Helicobacter最新文献

{"title":"Drug Repurposing Identifies Natamycin and Avacopan as Urease-Targeted Therapeutic Candidates Against Helicobacter pylori","authors":"Shwetlaxmi Patil,&nbsp;Sohinee Sarkar,&nbsp;Renitta Jobby,&nbsp;Songmin Yu,&nbsp;Abhishek Chowdhury,&nbsp;Atanuka Paul,&nbsp;Vipin Kumar Mishra,&nbsp;Vinothkannan Ravichandran","doi":"10.1111/hel.70094","DOIUrl":"10.1111/hel.70094","url":null,"abstract":"<div>\u0000 \u0000 <p>The global rise of antimicrobial resistance necessitates innovative strategies to combat persistent infections, including those caused by <i>Helicobacter pylori</i>. This study investigates potential inhibitors of the <i>H. pylori</i> urease enzyme, a key virulence factor that enables survival in the highly acidic gastric environment. A virtual screening of 1773 FDA-approved drugs was performed, followed by molecular dynamics simulations. Among the top candidates, Natamycin, Zavegepant, Midostaurin, Avacopan, and Metolazone displayed significant binding affinities towards urease. Further simulations confirmed the stability and favorable interaction profiles of these drug–enzyme complexes, with the Avacopan–urease complex exhibiting the highest stability based on RMSD and binding free energy analyses. Natamycin and Avacopan were subsequently selected for in vitro validation, where both significantly inhibited urease activity and demonstrated antibacterial effects against clinical isolates and the reference strain <i>H. pylori</i> B128. Avacopan exhibited inhibition ranging from 30.0% in strain CL2 to 99.7% in B128, whereas Natamycin showed consistently stronger inhibition across all clinical strains, ranging from 89.2% in CL4 to 99.9% in CL1, and exceeding 90% in CL1, CL2, CL3, and B128. Both inhibitors were effective against <i>cag</i>-positive and <i>cag</i>-negative clinical isolates, indicating broad-spectrum urease inhibition. However, the bactericidal activities of these compounds were more strain-specific with increased efficacies observed in <i>cag</i>⁻ isolates. Therefore, further studies are warranted to fully explore the specific mechanisms and selectivity of their individual inhibitory activities. These findings highlight Avacopan and Natamycin as promising urease-targeted drug repurposing candidates for future therapeutic development against <i>H. pylori</i>.</p>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"31 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145911370","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":"EUROHELICAN—Accelerating Gastric Cancer Reduction Through Helicobacter pylori Eradication","authors":"Bojan Tepeš,&nbsp;Tatjana Kofol Bric,&nbsp;Mitja Oblak,&nbsp;Jernej Završnik,&nbsp;Helena Blažun Vošner,&nbsp;Danute Ražuka-Ebela,&nbsp;Mārcis Leja,&nbsp;Viktoria Knaze,&nbsp;Jin Young Park,&nbsp;Tamara Matysiak-Budnik","doi":"10.1111/hel.70097","DOIUrl":"10.1111/hel.70097","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Most gastric cancer cases are attributable to chronic <i>Helicobacter pylori (H. pylori)</i> infection and can theoretically be prevented. The objectives of the EUROHELICAN project were to assess the feasibility, acceptability, effectiveness, and adverse events of the <i>H. pylori</i> screen-and-treat program in younger adults aged 30 to 34 years, for the first time in Europe; to evaluate long-term effects of <i>H. pylori</i> eradication in middle-aged adults (starting from 45 years of age) previously enrolled for at least 5 years in the GISTAR study in Latvia, and to prepare the IARC expert Working Group Report on population-based <i>H. pylori</i> screen-and-treat strategies for gastric cancer prevention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study of <i>H. pylori</i> screen-and-treat in younger adults was conducted in the Community Healthcare Center Dr. Adolf Drolc Maribor following methodology prepared by the National Institute of Public Health of Slovenia. Assessment of possible effects of <i>H. pylori</i> screen-and-treat in the long term was conducted by following up on the long-running GISTAR study conducted by the Institute of Clinical and Preventive Medicine at the University of Latvia. A team of experts led by the Nantes University Hospital evaluated the study protocols and their progress at different stages. The IARC convened a Working Group of international experts to develop globally applicable guidance on best practices for implementing population-based <i>H. pylori</i> screen-and-treat strategies in adult populations to prevent gastric cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Both studies received a positive evaluation at different stages of completion and were deemed appropriate for testing the feasibility of <i>H. pylori</i> screen-and-treat in a community health care setting and investigating possible adverse effects of the strategy in the long-term. The IARC expert group guidance report on the implementation of population-based <i>H. pylori</i> screen-and-treat strategies to prevent gastric cancer in adults will guide future primary gastric cancer prevention programs in Europe and beyond.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"31 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145911327","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":"An Open-Label Randomized Controlled Trial Comparing the Efficacy and Safety of a 7-Day Triple Therapy With Bismuth Versus 14-Day Standard Triple Therapy for Helicobacter pylori Eradication in Children and Adolescents","authors":"Anja Šterbenc,&nbsp;Bor Vratanar,&nbsp;Eva Miler Mojškerc,&nbsp;Matjaž Homan","doi":"10.1111/hel.70103","DOIUrl":"https://doi.org/10.1111/hel.70103","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>To achieve eradication rates &gt; 90%, the ESPGHAN/NASPGHAN guidelines for pediatric <i>Helicobacter pylori</i> infection recommend tailored antimicrobial therapy using sufficiently high doses over 10–14 days. However, prolonged treatment often leads to suboptimal compliance in children, which is a major contributor to reduced eradication rates. To address this, we evaluated the efficacy and safety of a shorter, 7 day triple therapy with bismuth compared with the 14 day standard triple therapy without bismuth in <i>H. pylori</i> infected children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>From 2020 to 2024, we carried out a randomized controlled trial involving treatment-naïve children and adolescents (5–18 years old) with confirmed <i>H. pylori</i> infection. Eligible participants were randomly allocated to receive either a 7 day triple therapy with bismuth (bismuth subcitrate, a proton pump inhibitor [PPI], amoxicillin, plus clarithromycin/metronidazole) or a 14 day standard triple therapy (a PPI, amoxicillin, plus clarithromycin/metronidazole) without bismuth. Two months after completing therapy, treatment success was determined using either a two-step monoclonal stool antigen assay or a urea breath test. Any adverse events were documented using a structured questionnaire.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventy-three children were enrolled in the study. In the intention-to-treat analysis, eradication was achieved in 91% of children treated with the 7 day triple therapy with bismuth and 87% of those receiving the 14 day standard triple therapy (<i>p</i> = 0.695). Per-protocol eradication rates were 94% and 87%, respectively (<i>p</i> = 0.418). No serious adverse events were reported, and most adverse events were mild to moderate. A metallic taste was significantly more frequent in the 14 day standard triple therapy group, while other adverse events occurred with similar frequency.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Adding bismuth to a 7 day triple regimen achieved high eradication rates and a safety profile similar to 14 day standard triple therapy, supporting its use as an effective and safe treatment option for pediatric <i>H. pylori</i> infection.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"31 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hel.70103","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145909061","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":"Expansion of cagA Copy Number in Helicobacter pylori During Co-Infection in a Mouse Model","authors":"Kavinda Tissera,&nbsp;Ashansa Ramanayake,&nbsp;Myeong-A Kim,&nbsp;Eui-Jeong Noh,&nbsp;Sacheera Angulmaduwa,&nbsp;Dowon Seo,&nbsp;Yong-Joon Cho,&nbsp;Jeong-Heon Cha","doi":"10.1111/hel.70091","DOIUrl":"10.1111/hel.70091","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The virulence factor CagA is critical in mediating inflammation, and &lt;i&gt;Helicobacter pylori&lt;/i&gt; PMSS1 dynamically modulates &lt;i&gt;cagA&lt;/i&gt; copy number in response to host immune pressure. Co-infection with &lt;i&gt;Salmonella enterica serotype Typhimurium&lt;/i&gt; has been shown to heighten systemic inflammation and reduce &lt;i&gt;H. pylori&lt;/i&gt; colonization while maintaining type IV secretion system functionality. This suggests that the inflammatory environments induced by co-infection may influence &lt;i&gt;H. pylori&lt;/i&gt; virulence mechanisms. This study investigates whether &lt;i&gt;H. pylori&lt;/i&gt; PMSS1 regulates its &lt;i&gt;cagA&lt;/i&gt; copy number during systemic co-infection in a mouse model.&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;Across three independent mouse experiments, &lt;i&gt;H. pylori&lt;/i&gt; isolated from control and co-infected mice was analyzed for &lt;i&gt;cagA&lt;/i&gt; gene copy number using quantitative real-time polymerase chain reaction. Three isolates with the highest &lt;i&gt;cagA&lt;/i&gt; copy numbers observed to date were further characterized for their virulence phenotypes and subjected to whole-genome sequencing to identify the mutations associated with co-infection.&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;&lt;i&gt;H. pylori&lt;/i&gt; isolates recovered from the stomachs of co-infected mice exhibited significantly higher &lt;i&gt;cagA&lt;/i&gt; copy numbers than those from control mice, with the mean copy number increasing from 2.64 (±1.03) in the control group to 3.22 (±1.63) in the co-infected group. Three &lt;i&gt;H. pylori&lt;/i&gt; isolates with high &lt;i&gt;cagA&lt;/i&gt; copy numbers (6.1, 9.1, and 11.0 copies) were assessed for virulence features. Notably, two of these isolates maintained elevated &lt;i&gt;cagA&lt;/i&gt; phosphorylation and cell elongation, suggesting their potential relevance as a model for &lt;i&gt;H. pylori&lt;/i&gt; infection studies in mice. Whole-genome sequencing further revealed co-infection-associated nonsynonymous mutations, notably in the &lt;i&gt;fur&lt;/i&gt; gene and membrane transport-related genes such as an MFS transporter and a corrinoid ABC transporter substrate-binding protein.&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;These findings suggest that co-infection with &lt;i&gt;S.&lt;/i&gt; promotes an increase in the &lt;i&gt;cagA&lt;/i&gt; copy number, thereby enhancing the virulence potential of &lt;i&gt;H. pylori&lt;/i&gt;. The study highlights the complex interplay between &lt;i&gt;H. pylori&lt;/i&gt; and co-infecting pathogens and their combined impact on &lt;i&gt;H. pylori&lt;/i&gt;-mediated disease, and the utility of high-&lt;i&gt;cagA&lt;/i&gt; copy isolates as valuable models for in vivo studies addressing pathogenesis.&lt;/p&gt;\u0000 ","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12748022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145855801","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":"Host Genetic Variants Associated With Helicobacter pylori Infection: A Meta-Analysis Combined With Functional Annotation","authors":"Wen-Jing Zhao,&nbsp;Heng-Min Xu,&nbsp;Chao Zhang,&nbsp;Xiao-Wen Jiang,&nbsp;Kai-Feng Pan,&nbsp;Wen-Qing Li","doi":"10.1111/hel.70098","DOIUrl":"10.1111/hel.70098","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p><i>Helicobacter pylori</i> (<i>H. pylori</i>) is a major risk factor for gastric cancer (GC) and multiple other chronic illnesses. Host genetic factors influence the susceptibility to <i>H. pylori</i> infection, as evidenced by elevated concordance in monozygotic twins and racial disparities independent of socioeconomic status. Leveraging meta-analyses and <i>in silico</i> functional annotation, we investigated host genetic susceptibility to <i>H. pylori</i> infection, and to examine how these variants may influence gastric cancer (GC) risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Meta-analyses were performed on 25 candidate genetic variants that had been investigated for the association with <i>H. pylori</i> infection in at least three studies, under five genetic models (allelic, dominant, recessive, homozygous, and heterozygous). Meta-analyses on genome-wide variants were conducted using the allelic model. The Bayesian False-Discovery Probability method and Venice criteria were used to assess genetic association credibility. The Genotype-Tissue Expression (GTEx) and eQTLGen databases were used for cis-expression quantitative trait locus (eQTL) analysis. Differential gene expression in <i>H. pylori</i>-positive (<i>n</i> = 61) vs. -negative (<i>n</i> = 17) samples, and GC (<i>n</i> = 414) vs. non-GC tissues (<i>n</i> = 210) was analyzed leveraging The Cancer Genome Atlas, GTEx, and in-house RNA-sequencing data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From a total of 103 studies for systematic review, meta-analyses based on 83 studies identified 47 variants across 18 loci associated with <i>H. pylori</i> susceptibility. These loci encompassed 29 cis-eQTLs affecting expression of 42 genes. Of them, seven genes at three loci—4p14 (<i>TLR10</i>, <i>TLR6</i>, <i>KLHL5</i>, <i>TMEM156</i>), 6p21.33 (<i>HLA-DRB6</i>, <i>C4B</i>), and 14q32.2 (<i>WARS</i>)—were consistently upregulated in <i>H. pylori</i> infection and GC, which may contribute to <i>H. pylori</i> infection-related GC development.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Host genetic predisposition alters the odds of <i>H. pylori</i> infection, demonstrating the importance of host-pathogen crosstalk in infection dynamics and subsequent gastric carcinogenesis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145849829","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":"Antibiotic Combinations in Bismuth-Containing Quadruple Therapy for Helicobacter pylori Eradication: A Systematic Review and Network Meta-Analysis","authors":"Miao Duan,&nbsp;Teng Teng,&nbsp;Qingzhou Kong,&nbsp;Yueyue Li,&nbsp;Xiuli Zuo","doi":"10.1111/hel.70101","DOIUrl":"10.1111/hel.70101","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>The rising antibiotic resistance of <i>Helicobacter pylori</i> has led to variability in efficacy of bismuth-containing quadruple therapy (BcQT). This network meta-analysis (NMA) aimed to compare the efficacy of antibiotic combinations in first-line BcQT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Following PRISMA guidelines with PROSPERO registration (CRD420251005598), we systematically searched PubMed, Embase, Web of Science, and Cochrane Library for randomized controlled trials (RCTs) published between January 1, 2005 and March 21, 2025. Eligible studies were selected by predefined criteria. Dichotomous outcomes included <i>H. pylori</i> eradication rates, adverse events, and compliance, analyzed as odds ratios (ORs) with 95% credible intervals (95% CrI) or 95% confidence intervals (95% CI). Treatments were ranked via surface under the cumulative ranking curve (SUCRA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This NMA included 25 RCTs (<i>n</i> = 7624) evaluating 19 regimens. Amoxicillin-metronidazole ranked highest globally (SUCRA = 0.866) in intention-to-treat analyses and in Asia (SUCRA = 0.851), particularly during 2016–2025 (SUCRA = 0.859; OR = 3.43, 95% CrI 1.17–10.05). Metronidazole-tetracycline was optimal in Europe (SUCRA = 0.969; OR = 2.13, 95% CrI 1.15–3.95), amoxicillin-minocycline in China (SUCRA = 0.733). Notably, regimens including levofloxacin or clarithromycin significantly decreased eradication rates in China (OR = 1.32; 95% CI 1.04–1.66; <i>p</i> = 0.02). Amoxicillin-furazolidone had the poorest adverse events (SUCRA = 0.792). Compliance was highest with amoxicillin-moxifloxacin (SUCRA = 0.878).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Superior eradication was achieved with BcQT by utilizing dual low-resistance antibiotics per local surveillance data. Amoxicillin-metronidazole may represent optimal regimens for primary <i>H. pylori</i> eradication efficacy in BcQT. Substantial efficacy variation in antibiotic combinations necessitates tailored treatment guided by antibiotic resistance surveillance.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145843748","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":"Incidence of Gastric Cancer and Neuroendocrine Tumors in Autoimmune Gastritis: A Systematic Review and Meta-Analysis of Follow-Up Studies","authors":"Baixiang He,&nbsp;Xiaochi Ma,&nbsp;Mingyue Liu,&nbsp;Xiangyun Zou,&nbsp;Jean Carlo Xin Peng Ye,&nbsp;Ran Zhang,&nbsp;Zhihong Li","doi":"10.1111/hel.70096","DOIUrl":"10.1111/hel.70096","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>A central controversy in autoimmune gastritis (AIG) concerns the true incidence of gastric cancer (GC) and gastric neuroendocrine tumors (gNETs). Reported risks vary widely, potentially influenced by <i>Helicobacter pylori</i> (HP) status, AIG subtypes, and age–factors not addressed in prior meta-analyses. This study aimed to determine the pooled incidence of GC and gNETs in AIG and to conduct a comprehensive stratified evaluation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched PubMed, Embase, and Cochrane Library through May 2025 for observational studies reporting incident GC or gNETs in AIG. Subgroup analyses, sensitivity analyses, and meta-regression were conducted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-three studies were included: 19 hospital-based cohorts (<i>n</i> = 4309) and 4 registries (<i>n</i> = 36,015). The pooled incidence of GC was 0.12/100 person-years (PY; 95% CI, 0.06–0.17; <i>I</i>² = 45.7%) and of gNETs 1.09/100 PY (95% CI, 0.61–1.58; <i>I</i>² = 81.3%). By subtype, GC incidence was 0.29/100 PY in pernicious anemia (PA), 0.12 in histopathology-defined AIG, and 0.09 in parietal cell antibody (PCA)-positive patients; gNETs were highest in the hypergastrinemia subgroup (1.74/100 PY). By HP status, GC incidence was 0.12/100 PY in HP-naïve and 0.07 in HP-exposed patients. Age-stratified analyses showed a consistent upward trend in patients ≥ 60 years for both GC (0.27 vs. 0.10/100 PY) and gNETs (1.48 vs. 0.87/100 PY).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study underscores the neoplastic risk associated with AIG. GC incidence is highest in PA and lower in PCA-positive patients, likely reflecting different AIG stages. HP-naïve status does not confer protection, and long-term GC risk persists. Age is a key modifier, providing a useful reference for risk stratification and individualized surveillance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>PROSPERO database (CRD420251047873)</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145762586","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":"Eradication Rates of Empiric Helicobacter pylori Treatment Regimens by Race/Ethnicity in a Predominantly Immigrant U.S. Population","authors":"Min J. Kim,&nbsp;Isiah Gonzalez,&nbsp;Nia M. Choi,&nbsp;David Y. Graham,&nbsp;Hashem B. El-Serag,&nbsp;Mimi C. Tan","doi":"10.1111/hel.70095","DOIUrl":"10.1111/hel.70095","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p><i>Helicobacter pylori</i> infections are mostly treated empirically (without antibiotic susceptibility testing). Determining eradication rates of different treatment regimens can inform antibiotic resistance. Our aim was to examine eradication rates of empiric <i>H. pylori</i> treatments based on treatment regimen, race/ethnicity and previous treatment status in a multiethnic U.S. population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This was a retrospective cross-sectional study of patients with a positive <i>H. pylori</i> test from 7/2021 to 4/2022 at Harris Health (Houston, Texas) who had received treatment and eradication testing within 1 year. We compared eradication rates based on treatment regimen, race/ethnicity, and prior treatment and examined other possible risk factors for treatment failure using logistic regression models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 1106 <i>H. pylori</i>-infected patients, 29.2% were male, 80.6% Hispanic, 10.7% black, 2.5% white, and 83.3% were non-U.S. born with a mean age of 50.8 years (standard deviation 12.6). Most patients (57.3%) received bismuth-tetracycline-metronidazole quadruple, 21.2% clarithromycin-metronidazole-amoxicillin quadruple, 15.6% clarithromycin-amoxicillin triple, and 3.9% received clarithromycin-metronidazole triple therapies. Eradication rates were highest for bismuth-tetracycline-metronidazole quadruple (83.8%), clarithromycin-metronidazole-amoxicillin quadruple (80.3%), and clarithromycin-amoxicillin triple therapies (79.2%). In 186 (16.8%) previously treated patients, all empiric regimens achieved &lt; 80% eradication rates. Clarithromycin-amoxicillin triple had high eradication rates (92.9%) in black patients and bismuth quadruple therapy in Asians (95.8%). Compared to bismuth quadruple therapy, clarithromycin-metronidazole triple (adjusted odds ratio [adjOR] 0.31, 95% confidence interval [CI] 0.13–0.73) and levofloxacin-amoxicillin triple (adjOR 0.20, 95% CI 0.05–0.89) regimens were associated with treatment failure, whereas clarithromycin-amoxicillin quadruple and triple therapies were not.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Empiric bismuth quadruple therapy had the highest eradication rate while metronidazole and levofloxacin triple therapies had the lowest. Eradication rates may thus serve as a surrogate clinical endpoint when choosing empiric therapies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12686601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145708074","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":"Anti-Parietal Cell Antibodies Show Differential Associations With Stomach Cancer by Site and Helicobacter pylori Status","authors":"Harindra Jayasekara,&nbsp;Julie K. Bassett,&nbsp;Howard Ho-Fung Tang,&nbsp;Yang Peng,&nbsp;Helen Tsimiklis,&nbsp;Robert L. O'Reilly,&nbsp;Brigid M. Lynch,&nbsp;Robert J. MacInnis,&nbsp;Graham G. Giles,&nbsp;Melissa C. Southey,&nbsp;Roger L. Milne,&nbsp;M. Constanza Camargo","doi":"10.1111/hel.70093","DOIUrl":"10.1111/hel.70093","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Autoimmune gastritis poses a risk for stomach cancer. However, its role relative to <i>Helicobacter pylori</i>-associated gastritis is uncertain. We assessed whether the associations between anti-parietal cell antibody (APCA) seropositivity and the risk of stomach cancer and its anatomical subtypes were modified by <i>H. pylori</i> infection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A total of 244 incident gastric adenocarcinoma cases were identified from the Melbourne Collaborative Cohort Study (<i>N</i> = 41,513) and matched with 448 cancer-free controls using incidence density sampling with age as the time scale, matching on sex, year of birth, and country of birth. IgG antibodies against parietal cells and <i>H. pylori</i> were analyzed using commercially available ELISA kits. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using conditional logistic regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seropositivity for APCA was 21% for controls and 24% for cases (28% cardia, 23% non-cardia), while seropositivity for <i>H. pylori</i> was 62% for controls and 76% for cases (55% cardia, 81% non-cardia). The following ORs were observed for total, cardia, and non-cardia cancers in relation to APCA seropositivity: 1.21 (95% CI: 0.84–1.76), 1.99 (0.84–4.73), and 1.09 (0.71–1.66), respectively. Stronger associations were observed for cardia cancer in <i>H. pylori</i>-seropositive individuals (ORs, 3.60 [95% CI: 1.07–12.12] vs. 0.93 [0.24–3.57] for <i>H. pylori</i>-seronegative individuals; <i>p</i>_interaction = 0.15) and for non-cardia cancer in <i>H. pylori</i>-seronegative individuals (ORs, 2.56 [1.02–6.40] vs. 0.93 [0.56–1.54] for <i>H. pylori</i>-seropositive individuals; <i>p</i>_interaction = 0.06).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings suggest a more complex association between autoimmune gastritis and the risk of stomach cancer. They also highlight the importance of early detection of autoimmune gastritis in stomach cancer prevention.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145677481","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":"Effects of Helicobacter pylori Eradication on the Risk and Clinical Parameters of Metabolic Dysfunction-Associated Steatotic Liver Disease: A Systematic Review and Meta-Analysis","authors":"Xiang Li,&nbsp;Yizhen Tao,&nbsp;Hangyu Li,&nbsp;Lisha Mai,&nbsp;Xindi He,&nbsp;Jingwen Yan,&nbsp;Xiao Yang","doi":"10.1111/hel.70092","DOIUrl":"10.1111/hel.70092","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Previous studies have established an association between <i>Helicobacter pylori</i> (<i>H. pylori</i>) infection and metabolic dysfunction-associated steatotic liver disease (MASLD). However, the specific effects of <i>H. pylori</i> eradication therapy on MASLD patients remain unclear. Therefore, this systematic review and meta-analysis aims to comprehensively evaluate the impact of <i>H. pylori</i> eradication therapy on the incidence and clinical course of MASLD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Cohort studies and randomized controlled trials (RCTs) were systematically retrieved from PubMed, Embase, Cochrane Library, and Web of Science. Hazard ratios (HRs) from cohort studies and mean differences (MDs) from RCTs with their corresponding 95% confidence intervals (CIs) were calculated to assess the impact of <i>H. pylori</i> eradication therapy on MASLD risk and changes in laboratory parameters. Subgroup analyses were performed based on varying follow-up periods and intervention type. Sensitivity analyses were conducted to assess the robustness of the findings. Funnel plots were used to evaluate publication bias.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eight studies, including two cohort studies assessing the incidence risk and six RCTs analyzing laboratory parameters, were included, encompassing a total of 5320 participants. All eligible studies were subjected to meta-analysis of their respective outcomes. <i>H. pylori</i> eradication therapy was found to significantly lower the risk of developing MASLD (HR = 0.74, 95% CI: 0.65–0.85). In patients already diagnosed with MASLD, eradication therapy was associated with reductions in waist circumference (MD = −0.62, 95% CI: −1.20 to −0.03), aspartate aminotransferase (AST; MD = −2.12, 95% CI: −2.78 to −1.45), fasting blood glucose (FBG; MD = −0.33, 95% CI: −0.66 to −0.01), homeostasis model assessment of insulin resistance (HOMA-IR; MD = −0.21, 95% CI: −0.25 to −0.17).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The application of <i>H. pylori</i> eradication therapy correlates with a reduced risk of MASLD and favorable changes in anthropometric, hepatic, glycemic, and inflammatory outcomes, though these benefits may vary depending on the duration of follow-up and eradication methods.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145648501","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}