{"title":"Exosome-Based Detection of Helicobacter pylori Infection and Clarithromycin Resistance in Children","authors":"Minghui Song, Jingqing Zeng, Zhanyong Yao, Chundi Xu, Yiqiu Huang, Yuan Xiao, Yi Yu, Jia Li, Xu Xu, Chenchen Shi, Qiuchen Wu, Yonglin Tao, Xing Tang, Gloria Ge, Shenshen Gao, Zhaohui Deng, Xinqiong Wang","doi":"10.1111/hel.70113","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>The prevalence of <i>Helicobacter pylori</i> (<i>H. pylori</i>) infection in children is high. Current diagnostic methods, particularly invasive techniques like gastroscopy, pose challenges for pediatric populations, highlighting the need for reliable non-invasive alternatives.</p>\n </section>\n \n <section>\n \n <h3> Aims</h3>\n \n <p>This study aimed to evaluate the diagnostic value of salivary and urinary exosomes for detecting <i>H. pylori</i> infection and clarithromycin resistance in children.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Saliva and urine samples were collected from children prior to elective gastroscopy. Exosomal DNA was extracted and subjected to qPCR for the detection of <i>H. pylori</i> DNA and clarithromycin resistance. The sensitivity and specificity of the salivary and urinary exosome tests were calculated against the reference standard, and their performance in detecting resistance was compared with tissue-based results.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Among 500 enrolled children, the <i>H. pylori</i> infection rate was 31.6%. Analysis of 500 salivary and 80 urine samples showed that salivary exosomes detected <i>H. pylori</i> with a sensitivity of 93.67% and specificity of 80.11%. Urinary exosomes offered higher specificity (90.56%) but lower sensitivity (62.96%). In the subset of 113 infected children tested for resistance, salivary exosome testing identified clarithromycin resistance in 17.70% of cases, showing a 91.15% concordance with gastric tissue testing (15.93%). The agreement between the two methods was substantial.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Salivary exosome-based detection represents a highly sensitive and well-tolerated non-invasive method for diagnosing <i>H. pylori</i> infection in children. It also demonstrates substantial agreement with invasive methods in identifying clarithromycin resistance, offering a promising tool to guide precise eradication therapy in the pediatric population.</p>\n </section>\n </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"31 2","pages":""},"PeriodicalIF":4.6000,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Helicobacter","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/hel.70113","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
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Abstract
Background
The prevalence of Helicobacter pylori (H. pylori) infection in children is high. Current diagnostic methods, particularly invasive techniques like gastroscopy, pose challenges for pediatric populations, highlighting the need for reliable non-invasive alternatives.
Aims
This study aimed to evaluate the diagnostic value of salivary and urinary exosomes for detecting H. pylori infection and clarithromycin resistance in children.
Methods
Saliva and urine samples were collected from children prior to elective gastroscopy. Exosomal DNA was extracted and subjected to qPCR for the detection of H. pylori DNA and clarithromycin resistance. The sensitivity and specificity of the salivary and urinary exosome tests were calculated against the reference standard, and their performance in detecting resistance was compared with tissue-based results.
Results
Among 500 enrolled children, the H. pylori infection rate was 31.6%. Analysis of 500 salivary and 80 urine samples showed that salivary exosomes detected H. pylori with a sensitivity of 93.67% and specificity of 80.11%. Urinary exosomes offered higher specificity (90.56%) but lower sensitivity (62.96%). In the subset of 113 infected children tested for resistance, salivary exosome testing identified clarithromycin resistance in 17.70% of cases, showing a 91.15% concordance with gastric tissue testing (15.93%). The agreement between the two methods was substantial.
Conclusion
Salivary exosome-based detection represents a highly sensitive and well-tolerated non-invasive method for diagnosing H. pylori infection in children. It also demonstrates substantial agreement with invasive methods in identifying clarithromycin resistance, offering a promising tool to guide precise eradication therapy in the pediatric population.
期刊介绍：
Helicobacter is edited by Professor David Y Graham. The editorial and peer review process is an independent process. Whenever there is a conflict of interest, the editor and editorial board will declare their interests and affiliations. Helicobacter recognises the critical role that has been established for Helicobacter pylori in peptic ulcer, gastric adenocarcinoma, and primary gastric lymphoma. As new helicobacter species are now regularly being discovered, Helicobacter covers the entire range of helicobacter research, increasing communication among the fields of gastroenterology; microbiology; vaccine development; laboratory animal science.
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