Helicobacter最新文献

{"title":"Reply: Is Tailored Bismuth Quadruple Therapy (With Clarithromycin or Furazolidone) Based on Fecal Molecular Susceptibility Testing in First-Line Helicobacter pylori Eradication Treatment More Effective? A Three-Arm, Multicenter Randomized Clinical Trial","authors":"Xinlu Ren, Zhiqiang Song","doi":"10.1111/hel.70043","DOIUrl":"https://doi.org/10.1111/hel.70043","url":null,"abstract":"","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 3","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143938992","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":"Characterization of Fecal Microbial Communities in Patients With Type 2 Diabetes Mellitus Combined With Helicobacter pylori Infection","authors":"Xiaoyan He,&nbsp;Han Chen,&nbsp;Fengdan Chen,&nbsp;Wei Su,&nbsp;Yan Wang,&nbsp;Die Hu,&nbsp;Jianwen Hu,&nbsp;Xiaoying Zhou","doi":"10.1111/hel.70041","DOIUrl":"https://doi.org/10.1111/hel.70041","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 has the capacity to alter the gut microbiota composition. There is a significant correlation between <i>H. pylori</i> infection and type 2 diabetes mellitus (T2DM). Further research is necessary to explore whether gut microbiota plays a role in the relationship between <i>H. pylori</i> and T2DM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Fecal samples were obtained from 44 patients with T2DM, including 20 who tested positive for <i>H. pylori</i> and 24 who tested negative. Intestinal microbiota composition was analyzed via 16S rRNA V3-V4 amplicon sequencing. Differences in microbial distribution and significant microbial biomarkers were identified between <i>H. pylori</i> positive and negative groups. A Spearman correlation analysis assessed the relationship between intestinal microbiota and glycemic parameters. Additionally, PICRUSt2 was used to predict intestinal bacterial functions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Results indicate that in <i>H. pylori</i> (+) T2DM patients, HbA1c levels were significantly higher (8.9% vs. 8.1%, <i>p</i> = 0.021), while both the C-peptide peak (3.70 vs. 5.98 ng/mL, <i>p</i> = 0.040) and fasting C-peptide levels (1.42 vs. 2.31 ng/mL, <i>p</i> = 0.008) were significantly lower compared to <i>H. pylori</i> (−) T2DM groups. A total of 11 colonic phyla and 100 genera were identified in all fecal samples. In groups positive for <i>H. pylori</i>, there was a significant enrichment of the phylum <i>Proteobacteria</i>, while the genera <i>Lactobacillus</i>, <i>Butyricimonas</i>, and <i>Akkermansia</i> were significantly reduced (all <i>p</i> &lt; 0.05). Correlation analysis showed that the abundance of the genera <i>Butyricimonas</i> (<i>p</i> = 0.01) and <i>Akkermansia</i> (<i>p</i> = 0.048) were negatively correlated with fasting plasma glucose. KEGG pathway analysis indicated a significant enrichment of methylmalonyl-CoA mutase and succinyl-CoA in <i>H. pylori</i>-infected T2DM patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study suggests that T2DM patients with <i>H. pylori</i> infection exhibit more impaired pancreatic islet function potentially due to <i>H. pylori</i>-induced alterations in the gut microbiota.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 3","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143919319","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":"The Optimal Age of Helicobacter pylori Screen-and-Treat for Gastric Cancer Prevention in the United States","authors":"Duco T. Mülder,&nbsp;James F. O'Mahony,&nbsp;Dianqin Sun,&nbsp;Luuk A. van Duuren,&nbsp;Rosita van den Puttelaar,&nbsp;Matthias Harlass,&nbsp;Weiran Han,&nbsp;Robert J. Huang,&nbsp;Manon C. W. Spaander,&nbsp;Uri Ladabaum,&nbsp;Iris Lansdorp-Vogelaar","doi":"10.1111/hel.70039","DOIUrl":"https://doi.org/10.1111/hel.70039","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Recent American College of Gastroenterology (ACG) guidelines recommend screening and eradicating <i>Helicobacter pylori</i> (<i>H. pylori</i>) in high-risk racial groups to prevent gastric cancer (GC), but do not provide guidance on the age to screen. We aimed to determine the optimal age for <i>H. pylori</i> screen-and-treat.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We developed a new microsimulation model, MISCAN-gastric, which was calibrated to SEER incidence and clinical studies on the natural history of GC. One-time screen-and-treat at ages 20–65 was compared to a no-screening scenario in terms of cumulative incidence reduction, number needed-to-screen (NNS) and number needed-to-treat (NNT) to prevent one GC case. The NNS represents the number of individuals that require testing to prevent one GC case, while the NNT reflects the number requiring treatment. The optimal age was investigated for a high-risk population subgroup (non-Hispanic [NH] Black males) and compared to other subgroups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Without screening, 332 noncardia GC cases occurred in a population of 100,000 NH Black males. <i>H. pylori</i> screen-and-treat reduced cumulative incidence by 43% when performed at age 20, but only by 5% when performed at age 65. The NNS was lowest at age 30 and increased markedly at older ages. The estimated NNS for test-ages 20, 30, 40, and 65 were 645, 563, 769, and 5487, respectively. The NNT was lowest at the youngest age (261) and increased with age to 448 at age 40 and 3681 at age 65. The NNT and NNS were substantially higher in groups with lower GC risk: the optimal NNT was four times higher in NH White females compared to non-Hispanic Black males.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p><i>H. pylori</i> screen-and-treat maximized population benefits when performed before age 40, emphasizing the need for early interventions. When performed at the optimal age, the benefits of <i>H. pylori</i> screen-and-treat may outweigh the harms for high-risk racial groups.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 3","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hel.70039","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914519","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":"HIF-1α-Induced GPR171 Expression Mediates CCL2 Secretion by Mast Cells to Promote Gastric Inflammation During Helicobacter pylori Infection","authors":"Hanmei Yuan,&nbsp;Yuetong Li,&nbsp;Hui Wu,&nbsp;Jin Zhang,&nbsp;Tingting Xia,&nbsp;Bin Li,&nbsp;Chao Wu","doi":"10.1111/hel.70042","DOIUrl":"https://doi.org/10.1111/hel.70042","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 one of the most important risk factors for chronic gastritis, gastric ulcers, and gastric cancer. Mast cells act as a crucial regulator in bacterial infection. The mechanisms underlying mast cell activation and their role in <i>H. pylori</i> infection remain poorly understood.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>In gastric mucosal tissue, the number of mast cells, G-protein-coupled receptor 171 (GPR171) and CCL2 expression were detected by immunohistochemistry (IHC) or immunofluorescence between <i>H. pylori</i>-negative and <i>H. pylori</i>-positive patients. Mast cells were co-cultured with <i>H. pylori</i>, and transcriptome sequencing, RT-qPCR, and Western blotting (WB) were performed to identify receptors involved in mast cell activation. WB, chromatin immunoprecipitation (ChIP), and dual-luciferase reporter assays were conducted to investigate the molecular mechanism by which HIF-1α regulates GPR171 expression. Lentiviral knockdown, ELISA, WB, and IHC were used to evaluate the role of GPR171 during <i>H. pylori</i> infection. An in vivo mouse model of <i>H. pylori</i> infection was employed to assess the effects of GPR171 blockade on CCL2 expression and gastric mucosal inflammation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the study, we found that mast cell numbers were greatly increased and correlated with the severity of inflammation in <i>H. pylori-</i>infected patients. We found a new receptor, GPR171, was upregulated and involved in mast cell activation upon <i>H. pylori</i> infection. Furthermore, <i>H. pylori</i> infection induced the expression of GPR171 by promoting the activation of hypoxia-inducible factor 1 alpha (HIF-1α), which directly bound to hypoxia response elements in the GPR171 promoter and regulated its transcriptional activity. Blockade or loss of GPR171 in mast cells partially inhibited CCL2 secretion via the ERK1/2 signaling pathway. In the human gastric mucosa, CCL2 derived from mast cells was associated with gastric inflammation during <i>H. pylori</i> infection. In vivo murine studies indicated that <i>H. pylori</i> infection significantly upregulated CCL2 expression, while GPR171 inhibition partially reduced CCL2 levels and alleviated gastric mucosal inflammation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We provide a novel mechanism that <i>H. pylori</i> activates mast cells to promote gastric inflammation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 3","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hel.70042","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143905010","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":"Seven-Day Versus 14-Day Tegoprazan and Tetracycline-Containing Quadruple Therapy for First-Line Eradication of Helicobacter pylori Infection: A Randomized, Open-Label, Noninferiority Trial","authors":"Xue-Ping Nan,&nbsp;Hong-Yu Zhao,&nbsp;Lei-Na Guo,&nbsp;Rui-Qi Zheng,&nbsp;Xi-Lan Wang,&nbsp;Yong-Fen Wang,&nbsp;Yan-Hua Su,&nbsp;Wen-Rong Geng,&nbsp;Xiu-Lan Liu,&nbsp;Hai-Miao Xu,&nbsp;Ke-Lun Zhou,&nbsp;Yu-Ting Guo,&nbsp;Jian-Hua Cao,&nbsp;Zhong-Xue Han,&nbsp;Qing-Zhou Kong,&nbsp;Xiu-Li Zuo,&nbsp;Yan-Qing Li,&nbsp;Yue-Yue Li","doi":"10.1111/hel.70036","DOIUrl":"https://doi.org/10.1111/hel.70036","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Tegoprazan, a new class of drugs, is a potassium-competitive acid blocker (P-CAB) that inhibits gastric H+/K+-ATPase through a different mechanism than proton pump inhibitor. Tetracycline also has anti-<i>Helicobacter pylori</i> properties. However, only a few randomized controlled trials (RCTs) have investigated the efficacy of tegoprazan and tetracycline-containing quadruple therapy (TTQT) for treating <i>H. pylori</i> infections, which this RCT explored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This multicenter RCT included treatment-naïve adults with <i>H. pylori</i> infection who received 7 or 14 days of TTQT (50-mg tegoprazan, 220-mg bismuth potassium citrate, and 1000-mg amoxicillin twice daily with 500-mg tetracycline four times daily). The primary outcome was the eradication rate; secondary endpoints included the incidence of adverse events, treatment compliance, and regimen costs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 258 patients. The eradication rates in the 7- and 14-day groups were 90.70% (117/129, 95% confidence interval [CI]: 83.98%–94.89%) and 91.47% (118/129, 95% CI: 84.90%–95.45%), respectively, in the intention-to-treat analysis (difference: −0.78%; −7.01%–8.58%; noninferiority <i>p</i> &lt; 0.001); 92.86% (117/126, 95% CI: 86.50%–96.48%) and 93.65% (118/126, 95% CI: 87.47%–97.02%), respectively, in the modified intention-to-treat analysis (difference: 0.79%; 95% CI: −6.36%–7.99%; noninferiority <i>p</i> &lt; 0.001); and 94.35% (117/124, 95% CI: 88.29%–97.50%) and 95.12% (117/123, 95% CI: 89.24%–98.00%), respectively, in the per-protocol analysis (difference: −0.77%; 95% CI: −5.91%–7.48%; noninferiority <i>p</i> &lt; 0.001). Significantly fewer adverse events occurred in the 7-day group than in the 14-day group (22.48% vs. 35.67%, <i>p</i> = 0.020). Treatment compliance did not differ between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The 7- and 14-day TTQT efficacies for the first-line treatment of <i>H. pylori</i> infection were comparable, and fewer adverse effects occurred in the 7-day group. This trial has been registered at Clinical Trials.gov (NCT05997433).</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143865876","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":"Comparison of Cefuroxime-Based Dual Therapy With Quadruple Therapy in Helicobacter pylori-Infected Treatment-Naive Patients: A Prospective, Multicenter, Randomized Controlled Trial","authors":"Ji-Yan Li,&nbsp;Ji-Chun Song,&nbsp;Xia Tian,&nbsp;Yun-Hua Liu,&nbsp;Xiang-Wu Ding,&nbsp;Ya Lin,&nbsp;Zhen-Yu Zhang,&nbsp;Hai Zhang,&nbsp;De-Min Li,&nbsp;Xiao-Wei Huang,&nbsp;Yun-Lian Hu,&nbsp;Li Li,&nbsp;Hong-Tian Li,&nbsp;Chao-Qun Huang,&nbsp;Pei-Yuan Li","doi":"10.1111/hel.70037","DOIUrl":"https://doi.org/10.1111/hel.70037","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>High-Dose Dual Therapy With Amoxicillin Has Shown Advantages to Eradicate <i>Helicobacter pylori</i> (<i>H. pylori</i>), but Not for Penicillin-Allergic Patients. It Is Recommended That Cefuroxime Could Be an Alternative, but Whether Cefuroxime Could Be Used in Dual Therapy Has Not Been Reported. This Study Aimed to Compare the Efficacy, Safety, and Compliance of Cefuroxime-Based Dual Therapy (CDT) With Cefuroxime-Based Bismuth Quadruple Therapy (CQT) to Treat <i>H. pylori</i> Infection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>The Prospective, Multicenter, Open-Label, Randomized Controlled Trial Was Conducted to Enroll Patients With Treatment-Naive <i>H. pylori</i> Infection From 9 Institutions. Patients Were Randomly Assigned to CDT Group (Cefuroxime 500 Mg Three Times/Day and Vonoprazan 20 Mg Twice/Day) or CQT Group (Cefuroxime 500 Mg Twice/Day, Levofloxacin 500 Mg Once/Day, Vonoprazan 20 Mg Twice/Day, and Bismuth 220 Mg Twice/Day), both for 14 Days.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>700 Patients (350 per Group) Were Enrolled. In the Intention-To-Treat Analysis, Eradication Rates Were 76.0% and 86.3% in CDT Group and CQT Group (<i>P</i> = 0.001). In the Modified Intention-To-Treat Analysis, Eradication Rates Were 78.9% and 89.1% (<i>P</i> &lt; 0.001). In the Per-Protocol Analysis, Eradication Rates Were 80.2% and 91.2% (<i>P</i> &lt; 0.001). The Incidence of Adverse Events Was Significantly Lower in CDT Group Than CQT Group (14.4% vs. 29.8%, <i>P</i> &lt; 0.001). Non-inferiority Was Confirmed Between CDT and CQT Group (All <i>P</i> &gt; 0.025). Compliance Was Good in Both Groups (96.0% vs. 92.8%, <i>P</i> = 0.073). Poor Adherence Was a Risk Factor for Reducing the Efficacy in Both Groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CQT Was More Effective Than CDT for <i>H. pylori</i> Eradication, Which Might Be Recommended for Penicillin-Allergic Patients. If There Were Contraindications or Intolerance of CQT, CDT Would Be an Alternative.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trail Registration</h3>\u0000 \u0000 <p>ChiCTR2300071210</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845827","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":"Parietal Cell Antibody Levels Among Chronic Gastritis Patients in a Country With Low Helicobacter pylori Infection: Epidemiology, Histopathological Features, and H. pylori Infection","authors":"Rizki Amalia,&nbsp;Muhammad Miftahussurur,&nbsp;Ari Fahrial Syam,&nbsp;Tomohisa Uchida,&nbsp;Ricky Indra Alfaray,&nbsp;Kartika Afrida Fauzia,&nbsp;Yudith Annisa Ayu Rezkitha,&nbsp;Junko Akada,&nbsp;Takashi Matsumoto,&nbsp;Yoshio Yamaoka","doi":"10.1111/hel.70035","DOIUrl":"https://doi.org/10.1111/hel.70035","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Despite the low prevalence of <i>Helicobacter pylori</i> in Indonesia, the high incidence of gastritis, predominantly atrophic gastritis, suggests that factors such as autoimmune gastritis (AIG) contribute to this unusual pattern. This study aims to investigate the epidemiology of AIG, histopathology, and its association with <i>H. pylori</i> status in Indonesia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional study was conducted in various regions in Indonesia between 2014 and 2017; 380 eligible sera and gastric biopsies were available when this study was conducted. As many as 138 sera samples were included in this study based on the initial examination by the updated Sydney system. The diagnosis of AIG was confirmed by serologic testing for parietal-cell antibodies (PCA) and detailed histopathological assessment with sparing of antrum histopathological features.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the included samples in this study, 78.99% (109/138) were PCA positive (≥ 10 RU/mL) and 0.72% (1/138) were considered to be diagnosed as AIG (spared from antrum histopathological features). The majority of PCA positive cases were <i>H. pylori</i> positive (61/109; 55.96%) with a significant correlation (<i>p</i> &lt; 0.05, <i>R</i> = 0.31). Additionally, a significant association was found between <i>H. pylori</i> infection and PCA level with gastric histopathological features (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study demonstrates that the incidence of gastritis without <i>H. pylori</i> infection in Indonesia is not attributable to AIG, as only a single AIG-positive case was found. These findings underscore the important role of <i>H. pylori</i> as a pathogenic factor in chronic gastritis and highlight its mechanisms in triggering immune responses and driving disease progression and histopathological changes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845873","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":"The Association Between Helicobacter pylori Infection and Eosinophilic Esophagitis: Systematic Review and Meta-Analysis","authors":"Lucía Gutiérrez-Ramírez,&nbsp;Sandra L. Garcia-Dionisio,&nbsp;Sara Feo-Ortega,&nbsp;Jesús González-Cervera,&nbsp;Antonio Tejera-Muñoz,&nbsp;Alfredo J. Lucendo,&nbsp;Ángel Arias","doi":"10.1111/hel.70038","DOIUrl":"https://doi.org/10.1111/hel.70038","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Exposure to <i>Helicobacter pylori</i> (<i>H. pylori</i>) has been associated with reduced odds of eosinophilic esophagitis (EoE).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To conduct a systematic review and meta-analysis of epidemiological studies in order to quantify the association between <i>H. pylori</i> infection and EoE, and to assess the certainty of the evidence linking both conditions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive literature search was conducted in MEDLINE/PUBMED, EMBASE, and SCOPUS databases (up to September 2024) to identify observational epidemiological studies that assessed the association between objectively measured <i>H. pylori</i> infection and EoE. The risk of study bias was assessed structurally using the ROBINS-E tool. Data were pooled using a random-effects meta-analysis. The certainty of the evidence was assessed using the GRADE approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixteen studies comprising 30,650 patients and 291,908 controls were included. Exposure to <i>H. pylori</i> was associated with a significant reduction in the odds of EoE (pooled odds ratio [OR] 0.56; 95% CI, 0.46–0.70; <i>I</i>² 50%) [low-certainty evidence]. The protective effect of <i>H. pylori</i> was stronger in case–control studies (OR 0.49; 95% CI, 0.35–0.69) than in cohort studies (OR 0.76; 95% CI, 0.58–0.98) and was statistically significant in retrospective studies (OR 0.57; 95% CI, 0.45–0.72) and studies with high or very high risk of bias (OR 0.52; 95% CI, 0.42–0.64), but not in prospective studies (OR 0.56; 95% CI, 0.27–1.18) or those with moderate to low risk of bias (OR, 0.91; 95% CI, 0.69–1.21).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The association between <i>H. pylori</i> and EoE is mainly supported by retrospective studies with a high risk of bias. Further well-designed studies are needed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>PROSPERO number: CRD42024586653</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845828","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":"Impact of an Electronic Medical Record Quality Improvement Intervention on Helicobacter pylori Treatment and Eradication Rates in a U.S. Hospital System","authors":"Shivani Kastuar,&nbsp;Samanthika Devalaraju,&nbsp;Juan Gomez Cifuentes,&nbsp;Hashem B. El-Serag,&nbsp;Mimi C. Tan","doi":"10.1111/hel.70034","DOIUrl":"https://doi.org/10.1111/hel.70034","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In this pre- and post-intervention quality improvement (QI) study, the impact of an electronic medical record (EMR) order set for <i>Helicobacter pylori</i> treatment was assessed. We evaluated changes in optimal treatment regimen usage, eradication testing, and successful eradication rates based on the intervention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Data were collected from patients within the Harris Health System (Houston, TX) with <i>H. pylori</i> infection. The pre-intervention cohort included patients with a positive <i>H. pylori</i> test from January to February 2022. An EMR order set for <i>H. pylori</i> treatment implemented in May 2022 included optimal treatment recommendations using local antibiotic resistance patterns and testing for eradication post-treatment. Comparisons of proportions with optimal treatment and eradication rates between the pre-intervention cohort, an early post-intervention group (June–July 2022), and a late post-intervention group (November–December 2022) were evaluated using chi-square tests.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 295 patients in the pre-intervention, 414 patients in the early post-intervention, and 320 patients in the late post-intervention cohorts. There was an increase in proportions of optimal treatment (bismuth-quadruple, clarithromycin-quadruple, or rifabutin-triple therapy with a proton pump inhibitor for 14 days) between the pre- and early post-intervention groups from 26.4% to 39.7% (<i>p</i> &lt; 0.01) with a further increase in the late post-intervention group to 85.3% (<i>p</i> &lt; 0.01). The proportion of post-treatment eradication testing within 24 months increased from 56% in the pre-intervention cohort to 65.8% in the early post-intervention cohort (<i>p</i> = 0.01) and 64.9% in the late post-intervention cohort (<i>p</i> = 0.03). In patients with post-treatment eradication testing, there was an increase in successful eradication from 80.6% in the pre-intervention cohort to 88.9% in the early post-intervention cohort (<i>p</i> = 0.03) and 82.6% in the late post-intervention cohort (<i>p</i> = 0.66).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>An EMR order set for <i>H. pylori</i> treatment and eradication testing significantly increased rates of using optimal, evidence-based treatment, post-treatment eradication testing, and confirmed eradication of <i>H. pylori</i> infection.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143840689","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":"Efficacy and Safety of Cefuroxime–Tetracycline-Containing Bismuth Quadruple Therapy for Helicobacter pylori Eradication in Penicillin-Allergic Patients: A Multicenter Randomized Controlled Trial","authors":"Hui Wang,&nbsp;Qingzhou Kong,&nbsp;Qiumei Zhang,&nbsp;Lili Zhang,&nbsp;Ruili Li,&nbsp;Teng Zhang,&nbsp;Leina Guo,&nbsp;Xilan Wang,&nbsp;Xiaowei Li,&nbsp;Hongyu Zhao,&nbsp;Fengqing Liu,&nbsp;Yuting Guo,&nbsp;Zhenzhen Zhai,&nbsp;Mingyu Li,&nbsp;Xiaorong Yang,&nbsp;Xiuli Zuo,&nbsp;Xiaoyun Yang,&nbsp;Yueyue Li","doi":"10.1111/hel.70033","DOIUrl":"https://doi.org/10.1111/hel.70033","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Penicillin allergy significantly restricts therapeutic options for <i>Helicobacter pylori</i> eradication. This multicenter randomized controlled study was designed to evaluate the efficacy and safety of a novel cefuroxime–tetracycline-containing bismuth quadruple therapy (Cef-Tet BQT) as first-line treatment in this population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Penicillin-allergic treatment-naïve patients with confirmed <i>H. pylori</i> infection (<i>N</i> = 248) were randomized to two 14-day regimens: one received Cef-Tet BQT (Tegoprazan 50 mg twice a day, bismuth potassium citrate 220 mg twice daily, cefuroxime 500 mg twice daily, tetracycline 500 mg three times daily), and the other received cefuroxime–levofloxacin-containing bismuth quadruple therapy (Cef-Lev BQT: cefuroxime 500 mg twice daily, levofloxacin 500 mg once daily). The primary endpoint assessed noninferiority of eradication rates, with secondary endpoints including safety profiles and adherence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 248 patients underwent randomization. The intention-to-treat (ITT) eradication rates were 90.32% (112/124, 95% confidence interval [CI]: 85.12%–95.52%) and 81.45% (101/124, 95% CI: 74.61%–88.29%) (<i>p</i> = 0.045); the modified intention-to-treat (MITT) eradication rates were 91.80% (112/122, 95% CI: 86.93%–96.67%) and 83.47% (101/121, 95% CI: 76.85%–90.09%) (<i>p</i> = 0.048); and the per-protocol (PP) eradication rates were 92.37% (109/118, 95% CI: 87.58%–97.16%) and 85.34% (99/116, 95% CI: 78.90%–91.78%) (<i>p</i> = 0.087) in the Cef-Tet BQT group and Cef-Lev BQT group, respectively. Noninferiority of the Cef-Tet BQT group was demonstrated in all three analyses (<i>p</i> &lt; 0.0001). The incidence of adverse events (21.77% vs. 24.19%) and compliance (96.77% vs. 95.97%) were comparable between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>BQT containing cefuroxime and tetracycline is efficacious and safe for the first-line eradication of <i>H. pylori</i> in penicillin-allergic patients. This regimen provides a viable alternative to circumvent the antimicrobial resistance concerns associated with levofloxacin-based regimens.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ClinicalTrials.gov ID: NCT06351891</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143836217","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}