Gastric Helicobacter Pylori Infection Research Articles

Novel endoscopic techniques for the diagnosis of gastric Helicobacter pylori infection: a systematic review and network meta-analysis.

This study aimed to conduct a network meta-analysis to compare the diagnostic efficacy of diverse novel endoscopic techniques for detecting gastric Helicobacter pylori infection. From inception to August 2023, literature was systematically searched across Pubmed, Embase, and Web of Science databases. Cochrane's risk of bias tool assessed the methodological quality of the included studies. Data analysis was conducted using the R software, employing a ranking chart to determine the most effective diagnostic method comprehensively. Convergence analysis was performed to assess the stability of the results. The study encompassed 36 articles comprising 54 observational studies, investigating 14 novel endoscopic techniques and involving 7,230 patients diagnosed with gastric H. pylori infection. Compared with the gold standard, the comprehensive network meta-analysis revealed the superior diagnostic performance of two new endoscopic techniques, Magnifying blue laser imaging endoscopy (M-BLI) and high-definition magnifying endoscopy with i-scan (M-I-SCAN). Specifically, M-BLI demonstrated the highest ranking in both sensitivity (SE) and positive predictive value (PPV), ranking second in negative predictive value (NPV) and fourth in specificity (SP). M-I-SCAN secured the top position in NPV, third in SE and SP, and fifth in PPV. After thoroughly analyzing the ranking chart, we conclude that M-BLI and M-I-SCAN stand out as the most suitable new endoscopic techniques for diagnosing gastric H. pylori infection. https://inplasy.com/inplasy-2023-11-0051/, identifier INPLASY2023110051.

Targeted delivery of a short antimicrobial peptide (CM11) against Helicobacter pylori gastric infection using concanavalin A-coated chitosan nanoparticles

Helicobacter pylori is the cause of most cases of stomach ulcers and also causes some digestive cancers. The emergence and spread of antibiotic-resistant strains of H. pylori is one of the most important challenges in the treatment of its infections. The present study aims to develop a concanavalin A (ConA) coated chitosan (CS) nanocarrier-based drug delivery for the targeted release of peptides to the site of H. pylori infection. Accordingly, chitosan was used as an encapsulating agent for CM11 peptide delivery by applying ionotropic gelation method. Con-A was used for coating CS nanoparticles to target H. pylori. The CS NPs and ConA-CS NPs were characterized by FTIR, dynamic light scattering (DLS), and scanning electron microscopy (SEM). The MIC of CM11-loaded ConA-CS NPs against H. pylori SS1 strain was analyzed in vitro. In order to evaluate the treatment efficiency in vivo, a gastric infection model of H. pylori SS1 strain was established in mice and histopathological studies and IL-1β cytokine assay were performed. Based on the results, the size frequency for CS NPs and ConA-CS NPs was about 200 and 350 nm, respectively. The prepared CM11-loaded ConA-CS NPs exhibited antibacterial activity against H. pylori SS1 strain with a concentration of 32 µg/ml. The highest healing process was observed in synthesized CM11-loaded ConA-CS NPs treatments and a significant decrease in IL-1β was observed. Our findings highlight the potential of chitosan nanoparticles as a drug delivery vehicle in the treatment of gastric infection model of H. pylori SS1 strain.Graphical

Successful treatment of coexisting membranous nephropathy and immune thrombocytopenia by eradicating gastric Helicobacter pylori infection: a case report

Membranous nephropathy (MN) is a common cause of nephrotic syndrome in middle-aged and older adults. MN etiology is mainly primary or idiopathic; however, it may also be secondary to infections, drugs, neoplasms, and autoimmune diseases. We present the case of a 52-year-old Japanese man with coexisting nephrotic MN and immune thrombocytopenic purpura (ITP). Renal biopsy revealed glomerular basement membrane thickening with immunoglobulin (Ig) G and complement component 3 deposition. Glomerular IgG subclass analysis revealed predominant IgG4 deposition with weak IgG1 and IgG2 deposition. IgG3 and phospholipase A2 receptor deposits were negative. Upper endoscopy revealed no ulcers, but histological examination demonstrated Helicobacter pylori infection in the gastric mucosa with elevated IgG antibodies. After gastric Helicobacter pylori eradication, the nephrotic-range proteinuria and thrombocytopenia of the patient were markedly improved without initiation of immunosuppressive treatment. Therefore, clinicians should consider the possibility of Helicobacter pylori infection in patients with coexisting MN and ITP. Further studies are required to demonstrate the associated pathophysiological aspects.

Gastrointestinal Talaromyces marneffei infection in a man with AIDS: A case report.

Reports of intestinal Talaromyces marneffei infection have increased year by year, but those of gastric infection remain rare. Here, we report disseminated talaromycosis with gastric and intestinal ulcers in an AIDS patient who was treated by antifungal agents and a proton pump inhibitor and achieved a satisfactory outcome. A 49-year-old man developed a gastrointestinal illness with main abdominal distension, poor appetite and a positive HIV infection to our AIDS clinical treatment center. Electronic gastrointestinal endoscopy showed that the patient had multiple ulcers in the gastric angle, gastric antrum and large intestine. Gastric Helicobacter pylori infection was ruled out by paraulcerative histopathological analysis and a C14 urea breath test. The diagnosis was confirmed by gastroenteroscopic biopsy and metagenomic next-generation sequencing of gastric ulcer tissue. Symptomatic and supportive treatments [a proton pump inhibitor and gastrointestinal motility promotion] were initiated. The patient was prescribed sequential antifungal therapy with amphotericin B (0.5 mg/kg·d, 2 weeks) and itraconazole (200 mg, q12h, 10 weeks), and then followed with itraconazole for long-term secondary prevention (200 mg, qd). The combined use of antifungal agents and a proton pump inhibitor improved the patient's condition, and he was discharged home 20 days later. He had no gastrointestinal symptom during 1 year of telephone-based follow-up. In endemic areas, clinicians should be alert to the possibility of Talaromyces marneffei infection presenting with gastric ulcers in patients with AIDS, after excluding Helicobacter pylori infection.

Detection of Helicobacter Pylori in Nasal Polyps: An Epidemiological Study

Many studies have described the detection of Helicobacter pylori (HP) in the nasal polyps; however, although gastroesophageal reflux has been associated with chronic rhinosinusitis and nasal polyps development, the role of HP remains unclear. Our aim was to describe the prevalence of HP detection in nasal polyps and its association with gastric HP infection and gastroesophageal reflux dsease (GERD). The prospective study involved 36 patients with nasal polyps, who underwent to endoscopic surgery removal of nasal polyps. Before surgical procedure all patients were tested for gastric HP infection by 13 C-urea breath test, while tissue samples from nasal polyps were tested for HP detection, using rapid urease test (CLO test) and histological examination with Giemsa stain. All patients were asked about GERD-related symptoms. HP in nasal polyps was detected in 9 out of 36 patients (25%) using histological examination with Giemsa stain, while the detection rate of HP was 30.5% (11/36) using CLO test. Furthermore, 28 out of 36 patients (77.7%) had gastric HP infection. All patients with HP colonization in nasal polyps had gastric HP infection and all patients with HP in nasal polyps reported symptoms related to GERD. HP was detected in approximately one out of three patients in nasal polyps, while all patients with HP detection in nasal polyps had concurrently gastric HP infection and reported GERD-related symptoms, suggesting a gastro-nasal route of HP.

Evaluation of Lipid Profile and Inflammatory Marker in Patients with Gastric Helicobacter pylori Infection, Ethiopia.

IntroductionH. pylori are gram-negative, microaerophilic helical-shaped bacteria with multiple flagella and commonly exist in the stomach. This infection may cause significant mucosal inflammation and damage, leading to ulcers in the stomach. It can also affect organ systems external to the gastrointestinal tract. To assess cardiovascular risk factors and to predict cardiovascular disorders, we are evaluating and comparing lipid profile and inflammatory marker between H. pylori-positive and negative patients.ObjectiveTo evaluate and compare lipid profile (TC; TG; LDL; HDL) and inflammatory marker (hs-CRP) in dyspeptic patients with and without H. pylori infection.MethodsComparative cross-sectional study was conducted from September 2020 to January 2021 at Debre Markos Referral Hospital, Debre Markos Health Center, and Hidassie Health Center, Ethiopia. Each of 50 H. pylori-positive and negative dyspeptic patients were studied. The data were checked for completeness and analyzed by SPSS version 25.0 Software. A p-value < 0.05 was considered statistically significant.ResultsSerum mean high-density lipoprotein (HDL) values were 37.54 ± 7.98 mg/dL and 43.12 ± 7.86 mg/dL (p < 0.05) for H. pylori-positive and negative dyspeptic patients, respectively, and median serum high sensitive C reactive protein (hs-CRP) levels were 6.29 mg/L (1.66–41.34) and 3.35 mg/L (0.39–10.01) (p < 0.05) for H. pylori-positive and negative dyspeptic patients, respectively.ConclusionH. pylori infection significantly alters serum high-density lipoprotein (HDL) and high sensitive C reactive protein (hs-CRP) levels in dyspeptic patients, as a result, increase the potential risk of cardiovascular diseases.

Research Progress of Jianpi Qushi Powder Combined with Standard Anti Hp Quadruple Therapy in the Treatment of Hp Infectious Gastritis with Spleen Deficiency and Dampness Stagnation

Stomach Helicobacter pylori infection is one of the common gastric diseases. Helicobacter pylori infectious gastritis of spleen deficiency and dampness stagnation is a relatively intractable chronic disease. In recent years, traditional Chinese medicine methods have emerged one after another in the treatment of gastric Helicobacter pylori infection. By collecting references, the author reviewed the clinical characteristics of gastric Helicobacter pylori infection and the new progress of traditional Chinese medicine treatment.

Interleukin-13 level accompanying with Helicobacter pylori gastric infection in Kirkuk city Abstract

Background: Helicobacter pylori recognized as the most common cause of chronic gastritis and an important pathogenic factor in peptic ulcer, after colonization and stomach mucus layers caused increase in the levels of anti-inflammatory cytokine such as IL-13.&#x0D; The aims of this study is compare of IL-13 levels among treated patients with H. Pylori gastric infection, patients with H. Pylori gastric infection without treatment and healthy person&#x0D; Materials and Methods: The study was conducted in Kirkuk city from the September 2020 to March 2020, ELISA test used for interleukin -13 with peptic ulcer diseases (PUD).&#x0D; Results: Elevated levels of IL-13 reported in patients with acute and chronic H. pylori gastric infection compared to control group (44.74+8.18). A moderate significant in IL-13 level determined in infected patients without treatment, previously treated patients (140.12+45.36 vs 105+22.71). While, there was a high significant difference when these two groups and compared with the control group (44.74+8.18)).&#x0D; Conclusion: IL-13 levels is highest in patients with H. pylori gastric infection in compare healthy person.

Higher Risk of Gastric Helicobacter pylori Infection in Patients with Periodontitis: A Nationwide Population-Based Retrospective Cohort Study in Taiwan.

Periodontitis is the most prevalent chronic inflammatory oral disease that is characterized by tooth loss and is commonly associated with several systemic inflammatory diseases. Some epidemiological studies suggest that those suffering from periodontitis might be at a greater risk of developing gastric Helicobacter pylori (Hp) infection; however, evidence that showing the association between periodontitis and the risk of gastric Hp infection is less clear. We conducted a large-scale, population-based study in Taiwan with a 13-year follow-up period to evaluate the risk of gastric Hp in a periodontitis patient cohort. To conduct this study, we used epidemiological data from the Taiwanese Longitudinal National Health Insurance Research Database (NHIRD) from 2000 to 2013. We selected 134,474 participants (64,868 males and 69,606 females with a minimum age of 20 years), with and without periodontitis, and matched patient cohort groups for age, sex, index year, and co-morbidities. The Cox proportional hazards regression model was used to examine the risk of gastric Hp infection in patients with periodontitis. Patients with periodontitis exhibited a higher risk of developing gastric Hp infection compared to those individuals/groups without periodontitis (1.35 vs. 0.87 per 1000 person-years, adjusted the hazards ratio (aHR 1.52), and 95% confidence intervals (CIs) 1.38–1.67, p < 0.001). The risk of gastric Hp infection persisted even after stratifying by age (aHR = 1.96 (1.79–2.13) for 50–64 years and 1.70 (1.49–1.94) for ≥65 years), gender (aHR = 1.20 (1.11–1.29) for men), and presence of comorbidities of hypertension (aHR = 1.24 (1.11–1.38)), hyperlipidemia (aHR = 1.28 (1.14–1.42)), COPD (aHR = 1.45 (1.31–1.61)), CLD (aHR = 1.62 (1.47–1.77)) and CKD (aHR = 1.44 (1.04–1.99)). Overall, our findings showed that periodontitis patients have a greater risk for gastric Hp than individuals without periodontitis. Clinicians should perform regular good oral hygiene practices, along with newer treatments, for patients with periodontitis, especially those at higher risk of gastric Hp infection.

Periodontitis and Helicobacter pylori Infection: Eradication and Periodontal Therapy Combination.

Objectives This study was aimed to assess (1) the prevalence of salivary and gastric Helicobacter pylori (HP) infection in patients with and without periodontitis, (2) the prevalence of HP infection in patients with periodontitis according to its clinical classification, (3) the effect of periodontitis treatment in patients with or without gastric HP infection, and (4) if gastric HP eradication in combination with periodontitis treatment influences periodontitis clinical outcome. Materials and Methods Thirty-three adults with periodontitis treated by quadrant scaling and root planning (QSRP). The simplified plaque index (PI), bleeding on probing index (BOP), probing pocket depth (PPD), and clinical attachment level (CAL) were assessed pretreatment and 3 months of posttreatment. The patients were tested for oral and gastric HP. Gastric HP (+) patients received eradication therapy. A control group of 32 periodontically healthy volunteers was tested for oral and gastric HP. Saliva samples were evaluated by real-time polymerase chain reaction (rtPCR); gastric HP was detected by urea breath test (UBT). Statistical Analysis Normality of variables assessed by the Kolmogorov–Smirnov test, while the differences of pre- and post-treatment were analyzed by paired samples t -test. Differences between subgroups were compared by a Student’s t -test or a Mann–Whitney U -test. Comparisons of nominal variables were made by Pearson’s Chi-square test. Results No saliva samples were positive for HP. Gastric HP was detected in six patients with periodontitis and seven controls ( p > 0.05). HP infection affected patients with higher disease stages and grades. All HP (+) patients underwent successful eradication treatment. All clinical periodontitis indices improved following QSRP. HP (+) patients who received QSRP as adjunctive to eradication treatment showed improvement in BOP ( p < 0.001), PI ( p < 0.013), and CAL ( p < 0.004) compared with HP (−) patients who received QSRP alone. Conclusion Periodontitis was not associated with gastric HP infection. Saliva was not a gastric HP supply reservoir. Gastric HP infection was associated with advanced stages and grades of periodontitis. Although all periodontal clinical markers improved after QSRP, BOP, PI, and CAL, they were further improved when combined with eradication treatment. Periodontal evaluation and treatment combined with HP eradication are recommended in patients with HP gastric infection.

Relationship of Halitosis with Gastric Helicobacter Pylori Infection

Background: Halitosis is a common human condition; however, the pathophysiological mechanism of halitosis is still unclear. Halitosis is mostly attributed with oral pathological conditions, in addition, halitosis resulting from gastrointestinal disorders is not rare either. Halitosis is often reported with symptoms related to Helicobacter pylori infection, epigastric pain and gastroesophageal reflux disease. Objective: Halitosis can stem from a number of gastric conditions and one of the most common causes of halitosis include the presence of a gastric infection with Helicobacter pylori. This study was conducted to evaluate the incidence ofhalitosis in patients presenting with Helicobacter pylori infection and epigastric pain. Additionally, to review whether there is a correlation between H pylori infection and halitosis; moreover, to determine whether halitosis is a valid indication for H pylori infection. Methods and Materials: This case control, comparative study was done at Medicine department of Isra University hospital and Civil hospital, Karachi during the period of January 2019 to December 2019. Participants were enrolled only after taking verbal and signed consent. Prior permission from the hospital management was taken as well. Result: Halitosis and H pylori are statistically significant with p value of 0.026. There was a clear correlation between halitosis and H pylori infection, and it may be a common contributor to halitosis.

Efficacy of immunohistochemical staining in detecting Helicobacter pylori in Saudi patients with minimal and atypical infection.

Gastric Helicobacter pylori infection is diagnosed based on histopathological evaluation of gastric mucosal biopsies, urease test, urea breath test, H. pylori culturing, or direct detection using polymerase chain reaction (PCR). This study aimed to evaluate the efficacy of immunohistochemical (IHC) staining in detecting H. pylori in gastric biopsies from patients with chronic gastritis and minimal or atypical infection. Gastric biopsies from 50 patients with chronic gastritis were subjected to routine haematoxylin and eosin (H&E), modified Giemsa, and IHC staining. The results of staining were compared with those of quantitative real-time PCR (qRT-PCR). The qRT-PCR analysis identified 32 (64%) H. pylori-positive cases, whereas IHC, H&E, and modified Giemsa staining identified 29 (58%), 27 (54%), and 21 (42%) positive cases. The sensitivity of IHC staining (87.50%) was higher than that of H&E (59.38%) and modified Giemsa (43.75%) staining. The specificity of H&E, modified Giemsa, and IHC staining was 55.56%, 61.11%, and 94.44%, respectively. IHC staining exhibited the highest diagnostic accuracy (90%), followed by H&E (58%) and modified Giemsa (50%) staining. Active gastritis, intestinal metaplasia, and lymphoid follicles were detected in 32 (64%), 4 (8%), and 22 (44%) cases, respectively, and all of these cases were H. pylori positive. In contrast to routine H&E and modified Giemsa staining, IHC allows for the accurate H. pylori detection in cases with minimal or atypical infection. Moreover, IHC can be an alternative diagnostic method to qRT-PCR for detection of H. pylori in such cases.

Fetal Sacrococcygeal Teratoma and the Development of Hydrops.

* Abbreviations: CVO: : combined ventricular output DVP: : deepest vertical pocket EXIT: : ex utero intrapartum therapy FTC: : Fetal Treatment Center MCA: : middle cerebral artery MRI: : magnetic resonance imaging NTD: : neural tube defect PPROM: : preterm premature rupture of membranes RFA: : radiofrequency ablation SCT: : sacrococcygeal teratoma TFR: : tumor volume–to–fetal weight ratio UCSF: : University of California, San Francisco A large sacrococcygeal teratoma (SCT) was detected on routine 18-week fetal ultrasonography in a 26-year-old, gravida 2, para 0 woman. She had a history of Helicobacter pylori gastric infection and an ovarian cyst, in addition to a previous spontaneous abortion at 15 weeks’ gestation. This pregnancy had been uncomplicated and prenatal laboratory testing was unremarkable. She was evaluated at an outside fetal care center at 21 weeks’ gestation. At that time, the fetal SCT measured 5.9×5.3 cm of mixed solid and cystic components, about 30% to 50% of the fetal size. Given the size of the SCT, with interval growth from initial diagnosis, she was referred to the University of California, San Francisco (UCSF) Fetal Treatment Center (FTC) to discuss the options for fetal surgical intervention. The woman was seen at the UCSF FTC at 23 weeks’ gestation. Imaging at that time included fetal ultrasonography and fetal echocardiography. Ultrasonography (Fig 1) demonstrated a largely exterior SCT with a small, presacral component. The tumor was largely solid with small cystic components and classified as an SCT type 1 lesion. The dimensions were 11.6×10.5×9.6 cm with an estimated volume of 611 mL, about 87% of the fetal size. There was no evidence of polyhydramnios, with the deepest vertical pocket (DVP) at 7.7 cm. Fetal echocardiography showed normal cardiac anatomy with significant dilation of the inferior vena cava and mild cardiomegaly with a cardiothoracic ratio of 0.36. The combined ventricular output (CVO) was significantly elevated at 817 mL/kg per minute (upper limit of normal is 500 mL/kg per minute). Diastolic flow velocity in the umbilical artery (systolic-to-diastolic velocity ratio of 6.2) was low, possibly secondary to a “steal phenomenon” to the tumor. The middle cerebral artery (MCA) diastolic flow velocity was also low, suggestive of cerebral vasodilation to maintain cerebral blood flow (brain-sparing). …

Current Prevalence of Oral Helicobacter pylori among Japanese Adults Determined Using a Nested Polymerase Chain Reaction Assay.

In Japan, gastric Helicobacter pylori infection prevalence has markedly decreased with socioeconomic development. We aimed to investigate the prevalence of oral H. pylori in Japanese adults in 2020 by sex, age, sampling site, and medical history. Unstimulated saliva, supragingival biofilm, and tongue coating were obtained from 88 subjects–with no complaints of upper digestive symptoms–attending a dentist’s office for dental check-up or disorders. Supragingival biofilm was collected from the upper incisors, lower incisors, upper right molars and lower left molars to analyze the characteristic distribution. Oral H. pylori was detected using nested polymerase chain reaction. Oral H. pylori prevalence did not statistically differ by sex or age. Supragingival biofilm (30.7%) was the most common oral H. pylori niche; it was also detected in 4.5% of saliva and 2.3% of tongue samples. The lower incisor was the most common site among the supragingival biofilm samples, followed by the upper incisors, lower left molars, and upper right molars. Oral H. pylori DNA was frequently detected in patients with a history of gastric H. pylori infection. Oral H. pylori has a characteristic distribution independent of sex and age, suggesting that it is part of the normal microflora in the adult oral cavity.

Efficacy of quadruple regimen with polaprezinc for gastric Helicobacter pylori infection eradication: protocol for a single-centre, single-blind, non-inferiority, randomised clinical trial

IntroductionHelicobacter pylori (H. pylori) is the most well-known risk factor for gastric cancer. At present, H. pylori shows varying levels of resistance to different treatments, leading to a lower rate...

Helicobacter pylori gastric infection in patients with laryngeal cancer and chronic laryngitis.

The purpose of this study was to investigate the pathohistological status of mucous lining infected with Helicobacte pylori as the possible cause of chronic laryngitis and laryngeal carcinoma. The prospective examination included 51 patients suffering from planocellular laryngeal cancer and 26 examinees suffering from chronic laryngitis. The examinees and the control group were subjected to esophagogastroduodenoscopy which described the local status of the esophagus and stomach. Two biopsy samplings are taken from the stomach antrum and corpus. One part of the biopsies was colored using the histological technique used in the pathohistological detection of H. pylori, while the other part was incorporated in paraffin cubes where the H. Pylori gene expression was determined using the deparaffinization and PCR method DNA isolation. In the group of examinees suffering from laryngeal tumor, there were a higher number of patients suffering also from chronic gastritis (32/51) than in the other group, suffering from chronic laryngitis (9/26). In the chronic laryngitis group, there were more examinees with acute gastritis (12/26) than in the examined group (11/51). The difference is statistically significant (p = 0.0457). Chronic gastritis and H. pylori infection are risk factors for laryngeal carcinoma formation; therefore, acute gastritis with helicobacter pylori infection must be immediately treated to not let infection to become chronic.

Impact of gastric Helicobacter pylori infection on nasal mucociliary clearance.

This study aimed to investigate the relationship between the presence of gastric Helicobacter pylori (HP) infection and nasal mucociliary clearance (NMC) time and to analyze the effect of HP eradication on NMC time. Patients who underwent gastric biopsy and had a positive result for HP constituted the study group, while the control group consisted of the patients who had a negative biopsy result. Two groups were compared in terms of NMC times. Quadruple medication therapy was given to HP-positive patients for 14days for eradication and NMC time was measured again in these patients 8weeks after eradication. Statistical analyses were performed with SPSS software (version 22.0; SPSS, Chicago, Illinois, USA). There were 60 patients in the study group (HP +), while the control group (HP-) included 50 patients. Mean NMC times were 12.86 ± 2.62 and 8.32 ± 2.24 for the study and control groups, respectively (p < 0.001). Pre- and post-eradication mean NMC times of the HP + patients were 12.71 ± 2.58 and 8.62 ± 1.39, respectively (p < 0.001). We determined that NMC time was significantly higher in HP-positive patients when compared with HP-negative patients, and the NMC times went back to normal after eradicating the HP infection. Because NMC dysfunction plays an essential role in the pathogenesis of chronic rhinosinusitis (CRS), we propose that eradication of HP can have positive effects on the prognosis of CRS. Further studies are needed to establish this relationship.

Associations between gastric histopathology and the occurrence of colonic polyps.

Compromise of the gastric acid barrier may facilitate bacterial invasion of the lower intestinal tract and promote the development of colonic neoplasia. Our study aimed to test the associations between histopathological abnormalities of the upper and lower gastrointestinal tract in patients undergoing bidirectional endoscopy. The Inform Diagnostics database is a national electronic repository of histopathological records of patients distributed throughout the USA. A case-control study of 302061 patients, 163168 of whom had colonic polyps, evaluated whether the occurrence of colonic polyps was influenced by the presence of the following gastro-oesophageal diagnoses: gastric Helicobacter pylori infection, gastric intestinal metaplasia, fundic gland polyps and gastric hyperplastic polyps. The influence of individual diagnoses on the occurrence of colonic polyps was expressed as odds ratios with their 95% confidence intervals. The odds ratio for tubular adenomas being associated with gastric H.pylori was 1.53 (1.49-1.58), with intestinal metaplasia 1.65 (1.59-1.71), with fundic gland polyps 1.49 (1.45-1.54) and with gastric hyperplastic polyps 1.85 (1.75-1.96). The odds ratio for sessile serrated polyps being associated with gastric H.pylori was 1.03 (0.96-1.10), with intestinal metaplasia 1.21 (1.13-1.30), with fundic gland polyps 1.79 (1.69-1.89) and with gastric hyperplastic polyps 1.52 (1.35-1.71. A diminished gastric acid barrier function, which occurs in various upper gastrointestinal diseases associated with lowered gastric acid output, may promote the development of colonic neoplasia.

Analysis of serum gastric function and Helicobacter pylori infection in patients with gastric hyperplastic polyps and gastric fundic gland polyps

Objective To analyze the serum gastric function and Helicobacter pylori (HP) infection in patients with gastric hyperplastic polyps and gastric fundic gland polyps. Methods From December 2017 to December 2018, 135 patients with gastric polyps and pathologically confirmed gastric hyperplastic polyps and gastric fundic gland polyps were enrolled in the hospital of Xuzhou Medical University.Among them, 68 patients with hyperplastic polyps, 67 cases of the gastric fundic gland polyps.Serum Hp antibodies (UreA, UreB, VacA, CagA antibodies) were qualitatively detected by immunoblotting.Eighty patients with chronic superficial gastritis were selected as the control group.Three groups of serum pepsinogen-I (PG-I), pepsinogen-Ⅱ (PG-Ⅱ), gastrin were detected by enzyme-linked immunosorbent assay (ELISA). Gastrin-17(G-17) and calculate PGⅠ and PGⅡ ratio(PGR). Results The levels of serum PGⅡ (13.13(8.15, 20.30) μg /L) and G17 (8.44(3.72, 27.17) pmol/L) in the gastric hyperplastic polyp group were higher than those in the control group (9.16(5.56, 15.14) μg/L and 1.83(0.87, 5.95) pmol/L) (P<0.05), and the PGR level was lower than the control group (P<0.05); serum PGI (120.12(86.72, 174.70) μg/L), PGII (11.92(7.27, 22.26) μg/L), G17 (5.68(1.79, 14.65) pmol/L) in the gastric fundic gland polyp group was higher than the control group ((101.32(79.17, 131.33) μg /L, 9.16(5.56, 15.14) μg /L, 1.83(0.87, 5.95) pmol/L)(P均<0.05)) (P<0.05); serum G17 (8.44(3.72, 27.17) pmol/L) level in gastric hyperplastic polyp group was higher than gastric fundus polyp group (5.68(1.79, 14.65) pmol/L) (P<0.05); Hp infection rate in gastric hyperplastic polyp group61.76%(42/68)was higher than that in the gastric fundic gland polyp group40.30%(27/67) (P<0.05), and type I Hp was the main one (P<0.05). The serum PGⅡ and G17 levels in the gastric hyperplastic polyp group were higher than those of Hp negative (all P<0.05). There were no significant differences in serum PGI, PGⅡ, G17, and PGR levels between the HP-positive and negative-positive patients in the gastric fundus polyp group.The serum PGI and PGR levels in the hypertrophic polyp group were higher than those in the HPⅡ type (all P<0.05). There was no significant difference in the levels of serum PGⅠ, PGⅡ, G17, and PGR between the gastric fundic gland polyps group and the type Ⅱ. Conclusion Serum PG and G17 levels in patients with gastric hypertrophic polyps and gastric fundic gland polyps are higher than those in patients with chronic superficial gastritis.Patients with gastric hyperplastic polyps have higher HP infection rate and abnormal gastric function than gastric fundic gland polyps. Key words: Gastric hyperplastic polyp; Gastric fundus polyp; Helicobacter pylori; pepsinogen; Gastrin

Development and Evaluation of Amoxicillin Loaded Carbopol 934P Mucoadhesive Microcapsules for Sustained Drug Release for H. pylori Treatment

Amoxicillin (α-amino-p-hydroxybenzyl-penicillin) is a semi-synthetic, orally absorbed and widely prescribed β-lactam antibiotic. It is now widely used for eradication of gastric Helicobacter pylori infection combined with a second antibiotic and an acid‐suppressing agent despite its short elimination half-life of one hour. The purpose of this study was to develop and evaluate amoxicillin loaded carbopol 934P mucoadhesive microcapsules for sustained drug release at the gastric mucosa to prolong the residence time of dosage form in the stomach and to achieve controlled drug release for more effective H. pylori eradication. Amoxicillin mucoadhesive microcapsules were formulated by ion gelation technique using 32 factorial designs. A 32 full factorial design was used to derive the statistical equation, ANOVA analysis, contour plots and 3D response surface plots. FT- IR (4000 cm-1- 450 cm-1) analysis of amoxicillin and with polymers was performed by using potassium bromide pellet method. Different polymer ratios of carbopol 934P and sodium alginate were used to formulate by nine formulations (F1 to F9) amoxicillin mucoadhesive microcapsules. The prepared formulations were characterized by determining their percentage of yield, particle size, percentage of entrapment efficiency, swelling index, percentage of mucoadhesion and percentage of drug release. Amoxicillin and used polymers are found to be compatible with no interaction reported by FTIR analysis. The optimized formulation (F9) exhibited a high drug entrapment efficiency of 96.04±0.03%, particle size of 847.2518±0.06 μm, yield of 98.86±0.01%, swelling index of 120.09±0.06%, and mucoadhesion of 67.00±0.02 after 8 h. A successful sustained drug release was achieved for more than 14 h. In-vitro dissolution test for optimized formulation (F9) demonstrated a slower release behavior in 0.1N hydrochloric acid followed by linear release profile in pH 7.4 phosphate buffer. The drug-to-polymer-to-polymer ratio had a more significant effect on the dependent variables. The release kinetic study of optimized formulation (F9) displayed a good fitting with zero order behavior and Korsmeyer-Peppas model has confirmed a non-Fickian release. The developed mucoadhesive amoxicillin microcapsules were observed to have adhered strongly with gastric mucosa with approximately 14 h of prolonged stay expecting improved bioavailability and reduced dosing frequency and subsequently improving patient’s compliance. The concentration of carbopol 934P and sodium alginate had highly significant effects on depended variables. The present study concludes that amoxicillin mucoadhesive microcapsules can be effectively used for the more effective treatment of H. pylori infection.