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Gupta A, Shetty S, Mutalik S, Chandrashekar H R, K N, Mathew EM, Jha A, Mishra B, Rajpurohit S, Ravi G, Saha M, Moorkoth S. Treatment of H. pylori infection and gastric ulcer: Need for novel Pharmaceutical formulation. Heliyon 2023; 9:e20406. [PMID: 37810864 PMCID: PMC10550623 DOI: 10.1016/j.heliyon.2023.e20406] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 10/10/2023] Open
Abstract
Peptic ulcer disease (PUD) is one of the most prevalent gastro intestinal disorder which often leads to painful sores in the stomach lining and intestinal bleeding. Untreated Helicobacter pylori (H. pylori) infection is one of the major reasons for chronic PUD which, if left untreated, may also result in gastric cancer. Treatment of H. pylori is always a challenge to the treating doctor because of the poor bioavailability of the drug at the inner layers of gastric mucosa where the bacteria resides. This results in ineffective therapy and antibiotic resistance. Current treatment regimens available for gastric ulcer and H. pylori infection uses a combination of multiple antimicrobial agents, proton pump inhibitors (PPIs), H2-receptor antagonists, dual therapy, triple therapy, quadruple therapy and sequential therapy. This polypharmacy approach leads to patient noncompliance during long term therapy. Management of H. pylori induced gastric ulcer is a burning issue that necessitates alternative treatment options. Novel formulation strategies such as extended-release gastro retentive drug delivery systems (GRDDS) and nanoformulations have the potential to overcome the current bioavailability challenges. This review discusses the current status of H. pylori treatment, their limitations and the formulation strategies to overcome these shortcomings. Authors propose here an innovative strategy to improve the H. pylori eradication efficiency.
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Affiliation(s)
- Ashutosh Gupta
- Department of Pharmaceutical Quality Assurance, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
| | - Shiran Shetty
- Department of Gastroenterology and Hepatology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
| | - Srinivas Mutalik
- Department of Pharmaceutics, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
| | - Raghu Chandrashekar H
- Department of Pharmaceutical Biotechnology, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
| | - Nandakumar K
- Department of Pharmacology, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
| | - Elizabeth Mary Mathew
- School of Pharmacy, Faculty of Health Sciences, University of Botswana, Gaborone, Botswana
| | - Abhishek Jha
- Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (BHU), Varanasi 221005, Uttar Pradesh, India
| | - Brahmeshwar Mishra
- Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (BHU), Varanasi 221005, Uttar Pradesh, India
| | - Siddheesh Rajpurohit
- Department of Gastroenterology and Hepatology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
| | - Gundawar Ravi
- Department of Pharmaceutical Quality Assurance, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
| | - Moumita Saha
- Department of Pharmaceutical Quality Assurance, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
| | - Sudheer Moorkoth
- Department of Pharmaceutical Quality Assurance, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
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Al-Eitan LN, Almomani FA, Al-Khatib SM. Association of CYP2C19, TNF-α, NOD1, NOD2, and PPARγ polymorphisms with peptic ulcer disease enhanced by Helicobacter pylori infection. Saudi Med J 2021; 42:21-29. [PMID: 33399167 PMCID: PMC7989310 DOI: 10.15537/smj.2021.1.25654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To assess the correlation between a number of genetic variations of CYP2C19, TNF-α, NOD1, NOD2, and PPARγ genes with the severity of Helicobacter pylori (H. pylori) infections and peptic ulcers (PU). METHODS A retrospective cross-sectional design was used in this study. Formalin-fixed paraffin-embedded (FFPE) tissue was used to extract genomic DNA that was collected from Jordanian patients who visited endoscopy clinics between 2014 to 2018 at the King Abdullah University Hospital (KAUH), Irbid, Jordan. Genotyping of the studied single nucleotide polymorphisms (SNPs) were applied using the sequencing protocol. Results: A total of 251 patients (mean age: 42.12 ± 16.09 years) and healthy controls (mean age: 52.76 ± 19.45 years) were enrolled in this study. This study showed no significant association between patients and the studied polymorphisms except for rs2075820 of the NOD1 (p=0.0046). It is hypothesized that the heterozygous genotype (TC); 44.8% in patients versus 61.3% in controls has a decreased risk of peptic ulcers (OR: 0.49). The alleles frequency association was insignificant in all studied SNPs with a p-value more than 0.05. CONCLUSION This study provided evidence regarding the association of the rs2075820 with H. pylori infections. The other studied SNPs were not statistically significant.
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Affiliation(s)
- Laith N Al-Eitan
- Department of Biotechnology & Genetic Engineering, Faculty of Science and Arts, Jordan University of Science and Technology, Irbid, Jordan. E-mail.
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Diagnosis of Helicobacter pylori Infection in a Routine Testing Workflow: Effect of Bacterial Load and Virulence Factors. J Clin Med 2021; 10:jcm10132755. [PMID: 34201588 PMCID: PMC8268826 DOI: 10.3390/jcm10132755] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 06/14/2021] [Accepted: 06/18/2021] [Indexed: 02/07/2023] Open
Abstract
Reliable diagnostic methods are mandatory for effective management of Helicobacter pylori infection. Histology and culture are the most common invasive methods in current practice, even if molecular methods are gaining in importance. The performance of these conventional methods varies significantly. We conducted a retrospective study of 1540 adults and 504 children with gastric biopsies taken during endoscopy to assess the impact of bacterial load and the cagA virulence factor on the performance of H. pylori infection testing. The association between virulence and histology findings was also investigated. With 23S rRNA qPCR confirmed by glmM amplification as the gold standard, culture and histology had lower sensitivity, 74.4% and 73.3%, respectively. However, their sensitivity was enhanced (>90%) in biopsies with high bacterial load (qPCR Ct < 30). Positive cagA status of the strain was associated with high bacterial load (94.9%), thus resulting in more frequent positive culture (94.3%) and H. pylori histology detection (91.7%) and more severe lesions on histology (p < 0.001). Conversely, the cagA status of the strains was negative in 110/119 (92.4%) of biopsies with low bacterial load (qPCR Ct < 30), 82/90 (91.1%) with negative H. pylori histology detection and 119/131 (90%) with negative culture findings (p < 0.001). This study highlights the low sensitivity of conventional culture and histology that may lead to false negative diagnosis if used alone. H. pylori quantification associated with cagA genotyping in routine workflow are essential for a sensitive and reliable diagnosis, to identify patients at high risk and to manage eradication therapies.
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Deng L, He XY, Tang B, Xiang Y, Yue JJ. An improved quantitative real-time polymerase chain reaction technology for Helicobacter pylori detection in stomach tissue and its application value in clinical precision testing. BMC Biotechnol 2020; 20:33. [PMID: 32571272 PMCID: PMC7310109 DOI: 10.1186/s12896-020-00624-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 05/19/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Helicobacter pylori (H. pylori) infection is a serious human health threat. The empiric H. pylori treatment paradigm guided by traditional testing technologies has led to antibiotic resistance. Here, we improved the qPCR method to provide technical support for precision H. pylori diagnosis and treatment. METHODS Two pairs of primers and probes targeting the glmM gene were designed to detect H. pylori, and a multiplex qPCR method was established for virulence factor detection. Then, a rapid urease test (RUT), culturing and qPCR were performed on 141 specimens collected from Xinqiao Hospital of China in 2017 to evaluate the qPCR detection capability. Finally, the H. pylori infectious amount and virulence genes were detected by qPCR. RESULTS 1. The improved qPCR method which used two pairs of primers had a higher detection rate (100%) and better accuracy (p = 0.000), compared with the qPCR using a pair of primers. It also had better consistency with the bacterial culture than with RUT (Kappa =0.440, p < 0.001). 2. The H. pylori infectious amount was significantly positively associated with gastritis in corpus (p = 0.003) and gastric erosion (p = 0.043). The H. pylori infectious amount in gastric precancerous patients was significantly lower than that in H. pylori-positive patients (p < 0.05), and the infectious H. pylori-vacA s1+ amount was significantly greater than that of H. pylori-vacA s1- (p < 0.05). 3. The vacA s1 frequency was significantly higher than that of vacA m1/cagA+/babA2+ in chronic superficial gastritis (p = 0.000), peptic ulcer (p = 0.037) and gastric erosion (p = 0.009). The H. pylori-vacA+/cagA+/babA2+ frequency showed a significant positive correlation (p < 0.05). CONCLUSIONS The H. pylori infectious amount and presence of H. pylori virulence factors showed complex correlations with gastric disease occurrence and development. The improved qPCR with good detection performance can be used for quantitative H. pylori detection and testing for the virulence genes vacA s1, vacA m1, cagA and babA2 simultaneously. These findings will provide valuable information for disease diagnosis and treatment.
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Affiliation(s)
- Ling Deng
- Department of Clinical Microbiology and Immunology, Faculty of Pharmacy and Medical Laboratory Sciences, Third Military Medical University (Army Medical University), No. 30 Gaotanyan Street, Chongqing, 400038, People's Republic of China
| | - Xiao-Yi He
- Department of Clinical Microbiology and Immunology, Faculty of Pharmacy and Medical Laboratory Sciences, Third Military Medical University (Army Medical University), No. 30 Gaotanyan Street, Chongqing, 400038, People's Republic of China
| | - Bin Tang
- Department of Digestive Disease Center, The Third Affiliated Hospital of Chongqing Medical University (General Hospital), Chongqing, China
| | - Yang Xiang
- Department of Clinical Microbiology and Immunology, Faculty of Pharmacy and Medical Laboratory Sciences, Third Military Medical University (Army Medical University), No. 30 Gaotanyan Street, Chongqing, 400038, People's Republic of China
| | - Juan-Juan Yue
- Department of Clinical Microbiology and Immunology, Faculty of Pharmacy and Medical Laboratory Sciences, Third Military Medical University (Army Medical University), No. 30 Gaotanyan Street, Chongqing, 400038, People's Republic of China.
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Wollein Waldetoft K, Råberg L, Lood R. Proliferation and benevolence-A framework for dissecting the mechanisms of microbial virulence and health promotion. Evol Appl 2020; 13:879-888. [PMID: 32431740 PMCID: PMC7232753 DOI: 10.1111/eva.12952] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 01/14/2020] [Accepted: 03/06/2020] [Indexed: 12/29/2022] Open
Abstract
Key topics in the study of host–microbe interactions—such as the prevention of drug resistance and the exploitation of beneficial effects of bacteria—would benefit from concerted efforts with both mechanistic and evolutionary approaches. But due to differences in intellectual traditions, insights gained in one field rarely benefit the other. Here, we develop a conceptual and analytical framework for the integrated study of host–microbe interactions. This framework partitions the health effects of microbes and the effector molecules they produce into components with different evolutionary implications. It thereby facilitates the prediction of evolutionary responses to inhibition and exploitation of specific molecular mechanisms.
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Affiliation(s)
| | - Lars Råberg
- Department of Biology Lund University Lund Sweden
| | - Rolf Lood
- Division of Infection Medicine Department of Clinical Sciences Lund University Lund Sweden
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Talarico S, Leverich CK, Wei B, Ma J, Cao X, Guo Y, Han G, Yao L, Self S, Zhao Y, Salama NR. Increased H. pylori stool shedding and EPIYA-D cagA alleles are associated with gastric cancer in an East Asian hospital. PLoS One 2018; 13:e0202925. [PMID: 30208068 PMCID: PMC6135355 DOI: 10.1371/journal.pone.0202925] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 08/10/2018] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Helicobacter pylori infection increases risk for gastric cancer. Geographic variation in gastric cancer risk has been attributed to variation in carriage and type of the H. pylori oncogene cagA. Colonization density may also influence disease and cagA has been associated with higher shedding in stool. However, the relationship between H. pylori load in the stool and in the stomach is not clear. METHODS To investigate possible differences in H. pylori load in the stomach and shedding in stool, H. pylori load and cagA genotype were assessed using droplet digital PCR assays on gastric mucosa and stool samples from 49 urea breath test-positive individuals, including 25 gastric cancer and 24 non-cancer subjects at Henan Cancer Hospital, Henan, China. RESULTS Quantitation of H. pylori DNA indicated similar gastric loads among cancer and non-cancer cases, but the gastric cancer group had a median H. pylori load in the stool that was six times higher than that of the non-cancer subjects. While the cagA gene was uniformly present among study subjects, only 70% had the East Asian cagA allele, which was significantly associated with gastric cancer (Fisher's Exact Test, p = 0.03). CONCLUSION H. pylori persists in a subset of gastric cancer cases and thus may contribute to cancer progression. In this East Asian population with a high prevalence of the cagA gene, the East Asian allele could still provide a marker for gastric cancer risk. IMPACT This study contributes to our understanding of H. pylori dynamics in the context of pathological changes.
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Affiliation(s)
- Sarah Talarico
- Human Biology Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | - Christina K. Leverich
- Human Biology Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | - Bing Wei
- The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
| | - Jie Ma
- The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
| | - XinGuang Cao
- The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
| | - YongJun Guo
- The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
| | - GuangSen Han
- The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
| | - Lena Yao
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | - Steve Self
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | - Yuzhou Zhao
- The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
| | - Nina R. Salama
- Human Biology Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
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El Khadir M, Alaoui Boukhris S, Benajah DA, El Rhazi K, Ibrahimi SA, El Abkari M, Harmouch T, Nejjari C, Mahmoud M, Benlemlih M, Bennani B. VacA and CagA Status as Biomarker of Two Opposite End Outcomes of Helicobacter pylori Infection (Gastric Cancer and Duodenal Ulcer) in a Moroccan Population. PLoS One 2017; 12:e0170616. [PMID: 28125638 PMCID: PMC5268467 DOI: 10.1371/journal.pone.0170616] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 01/06/2017] [Indexed: 12/13/2022] Open
Abstract
Helicobacter pylori (H. pylori) infection induces inflammation of the gastric mucosa, which may progress to precancerous lesions leading to gastric cancer. Pathological determinism is associated to some virulence genes of the bacterium, notably the vacA and cagA genes. The present study aimed to determine the H. pylori genotypes distribution and their association with sex, age and gastric diseases in a Moroccan population. Gastric biopsy was taken from 1079 consenting patients. The specimens were processed by PCR to identify H. pylori and to determine the genotypic profile by PCR characterizing vacA s, vacA m and vacA i regions directly from biopsies H. pylori positives. VacA genotyping revealed the predominance of vacA m2 (53.2%), vacA s2 (52.9%) and vacA i2 (52%). The most virulent vacA alleles (s1, i1 and m1) are more predominant in men (47.3%, 41.9% and 46.1% respectively) than in women (38.3%, 33.3% and 37% respectively). However, the association between vacA genotypes and age did not reach a statistical significant value. Logistic regression analysis results show that vacA i1m1 and vacA i1m2 genotypes were strongly associated with the risk of GC, the Odds Ratio (95% confidence interval) was 29.73 [5.08-173.73] and 9.17 [2.06-40.82] respectively, while vacAs1/cagA+ seems to be a risk factor for DU since it is inversely associated with GC (OR was 0.13 [0.02-0.75]. The results of this study suggest that vacA i1 genotype independently to vacAm status may be of a clinical usefulness and will help to identify patients at a high risk of GC development.
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Affiliation(s)
- Mounia El Khadir
- Laboratoire de Microbiologie et de Biologie Moléculaire, Equipe Micro-organismes, Génomique et Facteurs Oncogènes, Faculté de Médecine et de Pharmacie de Fès (FMPF), Université Sidi Mohammed Ben Abdellah (USMBA), Fez, Morocco
- Laboratoire de Biotechnologie, Faculté des Sciences Dhar El Mehraz, USMBA, Fez, Morocco
| | - Samia Alaoui Boukhris
- Laboratoire de Microbiologie et de Biologie Moléculaire, Equipe Micro-organismes, Génomique et Facteurs Oncogènes, Faculté de Médecine et de Pharmacie de Fès (FMPF), Université Sidi Mohammed Ben Abdellah (USMBA), Fez, Morocco
| | - Dafr-Allah Benajah
- Service d’Hépato Gastro-entérologie, CHU Hassan II de Fès, Equipe Maladies de l’Appareil Digestif, FMPF, Fez, Morocco
- Laboratoire de Pathologie Humaine, Biomédecine et Environnement, FMPF, USMBA, Fez, Morocco
| | - Karima El Rhazi
- Laboratoire d’Epidémiologie et de Recherche Clinique, FMPF, USMBA, Fez, Morocco
| | - Sidi Adil Ibrahimi
- Service d’Hépato Gastro-entérologie, CHU Hassan II de Fès, Equipe Maladies de l’Appareil Digestif, FMPF, Fez, Morocco
- Laboratoire de Pathologie Humaine, Biomédecine et Environnement, FMPF, USMBA, Fez, Morocco
| | - Mohamed El Abkari
- Service d’Hépato Gastro-entérologie, CHU Hassan II de Fès, Equipe Maladies de l’Appareil Digestif, FMPF, Fez, Morocco
- Laboratoire de Pathologie Humaine, Biomédecine et Environnement, FMPF, USMBA, Fez, Morocco
| | | | - Chakib Nejjari
- Laboratoire d’Epidémiologie et de Recherche Clinique, FMPF, USMBA, Fez, Morocco
| | | | - Mohamed Benlemlih
- Laboratoire de Biotechnologie, Faculté des Sciences Dhar El Mehraz, USMBA, Fez, Morocco
| | - Bahia Bennani
- Laboratoire de Microbiologie et de Biologie Moléculaire, Equipe Micro-organismes, Génomique et Facteurs Oncogènes, Faculté de Médecine et de Pharmacie de Fès (FMPF), Université Sidi Mohammed Ben Abdellah (USMBA), Fez, Morocco
- Laboratoire de Pathologie Humaine, Biomédecine et Environnement, FMPF, USMBA, Fez, Morocco
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Talarico S, Safaeian M, Gonzalez P, Hildesheim A, Herrero R, Porras C, Cortes B, Larson A, Fang FC, Salama NR. Quantitative Detection and Genotyping of Helicobacter pylori from Stool using Droplet Digital PCR Reveals Variation in Bacterial Loads that Correlates with cagA Virulence Gene Carriage. Helicobacter 2016; 21:325-33. [PMID: 26667241 PMCID: PMC4909588 DOI: 10.1111/hel.12289] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Epidemiologic studies of the carcinogenic stomach bacterium Helicobacter pylori have been limited by the lack of noninvasive detection and genotyping methods. We developed a new stool-based method for detection, quantification, and partial genotyping of H. pylori using droplet digital PCR (ddPCR), which allows for increased sensitivity and absolute quantification by PCR partitioning. MATERIALS AND METHODS Stool-based ddPCR assays for H. pylori 16S gene detection and cagA virulence gene typing were tested using a collection of 50 matched stool and serum samples from Costa Rican volunteers and 29 H. pylori stool antigen-tested stool samples collected at a US hospital. RESULTS The stool-based H. pylori 16S ddPCR assay had a sensitivity of 84% and 100% and a specificity of 100% and 71% compared to serology and stool antigen tests, respectively. The stool-based cagA genotyping assay detected cagA in 22 (88%) of 25 stools from CagA antibody-positive individuals and four (16%) of 25 stools from CagA antibody-negative individuals from Costa Rica. All 26 of these samples had a Western-type cagA allele. Presence of serum CagA antibodies was correlated with a significantly higher load of H. pylori in the stool. CONCLUSIONS The stool-based ddPCR assays are a sensitive, noninvasive method for detection, quantification, and partial genotyping of H. pylori. The quantitative nature of ddPCR-based H. pylori detection revealed significant variation in bacterial load among individuals that correlates with presence of the cagA virulence gene. These stool-based ddPCR assays will facilitate future population-based epidemiologic studies of this important human pathogen.
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Affiliation(s)
- Sarah Talarico
- Division of Human Biology, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | | | - Paula Gonzalez
- Proyecto Epidemiológico Guanacaste, Fundación INCIENSA, Guanacaste, Costa Rica
- International Agency for Research on Cancer, Lyon, France
| | | | - Rolando Herrero
- Proyecto Epidemiológico Guanacaste, Fundación INCIENSA, Guanacaste, Costa Rica
- International Agency for Research on Cancer, Lyon, France
| | - Carolina Porras
- Proyecto Epidemiológico Guanacaste, Fundación INCIENSA, Guanacaste, Costa Rica
| | - Bernal Cortes
- Proyecto Epidemiológico Guanacaste, Fundación INCIENSA, Guanacaste, Costa Rica
| | - Ann Larson
- Clinical Microbiology Laboratory, Harborview Medical Center, Seattle, WA, USA
- Department of Laboratory Medicine, University of Washington, Seattle, WA, USA
| | - Ferric C. Fang
- Clinical Microbiology Laboratory, Harborview Medical Center, Seattle, WA, USA
- Department of Laboratory Medicine, University of Washington, Seattle, WA, USA
- Department of Microbiology, University of Washington, Seattle, WA, USA
| | - Nina R. Salama
- Division of Human Biology, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Microbiology, University of Washington, Seattle, WA, USA
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Sabry D, Ahmed R, Abdalla S, Fathy W, Eldemery A, Elamir A. Braf, Kras and Helicobacter pylori epigenetic changes-associated chronic gastritis in Egyptian patients with and without gastric cancer. World J Microbiol Biotechnol 2016; 32:92. [PMID: 27116958 DOI: 10.1007/s11274-016-2048-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Accepted: 03/08/2016] [Indexed: 12/15/2022]
Abstract
UNLABELLED We aimed to study MLH1 and MGMT methylation status in Helicobacter pylori-associated chronic gastritis in Egyptian patients with and without gastric cancer. 39 patients were included in our study. They were divided into 2 groups; patients without (group I) and with gastric adenocarcinoma (group II). Patients were subjected to clinical examination, abdominal ultrasound and upper endoscopy for gastric biopsy. Biopsies were subjected to urease test, histological examination, and DNA purification. H. pylori, Braf, Kras, MLH1 and MGMT methylation were assessed by quantitative PCR. DNA sequencing was performed to assess Braf and Kras genes mutation. qPCR of H. pylori was significantly higher in patients with adenocarcinoma (group II) than those without adenocarcinoma (group I); with a p < 0.001 as well as in patients with age above 50 years with a p value = 0.008. By applying logistic regression analysis it was reported that the H. pylori qPCR is a significant predictor to the adenocarcinoma with OR = 1.025 (95 % CI: 1. 002-1.048), with sensitivity of 90 % and specificity of 100 %. Adenocarcinoma patients had a significantly higher mean age and levels of H. Pylori, Braf, K-ras, methylated MGMT and methylated MLH1 than those of gastritis patients. DNA sequence analysis of Braf (codon 12) and Kras (codon 600) had genes mutation in gastric adenocarcinoma versus chronic gastritis. CONCLUSION H. pylori may cause epigenetic changes predisposing the patients to cancer stomach. Estimation of H. pylori by qPCR can be a good predictor to adenocarcinoma. Braf and Kras genes mutation were reveled in gastritis and adenocarcinoma patients.
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Affiliation(s)
- Dina Sabry
- Medical Biochemistry and Molecular Biology Department, Faculty of Medicine, Cairo University, Giza, Egypt.
| | - Rasha Ahmed
- Endemic Medicine & Hepatology Department, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Sayed Abdalla
- Internal Medicine Department, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Wael Fathy
- Medical Biochemistry and Molecular Biology Department, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Ahmed Eldemery
- Medical Biochemistry Department, Faculty of Medicine, October 6 University, Giza, Egypt
| | - Azza Elamir
- Medical Biochemistry Department, Faculty of Medicine, El Fayoum University, Al Fayoum, Egypt
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Santibáñez M, Aguirre E, Belda S, Aragones N, Saez J, Rodríguez JC, Galiana A, Sola-Vera J, Ruiz-García M, Paz-Zulueta M, Sarabia-Lavín R, Brotons A, López-Girona E, Pérez E, Sillero C, Royo G. Relationship between tobacco, cagA and vacA i1 virulence factors and bacterial load in patients infected by Helicobacter pylori. PLoS One 2015; 10:e0120444. [PMID: 25794002 PMCID: PMC4368826 DOI: 10.1371/journal.pone.0120444] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2014] [Accepted: 01/22/2015] [Indexed: 12/19/2022] Open
Abstract
Background and Aim Several biological and epidemiological studies support a relationship between smoking and Helicobacter pylori (H. pylori) to increase the risk of pathology. However, there have been few studies on the potential synergistic association between specific cagA and vacA virulence factors and smoking in patients infected by Helicobacter pylori. We studied the relationship between smoking and cagA, vacA i1 virulence factors and bacterial load in H. pylori infected patients. Methods Biopsies of the gastric corpus and antrum from 155 consecutive patients in whom there was clinical suspicion of infection by H. pylori were processed. In 106 patients H. pylori infection was detected. Molecular methods were used to quantify the number of microorganisms and presence of cagA and vacA i1 genes. A standardized questionnaire was used to obtain patients’ clinical data and lifestyle variables, including tobacco and alcohol consumption. Adjusted Odds Ratios (ORadjusted) were estimated by unconditional logistic regression. Results cagA was significantly associated with active-smoking at endoscope: ORadjusted 4.52. Evidence of association was found for vacA i1 (ORadjusted 3.15). Bacterial load was higher in active-smokers, although these differences did not yield statistical significance (median of 262.2 versus 79.4 copies of H. pylori per cell). Conclusions The association between smoking and a higher risk of being infected by a virulent bacterial population and with higher bacterial load, support a complex interaction between H. pylori infection and environmental factors.
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Affiliation(s)
- Miguel Santibáñez
- Departamento de Salud Pública, Universidad de Cantabria, Santander, Spain
- IDIVAL-Instituto de Investigación Marqués de Valdecilla, Santander, Spain
- * E-mail:
| | - Estefanía Aguirre
- Microbiology S. Elche University General Hospital, Elche (Alicante), Spain
| | - Sofía Belda
- Microbiology S. Elche University General Hospital, Elche (Alicante), Spain
| | - Nuria Aragones
- CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Environmental and Cancer Epidemiology Unit, National Center of Epidemiology, ISCIII, Madrid, Spain
| | - Jesús Saez
- Digestive Medicine S. Elche University General Hospital, Elche (Alicante), Spain
| | - Juan Carlos Rodríguez
- Microbiology S. Alicante University General Hospital, Alicante, Spain
- Miguel Hernández University, Elche, Spain
| | - Antonio Galiana
- Microbiology S. Elche University General Hospital, Elche (Alicante), Spain
| | - Javier Sola-Vera
- Digestive Medicine S. Elche University General Hospital, Elche (Alicante), Spain
| | | | - María Paz-Zulueta
- Departamento de Enfermería, Universidad de Cantabria, Santander, Spain
| | | | - Alicia Brotons
- Digestive Medicine S. Elche University General Hospital, Elche (Alicante), Spain
| | - Elena López-Girona
- Microbiology S. Elche University General Hospital, Elche (Alicante), Spain
| | - Estefanía Pérez
- Digestive Medicine S. Elche University General Hospital, Elche (Alicante), Spain
| | - Carlos Sillero
- Digestive Medicine S. Elche University General Hospital, Elche (Alicante), Spain
| | - Gloria Royo
- Microbiology S. Elche University General Hospital, Elche (Alicante), Spain
- Miguel Hernández University, Elche, Spain
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Belda S, Saez J, Santibáñez M, Rodríguez JC, Galiana A, Sola-Vera J, Ruiz-García M, Brotons A, López-Girona E, Girona E, Sillero C, Royo G. Quantification of Helicobacter pylori in gastric mucosa by real-time polymerase chain reaction: comparison with traditional diagnostic methods. Diagn Microbiol Infect Dis 2012; 74:248-52. [DOI: 10.1016/j.diagmicrobio.2012.07.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2012] [Revised: 07/11/2012] [Accepted: 07/13/2012] [Indexed: 02/07/2023]
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Real-time PCR for diagnosing Helicobacter pylori infection in patients with upper gastrointestinal bleeding: comparison with other classical diagnostic methods. J Clin Microbiol 2012; 50:3233-7. [PMID: 22837325 DOI: 10.1128/jcm.01205-12] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The aim of this study was to determine the diagnostic usefulness of quantification of the H. pylori genome in detection of infection in patients with upper gastrointestinal bleeding (UGB). A total of 158 consecutive patients with digestive disorders, 80 of whom had clinical presentation of UGB, were studied. The number of microorganisms was quantified using a real-time PCR system which amplifies the urease gene with an internal control for eliminating the false negatives. A biopsy sample from the antrum and corpus of each patient was processed. The rapid urease test, culture, histological study, stool antigen test, and breath test were done. The gold standard was a positive culture or positive results in at least two of the other techniques. When a positive result was defined as any number of microorganisms/human cell, the sensitivity of real-time PCR was greater in bleeding patients, especially in the gastric corpus: 68.4% (95% confidence interval [CI], 52.3 to 84.5%) in non-UGB patients versus 91.5% (95% CI, 79.6 to 97.6%) in UGB patients. When a positive result was defined as a number of microorganisms/human cell above the optimal value that maximizes the Youden index (>3.56 microorganisms/human cell in the antrum and >2.69 in the corpus), the sensitivity and specificity in UGB patients were over 80% in both antrum and corpus. Our findings suggest that some bleeding patients with infection caused by H. pylori may not be correctly diagnosed by classical methods, and such patients could benefit from the improved diagnosis provided by real-time PCR. However, the clinical significance of a small number of microorganisms in patients with negative results in classical tests should be evaluated.
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