Emerging evidence suggests differential antagonism of lactic acid-producing bacteria (LAB) to Helicobacter pylori, posing challenges to human health and food safety due to unclear mechanisms. This study assessed 21 LAB strains from various sources on H. pylori growth, urease activity, and coaggregation. Composite scoring revealed that Latilactobacillus sakei LZ217, derived from fresh milk, demonstrates strong inhibitory effects on both H. pylori growth and urease activity. L. sakei LZ217 significantly reduced H. pylori adherence of gastric cells in vitro, with inhibition ratios of 47.62%. Furthermore, in vivo results showed that L. sakei LZ217 alleviated H. pylori-induced gastric mucosa damage and inflammation in mice. Metabolomic exploration revealed metabolic perturbations in H. pylori induced by L. sakei LZ217, including reduced amino acid levels (e.g., isoleucine, leucine, glutamate, aspartate, and phenylalanine) and impaired carbohydrate and nucleotide synthesis, contributing to the suppression of ureA (28.30%), ureE (84.88%), and ureF (59.59%) expressions in H. pylori. This study underscores the efficacy of LAB against H. pylori and highlights metabolic pathways as promising targets for future interventions against H. pylori growth and colonization.
{"title":"Effects of Latilactobacillus sakei LZ217 on Gastric Mucosal Colonization, Metabolic Interference, and Urease Expression in Helicobacter pylori Infection","authors":"Chenlan Xia, Ziqi Chen, Yongqiang Chen, Fangtong Wei, Shiying Wu, Qingqing Zhou, Ping Li, Qing Gu","doi":"10.1111/hel.13130","DOIUrl":"https://doi.org/10.1111/hel.13130","url":null,"abstract":"<div>\u0000 \u0000 <p>Emerging evidence suggests differential antagonism of lactic acid-producing bacteria (LAB) to <i>Helicobacter pylori</i>, posing challenges to human health and food safety due to unclear mechanisms. This study assessed 21 LAB strains from various sources on <i>H. pylori</i> growth, urease activity, and coaggregation. Composite scoring revealed that <i>Latilactobacillus sakei</i> LZ217, derived from fresh milk, demonstrates strong inhibitory effects on both <i>H. pylori</i> growth and urease activity. <i>L. sakei</i> LZ217 significantly reduced <i>H. pylori</i> adherence of gastric cells in vitro, with inhibition ratios of 47.62%. Furthermore, in vivo results showed that <i>L. sakei</i> LZ217 alleviated <i>H. pylori</i>-induced gastric mucosa damage and inflammation in mice. Metabolomic exploration revealed metabolic perturbations in <i>H. pylori</i> induced by <i>L. sakei</i> LZ217, including reduced amino acid levels (e.g., isoleucine, leucine, glutamate, aspartate, and phenylalanine) and impaired carbohydrate and nucleotide synthesis, contributing to the suppression of ureA (28.30%), ureE (84.88%), and ureF (59.59%) expressions in <i>H. pylori</i>. This study underscores the efficacy of LAB against <i>H. pylori</i> and highlights metabolic pathways as promising targets for future interventions against <i>H. pylori</i> growth and colonization.</p>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 4","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141994263","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}
The situation of Helicobacter pylori eradication therapy has been changing over time, owing to increases in antimicrobial-resistant strains, lifestyle improvements, and changes in indications for eradication. In Japan, eradication therapy is now available to all H. pylori-positive patients under the medical insurance system, and the potassium-competitive acid blocker vonoprazan has been used for eradication from 2015. Recently, with the aging of society, opportunities to provide eradication to elderly patients are increasing, but the current status and effectiveness of eradication in elderly patients remains unclear. Therefore, we aimed to investigate the trends of H. pylori eradication in a metropolitan area to determine the factors associated with successful H. pylori eradication in elderly patients older than 80 years.
Methods
Trends in the eradication rates of patients who received first- or second-line eradication at 20 hospitals in the Tokyo metropolitan area from 2013 to 2023 were investigated.
Results
The eradication rates in the per-protocol analysis were 82.3% (95% confidence interval [CI]: 81.2%–83.2%) for the first-line treatment (n = 6481), and 87.9% (86.9%–88.9%) for the second-line treatment (n = 4899). Multivariate analysis showed that independent factors for successful eradication in the first-line treatment were an age of older than 80 years (OR: 0.606; 95% CI: 0.448–0.822), peptic ulcers (vs. atrophic gastritis: 3.817; 3.286–4.433), and vonoprazan (vs. proton pump inhibiters (PPIs), 3.817; 3.286–4.433), and an age of older than 80 years (0.503; 0.362–0.699) and vonoprazan (1.386; 1.153–1.667) in the second-line treatment.
Conclusion
After 2015, the eradication rate of both first- and second-line therapies were maintained at a higher level than before 2015, owing to the use of vonoprazan. As the H. pylori eradication rate in patients older than 80 years was low, an effective strategy for these patients needs to be developed in the future.
{"title":"Characteristics of Helicobacter pylori Eradication Therapy in Patients 80 Years or Older Living in a Metropolitan Area: A Multicenter Retrospective Study","authors":"Eri Iwata, Mitsushige Sugimoto, Daisuke Asaoka, Mariko Hojo, Masayoshi Ito, Naoko Kitazawa, Naoto Kurihara, Tatsuhiro Masaoka, Shigeaki Mizuno, Hideki Mori, Akihito Nagahara, Ryota Niikura, Toshifumi Ohkusa, Masaya Sano, Yuji Shimada, Hidekazu Suzuki, Yoshiaki Takeuchi, Akifumi Tanaka, Kengo Tokunaga, Kumiko Ueda, Nobuhiro Sakaki, Shin'ichi Takahashi, Takashi Kawai","doi":"10.1111/hel.13125","DOIUrl":"https://doi.org/10.1111/hel.13125","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The situation of <i>Helicobacter pylori</i> eradication therapy has been changing over time, owing to increases in antimicrobial-resistant strains, lifestyle improvements, and changes in indications for eradication. In Japan, eradication therapy is now available to all <i>H. pylori</i>-positive patients under the medical insurance system, and the potassium-competitive acid blocker vonoprazan has been used for eradication from 2015. Recently, with the aging of society, opportunities to provide eradication to elderly patients are increasing, but the current status and effectiveness of eradication in elderly patients remains unclear. Therefore, we aimed to investigate the trends of <i>H. pylori</i> eradication in a metropolitan area to determine the factors associated with successful <i>H. pylori</i> eradication in elderly patients older than 80 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Trends in the eradication rates of patients who received first- or second-line eradication at 20 hospitals in the Tokyo metropolitan area from 2013 to 2023 were investigated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The eradication rates in the per-protocol analysis were 82.3% (95% confidence interval [CI]: 81.2%–83.2%) for the first-line treatment (<i>n</i> = 6481), and 87.9% (86.9%–88.9%) for the second-line treatment (<i>n</i> = 4899). Multivariate analysis showed that independent factors for successful eradication in the first-line treatment were an age of older than 80 years (OR: 0.606; 95% CI: 0.448–0.822), peptic ulcers (vs. atrophic gastritis: 3.817; 3.286–4.433), and vonoprazan (vs. proton pump inhibiters (PPIs), 3.817; 3.286–4.433), and an age of older than 80 years (0.503; 0.362–0.699) and vonoprazan (1.386; 1.153–1.667) in the second-line treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>After 2015, the eradication rate of both first- and second-line therapies were maintained at a higher level than before 2015, owing to the use of vonoprazan. As the <i>H. pylori</i> eradication rate in patients older than 80 years was low, an effective strategy for these patients needs to be developed in the future.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 4","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hel.13125","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141994247","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}
Joon Sung Kim, Byung-Wook Kim, Jin Il Kim, Woo Chul Chung, Sung Woo Jung, Chang Seok Bang, Gwang Ha Kim, Seon Woo Jeon, Moon Kyoung Joo, Si Hyung Lee, Yun Jeong Lim, Jae Kyu Sung, Seung Young Seo, Sun Young Park, Wan Sik Lee, Hang Lak Lee, Ki Bae Kim, Heung Up Kim
Background
The optimal duration of regimens for tailored therapy based on genotypic resistance for clarithromycin has yet to be established.
Aim
This study was a nationwide, multicenter, randomized trial comparing empirical therapy with tailored therapy based on genotypic resistance for first-line eradication of Helicobacter pylori. We also compared the eradication rates of 7- and 14-day regimens for each group.
Patients and Methods
Patients with H. pylori infection were first randomized to receive empirical or tailored therapy. Patients in each group were further randomized into 7- or 14-day regimens. Empirical therapy consisted of a triple therapy (TT) regimen (twice-daily doses of pantoprazole 40 mg, amoxicillin 1 g, and clarithromycin 500 mg) for 7 or 14 days. Tailored therapy consisted of TT of 7 or 14 days in patients without genotypic resistance. Patients with genotypic resistance were treated with bismuth quadruple therapy (BQT) regimens (twice-daily doses of pantoprazole 40 mg, three daily doses of metronidazole 500 mg, and four times daily doses of bismuth 300 mg and tetracycline 500 mg) for 7 or 14 days. A 13C-urea breath test assessed eradication rates. The primary outcome was eradication rates of each group.
Results
A total of 593 patients were included in the study. The eradication rates were 65.7% (201/306) in the empirical therapy group and 81.9% (235/287) in the tailored therapy group for intention-to-treat analysis (p < 0.001). In the per-protocol analysis, the eradication rates of the empirical therapy and tailored groups were 70.3% (201/286) and 85.5% (235/274) (p < 0.001), respectively. There was no difference in compliance between the two groups. The rate of adverse events was higher in the tailored group compared to the empirical group (p < 0.001).
Discussion
Our study confirmed that tailored therapy based on genotypic resistance was more effective than empirical therapy for H. pylori eradication in Korea. However, no significant difference was found between 7- and 14-day regimens for each group. Future studies are needed to determine the optimal duration of therapy for empirical and tailored therapy regimens.
{"title":"Empirical Therapy Versus Tailored Therapy of Helicobacter pylori in Korea: Results of the K-CREATE Study","authors":"Joon Sung Kim, Byung-Wook Kim, Jin Il Kim, Woo Chul Chung, Sung Woo Jung, Chang Seok Bang, Gwang Ha Kim, Seon Woo Jeon, Moon Kyoung Joo, Si Hyung Lee, Yun Jeong Lim, Jae Kyu Sung, Seung Young Seo, Sun Young Park, Wan Sik Lee, Hang Lak Lee, Ki Bae Kim, Heung Up Kim","doi":"10.1111/hel.13126","DOIUrl":"10.1111/hel.13126","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The optimal duration of regimens for tailored therapy based on genotypic resistance for clarithromycin has yet to be established.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study was a nationwide, multicenter, randomized trial comparing empirical therapy with tailored therapy based on genotypic resistance for first-line eradication of <i>Helicobacter pylori</i>. We also compared the eradication rates of 7- and 14-day regimens for each group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>Patients with <i>H. pylori</i> infection were first randomized to receive empirical or tailored therapy. Patients in each group were further randomized into 7- or 14-day regimens. Empirical therapy consisted of a triple therapy (TT) regimen (twice-daily doses of pantoprazole 40 mg, amoxicillin 1 g, and clarithromycin 500 mg) for 7 or 14 days. Tailored therapy consisted of TT of 7 or 14 days in patients without genotypic resistance. Patients with genotypic resistance were treated with bismuth quadruple therapy (BQT) regimens (twice-daily doses of pantoprazole 40 mg, three daily doses of metronidazole 500 mg, and four times daily doses of bismuth 300 mg and tetracycline 500 mg) for 7 or 14 days. A <sup>13</sup>C-urea breath test assessed eradication rates. The primary outcome was eradication rates of each group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 593 patients were included in the study. The eradication rates were 65.7% (201/306) in the empirical therapy group and 81.9% (235/287) in the tailored therapy group for intention-to-treat analysis (<i>p</i> < 0.001). In the per-protocol analysis, the eradication rates of the empirical therapy and tailored groups were 70.3% (201/286) and 85.5% (235/274) (<i>p</i> < 0.001), respectively. There was no difference in compliance between the two groups. The rate of adverse events was higher in the tailored group compared to the empirical group (<i>p</i> < 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Our study confirmed that tailored therapy based on genotypic resistance was more effective than empirical therapy for <i>H. pylori</i> eradication in Korea. However, no significant difference was found between 7- and 14-day regimens for each group. Future studies are needed to determine the optimal duration of therapy for empirical and tailored therapy regimens.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 4","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hel.13126","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141982117","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":"Letter to the Editor Regarding the Article: “Exploring the Capacities of ChatGPT: A Comprehensive Evaluation of Its Accuracy and Repeatability in Addressing Helicobacter pylori-Related Queries”","authors":"Pingping Yang, Jiuliang Jiang","doi":"10.1111/hel.13131","DOIUrl":"10.1111/hel.13131","url":null,"abstract":"","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 4","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141982177","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 screening with eradication reduces gastric cancer (GC) development. However, it was unknown at what age the H. pylori screening should be implemented to achieve the greatest benefits at the least cost. This study aimed to determine the optimal age of H. pylori screening for primary GC prevention.
Materials and Methods
A state transition model for a hypothetical cohort of 15-year-olds from a healthcare payer perspective on a lifetime horizon was developed. Nine ages for H. pylori testing were considered: 15, 18, 20, 30, 40, 50, 60, 70, and 80 years. H. pylori screening was compared with no screening and annual, biennial, and triennial endoscopies starting at age 50. The main outcomes were costs, quality-adjusted life-years (QALYs), life expectancy life-years (LYs), incremental cost-effectiveness ratios, GC cases, stage I GC cases, and GC-related deaths. One-way, two-way, and probabilistic sensitivity analyses were performed to assess the uncertainty of the parameters.
Results
All H. pylori screenings at ages 15–80 were more cost-effective than all endoscopies and no screening. H. pylori screening at age 15 yielded the greatest cost-saving and benefits. The cost-effectiveness was sensitive to the adherence rate of H. pylori screening at age 15. Cost-effectiveness acceptability curves showed that H. pylori screening at age 15 was 99.6% cost-effective at a willingness-to-pay threshold of US$50,000 per QALY gained. Compared with no screening and biennial endoscopy in 15.6 million 15-year-olds from 2022 to 2037, respectively, H. pylori screening at age 15 saves US$9.70 million and US$2.39 billion, increases 1.26 million QALYs with 1312 LYs and 651 LYs, prevents 436 GC cases with 254 stage I GC cases and 305 stage I GC cases, and avoids 176 GC-related deaths and 72 GC-related deaths.
Conclusions
The optimal age for population-based H. pylori screening at ages 15–80 is the youngest, 15 years old. Shifting population-based H. pylori screening to younger people will reduce GC morbidity and mortality worldwide, along with a detailed investigation of the feasibility and long-term consequences of H. pylori eradication at a young age.
{"title":"Cost-Effectiveness of Population-Based Helicobacter pylori Screening With Eradication for Optimal Age of Implementation","authors":"Akiko Kowada","doi":"10.1111/hel.13120","DOIUrl":"10.1111/hel.13120","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p><i>Helicobacter pylori</i> screening with eradication reduces gastric cancer (GC) development. However, it was unknown at what age the <i>H</i>. <i>pylori</i> screening should be implemented to achieve the greatest benefits at the least cost. This study aimed to determine the optimal age of <i>H</i>. <i>pylori</i> screening for primary GC prevention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A state transition model for a hypothetical cohort of 15-year-olds from a healthcare payer perspective on a lifetime horizon was developed. Nine ages for <i>H</i>. <i>pylori</i> testing were considered: 15, 18, 20, 30, 40, 50, 60, 70, and 80 years. <i>H</i>. <i>pylori</i> screening was compared with no screening and annual, biennial, and triennial endoscopies starting at age 50. The main outcomes were costs, quality-adjusted life-years (QALYs), life expectancy life-years (LYs), incremental cost-effectiveness ratios, GC cases, stage I GC cases, and GC-related deaths. One-way, two-way, and probabilistic sensitivity analyses were performed to assess the uncertainty of the parameters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All <i>H</i>. <i>pylori</i> screenings at ages 15–80 were more cost-effective than all endoscopies and no screening. <i>H</i>. <i>pylori</i> screening at age 15 yielded the greatest cost-saving and benefits. The cost-effectiveness was sensitive to the adherence rate of <i>H</i>. <i>pylori</i> screening at age 15. Cost-effectiveness acceptability curves showed that <i>H</i>. <i>pylori</i> screening at age 15 was 99.6% cost-effective at a willingness-to-pay threshold of US$50,000 per QALY gained. Compared with no screening and biennial endoscopy in 15.6 million 15-year-olds from 2022 to 2037, respectively, <i>H</i>. <i>pylori</i> screening at age 15 saves US$9.70 million and US$2.39 billion, increases 1.26 million QALYs with 1312 LYs and 651 LYs, prevents 436 GC cases with 254 stage I GC cases and 305 stage I GC cases, and avoids 176 GC-related deaths and 72 GC-related deaths.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The optimal age for population-based <i>H</i>. <i>pylori</i> screening at ages 15–80 is the youngest, 15 years old. Shifting population-based <i>H</i>. <i>pylori</i> screening to younger people will reduce GC morbidity and mortality worldwide, along with a detailed investigation of the feasibility and long-term consequences of <i>H</i>. <i>pylori</i> eradication at a young age.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 4","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hel.13120","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141975604","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}
Helicobacter pylori infection causes chronic gastritis, ulcers, and gastric cancer, making it a threat to human health. Despite the use of antibiotic therapy, the global prevalence of H. pylori infection remains high, necessitating early eradication measures. Immunotherapy, especially vaccine development, is a promising solution in this direction, albeit the selection of an appropriate animal model is critical in efficient vaccine production. Accordingly, we conducted a literature, search and summarized the commonly used H. pylori strains, H. pylori infection-related animal models, and models for evaluating H. pylori vaccines. Based on factors such as the ability to replicate human diseases, strain compatibility, vaccine types, and eliciting of immune responses, we systematically compared the advantages and disadvantages of different animal models, to obtain the informed recommendations. In addition, we have proposed novel perspectives on H. pylori–related animal models to advance research and vaccine evaluation for the prevention and treatment of diseases such as gastric cancer.
{"title":"Animal Models of Helicobacter pylori Infection and Vaccines: Current Status and Future Prospects","authors":"Zhili Liu, He Li, Xiaotian Huang, Qiong Liu","doi":"10.1111/hel.13119","DOIUrl":"10.1111/hel.13119","url":null,"abstract":"<div>\u0000 \u0000 <p><i>Helicobacter pylori</i> infection causes chronic gastritis, ulcers, and gastric cancer, making it a threat to human health. Despite the use of antibiotic therapy, the global prevalence of <i>H. pylori</i> infection remains high, necessitating early eradication measures. Immunotherapy, especially vaccine development, is a promising solution in this direction, albeit the selection of an appropriate animal model is critical in efficient vaccine production. Accordingly, we conducted a literature, search and summarized the commonly used <i>H. pylori</i> strains, <i>H. pylori</i> infection-related animal models, and models for evaluating <i>H. pylori</i> vaccines. Based on factors such as the ability to replicate human diseases, strain compatibility, vaccine types, and eliciting of immune responses, we systematically compared the advantages and disadvantages of different animal models, to obtain the informed recommendations. In addition, we have proposed novel perspectives on <i>H. pylori</i>–related animal models to advance research and vaccine evaluation for the prevention and treatment of diseases such as gastric cancer.</p>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 4","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141897266","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}
S. J. Martínez-Domínguez, O. P. Nyssen, A. Lanas, et al., “Indications of Helicobacter pylori Eradication Treatment and Its Influence on Prescriptions and Effectiveness (Hp-EuReg),” Helicobacter 29, no. 4 (2024): e13111.
The corresponding author email was incorrect. The correct corresponding author email is [email protected].
We apologize for this error.
S.J. Martínez-Domínguez, O. P. Nyssen, A. Lanas, et al., "Indications of Helicobacter pylori Eradication Treatment and Its Influence on Prescriptions and Effectiveness (Hp-EuReg)," Helicobacter 29, no.4 (2024): e13111.通讯作者的电子邮件有误。正确的通讯作者邮箱是 [email protected]。我们对此错误深表歉意。
{"title":"Correction to Indications of Helicobacter pylori Eradication Treatment and Its Influence on Prescriptions and Effectiveness (Hp-EuReg)","authors":"","doi":"10.1111/hel.13124","DOIUrl":"10.1111/hel.13124","url":null,"abstract":"<p>S. J. Martínez-Domínguez, O. P. Nyssen, A. Lanas, et al., “Indications of <i>Helicobacter pylori</i> Eradication Treatment and Its Influence on Prescriptions and Effectiveness (Hp-EuReg),” <i>Helicobacter</i> 29, no. 4 (2024): e13111.</p><p>The corresponding author email was incorrect. The correct corresponding author email is <span>[email protected]</span>.</p><p>We apologize for this error.</p>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 4","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hel.13124","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141897267","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}
Helicobacter pylori infection is a significant pathogen in gastrointestinal diseases. Previous studies have identified single-nucleotide polymorphisms (SNPs) are factors associated with H. pylori infection. Notably, Leb and Sialyl-Lex antigens, regulated by the FUT3 and FUT6 genes, play a crucial role in H. pylori infection. This study aimed to investigate the correlation between FUT3 and FUT6 gene polymorphisms and H. pylori infection in the Han population of northern China.
Materials and Methods
An immunoturbidimetric assay was employed to detect H. pylori infection, categorizing subjects into infected and noninfected groups. Gene variants were identified through sequencing. Finally, FUT3 and FUT6 gene polymorphisms were analyzed to assess their association with H. pylori infection.
Results
The frequency of the T allele (rs778805) and the G allele (rs61147939) in the infection group was significantly higher than that in the noninfection group (63.4% vs. 55.1%, p = 0.045; 55.2% vs. 47.0%, p = 0.042, respectively). In the infection group, the frequency of the AA genotype (rs3745635) in the recessive model, the TT genotype (rs778805) in the recessive model, and the GG genotype (rs61147939) in the recessive model were significantly higher than the noninfection group (5.8% vs. 2.3%, p = 0.042; 41.9% vs. 29.3%, p = 0.022; 34.9% vs. 20.5%, p = 0.0068, respectively). The frequency of the A13 haplotype and the A13/A13 diplotype of the FUT6 gene was significantly higher in the infection group than in the noninfection group (55.56% vs. 46.32%, p = 0.019; 34.94% vs. 20.30%, p = 0.045, respectively). The rs778805-rs17855739-rs28362459-rs3745635 combination was identified as the best interaction model (p < 0.05).
Conclusions
This study suggests that FUT3 and FUT6 gene polymorphisms are significantly associated with H. pylori infection in the Han Chinese from northern China.
背景：幽门螺杆菌感染是胃肠道疾病的重要病原体。以往的研究发现，单核苷酸多态性（SNPs）是幽门螺杆菌感染的相关因素。值得注意的是，由 FUT3 和 FUT6 基因调控的 Leb 和 Sialyl-Lex 抗原在幽门螺杆菌感染中起着至关重要的作用。本研究旨在调查中国北方汉族人群中 FUT3 和 FUT6 基因多态性与幽门螺杆菌感染的相关性：采用免疫比浊法检测幽门螺杆菌感染，将受试者分为感染组和非感染组。通过测序确定基因变异。最后，分析了FUT3和FUT6基因的多态性，以评估它们与幽门螺杆菌感染的关系：结果：感染组中T等位基因（rs778805）和G等位基因（rs61147939）的频率明显高于非感染组（分别为63.4% vs. 55.1%，p = 0.045；55.2% vs. 47.0%，p = 0.042）。在感染组中，隐性模型中的AA基因型（rs3745635）、隐性模型中的TT基因型（rs778805）和隐性模型中的GG基因型（rs61147939）的频率明显高于非感染组（分别为5.8% vs. 2.3%，p = 0.042；41.9% vs. 29.3%，p = 0.022；34.9% vs. 20.5%，p = 0.0068）。感染组 FUT6 基因 A13 单倍型和 A13/A13 双倍型的频率明显高于非感染组（分别为 55.56% vs. 46.32%，p = 0.019；34.94% vs. 20.30%，p = 0.045）。rs778805-rs17855739-rs28362459-rs3745635组合被确定为最佳交互作用模型（p 结论：rs778805-rs17855739-rs28362459-rs3745635组合被确定为最佳交互作用模型：本研究表明，FUT3 和 FUT6 基因多态性与中国北方汉族人的幽门螺杆菌感染显著相关。
{"title":"Correlation of FUT3 and FUT6 Gene Polymorphisms With Helicobacter pylori Infection","authors":"Shihang Zhou, Ziwei Zheng, Liying Wang, Wenqian Song, Yuexin Xia, Linnan Shao, Xiaohua Liang","doi":"10.1111/hel.13122","DOIUrl":"10.1111/hel.13122","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p><i>Helicobacter pylori</i> infection is a significant pathogen in gastrointestinal diseases. Previous studies have identified single-nucleotide polymorphisms (SNPs) are factors associated with <i>H. pylori</i> infection. Notably, Le<sup>b</sup> and Sialyl-Le<sup>x</sup> antigens, regulated by the <i>FUT3</i> and <i>FUT6</i> genes, play a crucial role in <i>H. pylori</i> infection. This study aimed to investigate the correlation between <i>FUT3</i> and <i>FUT6</i> gene polymorphisms and <i>H. pylori</i> infection in the Han population of northern China.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>An immunoturbidimetric assay was employed to detect <i>H. pylori</i> infection, categorizing subjects into infected and noninfected groups. Gene variants were identified through sequencing. Finally, <i>FUT3</i> and <i>FUT6</i> gene polymorphisms were analyzed to assess their association with <i>H. pylori</i> infection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The frequency of the T allele (rs778805) and the G allele (rs61147939) in the infection group was significantly higher than that in the noninfection group (63.4% vs. 55.1%, <i>p</i> = 0.045; 55.2% vs. 47.0%, <i>p</i> = 0.042, respectively). In the infection group, the frequency of the AA genotype (rs3745635) in the recessive model, the TT genotype (rs778805) in the recessive model, and the GG genotype (rs61147939) in the recessive model were significantly higher than the noninfection group (5.8% vs. 2.3%, <i>p</i> = 0.042; 41.9% vs. 29.3%, <i>p</i> = 0.022; 34.9% vs. 20.5%, <i>p</i> = 0.0068, respectively). The frequency of the A13 haplotype and the A13/A13 diplotype of the FUT6 gene was significantly higher in the infection group than in the noninfection group (55.56% vs. 46.32%, <i>p</i> = 0.019; 34.94% vs. 20.30%, <i>p</i> = 0.045, respectively). The rs778805-rs17855739-rs28362459-rs3745635 combination was identified as the best interaction model (<i>p</i> < 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study suggests that <i>FUT3</i> and <i>FUT6</i> gene polymorphisms are significantly associated with <i>H. pylori</i> infection in the Han Chinese from northern China.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 4","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141897268","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}
Yue Ma, Xianzhu Zhou, Yashi Liu, Shihan Xu, Aixia Ma, Yiqi Du, Hongchao Li
Objective
There is an economic evaluation on the family-based Helicobacter pylori screen-and-treat strategy (FBHS) in China. This study aimed to compare the cost-effectiveness of the FBHS with the traditional H. pylori screen-and-treat strategy (TBHS).
Materials and Methods
A seven-state microsimulation model, including H. pylori infection and gastric cancer states, was constructed on the basis of the target family samples from 29 provinces in China. Taking a lifetime horizon from a healthcare system perspective, the long-term costs and health outcomes of the FBHS and TBHS screening strategies were simulated separately, and economic evaluations were performed. The model parameters were primarily derived from real-world data, published literature, and expert opinions. The primary outcome was the incremental cost-effectiveness ratio (ICER) expressed as cost/quality-adjusted life-year (QALY) gained. One-way sensitivity analysis, probabilistic sensitivity analysis, and scenario analysis were performed to assess the uncertainty of the results.
Results
The base-case analysis revealed that the average costs for FBHS and TBHS were 563.67 CNY and 574.08 CNY, respectively, with corresponding average QALYs of 14.83 and 14.79. The ICER for the comparison between the two strategies was −214.07, indicating that FBHS was an absolutely dominant strategy with better cost-effectiveness. The results of both one-way sensitivity analysis and probabilistic sensitivity analysis were robust. When taking into account the added benefit of the higher H. pylori eradication rate in FBHS, the average costs were further reduced, and the average QALYs were increased, solidifying its position as an unequivocally dominant strategy.
Conclusion
The FBHS is an absolutely dominant and cost-effective strategy that enables an optimized allocation of screening resources. Decision-makers should prioritize FBHS when developing H. pylori prevention and control strategies.
{"title":"An Economic Evaluation of Family-Based Versus Traditional Helicobacter pylori Screen-and-Treat Strategy: Based on Real-World Data and Microsimulation Model","authors":"Yue Ma, Xianzhu Zhou, Yashi Liu, Shihan Xu, Aixia Ma, Yiqi Du, Hongchao Li","doi":"10.1111/hel.13123","DOIUrl":"10.1111/hel.13123","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>There is an economic evaluation on the family-based <i>Helicobacter pylori</i> screen-and-treat strategy (FBHS) in China. This study aimed to compare the cost-effectiveness of the FBHS with the traditional <i>H. pylori</i> screen-and-treat strategy (TBHS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A seven-state microsimulation model, including <i>H. pylori</i> infection and gastric cancer states, was constructed on the basis of the target family samples from 29 provinces in China. Taking a lifetime horizon from a healthcare system perspective, the long-term costs and health outcomes of the FBHS and TBHS screening strategies were simulated separately, and economic evaluations were performed. The model parameters were primarily derived from real-world data, published literature, and expert opinions. The primary outcome was the incremental cost-effectiveness ratio (ICER) expressed as cost/quality-adjusted life-year (QALY) gained. One-way sensitivity analysis, probabilistic sensitivity analysis, and scenario analysis were performed to assess the uncertainty of the results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The base-case analysis revealed that the average costs for FBHS and TBHS were 563.67 CNY and 574.08 CNY, respectively, with corresponding average QALYs of 14.83 and 14.79. The ICER for the comparison between the two strategies was −214.07, indicating that FBHS was an absolutely dominant strategy with better cost-effectiveness. The results of both one-way sensitivity analysis and probabilistic sensitivity analysis were robust. When taking into account the added benefit of the higher <i>H. pylori</i> eradication rate in FBHS, the average costs were further reduced, and the average QALYs were increased, solidifying its position as an unequivocally dominant strategy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The FBHS is an absolutely dominant and cost-effective strategy that enables an optimized allocation of screening resources. Decision-makers should prioritize FBHS when developing <i>H. pylori</i> prevention and control strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 4","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141897265","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}
Patient education contributes to improve public awareness of Helicobacter pylori. Large language models (LLMs) offer opportunities to revolutionize patient education transformatively. This study aimed to assess the quality of patient educational materials (PEMs) generated by LLMs and compared with physician sourced.
Materials and Methods
Unified instruction about composing a PEM about H. pylori at a sixth-grade reading level in both English and Chinese were given to physician and five LLMs (Bing Copilot, Claude 3 Opus, Gemini Pro, ChatGPT-4, and ERNIE Bot 4.0). The assessments of the completeness and comprehensibility of the Chinese PEMs were conducted by five gastroenterologists and 50 patients according to three-point Likert scale. Gastroenterologists were asked to evaluate both English and Chinese PEMs and determine the accuracy and safety. The accuracy was assessed by six-point Likert scale. The minimum acceptable scores were 4, 2, and 2 for accuracy, completeness, and comprehensibility, respectively. The Flesch–Kincaid and Simple Measure of Gobbledygook scoring systems were employed as readability assessment tools.
Results
Accuracy and comprehensibility were acceptable for English PEMs of all sources, while completence was not satisfactory. Physician-sourced PEM had the highest accuracy mean score of 5.60 and LLM-generated English PEMs ranged from 4.00 to 5.40. The completeness score was comparable between physician-sourced PEM and LLM-generated PEMs in English. Chinese PEMs from LLMs proned to have lower score in accuracy and completeness assessment than English PEMs. The mean score for completeness of five LLM-generated Chinese PEMs was 1.82–2.70 in patients' perspective, which was higher than gastroenterologists' assessment. Comprehensibility was satisfactory for all PEMs. No PEM met the recommended sixth-grade reading level.
Conclusion
LLMs have potential in assisting patient education. The accuracy and comprehensibility of LLM-generated PEMs were acceptable, but further optimization on improving completeness and accounting for a variety of linguistic contexts are essential for enhancing the feasibility.
{"title":"Artificial Intelligence-Generated Patient Education Materials for Helicobacter pylori Infection: A Comparative Analysis","authors":"Shuyan Zeng, Qingzhou Kong, Xiaoqi Wu, Tian Ma, Limei Wang, Leiqi Xu, Guanjun Kou, Mingming Zhang, Xiaoyun Yang, Xiuli Zuo, Yueyue Li, Yanqing Li","doi":"10.1111/hel.13115","DOIUrl":"10.1111/hel.13115","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Patient education contributes to improve public awareness of <i>Helicobacter pylori</i>. Large language models (LLMs) offer opportunities to revolutionize patient education transformatively. This study aimed to assess the quality of patient educational materials (PEMs) generated by LLMs and compared with physician sourced.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Unified instruction about composing a PEM about <i>H. pylori</i> at a sixth-grade reading level in both English and Chinese were given to physician and five LLMs (Bing Copilot, Claude 3 Opus, Gemini Pro, ChatGPT-4, and ERNIE Bot 4.0). The assessments of the completeness and comprehensibility of the Chinese PEMs were conducted by five gastroenterologists and 50 patients according to three-point Likert scale. Gastroenterologists were asked to evaluate both English and Chinese PEMs and determine the accuracy and safety. The accuracy was assessed by six-point Likert scale. The minimum acceptable scores were 4, 2, and 2 for accuracy, completeness, and comprehensibility, respectively. The Flesch–Kincaid and Simple Measure of Gobbledygook scoring systems were employed as readability assessment tools.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Accuracy and comprehensibility were acceptable for English PEMs of all sources, while completence was not satisfactory. Physician-sourced PEM had the highest accuracy mean score of 5.60 and LLM-generated English PEMs ranged from 4.00 to 5.40. The completeness score was comparable between physician-sourced PEM and LLM-generated PEMs in English. Chinese PEMs from LLMs proned to have lower score in accuracy and completeness assessment than English PEMs. The mean score for completeness of five LLM-generated Chinese PEMs was 1.82–2.70 in patients' perspective, which was higher than gastroenterologists' assessment. Comprehensibility was satisfactory for all PEMs. No PEM met the recommended sixth-grade reading level.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>LLMs have potential in assisting patient education. The accuracy and comprehensibility of LLM-generated PEMs were acceptable, but further optimization on improving completeness and accounting for a variety of linguistic contexts are essential for enhancing the feasibility.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 4","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889041","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}
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