Efficacy and safety of vonoprazan and high dose amoxicillin dual therapy in eradicating Helicobacter pylori: A systematic review and meta-analysis.

BACKGROUND: Vonoprazan, the new acid suppressive drug, provides more choices for eradicating H. pylori. Therefore, whether vonoprazan and high dose amoxicillin dual therapy is more effective and safer requires a systematic analysis. MATERIALS AND METHODS: A comprehensive search of the literature from PubMed, Embase, Cochrane Library, Web of Science database, up to May 16, 2024. Trails evaluating H. pylori eradicating rates, adverse events, and compliance of VHA dual therapy compared with other therapies were included. RevMan 5.4 was used for statistical analysis. RESULTS: 11 RCTs and 2 retrospective clinical studies with 4570 samples were included. The VHA dual therapy has superior H. pylori eradicating rates (ITT: 86.0% vs 80.7%, OR=1.36, 95% CI 1.07-1.73, P=0.01; PP: 90.6% vs 85.7%, OR=1.42, 95% CI 1.07-1.88, P=0.02), fewer adverse events(15.4% vs 27.7%, OR=0.49, 95%CI 0.35-0.68, P<0.0001), and similar compliance (94.6% vs 93.2%, OR=1.27, 95% CI 0.98-1.64, P=0.07) in comparison to other guideline therapies. According to subgroup analysis with PP data, VHA is more effective than P-BQT (93.5% vs 89.3%, OR=1.76, 95% CI 1.03-3.00, P=0.04). In addition, the eradicating rates of 10-day and 14-day VHA were 92% (95% CI 0.91-0.94) and 93% (95% CI 0.90-0.97) respectively, with the 7-day VHA 65% (95% CI 0.55-0.75). CONCLUSION: VHA dual therapy, for 10 or 14 days showed superior efficacy and safety comparing with therapies recommended by the guidelines, should be prioritized for adoption.

The intake of solid fat and cheese may be associated with a reduced risk of Helicobacter pylori infection status: a cross-sectional study based on NHANES 1999-2000.

BACKGROUND: Diet plays an important role in Helicobacter pylori (HP) infection, and our objective was to investigate potential connections between dietary patterns, specific food groups, and HP infection status in U.S. adults. METHODS: The data for this study was obtained from the NHANES (National Health and Nutrition Survey) database for the year 1999-2000. This cross-sectional study involved the selection of adults aged 20 years and older who had undergone dietary surveys and HP testing. Factor analysis was employed to identify dietary patterns, and logistic regression models were utilized to assess the association between these dietary patterns and specific food groups with HP infection status. RESULT: Based on the inclusion and exclusion criteria, our final analysis included 2,952 individuals. The median age of participants was 51.0 years, and 48.7% were male. In the study population, the overall prevalence of HP infection was 44.9%. Factor analysis revealed three distinct dietary patterns: High-fat and high-sugar pattern (including solid fats, refined grains, cheese, and added sugars); Vegetarian pattern (comprising fruits, juices, and whole grains); Healthy pattern (encompassing vegetables, nuts and seeds, and oils). Adjusted results showed that the high-fat and high-sugar pattern (OR = 0.689, 95% CI: 0.688-0.690), vegetarian pattern (OR = 0.802, 95% CI: 0.801-0.803), and healthy pattern (OR = 0.717, 95% CI: 0.716-0.718) were all linked to a lower likelihood of HP infection. Further analysis of the high-fat and high-sugar pattern revealed that solid fats (OR = 0.717, 95% CI: 0.716-0.718) and cheese (OR = 0.863, 95% CI: 0.862-0.864) were protective factors against HP infection, while refined grains (OR = 1.045, 95% CI: 1.044-1.046) and added sugars (OR = 1.014, 95% CI: 1.013-1.015) were identified as risk factors for HP infection. CONCLUSION: Both the Vegetarian pattern and the Healthy pattern are associated with a reduced risk of HP infection. Interestingly, the High-fat and High-sugar pattern, which is initially considered a risk factor for HP infection when the score is low, becomes a protective factor as the intake increases. Within this pattern, animal foods like solid fats and cheese play a protective role, while the consumption of refined grains and added sugars increases the likelihood of HP infection.

Ferroptosis and Cancer Immunotherapy.

Traditional treatment strategies for cancer are unsatisfactory. As a nonapoptotic cell death process and owning to the characteristics of iron-dependent lipid peroxide accumulation, ferroptosis has become a new target of tumor treatment. Numerous studies have proved that ferroptosis could enhance the immunogenicity of cancer and interact with immune cells. Cancer antigens, exposed to cancer cells that underwent ferroptosis, effectively improve the immunogenicity of the tumor microenvironment and promote the activation and maturation of immune cells. Meantime, immune cells release immunostimulatory cytokines including TNF-α and IFN-γ to downregulate the expression of SLC7A11 and SLC3A2, and reduce the absorption of cysteine, leading to lipid peroxidation and iron deposition in cancer cells. Consequently, induction of ferroptosis via iron deposition-based combination strategies could stimulate and activate natural and adaptive immune responses which release immune-stimulating factors to induce iron deposition in cancer cells. In this review, we provided a critical analysis of the correlation between ferroptosis and the immune responses, providing a novel way to effectively induce ferroptosis in cancer, which may be one of the focuses in future to improve the development of new therapeutic strategies of cancer.