Helicobacter Pylori Stool Antigen Test Research Articles

Clinical Utility of Helicobacter pylori Stool Antigen Testing with a Bioluminescent Enzyme Immunoassay Using a Fecal Occult Blood Test Container.

Background A dedicated stool container is required for Helicobacter pylori stool antigen testing. If H. pylori fecal antigen can be measured from a fecal occult blood test container (S fecal collection container or S container), which is widely used for colorectal cancer screening, screening of the upper and lower gastrointestinal tract can be performed with a single stool sample. We investigated the clinical usefulness of an H. pylori stool antigen assay using an S container. Patients and Materials A total of 347 patients who underwent esophagogastroduodenoscopy (EGD) were included. After the procedure, H. pylori stool antigen was measured using the S container and collection container recommended for H. pylori stool antigen (BL-stool collection container or BL container), and the qualitative outcomes of each were compared. A bioluminescent enzyme immunoassay (BLEIA) was used to measure H. pylori stool antigen. Results The overall agreement between S containers and BL containers was 100% (347/347), indicating that the qualitative outcomes were equivalent. As a secondary analysis, the results of the S container samples were evaluated according to the diagnosis made by physicians, and the overall agreement rate was 99.7% (345/346), indicating a high correlation. Conclusion The detection of H. pylori stool antigen using the S container is clinically useful because the results are equivalent to those obtained by the usual method. Screening of the upper and lower gastrointestinal tract is expected to be possible with a single stool sample in the future.

Acurateţea testelor neinvazive la copii pentru precizia diagnosticului de infecţie cu Helicobacter pylori

Helicobacter pylori infection is aquired in childhood, af­fects more than half of the world population and is as­so­cia­ted with chronic gastritis. The majority of the in­fec­ted children are asymptomatic. The most frequently used tests for the detection of Helicobacter pylori are ¹³C urea breath test and stool antigen test. Objective. In this stu­dy, we evaluated the accuracy and the utility of the ¹³C urea breath test and Helicobacter pylori stool antigen test in young children. We performed a prospective ob­ser­­va­­tio­nal study of 52 symptomatic children, mostly with uninvestigated dyspepsia suggestive for an or­ga­nic di­sease. The ¹³C urea breath test was used as gold stan­dard method for the diagnosis of Helicobacter py­lo­ri in­fec­tion. Forty-two of the 52 studied children had a po­si­tive ¹³C urea breath test, respectively 21 of 42 Heli­co­bac­ter pylori infected children presented a positive rapid stool antigen test for Helicobacter pylori. Our study did not reveal a strong agreement between Helicobacter py­lo­ri rapid stool antigen test and ¹³C urea breath test. The management of Helicobacter pylori infection in chil­dren remains a problem in clinical practice, therefore test­ing for Helicobacter pylori infection has become a very important part of the diagnostic process. Another mul­ti­cen­ter study from our country is recommended.

Evaluation of the effects of a proton pump inhibitor on Helicobacter pylori stool antigen testing.

Some patients find it difficult to discontinue proton pump inhibitors (PPIs). Unlike the 13 C-urea breath test (UBT), the stool antigen test (SAT), particularly when domestically produced kits are used, may be less likely to yield false-negative results. This prospective study included a convenience series of 35 healthy Japanese subjects. Based on a statistical calculation, acceptable numbers of subjects were considered at least 21 and 11 with and without Helicobacter pylori (H.pylori) infection, respectively. The H.pylori infection was determined using the UBT or rapid urease test. SATs were performed with three novel domestically produced kits (the rapid immunochromatography tests Quick Navi™-H.pylori [Navi™] and Quick Chaser® H.pylori [Chaser®], and the bioluminescent enzyme immunoassay test BLEIA® 'EIKEN' H.pylori Antigen [BLEIA®]) before and after oral PPI administration (30 mg lansoprazole once daily for 14 days). For each kit, the sensitivities and specificities were calculated and compared before and after PPI administration. Furthermore, the cutoff index (COI) values of BLEIA® before and after PPI administration were compared in H.pylori-infected subjects. H.pylori infection was detected in 68.6% (24/35) of the included subjects. The sensitivities and specificities before versus after PPI administration were as follows: 79.2% (19/24) and 100.0% (11/11) versus 75.0% (18/24) and 100.0% (11/11) for Navi™, respectively (p=1); 87.5% (21/24) and 100.0% (11/11) versus 75.0% (18/24) and 100.0% (11/11) for Chaser®, respectively (p=.371); 100.0% (24/24) and 100.0% (11/11) versus 95.8% (23/24) and 100.0% (11/11) for BLEIA®, respectively (p=1). The median COI values of BLEIA® before and after PPI administration were 1389.0 and 3207.25, respectively (p=.0839). In stool specimens, H.pylori antigenicity is maintained even during PPI use. SAT using a bioluminescent enzyme immunoassay is particularly recommended because of its extremely high sensitivity.

Population- and Gender-Based Investigation for Prevalence of Helicobacter pylori in Dhamar, Yemen.

Among 35 species of genus Helicobacter, H. pylori is the most common causative agent of human gastritis, peptic ulcer, and gastric cancer. The infection can spread through direct human-to-human contact, fecal-oral route, and contaminated water. The study was designed to investigate the rate of prevalence of H. pylori in the population of Dhamar, Yemen. In this one-year study, 460 including 250 male and 210 female stool specimens were collected between January to December 2020 in Dhamar Governorate, Yemen. Of the total 460, 215 rural (male: n = 120 and female: n = 95) and 245 urban (male: n = 130 and female: n = 115) specimens were investigated for identification of H. pylori by serological test using Helicobacter pylori stool antigen (HpSA) test. In addition, for comparing an improved recovery of H. pylori, conventional culture-based isolation was also carried out using three selective media. Modified Campy-blood Agar (MCA), Belo Horizonte Agar (BHA), and Egg yolk Emulsion (EYE) medium supplemented with antimicrobial agents including vancomycin (10 mg/L), cefsulodin (5 mg/L), trimethoprim (5 mg/L), and amphotericin B (5 mg/L) and isolates were phenotypically characterized. The HpSA test results revealed that of the total 460 specimens, 89 (19.3%) were positive for H. pylori with relatively low in male (n = 43; 17.2%) as compared to the female (n = 46; 21.9%) specimens. After 3-10 days of incubation, H. pylori was recovered at a variable rate on each selective (MCA: 16.5%; BHA: 15.0%; EYE: 13.0%) media. However, culture-based assay results showed less recovery (n = 81; 17.6%) with no significant difference among all selective media tested and between genders (male: n = 39; 15.6%; female: n = 42; 20.0%). The infection rate was comparatively higher in rural (n = 45; 20.9%) as compared to urban (n = 36; 14.7%) population. Overall, the study data showed the prevalence of infection in both genders of all age groups. The present study showed a relatively high rate of infection of H. pylori in the Dhamar population. The serological identification and culture-based methods are important for rapid detection, aid in treatment, and developing policies for the control and eradication of H. pylori infection and to prevent the disease in different age groups in Yemen.

Comparative Assessment of Current Serological Methods against the Conventional in the Diagnosis of Helicobacter pylori Infections in Suspected Peptic Ulcer Patients Attending Health Facilities in Lafia, Nigeria.

Purpose: Helicobacter pylori has been implicated in most severe cases of peptic ulcer. Despite this development, the diagnosis of this infection has been a major challenge due to the difficulty encountered during isolation using the conventional culture method. Presently, most health facilities in rural communities in Nigeria still adopt the culture method as the gold standard technique for the diagnosis of H. pylori infections. The need for the introduction of more accurate, robust and rapid diagnostic techniques is therefore imperative. This study was carried out to compare the overall performance of two diagnostic methods in the assessment of Helicobacter pylori infection status among peptic ulcer suspected patients attending health facilities in Lafia, Nigeria, using stool antigen immunoassay test and blood antibody test methods.
 Methodology: A total of 180 patients with peptic ulcer symptoms attending three health facilities (80 from DASH and 50 each from Jafamek Diagnostic Centre and Haske Hospital) were recruited by designated health workers through random selection using non-probability and convenience sampling. The blood and stool samples of each participant were screened using H. pylori antibody/ antigen test strips (Azure Biotech Inc). The stool samples were cultured on Brain Heart Infusion agar (Oxoid, UK) and the result used as a gold standard in this study. Data obtained were presented as frequencies and association between test methods analysed using contingency chi-square test and Cohen kappa statistics.
 Results: The outcome of the study showed that out of the 180 participants screened, 51 (28.33%) were positive using the culture method (CM), 111 (61.67%) were reactive for Helicobacter pylori blood antibody test (BAB), while 86 (47.78%) were positive for Helicobacter pylori stool antigen test (SAG). The sensitivity and specificity of the two methods were recorded as 74.50%, 44.20% and 70.60%, 61.20% for BAB and SAG respectively. The level of agreement according to the value of kappa was found to be poor with BAB but fair with SAG.
 Conclusion: Based on the findings of this study, the overall prevalence of H. pylori infection among the patients was relatively low compared to values obtained from other areas in Nigeria. Also, the stool antigen analytical method had the highest diagnostic accuracy compared to the serum antibody and culture techniques.
 Recommendation: The stool antigen method is considered the most effective in the diagnosis of Helicobacter pylori infections in the study community and should therefore be used regularly as first choice option.

Comparison of the Accuracy of Helicobacter pylori Stool Antigen (HPSA) Test with Campylobacter Like Organism (CLO) Test in Diagnostic of Helicobacter Pylori Gastritis in Children

This study aimed to find the accuracy of the HPSA test with the CLO test in diagnosing helicobacter pylori gastritis in children. The cross sectional study conducted on 57 children with gastritis in October 2019 up to May 2020. Subject were children between two until eighteen years old who met the inclusion and exclusion criteria. HPSA examination was performed on the patient's stool sample using rapid immunochromatographic monoclonal antibody test for qualitative detection of H. pylori bacteria in human feces. From 57 samples, there were 37 children positively infected H. pillory. There were no difference in characteristics in the study population. The diagnostic value of the HPSA test showed a sensitivity and specificity of 83.8% and 95%. The positive and negative predictive value are 96.9% and 76% (PPV and NPV) with positive and negative likelihood ratio (LR + and LR -) are 16.76% and 0.17%, and an accuracy value of 87.7%.

Diagnosis of Helicobacter pylori infection in the elderly using an immunochromatographic assay-based stool antigen test.

The diagnostic value of Helicobacter pylori stool antigen (HpSA) tests in elderly subjects remains unclear. The objective of this study was to assess the diagnostic accuracy of the immunochromatographic assay‐based HpSA test in a male elderly cohort and identify factors affecting the accuracy. Data for asymptomatic elderly male citizens (≥65 years old) who received health checkups at the Chinese PLA General Hospital between July 2007 and November 2018 were collected. The diagnostic accuracy of the HpSA test was determined using the 13C‐urea breath test as a reference standard. Associations between baseline comorbidities and the accuracy of the HpSA test were analyzed. In total, 316 participants were enrolled, including 193 in the pre‐treatment group (77.2 ± 7.8 years old) and 123 in the post‐treatment group (78.7 ± 8.3 years old). The accuracy (91.5%, 91.2%, and 91.9%) and specificity (97.6%, 98.7%, and 96.0%) were high in all participants, pre‐ and post‐treatment groups, respectively. However, sensitivities were only 68.7%, 65.1%, and 75.0%, respectively. In the pre‐treatment group, constipation was associated with decreased sensitivity (p = 0.039), while colorectal polyps were associated with increased sensitivity (p = 0.010). Multivariate analysis indicated that constipation and colorectal polyps are independent factors for the sensitivity of HpSA in the pre‐treatment group. The immunochromatographic assay‐based HpSA test achieved high accuracy with high specificity but suboptimal sensitivity in the elderly male cohort. Constipation and colorectal polyps were negatively and positively associated with HpSA sensitivity, respectively, in the pre‐treatment group.

Is the Utilization of Helicobacter pylori Stool Antigen Tests Appropriate in an Urban Canadian Population?

Helicobacter pylori stool antigen test (HpSAT) appropriateness was investigated by assessing its testing and positivity rates in Calgary, Canada. The laboratory information system was accessed for all patients who received an HpSAT in 2018. Testing volume, test results, age, and sex of patients were collected. Sociodemographic risk factors and geospatial analysis were performed by matching laboratory data to the 2016 census data. Testing appropriateness was defined as a concordance between testing and positivity rates for each sociodemographic variable. In 2018, 25,518 H pylori stool antigen tests were performed in Calgary, with an overall positivity rate of 14.7%. Geospatial mapping demonstrated significant distribution variations of testing and positivity rates of HpSAT in the city. Certain sociodemographic groups studied (eg, recent immigrants) appeared to be appropriately tested (testing rate relative risk [RR] = 2.26, positivity rate RR = 4.32; P < .0001), while other groups (eg, male) may have been undertested (testing rate RR = 0.85, positivity rate RR = 1.14; P < .0001). Determining concordance of testing and positivity rate of a laboratory test can be used for assessing testing appropriateness for other diseases in other jurisdictions. This study demonstrated some at-risk patients may be missed for H pylori testing.

Helicobacter pylori as a risk factor for gastric cancer: the evidence and primary prevention strategy

Russia is a country with a high prevalence of Helicobacter pylori (HP) infection, a high incidence of gastric cancer, and its late diagnosis. HР infection has been recognized as the leading manageable risk factor for gastric cancer. Accurate diagnostic tests must be used to identify and control the effectiveness of HP eradication, and effective schemes must be implemented for HP eradication. The aim of this article was to analyze the latest consensus documents, systematic reviews and meta-analyzes that reflected the role of HP as a risk factor for the development of gastric cancer, as well as measures for the risk reduction. We describe in detail the diagnostic methods for HP infection, provide data on their use in the Russian Federation, and analyze the efficacy of eradication regimens. In all HPinfected individuals, HP leads to chronic inflammation in the gastric mucosa and launches a precancerous cascade (Correa's cascade). The risk of gastric cancer increases with severe atrophy, intestinal metaplasia and dysplasia. Primary prevention of gastric cancer is most effective if the eradication is performed before atrophic gastritis develops. The available consensus documents underline the importance of HP infection identification by accurate diagnostics at this stage of chronic gastritis. In Russia, the primary HP diagnosis is based on histology (37.7%), rapid urease test (29.2%), and serology (29.7%). HP stool antigen test (31.3%), 13C-urea breath test (23.4%) and the histological method (23.3%) are most often used to control eradication. Currently, the first line of eradication therapy is recommended as triple therapy with clarithromycin prescribed for 14 days. It is recommended to use double dose of proton pump inhibitors and bismuth to increase the effectiveness of this scheme. A 14-days triple regimen enhanced by bismuth has been recommended as the first-line therapy in the Russian Federation.

Evaluation of Helicobacter pylori stool antigen test in comparison with conventional methods in detection of helicobacter pylori infection in dyspepsia patients

Background: Helicobacter pylori colonize the human stomach and is associated with gastritis, gastric and duodenal ulcers, gastric adenocarcinoma and mucosa associated lymphoid tissue lymphoma. Owing to its momentous pathogenic role, the diagnosis of H pylori infection remains a subject of interest. Helicobacter can be detected by invasive and non invasive methods. Aim: The purpose of this study was to evaluate the accuracy of stool antigen test as a non invasive method for the diagnosis of H pylori infection. Materials and Method: A prospective study was conducted in a tertiary medical college hospital. Patients presenting with dyspeptic symptoms were subjected to endoscopy and investigated for H pylori infection through rapid urease test, histopathology and culture. Stool samples were also collected from these patients and tested for H pylori infection by a rapid Hpylori Stool Antigen test. H pylori status was defined as positive when both rapid urease test (RUT) and histopathology were positive or culture alone was positive for biopsy based invasive methods. Similarly a positive rapid HpSA test also indicates H pylori infection. Results: Of the 100 patients tested, 63 were H pylori infected by the endoscopy based invasive methods, and 54 by the non-invasive rapid HpSA test. The sensitivity, specificity and accuracy of H pylori stool antigen test were 85.7%, 88% and 91% respectively. Conclusion: The rapid HpSA test could be used as a noninvasive diagnostictest for H pylori infection.

Prevalence of &lt;i&gt;Helicobacter pylori&lt;/i&gt; IgG and stool antigen detection from dyspeptic patients in Jos, Nigeria

Helicobacter pylori is a helical shaped gram negative microaerophilic bacterium , that can inhabit various areas of the stomach. The study was carried out to determine the prevalence of Helicobacter pylori infection among dyspeptic patients attending Endoscopy unit, Jos University Teaching Hospital (JUTH). The prevalence of H pylori ; antibodies in plasma and antigen in stool samples of 80 patients examined was studied using ELISA (DIA PRO, Italy) and ICA (BIOTEST China) respectively. Sociodemographic and clinical information was obtained through the assistance of attending gastroenterology staff. Blood grouping was also performed by slide agglutination test for all patients. Helicobacter pylori IgG antibodies were detected in plasma of 28 (35%) patients of which 27 patients out of the sero-positive cases were antigen positive while Helicobacter pylori antigen was detected in the stool of 31 (38.8%) patients of which 27 patients out of the antigen positive cases were also seropositve. No significant association was found between Helicobacter pylori and age, sex, ABO blood group, economic status, source of water and consumption of alcohol. Thus, Helicobacter pylori seropositivity with respect to blood groups was found to be 32.6%, 46.7%, 33.3% and 33.3% in blood groups O, B, A and AB respectively, while Helicobacter pylori stool antigen test positive results was found to be 33.3%, 33.3%, 46% and 39.5% in blood groups O, B, A and AB respectively. Hence, no statistical association was found between Helicobacter pylori infection and blood groups of the patients (P>0.05). However, marital status was significantly associated with Helicobacter pylori antibody test (P<0.05). There is need for government to encourage people about the Helicobacter pylori screening test since it is one of the etiologic agent of ulcer. Keywords : Helicobacter pylori , Jos, Peptic ulcer, Prevalence.

The Evaluation of Diagnostic and Predictive Values of Helicobacter pylori Stool Antigen Test in Iranian Patients with Dyspepsia

Iran, as a developing country, is experiencing high burdens of Helicobacter pylori (Hp)-associated non-communicable diseases. Hp stool antigen test (HpSA) is widely used as an inexpensive and feasible noninvasive method to diagnose Hp infection, instead of invasive approaches. The current study aimed at evaluating the diagnostic and predictive values of HpSA test for Hp infection in Iranian patients with dyspepsia. The current cross sectional study was performed on 100 patients with dyspepsia. Gastric mucosal specimens were taken, processed, and examined according to the standard protocols. Simultaneously, stool samples were obtained and sent to laboratory for further analyses. Hp stool antigen titers were assessed using enzyme-linked immunosorbent assay (ELISA) technique. Stool antigen titers were not associated with gender (P-value=0.284), but correlated to age (r=0.213, P-value=0.034). Considering 0.385 as a cutoff point, the HpSA test had 80.4% sensitivity and 85.7% specificity. Based on cost-effectiveness of HpSA test, the current study findings corroborated the use of HpSA test to detect and follow-up patients with Hp infection, as an alternative method to detect Hp rather than invasive procedures.

Analyzing the Abundance of the Gene glmM in Subjects with a Positive Helicobacter pylori Stool Antigen Test (HPSA) and Correlating glmM Abundance with Serum Levels of Cytokines TNF-α and IL-1β

Introduction: One of the most common genes in Helicobacter pylori is glmM which is usually used for identification of infection with the bacterium within gastric biopsy specimens by PCR, as a target gene. The aim of this study was to examine the prevalence rate of glmM gene in DNA samples of stool and evaluate its relationship with the fluctuations of serum levels of TNF-α and IL- 1β. Materials & methods: In this study, blood and stool samples were collected from 82 subjects in two groups with positive and negative HPSA test referred to laboratories of Ilam, Iran. PCR was used to investigate the presence of glmM gene in DNA extracted from stool samples, and then serum levels of studied cytokines were measured using specific kits by ELISA, and the results were analyzed using statistical tests. Findings: Analysis of data obtained from the study showed that the frequency of glmM gene in the sample of cases with positive HPSA was 23.8%, and there was a significant relationship between the presence of this gene in stool and fluctuations in serum levels of TNF-α and IL- 1β (P less-than 0.05). Disussion & conclusion: According to data, it can be said that the presence of glmM gene was associated with fluctuations in any of the variables of HPSA, TNF-α and IL- 1β and the possible presence of the gene in the stool raises with increase in each unit of HPSA and IL- 1β, which in turn raises the prognosis of diseases with a virulence form of bacteria by both serology and stool methods.

Role of Helicobacter Pylori stool antigen test in the diagnosis of Helicobacter Pylori infection

Introduction: Helicobacter pylori (H. pylori) infection is common in developing countries. There are various invasive and non-invasive methods for diagnosing H. pylori infection. Stool antigen test is a new non-invasive method to diagnose H. pylori infection. In this study we evaluated the diagnostic accuracy of HpSA for H. pylori infection in patients with gastrointestinal (GI) complaints. Methods: Sixty patients including 28 men and 32 women with mean age of 49.2 ± 19.8 years undergoing diagnostic endoscopy with 30 positive and 30 negative rapid urease test (RUT) and histology results for H. pylori infection were evaluated. H. pylori stool antigen test (HpSA) was measured in these patients and sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy for HpSA were calculated. Results: Among 31 positive HpSA results, 2 were negative in RUT and histology and among 29 negative HpSA results, 1 was positive in RUT and histology results. Sensitivity, specificity, PPV, NPV and accuracy for HpSA in diagnosing H. pylori infection were 96.67%, 93.33%, 93.55%, 96.55% and 95%, respectively. Conclusion: Although the sensitivity and specificity of the HpSA are evaluated in a relatively small sample size, these results showed that HpSA is a useful test in diagnosing H. pylori infection in patients with upper GI complaints.

Peptik ülserli hastalarda ikinci basamak Helicobacter pylori eradikasyonunda bizmut bazlı 4’lü ve levofloksasin bazlı 3’lü tedavilerin karşılaştırılması: Tek merkezli pilot çalışma

Background and Aims: The aim of this prospective, randomized trial was to compare bismuth-based quadruple therapy with levofloxacin-based triple therapy for the second-line eradication of Helicobacter pylori in peptic ulcer disease. Materials and Methods: From March 2014 to August 2015, 18 Helicobacter pylori-positive patients with peptic ulcer disease were consecutively randomized into two groups after 14 days of clarithromycin-based classic triple eradication. Group 1 (n=10) was given bismuth-based quadruple therapy and group 2 (n=8) was given levofloxacin-based triple therapy. In both groups, lansoprazole (1x1) was completed in 12 weeks. After a 15-day washout period, a urea breath test and Helicobacter pylori stool antigen test were performed to monitor eradication. Results: Sixty percent of the patients in group 1 were female, mean age was 45.7±8.8 (range: 36- 66) years, and in group 2, the mean age was 45.1±7.9 years (range: 29-54). The urea breath test and Helicobacter pylori stool antigen test were negative in 9 patients in group 1 (eradication rate: 90%) and 3 patients in group 2 (eradication rate: 38%). There was a significant difference in the eradication rate between the two groups in favor of bismuth-based quadruple therapy (p < 0.005). Conclusion: We conclude that bismuth-based quadruple therapy is superior to levofloxacin-based triple therapy for the second-line eradication of Helicobacter pylori in peptic ulcer disease. Although the number of patients was low in our study, this result might have been due to levofloxacin resistance. We propose that regional differences may have a role in second- line therapy, and more comprehensive studies including more patients are needed to address this issue.

Helicobacter pylori cytotoxin-associated gene A genotype in Egyptian patients with Parkinson’s disease: could eradication benefit?

Strong growing evidence supports a link between Helicobacter pylori (HP) infections and Parkinson’s disease (PD). The purpose of this study was to explore the association between infection with HP cytotoxin-associated gene A (cagA) genotype and PD in Egyptian patients and the influence of its eradication on pharmacokinetic and clinical response to l-dopa. This study was performed on 87 idiopathic PD patients and 45 age- and sex-matched controls. HP infection was diagnosed with HP stool antigen test and HP cagA genotype was detected by PCR. PD patients were subjected to UCLA parkinsonism scale, Hoehn and Yahr staging, and l-dopa plasma level detection by high-performance liquid chromatography. HP PD patients were divided into eradicated group (received standard anti-HP therapy) and placebo group (received antioxidant therapy). Four weeks after therapy, patients were reevaluated. Among PD patients, frequency of HP infection was significantly higher than controls (55.2 vs 33.3%, P = 0.02), especially with HP cagA strain (81.2 vs 40%, P = 0.002). PD was more severe in HP infected (P < 0.001), especially in HP cagA-positive patients (P = 0.04) with significant lower l-dopa plasma levels (P < 0.001). cagA strains were associated with higher risk of increased PD severity (OR, 2.139; P = 0.029). Opposing antioxidant therapy, HP eradication treatment improved PD severity (UCLA score decreases by 30%) and increased l-dopa level by 40%. There is a proved link between PD and infection with virulent HP cagA strains. HP could affect l-dopa level by mechanisms other than reactive oxygen radical’s production which need further evaluation.

Comparison of combination of probiotic and standard therapy compared to standard therapy on eradication of Helicobacter pylori infection in children

Background Helicobacter pylori (H. pylori) infection is thought to be the etiology of chronic gastritis, peptic ulcer, and risk factor for gastric cancer. Management of H. pylori infection in children is associated with several problems such as compliance to therapy, untolerated side effects, and antibiotic resistance. Probiotic is reported to give beneficial effect in the management of H. pylori infection and there is no study yet on the effect of probiotic in eradication of H. pylori infection in Indonesian children.Objectives To study the effect of additional probiotic in the standard therapy on the rate of H. pylori infection eradication in children and its side effect.Methods This was a double blind randomized controlled trial performed in 23 children with H. pylori infection at Kampung Melayu and Rawa Bunga District. The diagnosis was determined based on Helicobacter pylori stool antigen test (HpSA). Subjects were randomly assigned to either receive receive amoxiycilin, clarithromycin, omeprazole, and probiotic (2 x 109 cfu of Lactobacillus acidophilus La5 and Bifidobacterium lactis Bb12) or amoxicillin, clarithromycin, omeprazole dan placebo (maltodextrin). HpSA examination was evaluated again after 2 weeks of therapy.Results Two of 13 subjects in the treatment group and 6 of 10 subjects in the control group experienced side effects. Eradication rate in the treatment group is higher than the control group (13/13 vs 7/10) but the correlation between additional probiotic with the eradication rate of H. pylori is not statistically significant.Conclusions Probiotic can reduce the incidence of side effects due to antibiotic used in H. pylori eradication (2/13 vs 6/10, p &lt; 0.012). [Paediatr Indones. 2010;50:38-41].

Correlation of 16s rRNA with serum levels of the cytokines, TNF-α and IL-1β, in subjects with a positive Helicobacter pylori Stool Antigen test (HPSA)

Introduction: Helicobacter pylori (H. pylori), is a bacterium responsible for upper gastrointestinal tract diseases. The 16s rRNA is a common H. pylori gene which are usually preferred for diagnosis purpose. The aim of this study was to determine the prevalence and abundance of 16s rRNA in fecal samples and also evaluate correlation between the level of 16s rRNA and activities of the cytokines, TNF-α and IL-1β, in serum. Materials and methods: The present study was performed on 84 subjects with digestion problems. Fecal and blood samples were collected and 16s rRNA gene was assayed using PCR. The serum levels of TNF-α and IL-1β levels were measured by enzyme-linked immunosorbent assay (ELISA). Results: The results of the study revealed that there was a positive correlation between the 16s rRNA gene, H. pylori stool antigen (HPSA) and TNF-α cytokine. The study also noted that with every unit of increase in either of the quantified parameters of HPSA and IL-1β, the presence of 16s rRNA in fecal samples, showed a 2.98 and 1.01 times rise, respectively. Conclusion: According to the obtained results, it may be concluded that activities of cytokine TNF-a correlated well with the presence of HPSA and 16srRNA gene in the stomach’s lining. Increase in the activities of HPSA and TNF-a cytokine could be associated with the presence of 16s rRNA in feces.

The utility of the Helicobacter pylori stool antigen test in managing dyspepsia: an experience from a low resource setting.

Dyspepsia is defined as a chronic or recurrent pain or discomfort centered in the upper abdomen. Endoscopy is the best strategy for confirming the cause of dyspepsia. Non- invasive strategies would be more appropriate in low resource countries where endoscopy is not readily available. However, there is concern that these strategies may miss serious disease like gastric cancer. One test that needs to be assessed in this regard is the Helicobacter pylori stool antigen test (HPSAT). To determine the validity of the stool antigen test in predicting H. pylori associated disease among patients with dyspepsia. In this prospective study patients with dyspepsia attending Mulago Hospital were recruited consecutively. Helicobacter pylori was determined using the Rapid Strip HpSA ®, endoscopy and gastric mucosal biopsy were done. 167 patients with dyspepsia were recruited into the study. There were ninety six (57.5%) females and seventy one (42.5%) males with an average age of 48.1(±18.1) years. Patients presenting with dyspepsia in Mulago hospital were more likely to come from the Central 60 (36%) and western tribes 55 (33%). The commonest endoscopic finding was oesophagitis 25 (15%). Peptic ulcer disease was found in 32 (19.2%) and 54 (32.3%) had normal endoscopy findings. H pylori was found in 33.5% and 32.5% using the HPSAT and histology respectively. The validity of the HPSAT in predicting H.pylori associated diseases was generally low with an overall sensitivity of 55.8%, and specificity of 74.2%. However, the validity was higher in predicting the diagnosis of peptic ulcer disease with a sensitivity 59.4% and specificity 72.6%. The HPSAT may be used in the test and treat strategy for young patients with dyspepsia without alarm signs and symptoms in low resource settings. However, because of its low validity in predicting H.pylori associated disease, it is important to follow up patients so that if symptoms persist or recur endoscopy is performed.

In vitro effect of aspirin on Helicobacter pylori on upper gastrointestinal tract

The role of Helicobacter pylori in aspirin-associated gastroduodenal ulcer disease is a subject of controversy. Aspirin use is widespread, especially in elderly patients, leading to the increased incidence of gastrointestinal (GI) bleeding. Endoscopy-guided biopsy is diagnostic. H. pylori fecal antigen detection in stool samples by enzyme-linked immunosorbent assay (ELISA) is also an option. Aim: The aims of this study were to assess the in vitro action of aspirin on H. pylori and to determine whether this effect has a role in different gastroduodenal lesions. Materials and Methods: The study group consisted of 100 symptomatic cases with different upper GI tract disorders, the patients aged 20-60 years and of either sex. Ten (10) asymptomatic, apparently healthy individuals were also included as the control group, after their consent was obtained for endoscopy. Biopsy material obtained by endoscopy was subjected to rapid urease test and culture, and aspirin sensitivity was determined by incorporating 400 ug/mL of aspirin in the medium. Results and Discussion: Out of the 41 culture-positive cases, 27 isolates were aspirin-sensitive. Among the various GI disorders analyzed, aspirin-sensitive H. pylori was found mostly in cases of gastritis (7) and duodenal ulcer (7). Two of five strains from duodenitis cases, one of four from esophagitis, all four from carcinoma, five isolated from symptomatic patients without visible lesions, and only one isolated from those asymptomatic with lesion were sensitive. The aspirin-sensitive organisms may or may not be associated with lesions, but the resistant strains were definitely associated with lesions. Although these findings do not change the current clinical approach, they do emphasize the need for screening. The Helicobacter pylori stool antigen (HpSA) test is sensitive and specific for planning eradication programs of H. pylori in colonized but presymptomatic cases.