HP-associated Gastritis Research Articles

Influence of Cytokine Genetic Polymorphisms in Helicobacter pylori-Associated Gastric Inflammation According to Sex in South Korea.

: The relationship between genetic polymorphisms and gastric inflammation remains unclear. This study aimed to evaluate the impact of genetic polymorphisms on Helicobacter pylori (HP)-associated gastritis according to sex. : Two hundred thirty-two male and 404 female subjects with current HP infection were prospectively enrolled. The genotyping of IL-1B-511 C/T, IL-1RN variable number of tandem repeats, IL-6-572 G/C, IL-8-251 A/T, IL-8-781 C/T, IL-10-1082 G/A, IL-10-592 C/A, TNF-A-308 G/A, and transforming growth factor (TGF)-B-509 C/T, was determined by polymerase chain reaction-restriction fragment length polymorphism. The degree of monocyte or neutrophil infiltration, atrophic gastritis, and intestinal metaplasia was evaluated using the updated Sydney system. : Among the male subjects, moderate/severe atrophic gastritis of the corpus was higher in IL-1B-511 CC carriers than in CT and TT carriers independent of age, alcohol consumption, and HP virulence factors (26.9% vs 10.4%; adjusted hazard ratio [HR], 4.377; 95% confidence interval, 1.387 to 13.814). In females, IL-8-251 AA carriers were independently and significantly associated with moderate/severe atrophic gastritis of the corpus compared with that in AT and TT carriers (21.4% vs 6.0%, adjusted HR=3.799). In males, the IL-8-251 TT genotype was associated with moderate/severe intestinal metaplasia of the corpus compared with the AT and AA genotypes (13.4% vs 5.6%, adjusted HR=3.128), while the IL-10-592 CA and CC genotypes were associated with moderate/severe monocyte infiltration of the antrum compared with AA genotype (83.6% vs 71.8%, adjusted HR=2.227). : Genetic polymorphisms in cytokines play different roles in HP-associated gastritis according to sex.

Assessment of the effectiveness of vonoprazan C-CBK in the complex of eradication therapy in patients with chronic Hp-associated gastritis

The article presents data on the results of a comparative study of the clinical and antihelicobacteric efficacy of two schemes of eradication therapy in 60 patients with HP-associated chronic gastritis. The main group of patients received eradication therapy consisting of vonoprazane, amoxicillin, clarithromycin and bismuth tricalium decitrate for 10 days. In the second group of patients with chronic gastritis, esomeprazole was used as an antisecretory drug against the background of similar therapy. The results of the study showed that in the first group of patients, the dynamics of acid suppression under the influence of vonoprasane was significantly higher compared to esomeprazole. Also, in the main group of patients, the rate of eradication of HP infection was 93%, whereas in the group of patients taking esomeprazole, this indicator was 80%.

Association of attitude to illness with adherence to treatment in patients with chronic gastritis

Aim. To study the associations between the attitude towards illness and the level of compliance in patients with chronic gastritis.Materials and Methods. The study included 302 patients with chronic gastritis which have been stratified into 4 groups: 1) 96 patients with Helicobacter pylori (HP)-associated chronic gastritis and high treatment adherence; 2) 110 patients with HP-negative chronic gastritis and high treatment adherence; 3) 36 patients with HP-associated gastritis who refused treatment; 4) 60 patients with HP-associated gastritis and moderate treatment adherence. The level of adherence to treatment and personal response to the disease was assessed using Davydov and TOBOL questionnaires, respectively. Interrelations of the studied parameters were evaluated using correlation analysis.Results. Eradication of HP was associated with a high treatment adherence. The majority of patients (56.0%) had adaptive behavioural response, whilst mixed (18.2%) and maladaptive types (12.5% for intrapsychic and 11.6% for interpsychic orientation) were less frequently observed. In patients who refused treatment, adaptive behavioural response was less common than anosognosic and maladaptive attitudes. Correlation analysis revealed that treatment adherence positively correlates with harmonious and ergopathic attitudes.Conclusion. Attitude to illness affects adherence to treatment in patients with chronic gastritis.

The E3 ubiquitin ligase TRIM31 attenuates NLRP3 inflammasome activation in Helicobacter pylori-associated gastritis by regulating ROS and autophagy

BackgroundThe NLRP3 inflammasome activation is the molecular basis of Helicobacter pylori (Hp)-associated gastritis. Tripartite motif (TRIM) 31 is involved in diverse pathological events. However, whether TRIM31 plays a role in the activation of NLRP3 inflammasome in Hp infection is not clarified.MethodsA mouse model of chronic Hp infection was established, and the gastric tissues were subjected to the polymerase chain reaction, western blotting, histopathological analysis, and RNA sequencing. The mitochondrial membrane potential and ROS in the human gastric epithelium GES-1 cells with or without Hp infection were measured by flow cytometry. GES-1 cells with or without TRIM31 knockdown were transfected with mCherry-EGFP-LC3 adenovirus. After rapamycin and bafilomycin A1 stimulation, autophagy flux in the above primed GES-1 cells was assessed by laser confocal microscope. Lysosomal acidification and expression levels of cathepsin B and cathepsin D in GES-1 cells with Hp infection were measured.ResultsNLRP3 inflammasome was activated in the gastric tissues of mice with chronic Hp infection in vivo and the GES-1 cells with Hp infection in vitro. TRIM31 was downregulated in Hp infection. TRIM31 negatively regulated the NLRP3 inflammasome activation. Enhanced ROS, impaired autophagy flux, and decreased expression of lysosomal cathepsin B and cathepsin D were observed in TRIM31-deficient GES-1 cells with Hp infection. In turn, inhibition of ROS led to the decreased expression of NLRP3 inflammasome.ConclusionsTogether, our data identified that TRIM31 negatively regulated the activation of NLRP3 inflammasome in Hp-associated gastritis by affecting ROS and autophagy of gastric epithelial cells.BaPkEPhQjKRgDMqnjfdJ-VVideo abstract

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.

Functional state of the glands of the gastric mucosa in chronic Hp-associated gastritis in children

Introduction . Studies of the gastric mucosa using biomarkers of its functional state in children are isolated, and there is also no normative base for their assessment. The aim of the work was to establish the reference values of the levels of gastrin-17, pepsinogens I and II in the blood serum of children and the nature of their changes in chronic Hp-associated gastritis. Material and methods . 112 children aged 7–15 years with chronic gastritis associated with Hp were examined. The examination program included esophagogastroduodenoscopy, morphological examination of gastrobioptates and determination of serum concentrations of gastrin-17, pepsinogens I and II, class G antibodies to Hp. Results . A regulatory framework has been developed to assess serum concentrations of gastrin and pepsinogens in childhood. It was found that as infl ammation progresses in chronic Hp-associated gastritis in children, an increase in the level of biomarkers, as well as the titer of class G antibodies to Hp, is observed. Changes in the content of biomarkers in the blood serum of children are uninformative in relation to the diagnosis of atrophic gastritis. Conclusion . These studies of serum levels of gastrin-17, I and II and class G antibodies to Hp pepsinogens can be used as an additional non-morphological criterions for the severity of the infl ammatory process in the gastric mucosa during dynamic monitoring of children with chronic gastritis.

Morphofunctional state of the gastric mucosa in children with chronic gastritis and the persistence of Epstein-Barr virus

The aim is to establish the effect of the persistence of the Epstein-Barr virus on the morphofunctional state of the gastric mucosa in chronic gastritis in children. Methods. 324 children aged 6—16 years with chronic gastritis were examined. We analyzed clinical and anamnestic data, the results of esophagogastroduodenoscopy with biopsy, genetic typing of Hp with the identification of pathogenicity genes VacA, CagA, IceA, BabA. The persistence of the Epstein-Barr virus was determined by the detection of its DNA in the materials of gastrobiopsy. The titer of class G antibodies to gastric parietal cells was studied in 110 patients.The results of the study. In children with chronic gastritis, Epstein-Barr virus was detected in the gastric mucosa in 49.1% of cases. In these patients, its colonization by highly pathogenic Hp strains was detected 1.8 times more often than in patients who had no infection with this virus. The persistence of the Epstein-Barr virus contributed to an increase in the severity of inflammation, the appearance of signs of indefinite atrophy of the mucous membrane and in the absolute majority of children was not accompanied by an increase in the titer of antibodies to the parietal cells of the stomach.Conclusion. The persistence of Epstein-Barr virus in the gastric mucosa in chronic Hp-associated gastritis contributes to its infection with highly pathogenic Hp strains and severe inflammation. No data have been obtained indicating the role of Epstein-Barr virus in the formation of atrophic or autoimmune gastritis in childhood.

Patterns of changes in cellular composition of the stomach in chronic gastritis in children and adolescents

The aim of the work is to establish the regularities of changes in the cellular composition of the fundal and pyloric glands in chronic gastritis in children. Material and methods. 213 patients aged 7-17 years with chronic Hp-associated gastritis were examined. The cellular composition of the fundal and pyloric glands was determined in gastrobioptates. Immunohistochemical analysis was used to determine cells containing gastrin, somatostatin, pepsinogens I and II, acidic and neutral mucins. The results were expressed in‰ per 1000 epithelial cells. Results. As inflammation increases in the fundal glands, the number of main and cells containing pepsinogens I and II decreases, the number of lining, additional and endocrine cells increases. In the pyloric glands, the pool of endocrinocytes increases, the number of lining cells and cells immunopositive to pepsinogen II significantly decreases. Parallel to the severity of the process, there is a sharp increase in D- and G-cells and an increase in the number of epithelial cells containing acidic and neutral mucins. Conclusion. Chronic inflammation of the gastric mucosa is accompanied by a significant restructuring of the cellular composition of its glands.

Cellular composition of gastric glands in chronic gastritis among children

Objective. To establish the features of the cellular composition of gastric mucosa glands in chronic Hp-associated gastritis among children to improve its diagnostics. Material and methods. Morphometric analysis of fundal and pyloric gland cell populations was performed in 214 children aged 615 years with Hp-associated chronic gastritis. For this purpose, the number of main, parietal, endocrine and additional cells was calculated in the materials of gastrobiopsy of the gastric mucosa, the result was expressed in (per 1000 epithelial cells). Results. It was found that as the severity of inflammation in the fundal glands increases, the number of main cells decreases, the number of parietal, accessory and especially endocrine cells grows. In the pyloric glands, a reduction of the parietal pool, a decrease in the population of additional cells and a sharp increase in endocrinocytes is registered. With a decrease in the severity of inflammation, positive changes in the cellular composition of the glands are observed, but its full normalization does not occur 6 months after the course of antihelicobacter therapy. A significant proportion of patients, shows morphological signs of gastric mucosa atrophy, which is associated with inflammation and is uncertain. Its presence does not significantly affect the cellular composition of the gastric glands, and the regression of the inflammatory process is accompanied by a decrease in the degree of atrophy or complete disappearance of signs of the latter. Conclusions. The addition of a standard study of gastrobioptates with a quantitative morphometric analysis of the cellular composition of the fundal and pyloric glands in chronic gastritis among children objectifies the data of morphological assessment of pathohistological picture of gastric mucosa.

Clinical variants of chronic gastritis in childhood

Objective. To establish the features of various clinical variants of chronic gastritis in childhood.
 Material and methods. 415 children aged 617 years with chronic Hp-associated gastritis were examined. The clinical and anamnestic data, the results of laboratory, endoscopic and morphological studies of gastrobioptates were analyzed. Genetic typing of Hp was carried out with the determination of 16 pathogenicity factors. The persistence of human herpes viruses of types 6 and 8 and Epstein Barr viruses in the gastric mucosa was determined.
 Results. The clinical heterogeneity of chronic gastritis in children with the allocation of four topical variants was established: isolated duodenitis, duodenogastritis, antrum gastritis, pangastritis. It was found that with the first two, a high frequency of giardiasis is registered, with antrumgastritis and especially pangastritis, a significant contamination of the gastric mucosa with Hp is detected, mainly of CagA and VacA-positive strains. It is proved that the persistence of the type 6 human herpes virus does not affect the severity of inflammation, while the presence of the Epstein-Barr virus increases it. Colonization of the gastric mucosa by highly pathogenic Hp strains significantly increases the severity and activity of inflammation. It is shown that atrophy of the gastric mucosa in children is uncertain, and true atrophic gastritis occurs only in 0.61 % of cases.
 Conclusions. Chronic gastritis in children is a heterogeneous pathology, and its individual variants differ significantly in etiological factors including infectious, pathogenetic mechanisms and features of the morphology of gastric mucosa. This should be taken into account when carrying out medical support for patients.

Dependence of the state of the large intestine parietal microflora on the activity of Helicobacter pylori associated chronic gastritis

Introduction. The aim of the study was to detect the dependence of the composition of the parietal microflora of the colon on the activity of Helicobacter pylori-associated chronic gastritis and the degree of Helicobacter pylori contamination of the gastric mucosa. Materials and methods. The study was carried out on 50 patients aged 24 to 72 years, who were diagnosed with HP-associated chronic gastritis in the phase of exacerbation based on the results of FEGDS and histological examination of biopsies of the mucous membrane of the antrum of the stomach in combination with a rapid urease test. A series of dilutions 10¹-10⁹ was prepared from a homogenized biopsy specimen of the mucous membrane of the sigmoid colon in 0.1 ml of isotonic sodium chloride solution, and 0.1 ml of a solution of the corresponding dilution was inoculated onto the surface of the nutrient medium. The study of mucosal microflora was carried out by means of bacteriological examination of biopsies of the mucous membrane of the sigmoid and cecum. The degree of H. pylori contamination of the gastric mucosa was assessed in the course of histological examination by a semi-quantitative method: low degree of contamination — up to 20 microbial bodies, average — 20-50 microbial bodies, strong — over 50 microbial bodies in the field of view. Results. The study demonstrated that the indicators of the average concentrations of bifidobacteria, lactobacilli and typical strains of E. coli progressively decreased with the transition to a higher degree of HP infection. This tendency was maximum in relation to bifidobacteria — 6.1-1.57-1.09 x 10⁸ CFU/g, with a difference between the maximum (I degree) and minimum (III degree) 5.59 times. A similar relationship, but much less pronounced, was observed for Lactobacterium spp. and E. coli. As the severity of HP infiltration of the gastric mucosa increases, there is a decrease in the concentration of the above microorganisms in the parietal mucin - the correlation coefficient is r = -0.74. Discussion. Since the mucous microflora is more stable and functionally significant than the cavity microflora, the data obtained allow us to consider Helicobacter pylori as an etiological factor of colonic dysbiosis. Conclusion. The probability of excessive growth of conditionally pathogenic fraction of intestinal parietal microflora has a direct dependence on the severity of Helicobacter pylori infestation, being maximum at degree III contamination. Content of bifidobacteria, lactobacilli and typical E. coli strains in the intestinal biotope of the large intestine is inversely related to the degree of histological activity of HP-associated gastritis.

Фармакоэкономический анализ медикаментозного обеспечения военнослужащих при h. рylori-ассоциированном хроническом гастрите

Актуальность. Проблема лечения хронического гастрита у военнослужащих, как одного из самых частых заболеваний желудочно-кишечного тракта, приобретает особую актуальность через призму полученных доказательных данных по определяющей роли H. pylori (НР)-инфекции в прогрессировании заболевания и развития его осложнений и в связи с отсутствием фармакоэкономических обоснованных схем медикаментозной терапии. Высокий уровень резистентности H. рylori-инфекции к антибиотикам является одним из ключевых факторов, влияющих на эффективность антихеликобактерной терапии. Вопросам антибиотикорезистентности НР в Украине посвящены исследования, проведенные в северном, восточном и западном регионах. Из-за близкого географического размещения на западе значительный интерес представляет III Европейское многоцентровое исследование резистентности НР, охватившего 32 центра с 18-ти стран Европейского Союза с включением 2204 штаммов H. pylori. Цель исследования: оценка фармакоэкономической эффективности последовательной и тройной антихеликобактерной терапии при НР-ассоциированном хроническом гастрите с применением препаратов отечественного производства и потенциальной экономической выгоды для Вооруженных Сил Украины. Материалы и методы. При проведении исследований авторами использованы следующие методы: библиографический; математико-статистический; описательного моделирования; структурно-логический метод исследования. Статистическую обработку полученных результатов проводили с помощью пакета Statistica 6.0 (StatSoft Inc., USA). Результаты считались статистически достоверными при P < 0,05. Результаты. Авторами показана динамика заболеваемости хроническим гастритом (ХГ) среди военнослужащих в мирный период. Проанализированы результаты собственных исследований фармакоэкономически обоснованного медикаментозного обеспечения военнослужащих при Н. pylori – ассоциированном ХГ препаратами для проведения тройной и последовательной антигеликобактерной терапии, что способствует повышению эффективности и качества лечения, избеганию неоправданных бюджетных затрат и потенциальным экономическим выгодам для медицинской службы Вооруженных Сил Украины. Выводы. Фармакоэкономический анализ современного медикаментозного обеспечения военнослужащих антихеликобактерными и антисекреторными лекарственными средствами показал целесообразность перехода на последовательную антихеликобактерную терапию с использованием отечественного эзомепразола. Применение у военнослужащих с НР-ассоциированным ХГ последовательной антихеликобактерной и антисекреторной терапии на основе эзомепразола, оптимальной с точки зрения фармакоэкономического анализа, будет способствовать повышению эффективности и качества лечения, избежанию неоправданных бюджетных расходов на лечение и экономическим выгодам для медицинской службы Вооруженных сил Украины.

Giardia lamblia and Helicobacter pylori coinfection in gastrointestinal biopsies: A retrospective single-center analysis from Switzerland

BackgroundThe protozoan Giardia lamblia (GL) and the bacterium Helicobacter pylori (HP) are common causes of gastrointestinal disease. Coinfection is common and has been reported in studies from Africa, Europe, North America and Asia, but data for Switzerland are scarce. AimTo investigate GL and HP prevalence and coinfection rate in gastrointestinal biopsies from the Zurich area of Switzerland. MethodsCases were retrieved from the laboratory information system (Medica Institute of Clinical Pathology, Zurich, Switzerland). Histological slides of cases with GL were reviewed, as were the concurrent gastric biopsies, where available. ResultsBetween January 1, 2013 and December 31, 2020, GL was found in 88 (0.14%) of 62,402 patients with a small intestine biopsy and HP in 10,668 (15.5%) of 68,961 patients with a gastric biopsy. 74/88 (84.1%) of patients with GL had unremarkable small intestine biopsies, 13/88 (14.8%) had increased intraepithelial lymphocytes, 5/88 (5.7%) showed villous atrophy and 2/88 (2.3%) acute inflammation. 71/88 patients (80.7%) with GL had an available gastric biopsy, of which 12/71 (16.9%) were unremarkable, 28/71 (39.4%) had HP-associated gastritis, 11/71 (15.5%) showed reactive gastropathy and 1/71 (1.4%) had autoimmune gastritis. ConclusionCoinfection with HP is common in patients with GL in gastrointestinal biopsies from the Zurich area of Switzerland. Therefore, gastroenterologists should consider sampling the stomach when GL is suspected for evaluation of possible concurrent HP-associated gastritis. Likewise, pathologists should scrutinize any small intestine biopsy for the presence of GL when HP-associated gastritis is seen, and vice versa.

Elevated Expression of DNA Methyltransferases and Enhancer of Zeste Homolog 2 in Helicobacter pylori - Gastritis and Gastric Carcinoma

Aim: The aim of this study was to study the role of key epigenetic regulators pertaining to DNA methylation and histone-modification systems in Helicobacter pylori (HP)-associated gastritis and gastric carcinogenesis. Methods: The expression of DNA methyltransferase (DNMT-1, 3A, and 3B) and the catalytic subunit of polycomb repressive complex-2 (enhancer of zeste homolog 2 [EZH2]) in gastric carcinomas (n = 104), mucosa adjacent to carcinoma (n = 104), HP-associated gastritis (n = 95), and histologically normal mucosa (n = 31) was assessed by immunohistochemistry and qRT-PCR. Results: The expression of all 3 DNMTs and EZH2 was significantly higher in HP-associated gastritis and carcinoma cases than in those with adjacent and normal mucosa. The expression of DNMT-1 and 3B was maximum in HP-associated gastritis. DNMT-3A showed higher expression in carcinoma-adjacent mucosa than in normal mucosa. Interestingly, the expression of EZH2 was higher in cases of HP-associated gastritis with metaplasia than in those without metaplasia and also in cases of intestinal type of adenocarcinoma. Significant positive correlation of EZH2 was identified with DNMT-1, DNMT-3A, and DNMT-3B. However, none of these markers was associated with survival outcome. Conclusion: This study establishes an important role of the key epigenetic regulators in the pathogenesis of both HP-associated gastritis and gastric carcinoma. Higher expression of all the epigenetic markers in the gastritis and their persistence in the carcinoma point toward their implications in HP-driven gastric carcinogenesis. Further, an inter-relation between the 2 arms of epigenetics, namely, DNA methylation and histone-modification in the pathogenesis of gastric carcinoma, is also documented. Given the reversibility of epigenetic phenomenon, these molecules may be of important therapeutic use.

Influence of genetic characteristics of Helicobacter pylori on pathomorphology of gastric mucosa in young persons with chronic gastritis

Objective. To evaluate the effect of the genetic characteristics of Helicobacter pylori on the nature of pathomorphological disorders in the gastric mucosa in chronic Hp-associated gastritis in young people.
 Material and methods. Forty-two adults (25 men and 17 women) aged 19 to 40 years with Hp-associated chronic gastritis were examined. The severity and activity of inflammation, as well as the presence of atrophy and intestinal metaplasia were determined in gastrobioptates. Genetic typing of Hp was performed for 16 pathogenicity factors of infect: CagA, CagM, CagT, CagH, CagC, CagF, CagE, VacAs1 and As2, IceA, Baba; HpaA; OipA, AlpB; UreB and UreI using polymerase chain reaction.
 Results. Pathogenic Hp strains were detected in 59.5 % of patients. Factors of adhesion HpaA (83.3 %), OipA (81 %), and AlpB (83.3 %) were identified with the highest frequency. In 57.1 % of cases, cytotoxin of the Cag group was detected, and 54.8 % of patients had a positive CagA-status. The VacA S1 allele was registered in 73.8 %, VacA S2 in 4.8 %, IceA in 38.1 %, and BabA in 45.2 % of cases. The presence of Hp strains in the gastric mucosa, which have three or more pathogenicity island genes, significantly increases the severity and activity of the inflammatory process, revealing signs of moderate atrophy of the digestive tract and intestinal metaplasia.
 Conclusions. Colonization of the gastric mucosa in young patients with Hp-associated chronic gastritis by highly pathogenic Hp strains leads to severe violations of its morphology.

Прогностические возможности опросника GSRS при эрадикации Helicobacter pylori у пациентов с сахарным диабетом 2-го типа

The study aimed to determine the predictive capabilities of the Gastrointestinal Symptom Rating Scale (GSRS) for assessing the effectiveness of eradication therapy in Helicobacter pylori (HP) infected patients with type 2 diabetes mellitus. The study involved 60 patients of both sexes with a diagnosis of type 2 diabetes mellitus and chronic HP-associated gastritis, the average age of patients was 61.9 years, average duration of type 2 diabetes was 10.1 years. For statistical analysis of the data, we used the method of constructing ROC curves, which allowed us to identify prognostic factors (in this case, gastroenterological syndromes, such as abdominal pain, refl ux, indigestion, diarrhea and constipation) that influence the effectiveness of eradication therapy in patients with type 2 diabetes. It was found that high values of refl ux and indigestion syndromes scales of the GSRS are associated with the probability of low eradication therapy response in patients with type 2 diabetes, i.e. these syndromes can act as complicating factors for the elimination of Helicobacter pylori. The obtained data suggest the need for screening diagnostics of Helicobacter pylori, clinical manifestations of gastrointestinal pathology and subsequent etiological and pathogenetic treatment.

Prediction of true Helicobacter pylori-uninfected status using a combination of age, serum antibody and pepsinogen: Logistic regression analysis.

To prevent gastric cancer, it is important to accurately determine the presence of Helicobacter pylori (HP) infection. However, correctly identifying HP-uninfected individuals is difficult when using the combination of HP antibody and pepsinogen (PG). The aim of this study was to discriminate true HP-uninfected individuals from others without the need for endoscopic examination. A total of 684 subjects with no history of HP eradication who underwent a medical checkup at our hospital were enrolled. The "true uninfected individuals" were determined by a negative stool antigen test and no endoscopic findings of HP-associated gastritis. HP antibody was measured by the latex immunoassay method. Logistic regression analysis using a combination of noninvasive parameters was performed to develop a formula for predicting true uninfected individuals. A total of 528 subjects were classified as true uninfected individuals. Logistic regression analysis showed that statistically significant factors for true uninfected individuals were age (p < 0.001), HP antibody (p <0.001), PGI (p <0.001), and PGII (p = 0.012). The areas under the curve (AUCs) for true uninfected individuals were the highest (0.944) upon applying the prediction formula including four parameters: age, HP antibody, PGI, and PGII. Both the sensitivity and the specificity of the four-parameter prediction formula were higher than those of the traditional three-parameter model using HP antibody, PGI, and PGI/II ratio (sensitivity: 93.2% vs. 86.6% and specificity: 88.5% vs. 82.7%). Our findings suggest that a model with a combination of four noninvasive parameters is useful for predicting true HP-uninfected individuals without the need for endoscopic examination.

The treatment of helicobacter pylori-associated erosive lesions of gastroduodenal zone with the use of interactive learning technologies and rebamipide in young men

Purpose of the study. To evaluate the effectiveness of interactive teaching technologies and rebamipids in the complex therapy of erosive lesions of the gastroduodenal zone in young men.Material and research methods. Two groups of patients were examined. The observation group included 36 recruits with HP-associated gastritis with erosion (HSE) and duodenitis with erosion (DSE). Comprehensive treatment was used as a treatment: standard first-line triple therapy with the inclusion of rebamipide 100 mg 3 times a day for 14 days and interactive therapeutic training. The comparison group consisted of 18 patients with HP-associated GSE and DsE who received standard triple eradication therapy also for 14 days. The average age of the examined patients in the observation group was 21.0 ± 0.7 years, the comparison group was 20.1 ± 0.7 years.Results. The inclusion of Helicobacter pylori-associated gastritis and duodenitis with erosion of rebamipide and interactive learning technologies into the treatment regimen resulted in more effective relief of pain syndrome and dyspeptic manifestations in conscripts, restoration of mucus-forming and acid-producing functions of the stomach; to lower blood cortisol levels; reduce the degree of morphological activity of inflammation. There is a more effective eradication of Helicobacter pylori (91.7%) and epithelization of erosion (97.2%) in comparison with the standard scheme (88.9% and 94.4%, respectively). The use of interactive teaching technologies allowed to increase the level of medical activity and hygienic literacy (96.0% of recruits changed their diet, the nature of nutrition — 88.0%). The level of psycho-emotional status significantly improved after the treatment.Conclusion Combined therapy using rebamipide and interactive therapeutic training is effective in erosive lesions of the gastroduodenal zone in young men and increases patient adherence to treatment and leads to stabilization of psycho- emotional status.

Genetic characterization of the helicobacter pylori infection in adolescents with chronic gastritis

The aim of the work. To establish the features of clinical manifestations and pathomorphology of gastric mucosa in Hp - associated chronic gastritis in adolescents, depending on the genetic characteristics of Hp. Patients and methods. In 133 adolescents with Hp-associated gastritis, polymerase chain reaction was used to determine the presence of pathogenicity factors in the HP genome. Results. In 60,9% of cases, highly pathogenic strains of Helicobacter pylori containing genes Cag (A, C, E, F, H, M, T), UreB, UreI, VacAs1, IceA, BabA, hpaA, AlpB and OipA are detected. Conclusion. The presence of highly pathogenic strains of Hp does not affect the clinical manifestations of gastritis, but is associated with high rates of contamination, increased inflammation, the appearance of signs of atrophy of the gastric mucosa.

Histopathological Evaluation of Prevalent &amp;lt;i&amp;gt;H. pylori&amp;lt;/i&amp;gt; Induced Gastro Intestinal Diseases According to Updated Sydney Classification

Objective: To determine the prevalence of H. pylori induced gastritis and its association with development of chronic inflammation and carcinoma with reference to updated Sydney classification, to ensure the proper diagnosis and timely treatment. Methods: This was a cross sectional study conducted at the Department of Pathology, Dow Diagnostic Reference and Research Laboratory for the year 2018. Analysis of about 726 gastric biopsy specimens was performed to identify the epidemiological status of the disease. On the other hand, 100 of the specimens were analysed according to Sydney classification to ensure the accurate diagnosis of the gastritis and related disorders. Out of 726 biopsy samples positive samples for carcinoma were investigated in detail histological features. Giemsa stain was used to visualize the h pylori bacteria and the sections of biopsies were subjected to haematoxylin and eosin staining for histological analysis. Results: Out of 727 cases, H. pylori was found in 492 (67.8%) patients. About 1.79% (13) cases were identified as adenocarcinoma, 0.27% (2) squamous cell carcinoma and 0.13% (1) as B cell non Hodgkin lymphoma. Results of Sydney classification. The degree of chronic inflammatory activity was 57% mild; 38% moderate and 3% severe out of a total of 67% cases in an active phase of Hp gastritis. Hp-associated gastritis was the most common form of chronic gastritis, without intestinal metaplasia and with mild activity. The association of h pylori with mild inflammation and Neutrophilic infiltrates of the lamina propria, pits, or surface epithelium was statistically significant (p value H. pylori infection is common in our population but the infection is mild to moderate and its Sydney classification reveals that early diagnosis may prevent the later complication.