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2.
Medicine (Baltimore) ; 100(3): e24282, 2021 Jan 22.
Artículo en Inglés | MEDLINE | ID: mdl-33546052

RESUMEN

BACKGROUND: Helicobacter pylori (Hp) is the only bacterium in the stomach. It is characterized by its ability to adhere to gastric mucosa and cause a series of pathological changes in the gastric mucosa. Modern research shows that Hp is an important pathogenic factor for chronic gastritis, gastroduodenal ulcer, and gastric cancer. Triple, quadruple, and triple combinations of antibacterial drugs, proton pump inhibitors, and bismuth aluminate preparations have been developed in modern medical research. Sequential therapy is used to treat Hp, but antibiotic resistance and repeated infections still exist. A large number of clinical trials have proved that traditional Chinese medicine has a good therapeutic effect on Hp. In this systematic review, we aim to evaluate the efficacy and safety of traditional Chinese medicine in the treatment of Hp. METHODS AND ANALYSIS: We will search for publications from Web of Science, PubMed, Science Direct, Wan Fang Data Knowledge Service Platform, Chinese Biomedical Literature Database (CBM), Chinese Scientific Journal Database (VIP database), China National Knowledge Infrastructure (CNKI) and EMBASE, which should be published from inception to December 2020. Two researchers will independently perform the selection of the studies, data extraction, and synthesis. The Cochrane Risk of Bias Tool will be used to evaluate the risk of bias in the randomized controlled trials. Statistical analysis will be performed by using the Cochrane Review Manager (RevMan 5.3) software. The I2 test will be used to identify the extent of heterogeneity. We will use the Egger funnel chart to evaluate possible publication biases, in addition, when possible we will perform a subgroup/meta-regression analysis. The strength of the evidence will be assessed according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). RESULTS AND CONCLUSIONS: This study will systematically evaluate the efficacy of traditional Chinese medicine in the treatment of Hp infection, and provide evidence for the clinical application of this treatment. The results of the research will be published in a peer-reviewed journal. ETHICS: This systematic review will evaluate the efficacy of traditional Chinese medicine for Hp infection. Because all data used in this systematic review and meta-analysis have been published, this review does not require ethical approval. TRIAL REGISTRATION NUMBER: INPLASY2020120057.


Asunto(s)
Infecciones por Helicobacter/tratamiento farmacológico , Medicina China Tradicional/normas , Helicobacter pylori/efectos de los fármacos , Helicobacter pylori/patogenicidad , Humanos , Medicina China Tradicional/métodos , Metaanálisis como Asunto , Revisiones Sistemáticas como Asunto , Resultado del Tratamiento
3.
Nat Commun ; 12(1): 230, 2021 01 11.
Artículo en Inglés | MEDLINE | ID: mdl-33431861

RESUMEN

Infection of the human stomach by Helicobacter pylori remains a worldwide problem and greatly contributes to peptic ulcer disease and gastric cancer. Without active intervention approximately 50% of the world population will continue to be infected with this gastric pathogen. Current eradication, called triple therapy, entails a proton-pump inhibitor and two broadband antibiotics, however resistance to either clarithromycin or metronidazole is greater than 25% and rising. Therefore, there is an urgent need for a targeted, high-specificity eradication drug. Gastric infection by H. pylori depends on the expression of a nickel-dependent urease in the cytoplasm of the bacteria. Here, we report the 2.0 Å resolution structure of the 1.1 MDa urease in complex with an inhibitor by cryo-electron microscopy and compare it to a ß-mercaptoethanol-inhibited structure at 2.5 Å resolution. The structural information is of sufficient detail to aid in the development of inhibitors with high specificity and affinity.


Asunto(s)
Microscopía por Crioelectrón , Inhibidores Enzimáticos/química , Inhibidores Enzimáticos/farmacología , Helicobacter pylori/enzimología , Ureasa/antagonistas & inhibidores , Ureasa/ultraestructura , Dominio Catalítico , Concentración de Iones de Hidrógeno , Modelos Moleculares
4.
Isr Med Assoc J ; 23(1): 38-42, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33443341

RESUMEN

BACKGROUND: The antibiotic resistance profile of Helicobacter pylori (H. pylori) is constantly changing. Up-to-date and reliable data for the effectiveness of first-line H. pylori treatment protocols are necessary to provide evidence-based best-practice guidelines. OBJECTIVES: To determine the effectiveness, compliance and safety of first-line treatment for H. pylori in Israel. METHODS: An observational, prospective, multicenter study was conducted in tertiary referral centers in Israel, as part of the European registry on H. pylori management (Hp-EuReg). H. pylori-infected patients were included from 2013 to March 2020. Data collected included demographics, clinical data, diagnostic tests, previous eradication attempts, current treatment, compliance, adverse events, and treatment outcome result. RESULTS: In total, 242 patients were registered, including 121 (50%) who received first-line therapy, 41% of these individuals received clarithromycin based triple therapy and 58.9% received a four-drug regimen. The overall effectiveness of first-line therapy was 85% and 86% by modified intention-to-treat and per protocol analyses, respectively. The effectiveness of both sequential and concomitant therapies was 100% while clarithromycin-based triple therapy achieved an eradication rate of 79%. Treatment eradication was higher among patients who received high dose proton pump inhibitor (PPI) compared to those treated with low dose PPI (100% vs. 81.5% respectively, P < 0.01). No difference in treatment effectiveness was found between 7-, 10-, and 14-day treatment. CONCLUSIONS: The effectiveness of clarithromycin-based triple therapy is suboptimal. First-line treatment of H. pylori infection should consist of four drugs, including high dose PPI, according to international guidelines.


Asunto(s)
Antibacterianos , Claritromicina/administración & dosificación , Infecciones por Helicobacter , Helicobacter pylori/efectos de los fármacos , Inhibidores de la Bomba de Protones/administración & dosificación , Antibacterianos/administración & dosificación , Antibacterianos/clasificación , Relación Dosis-Respuesta a Droga , Quimioterapia Combinada/métodos , Quimioterapia Combinada/estadística & datos numéricos , Femenino , Infecciones por Helicobacter/diagnóstico , Infecciones por Helicobacter/tratamiento farmacológico , Infecciones por Helicobacter/epidemiología , Humanos , Israel/epidemiología , Masculino , Cumplimiento de la Medicación/estadística & datos numéricos , Persona de Mediana Edad , Sistema de Registros/estadística & datos numéricos , Retratamiento/métodos , Retratamiento/estadística & datos numéricos , Resultado del Tratamiento
5.
J Biol Regul Homeost Agents ; 35(1 Suppl. 1): 55-62, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33463143

RESUMEN

Helicobacter pylori bacteria (HPB) is one of the most common gastric infections in the world. It seems that HPB infects the subject early in life and is transmitted from person to person. The oral cavity could be a reservoir of HPB participating in infection transmission. HPB and recurrent aphthous stomatitis (RAS) show similar clinical and histological findings, and the discovery of HPB in RAS ulcers support the idea of a correlation between the two diseases. Another important relationship between RAS and HPB is the high incidence of anemia in patients with RAS that may be caused by HPB. In fact, antibiotic therapy and treatment of anemia can reduce the frequency of RAS ulcer recurrence. HPB is considered a carcinogenic agent type 1 of the stomach. In conclusion, the oral cavity is an extra-gastric reservoir of HPB and periodontal therapy associated with systemic therapy can better eradicate HPB from the mucosa of all gastro-enteric tract. Prospective cohort studies are needed to demonstrate the bacterial action in the oral cavity.


Asunto(s)
Infecciones por Helicobacter , Helicobacter pylori , Infecciones por Helicobacter/epidemiología , Humanos , Salud Bucal , Estudios Prospectivos , Recurrencia , Estomatitis Aftosa
6.
Medicine (Baltimore) ; 100(2): e24105, 2021 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-33466180

RESUMEN

BACKGROUND: Studies suggested Banxia Xiexin Decoction is effective in the treatment of helicobacter pylori (HP) positive peptic ulcer. The present meta-analysis aimed at evaluating the efficacy and safety of Banxia Xiexin decoction in the treatment HP positive peptic ulcer. METHODS: We will search PubMed, Web of Science, Cochrane Library, and Chinese biomedical databases from their inceptions to the November 30th, 2020. Two authors will independently carry out searching literature records, scanning titles and abstracts, full texts, collecting data, and assessing risk of bias. Review Manager 5.2 and Stata14.0 software will be used for data analysis. RESULTS: This systematic review will determine the efficacy and safety of Banxia Xiexin decoction in the treatment HP positive peptic ulcer. CONCLUSION: Its findings will provide helpful evidence for the efficacy and safety of Banxia Xiexin decoction in the treatment HP positive peptic ulcer. SYSTEMATIC REVIEW REGISTRATION: INPLASY2020120002.


Asunto(s)
Protocolos Clínicos , Medicamentos Herbarios Chinos/normas , Helicobacter pylori/efectos de los fármacos , Úlcera Péptica/etiología , Medicamentos Herbarios Chinos/farmacología , Medicamentos Herbarios Chinos/uso terapéutico , Helicobacter pylori/patogenicidad , Humanos , Úlcera Péptica/microbiología
7.
Nature ; 590(7844): 29-31, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33469204
8.
Med Clin North Am ; 105(1): 19-30, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33246519

RESUMEN

Dyspepsia affects a large percentage of the general population and can lead to lost work productivity and reduced quality of life. Patients with dyspepsia younger than 60 should not routinely undergo endoscopy but instead should pursue Helicobacter pylori test-and-treat approach. For patients 60 and older, endoscopy should be performed. Patients without any identifiable cause for their symptoms are diagnosed with functional dyspepsia. Guideline-based treatment includes H pylori eradication and proton pump inhibitor use. If acid suppression is not adequate, treatment with a tricyclic antidepressant followed by a prokinetic agent and psychological therapy are considered. Complementary therapies are not recommended due to limited evidence.


Asunto(s)
Dispepsia , Antibacterianos/uso terapéutico , Antidepresivos Tricíclicos/uso terapéutico , Terapia Cognitivo-Conductual , Terapias Complementarias , Diagnóstico Diferencial , Dieta , Dispepsia/diagnóstico , Dispepsia/etiología , Dispepsia/fisiopatología , Dispepsia/terapia , Fármacos Gastrointestinales/uso terapéutico , Infecciones por Helicobacter/tratamiento farmacológico , Helicobacter pylori , Humanos , Periodo Posprandial , Prebióticos , Probióticos/uso terapéutico , Inhibidores de la Bomba de Protones/uso terapéutico , Síndrome
9.
Life Sci ; 266: 118903, 2021 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-33340526

RESUMEN

AIMS: We will investigate the anti-inflammatory activities of berberine (BBR) in treating chronic atrophic gastritis (CAG) induced by Helicobacter pylori (H. pylori). Furthermore, the underlying molecular mechanisms of BBR also will be explored systematically. MATERIALS AND METHODS: Rats were infected by H. pylori. Lipopolysaccharide (LPS) and H. pylori were applied to induce M1 Mφs polarization, interleukin 4 (IL-4) and BBR were used to induce M2 Mφs polarization. Supernatants of polarized Mφs were collected as conditioned media (CM) for investigating the impact of Mφs and its' secreted cytokine on gastric epithelial cells (GES-1). Cell viability, morphology, proliferation, and quantitative analysis of RAW 264.7 cells and GES-1 cells were detected by high-content screening (HCS) imaging assay. To further investigate the potential mechanisms of BBR, relative mRNA, immunohistochemistry and protein expression were measured. KEY FINDINGS: BBR inhibited M1-polarized Mφs, which was induced by H. pylori and LPS, and advocated M2-polarized Mφs. The M1-specific markers (TNF-α and IFN-γ) in supernatants were reduced significantly and M2 specific markers (TGF-ß and IL-10) were increased obviously under BBR intervention. In addition, BBR significantly protected GES-1 from M1-polarized Mφs injury. The mRNA expression of M1-polarized Mφs, including TNF-α, NOS2, CCR7, and IRF-8, were suppressed by BBR administration and the mRNA expression of M2-polarized Mφs, including IL-4, STAT6, IL-10 and Chil3, were increased by BBR intervention. Meanwhile, BBR activated IL-4-STAT6 signaling pathway in vivo and in vitro when H. pylori infection and presented anti-inflammatory activities. SIGNIFICANCE: BBR promotes M2-polarized Mφs when H. pylori infection. The anti-inflammatory properties of BBR tightly related to M1-polarized Mφs inhibition and M2-polarized Mφs promotion. BBR activates IL-4-STAT6 signaling pathway, which is crucial exceedingly in M2 Mφs activation and anti-inflammatory response.


Asunto(s)
Berberina/farmacología , Gastritis Atrófica/tratamiento farmacológico , Infecciones por Helicobacter/complicaciones , Helicobacter pylori/aislamiento & purificación , Interleucina-4/metabolismo , Activación de Macrófagos/inmunología , Factor de Transcripción STAT6/metabolismo , Animales , Gastritis Atrófica/etiología , Gastritis Atrófica/patología , Regulación de la Expresión Génica , Infecciones por Helicobacter/microbiología , Humanos , Interleucina-4/genética , Activación de Macrófagos/efectos de los fármacos , Masculino , Ratones , Ratas , Factor de Transcripción STAT6/genética
10.
Life Sci ; 267: 118921, 2021 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-33358913

RESUMEN

AIMS: Helicobacter pylori (Hp) infection plays an important role in the development of gastric cancer. Hp can secrete gamma-glutamyltransferase (GGT), however, the impact of GGT of Hp on the human gastric cells is not clear. Although it has been demonstrated that ten-eleven translocation 1 (TET1) is overexpressed in gastric cancer, the relationship between the GGT of Hp and TET1 has not been studied. The aim of this study was to explore the relationship between GGT and TET1, and the role of TET1 in the development of gastric cancer induced by Hp was also explored. MATERIALS AND METHODS: The correlation between TET1 and prognosis of gastric adenoma cancer was analyzed by bioinformatics. The GGT gene of Hp26695 was knocked out by electroporation with plasmid to construct the GGT knockout strain of Hp (Hp-KS-1). The shTET1 lentivirus transfected GES-1, MGC-803 and SGC-7901 cell lines were constructed. The biological characteristics of the three kind of cells were detected. KEY FINDINGS: TET1 was overexpressed in gastric tissues of Hp infected patients and mice. Bioinformatics analysis showed that in patients with gastric cancer, higher TET1 expression would result in poorer prognosis. The GGT gene of Hp can lead to overexpression of TET1 in GES-1, MGC-803 and SGC-7901 cells, along with the activation of Wnt/ß-catenin signaling pathway, and then promoting tumorigenesis. After silencing TET1, the Wnt/ß-catenin signaling pathway which was activated by GGT of Hp was inhibited. SIGNIFICANCE: GGT of Helicobacter pylori can promote gastric carcinogenesis by activating Wnt/ß-catenin signaling pathway trough up-regulating TET1.


Asunto(s)
Infecciones por Helicobacter/microbiología , Helicobacter pylori/enzimología , Helicobacter pylori/genética , Oxigenasas de Función Mixta/metabolismo , Proteínas Proto-Oncogénicas/metabolismo , Neoplasias Gástricas/microbiología , Vía de Señalización Wnt , gamma-Glutamiltransferasa/genética , Pólipos Adenomatosos/metabolismo , Animales , Línea Celular Tumoral , Movimiento Celular/fisiología , Proliferación Celular/fisiología , Transformación Celular Neoplásica , Mucosa Gástrica/metabolismo , Infecciones por Helicobacter/metabolismo , Infecciones por Helicobacter/patología , Helicobacter pylori/metabolismo , Humanos , Masculino , Ratones , Ratones Desnudos , Oxigenasas de Función Mixta/genética , Proteínas Proto-Oncogénicas/genética , Neoplasias Gástricas/metabolismo , Activación Transcripcional , beta Catenina/metabolismo , gamma-Glutamiltransferasa/metabolismo
11.
J Clin Rheumatol ; 27(1): 40-41, 2021 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-33347033

RESUMEN

BACKGROUND/AIMS: A role for Helicobacter pylori in triggering systemic sclerosis (SSc) has been proposed, but data are conflicting. In previous studies, infection has been generally searched for by using serology. We designed this study to assess H. pylori prevalence in SSc patients with histology of gastric mucosa, considered the criterion standard for infection diagnosis. METHODS: This cross-sectional study enrolled 30 SSc patients who complained of upper gastrointestinal symptoms. All underwent upper endoscopy with gastric biopsies. Endoscopic alterations were recorded, and gastric mucosa biopsies were used for both histological examination and searching for H. pylori. The role for proton-pump inhibitor (PPI) therapy was considered. Fisher exact test was used for statistical analysis. RESULTS: Data of 28 SSc patients were available, 14 with ongoing PPI therapy. Helicobacter pylori infection at histology was detected in 14.3% patients, and it equally occurred in patients with or without PPI therapy. Erosive esophagitis/Barrett esophagus was detected in 26.6% of cases. Among patients with PPI therapy, 30% received half dose only. The prevalence of intestinal metaplasia was low (14.3%). Endoscopic esophageal alterations were significantly more frequent in those patients showing anti-Scl70 antibody positivity. CONCLUSIONS: This study showed that prevalence of H. pylori is very low in SSc patients, so that it seems not having a role in triggering SSc. Management of gastroesophageal diseases in SSc patients needs to be improved, and looking to the autoimmune profile may be of help. Thus, collaboration between rheumatologist and gastroenterologist is highly recommended.


Asunto(s)
Infecciones por Helicobacter/patología , Helicobacter pylori/aislamiento & purificación , Proteínas Nucleares/inmunología , Inhibidores de la Bomba de Protones/uso terapéutico , Esclerodermia Sistémica , Tracto Gastrointestinal Superior , Autoanticuerpos/sangre , Esófago de Barrett/patología , Biopsia/métodos , Endoscopía del Sistema Digestivo/métodos , Femenino , Mucosa Gástrica/microbiología , Mucosa Gástrica/patología , Reflujo Gastroesofágico/tratamiento farmacológico , Infecciones por Helicobacter/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Medición de Riesgo , Esclerodermia Sistémica/sangre , Esclerodermia Sistémica/diagnóstico , Esclerodermia Sistémica/microbiología , Esclerodermia Sistémica/fisiopatología , Tracto Gastrointestinal Superior/diagnóstico por imagen , Tracto Gastrointestinal Superior/microbiología , Tracto Gastrointestinal Superior/patología
13.
N Z Med J ; 133(1527): 51-70, 2020 12 18.
Artículo en Inglés | MEDLINE | ID: mdl-33332328

RESUMEN

AIM: To update data previously published on the health profile of the refugees resettling in New Zealand, and to draw attention to the change in health profile over time, with a decline of infectious disease/deficiencies, and a rise of non-communicable diseases, a worldwide phenomenon. METHOD: Comparative data was extracted from (1) written annual reports prepared by medical officers at the Mangere Refugee Resettlement Centre (1978-1991), (2) a Microsoft ACCESS patient management system between 1995 and 1999 and (3) a MEDTECH patient management system between 2010 and 2014. RESULTS: Over the period 1979-2014, the rate of infectious diseases has declined markedly in resettling refugees, and the rate of non-communicable diseases has increased. For example, the incidence of tuberculosis has decreased from 4% to 0.2%, gut parasites from more than 40% to, in some intakes, 15% and iron deficiency from 22% to 10%, while the diabetes rate has gone from 0.1% to 2.7%. CONCLUSION: While management of unfamiliar infectious diseases and deficiencies (especially vitamin D) still remains an important part of the management of refugee health, their management usually involves limited time and expense, and their burden is much less than before. However, refugees now resettling in New Zealand and the rest of the world often present with familiar non-communicable diseases that require long-term management.


Asunto(s)
Estado de Salud , Estilo de Vida/etnología , Atención Primaria de Salud/estadística & datos numéricos , Refugiados/estadística & datos numéricos , Adolescente , Adulto , África del Sur del Sahara/etnología , Anciano , Anciano de 80 o más Años , Asia Sudoriental/etnología , Bután/etnología , Índice de Masa Corporal , Niño , Preescolar , Colombia/etnología , Conducta Anticonceptiva/etnología , Conducta Anticonceptiva/tendencias , Diabetes Mellitus/tratamiento farmacológico , Diabetes Mellitus/etnología , Prescripciones de Medicamentos/estadística & datos numéricos , Femenino , Infecciones por VIH/etnología , Infecciones por Helicobacter/etnología , Helicobacter pylori , Humanos , Hipertensión/tratamiento farmacológico , Hipertensión/etnología , Lactante , Recién Nacido , Parasitosis Intestinales/etnología , Irak/etnología , Masculino , Salud Mental/etnología , Persona de Mediana Edad , Nueva Zelanda/epidemiología , Prevalencia , Enfermedades de Transmisión Sexual/etnología , Uso de Tabaco/etnología , Tuberculosis Pulmonar/etnología , Deficiencia de Vitamina D/etnología , Adulto Joven
14.
Medicine (Baltimore) ; 99(50): e22975, 2020 Dec 11.
Artículo en Inglés | MEDLINE | ID: mdl-33327230

RESUMEN

BACKGROUND: In recent years, the incidence of IBS has gradually increased, and it is considered as one of the most common functional gastrointestinal diseases. However, the etiology of IBS is still unclear, and expectations are rising for more targeted treatments. Many clinical trials have explored the link between Helicobacter pylori (H pylori) and IBS, with different conclusions. Therefore, we conducted a meta-analysis to explore whether there is an association between H pylori and IBS, which is of great significance for targeted treatment of IBS. METHODS: We performed a systematic review and meta-analysis of the association between H pylori and IBS. We searched PubMed, EMBASE, Medline and the Cochrane Library to collect related studies. OR was used to describe the ratio of the probability of the H pylori infection occurring in IBS patients versus the controls. Heterogeneity was assessed by subgroup and meta-regression analysis. RESULTS: Eight studies, including 1861 patients, assessed the association between H pylori infection and IBS. The OR of H pylori in IBS patients compared to controls was 1.32 (95% CI: 0.94-1.87; P = 0.11). Subgroup analyses showed a difference between IBS patients diagnosed with Roman III criteria and those diagnosed with non-Roman III criteria. CONCLUSIONS: Our study suggests that H pylori may have a positive effect on the development of IBS. Although the differences were not statistically significant, there were significant differences among subgroups of patients. Considering the limitations and heterogeneity, high quality studies are needed to further explore the effect of H pylori on the development of IBS.


Asunto(s)
Infecciones por Helicobacter/complicaciones , Infecciones por Helicobacter/microbiología , Helicobacter pylori/aislamiento & purificación , Síndrome del Colon Irritable/etiología , Adulto , Estudios de Casos y Controles , Femenino , Infecciones por Helicobacter/epidemiología , Humanos , Incidencia , Síndrome del Colon Irritable/epidemiología , Masculino , Persona de Mediana Edad
15.
Ter Arkh ; 92(8): 24-28, 2020 Sep 03.
Artículo en Ruso | MEDLINE | ID: mdl-33346458

RESUMEN

AIM: Determine the primary antibiotic resistance of Helicobacter pylori (H. pylori) strains isolated from patients living in the European part of the Russian Federation. MATERIALS AND METHODS: As part of a clinical laboratory study, from 2015 to 2018, 27 gastrobiopsy samples obtained from H. pylori-infected patients were analyzed. H. pylori infection was verified using a rapid urease test or a 13C-urea breath test. The values of the minimum inhibitory concentration (MIC) of antibiotics were determined by the diffusion method using E-test strips (BioMerieux, France) according to the recommendations of the manufacturer. The sensitivity of the isolates was determined for 6 antibacterial drugs (amoxicillin, clarithromycin, metronidazole, levofloxacin, tetracycline, rifampicin). RESULTS: According to the data obtained, resistance to amoxicillin was 0%, clarithromycin 11.1%, metronidazole 59.3%, levofloxacin 3.7%, tetracycline 0%, and rifampicin 14.8%. Dual resistance to clarithromycin and metronidazole was recorded in two isolates (7.4%). CONCLUSION: Thus, the first results of the evaluation of H. pylori antibiotic resistance in the European part of the Russian Federation indicate a low resistance of the microorganism to clarithromycin and quite high to metronidazole.


Asunto(s)
Infecciones por Helicobacter , Helicobacter pylori , Amoxicilina , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Claritromicina/farmacología , Farmacorresistencia Bacteriana , Farmacorresistencia Microbiana , Infecciones por Helicobacter/diagnóstico , Infecciones por Helicobacter/tratamiento farmacológico , Infecciones por Helicobacter/epidemiología , Humanos , Levofloxacino , Pruebas de Sensibilidad Microbiana , Federación de Rusia
16.
Ter Arkh ; 92(8): 52-59, 2020 Sep 03.
Artículo en Ruso | MEDLINE | ID: mdl-33346462

RESUMEN

BACKGROUND: As part of an observational multicenter prospective study European Registry on the management of Helicobacter pylori infection, conducted on the initiative of the European H. pylori and Microbiota Study Group, the compliance of clinical practice in the management of patients with Helicobacter pylori infection in Kazan with clinical guidelines was assessed. MATERIALS AND METHODS: The data of 437 patients included into the register by clinical sites in Kazan in 20132019 were analyzed. The methods used for the initial diagnosis of H. pylori infection and eradication control were evaluated. The frequency of various eradication therapy regimens prescription was analyzed in 379 cases. Data regarding the effectiveness of eradication therapy was analyzed in 173 patients. RESULTS: The rapid urease test (44.2% of cases) and cytology/histology (60% of cases) were most often used for the initial diagnosis of H. pylori infection; however non-invasive methods such as 13C-urea breath (9.2%), serology (6.2%), H. pylori stool antigen test (2.3%) were less common. In 21.7% of patients two methods of H. pylori detection were used for primary diagnosis. The control test to evaluate the effectiveness of eradication therapy at the recommended timepoint was performed in 46.2% of patients. 13C-urea breath test (31.7%), stool PCR/stool antigen test (28.7%), rapid urease test (22.3%), cytology/histology (26.2% of cases) prevailed in the assessment of eradication rate. Standard triple therapy, including proton pump inhibitor, clarithromycin and amoxicillin was most commonly prescribed as first-line therapy (64.6% of cases). The duration of eradication therapy was 14 days in the majority of cases with pantoprazole as the most common proton pump inhibitor in standard triple therapy regimens (84.8%). The efficacy of 14-day standard triple therapy (mITT) was 87.0%. CONCLUSION: The results indicate a high frequency of non-invasive methods use for assessing the effectiveness of eradication therapy; however, the overall rate of eradication efficacy assessment is low, limiting the possibility of analyzing the eradication results. The effectiveness of the most common 14-day standard triple first-line therapy in Kazan doesnt reach the recommended 90% eradication level. This could be explained by high rate of pantoprazole use, which is not an optimal proton pump inhibitor in eradication therapy regimens.


Asunto(s)
Infecciones por Helicobacter , Helicobacter pylori , Amoxicilina/uso terapéutico , Antibacterianos/uso terapéutico , Claritromicina/uso terapéutico , Quimioterapia Combinada , Infecciones por Helicobacter/diagnóstico , Infecciones por Helicobacter/tratamiento farmacológico , Infecciones por Helicobacter/epidemiología , Humanos , Estudios Prospectivos , Inhibidores de la Bomba de Protones/uso terapéutico , Sistema de Registros
17.
PLoS Pathog ; 16(12): e1008686, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33370399

RESUMEN

Helicobacter pylori chronically infects the stomach of approximately half of the world's population. Manifestation of clinical diseases associated with H. pylori infection, including cancer, is driven by strain properties and host responses; and as chronic infection persists, both are subject to change. Previous studies have documented frequent and extensive within-host bacterial genetic variation. To define how within-host diversity contributes to phenotypes related to H. pylori pathogenesis, this project leverages a collection of 39 clinical isolates acquired prospectively from a single subject at two time points and from multiple gastric sites. During the six years separating collection of these isolates, this individual, initially harboring a duodenal ulcer, progressed to gastric atrophy and concomitant loss of acid secretion. Whole genome sequence analysis identified 1,767 unique single nucleotide polymorphisms (SNPs) across isolates and a nucleotide substitution rate of 1.3x10-4 substitutions/site/year. Gene ontology analysis identified cell envelope genes among the genes with excess accumulation of nonsynonymous SNPs (nSNPs). A maximum likelihood tree based on genetic similarity clusters isolates from each time point separately. Within time points, there is segregation of subgroups with phenotypic differences in bacterial morphology, ability to induce inflammatory cytokines, and mouse colonization. Higher inflammatory cytokine induction in recent isolates maps to shared polymorphisms in the Cag PAI protein, CagY, while rod morphology in a subgroup of recent isolates mapped to eight mutations in three distinct helical cell shape determining (csd) genes. The presence of subgroups with unique genetic and phenotypic properties suggest complex selective forces and multiple niches within the stomach during chronic infection.


Asunto(s)
Úlcera Duodenal/microbiología , Infecciones por Helicobacter/complicaciones , Infecciones por Helicobacter/genética , Helicobacter pylori/genética , Gastropatías/microbiología , Animales , Atrofia/microbiología , Enfermedad Crónica , Ácido Gástrico , Humanos , Masculino , Ratones , Ratones Endogámicos C57BL , Persona de Mediana Edad , Fenotipo , Polimorfismo de Nucleótido Simple , Gastropatías/patología
18.
Arq Gastroenterol ; 57(4): 366-374, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33331471

RESUMEN

BACKGROUND: During the Helicobacter pylori (HP) infection, the infiltration of the leukocytes into stomach mucosa is directed by locally produced chemokines that play a decisive role in infection outcome. The CagA is the most potent virulence factor of HP, so that the infection with CagA + strains is associated with more severe complications than infection with CagA - HP. OBJECTIVE: The aim was to determine the expression of chemokines CXCL10, CCL17, CCL20 and CCL22, and their receptors by CagA + HP- and CagA - HP-derived crude extract (HP-CE)-stimulated peripheral blood mononuclear cells (PBMCs) from peptic ulcer (PU) patients. METHODS: The serum and the PBMCs were collected from 20 HP-infected PU patients, 20 HP-infected asymptomatic subjects (HIA) and 20 non-infected healthy subjects (NHS). The PBMCs were cultured in absence of stimulator or with 10 µg CagA + HP crude extract (CagA + CE), 10 µg CagA - HP crude extract (CagA - CE). Chemokines and receptors were measured by ELISA and real time-PCR respectively. RESULTS: In PU patients, the production of chemokines CXCL10, CCL17, CCL20 and CCL22, and the expression of chemokine receptors CXCR3, CCR4 and CCR6 by CagA + CE-induced PBMCs were significantly higher than non-stimulated and CagA - CE stimulated cultures. The CXCL10 production by CagA + CE stimulated PBMCs from HIA subjects was significantly higher than the equal cultures from PU and NHS groups. The CCL17 and the CCL20 production by non-stimulated, CagA + CE stimulated, and CagA - CE stimulated PBMCs from PU subjects were significantly higher than the equal cultures from NHS and HIA groups. The CCL22 production by non-stimulated, CagA + CE stimulated and CagA - CE stimulated PBMCs from NHS group were significantly higher than the equal cultures from HIA and PU groups. The CagA + CE stimulated PBMCs from HIA subjects expressed lower amounts of CCR6 in comparison with CagA + CE stimulated PBMCs from NHS and PU groups. The serum levels CXCL10 and CCL20 in PU and HIA groups were significantly higher than NHS subjects. NHS and HIA groups displayed higher serum levels of CCL22 in comparison with PU patients. CONCLUSION: Results indicated that the CagA status of bacterium influence the expression of chemokines and receptors by HP-CE stimulated PBMCs from PU patients.


Asunto(s)
Infecciones por Helicobacter , Helicobacter pylori , Úlcera Péptica , Antígenos Bacterianos , Proteínas Bacterianas , Quimiocina CCL17 , Quimiocina CCL20 , Quimiocina CCL22 , Quimiocina CXCL10 , Humanos , Leucocitos , Leucocitos Mononucleares , Factores de Virulencia
19.
Arq Gastroenterol ; 57(4): 381-398, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33331485

RESUMEN

Over the last years, there is growing evidence that microorganisms are involved in the maintenance of our health and are related to various diseases, both intestinal and extraintestinal. Changes in the gut microbiota appears to be a key element in the pathogenesis of hepatic and gastrointestinal disorders, including non-alcoholic fatty liver disease, alcoholic liver disease, liver cirrhosis, inflammatory bowel disease, irritable bowel syndrome, and Clostridium difficile - associated diarrhea. In 2019, the Brazilian Society of Hepatology (SBH) in cooperation with the Brazilian Nucleus for the Study of Helicobacter Pylori and Microbiota (NBEHPM), and Brazilian Federation of Gastroenterology (FBG) sponsored a joint meeting on gut microbiota and the use of prebiotics, probiotics, and synbiotics in gastrointestinal and liver diseases. This paper summarizes the proceedings of the aforementioned meeting. It is intended to provide practical information about this topic, addressing the latest discoveries and indicating areas for future studies.


Asunto(s)
Enfermedades del Sistema Digestivo , Gastroenterología , Microbioma Gastrointestinal , Helicobacter pylori , Probióticos , Simbióticos , Brasil , Congresos como Asunto , Prebióticos
20.
Medicine (Baltimore) ; 99(45): e22976, 2020 Nov 06.
Artículo en Inglés | MEDLINE | ID: mdl-33157939

RESUMEN

BACKGROUND: Helicobacter pylori (H pylori) infection plays a critical role in gastritis-associated diseases, gastroduodenal ulcers, and even gastric cancer. Studies have shown that probiotics may exhibit antagonistic activity against H pylori. METHODS: This study aimed to assess the efficacy and safety of monotherapy with Clostridium butyricum (C butyricum) and Bacillus coagulans (B coagulans) for H pylori treatment. Our research was an open-label, single-arm pilot study of H pylori eradication. Subjects diagnosed with H pylori infection as outpatients at Xijing Hospital were randomized (1:1:1) to receive 8 weeks of therapy with C butyricum (group A), B coagulans (group B), or C butyricum plus B coagulans (group C). H pylori status was assessed 1 to 2 weeks after treatment. The H pylori eradication rate according to intention-to-treat and per-protocol analyses was the primary outcome of study, and the delta over baseline score, adverse events, and compliance were the secondary outcomes. This study was registered at ClinicalTrials.gov (NCT03857425). RESULTS: A total of 150 subjects were consecutively enrolled from February 2019 to August 2019. The ITT analysis demonstrated that the 3 groups achieved similar eradication rates (18%, 20%, and 26%, respectively, P = .597). The PP analysis yielded a similar result (24.3%, 26.3%, and 32.5%, respectively, P = .703). None of the subjects reported adverse events during treatment. The 3 groups had comparable compliance rates (74% vs 76% vs 80%, P > .05). CONCLUSION: C butyricum and B coagulans may effectively inhibit H pylori to some extent, with rare adverse events, and thus may reduce the burden of antibiotic resistance.


Asunto(s)
Bacillus coagulans , Clostridium butyricum , Infecciones por Helicobacter/tratamiento farmacológico , Probióticos/uso terapéutico , Antibiosis , Femenino , Helicobacter pylori , Humanos , Análisis de Intención de Tratar , Masculino , Persona de Mediana Edad , Proyectos Piloto , Estudios Prospectivos
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