Helicobacter Pylori-associated Gastritis Research Articles

A novel endoscopic artificial intelligence system to assist in the diagnosis of autoimmune gastritis: a multicenter study.

Autoimmune gastritis (AIG), distinct from Helicobacter pylori-associated atrophic gastritis (HpAG), is underdiagnosed due to limited awareness. This multicenter study aims to develop a novel endoscopic artificial intelligence (AI) system assisting in AIG diagnosis. Patients diagnosed with AIG, as well as HpAG and non-atrophic gastritis (NAG), were retrospectively enrolled from six centers. Endoscopic images with relevant demographic and medical data, were collected for the development of AI-assisted system, SEER-SCOPE AI, based on multi-site feature fusion model. The diagnostic performance of SEER-SCOPE AI was evaluated in the internal and external datasets. Endoscopists' performance with and without AI support was tested and compared using Mann-Whitney U test. Heatmap analysis was performed to interpret SEER-SCOPE AI. 1 070 patients (294 AIG, 386 HpAG, 390 NAG) with 18 828 endoscopy images were collected. SEER-SCOPE AI achieved strong performance for identifying AIG, with 96.9% sensitivity, 92.2% specificity and an AUROC of 0.990 internally, and 90.3% sensitivity, 93.1% specificity and an AUROC of 0.973 externally. The performance of SEER-SCOPE AI (sensitivity 91.3%) was comparable to experts (87.3%) and significantly outperformed non-experts (70.0%). With AI support, the overall performance of endoscopists was improved (sensitivity: 90.3% [95% CI 86.0%-93.2%] vs. 78.7% [95% CI 73.6%-83.2%], p=0.008). Heatmap analysis revealed consistent focus of SEER-SCOPE AI on regions corresponding to atrophic areas. SEER-SCOPE AI demonstrated expert-level performance in identifying AIG, and enhanced the diagnostic ability of endoscopists. Its application holds promise as a potent endoscopy-assisted tool for guiding biopsy sampling and early detection of AIG.

γH2AX as an Indicator for DNA Double-Strand Breaks in Helicobacter pylori-Associated Chronic Gastritis among Jordanian Patients: A Retrospective Study

Background and Aims: Serine 139 phosphorylation of H2AX (γH2AX) is a biomarker for an early response to DNA double-strand breaks (DSB) and to monitor DNA damage and resolution. This study aimed to measure the rate of γH2AX expression associated with H. pylori infection in Jordanian patients with chronic gastritis. Materials and Methods: A retrospective case-control study was designed to evaluate the rate of γH2AX expression in the epithelium of gastric tissue in subjects chronically infected with H. pylori. A total of 75 gastric biopsy samples embedded in paraffin were chosen from the library, including 50 samples with chronic H. pylori infection and 25 negative samples for H. pylori and any other gastric pathologies. PCR and immunohistochemistry were used to confirm the diagnosis of H. pylori-infected and noninfected gastric biopsies, and the rate of γH2AX formation was analyzed in the mucosa using immunohistochemical staining analyses. Results: PCR and immunohistochemistry proved H. pylori infection in the gastric biopsies of diseased patients (n = 50) and the absence of H. pylori infection in negative samples (n = 25). A strong nuclear signal of γH2AX was detected in the positive samples using immunohistochemistry compared to the undetected signal in the noninfected samples of the gastric mucosa. Conclusion: Our findings show that H. pylori infection is accompanied with high levels of DSBs. This may play a role in the increased risk for tumor initiation associated with H. pylori carriage.

Expression of cytokeratin 7/20 and Ki67 in Helicobacter pylori-associated gastritis and intestinal metaplasia.

Cytokeratins (CKs) have been associated with precancerous and cancerous gastric lesions in patients with Helicobacter pylori-associated chronic gastritis, making them useful for diagnosing epithelial tumors. A retrospective study was conducted utilizing 200 formalin-fixed paraffin-embedded gastric biopsy samples collected from the lesser curvature of the stomach. Samples from the control group, patients with H. pylori infection, and patients with H. pylori-associated gastritis, with complete and incomplete intestinal metaplasia (IM) were immunostained. Monoclonal antibodies were utilized to determine the expression of CK7, CK20, and Ki-67. Patients infected with H. pylori had strong CK20 expression on the surface, and weak CK7 expression on the surface and deep glands; while non-specific chronic gastritis patients had weak focal CK7 expression and strong CK20 expression. The normal gastric mucosa of patients in the control group had relatively weak CK7 expression, restricted to a few cells in the neck and deep glands. CK20 showed diffuse strong reactivity on the surface. On the other hand, patients with complete IM showed a CK7 staining pattern that was either negative or weakly focal on the surface and crypts associated with diffuse surface CK20 and focal crypt staining corresponding to gastric type IM. The Ki67 proliferating index was low (≤ 15%) in H. pylori infected patients, high (> 30%) in patients with incomplete IM, and intermediate (16-30%) in patients with complete IM. These results indicate a significant link between the expressions of CK7/CK20 and Ki67 in patients afflicted with H. pylori and IM.

Investigating the mechanism of Banxia Xiexin Decoction in treating Helicobacter pylori-associated chronic atrophic gastritis through network pharmacology and molecular docking

ObjectiveThe aim of this study was to investigate the mechanism of Banxia Xiexin Decoction in treating Helicobacter pylori (HP)-associated chronic atrophic gastritis (CAG) using network pharmacology methods. MethodsDifferential genes between HP-associated CAG and healthy individuals were screened from the Gene Expression Omnibus (GEO) database using high-throughput gene expression data. The compounds and targets of Banxia Xiexin Decoction were obtained from the Traditional Chinese Medicine Systems Pharmacology (TCMSP) database. ResultsThrough screening, 217 differentially expressed genes were obtained. Banxia Xiexin Decoction contained a total of 211 active components corresponding to 258 target genes. Nine key targets, including DPP4, SLC6A4, CYP3A4, HMOX1, MGAM, MTTP, APOB, UGT1A1, and CASP1, were identified. The enrichment analysis showed that Banxia Xiexin Decoction exerted its therapeutic effects on HP-associated CAG by participating in biological processes such as energy metabolism, oxidative reactions, cell apoptosis, anti-inflammatory response, and immune response, as well as regulating drug metabolism processes, heme and chlorophyll metabolism, steroid hormone biosynthesis, and retinol metabolism pathways. ConclusionThe main active components of Banxia Xiexin Decoction are quercetin, ellagic acid, and genistein, and it exerts its therapeutic effects on HP-associated chronic atrophic gastritis through a mechanism involving multiple components, targets, and pathways.

Course of Helicobacter pylori-associated gastritis in adolescents with hypovitaminosis D

Introduction. The multifactorial nature of the occurrence and phasing of inflammatory changes in the gastric mucosa determine the need to search for conditions that can affect the slowing of the progression of gastritis in children.
 Aim: to determine the manifestations of Helicobacter pylori-associated antrum gastritis in adolescents with hypovitaminosis D.
 Material and methods. Ninety three 12–17 years adolescents with a morphologically confirmed diagnosis of gastritis were exa­mined. The content of vitamin D in the blood was determined using the ELISA method. Adolescents were divided into groups depending on the level of vitamin D supply and the period of solar insolation at the time of the examination. 
 Results. H. pylori infection in adolescents with hypovitaminosis D had a pronounced tendency to increase — 75% (53.6% in child­ren with sufficient vitamin D levels; p = 0.067).
 The frequency of H. pylori among adolescents examined during low solar insolation was higher than during high solar insolation (p = 0.015). During the period of low solar insolation, the highest rates of H. pylori infection in children were found among adolescents with vitamin D deficiency (88.2% compared to 62.1% among children with a normal vitamin D supply; p = 0.057). During the period of high insolation, H. pylori infection was approximately the same (p = 0.82).
 Antral gastritis with high activity was predominantly detected in adolescents infected with H. pylori and its frequency did not depend on the level of vitamin D in the blood.
 Conclusion. Hypovitaminosis D is associated with H. pylori-associated gastritis, characterized by greater activity of the inflammatory process and has a clear relationship with the intensity of solar insolation.

Chronic atrophic gastritis: focus on diagnosis

Currently, chronic atrophic gastritis is a risk factor for the development of gastric cancer. Data on the prevalence of chronic atrophic gastritis in Russia and the world are limited. Among the adult population of St. Petersburg aged 21 to 81 years, the prevalence of histologically verified chronic atrophic gastritis is 5.3%. Moreover, the chances of developing chronic atrophic gastritis in people over the age of 60 years compared to the group of 45–59 years are 2.5 times higher (95% confidence interval 1.5–4.1).
 Morphological verification of the Operative Link for Gastritis Assessment diagnosis is not carried out in clinical practice in most cases. However, this method remains the most reliable method for timely verification of chronic atrophic gastritis, including chronic atrophic gastritis of mixed origin (autoimmune gastritis and Helicobacter pylori-associated gastritis), especially in the case of a seronegative variant of autoimmune gastritis.
 Also, in addition to the heterogeneity of epidemiological data on chronic atrophic gastritis, there is disagreement about how to confirm its etiology as well as about the correlation of serological markers of atrophy and histological stage.

Принципы диагностики хронического гастрита, ассоциированного с патологическим дуоденогастральным рефлюксом: серия клинических наблюдений

In recent years in the structure of the incidence of chronic gastritis, there has been a decrease in the proportion of Helicobacter pylori-associated gastritis, but the contribution of other etiological factors is increasing. In addition to H. pylori, one of the most frequently diagnosed gastritis in real clinical practice is chemical gastritis, associated with the development of pathological duodenogastric reflux. The increase in prevalence makes the issue of diagnosing biliary gastritis relevant. This publication was prepared with the aim of systematizing and analyzing available data on the incidence, risk factors, mechanisms of formation, as well as clinical, endoscopic and pathomorphological signs of biliary gastritis and is illustrated by a series of observations from real clinical practice.

Marked intestinal trans-differentiation by autoimmune gastritis along with ectopic pancreatic and pulmonary trans-differentiation

BackgroundAutoimmune gastritis (AIG) is a prevalent chronic inflammatory disease with oncogenic potential that causes destruction of parietal cells and severe mucosal atrophy. We aimed to explore the distinctive gene expression profiles, activated signaling pathways, and their underlying mechanisms.MethodsA comprehensive gene expression analysis was conducted using biopsy specimens from AIG, Helicobacter pylori-associated gastritis (HPG), and non-inflammatory normal stomachs. Gastric cancer cell lines were cultured under acidic (pH 6.5) conditions to evaluate changes in gene expression.ResultsGastric mucosa with AIG had a unique gene expression profile compared with that with HPG and normal mucosa, such as extensively low expression of ATP4A and high expression of GAST and PAPPA2, which are involved in neuroendocrine tumorigenesis. Additionally, the mucosa with AIG and HPG showed the downregulation of stomach-specific genes and upregulation of small intestine-specific genes; however, intestinal trans-differentiation was much more prominent in AIG samples, likely in a CDX-dependent manner. Furthermore, AIG induced ectopic expression of pancreatic digestion-related genes, PNLIP, CEL, CTRB1, and CTRC; and a master regulator gene of the lung, NKX2-1/TTF1 with alveolar fluid secretion-related genes, SFTPB and SFTPC. Mechanistically, acidic conditions led to the downregulation of master regulator and stemness control genes of small intestine, suggesting that increased environmental pH may cause abnormal intestinal differentiation in the stomach.ConclusionsAIG induces diverse trans-differentiation in the gastric mucosa, characterized by the transactivation of genes specific to the small intestine, pancreas, and lung. Increased environmental pH owing to AIG may cause abnormal differentiation of the gastric mucosa.

Helicobacter pylori-associated Chronic Atrophic Gastritis and Progression of Gastric Carcinogenesis.

Chronic inflammation due to a Helicobacter pylori (H. pylori) infection is a representative cause of gastric cancer that can promote gastric carcinogenesis by abnormally activating immune cells and increasing the inflammatory cytokines levels. H. pylori infections directly cause DNA double-strand breaks in gastric epithelial cells and genetic damage by increasing the enzymatic activity of cytidine deaminase. Eventually, gastric cancer is induced through dysplasia. Hypermethylation of tumor suppressor genes is an important cause of gastric cancer because of a H. pylori infection. In addition, the changes in gastric microbiota and the mucosal inflammatory changes associated with a co-infection with the Epstein-Barr virus are associated with gastric cancer development. DNA damage induced by H. pylori and the subsequent responses of gastric stem cells have implications for gastric carcinogenesis. Although the pathogenesis of H. pylori has been established, many uncertainties remain, requiring more study.

Characteristics of Immune Checkpoint Inhibitor-Associated Gastritis: Report from a Major Tertiary Care Center.

Immune checkpoint inhibitors (ICIs) have increased our ability to treat an ever-expanding number of cancers. We describe a case series of 25 patients who were diagnosed with gastritis following ICI therapy. This was a retrospective study involving 1712 patients treated for malignancy with immunotherapy at Cleveland Clinic from January 2011 to June 2019 (IRB 18-1225). We searched electronic medical records using ICD-10 codes for gastritis diagnosis confirmed on endoscopy and histology within 3 months of ICI therapy. Patients with upper gastrointestinal tract malignancy or documented Helicobacter pylori-associated gastritis were excluded. Twenty-five patients were found to meet the criteria for diagnosis of gastritis. Of these 25 patients, most common malignancies were non-small cell lung cancer (52%) and melanoma (24%). Median number of infusions preceding symptoms was 4 (1-30) and time to symptom onset 2 (0.5-12) weeks after last infusion. Symptoms experienced were nausea (80%), vomiting (52%), abdominal pain (72%), and melena (44%). Common endoscopic findings were erythema (88%), edema (52%), and friability (48%). The most common diagnosis of pathology was chronic active gastritis in 24% of patients. Ninety-six percent received acid suppression treatment and 36% of patients also received steroids with an initial median dose of prednisone 75 (20-80) mg. Within 2 months, 64% had documented complete resolution of symptoms and 52% were able to resume immunotherapy. Patients presenting with nausea, vomiting, abdominal pain, or melena following immunotherapy should be assessed for gastritis and if other causes are excluded, may require treatment as consideration for complication of immunotherapy.

Oral and physiological benefits of cranberries

Cranberries are known to prevent urinary tract infection and it is also helpful in maintaining oral health. Cranberry juice is a widely consumed and recommended beverage for preventing urinary tract infections. Clinical studies in women have shown that cranberries help to stop the recurrence of infection, as the evidence showed the presence of various extracts of cranberries in the patients’ urinary tracts, proving the effectiveness and the mechanism. The primary compound involved in the fight against the infection is Proanthocyanidin A which is now the focus of studies to treat common diseases such as Helicobacter pylori-associated gastritis, as well as dental caries and periodontal disease, from which it is speculated the mechanism involves disrupting the bacterial adhesion.

Evaluation of the dynamics of symptoms of dyspepsia after eradication therapy in patients with Helicobacter pylori-associated gastritis

The treatment of functional dyspepsia remains a complex and incompletely resolved issue of gastroenterology. Subjective sensations of the patient, described as a feeling of fullness in the epigastrium after eating, early satiety, pain in the epigastrium, may be a manifestation of dyspepsia associated with Helicobacter pylori (H. pylori) infection. Aim was evaluation of the effectiveness of standard triple eradication therapy enhanced with bismuth tripotassium dicitrate for the relief of symptoms of dyspepsia in patients with H. pylori-associated chronic gastritis. Materials and Methods. The study involved 38 patients with H. pylori-associated chronic gastritis with symptoms of dyspepsia. The Questionnaire “7 × 7” was used to describe the dynamics of symptoms of dyspepsia. Results. At the initial examination, dyspeptic disorders in most patients corresponded the criteria for mild and moderate severity, respectively - 44.7% and 28.9% of patients. The severity of pain in the stomach area on average corresponded to a moderate pain syndrome, and the burning sensation was of low intensity. A feeling of fullness in the stomach after eating and/or early satiety was experienced by 76.3% of patients, pain disorders were observed in 92.1% of individuals. Two months after successful eradication treatment, complete relief of dyspepsia symptoms was noted in 57.9% of patients, and significant relief of symptoms of the combined form of dyspepsia in 23.7% of individuals. Conclusions: Successful standard triple eradication therapy enhanced with bismuth tripotassium dicitrate is effective for the treatment of dyspeptic symptoms in patients with H. pylori-associated chronic gastritis.

Concurrent Sarcina ventriculi infection in a patient with Helicobacter pylori-associated chronic gastritis: A case report

Abstract Sarcina ventriculi is a Gram-positive, nonmotile, chemo-organotrophic anaerobic organism, which is rare in humans. Although its role as a pathogen in humans remains poorly characterized, it has been associated with delayed gastric emptying, emphysematous gastritis, and gastric perforation in existing literature. The index case was a 34-year-old male who presented with a history of abdominal pain, 1-month history of frequent vomiting, bloating, and abdominal distension. He was evaluated for gastric-outlet obstruction secondary to a possible gastric tumor. Upper gastrointestinal endoscopy showed a stomach that is filled with food debris, hyperemia, and deformed pylorus but no mass was seen. Histology of a mucosal biopsy sample showed active antral predominant gastritis with concurrent H. pylori and S. ventriculi infections. A repeat endoscopy following antibiotic treatment showed the absence of H pylori and S. ventriculi and the patient reported a cessation of symptoms. S. ventriculi was found in association with H. pylori infection.

The comparative efficacy and safety of 9 traditional Chinese medicines combined with standard quadruple therapy for Helicobacter pylori-associated gastritis: a systematic review and network meta-analysis.

There are 9 traditional Chinese medicines (TCMs) combined with standard quadruple (SQ) available for the treatment of Helicobacter pylori (Hp)-associated gastritis, but their relative efficacy and best options in clinical decision making are unknown due to a lack of high-quality head-to-head randomized controlled trials (RCTs). This study aimed to explore which formulas are the most effective and/or safest for Hp-associated gastritis. We performed a search of electronic databases including PubMed, Web of Science, Cochrane Library, Embase, Chinese databases and South Korean database from inception to March 2022 to identify all relevant RCTs on the comparison between TCM combined with SQ and SQ for Hp-associated gastritis. Efficacy outcomes were the eradication rate of Hp and therapeutic response rate, and safety outcome was incidence of adverse reactions. Publication bias was assessed quantitatively using Egger's regression analysis and qualitatively using trim-and-fill method. Quality assessment was performed using Cochrane Risk of Bias, version 2 (ROB 2) tool. The Bayesian methods were applied to compare each treatment. A total of 55 trials with 6,187 patients were involved. The experimental group included 9 TCMs combined with SQ. The control group was SQ. The pair-wise meta-analysis demonstrated that compared with control group, 8 TCMs combined with SQ could statistically improve the eradication rate of Hp in patients with gastritis, 9 TCMs combined with SQ could significantly improve the therapeutic response rate. Additionally, Banxia Xiexin decoction combined with SQ (BXS) could statistically decrease the incidence of adverse reactions. The network meta-analysis results showed that BXS, Xiangsha Liujunzi combined with SQ (XSS), and Huangqi Jianzhong decoction combined with SQ (HQS) was the best measures to effectively eradicate Hp, enhance therapeutic effect, and decrease adverse reactions, respectively. The results of trim-and-fill method indicated that the results were stable and less affected by publication bias. Compared with SQ, TCM combined with SQ generally has a better clinical effect and higher safety in patients with Hp-associated gastritis. BXS, XSS, and HQS are recommended based on the patient's condition and needs in clinical practice. Further high-quality double-blinded RCTs are warranted to validate the conclusions.

Characteristics of basal gastric juice in Helicobacter pylori-associated gastritis before and after eradication therapy

Purpose: To evaluate the characteristics of basal gastric juice in Helicobacter pylori-positive patients before and after Helicobacter pylori eradication therapy. 
 Methods: This was a cross-sectional descriptive study on 150 gastritis patients admitted at the Hospital of Can Tho University of Medicine and Pharmacy. The patients were divided into 2 groups: study group (Helicobacter pylori gastritis patients) and control group (non-Helicobacter pylori gastritis patients). The pH, HCO3- concentration, and activities and concentrations of pepsin, lipase, and amylase were determined before and after treatment in study group. 
 Results: Patients with abnormal gastric juice comprised 76 % of the study population. Mean gastric potential of hydrogen (pH) was 2.31 (range: 1.64 - 7.68), while median concentration of HCO3- was 4.06 mmol/L (range: 0 - 73.04 mmol/L). The concentrations of pepsin, lipase, and amylase were 8.93, 0.93 and 1.38 ppm, respectively. Activities of pepsin, lipase, and amylase were 2.23, 0.28 and 0.04 U/mL, respectively. After the successful eradication of Helicobacter pylori, pH and HCO3- levels decreased, and there were significant differences in activities of pepsin and lipase before and after treatment (p < 0.05). Moreover, the levels of these parameters differed between patients in whom successful eradication was achieved and those in whom eradication failed (p < 0.05). The concentrations and activities of pepsin and lipase were statistically different between pre-treatment and post-treatment stages in both successful and failed Helicobacter pylori eradication categories (p < 0.05). 
 Conclusion: Basal gastric juice differs significantly between Helicobacter pylori-positive and Helicobacter pylori-negative patients. Intragastric ammonia produced by H. pylori may have a role in the increased pH of gastric juice.

Eesophagogastroduodenoscopy in paediatrics: does abiding by the international guidelines lead to appropriate management? A cross-sectional study

Objectives Esophagogastroduodenoscopy (EGD) is one of the most practiced procedures in paediatric gastroenterology. As with all other procedures, it is guided and controlled by specific guidelines developed and approved internationally....

HISTOPATHOLOGICAL BASES OF ORGANIC DYSPEPSIA IN BENIN CITY – A HOSPITAL BASED STUDY OF 186 CASES

Dyspepsia is a symptom complex characterized by features which include epigastric pain or discomfort, belching, bloating and heart burn amongst others, and is one of the commonest indications for upper gastrointestinal endoscopy in Nigeria. The aim of this study was to determine the histopathological bases of organic dyspepsia in this environment. Upper gastrointestinal endoscopy specimens from 186 patients diagnosed with organic dyspepsia in our centre over the 6-month study period were the materials for the study. These were subjected to tissue processing and histopathological examination. The vast majority of the cases of organic dyspepsia had their histopathological bases in the stomach, mostly from various forms of chronic and reactive gastritis, with occasional cases of gastric mucosal ulcers and frank malignancies. Helicobacter pylori-associated chronic gastritis continues to underlie most organic causes of dyspepsia in our environment.

Basic Traditional Chinese Medicinal Compound for Adjuvant Treatment of Helicobacter pylori-Related Gastritis: Implication for Anti-H. pylori-Related Gastritis Drug Discovery

This study was aimed at evaluating the efficacy of traditional Chinese medicine (TCM) in the adjuvant treatment of Helicobacter pylori-associated gastritis (HPAG) and exploring the molecular mechanism underlying the action of the basic TCM compounds against HPAG. Eight representative Chinese and British databases were combed for pertinent literature. In light of the basic principle of evidence-based medicine, this work rigorously stuck to the inclusion and exclusion of criteria so as to plump for qualified articles. Also, the data mining method was adopted to help determine the basic TCM compound for HPAG treatment. Furthermore, a network pharmacology-based strategy was used to uncover the underlying mechanisms of the basic TCM compound against HPAG. Ultimately, molecular docking was used for preliminary verification. TCM combined with triple or quadruple therapy against HPAG possessed more advantages in improving the total effective rate and H. pylori eradication rate than triple or quadruple therapy alone. The basic TCM plant materials against HPAG consisted of Citrus reticulata Blanco, Glycyrrhiza uralensis Fisch, Pinellia ternata (Thunb.) Breit, Coptis chinensis Franch, and Poria cocos (Schw.) Wolf. Quercetin, kaempferol, naringenin, baicalein, nobiletin, and hederagenin were determined as the key active ingredients of the basic TCM preparation against HPAG. Moreover, these ingredients played a therapeutic role by acting on AKT1, TP53, interleukin (IL)-6, VEGFA, CASP3, MAPK3, JUN, TNF, and MAPK8 via Pathways in cancer, PI3K-Akt signaling pathway, TNF signaling pathway, and MAPK signaling pathway. The results of molecular docking indicated that the key ingredients could bind stably with the core targets. The efficacy of the TCM in the adjuvant treatment of HPAG is worthy of affirmation. Compatible use of the key ingredients of the basic TCM compound is a novel idea of drug research with profound clinical significance and research value in the development of anti- H. pylori drugs.

Empathy, psychological characteristics, and compliance in patients with chronic gastritis

Aim . To study the associations between empathy, anxiety, and compliance in patients with chronic gastritis. Materials and Methods . Here we recruited 302 patients with chronic gastritis, further stratifed into 4 groups: 1) 96 patients with H. pylori-associated gastritis and high compliance; 2) 110 patients negative for Helicobacter pylori and also having high compliance; 3) 36 patients with H. pylori-associated gastritis and low compliance; 4) 60 patients with Helicobacter pylori-associated gastritis and partial compliance. Empathy was evaluated using Consultation and Relational Empathy Measure (CARE Measure) questionnaire, whilst anxiety was determined using the Spielberger-Khanin questionnaire. Results . The highest Helicobacter pylori eradication rate was observed in patients with high empathy and adherence and vice versa. Correlation analysis showed that physician interpersonal skills, therapeutic success, and adherence to treatment were positively associated with patient empathy and negatively associated with patient anxiety. Conclusion . Doctor-patient relationship defnes the patient compliance, while patient empathy is a key factor determining adherence to treatment in patients with chronic gastritis.

Characterization of Gastric Tissue-Resident T Cells in Autoimmune and Helicobacter pylori-Associated Gastritis.

Data regarding the in-depth surface marker profiles of gastric tissue-resident lymphocytes in autoimmune and Helicobacter pylori-associated gastritis are lacking. In this study, we investigated potential differences in lymphocyte composition between these profiles. We enrolled patients with autoimmune (n = 14), active (current infection of H. pylori in the stomach; n = 10), and inactive gastritis (post-eradication of H. pylori; n = 20). Lymphocytes were isolated from the greater curvature of the stomach and lesser curvature of the body and analyzed using flow cytometry. The CD8+/CD3+ and CD4+/CD3+ ratios differed between the samples. Body CD4+/antrum CD4+, which is calculated by dividing the CD4+/CD3+ ratio in the body by that in the antrum, was significantly higher in autoimmune gastritis (3.54 ± 3.13) than in active (1.47 ± 0.41) and inactive gastritis (1.42 ± 0.77). Antrum CD8+/CD4+ in autoimmune gastritis (7.86 ± 7.23) was also higher than that in active (1.49 ± 0.58) and inactive gastritis (2.84 ± 2.17). The area under the receiver operating characteristic curve of antrum CD8+/CD4+ was 0.842, and the corresponding optimal cutoff point was 4.0, with a sensitivity of 71.4% and a specificity of 93.3%. We propose that an antrum CD8+/CD4+ ratio > 4.0 is a potential diagnostic marker for autoimmune gastritis.