Harindra Jayasekara, Julie K. Bassett, Howard Ho-Fung Tang, Yang Peng, Helen Tsimiklis, Robert L. O'Reilly, Brigid M. Lynch, Robert J. MacInnis, Graham G. Giles, Melissa C. Southey, Roger L. Milne, M. Constanza Camargo
Background
Autoimmune gastritis poses a risk for stomach cancer. However, its role relative to Helicobacter pylori-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 H. pylori infection.
Materials and Methods
A total of 244 incident gastric adenocarcinoma cases were identified from the Melbourne Collaborative Cohort Study (N = 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 H. pylori were analyzed using commercially available ELISA kits. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using conditional logistic regression.
Results
Seropositivity for APCA was 21% for controls and 24% for cases (28% cardia, 23% non-cardia), while seropositivity for H. pylori 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 H. pylori-seropositive individuals (ORs, 3.60 [95% CI: 1.07–12.12] vs. 0.93 [0.24–3.57] for H. pylori-seronegative individuals; pinteraction = 0.15) and for non-cardia cancer in H. pylori-seronegative individuals (ORs, 2.56 [1.02–6.40] vs. 0.93 [0.56–1.54] for H. pylori-seropositive individuals; pinteraction = 0.06).
Conclusions
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.
{"title":"Anti-Parietal Cell Antibodies Show Differential Associations With Stomach Cancer by Site and Helicobacter pylori Status","authors":"Harindra Jayasekara, Julie K. Bassett, Howard Ho-Fung Tang, Yang Peng, Helen Tsimiklis, Robert L. O'Reilly, Brigid M. Lynch, Robert J. MacInnis, Graham G. Giles, Melissa C. Southey, Roger L. Milne, 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><sub>interaction</sub> = 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><sub>interaction</sub> = 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}
Xiang Li, Yizhen Tao, Hangyu Li, Lisha Mai, Xindi He, Jingwen Yan, Xiao Yang
Background
Previous studies have established an association between Helicobacter pylori (H. pylori) infection and metabolic dysfunction-associated steatotic liver disease (MASLD). However, the specific effects of H. pylori eradication therapy on MASLD patients remain unclear. Therefore, this systematic review and meta-analysis aims to comprehensively evaluate the impact of H. pylori eradication therapy on the incidence and clinical course of MASLD.
Materials and Methods
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 H. pylori 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.
Results
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. H. pylori 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).
Conclusions
The application of H. pylori 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.
{"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, Yizhen Tao, Hangyu Li, Lisha Mai, Xindi He, Jingwen Yan, 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}
Than Than Aye, Nwe Ni, Tin Tin May, Chit Kyi, Aye Mya Mya Kyaw, Thein Myint, Zeyar Lwin, Win Phyu Phyu Myint, Thein Saw, Than Than Swe, Kyaw Hla, Tin Moe Wai, Swe Mon Mya, Mya Thet Nwe, Thida Soe, Sandar Win, Than Than Aye, Thet Mar Win, Myint Naychi Tun, Thiri Tin, Aye Min Soe, Aung Kyaw Thu, Lin Htet Oo, Nang Khin Phone Tint, Kyaw Ko Ko Aung, Khun Nyi Nyi, Than Htun Oo, Moe Myint Aung, Naing Linn, Phyu Sin Aye, Kyaw Lun Aung Hmu, Nyi Nyi Aung, Min Htun, Tin Ma Ma Win, Kay Thi Kyaing, Swe Swe Lin, Kyaw Si Thu, Ohnmar Nyunt Tin, Su Su Hlaing
Myanmar has a significant rate of Helicobacter pylori (H. pylori) infection among Southeast Asian countries. The complications of H. pylori infections are common in Myanmar, ranging from peptic ulcer bleeding to gastric cancer. Myanmar has an intermediate risk of gastric cancer. In view of increasing drug resistance particularly to triple therapy, a standard management guideline is needed in Myanmar for the effective management of H. pylori infection. This is the first consensus guideline in Myanmar for local clinical practice. The consensus group consisted of 39 gastroenterologists and clinicians from Myanmar GI & Liver Society (MGLS), who had discussions in integrated meetings and developed consensus statements with the Delphi method and focused on the grades of recommendations, levels of evidence, and rationales for the management of H. pylori infection in daily practice in Myanmar. Due to the limited availability of high-quality local evidence, these consensus recommendations were based upon the best available evidence from the world's literature and guidelines, with special attention given to evidence from Myanmar. This consensus followed the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). The consensus level was defined as ≥ 80% for agreement on each statement. Finally, the panel reached a consensus on 26 statements which focus on four areas: (1) whom to test, (2) how to test, (3) whom to treat, and (4) how to treat with post-treatment confirmation of H. pylori status. This consensus will guide the proper diagnosis and treatment of H. pylori infection. In order to prevent antibiotic resistance, H. pylori infected individuals must have successful eradication. Future studies require third-line regimens and the development of antibiotic sensitivity tests. This consensus will serve as a useful guide for clinicians in their day-to-day clinical work.
{"title":"Management of Helicobacter pylori Infection: Myanmar Consensus Report","authors":"Than Than Aye, Nwe Ni, Tin Tin May, Chit Kyi, Aye Mya Mya Kyaw, Thein Myint, Zeyar Lwin, Win Phyu Phyu Myint, Thein Saw, Than Than Swe, Kyaw Hla, Tin Moe Wai, Swe Mon Mya, Mya Thet Nwe, Thida Soe, Sandar Win, Than Than Aye, Thet Mar Win, Myint Naychi Tun, Thiri Tin, Aye Min Soe, Aung Kyaw Thu, Lin Htet Oo, Nang Khin Phone Tint, Kyaw Ko Ko Aung, Khun Nyi Nyi, Than Htun Oo, Moe Myint Aung, Naing Linn, Phyu Sin Aye, Kyaw Lun Aung Hmu, Nyi Nyi Aung, Min Htun, Tin Ma Ma Win, Kay Thi Kyaing, Swe Swe Lin, Kyaw Si Thu, Ohnmar Nyunt Tin, Su Su Hlaing","doi":"10.1111/hel.70090","DOIUrl":"10.1111/hel.70090","url":null,"abstract":"<div>\u0000 \u0000 <p>Myanmar has a significant rate of <i>Helicobacter pylori</i> (<i>H. pylori</i>) infection among Southeast Asian countries. The complications of <i>H. pylori</i> infections are common in Myanmar, ranging from peptic ulcer bleeding to gastric cancer. Myanmar has an intermediate risk of gastric cancer. In view of increasing drug resistance particularly to triple therapy, a standard management guideline is needed in Myanmar for the effective management of <i>H. pylori</i> infection. This is the first consensus guideline in Myanmar for local clinical practice. The consensus group consisted of 39 gastroenterologists and clinicians from Myanmar GI & Liver Society (MGLS), who had discussions in integrated meetings and developed consensus statements with the Delphi method and focused on the grades of recommendations, levels of evidence, and rationales for the management of <i>H. pylori</i> infection in daily practice in Myanmar. Due to the limited availability of high-quality local evidence, these consensus recommendations were based upon the best available evidence from the world's literature and guidelines, with special attention given to evidence from Myanmar. This consensus followed the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). The consensus level was defined as ≥ 80% for agreement on each statement. Finally, the panel reached a consensus on 26 statements which focus on four areas: (1) whom to test, (2) how to test, (3) whom to treat, and (4) how to treat with post-treatment confirmation of <i>H. pylori</i> status. This consensus will guide the proper diagnosis and treatment of <i>H. pylori</i> infection. In order to prevent antibiotic resistance, <i>H. pylori</i> infected individuals must have successful eradication. Future studies require third-line regimens and the development of antibiotic sensitivity tests. This consensus will serve as a useful guide for clinicians in their day-to-day clinical work.</p>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145512597","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}
Helicobacter pylori (H. pylori) infection is a significant risk factor for gastric cancer. The effective implementation of strategies to mitigate gastric cancer requires widespread dissemination of information regarding H. pylori, diagnostic methods, and preventive measures. Despite the high incidence of gastric cancer, efforts to disseminate this information are lacking in Japan. Therefore, our survey aimed to evaluate H. pylori and gastric cancer awareness in Japan and identify factors associated with H. pylori knowledge, focusing on health literacy.
Materials and Methods
This nationwide cross-sectional survey was conducted online. We developed a questionnaire on H. pylori awareness and knowledge across four domains: infection risk, H. pylori-related diseases, testing and treatment, and gastric cancer-related problems. In addition, we evaluated health literacy using an established health literacy scale. Multivariable regression analysis was conducted using the H. pylori knowledge score as the dependent variable.
Results
Over half of the 3095 respondents were aware of H. pylori infection (56.4%). The overall correct response rate for the H. pylori knowledge questions was 45.7%, with varying performances across the knowledge domains: infection risk (57.3%), H. pylori-related diseases (50.9%), testing and treatment (37.5%), and gastric cancer (44.4%). The regression models identified the following factors as associated with a higher H. pylori knowledge: older age, higher health literacy scores, previous H. pylori testing, and healthcare professional status. Among participants without prior H. pylori testing, higher H. pylori knowledge scores were associated with a greater willingness to undergo H. pylori screening.
Conclusions
To our knowledge, this is the first nationwide assessment of H. pylori infection and gastric cancer awareness in Japan. Health literacy and previous H. pylori screening were significantly associated with H. pylori knowledge. The development of educational strategies for these factors may be desirable for gastric cancer prevention.
{"title":"Survey on Awareness of Helicobacter pylori and Gastric Cancer in the Japanese Population Using an Internet Survey","authors":"Chihiro Matsumoto, Hiroaki Saito, Yoshitaka Nishikawa, Yoshika Saito, Taiga Uchiyama, Toshihiko Kakiuchi, Yuichiro Eguchi, Yasuhiro Mizuno, Masaharu Tsubokura","doi":"10.1111/hel.70089","DOIUrl":"10.1111/hel.70089","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p><i>Helicobacter pylori</i> (<i>H. pylori</i>) infection is a significant risk factor for gastric cancer. The effective implementation of strategies to mitigate gastric cancer requires widespread dissemination of information regarding <i>H. pylori</i>, diagnostic methods, and preventive measures. Despite the high incidence of gastric cancer, efforts to disseminate this information are lacking in Japan. Therefore, our survey aimed to evaluate <i>H. pylori</i> and gastric cancer awareness in Japan and identify factors associated with <i>H. pylori</i> knowledge, focusing on health literacy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This nationwide cross-sectional survey was conducted online. We developed a questionnaire on <i>H. pylori</i> awareness and knowledge across four domains: infection risk, <i>H. pylori</i>-related diseases, testing and treatment, and gastric cancer-related problems. In addition, we evaluated health literacy using an established health literacy scale. Multivariable regression analysis was conducted using the <i>H. pylori</i> knowledge score as the dependent variable.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Over half of the 3095 respondents were aware of <i>H. pylori</i> infection (56.4%). The overall correct response rate for the <i>H. pylori</i> knowledge questions was 45.7%, with varying performances across the knowledge domains: infection risk (57.3%), <i>H. pylori</i>-related diseases (50.9%), testing and treatment (37.5%), and gastric cancer (44.4%). The regression models identified the following factors as associated with a higher <i>H. pylori</i> knowledge: older age, higher health literacy scores, previous <i>H. pylori</i> testing, and healthcare professional status. Among participants without prior <i>H. pylori</i> testing, higher <i>H. pylori</i> knowledge scores were associated with a greater willingness to undergo <i>H. pylori</i> screening.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>To our knowledge, this is the first nationwide assessment of <i>H. pylori</i> infection and gastric cancer awareness in Japan. Health literacy and previous <i>H. pylori</i> screening were significantly associated with <i>H. pylori</i> knowledge. The development of educational strategies for these factors may be desirable for gastric cancer prevention.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12605804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145495382","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}
Qiang Han, Ming Zu, Shiyu Du, Yinyan Guo, Yuanmin Zhu, Yali Wang, Xiuqing Liu, Hongwei Guo, Yanli Cheng, Shigang Ding
<div> <section> <h3> Background</h3> <p>Current <i>Helicobacter pylori (H. pylori)</i> eradication regimens—standard triple, bismuth-containing quadruple, and non-bismuth quadruple therapies—still face issues such as adverse effects and poor compliance. High-dose dual therapy, with its simplicity, lower pill burden, and comparable efficacy, has recently gained attention. However, existing studies are largely single-center with small sample sizes and lack sufficient evidence-based support. This study aims to further evaluate the efficacy and safety of ilaprazole-based dual and quadruple therapies for <i>H. pylori</i> eradication.</p> </section> <section> <h3> Methods</h3> <p>This was a prospective, multicenter, randomized controlled, non-inferiority clinical trial conducted at five hospitals from January to November 2023. A total of 480 patients were randomly assigned to one of three treatment groups for 14 days: Group A (ilaprazole 5 mg, amoxicillin 1 g, clarithromycin 500 mg, and bismuth potassium citrate 220 mg, all administered twice daily), Group B (ilaprazole 5 mg twice daily and amoxicillin 1 g three times daily), and Group C (ilaprazole 10 mg twice daily and amoxicillin 1 g three times daily). The eradication rates, adverse events, and patient compliance were recorded.</p> </section> <section> <h3> Results</h3> <p>The eradication rates of <i>H. pylori</i> in Groups A, B, and C were 76.9%, 88.1%, and 88.7% (<i>p</i> = 0.004) by intention-to-treat analysis, respectively, and 78.3%, 90.4%, and 91.0% (<i>p</i> = 0.001) using modified intention-to-treat analysis, and 81.8%, 92.1%, 92.2% (<i>p</i> = 0.005) by per-protocol analysis. The adverse event rates were 28.0%, 10.2%, 10.8% in Groups A, B, and C, respectively (<i>p <</i> 0.001), while patient compliance rates were 91.1%, 98.1%, 98.7%, respectively (<i>p =</i> 0.001). Sex, smoking history, alcohol intake, and sharing tableware or cups did not affect the efficacy of the three treatment regimens.</p> </section> <section> <h3> Conclusions</h3> <p>The standard- or high-dose dual therapy with ilaprazole demonstrated superior efficacy, safety, and patient compliance compared to quadruple therapy. No significant differences were observed between these dual therapies, which are expected to become promising alternatives for the primary treatment of <i>H. pylori</i> infection.</p> </section> <section> <h3> Trial Registration</h3> <p>Chinese Clinical Trial Registry: ChiCTR2400086862</p>
{"title":"Different Doses of Ilaprazole for Dual Therapy Versus Bismuth-Quadruple Therapy for Helicobacter pylori Infection: A Three-Arm, Randomized Clinical Trial","authors":"Qiang Han, Ming Zu, Shiyu Du, Yinyan Guo, Yuanmin Zhu, Yali Wang, Xiuqing Liu, Hongwei Guo, Yanli Cheng, Shigang Ding","doi":"10.1111/hel.70086","DOIUrl":"10.1111/hel.70086","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Current <i>Helicobacter pylori (H. pylori)</i> eradication regimens—standard triple, bismuth-containing quadruple, and non-bismuth quadruple therapies—still face issues such as adverse effects and poor compliance. High-dose dual therapy, with its simplicity, lower pill burden, and comparable efficacy, has recently gained attention. However, existing studies are largely single-center with small sample sizes and lack sufficient evidence-based support. This study aims to further evaluate the efficacy and safety of ilaprazole-based dual and quadruple therapies for <i>H. pylori</i> eradication.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a prospective, multicenter, randomized controlled, non-inferiority clinical trial conducted at five hospitals from January to November 2023. A total of 480 patients were randomly assigned to one of three treatment groups for 14 days: Group A (ilaprazole 5 mg, amoxicillin 1 g, clarithromycin 500 mg, and bismuth potassium citrate 220 mg, all administered twice daily), Group B (ilaprazole 5 mg twice daily and amoxicillin 1 g three times daily), and Group C (ilaprazole 10 mg twice daily and amoxicillin 1 g three times daily). The eradication rates, adverse events, and patient compliance were recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The eradication rates of <i>H. pylori</i> in Groups A, B, and C were 76.9%, 88.1%, and 88.7% (<i>p</i> = 0.004) by intention-to-treat analysis, respectively, and 78.3%, 90.4%, and 91.0% (<i>p</i> = 0.001) using modified intention-to-treat analysis, and 81.8%, 92.1%, 92.2% (<i>p</i> = 0.005) by per-protocol analysis. The adverse event rates were 28.0%, 10.2%, 10.8% in Groups A, B, and C, respectively (<i>p <</i> 0.001), while patient compliance rates were 91.1%, 98.1%, 98.7%, respectively (<i>p =</i> 0.001). Sex, smoking history, alcohol intake, and sharing tableware or cups did not affect the efficacy of the three treatment regimens.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The standard- or high-dose dual therapy with ilaprazole demonstrated superior efficacy, safety, and patient compliance compared to quadruple therapy. No significant differences were observed between these dual therapies, which are expected to become promising alternatives for the primary treatment of <i>H. pylori</i> infection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>Chinese Clinical Trial Registry: ChiCTR2400086862</p>\u0000 ","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12598915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145482007","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}
X. Guo, M. C. W. Spaander, and G. M. Fuhler, ‘Letter to the Editor: “Parietal Cell Antibody Levels Among Chronic Gastritis Patients in a Country With Low Helicobacter pylori Infection: Epidemiology, Histopathological Features, and H. pylori Infection,”’ Helicobacter 30 no. 3 (2025): e70053, doi: https://doi.org/10.1111/hel.70053.
The following funding statement was omitted from the published article:
This research was supported by ZonMw (11140012410004).
We apologize for this error.
郭晓明，M. C. W. Spaander， G. M. Fuhler，“致编辑信：幽门螺杆菌低感染率国家慢性胃炎患者的壁细胞抗体水平：流行病学、组织病理学特征和幽门螺杆菌感染”，《幽门螺杆菌》第30期。3 (2025): e70053, doi: https://doi.org/10.1111/hel.70053.The在已发表的文章中省略了以下资金说明：本研究得到了ZonMw（11140012410004）的支持。我们为这个错误道歉。
{"title":"Correction to “Letter to the Editor: ‘Parietal Cell Antibody Levels Among Chronic Gastritis Patients in a Country With Low Helicobacter pylori Infection: Epidemiology, Histopathological Features, and H. pylori Infection’”","authors":"","doi":"10.1111/hel.70088","DOIUrl":"https://doi.org/10.1111/hel.70088","url":null,"abstract":"<p>X. Guo, M. C. W. Spaander, and G. M. Fuhler, ‘Letter to the Editor: “Parietal Cell Antibody Levels Among Chronic Gastritis Patients in a Country With Low <i>Helicobacter pylori</i> Infection: Epidemiology, Histopathological Features, and <i>H. pylori</i> Infection,”’ <i>Helicobacter</i> 30 no. 3 (2025): e70053, doi: https://doi.org/10.1111/hel.70053.</p><p>The following funding statement was omitted from the published article:</p><p>This research was supported by ZonMw (11140012410004).</p><p>We apologize for this error.</p>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hel.70088","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145449977","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}
Kirsten Alexandra Eberhardt, Stefanie Schoppen, Carola Bindt, Stephan Ehrhardt, Yasmin Mohammed, Daniel Fordjour, Doris Kra-Yao, Carine Esther Bony Kotchi, Ekissi Jean Koffi Armel, Bernardin Ahouty Ahouty, Rebecca Hinz, John Appiah-Poku, Mathurin Koffi, Samuel Blay Nguah, Harry Tagbor, Eliezer N'Goran, Richard Odame Phillips, Tom Luedde, Dana Barthel, Torsten Feldt
Background
Helicobacter pylori (H. pylori) infection is highly prevalent in low-resource settings and has been implicated in adverse health outcomes beyond the gastrointestinal tract, including potential effects on early neurodevelopment. However, data from sub-Saharan Africa is limited.
Methods
We conducted a prospective cohort study among 229 mother–child dyads from Ghana and Côte d'Ivoire to assess the association between H. pylori infection and early child development at 12 months of age. Child development was evaluated using the Developmental Milestones Checklist (DMC), encompassing locomotor, fine motor, language, and personal–social domains. H. pylori infection status was determined by stool antigen testing. Quantile regression models, adjusted for socioeconomic status and sex, were applied to analyze associations between H. pylori infection and DMC scores.
Results
Among 229 children, 38 (16.6%) tested positive for H. pylori. The median total motor score was higher in H. pylori-negative children (45, IQR 41–50) compared to positive children (43, IQR 40–45; p = 0.031). At the 75th percentile, H. pylori infection was significantly associated with a 7-point reduction in the motor domain score (estimate = −7; 95% CI: −11.1 to −2.9; p = 0.001; FDR-adjusted p = 0.003) and a 10-point reduction in total DMC score (estimate = −10; 95% CI: −17.5 to −2.6; p = 0.009; FDR-adjusted p = 0.027) after multivariable adjustment. No significant associations were observed at lower or median quantiles, nor in language or personal-social domains.
Conclusion
H. pylori infection at 12 months of age is significantly associated with impaired motor development among children performing in the upper range of developmental achievement. These findings underscore the potential neurodevelopmental impact of early-life H. pylori infection in high-prevalence, resource-limited settings and highlight the importance of integrating infection control strategies into early childhood development programs. Further research is warranted to elucidate infection-related neurodevelopmental risks in early childhood.
{"title":"Helicobacter pylori and Impaired Early Childhood Development—Evidence From a Birth Cohort Study From Ghana and Côte d'Ivoire","authors":"Kirsten Alexandra Eberhardt, Stefanie Schoppen, Carola Bindt, Stephan Ehrhardt, Yasmin Mohammed, Daniel Fordjour, Doris Kra-Yao, Carine Esther Bony Kotchi, Ekissi Jean Koffi Armel, Bernardin Ahouty Ahouty, Rebecca Hinz, John Appiah-Poku, Mathurin Koffi, Samuel Blay Nguah, Harry Tagbor, Eliezer N'Goran, Richard Odame Phillips, Tom Luedde, Dana Barthel, Torsten Feldt","doi":"10.1111/hel.70087","DOIUrl":"https://doi.org/10.1111/hel.70087","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p><i>Helicobacter pylori</i> (<i>H. pylori</i>) infection is highly prevalent in low-resource settings and has been implicated in adverse health outcomes beyond the gastrointestinal tract, including potential effects on early neurodevelopment. However, data from sub-Saharan Africa is limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a prospective cohort study among 229 mother–child dyads from Ghana and Côte d'Ivoire to assess the association between <i>H. pylori</i> infection and early child development at 12 months of age. Child development was evaluated using the Developmental Milestones Checklist (DMC), encompassing locomotor, fine motor, language, and personal–social domains. <i>H. pylori</i> infection status was determined by stool antigen testing. Quantile regression models, adjusted for socioeconomic status and sex, were applied to analyze associations between <i>H. pylori</i> infection and DMC scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 229 children, 38 (16.6%) tested positive for <i>H. pylori</i>. The median total motor score was higher in <i>H. pylori</i>-negative children (45, IQR 41–50) compared to positive children (43, IQR 40–45; <i>p</i> = 0.031). At the 75th percentile, <i>H. pylori</i> infection was significantly associated with a 7-point reduction in the motor domain score (estimate = −7; 95% CI: −11.1 to −2.9; <i>p</i> = 0.001; FDR-adjusted <i>p</i> = 0.003) and a 10-point reduction in total DMC score (estimate = −10; 95% CI: −17.5 to −2.6; <i>p</i> = 0.009; FDR-adjusted <i>p</i> = 0.027) after multivariable adjustment. No significant associations were observed at lower or median quantiles, nor in language or personal-social domains.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p><i>H. pylori</i> infection at 12 months of age is significantly associated with impaired motor development among children performing in the upper range of developmental achievement. These findings underscore the potential neurodevelopmental impact of early-life <i>H. pylori</i> infection in high-prevalence, resource-limited settings and highlight the importance of integrating infection control strategies into early childhood development programs. Further research is warranted to elucidate infection-related neurodevelopmental risks in early childhood.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 5","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hel.70087","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145407449","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}
Bojan Tepes, Maja Denkovski, Nataša Brglez Jurecic, Katja Tepes, Anna Cano-Català, Pablo Parra, Leticia Moreira, Olga P. Nyssen, Francis Mégraud, Colm O'Morain, Javier P. Gisbert
Background
The best approach for H. pylori second- and third-line management remains unclear. The aim of this study was to evaluate the effectiveness and safety of second- and third-line H. pylori eradication regimens in Slovenia using a centralized registration database.
Methods
Patients second- and third-line eradication data from Slovenia registered in the European Registry on H. pylori Management (Hp-EuReg) from 2013 to 2024 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).
Results
We have included 402 s-line and 81 third-line eradication regimens. By mITT analysis > 90% eradication rate for second-line regimens were achieved with 14 day quadruple regimen proton pump inhibitor (PPI) amoxicillin (A) levofloxacin (L) bismuth oxide (B) (95.7%; 95% CI 78.1%–99.9%),10 day and 14 day regimen with a PPI + A + L (90.9%, 95% CI 75.7%–98.1% and 90.2%, 95% CI 85.5%–94.9% respectively) and a 10-day regimen with a PPI combined with bismuth quadruple therapy as single capsule (100%, 95% CI 80.5%–100%). The overall eradication rate for second-line empirical treatments was 86% (95% CI 81.9%–90%), while for culture-guided treatments, it was 89.2% (95% CI 74.6%–97%; p > 0.05). In third-line treatment, the PPI and single-capsule combination therapy was the only regimen to achieve an optimal cure rate of 94.1% (95% CI 71.3%–99.9%). The eradication rate for empirical treatment was 84.4% (95% CI 72.7%–96.1%), while for culture-guided treatment it was 84.6% (95% CI 54.6%–98.1%; p > 0.05). Adverse effects were reported by 52 patients in second-line regimens (12.9%), and treatment was discontinued in 0.7% of cases, and by 12 patients (14.8%) in third-line regimens with no need for treatment discontinuation.
Conclusions
In Slovenia, H. pylori eradication therapy appears to be effective and safe in real-world clinical practice.
Trial Registration
Registered at ClinicalTrials. Gov (NCT02328131)
背景幽门螺杆菌二线和三线治疗的最佳方法尚不清楚。本研究的目的是利用集中登记数据库评估斯洛文尼亚二线和三线幽门螺杆菌根除方案的有效性和安全性。方法纳入2013年至2024年在欧洲幽门螺杆菌管理登记处（Hp-EuReg）登记的斯洛文尼亚患者的二线和三线根除数据。分析了处方方案、根除次数、有效性、依从性和安全性。采用改良治疗意向（mITT）评价疗效。结果纳入402个s线和81个三线根除方案。采用质子泵抑制剂（PPI）、阿莫西林(A)、左氧氟沙星(L)、氧化铋(B)的14天四联方案（95.7%,95% CI 78.1%-99.9%）、PPI + A + L的10天和14天方案（分别为90.9%,95% CI 75.7%-98.1%和90.2%,95% CI 85.5%-94.9%）和PPI联合铋四联单胶囊治疗的10天方案（100%,95% CI 80.5%-100%），二线方案的根除率达到90%。二线经验处理的总根除率为86% (95% CI 81.9%-90%)，而培养引导处理的总根除率为89.2% （95% CI 74.6%-97%; p > 0.05）。在三线治疗中，PPI和单胶囊联合治疗是唯一达到94.1%最佳治愈率的方案（95% CI 71.3%-99.9%）。经验处理的根除率为84.4% (95% CI 72.7% ~ 96.1%)，而培养引导处理的根除率为84.6% （95% CI 54.6% ~ 98.1%; p > 0.05）。二线方案中有52例（12.9%）患者报告了不良反应，0.7%的病例停止治疗，三线方案中有12例（14.8%）患者报告了不需要停药的不良反应。结论在斯洛文尼亚，幽门螺杆菌根除治疗在现实世界的临床实践中似乎是有效和安全的。在ClinicalTrials注册。政府(NCT02328131)
{"title":"Second- and Third-Line Therapies for Helicobacter pylori Eradication in Slovenia: Data From 2013–2023 of the European Registry on H. pylori Management","authors":"Bojan Tepes, Maja Denkovski, Nataša Brglez Jurecic, Katja Tepes, Anna Cano-Català, Pablo Parra, Leticia Moreira, Olga P. Nyssen, Francis Mégraud, Colm O'Morain, Javier P. Gisbert","doi":"10.1111/hel.70085","DOIUrl":"https://doi.org/10.1111/hel.70085","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The best approach for <i>H. pylori</i> second- and third-line management remains unclear. The aim of this study was to evaluate the effectiveness and safety of second- and third-line <i>H. pylori</i> eradication regimens in Slovenia using a centralized registration database.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients second- and third-line eradication data from Slovenia registered in the European Registry on <i>H. pylori</i> Management (Hp-EuReg) from 2013 to 2024 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>We have included 402 s-line and 81 third-line eradication regimens. By mITT analysis > 90% eradication rate for second-line regimens were achieved with 14 day quadruple regimen proton pump inhibitor (PPI) amoxicillin (A) levofloxacin (L) bismuth oxide (B) (95.7%; 95% CI 78.1%–99.9%),10 day and 14 day regimen with a PPI + A + L (90.9%, 95% CI 75.7%–98.1% and 90.2%, 95% CI 85.5%–94.9% respectively) and a 10-day regimen with a PPI combined with bismuth quadruple therapy as single capsule (100%, 95% CI 80.5%–100%). The overall eradication rate for second-line empirical treatments was 86% (95% CI 81.9%–90%), while for culture-guided treatments, it was 89.2% (95% CI 74.6%–97%; <i>p</i> > 0.05). In third-line treatment, the PPI and single-capsule combination therapy was the only regimen to achieve an optimal cure rate of 94.1% (95% CI 71.3%–99.9%). The eradication rate for empirical treatment was 84.4% (95% CI 72.7%–96.1%), while for culture-guided treatment it was 84.6% (95% CI 54.6%–98.1%; <i>p</i> > 0.05). Adverse effects were reported by 52 patients in second-line regimens (12.9%), and treatment was discontinued in 0.7% of cases, and by 12 patients (14.8%) in third-line regimens with no need for treatment discontinuation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In Slovenia, <i>H. pylori</i> eradication therapy appears to be effective and safe in real-world clinical practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>Registered at ClinicalTrials. Gov (NCT02328131)</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 5","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145407152","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}
Wuyinxiao Zheng, Zijian Zheng, Jingyu Yang, Ruili Nie, Xin Luo, Long Yang, Haiping Li, Chunling Hu, Xiaochuan Ye, Pengtao You, Dan Liu
Background
Excessive inflammatory response represents the primary pathological hallmark of Helicobacter pylori (H. pylori) gastritis. Toll-like receptor 2 (TLR2) has emerged as a promising therapeutic target because of its crucial role in regulating inflammatory responses and tissue damage caused by H. pylori. Galangin (Gal), a naturally occurring flavone, possesses a variety of pharmacological activities, including anti-inflammatory and antibacterial effects. This study systematically evaluates the therapeutic potential of Gal in H. pylori gastritis, with specific emphasis on elucidating its TLR2-targeting mechanism.
Materials and Methods
An H. pylori-induced mouse gastritis model was established to evaluate the therapeutic effects of Gal at dosages of 50 and 100 mg/kg/day over a two-week administration period. The H. pylori-infected GES-1 human gastric epithelial cells were utilized for mechanistic exploration. Molecular docking and siRNA transient transfection techniques were integrated to elucidate the specific interactions between Gal and TLR2.
Results
Gal inhibited the proliferation of H. pylori and alleviated the inflammation caused by H. pylori in both in vitro and in vivo. Furthermore, Gal inhibited the activation of the TLR2/MyD88 signaling pathway, which suppressed the downstream phosphorylation of MAPK (p38/JNK/ERK) and NF-κB nuclear translocation. Notably, the knockdown of TLR2 diminished the inhibitory effects of Gal on MyD88 expression.
Conclusion
Gal demonstrated effectiveness in ameliorating H. pylori gastritis through the therapeutic inhibition of TLR2. Further investigation is warranted to explore the combination of Gal with other H. pylori eradication treatments.
{"title":"Galangin Alleviates Helicobacter pylori Gastritis Through TLR2 Inhibition and Modulation of the MyD88-Dependent Inflammatory Cascades","authors":"Wuyinxiao Zheng, Zijian Zheng, Jingyu Yang, Ruili Nie, Xin Luo, Long Yang, Haiping Li, Chunling Hu, Xiaochuan Ye, Pengtao You, Dan Liu","doi":"10.1111/hel.70084","DOIUrl":"10.1111/hel.70084","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Excessive inflammatory response represents the primary pathological hallmark of <i>Helicobacter pylori</i> (<i>H. pylori</i>) gastritis. Toll-like receptor 2 (TLR2) has emerged as a promising therapeutic target because of its crucial role in regulating inflammatory responses and tissue damage caused by <i>H. pylori</i>. Galangin (Gal), a naturally occurring flavone, possesses a variety of pharmacological activities, including anti-inflammatory and antibacterial effects. This study systematically evaluates the therapeutic potential of Gal in <i>H. pylori</i> gastritis, with specific emphasis on elucidating its TLR2-targeting mechanism.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>An <i>H. pylori</i>-induced mouse gastritis model was established to evaluate the therapeutic effects of Gal at dosages of 50 and 100 mg/kg/day over a two-week administration period. The <i>H. pylori-</i>infected GES-1 human gastric epithelial cells were utilized for mechanistic exploration. Molecular docking and siRNA transient transfection techniques were integrated to elucidate the specific interactions between Gal and TLR2.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Gal inhibited the proliferation of <i>H. pylori</i> and alleviated the inflammation caused by <i>H. pylori</i> in both in vitro and in vivo. Furthermore, Gal inhibited the activation of the TLR2/MyD88 signaling pathway, which suppressed the downstream phosphorylation of MAPK (p38/JNK/ERK) and NF-κB nuclear translocation. Notably, the knockdown of <i>TLR2</i> diminished the inhibitory effects of Gal on MyD88 expression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Gal demonstrated effectiveness in ameliorating <i>H. pylori</i> gastritis through the therapeutic inhibition of TLR2. Further investigation is warranted to explore the combination of Gal with other <i>H. pylori</i> eradication treatments.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 5","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145372642","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}
Sameh A. Lashen, Mohammed M. Shamseyea, Rasha H. Metwally, Galal Abou-Farrag, Engy S. Elkaragy
Background and Aim
While H. pylori infection is more commonly associated with adults, it can affect children with an impact on their well-being. Vonoprazan is effective in the eradication of H. pylori infection in adults. However, its effectiveness in adolescents and children is still being studied. The study aimed to investigate the efficacy of Vonoprazan-based triple therapy (VTT) compared to Esomeprazole-based triple therapy (ETT) for H. pylori eradication in adolescents and children.
Patients and Methods
In a multicenter, double-blind, randomized controlled design, we included 242 participants with H. pylori infection in the age group 10–18 years. They were randomly assigned to either weight-based Esomeprazole/Amoxicillin/Clarithromycin twice daily for 14 days (ETT) or to Vonoprazan 20 mg/weight-based Amoxicillin/Clarithromycin twice daily for 14 days (VTT). The H. pylori eradication was evaluated 8 weeks after therapy. Treatment-related adverse events were reported.
Results
In intention-to-treat analysis, eradication of H. pylori was achieved in 93 (76.9%) of the ETT arm and in 106 (87.6%) of the VTT arm (p = 0.029). In per-protocol analysis, eradication rates were 83% and 92.2% for ETT and VTT, respectively (p = 0.036). There was no difference between the two study arms in terms of overall adverse events (p = 0.46). In the VTT arm, the most frequent adverse events were diarrhea (5.8%) and nausea (6.6%).
Conclusion
Fourteen days of VTT is superior to ETT for H. pylori eradication and is well tolerated in children and adolescents aged between 10 and 18 years.
{"title":"Vonoprazan-Based Triple Therapy Versus Esomeprazole-Based Triple Therapy for H. pylori Eradication in Adolescents (VONTAPE): A Randomized, Double-Blind Controlled Trial","authors":"Sameh A. Lashen, Mohammed M. Shamseyea, Rasha H. Metwally, Galal Abou-Farrag, Engy S. Elkaragy","doi":"10.1111/hel.70083","DOIUrl":"10.1111/hel.70083","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>While <i>H. pylori</i> infection is more commonly associated with adults, it can affect children with an impact on their well-being. Vonoprazan is effective in the eradication of <i>H. pylori</i> infection in adults. However, its effectiveness in adolescents and children is still being studied. The study aimed to investigate the efficacy of Vonoprazan-based triple therapy (VTT) compared to Esomeprazole-based triple therapy (ETT) for <i>H. pylori</i> eradication in adolescents and children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>In a multicenter, double-blind, randomized controlled design, we included 242 participants with <i>H. pylori</i> infection in the age group 10–18 years. They were randomly assigned to either weight-based Esomeprazole/Amoxicillin/Clarithromycin twice daily for 14 days (ETT) or to Vonoprazan 20 mg/weight-based Amoxicillin/Clarithromycin twice daily for 14 days (VTT). The <i>H. pylori</i> eradication was evaluated 8 weeks after therapy. Treatment-related adverse events were reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In intention-to-treat analysis, eradication of <i>H. pylori</i> was achieved in 93 (76.9%) of the ETT arm and in 106 (87.6%) of the VTT arm (<i>p</i> = 0.029). In per-protocol analysis, eradication rates were 83% and 92.2% for ETT and VTT, respectively (<i>p</i> = 0.036). There was no difference between the two study arms in terms of overall adverse events (<i>p</i> = 0.46). In the VTT arm, the most frequent adverse events were diarrhea (5.8%) and nausea (6.6%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Fourteen days of VTT is superior to ETT for <i>H. pylori</i> eradication and is well tolerated in children and adolescents aged between 10 and 18 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Clinical Trial Registry</h3>\u0000 \u0000 <p>NCT06162949; https://clinicaltrials.gov/study/NCT06162949.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 5","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145354660","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号