Pylori Positivity Research Articles

Helicobacter pylori infection and disease severity in multiple sclerosis patients: Is there a link with HLA alleles?

Backgrounds: Environmental factors such as bacterial infections, as well as genetic factors—in particular the human leukocyte antigen (HLA) alleles—have been implicated in the etiology of multiple sclerosis (MS). This study aims to explore the relationship between Helicobacter pylori infection, HLA alleles, and disease severity in Iranian MS patients. Methods: The study population comprised 125 MS patients and 153 ethnically matched healthy controls. Stool antigen test was used to detect H. pylori, and the expanded disability status scale (EDSS) scores were assessed in the patients. HLA-DRB1 and DQB1 alleles and haplotypes were determined in both the patients and the controls. The relationships between H pylori infection, HLA alleles, and EDSS were also analyzed. Results: HLA-DRB1*15 and DQB1*06 alleles families and the DRB1*15~DQB1*06 haplotype were significantly more frequent in MS patients, whereas HLA-DRB1*14 and DRB1*14~DQB1*05 haplotype were less frequent. Of the 125 MS patients, 38 were diagnosed with active H. pylori infection. We found lower frequencies of HLA-DRB1*15 (P = .08) and DRB1*16 (P = .05) alleles and a higher frequency of DQB1*02 (P = .06) in the H. pylori-positive patients. HLA-DRB1*07 was more prevalent in patients with EDSS≤3.0 (P = .06). More severe MS cases (EDSS>3.0) were linked to H pylori positivity (P = .02), disease chronicity (P = .001), receiving non-steroidal anti-inflammatory drugs (P = .02), and female gender (P = .05). Conclusion: These preliminary findings suggest a link between H. pylori infection and the severity of MS H. pylori-positive patients regardless of the type of HLA carriage.

Abstract PO-183: Racial disparities in Helicobacter pylori infection: A systematic review and retrospective study

Abstract Background/Aims: Racial disparities exist across the spectrum of non-cardia gastric carcinogenesis, from H. pylori infection through gastric intestinal metaplasia and gastric cancer. Currently, there are no guidelines supporting widespread gastric cancer screening in the US, however there are suggestions that race and ethnicity may be important risk factors for both H. pylori infection and gastric cancer. A better understanding of racial differences in H. pylori infection prevalence and virulence might allow for improved risk stratification strategies for gastric cancer prevention. This systematic review sought to provide a comprehensive evaluation of the literature regarding racial disparities in H. pylori infection in the US. The review was performed to inform a larger translational research project at Duke that includes a retrospective study of Duke's patient population with H. pylori infection and gastric intestinal metaplasia. Methods: We performed a systematic search of Medline, EMBASE, and Web of Science through May 26, 2021. Using COVIDENCE software, 4143 studies were imported for screening, and 39 relevant studies that reported H. pylori infection prevalence by race in the US were identified. Odds ratios and prevalence of H. pylori for individual studies were compiled and assessed. We also present here an initial comparison of characteristics by race in a new, large retrospective study of H. pylori and intestinal metaplasia cases diagnosed from upper endoscopy from 2015-2019 at Duke University Hospitals. Results: All studies included documented higher H. pylori infection prevalence in Blacks and Hispanics compared to whites in the US. The ratio of Black to white H. pylori infection prevalence ranged from 1.3 to 5.4; for Hispanic to white H. pylori infection, the prevalence ranged from 1.8 to 4.4. Ten studies included odds ratios or risk ratios in their analysis. Compared to whites, Blacks had 2.6-4.4 times greater odds and Hispanics a 1.8-3.9 times greater odds of having an H. pylori infection. Four studies included prevalence of seropositivity to the H. pylori virulence factors VacA and CagA by race. In three of the four studies, Blacks and Hispanics had higher prevalence rates of infection with both VacA and CagA positive strains. In our local retrospective chart review, among all patients undergoing endoscopic biopsies at Duke in a 5-year period (n=20,352), H. pylori and H. pylori-positive intestinal metaplasia were 4-5 times more common in Blacks compared to whites. Conclusion: In a systematic review, across all identified studies and all time points, Blacks and Hispanics had significantly higher prevalence rates of H. pylori infection compared to whites in the US. This increased prevalence of H. pylori and H. pylori virulence factors may be relevant in the clinical setting relating to H. pylori testing and gastric cancer prevention. Similarly, in our local Duke cohort, a significantly greater percentage of Blacks presented with H. pylori positivity than whites at upper endoscopy. Citation Format: HannahSofia T. Brown, Meira Epplein, Helen Tang, Katherine Garman. Racial disparities in Helicobacter pylori infection: A systematic review and retrospective study [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-183.

Association between Helicobacter pylori infection and food-specific immunoglobulin G in Southwest China.

BACKGROUND Helicobacter pylori (H. pylori) has been found to be associated with extragastrointestinal diseases, possibly including adverse food reactions (such as food allergy or intolerance). However, there are few studies on H. pylori and food allergy or intolerance, and the results are inconsistent. Food-specific immunoglobulin (Ig) G has been revealed to be associated with food allergy or intolerance and can be used as a marker to explore the correlation between H. pylori infection and food allergy or intolerance.AIMTo explore the relationship between H. pylori infection and food-specific IgGMETHODSWe retrospectively analyzed the physical examination data of 21822 subjects from February 2014 to December 2018 in this study. H. pylori infection was detected using the 13C urea breath test. Food-specific IgG of eggs, milk and wheat in serum was assessed. Subjects were grouped according to H. pylori positivity, and the positive rates of three kinds of food-specific IgG were compared between the two groups. Multivariable logistic regression analysis was performed to elucidate the association between H. pylori infection and food-specific IgG.RESULTSThe total infection rate of H. pylori was 39.3%, and the total food-specific IgG-positive rates of eggs, milk and wheat were 25.2%, 9.0% and 4.9%, respectively. The infection rate of H. pylori was higher in males than in females, while the positive rates of food-specific IgG were lower in males than in females. The positive rates of food-specific IgG decreased with age in both males and females. In the H. pylori-positive groups, the positive rates of food-specific IgG of eggs, milk and wheat were all lower than those in the H. pylori-negative groups. Multivariate logistic regression analysis revealed that H. pylori infection was negatively correlated with the food-specific IgG-positive rates of eggs, milk and wheat (odds ratio value of eggs 0.844-0.873, milk 0.741-0.751 and wheat 0.755-0.788, in different models).CONCLUSION H. pylori infection was found to be negatively associated with the food-specific IgG of eggs, milk and wheat in Southwest China.

Elevated gaseous luminal nitric oxide and circulating IL-8 as features of Helicobacter pylori-induced gastric inflammation.

BackgroundGastric nitric oxide (NO) production in response to Helicobacter pylori via inducible nitric oxide synthase (iNOS) is suggested as a biomarker of inflammation and cytotoxicity. The aim of this study was to investigate relationships between gastric [NO], immunological biomarkers and histopathology.Materials and methodsEsophagogastroduodenoscopy was done in 96 dyspepsia patients. Luminal [NO] was measured by chemiluminescence. Biopsies were taken from gastric antrum and corpus for culture and histopathology. H. pylori IgG was detected by immunoblot assay. Biobanked plasma from 76 dyspepsia patients (11 H. pylori positives) was analyzed for 39 cytokines by multiplexed ELISA.ResultsH. pylori-positive patients had higher [NO] (336 ± 26 ppb, mean ± 95% CI, n = 77) than H. pylori-negative patients (128 ± 47 ppb, n = 19) (P < 0.0001). Histopathological changes were found in 99% of H. pylori-positive and 37% of H. pylori-negative patients. Histopathological concordance was 78–100% between corpus and antrum. Correlations were found between gastric [NO] and severity of acute, but not chronic, inflammation. Plasma IL-8 (increased in H. pylori positives) had greatest difference between positive and negative groups, with eotaxin, MIP-1β, MCP-4, VEGF-A, and VEGF-C also higher (P < 0.004 to P < 0.032). Diagnostic odds ratios using 75% cut-off concentration were 7.53 for IL-8, 1.15 for CRP, and 2.88 for gastric NO.ConclusionsOf the parameters tested, increased gastric [NO] and circulating IL-8 align most consistently and selectively in H. pylori-infected patients. Severity of mucosal inflammatory changes is proportional to luminal [NO], which might be tied to IL-8 production. It is proposed that IL-8 be further investigated as a blood biomarker of treatment outcomes.

Prevalence of Helicobacter pylori, gastric atrophy and intestinal metaplasia in gastric biopsy specimens: A retrospective evaluation of 1605 patients

Aim: To evaluate the prevalence of Helicobacter pylori (H. pylori) and related histopathological lesions in gastric mucosa samples in this single-center study. Methods: Esophagogastroduodenoscopy and endoscopic biopsy reports of 1605 elective cases were retrospectively evaluated. Histopathological examination was evaluated according to the Sydney classification. The data were analyzed according to the prevalence of H. pylori, age, gender, gastric atrophy and intestinal metaplasia rates, and the distribution of the study group in the population below 40 years old and over 40 years old. Results: 584 males (Mean age 51.5 ± 16.5 years) and 1021 females (mean age 49.6 ± 16 years), (p = 0.03), a total of 1605 cases were included in the study. The rate of atrophy, metaplasia and H. pylori positivity in total study population were 0.2%, 16%, 71%, respectively. The rate of atrophy in men and women were 1.2% and 0.8%, respectively (p = 0.006). The rate of metaplasia in men and women were 20.9% and 13.7%, respectively (p <0.001). In the population under 40 years of age, the rates of gastric atrophy and intestinal metaplasia were 0.7% and 2.5%, respectively (p = 0.02), above the age of 40, these rates were determined as 10.8% and 18.4%, respectively. (p <0.001). Conclusion: According to the data of our center, the prevalence of H. pylori is high. In addition, the rate of intestinal metaplasia is relatively high in the male population over the age of 40.

Analysis of Helicobacter pylori positiveness and upper gastrointestinal system endoscopy results of Yozgat region in Turkey

Aims: The aim of this study is to analyze the endoscopy and pathology results of patients who underwent endoscopy in Yozgat region, to determine the frequency of Helicobacter pylori (H. pylori) positivity and to compare the results with the data in the literature.&#x0D; Material and Method: Among the patients who applied to our clinic for any reason between 01/01/2019 and 31/12/2019, 772 patients who underwent upper gastrointestinal system endoscopy were included in the study and analyzed retrospectively.&#x0D; Results: The mean age of the patients was 50±16.78 (16–89). 61.3% (n=473) of the patients were female; 38.7% (n=299) were male. When gastroscopic diagnoses were evaluated, the rate of patients reported as "normal upper gastrointestinal endoscopy" was found to be 5.2% (n= 40). The most frequently reported diagnosis was “nonerosive gastritis” with a rate of 59.2% (n=457). Biopsy was obtained in 646 of 772 patients. The most common diagnosis was reported as “chronic active gastritis” with 90.6% (n=585). 626 of the patients had H. pylori pathological evaluation results. While 18.7% (n=117) of the patients were found to be H. pylori negative, 81.3% (n=509) were found to be H. pylori positive. Stomach cancer was found to be 1.3% (n=9) and esophageal cancer was found to be 0.1% (n=1).&#x0D; Conclusion: In the Yozgat region, the frequency of H. pylori positivity was found to be 81.3%, and it is often mildly (+) positive. In addition, the frequency of H. pylori positivity was similar between men and women, consistent with the literature. The most common diagnosis was reported as "chronic active gastritis". While stomach cancer was detected at a rate of 1.3%, esophageal cancer was found at a rate of 0.1%.

Demographic, Chemical, and Helicobacter pylori Positivity Assessment in Different Types of Gallstones and the Bile in a Random Sample of Cholecystectomied Iranian Patients with Cholelithiasis.

Background The occurrence of stones in the gallbladder or common bile duct and the symptoms and complications they cause is called gallstone disease. The symptoms of gallstone disease range from mild, nonspecific symptoms to a severe right quadrant abdominal pain. Characteristics of gallstone types in an Iranian population have not been well studied before and there are very limited studies on the demographic pattern of stone types in our country, so this study is one of the first studies on its kind on the epidemiology of gallstone types in Iran. As information on chemical components of the stone will help in the management and prevention of gallstones, in this study, we aimed to do chemical component analysis of gallstones including cholesterol, bilirubin, and calcium. Given the conflicting reports about the relationship between H. pylori infections and gallstone formation, this study aimed to investigate the relationship between H. pylori positivity in the bile specimen of Iranian patients with cholelithiasis and formation and type of stone. Methods This prospective study reviewed a total of 196 patients who underwent cholecystectomy for symptomatic cholelithiasis at Shahid Beheshti Training and Research Hospital affiliated to the Yasuj University of Medical Sciences between September 2015 and May 2018. Chemical analysis of gallstone components performed using the colorimetry method. Microbiological analysis for H. pylori was done using the OnSite H. pylori Ag Rapid Test on the bile sample. For the validation test of bile, the H. pylori Rapid Stool Ag Test on stool was used, and Cohen's Kappa statistical analysis was done next. Results There were significant associations between the stone types and age, chemical composition of the stones such as calcium, cholesterol, and bilirubin levels, and also H. pylori positivity and cholesterol and bilirubin levels; however, no significant association was found between the stone types and sex, H. pylori positivity and age, sex, stone types, and calcium level. The main bile and validity tests were matched to the substantial agreement according to Cohen's Kappa analysis. The most common drugs used were proton pump inhibitors, nonsteroidal anti-inflammatory drugs, antihypertensive drugs, and oral contraceptives. Conclusions This study suggested that the chemical composition of the stones could predict the presence of bacteria, there is no correlation between H. pylori and gallstone formation, and some of the drugs could be predisposing factors for gallstones. This work provides an objective basis for further research into gallbladder stone formation; meanwhile, it has great significance in the treatment and prevention of gallbladder stones. Trial registration. The project was found to be in accordance to the ethical principles and the national norms and standards for conducting research in Iran with the approval ID IR.YUMS.REC.1399.147 and date 2020.09.23, and this project is the result of a residency dissertation to obtain the specialty in general surgery, which has been registered with the research project number 960159 in the Vice Chancellor for Research and Technology Development of the Yasuj University of Medical Sciences, Yasuj, Iran, URL: https://ethics.research.ac.ir/EthicsProposalViewEn.php?id=160634.

Potential Predictors and Prevalence of Helicobacter pylori Infection Among Adult Patients With Dyspepsia: A Retrospective Study From Qatar.

AimTo study the prevalence of Helicobacter pylori (H. pylori) infection among dyspeptic patients of various ethnic origins in Qatar and determine the association between H. pylori infection and various demographic factors and endoscopic findings.MethodsA retrospective data review was carried at Alkhor Hospital, Hamad Medical Corporation, Qatar. Adult patients who underwent endoscopy for the evaluation of dyspepsia between January 2011 to December 2017 were included. Patients who underwent endoscopy for reasons other than dyspepsia and those with incomplete data were excluded.ResultsOf the 638 subjects included, 58.9% were males, and the mean age of the subjects was 42.2 years (range 18-79 years). Epigastric pain (80.6%) was the most common symptom, followed by heartburn (26.2%). Forty point nine percent (40.9%) had a positive Campylobacter-like organism (CLO) test for H. pylori. A higher prevalence of H. pylori infection was observed among subjects between 31-50 years of age (43.6%) and 18-30 years (40.5%), and in Asian (42.2%) and Middle East and North African nationals (MENA) nationals (40%). Among the endoscopic findings, esophagitis (P=0.002) and gastritis (P=0.001) showed a statistically significant correlation with H. pylori positivity. Univariate regression analysis revealed an increased risk for H. pylori infection among all age groups except above 65 years, with an odds ratio (OR) of more than 2 in all the three age groups. Among various ethnicities, patients from Asia and MENA countries showed an increased risk of getting H. pylori infection (OR 1.16, 95% CI; 0.77,1.75 and OR 1.06, 95% CI 0.70,-1.61 respectively). The multivariable logistic regression analysis showed that subjects with endoscopic findings of esophagitis (adjusted OR 1.67, 95%CI 1.19, 2.34; P=0.003), gastritis (adjusted OR 1.79, 95%CI 1.27, 2.57; P=0.001), and duodenal ulcer (adjusted OR 2.41, 95%CI 1.24, 4.70; P=0.010) remained significantly associated with an increased risk of having H. pylori infection.ConclusionThe burden of H. pylori infection in patients with dyspepsia undergoing endoscopy is not low in Qatar. Less than 65 years of age, Asian nationals, and being from the MENA region were the demographic predictors for H. pylori infection. The finding of esophagitis, gastritis, and duodenal ulcer on endoscopy were independent endoscopic predictors for having H. pylori infection.

Alteration of P53, hMLH1, and HER2 Gene in Bangladeshi Gastric Cancer Patients: Their Association with H. pylori Infection and Clinicopathological Factors

Background Gene alterations are required for the development of gastric cancer, which are influenced by environmental and host factors. We conducted the present study to find the status of Helicobacter pylori (H. pylori) infection and its association with altered genes P53, hMLH1, and HER2 in gastric cancer patients and to analyze their correlation with clinical, pathological, and environmental factors.Method This was a cross-sectional study. For genetic (P53 and hMLH1) study of the gastrectomized tissue DNA extraction and optimization, we performed PCR amplification and DNA sequencing. HER2 was studied by immunochemical technique. The results were matched with tumor status, age and sex, smoking, and H. pylori antibody status of the patients to find their association.Results The mean age of the patients was 52.91 (±13.94) years. Among the 45 patients selected for genetic tests, 12 aged 40 or more and 33 aged over 40. Among the genes, 33(73.3%) in P53 and 17(37.7%) in hMLH1 were mutated and 11(24.2%) in HER2 were found to be overexpressed. Chi square and regression analysis showed that they all had associations with H. pylori positivity (P 1). hMLH1 was associated with the location of the tumor, smoking, sex, blood group, and age, and P53 was found to be affected by extra salt intake, sex, blood group, and age of the patients (P ≤ 0.05 ).Conclusion Genetic mutation was found in nearly all the patients with gastric cancer, which was significantly associated with H. pylori infection. Mass eradication of this organism might play a role in reducing cancer incidence in Bangladesh.

Factors influencing Helicobacter Pylori positivity in children.

Helicobacter pylori (H. pylori) is a common bacteria all over the world. The factors influencing the acquisition and prevalence of H. pylori infection are still poorly understood. The aim of this study was to determine the factors that may affect H. pylori positivity in patients who presented to the pediatric clinic. The study included 374 children who attended the pediatric clinic with gastrointestinal complaints. The demographic characteristics of patients were recorded, and fecal samples were examined for H. pylori positivity with a prepared kit procedure. In addition, the samples were examined under microscope for the diagnosis of parasites in stool. The Chi-square analysis and binary logistic regression analysis were used for data analysis. The odds ratio was calculated as an estimate of the relative risk. Results: The study found the incidence of H. pylori positivity to be 18.7%. It was observed that in all H. pylori positive patients had growth retardation. H. pylori positivity had no significant relationship with the presence of parasites in the stool (p = 0.113). The results of the Chi-square test showed that H. pylori positivity was significantly changed age groups and educational levels. Logistic regression analysis showed that "age" and "educational status" are significant predictors of H. pylori positivity (p = 0.023 and 0.017, respectively). The risk of H. pylori positivity in the 11-18 age group patients was found about two times (OR: 2.024) higher than in the 6-10 age group patients. The risk of H. pylori positivity in those with education level of "Middle school and above" were found to be twice as high (OR: 2.126) than those with a primary education level (OR: 2.126). In this study, adolescent age and middle school and above level were found to be risk factors for H. pylori. This suggests that there may be other conditions influencing H. pylori positivity. Also, since the frequency of H. pylori is high in those with growth retardation, H. pylori should be considered when evaluating children with growth retardation.

Frequency infections of Helicobacter pylori and Epstein - Barr virus in Iraqi patients with chronic gastritis and their serum level of P16

PurposeThis study aimed to detect Epstein-Barr virus (EBV) and Helicobacter pylori (H. pylori) infections as leading causes to Gastric Cancer (GC). Furthermore, it detected the effect P16 protein and its association with the mentioned diseases. MethodsRapid Urease Test (RUT) was adopted to detect the presence of H. pylori in the gastritis samples. The total DNA was extracted from all samples for qualitative detection using real-time PCR specific kits. Both EBV and H. pylori were detected qualitatively. As for the level of P16, it was estimated in sera using ELISA technique. ResultsThe results of (RUT) showed that (78) samples were positive for H. pylori from the 115 total samples. On other hand, the results of the real time- PCR test showed that (82%) of patients with Gastric Cancer were infected with H. pylori and (5%) of them have EBV infection. The results also reported that (25%) of patients with gastric ulcer have an infection with H. pylori but none of the samples suffering from gastric ulcer showed an infection with EBV. The serum levels of p16 showed a significant change in testing groups (p < 0.05) when comparing between H. pylori with gastric cancer with control, and H. pylori with gastric ulcer groups. ConclusionsIt is concluded that (RUT) has low accuracy results (31.58%). The percentage of H. pylori positivity was significantly higher in gastric cancer (82%), whereas in gastric ulcer it showed lower frequency (25%) but it showed significant relationship. Moreover, the study concluded that the occurrence of EBV infection in gastric cancer is low (5%), while in gastric ulcer is rare (0%). However, there are significant differences in P16 regulatory protein, EBV, either alone or in combination with H. pylori infection.

The prevalence of Helicobacter pylori and its effect on prognosis of patients with COVID-19

Objective: SARS-CoV-2 RNA positivity in stool in COVID-19 infection has been reported at rates varying between 6-83%. The purpose of this study was to determine the prevalence of H.pylori and investigate whether it determines the disease prognosis in COVID-19 patients.&#x0D; Methods: This study was conducted on 117 confirmed COVID-19 patients who were hospitalized due to symptomatic pneumonia and tested for stool H.pylori antigen. Stool H. pylori test outcomes, demographic parameters, laboratory findings, and prognostic predictors of disease were recorded. The effect of the presence of H.pylori in patients with COVID-19 was analyzed.&#x0D; Results: The mean age of 117 included patients was 49.68 ± 14.62 years, 78 (66.7%) had COVID PCR positivity and 32 (27.35%) had H.pylori positivity. There was no statistical difference in demographic data, prognosis, and laboratory parameters between those with and without H.pylori.&#x0D; Conclusion: H.pylori positivity was detected as 27.35% in patients with COVID-19 infection. However, we could not find the positive or negative effect of H.pylori on the prognosis of COVID-19 disease. In conclusion, according to the results of this study, H. pylori positivity or negativity neither determined the severity of the COVID-19 disease nor the poor prognostic indicators of the disease.

EFFECT OF HELICOBACTER PYLORI INFECTION ON NON VARICEAL BLEEDING IN PATIENTS WITH LIVER CIRRHOSIS

Background: Variceal bleeding in chronic liver disease has been studied extensively. However, 30-40% of upper digestive hemorrhages in cirrhotic patients are non variceal (NVUGIB). Clinical features and endoscopic findings of this population have rarely been reported. Objective: To determine the prevalence of H. pylori infection in cirrhotic patients with non variceal upper gastrointestinal bleeding. Patients and methods: This was carried out at Hepatology, Gastroenterology and Infectious Diseases Department of Al-Azhar University Hospitals, and conducted on 150 patients infected by H. pylori From May 2019 till November 2019. Pateints were selected and divided into three equal groups: Group A: Patients with recent active bleeding (maximum within two days) of non variceal origin diagnosed endoscopically. Group B Matched cirrhotic patients without history of upper gastrointestinal bleeding, and group C Non-cirrhotic patients without history of upper gastrointestinal bleeding. Upper GI Endoscopy was done for all patients of the studied groups. Multiple biopsies were taken and H.pylori infection was determined by Histopathology. Results: The mean age of participants was 54.3 years. Males were 79 (52.6%) while females were 71 (47.3%). 58 of 150 patients (38.6%) were positive for H. pylori. there was no significant relation between H. pylori positivity and cause of cirrhosis. there was significant relation between H. pylori positivity and Sex of the studied cases. And there was high significant difference between the studied groups as regard H. pylori distribution. Conclusion: There was significant association between H. pylori infection and non variceal upper gastrointestinal bleeding. Eradication therapy has a role in reducing the incidence of NVUGIB in cirrhotic patients.

The Expression and Relationship of AdipoR1/R2 in Gastric Intestinal Metaplasia

Adiponectin (ApN) is a 244-amino acid protein mainly secreted from the adipose tissue and involved in various physiological functions. ApN exerts its metabolic effects by binding to two major receptors: adiponectin receptor-1 (Adipo-R1) and adiponectin receptor-2 (Adipo-R2). Recent studies have reported ApN's involvement in the progression of cancer. However, there are no studies evaluating the relationship between Adipo-R1/R2 expression and gastric intestinal metaplasia (IM), which is a predisposing factor in gastric cancer (GC) development, and Helicobacter pylori H. pylori infection. In this study we aimed to investigate the relationship between the Adipo-R1/-R2 expression and H. pylori infection in patients with GC and gastric IM. Forty patients that underwent gastric resection and 56 patients that developed gastric IM were included in the study. The Adipo-R1/-R2 expression and the presence of H. pylori were examined immunohistochemically. The univariate analyses showed that the expression of Adipo-R1/-R2 in GC patients was significantly lower compared to both complete metaplasia (CM) and incomplete metaplasia (ICM) patients (p <0.0001 for both). According to multiple multinomial logistic regression analysis, Adipo-R1/-R2 expression in the CM group was significantly higher than in the GC group (p = 0.05, p = 0.014, respectively). Moreover, Adipo-R1/-R2 expression was significantly higher in ICM group compared to the GC group (p=0.012, p=0.045, respectively). However, in both analyses no significant difference was determined in terms of H. pylori positivity between the groups. The resulting data suggests that ApN plays a role in GC processes via Adipo-R1/-R2 receptors.

The Relationship between Helicobacter pylori Infection of the Gallbladder and Chronic Cholecystitis and Cholelithiasis: A Systematic Review and Meta-Analysis.

Helicobacter pylori (H. pylori) is proved to be the main pathogenic agent of various diseases, including chronic gastritis, gastric ulcer, duodenal ulcer, and gastric cancer. In addition, chronic cholecystitis and cholelithiasis are common worldwide, which are supposed to increase the total mortality of patients. Epidemiologic evidence on the relationship between H. pylori infection of the gallbladder and chronic cholecystitis/cholelithiasis still remains unclear. We conducted a systematic review and meta-analysis of overall studies to investigate the relationship between H. pylori infection of the gallbladder and chronic cholecystitis/cholelithiasis. Two researchers searched PubMed, Embase, and Cochrane Library databases to obtain all related and eligible studies published before July 2020. The pooled odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were calculated by the random-effects model. Subgroup analysis, heterogeneity, publication bias, and sensitivity analysis were also conducted. Twenty studies were included in the meta-analysis, involving 1735 participants and 1197 patients with chronic cholecystitis/cholelithiasis. Helicobacter species infection of the gallbladder was positively correlated with increased risk of chronic cholecystitis and cholelithiasis, especially H. pylori (OR = 3.05; 95% CI, 1.81–5.14; I2 = 23.5%). Besides, country-based subgroup analysis also showed a positive correlation between the gallbladder H. pylori positivity and chronic cholecystitis/cholelithiasis risk. For Asian and non-Asian country studies, the ORs were 4.30 (95% CI, 1.76–10.50; I2 = 37.4%) and 2.13 (95% CI, 1.23–3.70; I2 = 0.0%), respectively. The association was more obvious using the bile sample and urease gene primer. In conclusion, this meta-analysis provided evidence that there is a positive correlation between H. pylori infection in the gallbladder and increased risk of chronic cholecystitis and cholelithiasis.

Relationship between Helicobacter Pylori and Parapsoriasis

Aim: Parapsoriasis is a rare skin disorder characterized by erythematous, squamous, atrophic patchy lesions. Its etiopathogenesis and trigger factors still remain unclear. Parapsoriasis cases carry an increased risk of transformation into cutaneous T cell lymphoma. In the literature, there is no data about Helicobacter pylori (H. pylori) frequency in parapsoriasis. This study aims to evaluate the relationship between H. pylori infection and parapsoriasis.Materials and Methods: The study included thirty patients with parapsoriasis who had no dispeptic complaint and thirty healthy individuals. The patient group was divided into two groups as patients with small plaque parapsoriasis (SPP) and those with large plaque parapsoriasis (LPP) based on clinical examination. Carbon 14 urea breath test was performed to evaluate presence of H. pylori in both patient and control groups.Results: Parapsoriasis cases had a significantly higher rate (18/30, 60.0%) of H. pylori positivity than controls (9/30, 30.0%) (p=0.020). Whereas patients with SPP and patients with LPP had similar rates of H. pylori positivity (55.6% vs 44.4%, p=0.279). Comparison of H. pylori status according to gender it was found that majority of H. pylori positive individuals were men, indicating a significant difference (p=0.014).Conclusion: Our results revealed that H. pylori infection is increased in patients with parapsoriasis. Therefore, it was thought that H. pylori may be associated with parapsoriasis and this agent may play a role in the etiopathogenesis of the disease.

Gastroduedonal Yakınmaları Olan Hastaların Dışkı Örneklerinde Helicobacter pylori Antijen Pozitifliğinin Retrospektif Olarak Değerlendirilmesi

Objective: Helicobacter pylori is an important pathogen that causes the development of important gastroduodenal pathologies such as acute and chronic gastritis, ulcer and gastric cancer. This pathogen is estimated to infect about half of the world’s population. In this study, it was aimed to evaluate the five-year data retrospectively by investigating the presence of H. pylori antigen in stool samples taken from patients who applied to Istanbul University-Cerrahpaşa Medical Faculty Medical Microbiology Department Serology/ELISA laboratory with gastroduodenal complaints between January 2015 and December 2019. Method: Stool specimens of 4696 patients admitted to the hospital with gastroduodenal complaints between January 2015 and December 2019 were analyzed using an immunochromotographic H. pylori stool antigen test containing monoclonal antibodies. Results: Among 4696 patients who were examined retrospectively in a five-year period, 1176 (25%) had positive, and 3520 (75%) of them negative H. pylori test results. H. pylori-positivity was found in 210 (21.30%) of 986 children and 966 (26.04%) of 3710 adults. H. pylori detection rate in children was found to be significantly lower than adults (p: 0.002). H. pylori positivity was found higher in the 30-39 age range compared to other age groups. Conclusion: Although current study results showed a lower prevalence compared to recent studies, it has been concluded that H. pylori is an important pathogen in all age groups with gastroduodenal complaints and should be monitored in the community.

Liver Involvement by Perforated Peptic Ulcer: A Systematic Review.

Background and Objective:Liver penetration by a confined perforation of peptic ulcer is a rare but severe event. Its clinical and pathological features are unclear.Methods:In total, 41 qualified English publications were identified using the PubMed database and one in-house case.Results:Among the 42 patients, 20 patients had liver involvement by a perforated duodenal ulcer and 22 by a gastric ulcer. Among the 23 cases of known ulcer histology, 2 ulcers were malignant and were adenocarcinomas in the gastric remnant and the remaining 21 ulcers were confirmed as histologically benign (for frequency of malignancy in duodenal versus gastric ulcers, p = 0.48). The presence of hepatocytes was the clue of diagnosis for 19 cases. The median ages of the patients were 64.5 years (95% Confidence Intervals [CI] 53.40–71.90) for duodenal ulcer and 65.5 years (95% CI: 59.23–70.95) for gastric ulcer, respectively. The male to female ratio was 1.5:1 for duodenal ulcers and 2:1 for gastric ulcers. Patients with liver involvement of a perforated gastric ulcer were more likely to have a larger ulcer (median largest dimension, 4.75 cm versus 2.5 cm, p = 0.014). Female patients with liver involvement of a gastric ulcer were older than male patients (median age 72 versus 60 years, p = 0.045). There were no differences in gender, region (Asia, Europe, America versus others), use of non-steroidal anti-inflammatory drugs (n = 15), H. Pylori positivity (n = 10), possible history of peptic ulcer disease (n = 19) or mortality (n = 32) between duodenal and gastric ulcers.Conclusions:Careful histologic examination, clinicopathological correlation, and immunohistochemistry are critical to establish the diagnosis and avoid misdiagnosing liver involvement as malignancy.

Relation of alcohol to Helicobacter pylori infection: A cross sectional study

Introduction: H. pylorus is found in half the population of the world. Worldwide, H. pylorus is by far the most common aetiological agent for non self-limiting gastritis. Socioeconomic conditions in childhood is identified as a major risk factor for infection. Many studies have been conducted to establish the association of alcohol consumption and H Pylori gastritis, however the results reported by these studies were inconsistent. Need of the present study is to assess the relation of alcohol consumption to H. pylori infection. Objective: To assess the proportion of H. pylori and atrophic gastritis in alcoholic patients with upper gastrointestinal symptoms. Materials and Methods: A prospective study was conducted from October 2013 to June 2015 in the Department of Gastroenterology, M.S. Ramaiah Hospitals (M.S. Ramaiah Teaching Hospital and M.S. Ramaiah Memorial Hospital), Bangalore. 150 alcoholic patients were involved in the study. Age, sex, presenting complaints and detailed history regarding alcohol intake was taken. Rapid urease test was done for all the patients and a gastric biopsy sample was obtained from the antrum of the stomach and sent to the pathology department. Sections made from the gastric biopsy sample were stained with H and E and Giemsa stain. Sections were then evaluated for the presence of H. pylori. Results: In the 150 alcoholic patients included in the study, prevalence of H. pylori was 76%. The age and the gender did not play a role in the H. pylori infection. It was observed in the study that the prevalence of H. pylori infection increased with the increase in frequency, duration, amount of alcohol intake with a statistically significant p value. It was found that the consumption of spirit was associated more with H. pylori positivity than beer intake. Conclusion: The prevalence of H. pylori infection increases with the increase in frequency, duration and quantity of alcohol intake. The type of alcohol consumed also plays a role in H. pylori

The Effect of Helicobacter pylori on the Presentation and Clinical Course of Coronavirus Disease 2019 Infection.

ABSTRACTObjectives:Novel coronavirus 2019 (corona virus disease 2019 [COVID-19]) binds angiotensin-converting enzyme-2 (ACE-2) receptors to enter the cell. These receptors are widely expressed in the intestine, and COVID-19 may cause gastrointestinal symptoms via these receptors during the course of the disease. Helicobacter pylori is known to increase the expression of ACE-2 receptors in the gastrointestinal tract. The aim of this study was to investigate the effects of H pylori on the presentation and clinical course of COVID-19 infections.Methods:This study was carried out from June 1 to July 20, 2020. Patients diagnosed with COVID-19 infections by PCR tests were included in the study. Antigen screening tests were performed on stool samples to determine the presence of H pylori. All patients were evaluated for manifestations of COVID-19 infection, severity of the course, hospitalized days because of the virus and outcome of the disease process.Results:Of 108 COVID-19 positive patients evaluated, 31 with a mean age of 49.54 ± 17.94 years were H pylori-positive (8 girls [25.8%]) and 77 with a mean age of 47.85 ± 20.51 years; (31 girls [40.3%]) were H pylori-negative. Abdominal pain (19.4% vs 2.6%) and diarrhea (32.3% vs 9.1%) were significantly higher in patients with H pylori than those without (P = 0.007 and P = 0.006, respectively). There was no statistically significant difference between H pylori positivity and the number of hospitalized days, the severity of the course of COVID-19 infection, or the outcome of the disease (P > 0.05).Conclusion:Our results revealed that the findings of abdominal pain and diarrhea strongly correlated with the presence of H pylori in COVID-19 patients.