Positive Result by Serology Indicates Active Helicobacter pylori Infection in Patients with Atrophic Gastritis

Patients with atrophic corpus gastritis and elevated Helicobacter pylori antibody titers but ¹³C-urea breath test (¹³C-UBT) and histology results negative for H. pylori were randomized into eradication therapy or follow-up only. Antibody levels decreased significantly in six out of seven patients in the eradication group, while in the follow-up group, the titers declined in only one out of eight patients. In patients with atrophic corpus gastritis, positive serology results may indicate an ongoing infection in spite of negative ¹³C-UBT and histology results.     

Helicobacter pylori and specific immunoglobulin E antibodies to food allergens in children

OBJECTIVES: It has been suggested that chronic Helicobacter pylori infection may increase gastric permeability, predisposing infected children for the development of food allergies. We assessed the presence of food-specific immunoglobulin (Ig)E antibodies in H. pylori positive children and controls. METHODS: We measured specific IgE values to six major food allergens (Pharmacia CAP-system) in a group of school-aged Caucasian (n = 36) and non-Caucasian (n = 38) children with a known H. pylori status. All children had undergone upper gastrointestinal endoscopy because of abdominal complaints. RESULTS: Among H. pylori positive children (mean age, 8.8 years; range, 5-15 years, 25 female, 26 male), 33% (17 of 51) had an elevated food-specific IgE level to at least one of the food allergens tested. Unexpectedly, the majority of those with elevated serum food-specific IgE levels (12 of 17) were to cow's milk. Among H. pylori negative children (mean age, 9.3 years; range, 5-15 years, 13 female, 10 male), 26% (6 of 23) of the children had an elevated serum IgE level to at least one of the food allergens tested, and 9% (2 of 23) were positive to cow's milk. The difference in the number of children with an elevated serum IgE level for cow's milk in H. pylori positive and negative children was not significant. The severity of gastritis did not correlate with the presence of food-specific IgEs. CONCLUSIONS: H. pylori infection had no effect on the manifestation of specific IgE to major food allergens in school-aged children. An IgE response to cow's milk was common among these school-aged children.     

Eradication of Helicobacter pylori improves the healing rate and reduces the relapse rate of nonbleeding ulcers in patients with bleeding peptic ulcer

OBJECTIVE: A causal relationship between Helicobacter pylori (H. pylori) and peptic ulcer complications remains obscure. The aim of this study was to determine the importance of H. pylori and other risk factors for healing rate, ulcer recurrence, and rebleeding in patients with bleeding peptic ulcer. METHOD: A total of 223 patients with H. pylori positive bleeding peptic ulcer were randomly allocated to three treatment groups: 1) quadruple therapy (QT) (88 patients); 2) dual therapy (DT) (88 patients); and 3) omeprazole and placebo therapy (OPl) (47 patients). Endoscopic assessment was performed initially and at 8 and 52 wk. Ulcer healing and eradication rates were assessed; endpoints were ulcer relapse and ulcer rebleeding during 52 wk. RESULTS: Results after 8 and 52 wk were available for 211 and 179 patients, respectively. Eradication rate was 100% (95% CI = 96-100%) in the QT, 84% (95% CI = 74-91%) in the DT, and 4% (95% CI = 1-15%) in the OPl group. Ulcer healing rate was 95% (95% CI = 91-98%) in H. pylori negative and 8% (95% CI = 70-91%) in H. pylori positive patients. Ulcer relapses occurred in 2% (95% CI = 0.5-6%) of H. pylori negative and in 38% (95% CI = 24-54%) of H. pylori positive patients, and rebleeding occurred in five patients (three H. pylori positive and two negative). CONCLUSIONS: Eradication of H. pylori infection enhances healing of bleeding peptic ulcers after endoscopic therapy. H. pylori infection is an important independent risk factor for relapsing of nonbleeding ulcers in patients with bleeding peptic ulcer.     

Stool Microbiota Composition Differs in Patients with Stomach,Colon, and Rectal Neoplasms

Background

Microbial ecosystems that inhabit the human gut form central component of our physiology and metabolism, regulating and modulating both health and disease. Changes or disturbances in the composition and activity of this gut microbiota can result in altered immunity, inflammation, and even cancer.

Aim

To compare the composition and diversity of gut microbiota in stool samples from patient groups based on the site of neoplasm in the gastrointestinal tract (GIT) and to assess the possible contribution of the bacterial composition to tumorigenesis.

Methods

We studied gut microbiota by16S RNA gene sequencing from stool DNA of 83 patients, who were diagnosed with different GIT neoplasms, and 13 healthy individuals.

Results

As compared to healthy individuals, stools of patients with stomach neoplasms had elevated levels of Enterobacteriaceae, and those with rectal neoplasms had lower levels of Bifidobacteriaceae. Lower abundance of Lactobacillaceae was seen in patients with colon neoplasms. Abundance of Lactobacillaceae was higher in stools of GIT patients sampled after cancer treatment compared to samples collected before start of any treatment. In addition to site-specific differences, higher abundances of Ruminococcus, Subdoligranulum and lower abundances of Lachnoclostridium and Oscillibacter were observed in overall GIT neoplasms as compared to healthy controls

Conclusion

Our study demonstrates that the alterations in gut microbiota vary according to the site of GIT neoplasm. The observed lower abundance of two common families, Lactobacillaceae and Bifidobacteriaceae, and the increased abundance of Enterobacteriaceae could provide indicators of compromised gut health and potentially facilitate GIT disease monitoring.

     

Effects of anti-Helicobacter pylori treatment and probiotic supplementation on intestinal microbiota

The aims of this study were (i) to evaluate the effect of recommended antimicrobial treatment of Helicobacter pylori infection, consisting of clarithromycin, amoxicillin and lansoprazole, on intestinal microbiota and (ii) to determine the ability of a probiotic combination containing Lactobacillus rhamnosus GG, L. rhamnosus LC705, Propionibacterium freudenreichii ssp. shermanii JS and Bifidobacterium breve Bb99 to prevent treatment-induced alterations in the intestinal microbiota. Faecal samples were obtained from 39 H. pylori-infected patients randomised into two treatment groups. In addition, 19 H. pylori-negative volunteers were included in the study as a control group. Samples were collected before, during and after treatment and microbiota were analysed by fluorescence in situ hybridisation and culture. The quantities of the predominant bacterial groups were altered significantly in both groups and disturbances were seen even 9 weeks after treatment was complete. Probiotics slightly counteracted the effects of anti-H. pylori treatment, seen as significantly less alterations in the total numbers of aerobes and lactobacilli/enterococci. At baseline, the composition of the microbiota between H. pylori-positive versus H. pylori-negative control individuals differed with regard to clostridia and the total number of anaerobes. The recommended treatment for H. pylori infection induces long-term disturbances in the intestinal microbiota. The probiotic combination appeared to result in only minor changes in the microbiota.     

cagA, vacA and iceA Virulence Genes of Helicobacter pylori Isolates of Children in Finland

 cagA, vacA s and m genotypes and iceA alleles were analyzed from Helicobacter pylori strains isolated from 17 Finnish children and 32 children of non-Finnish origin living in Finland. Twelve children in the latter group were eastern European and 15 were of African origin. Only three children of non-Finnish origin were born in Finland. The vacA s1a subtype was more prevalent in the isolates from Finnish children than African children (76% vs. 7%, P<0.001);vacA s1b frequencies were 5% and 67%, respectively (P<0.001). The iceA1 allele was significantly more prevalent in African than Finnish isolates (93% vs. 35%, P<0.01). Considerable variation was noted in the frequency of vacA s1 subtypes and iceA alleles in children originating from different geographic regions, but the geographic variation of s1 subtypes resembled that described in other reports.     

Azithromycin resistance inCampylobacter jejuni andCampylobacter coli

The MICs of erythromycin, azithromycin and ciprofloxacin were determined for 60 human fecal isolates ofCampylobacter. Of these, 30 strains selected on the basis of their resistance to erythromycin by disk diffusion were highly resistant to both erythromycin and azithromycin. Nine of these selected isolates were resistant to ciprofloxacin. The remaining 30 strains were non-selected, consecutive isolates ofCampylobacter susceptible to erythromycin by disk diffusion and were shown to be two- to five-fold more susceptible to azithromycin than to erythromycin as determined by MIC testing.     

Culture ofHelicobacter pylori from gastric biopsies transported in biopsy urease test tubes

Gastric biopsy specimens of 57 consecutively observed dyspeptic patients were studied for the presence ofHelicobacter pylori by histological examination, biopsy urease test (BUT) and culture. For culture, biopsy samples were transported in both Stuart media and BUT tubes. All 15 isolates could be cultured from both Stuart and BUT tubes. Thus, if the main reason for culture ofHelicobacter pylori is for antimicrobial susceptibility testing, only positive BUT tubes need to be submitted. This would reduce both the expense and the number of biopsies needed.     

Helicobacter pylori and associated gastroduodenal diseases. Review article

Helicobacter pylori is a microaerophilic, Gram-negative, spiral rod, the role of which in different gastric diseases has been investigated worldwide since the beginning of the 1980s. H. pylori has been shown to be the causative agent in active chronic gastritis, and it is regularly found in patients endoscopied for duodenal ulcer. The bacterium is also frequently isolated from persons with gastric ulcer, gastric carcinoma and non-ulcer dyspepsia. Apart from cultivation of the bacterium, other diagnostic procedures include various staining methods and urease tests of gastric biopsy samples. The application of non-invasive diagnostic methods, serology and urea breath tests, is rapidly increasing. H. pylori is susceptible to several antimicrobials in vitro, but eradication of the bacterium from the gastric mucosa is not always achieved. The best results until now have been obtained with the combined use of bismuth salts and two antibiotics. In active chronic gastritis and duodenal ulcer patients, eradication of the bacteria has resulted in healing of the disease with permanent decrease of circulating antibodies and negative urease tests. H. pylori has been found worldwide and the infection shows an age-dependent increase. Man, apparently, is the reservoir of the bacterium, but the exact mechanisms of interhuman transmission are still not defined.     

In vitro adhesion and platelet aggregation properties of bacteremia-associated lactobacilli

Eight bacteremia-associated Lactobacillus strains were evaluated in vitro for the ability to adhere to human intestinal mucosa and to aggregate platelets. Adherence varied significantly among the strains, and platelet aggregation was induced by three strains. In conclusion, strong binding ability does not appear to be a prerequisite for the involvement of lactobacilli in bacteremia or to their ability to aggregate platelets.