Pylori IgG Antibodies Research Articles

A comprehensive evaluation of fasting serum gastrin-17 as a predictor of diseased stomach in Chinese population

Background and aim. Fasting serum gastrin-17 (FsG17) is considered as a noninvasive biomarker reflecting the structure and functional status of gastric mucosa, but its clinical utility remains unclear. This study aimed to evaluate FsG17 comprehensively: establish the ranges and cut-off points of FsG17 levels in different gastric diseases, identify their influencing factors, and investigate the accuracy of FsG17 for identifying diseased stomach. Methods. The study included 4064 participants from Northern China between 2008 and 2013. FsG17 and serum Helicobacter pylori IgG antibody levels were measured by enzyme-linked immunosorbent assay. Diagnostic accuracy was assessed by receiver operator characteristic curves. Multivariate logistic regression analysis was performed to determine the best predictors of gastric histopathological conditions. Results. Median FsG17 levels in healthy, non-atrophic, atrophic, and cancerous stomachs were 1.8, 4.0, 3.8, and 6.1 pmol/l, respectively. Age, smoking status, alcohol consumption, H. pylori infection, and predominant lesion site were factors that affected FsG17 levels. The optimal cut-off values for FsG17 were 3.0 pmol/l (sensitivity of 59.3% and specificity of 67.3%) for discriminating between healthy stomach and diseased stomach and 10.7 pmol/l (sensitivity of 37% and specificity of 83.7%) for discriminating between cancerous stomach and cancer-free stomach; the screening accuracy was higher (sensitivity of 50.0% and specificity of 83.0%) for gastric cancer in the corpus. Multivariate analysis showed that FsG17, gender, age, and H. pylori infection were independent predictors of cancerous stomach. Conclusion. With the progression from health stomach to malignancy, FsG17 levels significantly increased and were influenced by other factors. FsG17 combined with age, gender, and H. pylori infection could distinguish between cancerous stomach and cancer-free stomach. The results will enhance our understanding of the potential clinical utility of FsG17.

The Role of Serological Tests in Diagnosis of Helicobacter pylori Infection in Children

Background: Helicobacter pylori infection is a common infection that affects human beings. This infection also affects children. Different diagnostic methods such as serology, stool antigen detection, rapid urease test and histology are used to detect this microorganism. Objectives: The aim of this study was to determine the correlation between serology and histology/rapid urease test. Patients and Methods: In this study, two groups (case and control) were selected and matched for age and sex. The case group comprised of 77 children with confirmed H. pylori infection, as they had positive rapid urease test and histology results. The control group included 77 healthy children. Both case and control groups were checked serologically for detection of anti H. pylori IgM, IgG and IgA antibody titers. Receiver operating characteristic (ROC)-analysis software was used for data analysis. Results: Amongst the case group 54.6% were female and 45.4% were male. The most common complaints were abdominal pain (96%) and anorexia (82%). Using ROC-analysis method three cut-off points for IgG, IgM and IgA were obtained. These points were 3.3 U/ML for IgA, 6.4 U/ML for IgM and 9.9 U/ML for IgG. Considering cut-off points for each antibody, higher levels were considered as positive and lower levels as negative. Antibody titers were compared with gold standard methods including histologic and rapid urease tests. IgA level had a sensitivity of 64%, specificity of 58%, accuracy of 59.3%, positive predictive value of 31.5% and negative predictive value of 76.9%. IgM level had a sensitivity of 76%, specificity of 36.1%, accuracy of 74.2%, positive predictive value of 31.5% and negative predictive value of 76.9%. IgG level had a sensitivity of 58.6%, specificity of 61.3%, accuracy of 60.6%, positive predictive value of 36.9% and negative predictive value of 79.3%. Conclusions: Therefore, these antibodies have a relatively high negative predictive value and a low positive predictive value. Thus, their negative results are more valuable. The most sensitive antibody is IgM and most specific antibody is IgG. However, the performances of all serological tests for H. pylori are poor in children and these tests should not be used for diagnosis of H. pylori infection and treatment decisions for the pediatric age group.

P-0071 - Gastric Cancer Risk Screening with Combined Assay for Serum Anti-Helicobacter Pylori IGG Antibody and Pepsinogen Level, So-Called “ABC Method”; Can We Need Imaging Study for Gastric Cancer Screening?

Introduction: Gastric cancer (GC) is the fifth most common cancer (952,000 in 2012) and the second leading cancer deaths (738,000 in 2008) worldwide. The highest incidence rates are in Eastern Asia, Eastern Europe, and South America. Regional variations in part reflect differences in dietary patterns and the Helicobacter pylori (Hp) infection. GC risk screening with combined assay for serum anti-Helicobacter pylori IgG antibody (HpAb) and serum pepsinogen level (PG), so-called “ABC method” classifies population into four different risk groups. Group A, or HpAb(-)PG(-) shows the lowest risk and is expected to have no GC. GC risk increases from B, or HpAb(+)PG(-) to C, or HpAb(+)PG(+). Group D, or HpAb(-)PG(+) reveals the greatest GC risk. Methods: We review the data of endoscopical GC screening program between Jun '12 and Dec '13 in our institute and analyze GC cases detected. Results: ABC method was done to 5850 cases among consecutive 6460 individuals of our endoscopical GC screening program. 70% cases were classified in Group A, 19% in B, 10% in C, and 1% in D. Ten cases of GC were found. Four GC cases belonged to Group A that should have no GC. Two were in B, and four in C. 23% of Group A had Hp eradication history (Hp-er Hx). Three GC cases in Group A experienced Hp eradication. 23% of Group A revealed Hp related findings endoscopically (Hp endo-findings) such as atrophic gastritis. The rest of one GC in Group A had such a condition without Hp-er Hx. No GC was found in all 2885 individuals without Hp-er Hx and Hp endo-findings in Group A. Conclusion: Even Group A in ABC method contains some cases with Hp-er Hx or Hp endo-findings. Such population has certain GC risk. Group A without Hp-er Hx and Hp endo-findings might need no imaging study for GC anymore.

Su1933 Investigating the Role of Helicobacter pylori Pria Protein

G A A b st ra ct s suppresses the development of MGC. To clarify the molecular changes due to H. pylori eradication, in this study, we evaluated differences in molecular alterations related to carcinogenesis in background mucosa of GC between H. pylori positive and negative patients. Materials and Methods: Seventy-seven consecutive patients who underwent ER for GC were enrolled. H. pylori status was analyzed in each patient by two methods: Giemsa staining and serum H. pylori-IgG antibody. Biopsy specimens were obtained from all cases, and DNA was extracted from intestinal metaplasia (IM), a precancerous lesion, via laser capture microdissection. Microsatellite instability (MSI) was evaluated at five loci based on the Bethesda panel; promoter methylation at hMLH1, E-cadherin, p16, and APC was assessed using methylation-specific polymerase chain reaction. Reactivity of monoclonal antibody for colonic phenotype (mAb Das-1) to IM was also evaluated by an immunoperoxidase assay. Results: H. pylori status was negative in 32 of 77 participants (41.6%). The incidence of MSI and hypermethylation at hMLH1, E-cadherin, p16, and APC genes in IM for H. pylori positive and negative patients, respectively, were 47.6%, 23.7%, 10.5% and 56.1% and 36.7%, 6.7%, 3.4%, 38.7% and 35.5%. There were no significant differences in molecular alterations between H. pylori positive and negative cases. mAb Das-1 reactivity to IM was 70.5% in H. pylori positive and 71.0% in H. pylori negative patients, demonstrating no significant difference. Conclusions: Early GC occurs frequently even in H. pylori negative patients. There were no significant differences in molecular alterations in IM between H. pylori positive and negative patients, suggesting that H. pylori eradication may not change the course of molecular alterations in background mucosa once GC has occured in the stomach.

Su1932 H. pylori Might Induce TGF-β1-Induced EMT by Way of cagE

G A A b st ra ct s suppresses the development of MGC. To clarify the molecular changes due to H. pylori eradication, in this study, we evaluated differences in molecular alterations related to carcinogenesis in background mucosa of GC between H. pylori positive and negative patients. Materials and Methods: Seventy-seven consecutive patients who underwent ER for GC were enrolled. H. pylori status was analyzed in each patient by two methods: Giemsa staining and serum H. pylori-IgG antibody. Biopsy specimens were obtained from all cases, and DNA was extracted from intestinal metaplasia (IM), a precancerous lesion, via laser capture microdissection. Microsatellite instability (MSI) was evaluated at five loci based on the Bethesda panel; promoter methylation at hMLH1, E-cadherin, p16, and APC was assessed using methylation-specific polymerase chain reaction. Reactivity of monoclonal antibody for colonic phenotype (mAb Das-1) to IM was also evaluated by an immunoperoxidase assay. Results: H. pylori status was negative in 32 of 77 participants (41.6%). The incidence of MSI and hypermethylation at hMLH1, E-cadherin, p16, and APC genes in IM for H. pylori positive and negative patients, respectively, were 47.6%, 23.7%, 10.5% and 56.1% and 36.7%, 6.7%, 3.4%, 38.7% and 35.5%. There were no significant differences in molecular alterations between H. pylori positive and negative cases. mAb Das-1 reactivity to IM was 70.5% in H. pylori positive and 71.0% in H. pylori negative patients, demonstrating no significant difference. Conclusions: Early GC occurs frequently even in H. pylori negative patients. There were no significant differences in molecular alterations in IM between H. pylori positive and negative patients, suggesting that H. pylori eradication may not change the course of molecular alterations in background mucosa once GC has occured in the stomach.

Su1931 Genetic and Serological Predictors of H. pylori Infection in Patients With Inflammatory Bowel Disease

G A A b st ra ct s suppresses the development of MGC. To clarify the molecular changes due to H. pylori eradication, in this study, we evaluated differences in molecular alterations related to carcinogenesis in background mucosa of GC between H. pylori positive and negative patients. Materials and Methods: Seventy-seven consecutive patients who underwent ER for GC were enrolled. H. pylori status was analyzed in each patient by two methods: Giemsa staining and serum H. pylori-IgG antibody. Biopsy specimens were obtained from all cases, and DNA was extracted from intestinal metaplasia (IM), a precancerous lesion, via laser capture microdissection. Microsatellite instability (MSI) was evaluated at five loci based on the Bethesda panel; promoter methylation at hMLH1, E-cadherin, p16, and APC was assessed using methylation-specific polymerase chain reaction. Reactivity of monoclonal antibody for colonic phenotype (mAb Das-1) to IM was also evaluated by an immunoperoxidase assay. Results: H. pylori status was negative in 32 of 77 participants (41.6%). The incidence of MSI and hypermethylation at hMLH1, E-cadherin, p16, and APC genes in IM for H. pylori positive and negative patients, respectively, were 47.6%, 23.7%, 10.5% and 56.1% and 36.7%, 6.7%, 3.4%, 38.7% and 35.5%. There were no significant differences in molecular alterations between H. pylori positive and negative cases. mAb Das-1 reactivity to IM was 70.5% in H. pylori positive and 71.0% in H. pylori negative patients, demonstrating no significant difference. Conclusions: Early GC occurs frequently even in H. pylori negative patients. There were no significant differences in molecular alterations in IM between H. pylori positive and negative patients, suggesting that H. pylori eradication may not change the course of molecular alterations in background mucosa once GC has occured in the stomach.

Unique features and risk factors of Helicobacter pylori infection at the main children's intermediate school in Rabigh, Saudi Arabia.

This study was conducted to determine characters and risk factors of Helicobacter pylori infection and its relationship with recurrent abdominal pain and other gastrointestinal symptoms at the main children's intermediate school in Rabigh, Saudi Arabia. A cross-sectional study was conducted at a boys' intermediate school. A questionnaire for the gastrointestinal (GI) symptoms and relevant personal and socioeconomic risk factors related to H. pylori infection was distributed followed by H. pylori IgG antibody assay and 14C urea breath test to detect active infection. H. pylori was diagnosed by positive urea breath test in 51.5% of students. H. pylori infection was symptomatic with at least one upper GI symptom in 89.7% of infected students which was higher than symptomatic cases reported in any other study. H. pylori-infected students had significantly more association with the presence of any upper GI symptom (p < 0.001), recurrent abdominal pain (p < 0.001), anorexia (p < 0.001), nausea (p < 0.026), family history of peptic disease (p < 0.001), drinking desalinated municipal water (p < 0.001), lower income (p = 0.02), and eating outside home (p = 0.003) than uninfected students. Logistic regression analysis showed that the most significant predictors of H. pylori infection were presence of any upper GI symptom (OR 5.3, 95% CI 2.32-15.71), family history of peptic disease (OR 2.2, 95% CI 1.11-3.9), and drinking desalinated municipal water (OR 2.1, 95% CI 1.09-3.2). This study presented unique features and risk factors of H. pylori infection in 12-15-year-old Saudi boys in Rabigh, and mainly supported the role of H. pylori in causing recurrent abdominal pain.

Genetic and infectious profiles influence cerebrospinal fluid IgG abnormality in Japanese multiple sclerosis patients.

BackgroundAbnormal intrathecal synthesis of IgG, reflected by cerebrospinal fluid (CSF) oligoclonal IgG bands (OBs) and increased IgG index, is much less frequently observed in Japanese multiple sclerosis (MS) cohorts compared with Western cohorts. We aimed to clarify whether genetic and common infectious backgrounds influence CSF IgG abnormality in Japanese MS patients.MethodologyWe analyzed HLA-DRB1 alleles, and IgG antibodies against Chlamydia pneumoniae, Helicobacter pylori, Epstein-Barr virus nuclear antigen (EBNA), and varicella zoster virus (VZV) in 94 patients with MS and 367 unrelated healthy controls (HCs). We defined CSF IgG abnormality as the presence of CSF OBs and/or increased IgG index (>0.658).Principal FindingsCSF IgG abnormality was found in 59 of 94 (62.8%) MS patients. CSF IgG abnormality-positive patients had a significantly higher frequency of brain MRI lesions meeting the Barkhof criteria compared with abnormality-negative patients. Compared with HCs, CSF IgG abnormality-positive MS patients showed a significantly higher frequency of DRB1*1501, whereas CSF IgG abnormality-negative patients had a significantly higher frequency of DRB1*0405. CSF IgG abnormality-positive MS patients had a significantly higher frequency of anti-C. pneumoniae IgG antibodies compared with CSF IgG abnormality-negative MS patients, although there was no difference in the frequency of anti-C. pneumoniae IgG antibodies between HCs and total MS patients. Compared with HCs, anti-H. pylori IgG antibodies were detected significantly less frequently in the total MS patients, especially in CSF IgG abnormality-negative MS patients. The frequencies of antibodies against EBNA and VZV did not differ significantly among the groups.ConclusionsCSF IgG abnormality is associated with Western MS-like brain MRI features. DRB1*1501 and C. pneumoniae infection confer CSF IgG abnormality, while DRB1*0405 and H. pylori infection are positively and negatively associated with CSF IgG abnormality-negative MS, respectively, suggesting that genetic and environmental factors differentially contribute to MS susceptibility according to the CSF IgG abnormality status.

P674 DNA of Helicobacter species is present in patients with inflammatory bowel diseases

Background: Etiology of inflammatory bowel diseases, chronic diseases of gastrointestinal tract, encompassing Crohn’s disease (CD) and ulcerative colitis (UC) remains unclear. It has been speculated that they are the result of an activation of the immune response to an unknown antigen. Microorganisms of the genus Helicobacter could be this unknown antigen. The aim of this study was to determine the presence of Helicobacter species in patients with IBD. Methods: The study was performed on 62 colon biopsies and serum samples taken from 30 patients with CD and from 32 patients with UC. 16S rRNA gene of Helicobacter spp. was amplified by PCR and analyzed by sequencing analysis. AntiH. pylori IgG antibodies detection was performed by ELISA. Results: In analyzed colon biopsies 25 (40%) were positive for Helicobacter 16S rRNA gene. H. pylori was detected in 16 (25%) patients whereas other Helicobacter spp. in 9 (15%) patients. In patients with CD H. pylori genetic material was detected in 5 biopsies whereas in patients with UC in 11 patients. Other Helicobacter species were detected in 3 patients with CD and in 6 patients with UC. Anti-H. pylori IgG antibodies were detected in 15 (50%) of samples from patients with CD and 15 (46%) of patients with UC. Conclusions: Results of our study suggest that microorganisms of the genus Helicobacter spp. might be involved in the pathogenesis of inflammatory bowel disease. Further studies are needed to establish the relationship between the presence of Helicobacter spp. and IBD.

Eradication Therapy for Urticaria with High Titers of Anti H. pylori IgG Antibody

It is known that idiopathic chronic urticaria occasionally develops with Helicobacter pylori (H. pylori) infection, but the association between urticaria and H. pylori remains unknown. We focused on the relationship between the titer of anti H. pylori IgG antibodies and urticaria. Sixty-five patients with idiopathic urticaria were divided into 3 groups by a difference of their titers. All patients in the high titer (≥40U/ml) group underwent endoscopy of the upper gastrointestinal tract with antral biopsy for the Rapid Urease Test (RUT) or a culture test. We investigated the relationship between the efficacy of eradication therapy against H. pylori and urticaria. The positive rate for H. pylori was 100% (20/20) by RUT or culture test in the high titer group. A CR using antihistamines alone was 0% (0/20) in the high titer group, 27.2% (3/11) in the low titer group and 38.2% (13/34) in the negative group respectively. A CR or PR using antihistamines was 70% (14/20) in the high titer group, 81.8% (9/11) in the low titer group and 97.1% (33/34) in the negative group. After successful eradication therapy, the CR was increased to 56% (9/16) in the high titer group. Regardless of acute or chronic urticaria, a high titer of anti H. pylori IgG antibody can be an indicator for undergoing upper endoscopy, and eradication therapy is strongly recommended. It will be necessary to develop diagnostic criteria for urticaria associated with H. pylori.

Pepsinogen testing for evaluation of the success of Helicobacter pylori eradication at 4 weeks after completion of therapy

Background and objectivePepsinogen levels in plasma are increased by inflammation in the gastric mucosa, including inflammation resulting from Helicobacter pylori infection. A decrease in pepsinogen II level has been suggested as a reliable marker to confirm the successful eradication of infection. The aim of our study was to evaluate the potential role of pepsinogens I and II, gastrin-17 and H. pylori antibodies in confirming successful eradication. Material and methodsAltogether 42 patients (25 women, 17 men), mean age 45 years (range 23–74), were enrolled. Pepsinogens I and II, gastrin-17 and H. pylori IgG antibodies were measured in plasma samples using an ELISA test (Biohit, Oyj., Finland) before the eradication and 4 weeks after completing the treatment. The success of eradication was determined by a urea breath test. ResultsEradication was successful in 31 patients (74%) and unsuccessful in 11 patients (26%). Pepsinogen II decreased significantly in both the successful (P=0.029) and unsuccessful (P=0.042) eradication groups. Pepsinogen I decreased significantly in the successful (P=0.025) but not the unsuccessful (P=0.29) eradication group. The pepsinogen I/II ratio increased in the successful eradication group (P=0.0018) but not in the group in which treatment failed (P=0.12). There were no differences in gastrin-17 or H. pylori antibody values. ConclusionsA decrease in pepsinogen II levels cannot be used as a reliable marker for the successful eradication of H. pylori 4 weeks after the completion of treatment. The increase in pepsinogen I/II ratio reflects differences in pepsinogen production following the eradication irrespective of improvement in atrophy.

Cutoff Serum Pepsinogen Values for Predicting Gastric Acid Secretion Status

Measurement of the gastric acid secretion is useful for estimating the risk for various diseases in the upper gastro-intestinal tract; however, the procedure causes significant distress to the subjects. Pepsinogens I and II are secreted from the gastric fundic glands, and thus, the serum pepsinogen levels reflect the gastric functional statuses. The aim of this study is to establish appropriate serum pepsinogen cutoff points for predicting the gastric acid secretion status. In a total of 627 Japanese subjects, gastric acid secretion was measured with an endoscopic gastrin test, and the serum pepsinogen values and serum Helicobacter (H.) pylori-IgG antibody were also measured. After checking the correlation between gastric acid secretion and serum pepsinogen, the receiver operating characteristics analyses were employed for determining the most suitable cutoff points of serum pepsinogen for the gastric acid secretion status (i.e., hypochlorhydria, profound hypochlorhydria, and hyperchlorhydria). The pepsinogen I/II ratio and pepsinogen I showed the best correlation with gastric acid secretion in H. pylori-positive and H. pylori-negative subjects, respectively. The serum pepsinogen I/II ratio (or pepsinogen I in cases of H. pylori-negative subjects) was useful to determine the gastric acid secretion status with acceptable to outstanding diagnostic accuracy (the range of the area under the curve: 0.79-0.93). The diagnostic accuracy was further improved after stratifying the subjects by H. pylori-infection status. Estimating gastric acid secretion levels by simple measurement of serum pepsinogens will have significant clinical implications in estimating the risks for various diseases of the upper gastrointestinal tract.

Helicobacter Pylori Infection in Patients with Chronic Calcular Cholecystitis a Cross- Sectional Study

Aims: Helicobacter pylori was found in the bile and gallbladder, so we are aiming to examine the relationship between H. pylori-like bacteria and chronic calcular cholecystitis. METHODS: This cross-sectional study was conducted at our hospitals from May 2011 to January 2012. One hundred and forty patients with chronic calcular cholecystitis were enrolled in this study. Gastroscopy with gastric or duodenal H.pylori urease test and detection of H. pylori in serum were done before the surgical procedure for all patients. After cholecystectomy, the gallbladder tissue was investigated for H. pylori by rapid urease test and Geimsa stain. RESULTS: Of all 140 patients 62.1 % were females, mean age of our patients was 39.04 ± 7.3 years. H. pylori IgG antibody titre was positive in 32 patients with biliary duodenitis, in 43 patients with biliary gastritis, and in 18 patients with duodenal ulcer. The gastric rapid urease test was positive in 40.7 %. The gallbladder rapid urease test was positive in 25 %. In 24 patients both gastric and gallbladder mucosa tested positive for rapid urease test. In 28 patients, the gastric urease test was positive while the gallbladder mucosa tested negative. In 13 patients, the gallbladder mucosa tested positive while the gastric mucosa was negative. There was a significant correlation between the rapid urease test in the gallbladder and in the gastric or duodenal mucosa (P = 0.002). Modified Geimsa staining of gallbladder specimens revealed that H. pylori-like bacteria were detected in 63.6 %. There was a significant correlation between histopathological examination of gallbladder mucosa stained with Geimsa stain and the gallbladder rapid urease test (P < 0.001), but not correlated with the gastric urease test (P = 0.210). CONCLUSION: Our study demonstrates that H. pylori is present in the gallbladder mucosa in patients with chronic calcular cholecystitis and might be an etiological cause of chronic inflammation`.

False Sero-Negative Results for Helicobacter Pylori Infection Indicate Increased Risk of Severe Atrophic Gastritis in Japanese Patients

Background/objective: H. pylori infection is commonly diagnosed using an anti-H. pylori IgG antibody test. However, a proportion of results are falsely sero-negative. We investigated characteristics of patients falsely seronegative for H. pylori in relation to gastric atrophy. Methods: H. pylori infection (Hp+ or Hp-) was determined based on culture test, rapid urease test (RUT), and polymerase chain reaction (PCR) test in 280 outpatients. Anti-H. pylori antibody titers ≥ 10 U/ml were diagnosed as sero-positive for H. pylori (IgG+), while those <10 U/ml were sero-negative (IgG-). Serum pepsinogen (PG) I/PG II ratios were calculated as a serological marker of gastric atrophy. Endoscopic gastric mucosal atrophy was also assessed according to the Kimura-Takemoto classification system. Results: The mean PG I/PG II ratio in each group was as follows: Hp-/IgG- (4.99 ± 1.04, n=10), Hp+/IgG+ (2.59 ± 1.51, n=240), Hp-/IgG+ (5.65 ± 2.72, n=4) and Hp+/IgG- (3.02 ± 2.61, n=26). The mean serum PG I/PG II ratio in the Hp+/IgG- group was lower than those of Hp-/IgG- and Hp-/IgG+ groups (P=0.028 and 0.072). Incidence of severe gastric mucosal atrophy in the Hp+/IgG- group was highest of the four groups. Conclusions: Individuals falsely sero-negative for H. pylori infection is at increased risk of severe atrophic gastritis, which is well known as precancerous lesion.

New Guidelines forHelicobacter pyloriTreatment: Comparisons between Korea and Japan

Korea and Japan show the highest incidence of gastric cancer and Helicobacter pylori infection. New 2013 guidelines on H. pylori infection differ between the two countries with regard to the indications for H. pylori eradication, diagnostic methods, and treatment regimens. Indications for eradication in Korean guideline focus on specific diseases such as peptic ulcer disease, low-grade gastric mucosa-associated lymphoid tissue lymphoma, and after resection of early gastric cancer, while Japanese guideline includes all H. pylori-associated gastritis for the prevention of dissemination. With regard to the diagnosis, either noninvasive or invasive method (except for bacterial culture) is recommended in Korea, while two noninvasive tests including serum anti-H. pylori IgG antibody level are preferred in Japan. As for the treatment regimens, second-line treatment (quadruple bismuth-containing regimen) is recommended without first-line triple therapy in areas of high clarithromycin resistance in Korea. However, there is no bismuth-based second-line treatment in Japan, and the Japanese regimen consists of a lower dose of antibiotics for a shorter duration (7 days). Such discrepancies between the two countries are based not only on the differences in the literature search and interpretation, but also on the different approvals granted by the national health insurance system, manufacturing process of the antibiotics, and diagnostic techniques in each country. Collaborations are required to minimize the discrepancies between the two countries based on cost-effectiveness.

Diagnostic Accuracy of the E-Plate Serum Antibody Test Kit in Detecting Helicobacter pylori Infection Among Japanese Children

BackgroundA number of noninvasive diagnostic tests are available to detect Helicobacter pylori infection. Data on serologic testing of children are lacking, however, and thus it remains unclear whether the serology cutoff points used for adults are appropriate for children.MethodsSerum and stool samples were obtained from 73 children who visited 5 hospitals in Japan between March 1993 and December 2009. Analysis of stool samples was carried out using an H pylori stool antigen enzyme-linked immunosorbent assay (HpSA ELISA), and serum antibodies to H pylori were examined using an antibody determination kit (E-Plate Eiken H pylori antibody). The validity of the serologic test was evaluated based on its sensitivity, specificity, and receiver operating characteristics curve.ResultsOf the 73 children included in this study, 34 were HpSA-positive and 39 were negative. Among the 34 HpSA-positive patients, 32 were IgG-positive and 2 were IgG-negative. Of the 39 patients who were HpSA-negative, 38 were IgG-negative and 1 was IgG-positive. The sensitivity, specificity, and positive likelihood ratio for IgG antibody testing were 91.2%, 97.4%, and 35.6, respectively, based on the recommended adult cutoff point of 10 U/ml. Among children, use of cutoff points in the range of 7 to 9 U/ml yielded optimal values for sensitivity and specificity, as well as a positive likelihood ratio.ConclusionsThe performance of the E-plate anti-H pylori IgG antibody test was comparable to that of the stool antigen test and is therefore suitable for epidemiologic studies of H pylori infection in large samples.

Seroepidemiology of Helicobacter Pylori Infection in Pregnant Women in Rural Durango, Mexico

The seroepidemiology of Helicobacter pylori infection in pregnant women in Durango, Mexico is largely unknown. The prevalence of anti-H. pylori IgG antibodies was examined in 343 pregnant women living in rural areas in 7 municipalities in Durango State, Mexico, using enzyme-linked immunosorbent assays (ELISA). A correlation of H. pylori seropositivity with socio-demographic, obstetric and behavioral characteristics of pregnant women was also assessed. In total, 179 (52.2%) of the 343 pregnant women (mean age, 24.2 ± 5.9 years) had H. pylori IgG antibodies, 75 (41.9%) of whom had H. pylori IgG antibody levels higher than 100 U/mL. The seroprevalence of H. pylori infection varied from 33.3% to 65% among municipalities. In contrast, the seroprevalence was comparable among women regardless their age, educational level, occupation, socioeconomic status, animal contacts, foreign travel, eating habits, contact with soil, crowding, sanitary conditions at home and educational level of the head of their families. Multivariant analysis of socio-demographic and behavioral variables showed that H. pylori seropositivity was associated with municipality (OR=1.12; 95% CI: 1.01–1.24; P=0.02). Of the obstetric characteristics, the seroprevalence of H. pylori infection increased significantly with the number of pregnancies and deliveries but not with the number of cesarean sections or miscarriages. Rural pregnant women in Durango had a lower seroprevalence of H. pylori infection than those from populations in developing countries. Results support a variability of H. pylori seroprevalence within a region. Further research at a municipal level might help to understand the epidemiology of H. pylori infection.

Detection of Anti-Helicopacter pylori IgG Antibody, Anti-GAD antibody, Anti-Beta islets cell in a sample of serum with type-2 Diabetes mellitus patients

We have investigated twenty five patients with type-2 diabetes mellitus aged (35-60) years and fifteen healthy persons as control group to detect Anti-Helicobacter pylori IgG antibody. All studied groups were carried out to measure fasting blood sugar, anti- Glutamic acid decarboxylase (GAD), anti-? islets cells antibody by IFAT, Anti-H. pylori IgG antibody by ELISA technique. There was significant elevation in the concentration of fasting blood sugar than in control group (P &lt; 0.05), the patients had negative results for anti-GAD antibody and anti- ? islets cells antibody, there were significant differences (P &lt; 0.05) of anti-H. pylori IgG antibody in 28 % of patients had type-2 diabetes than control group. This lead to suggestion that type -2 diabetes mellitus patients are more susceptible to H. pylori .

Detection of Anti-Helicopacter pylori IgG Antibody, Anti-GAD antibody, Anti-Beta islets cell in a sample of serum with type-2 Diabetes mellitus patients

We have investigated twenty five patients with type-2 diabetes mellitus aged (35-60) years and fifteen healthy persons as control group to detect Anti-Helicobacter pylori IgG antibody. All studied groups were carried out to measure fasting blood sugar, anti- Glutamic acid decarboxylase (GAD), anti-? islets cells antibody by IFAT, Anti-H. pylori IgG antibody by ELISA technique. There was significant elevation in the concentration of fasting blood sugar than in control group (P &lt; 0.05), the patients had negative results for anti-GAD antibody and anti- ? islets cells antibody, there were significant differences (P &lt; 0.05) of anti-H. pylori IgG antibody in 28 % of patients had type-2 diabetes than control group. This lead to suggestion that type -2 diabetes mellitus patients are more susceptible to H. pylori .

Seroprevalence of Helicobacter Pylori Infection among Family Members of Infected and Non-Infected Symptomatic Children

This study determined the prevalence of seropositivity of anti-H. pylori IgG antibodies, and evaluated some socio-epidemiologic characteristics among family members of infected and non-infected symptomatic children. One hundred children with upper gastrointestinal symptoms without previous H. pylori eradication treatment were prospectively studied by both upper endoscopy with histopathological biopsies examination, and serum anti-H. pylori IgG test between July 2012 to June 2013. The patients were subdivided into: H. pylori infected children (GI), and H. pylori non-infected children (GII). Also, 320 of their family members were examined for serum anti-H. pylori IgG and stool antigen tests. Sheets were filled out included personal and medical history. The results showed statistically significant difference between both groups as regard dyspepsia, anemia, and histopathological findings (chronic active gastritis, peptic ulcer, and duodenitis). Family members were subdivided into: those of H. pylori infected symptomatic children (165) and those of H. pylori non-infected symptomatic children (155). Anti-H. pylori IgG prevalence was significantly higher in relatives of GI than those of GII (69.1% vs. 29%; p<0.05). The seroprevalence of H.pylori infection in all family members was (49.7%). Mothers of GI showed the highest seroprevalence (39.5%) as compared to fathers and siblings (22.8%, & 37.7%, respectively). Relatives of GI with low socioeconomic status, and lived in rural area showed the highest seroprevalence (82.5%, & 78.1% respectively).