Helicobacter最新文献

{"title":"Management of Helicobacter pylori Infection: Myanmar Consensus Report","authors":"Than Than Aye,&nbsp;Nwe Ni,&nbsp;Tin Tin May,&nbsp;Chit Kyi,&nbsp;Aye Mya Mya Kyaw,&nbsp;Thein Myint,&nbsp;Zeyar Lwin,&nbsp;Win Phyu Phyu Myint,&nbsp;Thein Saw,&nbsp;Than Than Swe,&nbsp;Kyaw Hla,&nbsp;Tin Moe Wai,&nbsp;Swe Mon Mya,&nbsp;Mya Thet Nwe,&nbsp;Thida Soe,&nbsp;Sandar Win,&nbsp;Than Than Aye,&nbsp;Thet Mar Win,&nbsp;Myint Naychi Tun,&nbsp;Thiri Tin,&nbsp;Aye Min Soe,&nbsp;Aung Kyaw Thu,&nbsp;Lin Htet Oo,&nbsp;Nang Khin Phone Tint,&nbsp;Kyaw Ko Ko Aung,&nbsp;Khun Nyi Nyi,&nbsp;Than Htun Oo,&nbsp;Moe Myint Aung,&nbsp;Naing Linn,&nbsp;Phyu Sin Aye,&nbsp;Kyaw Lun Aung Hmu,&nbsp;Nyi Nyi Aung,&nbsp;Min Htun,&nbsp;Tin Ma Ma Win,&nbsp;Kay Thi Kyaing,&nbsp;Swe Swe Lin,&nbsp;Kyaw Si Thu,&nbsp;Ohnmar Nyunt Tin,&nbsp;Su Su Hlaing","doi":"10.1111/hel.70090","DOIUrl":"10.1111/hel.70090","url":null,"abstract":"<div>\u0000 \u0000 <p>Myanmar has a significant rate of <i>Helicobacter pylori</i> (<i>H. pylori</i>) infection among Southeast Asian countries. The complications of <i>H. pylori</i> infections are common in Myanmar, ranging from peptic ulcer bleeding to gastric cancer. Myanmar has an intermediate risk of gastric cancer. In view of increasing drug resistance particularly to triple therapy, a standard management guideline is needed in Myanmar for the effective management of <i>H. pylori</i> infection. This is the first consensus guideline in Myanmar for local clinical practice. The consensus group consisted of 39 gastroenterologists and clinicians from Myanmar GI &amp; Liver Society (MGLS), who had discussions in integrated meetings and developed consensus statements with the Delphi method and focused on the grades of recommendations, levels of evidence, and rationales for the management of <i>H. pylori</i> infection in daily practice in Myanmar. Due to the limited availability of high-quality local evidence, these consensus recommendations were based upon the best available evidence from the world's literature and guidelines, with special attention given to evidence from Myanmar. This consensus followed the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). The consensus level was defined as ≥ 80% for agreement on each statement. Finally, the panel reached a consensus on 26 statements which focus on four areas: (1) whom to test, (2) how to test, (3) whom to treat, and (4) how to treat with post-treatment confirmation of <i>H. pylori</i> status. This consensus will guide the proper diagnosis and treatment of <i>H. pylori</i> infection. In order to prevent antibiotic resistance, <i>H. pylori</i> infected individuals must have successful eradication. Future studies require third-line regimens and the development of antibiotic sensitivity tests. This consensus will serve as a useful guide for clinicians in their day-to-day clinical work.</p>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145512597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survey on Awareness of Helicobacter pylori and Gastric Cancer in the Japanese Population Using an Internet Survey","authors":"Chihiro Matsumoto,&nbsp;Hiroaki Saito,&nbsp;Yoshitaka Nishikawa,&nbsp;Yoshika Saito,&nbsp;Taiga Uchiyama,&nbsp;Toshihiko Kakiuchi,&nbsp;Yuichiro Eguchi,&nbsp;Yasuhiro Mizuno,&nbsp;Masaharu Tsubokura","doi":"10.1111/hel.70089","DOIUrl":"10.1111/hel.70089","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p><i>Helicobacter pylori</i> (<i>H. pylori</i>) infection is a significant risk factor for gastric cancer. The effective implementation of strategies to mitigate gastric cancer requires widespread dissemination of information regarding <i>H. pylori</i>, diagnostic methods, and preventive measures. Despite the high incidence of gastric cancer, efforts to disseminate this information are lacking in Japan. Therefore, our survey aimed to evaluate <i>H. pylori</i> and gastric cancer awareness in Japan and identify factors associated with <i>H. pylori</i> knowledge, focusing on health literacy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This nationwide cross-sectional survey was conducted online. We developed a questionnaire on <i>H. pylori</i> awareness and knowledge across four domains: infection risk, <i>H. pylori</i>-related diseases, testing and treatment, and gastric cancer-related problems. In addition, we evaluated health literacy using an established health literacy scale. Multivariable regression analysis was conducted using the <i>H. pylori</i> knowledge score as the dependent variable.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Over half of the 3095 respondents were aware of <i>H. pylori</i> infection (56.4%). The overall correct response rate for the <i>H. pylori</i> knowledge questions was 45.7%, with varying performances across the knowledge domains: infection risk (57.3%), <i>H. pylori</i>-related diseases (50.9%), testing and treatment (37.5%), and gastric cancer (44.4%). The regression models identified the following factors as associated with a higher <i>H. pylori</i> knowledge: older age, higher health literacy scores, previous <i>H. pylori</i> testing, and healthcare professional status. Among participants without prior <i>H. pylori</i> testing, higher <i>H. pylori</i> knowledge scores were associated with a greater willingness to undergo <i>H. pylori</i> screening.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>To our knowledge, this is the first nationwide assessment of <i>H. pylori</i> infection and gastric cancer awareness in Japan. Health literacy and previous <i>H. pylori</i> screening were significantly associated with <i>H. pylori</i> knowledge. The development of educational strategies for these factors may be desirable for gastric cancer prevention.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12605804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145495382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Different Doses of Ilaprazole for Dual Therapy Versus Bismuth-Quadruple Therapy for Helicobacter pylori Infection: A Three-Arm, Randomized Clinical Trial","authors":"Qiang Han,&nbsp;Ming Zu,&nbsp;Shiyu Du,&nbsp;Yinyan Guo,&nbsp;Yuanmin Zhu,&nbsp;Yali Wang,&nbsp;Xiuqing Liu,&nbsp;Hongwei Guo,&nbsp;Yanli Cheng,&nbsp;Shigang Ding","doi":"10.1111/hel.70086","DOIUrl":"10.1111/hel.70086","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Current &lt;i&gt;Helicobacter pylori (H. pylori)&lt;/i&gt; eradication regimens—standard triple, bismuth-containing quadruple, and non-bismuth quadruple therapies—still face issues such as adverse effects and poor compliance. High-dose dual therapy, with its simplicity, lower pill burden, and comparable efficacy, has recently gained attention. However, existing studies are largely single-center with small sample sizes and lack sufficient evidence-based support. This study aims to further evaluate the efficacy and safety of ilaprazole-based dual and quadruple therapies for &lt;i&gt;H. pylori&lt;/i&gt; eradication.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This was a prospective, multicenter, randomized controlled, non-inferiority clinical trial conducted at five hospitals from January to November 2023. A total of 480 patients were randomly assigned to one of three treatment groups for 14 days: Group A (ilaprazole 5 mg, amoxicillin 1 g, clarithromycin 500 mg, and bismuth potassium citrate 220 mg, all administered twice daily), Group B (ilaprazole 5 mg twice daily and amoxicillin 1 g three times daily), and Group C (ilaprazole 10 mg twice daily and amoxicillin 1 g three times daily). The eradication rates, adverse events, and patient compliance were recorded.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The eradication rates of &lt;i&gt;H. pylori&lt;/i&gt; in Groups A, B, and C were 76.9%, 88.1%, and 88.7% (&lt;i&gt;p&lt;/i&gt; = 0.004) by intention-to-treat analysis, respectively, and 78.3%, 90.4%, and 91.0% (&lt;i&gt;p&lt;/i&gt; = 0.001) using modified intention-to-treat analysis, and 81.8%, 92.1%, 92.2% (&lt;i&gt;p&lt;/i&gt; = 0.005) by per-protocol analysis. The adverse event rates were 28.0%, 10.2%, 10.8% in Groups A, B, and C, respectively (&lt;i&gt;p &lt;&lt;/i&gt; 0.001), while patient compliance rates were 91.1%, 98.1%, 98.7%, respectively (&lt;i&gt;p =&lt;/i&gt; 0.001). Sex, smoking history, alcohol intake, and sharing tableware or cups did not affect the efficacy of the three treatment regimens.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The standard- or high-dose dual therapy with ilaprazole demonstrated superior efficacy, safety, and patient compliance compared to quadruple therapy. No significant differences were observed between these dual therapies, which are expected to become promising alternatives for the primary treatment of &lt;i&gt;H. pylori&lt;/i&gt; infection.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Trial Registration&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Chinese Clinical Trial Registry: ChiCTR2400086862&lt;/p&gt;\u0000 ","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12598915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145482007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to “Letter to the Editor: ‘Parietal Cell Antibody Levels Among Chronic Gastritis Patients in a Country With Low Helicobacter pylori Infection: Epidemiology, Histopathological Features, and H. pylori Infection’”","authors":"","doi":"10.1111/hel.70088","DOIUrl":"https://doi.org/10.1111/hel.70088","url":null,"abstract":"<p>X. Guo, M. C. W. Spaander, and G. M. Fuhler, ‘Letter to the Editor: “Parietal Cell Antibody Levels Among Chronic Gastritis Patients in a Country With Low <i>Helicobacter pylori</i> Infection: Epidemiology, Histopathological Features, and <i>H. pylori</i> Infection,”’ <i>Helicobacter</i> 30 no. 3 (2025): e70053, doi: https://doi.org/10.1111/hel.70053.</p><p>The following funding statement was omitted from the published article:</p><p>This research was supported by ZonMw (11140012410004).</p><p>We apologize for this error.</p>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hel.70088","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145449977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Helicobacter pylori and Impaired Early Childhood Development—Evidence From a Birth Cohort Study From Ghana and Côte d'Ivoire","authors":"Kirsten Alexandra Eberhardt,&nbsp;Stefanie Schoppen,&nbsp;Carola Bindt,&nbsp;Stephan Ehrhardt,&nbsp;Yasmin Mohammed,&nbsp;Daniel Fordjour,&nbsp;Doris Kra-Yao,&nbsp;Carine Esther Bony Kotchi,&nbsp;Ekissi Jean Koffi Armel,&nbsp;Bernardin Ahouty Ahouty,&nbsp;Rebecca Hinz,&nbsp;John Appiah-Poku,&nbsp;Mathurin Koffi,&nbsp;Samuel Blay Nguah,&nbsp;Harry Tagbor,&nbsp;Eliezer N'Goran,&nbsp;Richard Odame Phillips,&nbsp;Tom Luedde,&nbsp;Dana Barthel,&nbsp;Torsten Feldt","doi":"10.1111/hel.70087","DOIUrl":"https://doi.org/10.1111/hel.70087","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p><i>Helicobacter pylori</i> (<i>H. pylori</i>) infection is highly prevalent in low-resource settings and has been implicated in adverse health outcomes beyond the gastrointestinal tract, including potential effects on early neurodevelopment. However, data from sub-Saharan Africa is limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a prospective cohort study among 229 mother–child dyads from Ghana and Côte d'Ivoire to assess the association between <i>H. pylori</i> infection and early child development at 12 months of age. Child development was evaluated using the Developmental Milestones Checklist (DMC), encompassing locomotor, fine motor, language, and personal–social domains. <i>H. pylori</i> infection status was determined by stool antigen testing. Quantile regression models, adjusted for socioeconomic status and sex, were applied to analyze associations between <i>H. pylori</i> infection and DMC scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 229 children, 38 (16.6%) tested positive for <i>H. pylori</i>. The median total motor score was higher in <i>H. pylori</i>-negative children (45, IQR 41–50) compared to positive children (43, IQR 40–45; <i>p</i> = 0.031). At the 75th percentile, <i>H. pylori</i> infection was significantly associated with a 7-point reduction in the motor domain score (estimate = −7; 95% CI: −11.1 to −2.9; <i>p</i> = 0.001; FDR-adjusted <i>p</i> = 0.003) and a 10-point reduction in total DMC score (estimate = −10; 95% CI: −17.5 to −2.6; <i>p</i> = 0.009; FDR-adjusted <i>p</i> = 0.027) after multivariable adjustment. No significant associations were observed at lower or median quantiles, nor in language or personal-social domains.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p><i>H. pylori</i> infection at 12 months of age is significantly associated with impaired motor development among children performing in the upper range of developmental achievement. These findings underscore the potential neurodevelopmental impact of early-life <i>H. pylori</i> infection in high-prevalence, resource-limited settings and highlight the importance of integrating infection control strategies into early childhood development programs. Further research is warranted to elucidate infection-related neurodevelopmental risks in early childhood.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 5","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hel.70087","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145407449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Second- and Third-Line Therapies for Helicobacter pylori Eradication in Slovenia: Data From 2013–2023 of the European Registry on H. pylori Management","authors":"Bojan Tepes,&nbsp;Maja Denkovski,&nbsp;Nataša Brglez Jurecic,&nbsp;Katja Tepes,&nbsp;Anna Cano-Català,&nbsp;Pablo Parra,&nbsp;Leticia Moreira,&nbsp;Olga P. Nyssen,&nbsp;Francis Mégraud,&nbsp;Colm O'Morain,&nbsp;Javier P. Gisbert","doi":"10.1111/hel.70085","DOIUrl":"https://doi.org/10.1111/hel.70085","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The best approach for <i>H. pylori</i> second- and third-line management remains unclear. The aim of this study was to evaluate the effectiveness and safety of second- and third-line <i>H. pylori</i> eradication regimens in Slovenia using a centralized registration database.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients second- and third-line eradication data from Slovenia registered in the European Registry on <i>H. pylori</i> Management (Hp-EuReg) from 2013 to 2024 were included. The regimens prescribed, the number of eradication attempts, effectiveness, adherence and safety were analyzed. The effectiveness was assessed by modified intention to treat (mITT).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We have included 402 s-line and 81 third-line eradication regimens. By mITT analysis &gt; 90% eradication rate for second-line regimens were achieved with 14 day quadruple regimen proton pump inhibitor (PPI) amoxicillin (A) levofloxacin (L) bismuth oxide (B) (95.7%; 95% CI 78.1%–99.9%),10 day and 14 day regimen with a PPI + A + L (90.9%, 95% CI 75.7%–98.1% and 90.2%, 95% CI 85.5%–94.9% respectively) and a 10-day regimen with a PPI combined with bismuth quadruple therapy as single capsule (100%, 95% CI 80.5%–100%). The overall eradication rate for second-line empirical treatments was 86% (95% CI 81.9%–90%), while for culture-guided treatments, it was 89.2% (95% CI 74.6%–97%; <i>p</i> &gt; 0.05). In third-line treatment, the PPI and single-capsule combination therapy was the only regimen to achieve an optimal cure rate of 94.1% (95% CI 71.3%–99.9%). The eradication rate for empirical treatment was 84.4% (95% CI 72.7%–96.1%), while for culture-guided treatment it was 84.6% (95% CI 54.6%–98.1%; <i>p</i> &gt; 0.05). Adverse effects were reported by 52 patients in second-line regimens (12.9%), and treatment was discontinued in 0.7% of cases, and by 12 patients (14.8%) in third-line regimens with no need for treatment discontinuation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In Slovenia, <i>H. pylori</i> eradication therapy appears to be effective and safe in real-world clinical practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>Registered at ClinicalTrials. Gov (NCT02328131)</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 5","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145407152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Galangin Alleviates Helicobacter pylori Gastritis Through TLR2 Inhibition and Modulation of the MyD88-Dependent Inflammatory Cascades","authors":"Wuyinxiao Zheng,&nbsp;Zijian Zheng,&nbsp;Jingyu Yang,&nbsp;Ruili Nie,&nbsp;Xin Luo,&nbsp;Long Yang,&nbsp;Haiping Li,&nbsp;Chunling Hu,&nbsp;Xiaochuan Ye,&nbsp;Pengtao You,&nbsp;Dan Liu","doi":"10.1111/hel.70084","DOIUrl":"10.1111/hel.70084","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Excessive inflammatory response represents the primary pathological hallmark of <i>Helicobacter pylori</i> (<i>H. pylori</i>) gastritis. Toll-like receptor 2 (TLR2) has emerged as a promising therapeutic target because of its crucial role in regulating inflammatory responses and tissue damage caused by <i>H. pylori</i>. Galangin (Gal), a naturally occurring flavone, possesses a variety of pharmacological activities, including anti-inflammatory and antibacterial effects. This study systematically evaluates the therapeutic potential of Gal in <i>H. pylori</i> gastritis, with specific emphasis on elucidating its TLR2-targeting mechanism.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>An <i>H. pylori</i>-induced mouse gastritis model was established to evaluate the therapeutic effects of Gal at dosages of 50 and 100 mg/kg/day over a two-week administration period. The <i>H. pylori-</i>infected GES-1 human gastric epithelial cells were utilized for mechanistic exploration. Molecular docking and siRNA transient transfection techniques were integrated to elucidate the specific interactions between Gal and TLR2.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Gal inhibited the proliferation of <i>H. pylori</i> and alleviated the inflammation caused by <i>H. pylori</i> in both in vitro and in vivo. Furthermore, Gal inhibited the activation of the TLR2/MyD88 signaling pathway, which suppressed the downstream phosphorylation of MAPK (p38/JNK/ERK) and NF-κB nuclear translocation. Notably, the knockdown of <i>TLR2</i> diminished the inhibitory effects of Gal on MyD88 expression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Gal demonstrated effectiveness in ameliorating <i>H. pylori</i> gastritis through the therapeutic inhibition of TLR2. Further investigation is warranted to explore the combination of Gal with other <i>H. pylori</i> eradication treatments.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 5","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145372642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vonoprazan-Based Triple Therapy Versus Esomeprazole-Based Triple Therapy for H. pylori Eradication in Adolescents (VONTAPE): A Randomized, Double-Blind Controlled Trial","authors":"Sameh A. Lashen,&nbsp;Mohammed M. Shamseyea,&nbsp;Rasha H. Metwally,&nbsp;Galal Abou-Farrag,&nbsp;Engy S. Elkaragy","doi":"10.1111/hel.70083","DOIUrl":"10.1111/hel.70083","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>While <i>H. pylori</i> infection is more commonly associated with adults, it can affect children with an impact on their well-being. Vonoprazan is effective in the eradication of <i>H. pylori</i> infection in adults. However, its effectiveness in adolescents and children is still being studied. The study aimed to investigate the efficacy of Vonoprazan-based triple therapy (VTT) compared to Esomeprazole-based triple therapy (ETT) for <i>H. pylori</i> eradication in adolescents and children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>In a multicenter, double-blind, randomized controlled design, we included 242 participants with <i>H. pylori</i> infection in the age group 10–18 years. They were randomly assigned to either weight-based Esomeprazole/Amoxicillin/Clarithromycin twice daily for 14 days (ETT) or to Vonoprazan 20 mg/weight-based Amoxicillin/Clarithromycin twice daily for 14 days (VTT). The <i>H. pylori</i> eradication was evaluated 8 weeks after therapy. Treatment-related adverse events were reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In intention-to-treat analysis, eradication of <i>H. pylori</i> was achieved in 93 (76.9%) of the ETT arm and in 106 (87.6%) of the VTT arm (<i>p</i> = 0.029). In per-protocol analysis, eradication rates were 83% and 92.2% for ETT and VTT, respectively (<i>p</i> = 0.036). There was no difference between the two study arms in terms of overall adverse events (<i>p</i> = 0.46). In the VTT arm, the most frequent adverse events were diarrhea (5.8%) and nausea (6.6%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Fourteen days of VTT is superior to ETT for <i>H. pylori</i> eradication and is well tolerated in children and adolescents aged between 10 and 18 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Clinical Trial Registry</h3>\u0000 \u0000 <p>NCT06162949; https://clinicaltrials.gov/study/NCT06162949.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 5","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145354660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-Effectiveness of Tailored vs. Empirical Therapy for H. pylori: A Decision-Tree Analysis","authors":"Joon Sung Kim,&nbsp;Hankil Lee,&nbsp;Yuri Jeong,&nbsp;Byung-Wook Kim","doi":"10.1111/hel.70081","DOIUrl":"10.1111/hel.70081","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In Korea, tailored therapy for <i>H. pylori</i> based on clarithromycin resistance has been shown to be more effective than empirical therapy. However, the cost-effectiveness of tailored therapy has not yet been fully established.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study evaluated the cost-effectiveness of tailored therapy guided by genotypic resistance compared to empirical clarithromycin-based triple therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A decision-tree model was developed to compare two treatment strategies: empirical therapy and tailored therapy. In the empirical therapy group, patients received clarithromycin-based triple therapy. In the tailored therapy group, patients susceptible to clarithromycin received clarithromycin-based triple therapy, while those with clarithromycin resistance were treated with bismuth-based quadruple therapy. A cost-effectiveness analysis was conducted, and the incremental cost-effectiveness ratio (ICER) was calculated to compare the two strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The estimated costs for empirical and tailored therapies were $173.93 and $249.48, respectively. Compared to empirical therapy, the ICER for tailored therapy was $4.66 per 1% increase in eradication rate, representing the additional cost required to achieve a 1% improvement in eradication. In subgroup analyses, the estimated costs of 7-day empirical and tailored therapies were $157.46 and $233.88, respectively, while the costs for 14-day empirical and tailored therapies were $190.40 and $265.08, respectively. The ICERs for the 7- and 14-day regimens were $3.53 and $7.12, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Tailored therapy guided by genotypic resistance is a cost-effective strategy for <i>H. pylori</i> eradication in Korea, particularly in the context of high clarithromycin resistance rates.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 5","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12538028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145336946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tailored Therapy Guided by Antibiotic Genotypic Resistances and CYP2C19 Polymorphisms Detected From Fecal Specimens for the First-Line Helicobacter pylori Eradication: A Randomized Controlled Trial","authors":"Baojun Suo,&nbsp;Xinlu Ren,&nbsp;Cailing Li,&nbsp;Yanyan Shi,&nbsp;Xueli Tian,&nbsp;Kai Zhou,&nbsp;Liya Zhou,&nbsp;Zhiqiang Song","doi":"10.1111/hel.70082","DOIUrl":"10.1111/hel.70082","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Tailored therapy based on genetic testing of fecal samples is a promising method for <i>Helicobacter pylori</i> eradication, but relevant research is still lacking, and the effectiveness remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study conducted a randomized controlled trial to evaluate the efficacy, safety, and compliance of triple plus bismuth therapy (TBT) guided by clarithromycin and levofloxacin genotypic resistances and CYP2C19 polymorphisms from stool samples. A preliminary health economics analysis was also conducted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Six hundred and sixteen treatment-naïve patients were randomly divided into tailored (individualized drug selection based on genetic testing for 7 or 14 days) and empiric (esomeprazole 20 mg, amoxicillin 1000 mg, clarithromycin 500 mg, and bismuth potassium citrate 220 mg, all twice daily for 14 days) TBT groups. Safety and compliance were assessed within 1–3 days after eradication. ¹³C-urea breath test was performed within 4–8 weeks after eradication to evaluate the therapeutic outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The eradication rates of the tailored TBT group were non-inferior to those of the empiric TBT group [intention-to-treat analysis 87.7% vs. 80.8%, rate difference 6.8% (95% confidence interval 0.8%–12.9%); modified intention-to-treat analysis 93.4% vs. 86.8%, rate difference 6.7% (95% confidence interval 1.5%–11.9%); per-protocol analysis 95.7% vs. 88.7%, rate difference 7.0% (95% confidence interval 2.2%–11.8%)]. The tailored TBT group achieved satisfactory efficacies (acceptable in intention-to-treat and excellent in per-protocol analyses). Safety and compliance were similar between the two groups. The average cost of each successful eradication case in the tailored TBT group is lower than that in the empiric TBT group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The tailored TBT guided by antibiotic genotypic resistances and CYP2C19 polymorphisms detected from fecal specimens achieved satisfactory efficacy, safety, and compliance in the first-line <i>Helicobacter pylori</i> eradication with less expenses (ChiCTR2300068620).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>Chinese Clinical Trials Registration: ChiCTR2300068620</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 5","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145336876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}