSS) provided the greatest reduction of GC incidence by 70.6%, with 7,374 GC deaths averted per 100,000 individuals and the lowest benefit-to-harm ratio of 0.392. Compared with no screening or previous less costly strategy, at a willingness-to-pay (WTP) threshold of $37,655 per QALY, the 40-GCRSS strategy was cost-effective, with ICERs of $12,586 and $29,115 per QALY, respectively. Results were robust across univariate and probabilistic sensitivity analyses. The 40-GCRSS strategy showed a 0.856 probability of being cost-effective at a $37,655 per QALY WTP threshold. Conclusions The findings suggest that the GCRSS strategy is effective and cost-effective in reducing the GC disease burden in China from a Chinese healthcare system perspective. Screening from the age of 40 would be the optimal strategy.
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Affiliation(s)
- Shuxia Qin
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Xuehong Wang
- Department of Gastroenterology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Sini Li
- Xiangya Nursing School, Central South University, Changsha, China,School of Health and Related Research, Faculty of Medicine, Dentistry and Health, University of Sheffield, Sheffield, United Kingdom
| | - Chongqing Tan
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Xiaohui Zeng
- PET-CT Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Meiyu Wu
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Ye Peng
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Liting Wang
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Xiaomin Wan
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China,*Correspondence: Xiaomin Wan
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22
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Ma J, Yu M, Shao QQ, Yu XC, Zhang C, Zhao JB, Yuan L, Qi YB, Hu RB, Wei PR, Xiao W, Chen Q, Jia BL, Chen CL, Lu H, Ding SZ. Both family-based Helicobacter pylori infection control and management strategy and screen-and-treat strategy are cost-effective for gastric cancer prevention. Helicobacter 2022; 27:e12911. [PMID: 35706404 DOI: 10.1111/hel.12911] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 05/23/2022] [Accepted: 05/28/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND Helicobacter pylori (H. pylori) infection and its related diseases are substantial public health burden for highly infected areas. Recently, a novel family-based H. pylori infection control and management (FBCM) strategy is introduced for H. pylori infection prevention and control. However, its cost-effectiveness has not been evaluated. We conducted this health economic evaluation to investigate the cost-effectiveness of FBCM, screen-and-treat, and no-screen strategies in Chinese population. MATERIALS AND METHODS Cost-effectiveness analysis was performed using decision tree and Markov model. Parameters required for the model were from published literatures and public databases, including health state utility, screening characteristics, treatment effectiveness, and medical costs for the three strategies. Outcomes were cost, quality-adjusted life year (QALY), incremental cost-effectiveness ratio (ICER). Uncertainty analysis was performed to verify the robustness of this model. RESULTS To prevent gastric cancer in a cohort of 1 million asymptomatic Chinese families, FBCM and screen-and-treat strategies prevented 1010 and 1201 new gastric cancer cases, reduced 2809 and 3339 gastric cancer-related death, and saved 956,971 and 1,137,549 QALYs, respectively, when compared with no-screen strategy. Cost-effectiveness analysis showed that FBCM strategy cost $9.18/QALY, and screen-and-treat strategy cost $12.08/QALY for gastric cancer prevention when compared with no-screen strategy. One-way sensitivity analysis revealed that screening from younger age by both strategies are more cost-effective. When compared with FBCM strategy, screen-and-treat strategy saved 5.98% gastric cancer cases and 5.78% of gastric cancer deaths, but costed $9348 to reduce a gastric cancer case. Results are not sensitive to any variables, and probabilistic sensitivity analysis confirmed robustness of the results. CONCLUSIONS Both FBCM and screen-and-treat strategies are cost-effective for gastric cancer prevention compared with no-screen strategy. Since FBCM is more practical and convenient, it may be an efficient and excellent cost-effective strategy for gastric cancer prevention in H. pylori and gastric cancer prevalent areas.
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Affiliation(s)
- Jing Ma
- Department of Gastroenterology and Hepatology, People's Hospital of Zhengzhou University, and Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Miao Yu
- Department of Gastroenterology and Hepatology, People's Hospital of Zhengzhou University, and Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Qiao-Qiao Shao
- Department of Gastroenterology and Hepatology, People's Hospital of Zhengzhou University, and Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Xue-Chun Yu
- Department of Gastroenterology and Hepatology, People's Hospital of Zhengzhou University, and Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Chen Zhang
- Department of Gastroenterology and Hepatology, People's Hospital of Zhengzhou University, and Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Jun-Bo Zhao
- Department of Gastroenterology and Hepatology, People's Hospital of Zhengzhou University, and Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Lin Yuan
- Department of Gastroenterology and Hepatology, People's Hospital of Zhengzhou University, and Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Ya-Bin Qi
- Department of Gastroenterology and Hepatology, People's Hospital of Zhengzhou University, and Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Ruo-Bing Hu
- Department of Gastroenterology and Hepatology, People's Hospital of Zhengzhou University, and Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Pei-Ru Wei
- Department of Gastroenterology and Hepatology, People's Hospital of Zhengzhou University, and Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Wei Xiao
- Department of Gastroenterology and Hepatology, People's Hospital of Zhengzhou University, and Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Qi Chen
- Department of Gastroenterology and Hepatology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Bai-Ling Jia
- Department of Gastroenterology and Hepatology, People's Hospital of Zhengzhou University, and Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Chuan-Liang Chen
- Department of Medical Imaging, People's Hospital of Zhengzhou University, and Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Hong Lu
- Department of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology & Hepatology, Ministry of Health, Renji Hospital, School of Medicine, Shanghai Institute of Digestive Disease, Shanghai Jiao Tong University, Shanghai, China
| | - Song-Ze Ding
- Department of Gastroenterology and Hepatology, People's Hospital of Zhengzhou University, and Henan Provincial People's Hospital, Zhengzhou, Henan, China
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Qin S, Wang X, Li S, Tan C, Zeng X, Luo X, Yi L, Peng L, Wu M, Peng Y, Wang L, Wan X. Clinical Benefit and Cost Effectiveness of Risk-Stratified Gastric Cancer Screening Strategies in China: A Modeling Study. PHARMACOECONOMICS 2022; 40:725-737. [PMID: 35701687 DOI: 10.1007/s40273-022-01160-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/19/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND AND OBJECTIVE A new gastric cancer screening scoring system (NGCS) strategy was recommended for the early gastric cancer (GC) screening process in China. The current study aimed to assess the clinical benefits and the cost effectiveness of the NGCS strategy in GC high-risk areas of China from a societal perspective. METHODS A Markov microsimulation model was developed to evaluate 30 alternative screening strategies with varying initiation age, including the NGCS strategy, the modified NGCS strategy, and the endoscopic screening strategy with various screening intervals. The primary outcomes included GC mortality, number of endoscopies, quality-adjusted life-years (QALYs), costs, and incremental cost-effectiveness ratios (ICERs). Cost estimates were reported in 2021 USD (US$) and both costs and benefits were discounted at 5% annually. Deterministic and probabilistic sensitivity analyses were performed to evaluate model uncertainty. RESULTS Screening with the NGCS strategy from age 40 years (40-NGCS) reduced the GC incidence by 86.4%, which provided the greatest benefit across strategies. Compared with all strategies, at a willingness-to pay threshold of US$17,922 per QALY, the 40-NGCS strategy was a leading cost-effective strategy, with an ICER of US$15,668 per QALY. Results were robust in univariate and probabilistic sensitivity analyses. The probability of the 40-NGCS strategy being cost effective was 0.863. CONCLUSIONS The 40-NGCS strategy was an effective and cost-effective strategy to reduce GC incidence and mortality in China. The findings provide important evidence for decision makers to formulate and optimize targeted approaches for GC prevention and control policies in China.
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Affiliation(s)
- Shuxia Qin
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Xuehong Wang
- Department of Gastroenterology, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Sini Li
- Xiangya Nursing School, Central South University, Changsha, 410013, Hunan, China
- Faculty of Medicine, Dentistry and Health, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Chongqing Tan
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Xiaohui Zeng
- PET-CT Center, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Xia Luo
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Lidan Yi
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Liubao Peng
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Meiyu Wu
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Ye Peng
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Liting Wang
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Xiaomin Wan
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.
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Zhou Y, Zeng J, Zhou W, Wu K, Tian Z, Shen W. Prognostic significance of CKS2 and CD47 expression in patients with gastric cancer who underwent radical gastrectomy. Scand J Immunol 2022; 96:e13198. [PMID: 35703112 DOI: 10.1111/sji.13198] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 06/03/2022] [Accepted: 06/09/2022] [Indexed: 11/29/2022]
Abstract
To investigate the protein expression levels of cyclin-dependent kinase subunit 2 (CKS2) and the cluster of differentiation (CD) 47 in gastric cancer (GC) and their clinical significance. A total of 126 GC patients who underwent radical resection were selected as study subjects. Additionally, 32 patients with benign gastric tumour, 42 patients with low-grade intraepithelial neoplasia (LGIEN), and 49 patients with high-grade intraepithelial neoplasia (HGIEN) who underwent surgery were selected as the control groups. Immunohistochemistry was used to detect the expression of CKS2 and CD47 in surgical specimens. We statistically analysed the clinical significance of the expression of the two factors. (1) The positivity rates for CKS2 in benign gastric tumour tissue, LGIEN tissue, HGIEN tissue, and GC tissue gradually increased, that is, 6.3% (2/32), 30.9% (13/42), 38.8% (19/49), and 60.3% (76/126), respectively, and the positivity rates for CD47 were 18.8% (6/32), 38.1% (16/42), 46.9% (23/49), and 65.9% (83/126), respectively. (2) High expression of CKS2 and CD47 were associated with tumour diameter, Lauren classification, number of lymph node metastases, and TNM stage. In addition, the immunohistochemical scores for CKS2 and CD47 were positively correlated (r = .625, P = .000). (3) The median follow-up time of 126 patients was 46.5 months, and the overall survival (OS) rate was 40.5% (51/126). Survival analysis showed that compared with that in the CKS2 (-) group, the OS rate for patients in the CKS2 (+) group was significantly worse and that compared with the CD47 (-) group, the CD47 (+) group had significantly worse OS (30.1% vs 60.5%, χ2 = 15.67, P = .000). (4) The OS rates of CKS2 (+) CD47 (+) group, CKS2 (+) CD47 (-) group, CKS2 (-) CD47 (+) group, and CKS2 (-) CD47 (-) group were 20.0% (13/65), 58.3% (7/12), 57.1% (8/14), 65.7% (23/35), respectively, the prognosis of patients in CKS2 (+) CD47 (+) group was significantly poor. High expression levels of CKS2 and CD47 were closely related to the occurrence of GC and can be used as independent risk factors to assess the prognosis of patients.
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Affiliation(s)
- Yang Zhou
- Department of Cell Biology, School of Medicine of Yangzhou University, Yangzhou, China
| | - Jing Zeng
- Department of Cell Biology, School of Medicine of Yangzhou University, Yangzhou, China
| | - Wei Zhou
- Department of Cell Biology, School of Medicine of Yangzhou University, Yangzhou, China
| | - Keyan Wu
- Department of Cell Biology, School of Medicine of Yangzhou University, Yangzhou, China
| | - Zhen Tian
- Department of Cell Biology, School of Medicine of Yangzhou University, Yangzhou, China
| | - Weigan Shen
- Department of Cell Biology, School of Medicine of Yangzhou University, Yangzhou, China
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25
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Zhang C, Hu A, Li J, Zhang F, Zhong P, Li Y, Li Y. Combined Non-Invasive Prediction and New Biomarkers of Oral and Fecal Microbiota in Patients With Gastric and Colorectal Cancer. Front Cell Infect Microbiol 2022; 12:830684. [PMID: 35663463 PMCID: PMC9161364 DOI: 10.3389/fcimb.2022.830684] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 04/13/2022] [Indexed: 11/13/2022] Open
Abstract
Background There is no information on the commonality and specificity of oral and fecal microbiota in patients with gastric cancer (GC) and colorectal cancer (CRC). Methods The high-throughput 16S rRNA gene V4 region sequencing was used to perform bioinformatics analysis of oral, fecal, and tissue microbiota in GC (76 subjects), CRC (53), and healthy controls (HC, 70). Furthermore, we determined the microbial characteristics of each part, constructed and verified three classifiers for GC and CRC, and evaluated curves of receiver operating characteristic and precision–recall with probability of disease. Results Compared to HC, the microbial richness and diversity of GC and CRC decreased in oral cavity and increased in stool; additionally, these indexes in GC tissue were higher than those in CRC tissue. In GC and CRC patients, Haemophilus, Neisseria, Faecalibacterium, and Romboutsia were significantly reduced compared to the relative abundance value of oral or fecal bacterial genera in the HC group, while the Streptococcus, Gemella, Escherichia-Shigella, and Fusobacterium were significantly increased. The oral and tissue microbiota have similar and abundant shared bacterial networks. The single and combined microbial detection have good AUC values based on POD indices for predicting GC, CRC, and gastrointestinal (GI) cancers (GC and CRC). Conclusion This study is the first to examine the characteristics of oral, fecal, and tumor microbiota in GC and CRC patients, and the similarities and differences in their microbial changes are reported. These oral or fecal bacteria (Haemophilus, Neisseria, Faecalibacterium, Romboutsia, Streptococcus, Gemella, Escherichia-Shigella, and Fusobacterium) may be involved in tumor evolution as potentially characteristic genera. In addition, both oral and fecal microbial detection may provide a solid theoretical foundation for the non-invasive prediction of these cancers.
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Affiliation(s)
- Chaoyang Zhang
- Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Asheng Hu
- Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Jingxing Li
- Department of Computer Science, Faculty of Science, University of Western Ontario, London, ON, Canada
| | - Fangfang Zhang
- Department of Anesthesiology, Hefei BOE Hospital, Hefei, China
| | - Pei Zhong
- Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yaxian Li
- Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yongxiang Li
- Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
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Hu Y, Xu X, Ouyang YB, He C, Li NS, Xie C, Peng C, Zhu ZH, Shu X, Xie Y, Lu NH, Zhu Y. Altered Gut Microbiota and Short-Chain Fatty Acids After Vonoprazan-Amoxicillin Dual Therapy for Helicobacter pylori Eradication. Front Cell Infect Microbiol 2022; 12:881968. [PMID: 35719338 PMCID: PMC9201212 DOI: 10.3389/fcimb.2022.881968] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 05/09/2022] [Indexed: 12/17/2022] Open
Abstract
The combination of vonoprazan (VPZ) and amoxicillin (VA therapy) has been shown to achieve acceptable eradication rates for Helicobacter pylori (H. pylori). Herein, our aim was to explore the short-term effect of VA therapy on the gut microbiota and short-chain fatty acids (SCFAs) using human fecal samples. A total of 119 H. pylori-positive patients were randomized into low- or high-dose VA therapy (i.e., amoxicillin 1 g b.i.d. or t.i.d. and VPZ 20 mg b.i.d.) for 7 or 10 days. Thirteen H. pylori-negative patients served as controls. Fecal samples were collected from H. pylori-positive and H. pylori-negative patients. The gut microbiota and SCFAs were analyzed using 16S rRNA gene sequencing and gas chromatography–mass spectrometry, respectively. The gut microbiota in H. pylori-positive patients exhibited increased richness, diversity, and better evenness than matched patients. Fifty-three patients studied before and after H. pylori eradication were divided into low (L-VA) and high (H-VA) amoxicillin dose groups. The diversity and composition of the gut microbiota among L-VA patients exhibited no differences at the three time points. However, among H-VA patients, diversity was decreased, and the microbial composition was altered immediately after H-VA eradication but was restored by the confirmation time point. The decreased abundance of Anaerostipes, Dialister, and Lachnospira induced by H-VA was associated with altered SCFA levels. VA dual therapy for H. pylori eradication has minimal negative effects on gut microbiota and SCFAs.
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Affiliation(s)
- Yi Hu
- Department Of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, China
- JiangXi Clinical Research Center for Gastroenterology, Nanchang, China
| | - Xin Xu
- Department Of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, China
- JiangXi Clinical Research Center for Gastroenterology, Nanchang, China
| | - Yao-Bin Ouyang
- Department Of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, China
- JiangXi Clinical Research Center for Gastroenterology, Nanchang, China
| | - Cong He
- Department Of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, China
- JiangXi Clinical Research Center for Gastroenterology, Nanchang, China
| | - Nian-Shuang Li
- Department Of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, China
- JiangXi Clinical Research Center for Gastroenterology, Nanchang, China
| | - Chuan Xie
- Department Of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, China
- JiangXi Clinical Research Center for Gastroenterology, Nanchang, China
| | - Chao Peng
- Department Of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, China
- JiangXi Clinical Research Center for Gastroenterology, Nanchang, China
| | - Zhen-Hua Zhu
- Department Of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, China
- JiangXi Clinical Research Center for Gastroenterology, Nanchang, China
| | - Xu Shu
- Department Of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, China
- JiangXi Clinical Research Center for Gastroenterology, Nanchang, China
| | - Yong Xie
- Department Of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, China
- JiangXi Clinical Research Center for Gastroenterology, Nanchang, China
- *Correspondence: Yin Zhu, ; Nong-Hua Lu,
| | - Nong-Hua Lu
- Department Of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, China
- JiangXi Clinical Research Center for Gastroenterology, Nanchang, China
| | - Yin Zhu
- Department Of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, China
- JiangXi Clinical Research Center for Gastroenterology, Nanchang, China
- *Correspondence: Yin Zhu, ; Nong-Hua Lu,
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Gastric Cancer Screening Methods: A Comparative Study of the Chinese New Gastric Cancer Screening Score and Kyoto Classification of Gastritis. Gastroenterol Res Pract 2022; 2022:7639968. [PMID: 35309108 PMCID: PMC8926535 DOI: 10.1155/2022/7639968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 02/10/2022] [Accepted: 02/22/2022] [Indexed: 02/07/2023] Open
Abstract
Objective To evaluate the Chinese new gastric cancer screening score (i.e., Li's score) and Kyoto Classification of Gastritis for screening gastric cancer. Methods A total of 702 patients were scored using the two scoring methods. Gastric atrophy, intestinal metaplasia, and gastric cancer (including early gastric cancer) were compared between the two scoring methods. The area under the ROC curve, sensitivity, and specificity of the two scoring methods were evaluated. Results Both of the two scoring methods found that gastric atrophy, intestinal metaplasia, and gastric cancer (including early gastric cancer) were all significantly higher in the medium-risk and high-risk group patients than those in the low-risk group patients. According to the Kyoto Classification of Gastritis, patients in the high-risk group had more gastric atrophy, intestinal metaplasia, and gastric cancer than those in the medium-risk group patients. Gastric atrophy, intestinal metaplasia, and gastric cancer in the low-risk and medium-risk group patients evaluated by the Li score were all significantly higher than those in patients with corresponding risk level evaluated by Kyoto Classification of Gastritis, respectively. The area under the ROC curve of the Li score was 0.702, and the sensitivity and specificity were 57.6% and 85.3%, respectively. The area under the ROC curve of the Kyoto Classification of Gastritis was 0.826, and the sensitivity and specificity were 75.4% and 83.6%, respectively. Conclusion Both Li's score and Kyoto Classification of Gastritis showed good screening value for gastric cancer, but Kyoto Classification of Gastritis was more sensitive than the Li score.
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Guan JL, Hu YL, An P, He Q, Long H, Zhou L, Chen ZF, Xiong JG, Wu SS, Ding XW, Luo HS, Li PY. Comparison of high-dose dual therapy with bismuth-containing quadruple therapy in Helicobacter pylori-infected treatment-naive patients: An open-label, multicenter, randomized controlled trial. Pharmacotherapy 2022; 42:224-232. [PMID: 35075679 DOI: 10.1002/phar.2662] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 10/21/2021] [Accepted: 11/23/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Bismuth-containing quadruple therapy for Helicobacter pylori (H. pylori) eradication has a relatively high rate of side effects and high cost, thus the option of a high-dose dual therapy with a high eradication rate and fewer adverse events is a consideration. However, studies of dual therapy are still scarce and are mostly single-center studies with limited generalizability. Large-scale, multicenter studies are required. Our study investigated and compared the effectiveness, adverse events, patient compliance, and costs of high-dose dual therapy with those of bismuth-containing quadruple therapy in H. pylori-infected treatment-naive patients in a prospective, multicenter, open-label, randomized controlled trial. METHOD Treatment-naive patients infected with H. pylori were randomly assigned to receive high-dose dual therapy (esomeprazole 20 mg 4 times daily and amoxicillin 1000 mg 3 times daily, for 14 days) or bismuth-containing quadruple therapy (esomeprazole 20 mg, amoxicillin 1000 mg, clarithromycin 500 mg, and bismuth potassium citrate 220 mg, all twice daily for 14 days). The effectiveness, adverse events, patient compliance, and costs of both groups were compared. RESULTS A total of 700 patients were enrolled. The high-dose dual therapy group (N = 350) achieved eradication rates of 89.4% (intention-to-treat), 90.4% (modified intention-to-treat), and 90.6% (per-protocol), which were similar to rates in the bismuth-containing quadruple therapy group (N = 350), 84.6%, 88.0%, and 88.2%, respectively (p > 0.05). The high-dose dual therapy group had a lower rate of adverse events (12.9% vs. 28.1%, p < 0.001) and lower costs (¥590.2 vs. ¥723.22) compared with the quadruple therapy group, respectively. The compliance of both groups was satisfactory (97.7% high-dose dual vs. 96.8% quadruple, p > 0.05). CONCLUSION High-dose dual therapy for H. pylori eradication had similar efficacy and compliance, fewer adverse events, and lower costs than bismuth-containing quadruple therapy for treatment-naive patients.
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Affiliation(s)
- Jia-Lun Guan
- Division of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yun-Lian Hu
- Department of Gastroenterology, Hubei University of Chinese Medicine, Wuhan, China
| | - Ping An
- Department of Gastroenterology, Wuhan University People's Hospital, Wuhan, China
| | - Qiong He
- Department of Gastroenterology, Wuhan Red Cross Hospital, Wuhan, China
| | - Hui Long
- Department of Gastroenterology, Tianyou Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
| | - Lin Zhou
- Department of Gastroenterology, Suizhou Central Hospital, Wuhan, China
| | - Zhi-Fen Chen
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Jian-Guang Xiong
- Department of Gastroenterology, Xianning Central Hospital, Wuhan, China
| | - Shi-Sheng Wu
- Department of Gastroenterology, The Second Hospital of Huangshi, Wuhan, China
| | - Xiang-Wu Ding
- Department of Gastroenterology, Wuhan Puai Hospital, Wuhan, China
| | - He-Sheng Luo
- Department of Gastroenterology, Wuhan University People's Hospital, Wuhan, China
| | - Pei-Yuan Li
- Division of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Department of Gastroenterology, Wenchang People's Hospital, Hainan, China
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Ding SZ, Du YQ, Lu H, Wang WH, Cheng H, Chen SY, Chen MH, Chen WC, Chen Y, Fang JY, Gao HJ, Guo MZ, Han Y, Hou XH, Hu FL, Jiang B, Jiang HX, Lan CH, Li JN, Li Y, Li YQ, Liu J, LI YM, Lyu B, Lu YY, Miao YL, Nie YZ, Qian JM, Sheng JQ, Tang CW, Wang F, Wang HH, Wang JB, Wang JT, Wang JP, Wang XH, Wu KC, Xia XZ, Xie WF, Xie Y, Xu JM, Yang CQ, Yang GB, Yuan Y, Zeng ZR, Zhang BY, Zhang GY, Zhang GX, Zhang JZ, Zhang ZY, Zheng PY, Zhu Y, Zuo XL, Zhou LY, Lyu NH, Yang YS, Li ZS. Chinese Consensus Report on Family-Based Helicobacter pylori Infection Control and Management (2021 Edition). Gut 2022; 71:238-253. [PMID: 34836916 PMCID: PMC8762011 DOI: 10.1136/gutjnl-2021-325630] [Citation(s) in RCA: 64] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 11/03/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Helicobacter pylori infection is mostly a family-based infectious disease. To facilitate its prevention and management, a national consensus meeting was held to review current evidence and propose strategies for population-wide and family-based H. pylori infection control and management to reduce the related disease burden. METHODS Fifty-seven experts from 41 major universities and institutions in 20 provinces/regions of mainland China were invited to review evidence and modify statements using Delphi process and grading of recommendations assessment, development and evaluation system. The consensus level was defined as ≥80% for agreement on the proposed statements. RESULTS Experts discussed and modified the original 23 statements on family-based H. pylori infection transmission, control and management, and reached consensus on 16 statements. The final report consists of three parts: (1) H. pylori infection and transmission among family members, (2) prevention and management of H. pylori infection in children and elderly people within households, and (3) strategies for prevention and management of H. pylori infection for family members. In addition to the 'test-and-treat' and 'screen-and-treat' strategies, this consensus also introduced a novel third 'family-based H. pylori infection control and management' strategy to prevent its intrafamilial transmission and development of related diseases. CONCLUSION H. pylori is transmissible from person to person, and among family members. A family-based H. pylori prevention and eradication strategy would be a suitable approach to prevent its intra-familial transmission and related diseases. The notion and practice would be beneficial not only for Chinese residents but also valuable as a reference for other highly infected areas.
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Affiliation(s)
- Song-Ze Ding
- Department of Gastroenterology and Hepatology, People's Hospital, Zhengzhou University, Zhengzhou, Henan, China .,Department of Gastroenterology and Hepatology, People's Hospital, Henan University, Kaifeng, Henan, China
| | - Yi-Qi Du
- Gastroenterology Division, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Hong Lu
- GI Division, Renji Hospital, Shanghai Institution of Digestive Diseas, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei-Hong Wang
- Department of Gastroenterology and Hepatology, Peking University First Hospital, Beijing, China
| | - Hong Cheng
- Department of Gastroenterology and Hepatology, Peking University First Hospital, Beijing, China
| | - Shi-Yao Chen
- Department of Gastroenterology and Hepatology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Min-Hu Chen
- Division of Gastroenterology and Hepatology, Sun Yat-Sen University First Affiliated Hospital, Guangzhou, Guangdong, China
| | - Wei-Chang Chen
- Department of Gastroenterology and Hepatology, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Ye Chen
- Department of Gastroenterology and Hepatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Jing-Yuan Fang
- Renji Hospital, Gastroenterology Division, Shanghai Jiao Tong University, Shanghai, China
| | - Heng-Jun Gao
- Department of Gastroenterology and Hepatology, School of Medicine, Tongji University, Shanghai, China
| | - Ming-Zhou Guo
- Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Beijing, China
| | - Ying Han
- Department of Gastroenterology and Hepatology, The Seventh Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Xiao-Hua Hou
- Department of Gastroenterology and Hepatology, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Fu-Lian Hu
- Department of Gastroenterology and Hepatology, Peking University First Hospital, Beijing, China
| | - Bo Jiang
- Department of Gastroenterology and Hepatology, Changgeng Hospital, Tsinghua University, Beijing, China
| | - Hai-Xing Jiang
- Department of Gastroenterology and Hepatology, First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
| | - Chun-Hui Lan
- Department of Gastroenterology and Hepatology, Daping Hospital, Army Medical University, Chongqing, China
| | - Jing-Nan Li
- Department of Gastroenterology and Hepatology, Peking Union Medical College Hospital, Beijing, China
| | - Yan Li
- Department of Gastroenterology and Hepatology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Yan-Qing Li
- Department of Gastroenterology and Hepatology, Qilu Hospital, Shandong University, Jinan, Shandong, China
| | - Jie Liu
- Department of Gastroenterology and Hepatology, Huashan Hospital, Fudan University, Shanghai, China
| | - You-Ming LI
- Department of Gastroenterology and Hepatology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Bin Lyu
- Department of Gastroenterology and Hepatology, First Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - You-Yong Lu
- Laboratory of Molecular Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital, Beijing, China
| | - Ying-Lei Miao
- Department of Gastroenterology and Hepatology, First Affilliated Hospital, Kunming Medical University, Kunming, Yunnan, China
| | - Yong-Zhan Nie
- State Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases, Xijing Hospital, Air Force Medical University, Xian, Shaanxi, China
| | - Jia-Ming Qian
- Department of Gastroenterology and Hepatology, Peking Union Medical College Hospital, Beijing, China
| | - Jian-Qiu Sheng
- Department of Gastroenterology, The Seventh Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Cheng-Wei Tang
- Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Fen Wang
- Department of Gastroenterology and Hepatology, Third Xiangya Hospital, Central South University, Changsha, Hunan, China,Hunan Key Laboratory of Nonresolving Inflammation and Cancer, Changsha, Hunan, China
| | - Hua-Hong Wang
- Department of Gastroenterology and Hepatology, Peking University First Hospital, Beijing, China
| | - Jiang-Bin Wang
- Department of Gastroenterology and Hepatology, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
| | - Jing-Tong Wang
- Department of Gastroenterology and Hepatology, Peking University Third Hospital, Beijing, China
| | - Jun-Ping Wang
- Department of Gastroenterology and Hepatology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Xue-Hong Wang
- Department of Gastroenterology and Hepatology, Qinghai University Hospital, Qinghai University, Xining, Qinghai, China
| | - Kai-Chun Wu
- Department of Gastroenterology and Hepatology, Xijing Hospital, Air Force Medical University, Xian, Shaanxi, China
| | - Xing-Zhou Xia
- Department of Gastroenterology and Hepatology, The Fifth Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Wei-Fen Xie
- Department of Gastroenterology, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Yong Xie
- Department of Gastroenterology and Hepatology, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Jian-Ming Xu
- Department of Gastroenterology and Hepatology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Chang-Qing Yang
- Division of Gastroenterology and Hepatology, Tongji Hospital, Tongji University, Shanghai, China
| | - Gui-Bin Yang
- Department of Gastroenterology and Hepatology, Aerospace Central Hospital, Beijing, China
| | - Yuan Yuan
- Key Laboratory of GI Cancer Etiology and Prevention in Liaoning Province, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Zhi-Rong Zeng
- Department of Gastroenterology and Hepatology, First Affiliated Hospital, Zhongshan University, Guangzhou, Guangdong, China
| | - Bing-Yong Zhang
- Department of Gastroenterology and Hepatology, People's Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Gui-Ying Zhang
- Department of Gastroenterology and Hepatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Guo-Xin Zhang
- Department of Gastroenterology and Hepatology, First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jian-Zhong Zhang
- Department of Communicable Disease Diagnostics(DCDD), National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhen-Yu Zhang
- Department of Gastroenterology and Hepatology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Peng-Yuan Zheng
- Department of Gastroenterology and Hepatology, The Fifth Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Yin Zhu
- Department of Gastroenterology, First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, China
| | - Xiu-Li Zuo
- Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan, Shandong, China
| | - Li-Ya Zhou
- Department of Gastroenterology and Hepatology, Peking University Third Hospital, Beijing, China
| | - Nong-Hua Lyu
- Department of Gastroenterology and Hepatology, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Yun-Sheng Yang
- Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Beijing, China
| | - Zhao-Shen Li
- Department of Gastroenterology and Hepatology, Changhai Hospital, Naval Medical University, Shanghai, China
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Liu D, Chen S, Gou Y, Yu W, Zhou H, Zhang R, Wang J, Ye F, Liu Y, Sun B, Zhang K. Gastrointestinal Microbiota Changes in Patients With Gastric Precancerous Lesions. Front Cell Infect Microbiol 2021; 11:749207. [PMID: 34956928 PMCID: PMC8695999 DOI: 10.3389/fcimb.2021.749207] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 11/16/2021] [Indexed: 12/24/2022] Open
Abstract
Background Gastric microbiota may be involved in gastric cancer. The relationship between gastrointestinal microbes and the risk of gastric cancer is unclear. This study aimed to explore the gastric and intestinal bacteria associated with gastritis and gastric precancerous lesions. We conducted a case-control study by performing 16S rRNA gene analysis of gastric biopsies, juices, and stool samples from 148 cases with gastritis or gastric precancerous lesions from Anhui and neighboring provinces, China. And we validated our findings in public datasets. Results Analysis of microbial sequences revealed decreased bacterial alpha diversity in gastric bacteria during the progression of gastritis. Helicobacter pylori was the main contributor to the decreased microbial composition and diversity in the gastric mucosa and had little influence on the microbiota of gastric juice and feces. The gastric mucosal genera Gemella, Veillonella, Streptococcus, Actinobacillus, and Hemophilus had the higher degree of centrality across the progression of gastric precancerous lesions. And Acinetobacter may contribute to the occurrence of intraepithelial neoplasia. In addition, the microbial model of H. pylori-positive gastric biopsies and feces showed value in the prediction of gastric precancerous lesions. Conclusions This study identified associations between gastric precancerous lesions and gastric microbiota, as well as the changes in intestinal microbiota, and explored their values in the prediction of gastric precancerous lesions.
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Affiliation(s)
- Dehua Liu
- The First Affiliated Hospital of University of Science and Technology of China (USTC), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Si Chen
- The First Affiliated Hospital of University of Science and Technology of China (USTC), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Yawen Gou
- The First Affiliated Hospital of University of Science and Technology of China (USTC), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Wenyong Yu
- The First Affiliated Hospital of University of Science and Technology of China (USTC), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Hangcheng Zhou
- The First Affiliated Hospital of University of Science and Technology of China (USTC), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Rutong Zhang
- The First Affiliated Hospital of University of Science and Technology of China (USTC), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Jinghao Wang
- The First Affiliated Hospital of University of Science and Technology of China (USTC), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Fei Ye
- The First Affiliated Hospital of University of Science and Technology of China (USTC), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Yingling Liu
- The First Affiliated Hospital of University of Science and Technology of China (USTC), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Baolin Sun
- School of Life Sciences, University of Science and Technology of China, Hefei, China
| | - Kaiguang Zhang
- The First Affiliated Hospital of University of Science and Technology of China (USTC), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
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He J, He X, Ma Y, Yang L, Fang H, Shang S, Xia H, Lian G, Tang H, Wang Q, Wang J, Lin Z, Wen J, Liu Y, Zhai C, Wang W, Jiang X, Xuan J, Liu M, Lu S, Li X, Wang H, Ouyang C, Cao M, Lin A, Zhang B, Wu D, Chen Y, Xiao C. A comprehensive approach to stool donor screening for faecal microbiota transplantation in China. Microb Cell Fact 2021; 20:216. [PMID: 34838016 PMCID: PMC8626716 DOI: 10.1186/s12934-021-01705-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 11/09/2021] [Indexed: 12/31/2022] Open
Abstract
Background Faecal microbiota transplantation (FMT) is an effective therapy for recurrent Clostridium difficile infections and chronic gastrointestional infections. However, the risks of FMT and the selection process of suitable donors remain insufficiently characterized. The eligibility rate for screening, underlying microbial basis, and core ethical issues of stool donors for FMT are yet to be elucidated in China. Results The potential stool donors were screened from December 2017 to December 2019 with the help of an online survey, clinical assessments, and stool and blood testing. Bioinformatics analyses were performed, and the composition and stability of gut microbiota in stool obtained from eligible donors were dynamically observed using metagenomics. Meanwhile, we build a donor microbial evaluation index (DoMEI) for stool donor screening. In the screening process, we also focused on ethical principles and requirements. Of the 2071 participants, 66 donors were selected via the screening process (3.19% success rate). Although there were significant differences in gut microbiota among donors, we found that the changes in the gut microbiota of the same donor were typically more stable than those between donors over time. Conclusions DoMEI provides a potential reference index for regular stool donor re-evaluation. In this retrospective study, we summarised the donor recruitment and screening procedure ensuring the safety and tolerability for FMT in China. Based on the latest advances in this field, we carried out rigorous recommendation and method which can assist stool bank and clinicians to screen eligible stool donor for FMT. Supplementary Information The online version contains supplementary material available at 10.1186/s12934-021-01705-0.
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Affiliation(s)
- Jianquan He
- School of Medicine, Xiamen University, Xiamen, China
| | - Xingxiang He
- Department of Gastroenterology, The First Affiliated Hospital of Clinical Medicine of Guangdong Pharmaceutical University, Guangzhou, China
| | - Yonghui Ma
- School of Medicine, Xiamen University, Xiamen, China
| | - Luxi Yang
- School of Medicine, Xiamen University, Xiamen, China
| | - Haiming Fang
- Department of Gastroenterology and Hepatology, The Second Hospital of Anhui Medical Univerisity, Hefei, China
| | - Shu Shang
- Department of Gastroenterology, The Fifth People's Hospital of Shenyang, Shenyang, China
| | - Huping Xia
- Anorectal Diagnosis and Treatment Center, The General Hospital of Xinjiang Military Region, Wulumuqi, China
| | - Guanghui Lian
- Department of Gastroenterology, Xiangya Hospital, Changsha, China
| | - Hailing Tang
- Department of Gastroenterology, Xi'an Central Hospital, Xi'an, China
| | - Qizhi Wang
- Department of Gastroenterology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Junping Wang
- Department of Gastroenterology, The Affiliated People's Hospital of Shanxi Medical University, Taiyuan, China
| | - Zhihui Lin
- Department of Gastroenterology, Fujian Provincial Hospital, Fuzhou, China
| | - Jianbo Wen
- Department of Gastroenterology, Pingxiang People's Hospital, Pingxiang, China
| | - Yuedong Liu
- Department of Gastroenterology, The Third Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, China
| | - Chunbao Zhai
- Department of Proctology, The Affiliated People's Hospital of Shanxi Medical University, Taiyuan, China
| | - Wen Wang
- Department of Gastroenterology, 900th Hospital of PLA, Fuzhou, China
| | - Xueliang Jiang
- Department of Gastroenterology, The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Ji Xuan
- Department of Gastroenterology, Jinling Hospital, Nanjing, China
| | - Morong Liu
- Department of Gastroenterology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Shiyun Lu
- Department of Gastroenterology, Fujian Provincial Hospital, Fuzhou, China
| | - Xuejun Li
- Department of Gastroenterology, The Second Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, China
| | - Han Wang
- Xiamen Treatgut Biotechnology Co., Ltd., Xiamen, China
| | - Cong Ouyang
- Xiamen Treatgut Biotechnology Co., Ltd., Xiamen, China
| | - Man Cao
- Xiamen Treatgut Biotechnology Co., Ltd., Xiamen, China
| | - Aiqiang Lin
- Xiamen Treatgut Biotechnology Co., Ltd., Xiamen, China
| | | | - Depei Wu
- National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Ye Chen
- Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Zhou X, Zhu H, Zhu C, Lin K, Cai Q, Li Z, Du Y. Helicobacter pylori Infection and Serum Pepsinogen Level With the Risk of Gastric Precancerous Conditions: A Cross-sectional Study of High-risk Gastric Cancer Population in China. J Clin Gastroenterol 2021; 55:778-784. [PMID: 33116065 DOI: 10.1097/mcg.0000000000001444] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 09/04/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND AIM Gastric precancerous conditions are generally considered to play an essential role in the gastric carcinogenesis cascade. This study identified risk factors of gastric precancerous conditions in a nationwide multicenter cross-sectional study. METHODS Individuals who made their visit to 115 hospitals in China for gastric cancer screening were recruited. Lifestyle habits and personal information were collected through a series of questionnaires. Serum biomarker test (pepsinogen I, pepsinogen II, gastrin-17, and anti-Helicobacter pylori immunoglobulin G antibody) and endoscopy were then performed. Risk factors for gastric precancerous conditions were identified by univariate and multivariate analyses. RESULTS Of 14,929 subjects eligible for analysis, 4477 (30.0%) developed gastric precancerous conditions and 405 (2.71%) developed gastric cancer. In multiple logistic regression, precancerous conditions were associated with advanced age [odds ratio (OR)=1.027; 95% confidence interval (Cl), 1.023-1.032; P<0.001], male gender (OR=1.303; 95% Cl, 1.188-1.429; P<0.001), H. pylori infection (OR=1.377; 95% Cl, 1.272-1.490, P<0.001), and smoking (OR=1.142; 95% Cl, 1.005-1.298, P=0.004), whereas they were inversely correlated with white meat intake (OR=0.731; 95% Cl, 0.673-0.794; P<0.001) and pepsinogen I level (30 to 70 subgroup OR=1.536; 95% Cl, 1.163-2.028; P=0.002; <30 subgroup OR=1.354; 95% Cl, 1.206-1.520; P<0.001). Also, the authors observed a statistically lower prevalence of reflux esophagitis (2.8% vs. 4.7%) and of gastric polyps (11.0% vs. 13.7%) in H. pylori-infected population. CONCLUSIONS Patients with H. pylori have a 1.4-fold higher risk of having gastric precancerous conditions. Besides, precancerous conditions were associated with advanced age, male gender, H. pylori infection, and smoking in a large population. However, regular white meat intake and higher pepsinogen I level were associated with reduced risk of having precancerous lesions.
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Affiliation(s)
- Xianzhu Zhou
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
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Jin T. LncRNA DRAIR is a novel prognostic and diagnostic biomarker for gastric cancer. Mamm Genome 2021; 32:503-507. [PMID: 34510245 DOI: 10.1007/s00335-021-09911-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 08/30/2021] [Indexed: 12/01/2022]
Abstract
LncRNA diabetes regulated anti-inflammatory RNA (DRAIR) has been reported to be involved in diabetes-induced injury. However, its role in other human diseases is unclear. Our preliminary sequencing analysis showed its expression was altered in gastric cancer (GC). Thus, this study aimed to explore its diagnostic and prognostic values in GC. DRAIR expression in paired tumor and non-tumor tissues and plasma of GC patients and control samples was determined by RT-qPCR. The diagnostic value of DRAIR for early-stage GC was analyzed using ROC curve analysis. The prognostic value of DRAIR was explored by performing a follow-up (5-year) study. DRAIR expression was downregulated in GC tissues than in non-tumor tissues and in plasma of GC patients than in plasma of healthy controls. DRAIR expression in tumor tissues was closely and positively correlated with its expression in plasma. Plasma DRAIR effectively separated GC patients from controls. High DRAIR levels in tumor tissues and plasma samples were closely correlated with poor survival of GC patients. DRAIR is overexpressed in GC and may serve as an early diagnostic and prognostic biomarker for GC.
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Affiliation(s)
- Tian Jin
- Department of Gastrointestinal Surgery, Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine of Hebei Province, No. 31, Huanghe West Road, Yunhe District, Cangzhou, 061000, Hebei, People's Republic of China.
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Zhou X, Zhu H, Chen Y, Li Z, Du Y. Role of Helicobacter pylori in gastric diseases pathogenesis cannot be ignored. Gut 2021; 70:1601-1602. [PMID: 32994310 DOI: 10.1136/gutjnl-2020-322629] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 09/15/2020] [Accepted: 09/16/2020] [Indexed: 01/31/2023]
Affiliation(s)
- Xianzhu Zhou
- Department of Gastroenterology, Changhai Hospital, Shanghai, China
| | - Huiyun Zhu
- Department of Gastroenterology, Changhai Hospital, Shanghai, China
| | - Yan Chen
- Department of Gastroenterology, Changhai Hospital, Shanghai, China
| | - Zhaoshen Li
- Department of Gastroenterology, Changhai Hospital, Shanghai, China
| | - Yiqi Du
- Department of Gastroenterology, Changhai Hospital, Shanghai, China
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Zhang W, Li Z, Akram MS, Rehman MFU, Khan NH, Hu D, Mustaqeem M, Zeng Y, Kanwal F. Gastric Cancer Screening Methods: A Comparative Study of Two Scoring Methods. Cancer Manag Res 2021; 13:5785-5791. [PMID: 34321925 PMCID: PMC8312504 DOI: 10.2147/cmar.s308395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 06/18/2021] [Indexed: 01/09/2023] Open
Abstract
Objective To evaluate the Li’s and Japanese scoring methods scoring for screening early gastric cancer in a healthy population. Methods During January 2016–December 2018, profiles of the healthy people participated in a physical examination in the first people’s Hospital of Shanghai were collected. A total of 342 volunteers, including 137 males and 205 females ageing 40–74, were enrolled. After recording the basic information, all volunteers were scored using the Japan scoring method and the new gastric cancer screening score (ie, Li’s score). The subjects’ work characteristics (ROC curve) were drawn according to the patient’s endoscopic pathological examination to indicate early gastric cancer, to determine the best cut-off point for the diagnosis of early gastric cancer by Japanese scoring and Li’s scoring, respectively. The sensitivity and specificity of both scoring methods were calculated as well. Results The area under the ROC curve of Japanese and Li’s score, in the diagnosis of early gastric cancer, was 0.763 and 0.837, respectively. Japanese and Li’s score ≥14 were considered as the best cut-off point. The sensitivity and specificity of Li’s scoring were 63.60% and 91.10%, respectively. The sensitivity and specificity of the Japanese score were 54.50% and 87.50%, respectively. The area under the ROC curve in Li’s scoring is more significant than that in Japanese scoring, and there was a substantial difference in the two methods (P<0.05). Conclusion Both Li’s scoring and Japanese scoring have shown good screening value for early gastric cancer in a healthy population, but Li’s scoring is more sensitive/specific than Japanese scoring.
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Affiliation(s)
- Weixing Zhang
- Department of Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, People's Republic of China
| | - Zhangzhi Li
- Department of Hematology, Taihe Hospital, Hubei University of Medicine, Hubei, 442000, People's Republic of China
| | | | | | - Nazeer Hussain Khan
- Henan International Key Laboratory of Nuclear Protein, School of Life Sciences, Henan University Kaifeng, Henan, 475004, People's Republic of China.,Laboratory of Animal and Human Physiology, Department of Biological Sciences, Quaid I Azam University, Islamabad, 45320, Pakistan
| | - Dan Hu
- Department of Neurology, The Central Hospital of Xiaogan, Hubei, 432100, People's Republic of China
| | - Muhammad Mustaqeem
- Department of Chemistry, University of Sargodha, Sub Campus Bhakkar, Bhakkar, 30000, Pakistan
| | - Yuanyuan Zeng
- Department of Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, People's Republic of China
| | - Fariha Kanwal
- Med-X Research Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, People's Republic of China
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Abstract
Helicobacter pylori is present in approximately one-half of the world's population. There are significant differences in prevalence based on region, age, race/ethnicity, and socioeconomic status. H pylori is the most common cause of infection-related cancers. Studies have demonstrated the relationship between H pylori infection and gastric adenocarcinoma and mucosa-associated lymphoid tissue lymphoma. H pylori has features and enzymatic properties allowing it to survive in the acidic stomach environment, and has specific virulence factors that promote an increased risk of gastric pathology. Eradication of H pylori is first-line therapy for mucosa-associated lymphoid tissue lymphoma and decreases the risk of gastric adenocarcinoma.
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The penicillin binding protein 1A of Helicobacter pylori, its amoxicillin binding site and access routes. Gut Pathog 2021; 13:43. [PMID: 34183046 PMCID: PMC8240269 DOI: 10.1186/s13099-021-00438-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 06/15/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Amoxicillin-resistant H. pylori strains are increasing worldwide. To explore the potential resistance mechanisms involved, the 3D structure modeling and access tunnel prediction for penicillin-binding proteins (PBP1A) was performed, based on the Streptococcus pneumoniae, PBP 3D structure. Molecular covalent docking was used to determine the interactions between amoxicillin (AMX) and PBP1A. RESULTS The AMX-Ser368 covalent complex interacts with the binding site residues (Gly367, Ala369, ILE370, Lys371, Tyr416, Ser433, Thr541, Thr556, Gly557, Thr558, and Asn560) of PBP1A, non-covalently. Six tunnel-like structures, accessing the PBP1A binding site, were characterized, using the CAVER algorithm. Tunnel-1 was the ultimate access route, leading to the drug catalytic binding residue (Ser368). This tunnel comprises of eighteen amino acid residues, 8 of which are shared with the drug binding site. Subsequently, to screen the presence of PBP1A mutations, in the binding site and tunnel residues, in our clinical strains, in vitro assays were performed. H. pylori strains, isolated under gastroscopy, underwent AMX susceptibility testing by E-test. Of the 100 clinical strains tested, 4 were AMX-resistant. The transpeptidase domain of the pbp1a gene of these resistant, plus 10 randomly selected AMX-susceptible strains, were amplified and sequenced. Of the amino acids lining the tunnel-1 and binding site residues, three (Ser414Arg, Val469Met and Thr556Ser) substitutions, were detected in 2 of the 4 resistant and none of the sequenced susceptible strains, respectively. CONCLUSIONS We hypothesize that mutations in amino acid residues lining the binding site and/or tunnel-1, resulting in conformational/spatial changes, may block drug binding to PBP1A and cause AMX resistance.
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Tang M, Shen X, Chai J, Cheng J, Wang D. Dose-Effect Relationship Between Gastric Cancer and Common Digestive Tract Symptoms and Diagnoses in Anhui, China. Cancer Manag Res 2021; 13:4955-4966. [PMID: 34188548 PMCID: PMC8235950 DOI: 10.2147/cmar.s313771] [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: 04/01/2021] [Accepted: 05/29/2021] [Indexed: 11/23/2022] Open
Abstract
Background Early prevention and diagnosis are key to reducing the huge burden of gastric cancer (GC). Nearly half of the population worldwide are suffering from some form of digestive tract conditions (symptoms/diagnoses, DTCs) but their relations with GC are not well understood. We aim to explore the relationships (especially dose–effect relationships) between GC and DTCs. Methods This study used data from a community-based case–control study in Anhui, China during 2016–2019 and performed multivariate conditional logistic regression modeling of the associations between GC and DTCs. Results A total of 2255 participants (451 cases and 1804 controls) completed the study. Statistically significant relations (P<0.05) were found between GC and the presence of gastroesophageal reflux [odds ratio (OR)=1.41], odynophagia (OR=1.87), stomach discomfort (OR=1.86), poor appetite (OR=2.01) and Helicobacter pylori (H. pylori) infection (OR=4.39). When the DTCs were divided into duration grades, all these ORs presented an increasing trend (P<0.05), being 1.89 to 2.45 for gastroesophageal reflux, 1.63 to 3.78 for stomach discomfort, 2.36 to 5.29 for poor appetite, and 3.95 to 10.03 for H. pylori infection. When the DTCs were divided into severity grades, the ORs also witnessed an increasing trend (P<0.05), being 1.69 to 2.52 for gastroesophageal reflux, 2.44 to 3.56 for stomach discomfort, and 2.22 to 2.75 for poor appetite. When the DTCs were divided into duration-severity grades, the ORs displayed a much steeper increasing trend, being 0.49 to 4.96 for gastroesophageal reflux, 1.50 to 6.33 for odynophagia, 0.47 to 3.32 for stomach discomfort, and 0.40 to 10.47 for poor appetite. In contrast, the ORs for the lower DTCs were generally tested without statistical significance. Conclusion The study revealed consistent dose–effect associations between GC and duration of gastroesophageal reflux, stomach discomfort, poor appetite, and H. pylori infection; severity of gastroesophageal reflux, stomach discomfort and poor appetite; and duration-severity of gastroesophageal reflux, odynophagia, stomach discomfort and poor appetite. These should inform future prevention, diagnosis and further research in patients with GC.
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Affiliation(s)
- Mengsha Tang
- School of Public Health, Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Xingrong Shen
- School of Health Service Management, Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Jing Chai
- School of Health Service Management, Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Jing Cheng
- School of Health Service Management, Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Debin Wang
- School of Public Health, Anhui Medical University, Hefei, Anhui, People's Republic of China.,School of Health Service Management, Anhui Medical University, Hefei, Anhui, People's Republic of China
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Fan X, Qin X, Zhang Y, Li Z, Zhou T, Zhang J, You W, Li W, Pan K. Screening for gastric cancer in China: Advances, challenges and visions. Chin J Cancer Res 2021; 33:168-180. [PMID: 34158737 PMCID: PMC8181866 DOI: 10.21147/j.issn.1000-9604.2021.02.05] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Gastric cancer (GC) is one of the major cancers in China and all over the world. Most GCs are diagnosed at an advanced stage with unfavorable prognosis. Along with some other countries, China has developed the government-funded national screening programs for GC and other major cancers. GC screening has been shown to effectively decrease the incidence of and mortality from GC in countries adopting nationwide screening programs (Japan and Korea) and in studies based on selected Chinese populations. The screening of GC relies mostly on gastroendoscopy, the accuracy, reliability and safety of which have been indicated by previous studies. However, considering its invasive screening approach, requirements on skilled endoscopists and pathologists, and a high cost, developing noninvasive methods to amend endoscopic screening would be highly needed. Numerous studies have examined biomarkers for GC screening and the combination of biomarkers involving pepsinogen, gastrin, and Helicobacter pylori antibodies has been proposed for risk stratification, seeking to narrow down the high-risk populations for further endoscopy. Despite all the achievements of endoscopic screening, evidence on appropriate screening age, intervals for repeated screening, novel biomarkers promoting precision prevention, and health economics need to be accumulated to inform policymakers on endoscopic screening in China. With the guide of Health China 2030 Planning Outline, we have golden opportunities to promote prevention and control of GC. In this review, we summarize the characteristics of screening programs in China and other East Asian countries and introduce the past and current approaches and strategies for GC screening, aiming for featuring the latest advances and key challenges, and illustrating future visions of GC screening.
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Affiliation(s)
- Xiaohan Fan
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Cancer Epidemiology, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Xiangxiang Qin
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Cancer Epidemiology, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Yang Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Cancer Epidemiology, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Zhexuan Li
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Cancer Epidemiology, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Tong Zhou
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Cancer Epidemiology, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Jingying Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Cancer Epidemiology, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Weicheng You
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Cancer Epidemiology, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Wenqing Li
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Cancer Epidemiology, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Kaifeng Pan
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Cancer Epidemiology, Peking University Cancer Hospital & Institute, Beijing 100142, China
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Zheng H, Xie Q, Zhan M, Jin C, Li Q. Cost‑effectiveness Analysis of Helicobacter pylori Eradication Therapy in First-Degree Relatives of Patients with Gastric Cancer. Patient Prefer Adherence 2021; 15:77-85. [PMID: 33519193 PMCID: PMC7837576 DOI: 10.2147/ppa.s286860] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 12/15/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Helicobacter pylori (H. pylori) eradication therapy has been shown to reduce the risk of gastric cancer in patients who have a family history of gastric cancer in first-degree relatives. The aim of this study was to assess the cost-effectiveness of H. pylori eradication therapy in a select population in the People's Republic of China. METHODS A Markov model was applied to evaluate the cost-effectiveness of H. pylori eradication therapy. The long-term costs of H. pylori eradication therapy were calculated from the Chinese perspective. Health outcomes were measured by quality-adjusted life years (QALYs). Epidemiological information and health utilities used in the model were collected from published literatures or statistical bureaus. A sensitivity analysis was conducted to explore the influence of parameters on the uncertainty of the model. RESULTS Compared with the no eradication therapy group, H. pylori eradication therapy prolonged an average of 4.52 QALYs (32.64 QALYs vs 28.12 QALYs) and saved $3227.07 ($2472.83 vs $5699.90). The cost-effectiveness analysis demonstrated that no H. pylori eradication therapy cost more and produced less QALYs. It was dominated by H. pylori eradication therapy. The one-way sensitive analyses proved that the results were robust to the fluctuations of the input parameters. CONCLUSION H. pylori eradication therapy not only reduced the risk of gastric cancer in first-degree relatives of patients with gastric cancer but also was an economical strategy with lower costs and greater efficacy.
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Affiliation(s)
- Hanrui Zheng
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Qian Xie
- International Medical Center/Ward of General Practice, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Mei Zhan
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Chaohui Jin
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
- Correspondence: Chaohui Jin Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, People’s Republic of ChinaTel +86-28-85421763 Email
| | - Qiu Li
- Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
- West China Biomedical Big Data Center, Sichuan University, Chengdu, People’s Republic of China
- Qiu Li Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, People’s Republic of ChinaTel +86-28-85423262 Email
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Management of Helicobacter pylori. Curr Opin Gastroenterol 2020; 36:518-524. [PMID: 32868505 DOI: 10.1097/mog.0000000000000678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
PURPOSE OF REVIEW Gastroenterologists and many general internists and primary care physicians confront questions regarding the management of Helicobacter pylori on a daily basis. The subject remains of global interest and continue to generate debate and research. Using the search terms 'pylori and treatment' or 'pylori and management' we identified over 1000 relevant articles in PubMed published over the time period 1 January 2019 to 30 April 2020. We have selected the most highly clinically relevant of these to review here. RECENT FINDINGS Clinical evidence grows regarding the benefits of H. pylori eradication on gastric cancer prevention. High rates of resistance to clarithromycin and levofloxacin, correlating with treatment failure in regimens utilizing these drugs, has stimulated interest in alternative regimens as well as the need for susceptibility testing of individual patients and populations. Although many aspects of H. pylori management are well established, implementation of appropriate testing and treatment pathways remains suboptimal throughout healthcare settings. SUMMARY Increased emphasis on measuring H. pylori-related clinical outcomes in practice is needed to identify implementation gaps, and to suggest means to best apply the knowledge gained on H. pylori for the prevention of gastric symptoms and disease.
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Kong S, Huang K, Wang J, Wang X, Yang N, Dong Y, Zhuang Y, Dang Y, Zhang G, Ye F. Efficacy of tailored second-line therapy of Helicobacter pylori eradication in patients with clarithromycin-based treatment failure: a multicenter prospective study. Gut Pathog 2020; 12:39. [PMID: 32874206 PMCID: PMC7456506 DOI: 10.1186/s13099-020-00378-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 08/19/2020] [Indexed: 01/10/2023] Open
Abstract
Background After the failure of clarithromycin- and bismuth-based quadruple therapy (CBQT), levofloxacin- and bismuth-based quadruple therapy (LBQT) is recommended for Helicobacter pylori eradication. We compared the efficacies of second-line tailored bismuth-based quadruple therapy (TBQT) and empirical LBQT. Methods Patients with CBQT failure were randomly assigned to receive TBQT or LBQT for 14 days. All patients underwent endoscopy for culture-based antibiotic susceptibility testing. Patients in the TBQT group exhibiting levofloxacin susceptibility were randomized to receive amoxicillin, levofloxacin, esomeprazole, and colloidal bismuth pectin (ALEB) or amoxicillin, furazolidone, esomeprazole, and colloidal bismuth pectin (AFEB) for 14 days; patients with levofloxacin resistance received AFEB. Results From May 2016 to June 2019, 364 subjects were enrolled. Eradication rates were significantly higher in the TBQT group (n = 182) than in the LBQT group (n = 182) according to both intention-to-treat (ITT) analysis (89.6% vs. 64.8%, P < 0.001) and per protocol (PP) analysis (91.1% vs. 67.8%, P < 0.001). Among patients in the TBQT group with levofloxacin susceptibility, eradication rates were similar in the ALEB (n = 51) and AFEB (n = 50) subgroups according to both the ITT (86.3% vs. 90.0%, P = 0.56) and PP (88.0% vs. 90.0%, P = 0.75) analyses. Isolated clarithromycin and levofloxacin resistance rates were 57.7% and 44.5%, respectively. The total clarithromycin and levofloxacin resistance rate in strains with dual or triple resistance was 35.7%. Conclusions TBQT was more effective than LBQT as a second-line strategy after CBQT failure. In the absence of antibiotic susceptibility testing, AFEB therapy might be used as a rescue therapy to eradicate H. pylori and avoid levofloxacin resistance.Trial registration: Chinese Clinical Trial Registry (www.chictr.org.cn): ChiCTR1900027743.
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Affiliation(s)
- Siya Kong
- Department of Gastroenterology, First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, 210029 Nanjing, China.,First Clinical Medical College of Nanjing Medical University, Nanjing, China
| | - Keting Huang
- Department of Gastroenterology, First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, 210029 Nanjing, China.,First Clinical Medical College of Nanjing Medical University, Nanjing, China
| | - Jun Wang
- Department of Gastroenterology and Hepatology, Jinhu County People's Hospital, Huaian, China
| | - Xiaoyong Wang
- Department of Gastroenterology, Changzhou Second People's Hospital Affiliated to Nanjing Medical University, Changzhou, China
| | - Ningmin Yang
- Jiangsu Zhiyuan Inspection Medical Institute, Nanjing, China
| | - Yu Dong
- Department of Gastroenterology, First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, 210029 Nanjing, China
| | - Ya Zhuang
- First Clinical Medical College of Nanjing Medical University, Nanjing, China
| | - Yini Dang
- Department of Gastroenterology, First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, 210029 Nanjing, China.,First Clinical Medical College of Nanjing Medical University, Nanjing, China
| | - Guoxin Zhang
- Department of Gastroenterology, First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, 210029 Nanjing, China.,First Clinical Medical College of Nanjing Medical University, Nanjing, China
| | - Feng Ye
- Department of Gastroenterology, First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, 210029 Nanjing, China.,First Clinical Medical College of Nanjing Medical University, Nanjing, China
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43
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Yan TL, Gao JG, Wang JH, Chen D, Lu C, Xu CF. Current status of Helicobacter pylori eradication and risk factors for eradication failure. World J Gastroenterol 2020; 26:4846-4856. [PMID: 32921961 PMCID: PMC7459200 DOI: 10.3748/wjg.v26.i32.4846] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 07/18/2020] [Accepted: 07/30/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The Helicobacter pylori (H. pylori) eradication rate is decreasing in the general population of China.
AIM To evaluate the H. pylori eradication status in real-world clinical practice and to explore factors related to eradication failure.
METHODS Patients with H. pylori infection who were treated with standard 14-d quadruple therapy and received a test of cure at a provincial medical institution between June 2018 and May 2019 were enrolled. Demographic and clinical data were recorded. Eradication rates were calculated and compared between regimens and subgroups. Multivariate analysis was performed to identify predictors of eradication failure.
RESULTS Of 2610 patients enrolled, eradication was successful in 1999 (76.6%) patients. Amoxicillin-containing quadruple regimens showed a higher eradication rate than other quadruple therapy regimens (83.0% vs 69.0%, P < 0.001). The quadruple therapy containing amoxicillin plus clarithromycin achieved the highest eradication rate (83.5%). Primary therapy had a higher eradication rate than rescue therapy (78.3% vs 66.5%, P < 0.001). In rescue therapy, the amoxicillin- and furazolidone-containing regimens achieved the highest eradication rate (80.8%). Esomeprazole-containing regimens showed a higher eradication rate than those containing other proton pump inhibitors (81.8% vs 74.9%, P = 0.001). Multivariate regression analysis found that older age, prior therapy, and use of omeprazole or pantoprazole were associated with an increased risk of eradication failure.
CONCLUSION The total eradication rate is 76.6%. Amoxicillin-containing regimens are superior to other regimens. Age, prior therapy, and use of omeprazole or pantoprazole are independent risk factors for eradication failure.
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Affiliation(s)
- Tian-Lian Yan
- Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
| | - Jian-Guo Gao
- Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
| | - Jing-Hua Wang
- Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
| | - Dan Chen
- Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
| | - Chao Lu
- Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
| | - Cheng-Fu Xu
- Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
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44
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Sung JJY. Population-based screening and mass eradication of Helicobacter pylori infection to prevent gastric cancer: There are more questions than answers. J Gastroenterol Hepatol 2020; 35:521-522. [PMID: 32285527 DOI: 10.1111/jgh.15024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Joseph J Y Sung
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.,Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China
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