Helicobacter最新文献

{"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}

{"title":"Chronic Infection With Gastric Helicobacters Induces Hepatic Lesions in Mice","authors":"Lornella Seeneevassen,&nbsp;Elodie Sifré,&nbsp;Sadia Khalid,&nbsp;Mathilde Managau,&nbsp;Francis Mégraud,&nbsp;Armelle Ménard,&nbsp;Pierre Dubus,&nbsp;Pirjo Spuul,&nbsp;Christine Varon","doi":"10.1111/hel.70032","DOIUrl":"https://doi.org/10.1111/hel.70032","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p><i>Helicobacter pylori</i> infection is one of the most prevalent chronic bacterial infections worldwide. This bacillus colonizes the human stomach lifelong, where it induces chronic gastritis, evolving in some cases to gastro-duodenal ulcers, gastric adenocarcinoma, and mucosa-associated lymphoid tissue lymphoma. <i>H. pylori</i> infection has also been associated with extragastric diseases, and clinical data have suggested a role in liver pathogenesis. This retrospective study evaluated the consequences of chronic infection with gastric <i>Helicobacters</i> on liver pathogenesis in a mouse experimental model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>C57BL6 mice were infected with either <i>H. felis</i> (<i>n</i> = 12) or five human and mouse-adapted strains of <i>H. pylori</i> (<i>n</i> = 77) for one year. Uninfected mice were used as negative controls (<i>n</i> = 10). Histopathological analysis of paraffin-embedded liver tissue sections was performed, and scores were determined in a double-blind manner for inflammation and steatosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mice infected with <i>H. felis</i> and several <i>H. pylori</i> strains developed more liver parenchymal inflammation and steatosis, known precursor lesions of liver carcinogenesis, compared to non-infected mice. The presence of liver lesions was positively correlated with the detection of lesions of the gastric mucosa, more particularly gastric inflammation and metaplasia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Chronic infection of mice with <i>H. felis</i> and <i>H. pylori</i> induces liver pathogenesis characterized by parenchymal inflammation and steatosis, which may be associated with the severity of gastric histopathological lesions. Understanding <i>H. pylori</i> infection's impact on extragastric lesions could <i>in fine</i> help detect and prevent the emergence of other digestive tract-related diseases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hel.70032","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143809692","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":"Real-Time PCR Helicobacter pylori Test in Comparison With Culture and Histology for Helicobacter pylori Detection and Identification of Resistance to Clarithromycin: A Single-Center Real-Life Study","authors":"Kateryna Priadko,&nbsp;Sophie-Anne Gibaud,&nbsp;Amaury Druet,&nbsp;Louise Galmiche,&nbsp;Francis Megraud,&nbsp;Stéphane Corvec,&nbsp;Tamara Matysiak-Budnik","doi":"10.1111/hel.70031","DOIUrl":"https://doi.org/10.1111/hel.70031","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In our center, RT-PCR was integrated as a routine method to diagnose <i>Helicobacter pylori</i> due to its higher availability after COVID-19 pandemics. The objective of this study was to assess the feasibility and performance of systematically performed RT-PCR for <i>H. pylori</i> detection and clarithromycin (CLA) resistance in a real-life clinical practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>One hundred consecutive patients underwent an upper digestive endoscopy during which at least four biopsies (two from the antrum and two from the corpus) were obtained for RT-PCR and culture with antibiogram and four additional biopsies for histology. The results of <i>H. pylori</i> detection were compared among RT-PCR, histology, and bacterial culture, and the results of CLA susceptibility were compared between culture-based antibiogram and RT-PCR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Out of 100 patients, 64 were positive for <i>H. pylori</i> by RT-PCR, 66 by histology, and 53 by culture, with no statistically significant difference among the three methods (<i>p</i> &gt; 0.05). CLA resistance was found in 8 out of 45 patients (17.7%) by culture and in 12 out of 64 patients (18.7%) by PCR. In 8 <i>H. pylori</i>-positive patients by culture, the antibiogram could not be realized due to lack of viability of the strains. In one patient, after a double checking, discrepant results were observed, requiring a complementary molecular analysis by the French National Reference Center for Helicobacters, which confirmed the existence of a double population of <i>H. pylori</i> strains within biopsies, with and without CLA resistance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our study demonstrates that in real-life clinical practice, RT-PCR is feasible and comparable in the ability to detect <i>H. pylori</i> and its resistance to CLA to bacterial culture with antibiogram and histology. Given its rapidity and limited dependence on the operator's interpretation, it appears preferable to the other methods.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hel.70031","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143786780","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":"First-Line Therapy for Helicobacter pylori in Slovenia: Data From 2013 to 2023 of the European Registry on H. pylori Management","authors":"Bojan Tepes,&nbsp;Nataša Brglez Jurečič,&nbsp;Maja Denkovski,&nbsp;Miroslav Vujasinovič,&nbsp;Zdenko Kikec,&nbsp;Jurij Bednarik,&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.70029","DOIUrl":"https://doi.org/10.1111/hel.70029","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Treatment is indicated for all <i>Helicobacter pylori</i> infections. However, the best approach for <i>H. pylori</i> management remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p><i>H. pylori</i> eradication data from Hp-EuReg on treatment-naive patients in Slovenia from 2013 to 2023 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>Eight Slovenian medical institutions contributed data for 4016 treatment-naive patients to Hp-EuReg. Of these, 18% did not undergo confirmatory post-treatment; most who did received a urea breath test. Between 2013 and 2018, 7-day triple therapy with amoxicillin and clarithromycin was most frequently used in first-line treatment, with an 88% eradication rate. From 2019 to 2023, a 14-day high-dose PPI (esomeprazole 40 mg b.i.d.) triple therapy with amoxicillin and clarithromycin was used, showing a significantly higher effectiveness at 94% (<i>p</i> &lt; 0.05). Quadruple bismuth-based therapy (esomeprazole 40 mg b.i.d., plus amoxicillin 500 mg, metronidazole 400 mg, and bismuth 120 mg, all q.i.d.) provided a 96.9% eradication rate, though this was not significantly better than the 14-day triple regimen. The <i>H. pylori</i> resistance rate to clarithromycin was 16% from 2013 to 2018, dropping to 13.5% from 2019 to 2023. Side effects were reported by 9.6% of patients, and treatment compliance was &gt; 99%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The study suggests that systematic data collection from routine clinical practice in Hp-EuReg can guide first-line <i>H. pylori</i> treatment. Established 90% treatment effectiveness threshold may serve as a surrogate marker for monitoring <i>H. pylori</i> resistance rates to antibiotics. In countries with a <i>H. pylori</i> resistance rate &lt; 15%, such as Slovenia, the 14-day high-dose PPI amoxicillin-clarithromycin regimen is an optimal first-line empirical treatment.</p>\u0000 \u0000 <p><b>Trial Registration:</b> NCT02328131</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143761839","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":"Helicobacter pylori Eradication Is Associated With a Reduced Risk of Metachronous Gastric Neoplasia by Restoring Immune Function in the Gastric Mucosa","authors":"Min-Jae Kim,&nbsp;Yeonjin Je,&nbsp;Jaeyoung Chun,&nbsp;Young Hoon Youn,&nbsp;Hyojin Park,&nbsp;Ji Hae Nahm,&nbsp;Jie-Hyun Kim","doi":"10.1111/hel.70030","DOIUrl":"https://doi.org/10.1111/hel.70030","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p><i>Helicobacter pylori</i> infection is a significant contributing factor of gastric cancer. Metachronous neoplasms also pose a risk. The mechanism underlying the impact of <i>H. pylori</i> eradication on preventing metachronous gastric cancer is unclear. This study aimed to investigate immunity changes in gastric mucosa after <i>H. pylori</i> eradication and to identify mechanisms preventing metachronous recurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Patients diagnosed with gastric neoplasm and <i>H. pylori</i> infection, who underwent endoscopic resection, were included. Thirty-six cases of metachronous neoplasms occurring after eradication (metachronous group) were compared to 36 controls matched for age, sex, atrophy, and metaplasia (control group). Histological features and immunohistochemical staining for T-cell (CD3, CD4, and CD8) and immune exhaustion (forkhead/winged helix transcription factor and programmed cell death-ligand 1) markers in the non-tumor-bearing mucosa were evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In histologic features, glandular atrophy and intestinal metaplasia in the gastric mucosa significantly improved following <i>H. pylori</i> eradication in the control group (<i>p</i> &lt; 0.001, 0.008), whereas they did not improve in the metachronous group (<i>p</i> = 0.449, 0.609). CD8 and CD8/CD3 ratios increased in the control group (<i>p</i> &lt; 0.001, 0.04), but did not show differences in the metachronous group (<i>p</i> = 0.057, 0.245). The CD4/CD3 ratio and programmed cell death-ligand 1/CD4 expression significantly decreased after <i>H. pylori</i> eradication in the control group (<i>p</i> = 0.003, 0.042), but not in the metachronous group (<i>p</i> = 0.54, 0.55).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This observational study suggests that <i>H. pylori</i> eradication may prevent the recurrence of gastric neoplasia by improving histological inflammation and overcoming immune exhaustion.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hel.70030","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143749750","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":"Management of Helicobacter pylori Infection in Spain Beyond the Data Collected in the European Registry on H. pylori Management (Hp-EuReg): Results of a Nationwide Survey","authors":"Javier Tejedor-Tejada,&nbsp;Samuel J. Martínez-Domínguez,&nbsp;Luis Hernández,&nbsp;Anna Cano-Català,&nbsp;Pablo Parra,&nbsp;Leticia Moreira,&nbsp;Olga P. Nyssen,&nbsp;Javier P. Gisbert,&nbsp;the Hp-EuReg Investigators","doi":"10.1111/hel.70028","DOIUrl":"https://doi.org/10.1111/hel.70028","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The management of <i>Helicobacter pylori</i> (<i>H. pylori</i>) infection encompasses different diagnostic and therapeutic procedures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A survey was developed to investigate further factors of the clinical practice concerning the management of <i>H. pylori</i> infection that are currently not collected within the European Registry on <i>H. pylori</i> Management (Hp-EuReg). The survey was distributed among Spanish Hp-EuReg investigators, members of the Spanish Gastroenterology Association, and through social media.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 128 investigators from all Spanish regions participated (79% from centers enrolling patients in the Hp-EuReg). Most participants (66%) reported having at least five diagnostic methods available. Culture was usually performed following the second-line failure (64%). Contrary to the recommendations, 17% of physicians did not investigate <i>H. pylori</i> infection in patients admitted for peptic ulcer bleeding, and 35% did not treat the infection right away. Furthermore, most investigators (95%) did not test for the infection in cohabitants, and 32% in gastric cancer relatives. The test-and-treat strategy was used in 84% of patients under 55 years without alarm symptoms, and in 15% of patients over 55 years. The majority (74%) did not confirm the penicillin allergy, only 26% were aware of the local clarithromycin resistance rate, and 37% periodically evaluated the efficacy of eradication treatments. Finally, most Spanish investigators (83%) followed the V Spanish Consensus, while up to 35% followed the Maastricht VI recommendation guidelines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The management of <i>H. pylori</i> infection in Spain is suboptimal, even among Hp-EuReg investigators. We must optimize <i>H. pylori</i> management by implementing educational measures adapted to each setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ClinicalTrials.gov: NCT02328131</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741062","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":"Artificial Intelligence in Endoscopy for Predicting Helicobacter pylori Infection: A Systematic Review and Meta-Analysis","authors":"Yiwen Jiang,&nbsp;Hengxu Yan,&nbsp;Jiatong Cui,&nbsp;Kaiqiang Yang,&nbsp;Yue An","doi":"10.1111/hel.70026","DOIUrl":"10.1111/hel.70026","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This meta-analysis aimed to assess the diagnostic performance of artificial intelligence (AI) based on endoscopy for detecting <i>Helicobacter pylori</i> (<i>H. pylori</i>) infection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive literature search was conducted across PubMed, Embase, and Web of Science to identify relevant studies published up to January 10, 2025. The selected studies focused on the diagnostic accuracy of AI in detecting <i>H. pylori</i>. A bivariate random-effects model was employed to calculate pooled sensitivity and specificity, both presented with 95% confidence intervals (CIs). Study heterogeneity was assessed using the <i>I</i>² statistic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 604 studies identified, 16 studies (25,002 images or patients) were included. For the internal validation set, the pooled sensitivity, specificity, and area under the curve (AUC) for detecting <i>H. pylori</i> were 0.91 (95% CI: 0.84–0.95), 0.91 (95% CI: 0.86–0.94), and 0.96 (95% CI: 0.94–0.97), respectively. For the external validation set, the pooled sensitivity, specificity, and AUC were 0.91 (95% CI: 0.86–0.95), 0.94 (95% CI: 0.90–0.97), and 0.98 (95% CI: 0.96–0.99). For junior clinicians, the pooled sensitivity, specificity, and AUC were 0.76 (95% CI: 0.66–0.83), 0.75 (95% CI: 0.70–0.80), and 0.81 (95% CI: 0.77–0.84). For senior clinicians, the pooled sensitivity, specificity, and AUC were 0.81 (95% CI: 0.74–0.86), 0.89 (95% CI: 0.86–0.91), and 0.92 (95% CI: 0.90–0.94).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Endoscopy-based AI demonstrates higher diagnostic performance compared to both junior and senior endoscopists. However, the high heterogeneity among studies limits the strength of these findings, and further research with external validation datasets is necessary to confirm the results.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669687","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":"Letter to the Editor: “Efficacy of Lactobacillus spp. Supplementation in Helicobacter pylori Eradication: A Systematic Meta-Analysis of Randomized Controlled Trials With Trial Sequential Analysis”","authors":"Ben-Gang Zhou,&nbsp;Yao-Yao Li,&nbsp;Yan-Bing Ding","doi":"10.1111/hel.70027","DOIUrl":"10.1111/hel.70027","url":null,"abstract":"","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663577","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":"Innate Immunity in Helicobacter pylori Infection and Gastric Oncogenesis","authors":"Yuheng Zhang,&nbsp;Zhiyu Yan,&nbsp;Yuhao Jiao,&nbsp;Yunlu Feng,&nbsp;Shengyu Zhang,&nbsp;Aiming Yang","doi":"10.1111/hel.70015","DOIUrl":"https://doi.org/10.1111/hel.70015","url":null,"abstract":"<p><i>Helicobacter pylori</i> is an extremely common cause of gastritis that can lead to gastric adenocarcinoma over time. Approximately half of the world's population is infected with <i>H. pylori</i>, making gastric cancer the fourth leading cause of cancer-related deaths worldwide. Innate immunity significantly contributes to systemic and local immune responses, maintains homeostasis, and serves as the vital link to adaptive immunity, and in doing so, mediates <i>H. pylori</i> infection outcomes and consequent cancer risk and development. The gastric innate immune system, composed of gastric epithelial and myeloid cells, is uniquely challenged by its need to interact simultaneously and precisely with commensal microbiota, exogenous pathogens, ingested substances, and endogenous exfoliated cells. Additionally, innate immunity can be detrimental by promoting chronic infection and fibrosis, creating an environment conducive to tumor development. This review summarizes and discusses the complex role of innate immunity in <i>H. pylori</i> infection and subsequent gastric oncogenesis, and in doing so, provides insights into how these pathways can be exploited to improve prevention and treatment.</p>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hel.70015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639027","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":"Flagellar Assembly Factor FliW2 De-Represses Helicobacter pylori FlaA-Mediated Motility by Allosteric Obstruction of Global Regulator CsrA","authors":"Marcia Shu-Wei Su,&nbsp;Benjamin Dickins,&nbsp;Fang Yie Kiang,&nbsp;Wei-Jiun Tsai,&nbsp;Yueh-Lin Chen,&nbsp;Jenn-Wei Chen,&nbsp;Shuying Wang,&nbsp;Pei-Jane Tsai,&nbsp;Jiunn-Jong Wu","doi":"10.1111/hel.70019","DOIUrl":"https://doi.org/10.1111/hel.70019","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p><i>Helicobacter pylori</i> colonizes the human stomach as a dominant member of the gastric microbiota and constitutively expresses flagellar motility for survival. Carbon storage regulator A (CsrA) is a posttranscriptional global regulator and a critical determinant of <i>H. pylori</i>'s motility and pathogenicity. The regulation of <i>H. pylori</i> CsrA is still uncertain although in other species CsrA is reported to be antagonized by small RNAs and proteins. In this study, we attempted to unveil how CsrA is regulated and hypothesized that <i>H. pylori</i> CsrA activity is antagonized by a flagellar assembly factor, FliW2, via protein allosteric obstruction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Multiple sequence comparisons indicated that, along its length and in contrast to <i>fliW1</i>, the <i>fliW2</i> of <i>H. pylori</i> J99 is conserved. We then generated an isogenic Δ<i>fliW2</i> strain whose function was characterized using phenotypic and biochemical approaches. We also applied a machine learning approach (AlphaFold2) to predict FliW2-CsrA binding domains and investigated the FliW2-CsrA interaction using pull-down assays and in vivo bacterial two-hybrid systems.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We observed the reduced expression of major flagellin FlaA and impaired flagellar filaments that attenuated the motility of the Δ<i>fliW2</i> strain. Furthermore, a direct interaction between FliW2 and CsrA was demonstrated, and a novel region of the C-terminal extension of CsrA was suggested to be crucial for CsrA interacting with FliW2. Based on our AlphaFold2 prediction, this C-terminal region of FliW2-CsrA interaction does not overlap with CsrA's N-terminal RNA binding domain, implying that FliW2 allosterically antagonizes CsrA activity and restricts CsrA's binding to <i>flaA</i> mRNAs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our data points to novel regulatory roles that the <i>H. pylori</i> flagellar assembly factor FliW2 has in obstructing CsrA activity, and thus FliW2 may indirectly antagonize CsrA's regulation of <i>flaA</i> mRNA processing and translation. Our findings reveal a new regulatory mechanism of flagellar motility in <i>H. pylori</i>.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hel.70019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143602475","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}