Helicobacter最新文献

{"title":"Worldwide Phylogenetic and Clinical Risk Association of the Helicobacter pylori Outer Membrane Gene hopQ","authors":"Edson I. Rubio-Hernández,&nbsp;Ezequiel M. Fuentes-Pananá,&nbsp;Kaisa Thorell,&nbsp;Yonne Nasimiyu,&nbsp;Meredith Yeager,&nbsp;Roberto C. Torres,&nbsp;Wen Luo,&nbsp;Difei Wang,&nbsp;M. Constanza Camargo,&nbsp;Javier Torres,&nbsp;Zilia Y. Muñoz-Ramírez","doi":"10.1111/hel.70145","DOIUrl":"https://doi.org/10.1111/hel.70145","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p><i>Helicobacter pylori</i> (Hp) infection is the primary risk factor for gastric cancer, yet the consequences of the infection vary by bacterial and host factors. The outer membrane protein HopQ plays a key role in Hp adhesion, but its genetic diversity and clinical implications are unclear. HopQ–CEACAM interaction facilitates the translocation of the cytotoxin-associated gene A (CagA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We analyzed <i>hopQ</i> sequences from 1038 Hp strains, mainly from the <i>Helicobacter pylori</i> Genome Project, integrating phylogenetic, genotypic, and disease association analyses. Logistic regression models assessed the association between <i>hopQ</i> genotypes and disease, accounting for <i>cagA</i> status and Hp ancestry.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p><i>hopQ</i> genotypes have a strong population structure. The hpAfrica1 and hpNorthAsia (including hspIndigenousAmerica) populations exhibited distinct <i>hopQ</i> patterns, suggesting ancestry-specific pathogenicity. <i>hopQ</i> genotypes were classified as <i>hopQI</i> and <i>hopQII</i>; <i>hopQI</i> was further divided into high-risk and low-risk variants. Ancestry-adjusted analyses showed that <i>hopQI</i> high-risk was associated (odds ratio = 3.1; <i>p</i> &lt; 0.0001) with advanced disease (intestinal metaplasia and gastric cancer combined vs. non-atrophic gastritis), independently of <i>cagA</i>. In contrast, <i>hopQII</i> and <i>hopQI</i> low-risk variants correlated with a reduced risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The <i>hopQ</i> diversity is a key determinant of Hp pathogenicity. <i>hopQI</i> high-risk is a predictor of advanced disease, whereas <i>hopQII</i> and <i>hopQI</i> low-risk may be protective. Understanding <i>hopQ</i> variability could improve risk stratification and the targeted therapies for gastric cancer.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"31 4","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148373076","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":"Global Diversity of Helicobacter pylori Prophages Reveals Genetic Drivers of Virulence and Associations With Gastric Cancer","authors":"Zhenkai Li,&nbsp;Ying Li,&nbsp;Shixuan Huang,&nbsp;Yanyan Shang,&nbsp;Yuecong Li,&nbsp;Tiantian Zhang,&nbsp;Xianhu Wei,&nbsp;Xinqiang Xie,&nbsp;Qingping Wu,&nbsp;Xinyu Zhao","doi":"10.1111/hel.70140","DOIUrl":"https://doi.org/10.1111/hel.70140","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p><i>Helicobacter pylori</i> is a globally prevalent gastric pathogen, and chronic infection accounts for most gastric cancer (GC) cases worldwide. Major oncogenic determinants, including CagA, VacA, and the type IV secretion system, show marked geographic heterogeneity, yet the evolutionary forces shaping this uneven distribution remain unclear. Prophages can mediate horizontal gene transfer and modulate bacterial fitness and virulence, but their contribution to <i>H. pylori</i> carcinogenicity has not been systematically evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We characterized prophage diversity, population structure, and virulence potential using 2379 <i>H. pylori</i> host genomes and 139 complete prophage genomes. Prophage population structure and intergenomic relatedness were inferred, and the prophage pangenome and protein-sharing network were reconstructed. Homology-based association analyses were performed to test enrichment of prophage orthologous groups (POGs) with major oncogenic virulence factors (CagA and/or VacA) across the 2379 host genomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Prophages segregated into geographically structured populations. The EastAsia and EastAsia2 prophage groups were tightly coupled to high-risk hspEAsia hosts and exhibited the largest and most diverse accessory repertoires. Virulence-associated genes were strongly population-specific and were detected only in the EastAsia/EastAsia2 prophage populations. Moreover, carriage of POGs homologs from 1961P, HPy1R, and phiHP33 showed significant positive associations with CagA and/or VacA across the 2379 genomes, whereas no enrichment was observed for KHP30 or KHP40.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p><i>H. pylori</i> prophages are not passive genomic remnants but population-structured reservoirs whose gene repertoires track high-risk virulence backgrounds and may contribute to the bacterium's carcinogenic potential.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"31 3","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148324953","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 Tegoprazan-Based Dual, Triple, and Quadruple Therapies in First-Line Helicobacter pylori Eradication: A Prospective Randomized Controlled Trial","authors":"Yu-Cheng Zhu,&nbsp;Keng Li,&nbsp;Anjiang Sun,&nbsp;Sihui Lin,&nbsp;Jun Zhang,&nbsp;Shanshan Meng,&nbsp;Xin Xia,&nbsp;Hong Gao,&nbsp;Juan Lin,&nbsp;Wei Jiang","doi":"10.1111/hel.70147","DOIUrl":"10.1111/hel.70147","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Resistance to antibiotics has resulted in the effectiveness of conventional eradication therapies for <i>Helicobacter pylori</i> being reduced, creating a need for regimens that are effective, safe, and simple. In this study, we evaluated the eradication efficacy, adverse events, and medication adherence of four different tegoprazan-based regimens administered as first-line therapy for <i>H. pylori</i> infection. We also explored the clinical value of adding bismuth to a triple therapy regimen.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this prospective, randomized controlled trial, 640 treatment-naive patients with confirmed <i>H. pylori</i> infection were randomly assigned to one of the four groups undergoing 14-day treatment regimens of tegoprazan–amoxicillin (TA), tegoprazan–tetracycline (TT), tegoprazan–amoxicillin–tetracycline (TAT), or tegoprazan–amoxicillin–tetracycline–bismuth (TATB), with 160 patients in each group. The outcomes were the eradication rate, incidence of adverse events, and medication adherence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the intention-to-treat analysis, the <i>H. pylori</i> eradication rates in the TA, TT, TAT, and TATB groups were 80.0% (95% confidence interval [CI]: 73.0–85.9), 61.9% (95% CI: 53.9–69.4), 93.1% (95% CI: 88.0–96.5), and 89.4% (95% CI: 83.5–93.7), respectively. Compared with the TATB regimen, the TAT regimen was non-inferior (95% CI, −3.9% to 11.5%; non-inferiority <i>p</i> &lt; 0.001), whereas demonstrating non-inferiority in the TA and TT regimens failed. Adverse events were less frequent in the TA (10.6%), TT (17.5%), and TAT (20.0%) groups than in the TATB group (36.9%; all <i>p</i> &lt; 0.001). Medication adherence was high across groups, with no significant between-group differences observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>High eradication efficacy was demonstrated for the TAT regimen; this regimen was non-inferior to the TATB regimen, and it was associated with fewer adverse events. These findings suggest that it may be an effective first-line treatment option for <i>H. pylori</i> infection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ClinicalTrials.gov identifier: NCT06977841</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"31 3","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148224783","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":"How to Improve Patient Adherence During Helicobacter pylori Diagnosis and Treatment","authors":"Song-Ze Ding,&nbsp;Shailja C. Shah,&nbsp;Aaron P. Thrift,&nbsp;Mimi C. Tan,&nbsp;David Y. Graham,&nbsp;Wai-Keung Leung","doi":"10.1111/hel.70148","DOIUrl":"10.1111/hel.70148","url":null,"abstract":"","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"31 3","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148224831","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 Fexuprazan-Based Modified High-Dose Dual Therapy for Helicobacter pylori Eradication: A Randomized Clinical Trial","authors":"Ji Yong Ahn,&nbsp;Ki-Nam Shim,&nbsp;Jung-Ho Park,&nbsp;Sang Gyun Kim,&nbsp;Jeong Hwan Kim,&nbsp;Jeong Seop Moon,&nbsp;Young Hoon Youn,&nbsp;Jae J Kim","doi":"10.1111/hel.70146","DOIUrl":"10.1111/hel.70146","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background/Aims&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The eradication efficacy of proton pump inhibitor (PPI)–based standard triple therapy (STT) for &lt;i&gt;Helicobacter pylori&lt;/i&gt; infection has declined in Korea, largely because of increasing clarithromycin resistance. High-dose dual therapy (HDDT) using potent acid suppression represents a promising clarithromycin-sparing strategy. This study evaluated the efficacy and safety of fexuprazan-based modified HDDT (m-HDDT) including bismuth, compared with conventional PPI-based STT as first-line eradication therapy.&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 prospective, multicenter, randomized, open-label, non-inferiority trial was conducted at eight tertiary hospitals in Korea. Treatment-naïve adults with confirmed &lt;i&gt;H. pylori&lt;/i&gt; infection were randomized to receive either m-HDDT (fexuprazan 40 mg twice daily, amoxicillin 1000 mg three times daily, and bismuth subcitrate potassium 300 mg three times daily) or STT (lansoprazole 30 mg, amoxicillin 1000 mg, and clarithromycin 500 mg, all twice daily) for 14 days. Eradication was assessed by urea breath test 4–8 weeks after therapy. The primary endpoint was the eradication rate in the full analysis set (FAS), with a prespecified non-inferiority margin of −10%. Safety and compliance were evaluated as secondary outcomes.&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;In total, 196 patients were included in the FAS (m-HDDT, &lt;i&gt;n&lt;/i&gt; = 96; STT, &lt;i&gt;n&lt;/i&gt; = 100). &lt;i&gt;Helicobacter pylori&lt;/i&gt; eradication was achieved in 81.3% of patients in the m-HDDT group and 79.0% in the STT group, demonstrating non-inferiority of m-HDDT (one-sided Wald test, &lt;i&gt;p&lt;/i&gt; = 0.0158). Per-protocol analysis yielded consistent results (&lt;i&gt;p&lt;/i&gt; = 0.0215). Drug compliance was high in both groups, with mean compliance rates of 97.0% in the m-HDDT group and 99.0% in the STT group; more than 95% of patients in each group achieved ≥ 80% compliance. The incidence of treatment-emergent adverse events was comparable between groups (16.7% vs. 14.0%); most events consisted of mild gastrointestinal symptoms. No serious adverse events or treatment discontinuations due to adverse events were observed in either group.&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;Fexuprazan-based m-HDDT with bismuth was non-inferior to PPI-based STT for &lt;i&gt;H. pylori&lt;/i&gt; eradication and demonstrated comparable safety and excellent compliance. This clarithromycin-sparing regimen can be considered an alternative treatment option in regions with high macrolide resistance.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 &lt;/di","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"31 3","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hel.70146","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148198816","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":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"31 3","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148079984","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":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"31 3","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148079421","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":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"31 3","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148079417","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":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"31 3","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148079986","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":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"31 3","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148079420","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}