Extragastric Diseases Research Articles

Possible Role of Helicobacter pylori in Ear Nose and Throat Diseases.

Helicobacter pylori is assumed to cause many gastric and extragastric diseases. We aimed to assess the possible association role of H. pylori in Otitis media with effusion (OME), nasal polyps and adenotonsillitis. A total of 186 patients with various ear, nose and throat diseases were included. The study comprised 78 children with chronic adenotonsillitis, 43 children with nasal polyps and 65 children with OME. OME patients were assigned to two subgroups: those who have and those who did not have adenoid hyperplasia. Among the patients with bilateral nasal polyps, 20individuals had recurrent nasal polyps and 23 had de novo nasal polyps. Patients who have chronic adenotonsillitis were divided into three groups: those with chronic tonsillitis and those who underwent tonsillitis, those with chronic adenoiditis and adenoidectomy was performed, and those with chronic adenotonsillitis and underwent adenotonsillectomy. In addition to examination of H. pylori antigen in stool samples of all included patients, real-time polymerase chain reaction (RT-PCR) for detection of H. pylori in the effusion fluid was performed, additionally, Giemsa stain was used for detection of H. pylori organism within the tissue samples when available. Frequency of H. pylori in effusion fluid was 28.6% in patients with OME and adenoid hyperplasia, while in those with OME it was only 17.4% with a p value of 0.2. Nasal polyp biopsies were positive in 13% patients of denovo, and 30% patients with recurrent nasal polyps, p=0.2. De novo nasal polyps were more prevalent in the positive stools than recurrent ones, p=0.7. All adenoid samples were negative for H. pylori, only two samples of tonsillar tissue (8.3%) were positive for H. pylori, and stool analysis was positive in 23 patients with chronic adenotonsillitis. Lack of association between Helicobacter pylori and occurrence of OME, nasal polyposis or recurrent adenotonsillitis.

Hematological manifestations of Helicobacter Pylori (literature review)

It is known that Helicobacter pylori to be a key factor in the etiology of various gastrointestinal diseases, ranging from chronic gastritis without clinical symptoms to peptic ulcer, autoimmune gastritis, adenocarcinoma and gastric MALT lymphoma. However, current research suggests that Helicobacter pylori may be associated with numerous extra-gastric diseases that lead to chronic local or systemic inflammation and the initiation of autoimmune reactions, including hematological ones. The article describes the role of Helicobacter pylori CagA in the pathogenesis of iron deficiency anemia, immune thrombocytopenic purpura and MALT lymphoma. Studies of the iron-deficiency anemia pathogenesis in infected H. pylori patients have shown a connection between the CagA oncoprotein and iron homeostasis. It was established that transferrin endocytosis is mediated and iron absorption increases. In the development of immune thrombocytopenic purpura, CagA leads to a systemic host immune response through mechanisms of molecular mimicry. In pathogenesis of MALT lymphoma, it is considered significant that after the transfer of CagA to B-cell lymphocytes, through the type 4 secretory system (T4SS), a phosphorylated CagA-SHP2 complex is formed by affecting endoplasmic reticulum kinases 1 and 2 (ERK1, ERK2), p38MAPK, BCL2 and NF -κB, as well as through inhibition of p53 accumulation or inhibition of the JAK-STAT signaling pathway, ultimately promoting lymphogenesis and immortalization of B-cell lymphocytes. So, it was established that the presence of CagA protein in the Helicobacter pylori strain is key to the development of inflammation and tumor transformation. The disclosure of these mechanisms is necessary for a more accurate understanding of some pathological processes caused by this bacterium, both in the stomach and outside it. This will help improve diagnosis, guide treatment and predict clinical prognosis. Keywords: hypomagnesaemia, blood pressure, diabetes mellitus.

Helicobacter pylori virulence factors: subversion of host immune system and development of various clinical outcomes.

Helicobacter pylori (H. pylori) is a worldwide spread bacterium, co-evolving with humans for at least 100 000 years. Despite the uncertainty about the mode of H. pylori transmission, the development of intra-gastric and extra-gastric diseases is attributed to this bacterium. The morphological transformation and production of heterogenic virulence factors enable H. pylori to overcome the harsh stomach environment. Using numerous potent disease-associated virulence factors makes H. pylori a prominent pathogenic bacterium. These bacterial determinants are adhesins (e.g., blood group antigen-binding adhesin (BabA)/sialic acid-binding adhesin (SabA)), enzymes (e.g., urease), toxins (e.g., vacuolating cytotoxin A (VacA)), and effector proteins (e.g., cytotoxin-associated gene A (CagA)) involved in colonisation, immune evasion, and disease induction. H. pylori not only cleverly evades the immune system but also robustly induces immune responses. This insidious bacterium employs various strategies to evade human innate and adaptive immune responses, leading to a life-long infection. Owing to the alteration of surface molecules, innate immune receptors couldn't recognise this bacterium; moreover, modulation of effector T cells subverts adaptive immune response. Most of the infected humans are asymptomatic and only a few of them present severe clinical outcomes. Therefore, the identification of virulence factors will pave the way for the prediction of infection severity and the development of an effective vaccine. H. pylori virulence factors are hereby comprehensively reviewed and the bacterium evasion from the immune response is properly discussed.

Discussion on the common controversies of Helicobacter pylori infection.

Helicobacter pylori ( H.pylori ) can persistently colonize on the gastric mucosa after infection and cause gastritis, atrophy, metaplasia, and even gastric cancer (GC). Therefore, the detection and eradication of H.pylori are the prerequisite. Clinically, there are some controversial issues, such as why H.pylori infection is persistent, why it translocases along with the lesser curvature of the stomach, why there is oxyntic antralization, what the immunological characteristic of gastric chronic inflammation caused by H.pylori is, whether H.pylori infection is associated with extra-gastric diseases, whether chronic atrophic gastritis (CAG) is reversible, and what the potential problems are after H.pylori eradication. What are the possible answers? In the review, we will discuss these issues from the attachment to eradication in detail.

Helicobacter pylori and unignorable extragastric diseases: Mechanism and implications.

Considered as the most popular pathogen worldwide, Helicobacter pylori is intensively associated with diverse gastric diseases, including gastric ulcers, chronic progressive gastritis, and gastric cancer. Aside from its pathogenic effect on gastric diseases, growing evidences reveal that H. pylori may be related to numerous extragastric diseases. In this article, we reviewed recent studies and systematically elucidated that H. pylori may interfere with many biological processes outside the stomach and influence the occurrence of various extragastric diseases. Many epidemiological studies have indicated that H. pylori plays a pathogenic role in COVID-19, atherosclerosis, hyperemesis gravidarum and several other extragastric diseases, while the effect of H. pylori is currently under investigation in gastroesophageal reflux disease, asthma, and inflammatory bowel disease. Moreover, we also summarized the possible pathogenic mechanisms of H. pylori that may be related to chronic systemic inflammation and molecular mimicker. Taken together, this review provides a new perspective on the role of H. pylori in extragastric diseases and explores the possible mechanisms, which may help guide clinical treatment.

Helicobacter pylori roles in haematology disease pathogenesis

Helicobacter pylori is considered to be one of the significant reasons of formation of gastroduodenal pathology. Data on the role of H. pylori in the development of extragastric diseases are confirmed by a positive effect of eradication on peripheral blood changes. In spite of this fact both aspects are still not revealed. However, undoubtedly that H. pylori persistence on gastric epithelium creates conditions for chronic local and systematic inflammation. The aim of the sur- vey was the analysis of literary data about bacterial factors in the development of iron-, vitamin B 12 - deficiency anaemia and thrombocytopenic purpura included by the international consensus into the circle of evedences for diagnosis and treatment of H. pylori . Material and methods. There was accomplished search of literature sources with the help of data bases PubMed, CyberLeninka, eLibrary, Google Scholar. The results of our analysis specify mechanisms of cer- tain blood diseases pathogenesis in association with H. pylori . Multiple roles of virulent strains of pathogen in anaemia and thrombocytopenic purpura include: development of erosive and ulcerative lesions of mucosa, hypoacidity, chron- ic inflammation and autoimmune response. Data about these changes in haematological syndromes and independent eradication effects on blood parameters normalisation, are controversial. Н. pylori host iron competition theory has not been found convincing confirmation. Conclusions . It is necessary to study more deeply the connection of H. pylori and haematological diseases. The dietary research and application to maintain the mucous integrity and bacterial adhesion prevention are perspective.

A new approach against Helicobacter pylori using plants and its constituents: A review study

Helicobacter pylori is a Gram-negative, spiral-shaped bacillus that colonizes 50% of the world population and is considered a class 1 carcinogen by the World Health Organization. This pathogen is the most common cause of infection-related cancers. Apart from cancer, it also causes several gastric and extra gastric diseases. Eradication of H. pylori using antibiotics is a global challenge because of its drug resistance. Alternative treatment options are gaining more attention to tackle drug-resistant H. pylori infections. Several medicinal plants and their isolated compounds have been reported for their antimicrobial activity against H. pylori. The mechanism of action of many of these plant extracts and plant-derived compounds is different from that of conventional antibiotics. Therefore they are shown to be effective against drug-resistant strains of H. pylori. They act by inhibiting bacterial enzymes, adhesions with gastric mucosa, suppression of nuclear factor-κB and by inhibition of oxidative stress. Extracts from Pistacia lentiscus, Brassica oleracea, Glycyrrhiza glabra, Camellia sinensis, Cinnamomum cassia, Allium sativum and Nigella sativa plants and isolated phyto-compounds such as curcumin, resveratrol, quercetin, allicin and ellagic acid demonstrated antimicrobial activity against H. pylori under in vivo conditions. The plant extracts of Zingiber officinale, Glycyrrhiza glabra; and phytochemical allicin and berberine when combined with standard treatment, result in a dramatic increase in H. pylori eradication. In this review, we highlighted the therapeutic efficacy of different plant extracts and isolated phyto compounds against H. pylori infection and described their role in tackling H. pylori resistance to antibiotics.

A Review Paper on Helicobacter Pylori

Abstract: Helicobacter pylori (H. pylori) infection is a primary cause of gastroduodenal ulcer disease, gastric cancer, and a variety of other gastric and extra gastric diseases. The medical management of H. pylori is a dynamic process that requires frequent reconsideration due to changing epidemiologic conditions (e.g., immigration), changing resistance patterns with therapeutic implications, and new understanding relating to the reasons for pathogen eradication. Keywords: helicobacter pylori, pathogenic infection, gastric cancer.

Concentration of alpha-defensins in the blood plasma of children with Helicobacter pylori – associated peptic ulcer of the duodenum

Introduction. Various gastrointestinal and extragastric diseases are associated with H. pylori in children and adolescents, but the strongest testing and treatment guidelines are only for children and adolescents with peptic ulcer. The most promising developments now are the study of the antibacterial effect of endogenous antimicrobial peptides (AP), among which the most important are defenses 1-3 (human neutrophil peptides, HNPs1-3). Objective. To investigate the concentration of HNPs 1-3 in children with H. pylori-associated peptic ulcer of the duodenum (DU). Methods. A study of 65 children with DU (47 children with H. pylori-associated DU, 18 children with H. pylori-negative DU) and 25 healthy children aged 7-18 years with the determination of HNPs 1-3 levels in plasma. Results. More common was H. pylori in the group of children with III grade of inflammation than in the group of children with II grade (χ2:p<0.0001). A significant association was found between mucosal inflammation activity and the presence of H. pylori (r=0.66, p<0.0001). The mean level of HNP1-3 in healthy children was 13.67±0.96 ng/ml, in children with DU it was probably higher and was 104.88±11.5 ng/ml (p=0.005). There is a direct correlation between the level of HNP1-3 and the severity of DU in children (r=0.67, p>0.05), as well as between HNP1-3 and the activity of the inflammatory process (r=0.73, p>0.01). In children with H. pylori-associated DU, HNP1-3 values were significantly higher (107.34±16.18 [98.45-119.22]) ng/ml than those in children with DU not associated with H. pylori infection (66.70±11.31 [59.54-73.29]) ng/ml and in healthy children (13.67±0.96 [7.27-18.91] ng/ml). Conclusion. Elevated plasma HNP1-3 levels in children with DU in the presence of H. pylori are likely to be a protective response to limit infection that can be used as a potential biomarker of adverse events.

Extracellular vesicles from helicobacter pylori-infected cells and helicobacter pylori outer membrane vesicles in atherosclerosis.

The role of H.pylori infection has been reported in various extragastric diseases, particularly, the correlation between H.pylori and atherosclerosis (AS) have received lots of attention. Some scholars demonstrated that the presence of H.pylori-specific DNA in the sclerotic plaques of atheromatous patients provides biological evidences, with indicating that H.pylori infection is a potential factor of AS. However, the underlying mechanism of H.pylori or their products cross the epithelial barriers to enter the blood circulation remains unclear. Recent studies have shown that the extracellular vesicles (EVs) derived from H.pylori-infected gastric epithelial cells encapsulated H.pylori virulence factor cytotoxin-associated gene A (CagA) and existed in the blood samples of patients or mice, which indicating that they can carry CagA into the blood circulation. Based on these findings, some researchers proposed a hypothesis that H.pylori is involved in the pathogenesis of AS via EVs-based mechanisms. In addition, outer membrane vesicles (OMVs) serve as transport vehicles to deliver H.pylori virulence factors to epithelial cells. It is necessary to discuss the role of H.pyloriOMVs in the development of AS. This review will focus on the correlation between H.pyloriinfection and AS and tried to unveil the possible role of EVs from H.pylori-infected cells and H.pyloriOMVs in the pathogenesis of AS, with a view to providing help in refining our knowledge in this aspect. All of information included in this review was retrieved from published studies on H.pyloriinfection in AS. H.pyloriinfection may be an atherosclerotic risk factor and drives researchers to reevaluate the role of H.pyloriin the pathogenesis of AS. Some findings proposed a new hypothesis that H.pylorimay be involved in the pathogenesis of AS through EVs-based mechanisms. Besides EVs from H.pylori-infected cells, whether H.pylori OMVs may play some role in the pathogenesis of AS is still remain unclear. Existing epidemiological and clinical evidence had shown that there is a possible association between H.pyloriand AS. However, except for the larger randomized controlled trials, more basic research about EVs from H.pylori-infected cells and H.pyloriOMVs is the need of the hour to unveil the possible role of H.pyloriinfection in the pathogenesis of AS.

Utility of immature granulocyte in severity of helicobacter pylori infection

Helicobacter pylori infection is a chronic bacterial infection associated with some extragastric diseases as well as gastric involvements that occur most commonly worldwide. In our study, we aimed to investigate the usability of immature granulocytes as a basic indicator that can reflect the severity of helicobacter pylori inflammation, to the best of our knowledge, for the first time. Patients who underwent upper gastrointestinal endoscopy between April 2019 and April 2020 and were diagnosed with antral gastritis were included in this study. The relationship between helicobacter infection and its severity detected in gastric biopsies of patients and immature granulocyte count (IGC), immature granulocyte percentage (IG%), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and mean platelet volume (MPV) were investigated. Of the 868 patients, 210 were HP negative, 658 were HP positive (218 mild HP positive, 293 moderate HP positive, and 147 severe HP positive). There were statistically significant differences between the HP negative and HP positive groups in terms of IGC, IG%, NLR, and PLR. However, IG% and IGC were not clinically useful because the median IG% (0.3 vs 0.3) and IGC (0.02 vs 0.02) were the same in the HP negative and total HP positive groups. In our study, IGC and IG% were not found useful to detect H. pylori intensity and severity of inflammation.

Lack of Association Between Helicobacter pylori Infection and the Risk of Thyroid Nodule Types: A Multicenter Case-Control Study in China.

The prevalence of Helicobacter pylori infection is high worldwide, while numerous research has focused on unraveling the relationship between H. pylori infection and extragastric diseases. Although H. pylori infection has been associated with thyroid diseases, including thyroid nodule (TN), the relationship has mainly focused on potential physiological mechanisms and has not been validated by large population epidemiological investigations. Therefore, we thus designed a case-control study comprising participants who received regular health examination between 2017 and 2019. The cases and controls were diagnosed via ultrasound, while TN types were classified according to the guidelines of the American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS). Moreover, H. pylori infection was determined by C14 urea breath test, while its relationship with TN type risk and severity was analyzed using binary and ordinal logistic regression analyses. A total of 43,411 participants, including 13,036 TN patients and 30,375 controls, were finally recruited in the study. The crude odds ratio (OR) was 1.07 in Model 1 (95% CI = 1.03–1.14) without adjustment compared to the H. pylori non-infection group. However, it was negative in Model 2 (OR = 1.02, 95% CI = 0.97–1.06) after being adjusted for gender, age, body mass index (BMI), and blood pressure and in Model 3 (OR = 1.01, 95% CI = 0.97–1.06) after being adjusted for total cholesterol, triglyceride, low-density lipoprotein, and high-density lipoprotein on the basis of Model 2. Control variables, including gender, age, BMI, and diastolic pressure, were significantly correlated with the risk of TN types. Additionally, ordinal logistic regression results revealed that H. pylori infection was positively correlated with malignant differentiation of TN (Model 1: OR = 1.06, 95% CI = 1.02–1.11), while Model 2 and Model 3 showed negative results (Model 2: OR = 1.01, 95% CI = 0.96–1.06; Model 3: OR = 1.01, 95% CI = 0.96–1.05). In conclusion, H. pylori infection was not significantly associated with both TN type risk and severity of its malignant differentiation. These findings provide relevant insights for correcting possible misconceptions regarding TN type pathogenesis and will help guide optimization of therapeutic strategies for thyroid diseases.

Benefits of Helicobacter pylori Eradication on Extragastric Diseases

Helicobacter pylori (H. pylori) eradication can reduce the risk of gastric diseases such as gastritis, gastric ulcer, and gastric adenocarcinoma. Since H. pylori was discovered more than 30 years ago, many studies have reported associations between H. pylori infection and extragastric diseases such as immune thrombocytopenia and iron-deficiency anemia. Thus, recent guidelines recommended H. pylori eradication in patients with those diseases. In contrast, although the role of H. pylori eradication in other extragastric diseases remains controversial, there is growing evidence of its benefit on them, especially cardiovascular (ischemic heart disease and stroke), metabolic (dyslipidemia, diabetes mellitus, and non-alcoholic fatty liver disease), neurodegenerative (Parkinson’s disease and Alzheimer’s disease), autoimmune (Graves’ disease, Hashimoto’s thyroiditis, Raynaud’s syndrome, rosacea, and chronic urticaria), and other (cap polyposis, colorectal mucosa-associated lymphoid tissue lymphoma, periodontal disease, hyperemesis gravidarum, and osteoporosis) conditions. A recent prospective randomized study reported that H. pylori eradication improved insulin resistance and dyslipidemia. These findings were consistent with the results of a recent meta-analysis. Therefore, well-designed prospective interventional studies are needed to examine the effects of H. pylori eradication on various extragastric diseases.

Detrimental relevance of Helicobacter pylori infection with sarcopenia

BackgroundHelicobacter pylori (H. pylori), Gram negative microaerophilic bacteria, is a well-known pathogen of many gastrointestinal diseases. But several emerging evidences suggest it role in numerous other extra-gastric diseases. The current study investigates the relationship between H. pylori infection and sarcopenia, a clinical condition characterized by the loss of mass and function of skeletal muscle. A total of 3453 eligible participants from the Third National Health and Nutrition Examination Survey (NHANES III), the United States, were enrolled. Based on the serum laboratory results, subjects were categorized into three groups: normal (without evidence of any H. pylori infection), anti-H. pylori IgG positive [H. pylori (+)], and concurrent anti-H. pylori IgG and anti-cytotoxin-associated gene A IgG positive [CagA (+)]. Sarcopenia was determined as having a skeletal muscle index (SMI) value that is more than 1 standard deviation away from the mean value of sex-specific, healthy young adults between 20 and 39 years old. Risk of sarcopenia and its components are compared between subgroups.ResultsOdds ratios (OR) for confirmed diagnosis of sarcopenia were higher in H. pylori (+) (OR = 2.052, 95% CI 1.697–2.481, p < 0.001) and CagA (+) (OR = 1.585, 95% CI 1.278–1.965, p < 0.001) groups. Moreover, negative beta regression coefficient of SMI were shown in H. pylori (+) (β: − 0.023, p < 0.001) and CagA (+) (β: − 0.017, p < 0.001). Sub-analyses which categorized participants by gender revealed that absolute value of beta regression coefficient for SMI were higher in female in H. pylori (+) subgroup (β: − 1.745 in male and − 2.942 in female, p were both < 0.001), and the CagA (+) subgroup (β: − 1.407 in male and − 2.159 in female, p were both < 0.001).ConclusionsPositive serum H. pylori infectious markers including anti-H. pylori antibody and CagA seropositivity are correlated with sarcopenia and low muscle quantity. Therefore, H. pylori eradication therapy may bring benefits to sarcopenia patients with concurrent active H. pylori infection.

Helicobacter pylori and Respiratory Diseases: 2021 Update.

Helicobacter pylori (H. pylori) is a Gram-negative bacterium involved in the development of gastritis, peptic ulcer disease, gastric adenocarcinoma, and gastric mucosa-associated lymphoid tissue. Unexplained iron deficiency anemia, idiopathic thrombocytopenic purpura and vitamin B12 deficiency have also been related to H. pylori infection, whereas for other extra-gastric diseases, the debate is still open. In this review, we evaluate and discuss the potential involvement of H. pylori infection in the pathogenesis of several respiratory diseases. A MEDLINE search of all studies published in English from 1965 to 2021 was carried out. Controversial findings have been reported in patients with bronchial asthma, chronic obstructive pulmonary disease, bronchiectasis, lung cancer, tuberculosis, cystic fibrosis, and sarcoidosis. Most of the available literature is concerned with case-control studies based on seroprevalence, with a small sample size and low consideration of confounders, which represents a potential issue. So far, there is no clear evidence of a causal association between H. pylori infection and respiratory diseases, and larger studies with appropriate epidemiological design are required.

Glycosaminoglycan biosynthesis pathway in host genome is associated with Helicobacter pylori infection

Helicobacter pylori is a causative pathogen of many gastric and extra-gastric diseases. It has infected about half of the global population. There were no genome-wide association studies (GWAS) for H. pylori infection conducted in Chinese population, who carried different and relatively homogenous strain of H. pylori. In this work, we performed SNP (single nucleotide polymorphism)-based, gene-based and pathway-based genome-wide association analyses to investigate the genetic basis of host susceptibility to H. pylori infection in 480 Chinese individuals. We also profiled the composition and function of the gut microbiota between H. pylori infection cases and controls. We found several genes and pathways associated with H. pylori infection (P < 0.05), replicated one previously reported SNP rs10004195 in TLR1 gene region (P = 0.02). We also found that glycosaminoglycan biosynthesis related pathway was associated with both onset and progression of H. pylori infection. In the gut microbiome association study, we identified 2 species, 3 genera and several pathways had differential abundance between H. pylori infected cases and controls. This paper is the first GWAS for H. pylori infection in Chinese population, and we combined the genetic and microbial data to comprehensively discuss the basis of host susceptibility to H. pylori infection.

Helicobacter pylori Infection and Extragastric Diseases-A Focus on the Central Nervous System.

Helicobacter pylori (H. pylori) is most known to cause a wide spectrum of gastrointestinal impairments; however, an increasing number of studies indicates that H. pylori infection might be involved in numerous extragastric diseases such as neurological, dermatological, hematologic, ocular, cardiovascular, metabolic, hepatobiliary, or even allergic diseases. In this review, we focused on the nervous system and aimed to summarize the findings regarding H. pylori infection and its involvement in the induction/progression of neurological disorders. Neurological impairments induced by H. pylori infection are primarily due to impairments in the gut–brain axis (GBA) and to an altered gut microbiota facilitated by H. pylori colonization. Currently, regarding a potential relationship between Helicobacter infection and neurological disorders, most of the studies are mainly focused on H. pylori.

Helicobacter pylori eradication: Exploring its impacts on the gastric mucosa.

Helicobacter pylori (H. pylori) infects approximately 50% of all humans globally. Persistent H. pylori infection causes multiple gastric and extragastric diseases, indicating the importance of early diagnosis and timely treatment. H. pylori eradication produces dramatic changes in the gastric mucosa, resulting in restored function. Consequently, to better understand the importance of H. pylori eradication and clarify the subsequent recovery of gastric mucosal functions after eradication, we summarize histological, endoscopic, and gastric microbiota changes to assess the therapeutic effects on the gastric mucosa.

Association between Helicobacter pylori antibody-positive status and extragastric diseases in Japanese junior high school students.

Helicobacter pylori (H.pylori) infection causes various extragastric diseases. Its transmission route has still not been clarified. However, no large-scale studies have examined the extragastric diseases caused by H.pylori in adolescents. This study aimed to examine the association of H.pylori infection with anemia, serum cholesterol levels, physique, and birth delivery method (vaginal or cesarean) in a large number of Japanese adolescents. From 2016 to 2018, we screened 2,399 adolescents (aged 13-15years) in their second and third years of junior high school using an enzyme-linked immunosorbent assay-based antibody test. Red blood cells, hemoglobin, hematocrit, total cholesterol, high-density lipoprotein (HDL) cholesterol, and serum antibody levels were measured. Hemoglobin and hematocrit levels were significantly lower in the H.pylori antibody-positive group than in the H.pylori antibody-negative group in both sexes (boys: P = 0.0004 and 0.0022; girls: P = 0.0019 and 0.0005, respectively). Total cholesterol and non-HDL cholesterol levels were significantly higher in the H. pylori-positive group than in the H.pylori-negative group among boys (P = 0.0370 and 0.0293 respectively). There was no significant difference in body mass index percentile and birth delivery method between the H.pylori-positive and H.pylori-negative groups in both boys and girls. Among Japanese junior high school students, H.pylori antibody-positive status was associated with anemia in both sexes while total cholesterol and non-HDL cholesterol levels were associated among boys. There was no association between H.pylori antibody status, body mass index percentile, and birth-delivery method.

Diagnosis of Helicobacter pylori Infection and Recent Advances.

Background: Helicobacter pylori (H. pylori) infects approximately 50% of the world population. Its infection is associated with gastropathies, extra-gastric digestive diseases, and diseases of other systems. There is a canonical process from acute-on-chronic inflammation, chronic atrophic gastritis (CAG), intestinal metaplasia (IM), dysplasia, and intraepithelial neoplasia, eventually to gastric cancer (GC). H. pylori eradication abolishes the inflammatory response and early treatment prevents the progression to preneoplastic lesions. Methods: the test-and-treat strategy, endoscopy-based strategy, and screen-and-treat strategy are recommended to prevent GC based on risk stratification, prevalence, and patients’ clinical manifestations and conditions. Challenges contain false-negative results, increasing antibiotic resistance, decreasing eradication rate, and poor retesting rate. Present diagnosis methods are mainly based on invasive endoscopy and noninvasive laboratory testing. Results: to improve the accuracy and effectiveness and reduce the missed diagnosis, some advances were achieved including newer imaging techniques (such as image-enhanced endoscopy (IEE), artificial intelligence (AI) technology, and quantitative real-time polymerase chain reaction (qPCR) and digital PCR (dPCR). Conclusion: in the article, we summarized the diagnosis methods of H. pylori infection and recent advances, further finding out the opportunities in challenges.