Helicobacter最新文献

{"title":"Comparative Efficacy and Safety of Potassium-Competitive Acid Blockers and Proton Pump Inhibitors for First-Line Helicobacter pylori Eradication Therapy: A Systematic Review and Network Meta-Analysis","authors":"Mengling Ouyang,&nbsp;Shupeng Zou,&nbsp;Qian Cheng,&nbsp;Xuan Shi,&nbsp;Minghui Sun","doi":"10.1111/hel.13150","DOIUrl":"10.1111/hel.13150","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Given the increasing antibiotic resistance and the inadequate acid-suppressing effects of proton pump inhibitors (PPIs), it is crucial to continuously optimize existing <i>Helicobacter pylori</i> (<i>H. pylori</i>) treatment regimens. This study aimed to evaluate the clinical efficacy and safety of novel potassium-competitive acid blocker (P-CAB)-based eradication regimens compared with traditional PPI-based regimens for the initial treatment of <i>H. pylori</i>.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We conducted a systematic review and network meta-analysis, searching seven electronic databases for randomized controlled trials (RCTs) evaluating initial P-CAB-based <i>H. pylori</i> eradication therapy. The primary outcome was the <i>H. pylori</i> eradication rate. Secondary outcomes included adverse events and patient compliance. We synthesized the effect sizes of the trials using odds ratios (OR) and 95% confidence intervals (95% CI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 54 RCTs involving 15,320 patients (74.9% male, mean age 30.2 years) were included in this study. In the intention-to-treat (ITT) analysis, VPZ-HD-dual, VPZ-triple, and VPZ-quadruple regimens demonstrated significantly higher eradication rates than PPI-triple, PPI-quadruple, and VPZ-dual regimens. Similar trends were observed in the per-protocol (PP) analysis. Subgroup analysis indicated that poor patient compliance significantly reduced eradication rates. Resistance to clarithromycin and metronidazole significantly weakened the eradication effects of PPI-triple, TPZ-triple, and VPZ-triple regimens. Additionally, the eradication rates for 7-day regimens were significantly lower than those for 14-day or 10-day regimens, but there was no significant difference between the eradication rates of 10-day and 14-day regimens. Notably, the risk of adverse events with VPZ-HD-dual was significantly lower than with VPZ-quadruple.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Vonoprazan combined with high-dose amoxicillin dual therapy not only provides satisfactory eradication rates but also exhibits lower adverse event rates and good patient compliance, indicating its potential as a promising regimen for further promotion.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Bismuth Quadruple Therapy in the Treatment of Helicobacter pylori-Infected Peptic Ulcer Children in Vietnam","authors":"Thi Minh Phuong Do,&nbsp;Thi Huyen Trang Tran,&nbsp;Van Tinh Nguyen,&nbsp;Thi Phuong Mai Chu,&nbsp;Loi Nguyen,&nbsp;Kim Thanh Nguyen,&nbsp;Thi Bich Ngoc Hoang,&nbsp;Anh Le Huu Phuong,&nbsp;Yoshio Yamaoka,&nbsp;Linus Olson,&nbsp;Thi Viet Ha Nguyen","doi":"10.1111/hel.13149","DOIUrl":"10.1111/hel.13149","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The continuous increase in drug-resistant strains, the lack of novel antibiotics, and the fewer options available to combat antibiotic-resistant infections in pediatrics pose significant challenges to the eradication of <i>Helicobacter pylori (H. pylori)</i> in children. This study evaluated the efficacy of first-line therapy with bismuth quadruple therapy in <i>H. pylori</i>-positive pediatric patients with peptic ulcers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>136 patients (aged between 8 and 17 years) diagnosed with active peptic ulcers with <i>H. pylori</i> infection were enrolled in this study. Patients with <i>H. pylori</i> strain sensitive to tetracycline and metronidazole were assigned to bismuth quadruple therapy, including a proton pump inhibitor (PPI), bismuth, tetracycline, and metronidazole. Antibiotic resistance of <i>H. pylori</i> was analyzed by the Epsilometer test. Treatment efficacy was evaluated at 12 weeks based on <i>H. pylori</i> eradication and peptic ulcer healing rates. <i>H. pylori</i> infection status was evaluated by a ¹³C-urea breath test.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Most isolates showed extremely high rates of resistance to commonly prescribed antibiotics used for children, including clarithromycin (97.0%) and amoxicillin (84.6%), while the low rate of resistance to levofloxacin (16.2%). The overall success rate of eradication therapy in the intention-to-treat and the per-protocol group were 86.0% and 89.3%, respectively. Peptic ulcer healing rates for total patients at 6 weeks and 12 weeks were 75.0% and 97.7%, respectively. There were no entail unpleasant adverse events, and peptic ulcer symptoms decreased steadily over time in all cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The bismuth quadruple therapy with a 2-week PPI pretreatment and followed by prolonged PPI was highly successful in eradicating <i>H. pylori</i> infection and healing ulcers in pediatric patients with active peptic ulcer. This might be preferable as a first-line empiric treatment regimen for <i>H. pylori</i>-positive pediatric patients with peptic ulcers, especially in populations with high rates of resistance to amoxicillin and clarithromycin.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582950","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":"Map-Like Redness Development After Eradication Therapy for Helicobacter pylori Infection: Prospective Multicenter Observational Study","authors":"Sho Matsumoto,&nbsp;Mitsushige Sugimoto,&nbsp;Tomohiro Terai,&nbsp;Yasuhiko Maruyama,&nbsp;Shu Sahara,&nbsp;Shigeru Kanaoka,&nbsp;Yashiro Yoshizawa,&nbsp;Shuhei Unno,&nbsp;Masaki Murata,&nbsp;Takahiro Uotani,&nbsp;Tomohiro Sugiyama,&nbsp;Shigemi Nakajima,&nbsp;Kiyoyuki Hayafuji,&nbsp;Ken Haruma,&nbsp;Tomoari Kamada,&nbsp;Masakatsu Fukuzawa,&nbsp;Takashi Kawai,&nbsp;Takao Itoi","doi":"10.1111/hel.13146","DOIUrl":"10.1111/hel.13146","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Map-like redness, pathological intestinal metaplasia, is observed in one-fourth to one-third of patients 1 year after <i>Helicobacter pylori</i> eradication therapy, mainly in the corpus, and is a newly identified endoscopic risk factor for gastric cancer development after eradication. However, it is unclear whether intestinal metaplasia is present before eradication at the site where the map-like redness appears. We aimed to identify endoscopic findings that predict the occurrence of map-like redness before <i>H. pylori</i> eradication.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>As a prospective multicenter trial, the characteristics of patients in whom map-like redness developed after eradication, and the association between the endoscopic severity of gastritis and the development of map-like redness in patients who underwent endoscopy before and 1-year after eradication were investigated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The rate of map-like redness in all 93 patients 1-year postsuccessful eradication was 30.1% (95% confidence interval [CI]: 21.0–40.5). All patients with map-like redness were endoscopically observed to have intestinal metaplasia before eradication, in the site that subsequently developed map-like redness. Patients who developed map-like redness were older, had more severe intestinal metaplasia and nodularity and a higher total score on the Kyoto Classification of Gastritis both before and after eradication than patients who did not. On multivariate analysis, map-like redness was found to be associated with posttreatment intestinal metaplasia (odds ratio: 8.144; 95% CI: 2.811–23.592).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In all patients who developed map-like redness after eradication, endoscopic intestinal metaplasia was observed at the site developed map-like redness before eradication therapy. Map-like redness was especially observed in patients with more severe intestinal metaplasia at 1-year after eradication. Such patients require increased attention at surveillance endoscopy, owing to generally having a higher risk of gastric cancer development.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>University Hospital Medical Information Network: UMIN000044707</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hel.13146","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568064","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":"Effects of High Altitude and Diet on Gastric Disease Severity in Helicobacter pylori Infection in Peru.","authors":"David Requena, Eduardo Ribas, Robert H Gilman, Lilia Cabrera, Jaime Cok, Walter Barriga-Rivera, Juan Combe-Gutiérrez, Gloria Vargas-Cardenas, Lisa Seidelmann, Catherine H Miele","doi":"10.1111/hel.13147","DOIUrl":"10.1111/hel.13147","url":null,"abstract":"<p><p>Helicobacter pylori is a bacterium that infects approximately half of the world's population, being more prevalent in low- and middle-income countries. H. pylori can cause gastritis, peptic ulcer disease, mucosa-associated lymphoid tissue lymphoma, and gastric cancer, which is among the five most frequent cancers worldwide. Other factors such as a diet low in vegetables and high in processed red meat have been associated with gastric cancer. Here, we studied the effects of high altitude and diet on gastric disease severity in H. pylori infection in a multicenter cross-sectional study in Peru (N = 343). We recruited people from villages with distinct eating habits (high meat consumption, mixed, and limited meat consumption diet) in the Andes (Puno), and compared them to people living at sea level with a mixed diet (Lima). H. pylori infection prevalence was higher at high altitude than at sea level. High altitude, diet, and age showed a significant correlation with the severity of gastric disease, whereas H. pylori infection and sex did not. However, high altitude was not found to be a risk factor for intestinal metaplasia, while diet and age were. At high altitude, a meat-rich diet was associated with a higher incidence of metaplasia compared to a plant-based diet. This study provides a comparison of communities living at high altitude with spontaneously different diets, showing that high processed red meat consumption is a risk factor for gastric disease. Further studies are needed to explain this phenomenon and its impact on the development and progression of gastric pathologies.</p>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 6","pages":"e13147"},"PeriodicalIF":4.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647641","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":"Correction to Antimicrobial Resistance of Helicobacter pylori Isolated From Latin American Children and Adolescents (2008–2023): A Systematic Review","authors":"","doi":"10.1111/hel.13145","DOIUrl":"10.1111/hel.13145","url":null,"abstract":"&lt;p&gt;C. Cabrera, J. Torres, C. Serrano, P. Gallardo, V. Orellana, S. George, M. O'Ryan, and Y. Lucero, “Antimicrobial Resistance of &lt;i&gt;Helicobacter pylori&lt;/i&gt; Isolated From Latin American Children and Adolescents (2008–2023): A Systematic Review,” &lt;i&gt;Helicobacter&lt;/i&gt; 29, (2024): e13101. https://doi.org/10.1111/hel.13101.&lt;/p&gt;&lt;p&gt;In the article, the errors detailed below were identified. These errors are due to an earlier version of the manuscript being published. These have been corrected in the online version of the article, and they do not affect the overall conclusions.&lt;/p&gt;&lt;p&gt;\u0000 &lt;b&gt;Abstract&lt;/b&gt;\u0000 &lt;/p&gt;&lt;p&gt;The first sentence of the Results paragraph originally stated that out of 51 studies, 45 were excluded. This has been corrected to 44 excluded studies.&lt;/p&gt;&lt;p&gt;The second sentence of the Results paragraph originally read, “the quality of the six analyzed studies…was satisfactory.” This has been corrected to seven analyzed studies.&lt;/p&gt;&lt;p&gt;The fourth sentence of the Results paragraph originally read, “Clarithromycin resistance ranged from 8.0% to 26.7% (6 studies; 297 samples).” This has been corrected to 8.1%–79.6% (seven studies, 346 samples).&lt;/p&gt;&lt;p&gt;\u0000 &lt;b&gt;Results&lt;/b&gt;\u0000 &lt;/p&gt;&lt;p&gt;In the second paragraph of section 3.1, it was originally stated that 16 studies were excluded and that eight were conducted solely in adult populations. This has been corrected to read that 15 studies were excluded and nine were conducted solely in adult populations.&lt;/p&gt;&lt;p&gt;In the first paragraph of section 3.2, it was originally stated that the quality of the six selected studies was assessed. This has been corrected to seven studies. Additionally, it was stated that the other four studies used statistical tools to validate their results. This has been corrected to six studies.&lt;/p&gt;&lt;p&gt;In the first paragraph of section 3.3, the first sentence originally read, “All six studies were cross-sectional observational studies, each including pediatric patients [7–12].” This has been corrected to “All seven studies were cross-sectional observational studies, each including pediatric patients [7–13].” Additionally, the fifth sentence originally stated that two of the studies evaluated antimicrobial resistance. This has been corrected to three studies.&lt;/p&gt;&lt;p&gt;In the second paragraph of section 3.4, the first sentence originally read, “Genotypic studies (Table 2) explored susceptibility to clarithromycin (&lt;i&gt;n&lt;/i&gt; = 3; 139 samples).” This has been corrected to “Genotypic studies explored susceptibility to clarithromycin (&lt;i&gt;n&lt;/i&gt; = 4; 188 samples).” Additionally, the second sentence originally read, “The mean rate of resistance to clarithromycin was 13.8%, with the A2143G mutation being the most frequently detected in these strains (87.5%, 14/16 tested), followed by the A2142G mutation (12.5%, 2/16 tested).” This has been corrected to, “The resistance to clarithromycin ranged between 8.1% and 79.6%, with the A2143G mutation as the most frequently detecte","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 5","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hel.13145","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499452","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":"Optimal Duration of Bismuth-Containing Quadruple Therapy for Helicobacter pylori Eradication: A Systematic Review and Meta-Analysis","authors":"Miao Duan,&nbsp;Qingzhou Kong,&nbsp;Hui Wang,&nbsp;Yueyue Li","doi":"10.1111/hel.13144","DOIUrl":"10.1111/hel.13144","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The eradication of &lt;i&gt;Helicobacter pylori&lt;/i&gt; (&lt;i&gt;H. pylori&lt;/i&gt;) is crucial due to its rising prevalence and increasing resistance. Bismuth-containing quadruple therapies (BcQTs) have been proposed as a viable treatment option; however, the optimal duration for it remains contentious. This systematic review and meta-analysis aimed to compare the clinical efficacy of short-term BcQT (defined as 7 or 10 days) with a standard 14-day course.&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;A systematic search of PubMed, Embase, Web of Science, and the Cochrane Library was conducted for randomized controlled trials published in English until June 20, 2024. Eligibility criteria were applied to identify relevant studies. Summary risk ratios (RRs) and 95% confidence intervals (CIs) were calculated for the included studies regarding eradication rates, adverse effects, and compliance. This systematic review and meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and was previously registered in PROSPERO under registration number CRD42024547773.&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;This meta-analysis finally included 15 trials involving a total of 4505 patients. The eradication rates for short courses of BcQT were lower than those for the 14-day course (RR 0.96, 95% CI 0.93–0.99). However, the eradication rate for the 10-day therapy was comparable to that of the 14-day therapy (RR 0.98, 95% CI 0.95–1.00). Subgroup analyses of antibiotic combinations indicated that tetracycline and metronidazole combinations yielded similar &lt;i&gt;H. pylori&lt;/i&gt; eradication rates in the 7-day versus the 14-day BcQT (RR 0.93, 95% CI 0.84–1.02). In the potassium-competitive acid blocker subgroup, the eradication rates remained similar across the 14-day group and the short-course treatment groups, whether evaluating the short-term treatment groups as a whole or the 7- and 10-day subgroups separately. Additionally, the adverse effects and compliance associated with the short course of BcQT were comparable to those of the 14-day therapy.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A 10-day course of BcQT may represent the optimal treatment duration. Nevertheless, the choice of antibiotic combination should be guided by the regional antibiotic resistance patterns of &lt;i&gt;H. pylori&lt;/i&gt;, as combinations with lower resistance rates are more effective.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Trial Registration&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;PROSPERO number: CRD42024547773&lt;/p&gt;\u0000 &lt;/secti","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 5","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499454","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":"Influence of oipA Phase Variation on Virulence Phenotypes Related to Type IV Secretion System in Helicobacter pylori","authors":"Jing Lai,&nbsp;Sacheera Angulmaduwa,&nbsp;Myeong-A Kim,&nbsp;Aeryun Kim,&nbsp;Kavinda Tissera,&nbsp;Yong-Joon Cho,&nbsp;Jeong-Heon Cha","doi":"10.1111/hel.13140","DOIUrl":"10.1111/hel.13140","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p><i>oipA</i>, an outer membrane protein of <i>Helicobacter pylori</i>, is linked to IL-8 induction and gastric inflammation, but its role is debated due to inconsistent findings. This study aims to explore the role of <i>oipA</i> phase variation in modulating the virulence traits of <i>H. pylori</i>, a bacterium strongly associated with the development of gastric cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>American clinical isolate AH868 strain for naturally occurring phase variations of the <i>oipA</i> gene, and G27 strain for in vitro–induced phase variations were used to elucidate <i>oipA</i>'s impact on key virulence phenotypes, including cell elongation, CagA phosphorylation, and IL-8 induction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Using AH868 strain, natural <i>oipA</i> phase variation does not affect cell elongation and IL-8 induction. Interestingly, however, in vitro–induced <i>oipA</i> phase variations in G27 strain uncovered that 9.4% of <i>oipA</i> “Off” transformants exhibit reduced cell elongation while all maintaining consistent IL-8 induction levels. Additionally, complementation of <i>oipA</i> “Off to On” status restores the cell elongation phenotype in 12.5% of transformants, highlighting the importance of <i>oipA</i> in maintaining normal cell morphology. Crucially, these variations in cell elongation are not linked to changes in bacterial adherence capabilities. Furthermore, the study shows a correlation among <i>oipA</i> phase variation, cell elongation, and CagA phosphorylation, suggesting that <i>oipA</i> influences the functionality of the Type IV secretion system. Whole-genome sequencing of selected transformants reveals genetic variations in <i>bab</i> paralogue, <i>cagY</i> gene, and other genomic regions, underscoring the complex genetic interactions that shape <i>H. pylori</i>'s virulence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our research provides new insights into the subtle yet significant role of <i>oipA</i> phase variation in <i>H. pylori</i> pathogenicity, emphasizing the need for further studies to explore the intricate molecular mechanisms involved. This understanding could pave the way for targeted therapeutic strategies to mitigate the impact of <i>H. pylori</i> on human health.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 5","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hel.13140","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499453","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":"Efficacy of Tegoprazan-Containing Sequential Eradication Treatment Compared to Esomeprazole-Containing Sequential Eradication of Helicobacter pylori in South Korea, a Region With High Antimicrobial Resistance: A Prospective, Randomized, Single Tertiary Center Study","authors":"Jung Won Lee,&nbsp;Nayoung Kim,&nbsp;Jongchan Lee,&nbsp;So Young Jo,&nbsp;Dong Ho Lee","doi":"10.1111/hel.13143","DOIUrl":"10.1111/hel.13143","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Treatment with potassium-competitive acid blockers has shown acceptable efficacy in <i>Helicobacter pylori</i> eradication. In regions like Korea, where the clarithromycin resistance rate is high, alternative combinations like non-bismuth quadruple therapies have shown favorable results. This study compared the outcomes of sequential eradication therapy with new potassium-competitive acid blocker tegoprazan and conventional esomeprazole-containing sequential therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Patients with <i>Helicobacter pylori</i> (<i>H. pylori</i>) infection were consecutively recruited. Patients were allocated to either an esomeprazole-containing sequential or a tegoprazan-containing sequential therapy group. Sequential therapy comprised esomeprazole (40 mg) or tegoprazan (50 mg) plus amoxicillin (1000 mg) twice daily for the initial 5 days, followed by esomeprazole (40 mg) or tegoprazan (50 mg) with clarithromycin (500 mg) and metronidazole (500 mg) twice daily for the remaining 5 days. Eradication rate, compliance, and adverse events were recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 406 patients with <i>H. pylori</i> infection were enrolled in the trial and analyzed per protocol. Eradication rate by intention-to-treat and per-protocol was 83.8% (95% confidence interval [CI]: 78.7–88.9) for esomeprazole-containing sequential therapy, and 87.1% (95% CI: 82.5–91.8) for tegoprazan-containing sequential therapy, with no statistical significance (<i>p</i> = 0.399). Additionally, there was no statistically significant difference in treatment compliance between the two groups. Nausea was more prevalent (23.3%, 27/202) with sequential tegoprazans than with esomeprazole-containing sequential therapy (14.2%, 29/204; <i>p</i> = 0.022).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Tegoprazan-containing 10-day sequential eradication treatment demonstrated similar eradication efficacy compared to esomeprazole-containing treatment, even in regions with high antimicrobial resistance, such as Korea.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ClinicalTrials.gov: NCT06382493</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 5","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hel.13143","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464196","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":"Efficacy of Bismuth Therapy in Eradicating Helicobacter pylori in Children—Data From the RENIHp Registry","authors":"Gonzalo Botija,&nbsp;Gonzalo Galicia,&nbsp;Beatriz Martínez,&nbsp;Carmen Cuadrado,&nbsp;Marta Soria,&nbsp;Sonia Fernández,&nbsp;Pedro Urruzuno,&nbsp;María-Luz Cilleruelo,&nbsp;SEGHNP H. pylori Working Group","doi":"10.1111/hel.13142","DOIUrl":"10.1111/hel.13142","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate the efficacy of colloidal bismuth subcitrate (CBS) therapy for the eradication of <i>H. pylori</i> in patients from a national pediatric registry of <i>H. pylori</i> infection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The Spanish Registry of Children with <i>H. pylori</i> Infection (RENIHp) is a national, multi-center, prospective, non-interventional registry that includes children aged 5–18 years with <i>H. pylori</i> infection diagnosed by endoscopy. All patients in the registry who were treated with CBS between the period 2020 and 2023 were included in this study. The primary outcome was the eradication rate, which was assessed using a ¹³C-urea breath test or monoclonal antigen in the stool 6–8 weeks post-treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The registry included 682 patients, 38 (5.6%) of whom underwent treatment with CBS. Fifty percent (19/38) of patients had previously undergone unsuccessful eradication treatment. In 78.9% (30/38) of patients, treatment was guided by an antibiotic sensitivity test. In the remaining patients, an empirical approach was employed. The CBS therapies used were as follows: quadruple therapy with proton pump inhibitors (PPIs), CBS, amoxicillin, and metronidazole (MET) [18/38 (47.3%)]; quadruple therapy with PPIs, CBS, tetracycline, and MET [13/38 (34.2%)]; and other therapies [7/38 (18.4%)]. Thirty-two patients (84.2%) treated with CBS were followed-up with eradication monitoring. The overall eradication rate in patients treated with CBS was 93.8% (30/32, [95% CI: 85.4%–100%]), whereas it was 86.7% in patients in the registry who were not on CBS treatment (430/496, [95% CI: 83.3%–89.5%], <i>p</i> = 0.208). In the six patients with dual resistance to clarithromycin (CLA) and MET who were treated with quadruple therapy with CBS, the eradication rate was 100% (<i>n</i> = 6/6, [95% CI: 61.0%–100%]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>CBS therapies in our registry, although only used in selected cases and at lower than recommended levels, were very effective and showed an eradication rate of &gt; 90%.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 5","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390222","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":"Systematic Review and Meta-Analysis: Bismuth Enhances the Efficacy for Eradication of Helicobacter pylori","authors":"A Reum Choe,&nbsp;Chung Hyun Tae,&nbsp;Miyoung Choi,&nbsp;Ki-Nam Shim,&nbsp;Hye-Kyung Jung","doi":"10.1111/hel.13141","DOIUrl":"10.1111/hel.13141","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In the eradication of <i>Helicobacter pylori</i>, the efficacy of bismuth remains inconclusive. We aimed to compare the efficacy of bismuth on various <i>H. pylori</i> eradication regimens.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Randomized controlled trials were collected to compare the efficacy of bismuth to nonbismuth regimens in <i>H. pylori</i> eradication. We pooled information to study eradication, adverse events, and drug compliance. In addition, subgroup analyses for eradication efficacy were performed according to high or low clarithromycin-resistance area, bismuth drug form, and amount of bismuth element.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Records for a total of 2506 patients in 15 trials from 13 randomized controlled studies were included. The eradication of <i>H. pylori</i> was superior when bismuth compared to nonbismuth regimen (odds ratio [OR] = 1.63, 95% confidence interval [CI], 1.33–2.00 in intention-to-treat [ITT]; OR = 2.05, 95% CI, 1.58–2.68 in per-protocol [PP] analyses), without significant difference in drug compliance or adverse events. Bismuth regimens in the high clarithromycin resistance area tend to enhance the eradication rate (OR = 1.66, 95% CI, 1.34–2.05 in ITT; OR = 2.22, 95% CI, 1.67–2.95 in PP analyses). Bismuth potassium citrate and bismuth subcitrate were more effective drug forms in regard to eradication rate. Bismuth at a dosage of &lt; 500 mg/day was significantly higher for the eradication rate.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Bismuth to the <i>H. pylori</i> eradication regimens achieve a higher eradication rate, especially in the high clarithromycin resistance area. It could be an eradication option achieving sufficient resistance rates without increasing antibiotic resistance, side effects, or poor compliance.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 5","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hel.13141","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390223","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}