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Yamasaki S, Murata M, Ohta A, Matsumoto Y, Ikezaki H, Furusyo N. Analyses of the association between Helicobacter pylori antibody titre and pathogenicity before and after eradication: results of the Kyushu and Okinawa population study, a retrospective observational cohort study. BMJ Open 2024; 14:e083157. [PMID: 39117418 DOI: 10.1136/bmjopen-2023-083157] [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] [Indexed: 08/10/2024] Open
Abstract
OBJECTIVES To assess the utility of Helicobacter pylori antibody testing, we evaluated the correlation between the H. pylori antibody titre and H. pylori-associated pathogenicity and the changes in antibody titre after H. pylori eradication therapy. DESIGN A retrospective observational cohort study. SETTING AND PARTICIPANTS From 2004 to 2016, medical check-ups were performed in different regions of Japan. In total, 324 subjects infected with H. pylori who received H. pylori eradication therapy were enrolled; H. pylori was eradicated in 266 of these subjects. We examined the associations between H. pylori antibody titre with pepsinogen and the presence or absence of H. pylori-associated pathogenic proteins, such as cytotoxin-associated gene A and vacuolating cytotoxin gene A, at baseline and after H. pylori eradication therapy. RESULTS The H.pylori antibody titre showed a positive correlation with pepsinogen II and a negative correlation with the pepsinogen I/II ratio. Moreover, the H.pylori antibody titre significantly correlated with the positive rates of H. pylori-associated pathogenic protein before eradication therapy. Antibody titres decreased after eradication, the pepsinogen I/II ratio increased and the H. pylori-associated pathogenic protein-positive rate decreased in patients with successful eradication. The determination of eradication using the decline in antibody titre 6 months after eradication therapy was useful (area under the receiver operating characteristic curve: 0.98). CONCLUSIONS Our data indicate that the H. pylori antibody titre may represent the degree of pathogenicity. The H. pylori antibody titre was associated with attenuation of pathogenicity in patients with H. pylori eradication, indicating the clinical utility of H. pylori antibody testing.
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Affiliation(s)
- Sho Yamasaki
- Department of Environmental Medicine and Infectious Diseases, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Masayuki Murata
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Azusa Ohta
- Department of Environmental Medicine and Infectious Diseases, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Yuji Matsumoto
- Department of Environmental Medicine and Infectious Diseases, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Hiroaki Ikezaki
- Department of Comprehensive General Internal Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Norihiro Furusyo
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
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Muhina IAI, Sadiq AM, Said FH, Raza FM, Gharib SK, Muhali SS, Costantine AR, Abdalla MS, Shirima LJ, Chamba NG, Lyamuya FS, Mkwizu EW, Kilonzo KG, Maro VP, Shao ER. Feco-prevalence, endoscopic pattern and associated factors of Helicobacter Pylori infection among symptomatic adult patients in Northern Tanzania. PLoS One 2024; 19:e0307705. [PMID: 39038026 PMCID: PMC11262669 DOI: 10.1371/journal.pone.0307705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Accepted: 07/05/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND Africa has consistently had the highest prevalence (70.1%) of H. pylori, and this has led to significant cases of dyspepsia, gastric cancers, and upper gastrointestinal bleeding. However, most studies have used sero-prevalence, which might not give the current state of the infection. Among the tests, the stool antigen test is simple, quick, and effective. The study aimed to determine the feco-prevalence, endoscopic pattern, and associated factors of H. pylori infection among symptomatic adult patients in Northern Tanzania. MATERIALS AND METHODS A hospital-based, cross-sectional study was conducted from October 2022 to April 2023 among adults attending the gastroenterology clinic at Kilimanjaro Chistian Medical Centre. A systematic random sampling was used to select the participants with indications of undergoing esophagogastroduodenoscopy. Questionnaires, stool and blood samples, and endoscopy were used to collect variable data. Numerical and categorical variables were summarized into narrations and tables. Logistic regression was used to assess the factors associated with H. pylori. RESULTS The feco-prevalence of H. pylori was 43.4%. Chronic gastritis (51.1%) was the most common endoscopic pattern, whereas duodenal ulcers and gastric ulcers were significantly associated with H. pylori infection. Increasing in age (p <0.001) and blood group (p <0.001) were significantly associated with H. pylori infection in the adjusted analysis. CONCLUSION The feco-prevalence of H. pylori is high in this setting. H. pylori stool antigen can be used as the initial workup for symptomatic patients before the initiation of proton pump inhibitors. Additionally, due to other causes of dyspepsia, it is advised that H. pylori stool antigen testing be part of the initial evaluation and esophagogastroduodenoscopy be considered in the absence of other alarm symptoms if symptoms persist despite an appropriate trial of medical therapy.
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Affiliation(s)
| | - Abid M. Sadiq
- Department of Internal Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Department of Internal Medicine, Kilimanjaro Christian Medical Centre (KCMC), Moshi, Tanzania
| | - Fuad H. Said
- Department of Internal Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Faryal M. Raza
- Department of Internal Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Sarah K. Gharib
- Department of Internal Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Sophia S. Muhali
- Department of Internal Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Andrea R. Costantine
- Department of Internal Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Department of Internal Medicine, Kilimanjaro Christian Medical Centre (KCMC), Moshi, Tanzania
| | | | - Laura J. Shirima
- Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Nyasatu G. Chamba
- Department of Internal Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Department of Internal Medicine, Kilimanjaro Christian Medical Centre (KCMC), Moshi, Tanzania
| | - Furaha S. Lyamuya
- Department of Internal Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Department of Internal Medicine, Kilimanjaro Christian Medical Centre (KCMC), Moshi, Tanzania
| | - Elifuraha W. Mkwizu
- Department of Internal Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Department of Internal Medicine, Kilimanjaro Christian Medical Centre (KCMC), Moshi, Tanzania
| | - Kajiru G. Kilonzo
- Department of Internal Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Department of Internal Medicine, Kilimanjaro Christian Medical Centre (KCMC), Moshi, Tanzania
| | - Venance P. Maro
- Department of Internal Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Elichilia R. Shao
- Department of Internal Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Department of Internal Medicine, Kilimanjaro Christian Medical Centre (KCMC), Moshi, Tanzania
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Kishikawa H, Nakamura K, Takarabe S, Katayama T, Sasaki A, Miura S, Hayashi Y, Hoshi H, Kanai T, Nishida J. Clinical Characteristics of Patients With Previous Helicobacter pylori Infection-Induced Atrophic Gastritis. Cureus 2024; 16:e63368. [PMID: 39070512 PMCID: PMC11283760 DOI: 10.7759/cureus.63368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2024] [Indexed: 07/30/2024] Open
Abstract
AIMS Patients with atrophic gastritis unrelated to autoimmune gastritis (AIG) and without active Helicobacter pylori (H.pylori) infection or previous eradication therapy are considered to have previous Helicobacter pylori infection-induced atrophic gastritis (PHIG). This study aimed to clarify the clinical characteristics of patients with PHIG. METHODS Consecutive patients who underwent upper gastrointestinal endoscopy during the study period were enrolled in the study. Pepsinogen and gastrin levels, H. pylori serology, and endoscopic atrophic grade were assessed. Patients were divided into five groups based on their H. pylori status and disease history (PHIG, without H. pylori infection, with active H. pylori infection, with successful H. pylori eradication, and AIG). Their gastric cancer risk status was classified according to the ABC method of serological gastric cancer screening. RESULTS Of 536 consecutive patients who underwent upper gastrointestinal endoscopy during the study period, 318 were included (31 with PHIG, 77 without H. pylori infection, 101 with active H. pylori infection, 80 with successful H. pylori eradication, and 29 with AIG). Of the 31 patients with PHIG, 21 (68%) were H. pylori-seronegative, and 20 (65%) were classified as group A (normal pepsinogen, H. pylori-seronegative). Patients with PHIG accounted for 90.1% of the patients at high risk for gastric cancer misclassified as group A. The pepsinogen and H. pylori serological profiles of patients with PHIG were similar to those of patients with successful H. pylori eradication more than six years previously. A receiver-operating characteristic curve (ROC) analysis that included 13 patients with AIG and without active H. pylori infection and no previous eradication therapy and 31 patients with PHIG revealed that an endoscopic atrophy grade of O-III or greater according to the Kimura-Takemoto classification can predict AIG. CONCLUSIONS Two-thirds of the patients with PHIG were misclassified as being at low risk (group A) according to the ABC method, suggesting that endoscopy is necessary for group A patients. The results of the serological evaluation of PHIG indicated that patients with PHIG may have experienced spontaneous H. pylori eradication, possibly because of the use of antibiotics for other conditions. Autoimmune gastritis should be considered in the presence of grade 0-III or greater gastric mucosal atrophy in patients with suspected PHIG, even if the autoantibody and histological findings are not available.
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Affiliation(s)
- Hiroshi Kishikawa
- Gastroenterology, Tokyo Dental College, Ichikawa General Hospital, Chiba, JPN
| | - Kenji Nakamura
- Gastroenterology, Tokyo Dental College, Ichikawa General Hospital, Chiba, JPN
| | - Sakiko Takarabe
- Gastroenterology, Tokyo Dental College, Ichikawa General Hospital, Chiba, JPN
| | - Tadashi Katayama
- Gastroenterology, Tokyo Dental College, Ichikawa General Hospital, Chiba, JPN
| | - Aya Sasaki
- Clinical Laboratory, Tokyo Dental College, Ichikawa General Hospital, Chiba, JPN
| | - Soichiro Miura
- Graduate School, International University of Health and Welfare, Tokyo, JPN
| | - Yukie Hayashi
- Gastroenterology and Hepatology, Keio University, Tokyo, JPN
| | - Hitomi Hoshi
- Gastroenterology and Hepatology, Keio University, Tokyo, JPN
| | - Takahiro Kanai
- Gastroenterology and Hepatology, Keio University, Tokyo, JPN
| | - Jiro Nishida
- Gastroenterology, Tokyo Dental College, Ichikawa General Hospital, Chiba, JPN
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Magahis PT, Maron SB, Faleck D, Laszkowska M. Response to Yu and Fuhler et al. J Immunother Cancer 2024; 12:e008784. [PMID: 38242719 PMCID: PMC10806506 DOI: 10.1136/jitc-2024-008784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2024] [Indexed: 01/21/2024] Open
Affiliation(s)
| | - Steven B Maron
- Gastrointestinal Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - David Faleck
- Gastroenterology, Hepatology, and Nutrition Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Monika Laszkowska
- Gastroenterology, Hepatology, and Nutrition Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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Namikawa K, Tanaka N, Ota Y, Takamatsu M, Kosugi M, Tokai Y, Yoshimizu S, Horiuchi Y, Ishiyama A, Yoshio T, Hirasawa T, Amino S, Furuya R, Gotoh O, Kaneyasu T, Nakayama I, Imamura Y, Noda T, Fujisaki J, Mori S. Genomic features of Helicobacter pylori-naïve diffuse-type gastric cancer. J Pathol 2022; 258:300-311. [PMID: 36111561 PMCID: PMC9825990 DOI: 10.1002/path.6000] [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: 04/19/2022] [Revised: 07/25/2022] [Accepted: 08/09/2022] [Indexed: 01/11/2023]
Abstract
Helicobacter pylori (HP) is a major etiologic driver of diffuse-type gastric cancer (DGC). However, improvements in hygiene have led to an increase in the prevalence of HP-naïve DGC; that is, DGC that occurs independent of HP. Although multiple genomic cohort studies for gastric cancer have been conducted, including studies for DGC, distinctive genomic differences between HP-exposed and HP-naïve DGC remain largely unknown. Here, we employed exome and RNA sequencing with immunohistochemical analyses to perform binary comparisons between 36 HP-exposed and 27 HP-naïve DGCs from sporadic, early-stage, and intramucosal or submucosal tumor samples. Among the samples, 33 HP-exposed and 17 HP-naïve samples had been preserved as fresh-frozen samples. HP infection status was determined using stringent criteria. HP-exposed DGCs exhibited an increased single nucleotide variant burden (HP-exposed DGCs; 1.97 [0.48-7.19] and HP-naïve DGCs; 1.09 [0.38-3.68] per megabase; p = 0.0003) and a higher prevalence of chromosome arm-level aneuploidies (p < 0.0001). CDH1 was mutated at similar frequencies in both groups, whereas the RHOA-ARHGAP pathway misregulation was exclusive to HP-exposed DGCs (p = 0.0167). HP-exposed DGCs showed gains in chromosome arms 8p/8q (p < 0.0001), 7p (p = 0.0035), and 7q (p = 0.0354), and losses in 16q (p = 0.0167). Immunohistochemical analyses revealed a higher expression of intestinal markers such as CD10 (p < 0.0001) and CDX2 (p = 0.0002) and a lower expression of the gastric marker, MUC5AC (p = 0.0305) among HP-exposed DGCs. HP-naïve DGCs, on the other hand, had a purely gastric marker phenotype. This work reveals that HP-naïve and HP-exposed DGCs develop along different molecular pathways, which provide a basis for early detection strategies in high incidence settings. © 2022 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.
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Affiliation(s)
- Ken Namikawa
- Department of Gastroenterology, Cancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan
| | - Norio Tanaka
- Project for Development of Innovative Research on Cancer TherapeuticsCancer Precision Medicine Center, Japanese Foundation for Cancer ResearchTokyoJapan
| | - Yuki Ota
- Project for Development of Genomics‐based Cancer Medicine, Cancer Precision Medicine CenterJapanese Foundation for Cancer ResearchTokyoJapan
| | - Manabu Takamatsu
- Division of Pathology, Cancer InstituteJapanese Foundation for Cancer ResearchTokyoJapan
| | - Mayuko Kosugi
- Project for Development of Innovative Research on Cancer TherapeuticsCancer Precision Medicine Center, Japanese Foundation for Cancer ResearchTokyoJapan
| | - Yoshitaka Tokai
- Department of Gastroenterology, Cancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan
| | - Shoichi Yoshimizu
- Department of Gastroenterology, Cancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan
| | - Yusuke Horiuchi
- Department of Gastroenterology, Cancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan
| | - Akiyoshi Ishiyama
- Department of Gastroenterology, Cancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan
| | - Toshiyuki Yoshio
- Department of Gastroenterology, Cancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan
| | - Toshiaki Hirasawa
- Department of Gastroenterology, Cancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan
| | - Sayuri Amino
- Project for Development of Genomics‐based Cancer Medicine, Cancer Precision Medicine CenterJapanese Foundation for Cancer ResearchTokyoJapan
| | - Rie Furuya
- Project for Development of Genomics‐based Cancer Medicine, Cancer Precision Medicine CenterJapanese Foundation for Cancer ResearchTokyoJapan
| | - Osamu Gotoh
- Project for Development of Innovative Research on Cancer TherapeuticsCancer Precision Medicine Center, Japanese Foundation for Cancer ResearchTokyoJapan
| | - Tomoko Kaneyasu
- Project for Development of Innovative Research on Cancer TherapeuticsCancer Precision Medicine Center, Japanese Foundation for Cancer ResearchTokyoJapan
| | - Izuma Nakayama
- Department of Gastroenterological ChemotherapyCancer Institute Hospital, Japanese Foundation for Cancer ResearchTokyoJapan
| | - Yu Imamura
- Department of Gastroenterological Surgery, Cancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan
| | - Tetsuo Noda
- Cancer InstituteJapanese Foundation for Cancer ResearchTokyoJapan
| | - Junko Fujisaki
- Department of Gastroenterology, Cancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan
| | - Seiichi Mori
- Project for Development of Innovative Research on Cancer TherapeuticsCancer Precision Medicine Center, Japanese Foundation for Cancer ResearchTokyoJapan,Department of Genetic Diagnosis, Cancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan
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