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Potassium-competitive Acid Blockers: A New Therapeutic Strategy for Helicobacter pylori Eradication 钾竞争性酸阻滞剂:根除幽门螺杆菌的新治疗策略
Pub Date : 2023-09-15 DOI: 10.7704/kjhugr.2023.0041
Byeong Yun Ahn, Soo-Jeong Cho
The escalating prevalence of clarithromycin resistance in cases of Helicobacter pylori, insufficient acid suppression, and pharmacodynamic variations secondary to inter-individual differences in CYP2C19 polymorphism collectively contribute to suboptimal eradication rates observed with proton pump inhibitor (PPI)-based therapy. Compared with PPIs, potassium-competitive acid blockers (PCABs) produce rapid, potent, and long-lasting suppression of gastric acid through reversible inhibition of gastric H+, K+-ATPase. PCAB-based therapy results in significant inhibition of acid secretion and has therefore emerged as a novel and effective approach for H. pylori eradication. In this study, we review the efficacy and safety profile of PCAB-based eradication regimens comprising vonoprazan, tegoprazan, and fexuprazan.
幽门螺杆菌中克拉霉素耐药性的不断上升,酸抑制不足,以及CYP2C19多态性的个体差异导致的药效学变化,共同导致质子泵抑制剂(PPI)治疗的根除率不理想。与PPIs相比,钾竞争酸阻滞剂(PCABs)通过可逆抑制胃H+, K+- atp酶产生快速,有效和持久的胃酸抑制。基于pcab的治疗结果显着抑制酸分泌,因此已成为根除幽门螺杆菌的一种新颖有效的方法。在这项研究中,我们回顾了基于pcabs的根除方案的有效性和安全性,包括vonoprazan,替戈拉赞和非特普拉赞。
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引用次数: 0
Bifurcated Lumen Observed on Capsule Endoscopy 胶囊内窥镜观察到分岔管腔
Pub Date : 2023-09-15 DOI: 10.7704/kjhugr.2023.0036
Byeong Yun Ahn, Bokyung Kim, Hyun-Chae Chung, Sang Gyun Kim, Soo-Jeong Cho
The Korean Journal of Helicobacter and Upper Gastrointestinal Research is an Open-Access Journal. All articles are distributed under the terms of the Creative Commons Attribution Non-Commercial License (https:// creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. IMAGE OF THE ISSUE ISSN 1738-3331 eISSN 2671-826X, https://doi.org/10.7704/kjhugr.2023.0036 Korean J Helicobacter Up Gastrointest Res, 2023;23(3):222-224
《韩国幽门螺杆菌与上消化道研究杂志》是一本开放获取期刊。所有文章都是根据知识共享署名非商业许可证(https://creativecommons.org/licenses/by-nc/4.0)的条款分发的,该许可证允许在任何媒体上进行不受限制的非商业使用、分发和复制,前提是正确引用了原作。本期图片ISSN 1738-3331 eISSN 2671-826X,https://doi.org/10.7704/kjhugr.2023.0036韩国幽门螺杆菌研究杂志,2023;23(3):222-224
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引用次数: 0
Scratch Sign as an Endoscopic Marker for Predicting the Absence of Current Helicobacter pylori Infection 抓痕征作为内镜标记物预测当前幽门螺杆菌感染的缺失
Pub Date : 2023-09-15 DOI: 10.7704/kjhugr.2023.0032
Su Jin Kim
pylori
幽门
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引用次数: 0
History and Pharmacological Mechanism of Gastric Acid-suppressive Drugs 抑胃酸药物的历史及药理机制
Pub Date : 2023-09-15 DOI: 10.7704/kjhugr.2023.0040
Dong Han Yeom, Yong Sung Kim
Gastric acid-related disorders are commonly encountered in clinical practice. Acetylcholine, gastrin, and histamine are physiological agonists that stimulate acid secretion from parietal cells. Histamine plays a decisive role in the transformation of parietal cells into acid-secreting forms. The H+, K+- ATPase proton pump, which represents the final step of acid secretion, translocates from cytoplasmic tubulovesicles to secretory canaliculi upon parietal cell stimulation and facilitates exchange of intracellular H+ with extracellular K+ in a 1:1 ratio. Histamine-2 receptor antagonists and proton pump inhibitors (PPIs) are widely used in clinical practice, and potassium-competitive acid blockers (P-CABs) have gained attention in recent times. P-CABs address the unmet needs of patients who receive conventional PPIs and have broadened the spectrum of drug choices; however, further research is warranted to confirm long-term safety of these drugs. Comprehensive understanding of the mechanisms of actions, characteristics, advantages and disadvantages, and the adverse effect profile is essential for appropriate prescription of gastric acid-suppressive drugs. In this review, we provide a developing history and outline the pharmacological mechanisms underlying various gastric acid-suppressive drugs used in clinical settings.
胃酸相关疾病在临床实践中常见。乙酰胆碱、胃泌素和组胺是刺激顶叶细胞分泌酸的生理激动剂。组胺在壁细胞转化为分泌酸的形式中起着决定性作用。H+,K+-ATP酶质子泵代表酸分泌的最后一步,在壁细胞刺激时从细胞质微管转移到分泌小管,并促进细胞内H+与细胞外K+以1:1的比例交换。组胺-2受体拮抗剂和质子泵抑制剂(PPIs)在临床实践中被广泛应用,钾竞争性酸阻滞剂(P-CABs)近年来受到关注。P-CABs解决了接受常规PPI的患者未满足的需求,并拓宽了药物选择范围;然而,需要进一步的研究来证实这些药物的长期安全性。全面了解抑酸药物的作用机制、特点、优缺点和不良反应概况,对于合理处方抑酸药物至关重要。在这篇综述中,我们提供了一个发展历史,并概述了临床上使用的各种胃酸抑制药物的药理学机制。
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引用次数: 0
Endoscopic Submucosal Dissection for Treatment of Localized Gastric Mucosa-Associated Lymphoid Tissue Lymphoma: A Case Series 内镜下粘膜剥离治疗局部胃粘膜相关淋巴组织淋巴瘤:一个病例系列
Pub Date : 2023-08-30 DOI: 10.7704/kjhugr.2023.0025
J. Seo, Kee Don Cho, I. Song, Y. S. Park, H. Na, J. Ahn, Jeong Hoon Lee, K. Jung, D. Kim, H. Song, G. Lee, H. Jung
Background/Aims: The treatment for gastric mucosa-associated lymphoid tissue lymphoma (MALToma) generally involves eradication of Helicobacter pylori . However, MALToma lesions may recur even without H. pylori re-infection. Furthermore, the remission rate of H. pylori -negative MALToma after eradication is low. Therefore, herein, we report on endoscopic submucosal dissection (ESD) as a treatment strategy for gastric MALToma. Methods: We retrospectively reviewed the data of all patients of gastric MALToma who underwent endoscopic resection at our institution between January 2000 and December 2021. Clinical remission was defined as complete histological remission or probable minimal residual disease according to the GELA grading system for post-treatment evaluation of gastric MALToma. Results: Six patients with gastric MALToma underwent ESD. Two patients were diagnosed with gastric MALToma, which improved after eradication treatment and relapsed approximately 36 and 41 months later, respectively. These patients had singular lesions localized to the mucosa and did not experience H. pylori re-infection. The lesions were successfully removed via ESD. The remaining four patients had H. pylori -negative gastric MALToma. These patients also had single, localized lesions that were removed via ESD. All the patients remained in clinical remission until the final follow-up. Conclusions: ESD is a safe and effective intervention for H. pylori -negative gastric MALToma when the lesion is single and confined to the mucosal layer. (Korean J Helicobacter Up Gastrointest Res 2023 Aug 30. [Epub ahead of print])
背景/目的:胃黏膜相关淋巴组织淋巴瘤(MALToma)的治疗通常包括根除幽门螺杆菌。然而,即使没有幽门螺杆菌再次感染,MALToma病变也可能复发。此外,幽门螺杆菌阴性MALToma根除后的缓解率较低。因此,在本文中,我们报道了内镜下黏膜下剥离术(ESD)作为胃MALToma的治疗策略。方法:我们回顾性回顾了2000年1月至2021年12月期间在我院接受内镜切除的所有胃MALToma患者的数据。根据胃MAL托马治疗后评估的GELA分级系统,临床缓解被定义为完全的组织学缓解或可能的最小残留疾病。结果:6例胃MALToma患者行ESD治疗。两名患者被诊断为胃MALToma,在根除治疗后病情好转,分别在约36个月和41个月后复发。这些患者有局限于粘膜的独特病变,没有幽门螺杆菌再次感染。通过ESD成功切除病灶。其余4例患者为幽门螺杆菌阴性的胃MALToma。这些患者也有通过ESD切除的单个局部病变。所有患者在最终随访前均处于临床缓解状态。结论:当幽门螺杆菌阴性胃MALToma病变为单一病变且局限于粘膜层时,ESD是一种安全有效的干预措施。(韩国幽门螺杆菌研究杂志2023年8月30日。[印刷前的Epub])
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引用次数: 1
Primary Esophageal Mucosa-associated Lymphoid Tissue Lymphoma: A Rare Case Report and Review of Other Published Data 原发性食管黏膜相关淋巴组织淋巴瘤:一例罕见病例报告和其他已发表资料的回顾
Pub Date : 2023-08-30 DOI: 10.7704/kjhugr.2023.0026
Ji Hea Bang, Jin Hyong Kang, Seung Han Kim, Jong-Jae Park, B. Lee, M. Joo, Tae-Sung Jeon
The gastrointestinal tract is the most common extranodal site for lymphomas, and mucosa-associated lymphoid tissue lymphoma is the second most common histological lymphoma subtype. However, primary esophageal mucosa-associated lymphoid tissue lymphomas are extremely rare. Few such cases are documented, and the reports demonstrate inconsistent diagnostic and therapeutic strategies. Herein, a 54-year-old man was referred to our hospital for treatment of dysphagia. Esophagogastroduodenoscopy revealed a large, horseshoe-shaped subepithelial mass in the upper esophagus. Endoscopic ultrasonography and computed tomography revealed that the mass was well-demarcated and confined to the muscularis mucosa, with no abnormalities in other organs or lymph nodes. The mass was presumptively diagnosed as benign, and the patient underwent endoscopic mucosal dissection for pathological confirmation and symptom relief. Pathological examination of the dissection specimen revealed that it was a primary esophageal mucosa-associated lymphoid tissue lymphoma. As the patient had an elevated immunoglobulin G level and Helicobacter pylori infection, we administered adjuvant eradication therapy. The patient remains under surveillance and is free of lymphoma recurrence 36 months postoperatively. This case report demonstrates that endoscopic resection and H. pylori eradication are effective treatment strategies for early-stage esophageal mucosa-associated lymphoid tissue lymphoma. (Korean J Helicobacter Up Gastrointest Res 2023 Aug 30. [Epub ahead of print])
胃肠道是结外淋巴瘤最常见的部位,粘膜相关淋巴组织淋巴瘤是第二常见的组织学淋巴瘤亚型。然而,原发性食管黏膜相关淋巴组织淋巴瘤极为罕见。很少有这样的病例被记录下来,报告显示了不一致的诊断和治疗策略。在此,一位54岁的男性因吞咽困难被转介到我院治疗。食管胃十二指肠镜检查发现食管上部有一个大的马蹄形上皮下肿块。超声内镜及计算机断层扫描显示肿块界限清晰,局限于肌层粘膜,其他器官及淋巴结未见异常。肿块推定为良性,患者行内镜下粘膜剥离以病理证实并缓解症状。解剖标本病理检查显示为原发性食管黏膜相关淋巴组织淋巴瘤。由于患者免疫球蛋白G水平升高和幽门螺杆菌感染,我们给予辅助根除治疗。术后36个月,患者仍在监测中,无淋巴瘤复发。本病例报告表明内镜切除和根除幽门螺杆菌是早期食管黏膜相关淋巴组织淋巴瘤的有效治疗策略。韩国幽门螺杆菌研究2023年8月30日。[印刷前的Epub])
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引用次数: 0
Validation of a Novel Endoscopic Feature that Predicts Helicobacter pylori-negative Status: Does the Scratch Sign Reflect H. pylori Non-infection? 预测幽门螺杆菌阴性状态的新内镜特征的验证:抓痕标志是否反映幽门螺杆菌未感染?
Pub Date : 2023-08-30 DOI: 10.7704/kjhugr.2023.0029
J. Seo, Hyo-Jin Cho, Sang Jong Park, Ah Young Lee, Sang-Jung Kim, Ji Yong Ahn
Background/Aims: Identification of Helicobacter pylori infection status is necessary as H. pylori is associated with gastric malignancy. Recently, a red linear scrape-like appearance on the gastric mucosa, called the “scratch sign,” was reported to be associated with H. pylori -negative gastric mucosal status. Herein, we aimed to validate the association between the scratch sign and H. pylori infection status. Methods: The data of patients who underwent screening endoscopy at Bundang Jesaeng General Hospital between March 2023 and April 2023 were reviewed. Patients were classified as having an H. pylori current infection or non-infection status based on the re-sults of rapid urease tests. Patients who had undergone H. pylori eradication therapy were excluded. Endoscopic features of the gastric mucosa were assessed using the Kyoto classification of gastritis. Results: The scratch sign appeared more frequently in patients with non-infection than in those with current infection status (32.7% vs. 10.6%, respectively; P <0.001). Multivariate analysis showed that only the presence of sticky mucus was significantly associated with the presence of the scratch sign. Patient without the scratch sign had a higher prevalence of open-type atrophy, intestinal meta-plasia, enlarged folds, and diffuse redness, which reflected a higher Kyoto score. Conclusions: Presence of the gastric mucosal scratch sign, a novel endoscopic marker, is indicative of H. pylori -negative status and appears to be inversely correlated with the presence of sticky mucus. In addition to the Kyoto classification of gastritis, detection of the scratch sign may facilitate identification of the H. pylori infection status. (Korean J Helicobacter Up Gastrointest Res 2023 Aug 30. [Epub ahead of print])
背景/目的:幽门螺杆菌感染状况的鉴定是必要的,因为幽门螺杆菌与胃恶性肿瘤有关。最近,据报道,胃黏膜上出现一种被称为“抓痕征”的红色线状抓痕状外观,与幽门螺杆菌阴性的胃黏膜状态有关。在此,我们旨在验证抓痕征与幽门螺杆菌感染状态之间的相关性。方法:对2023年3月至2023年4月在Bundang Jesaeng综合医院接受筛查内镜检查的患者的数据进行回顾性分析。根据快速尿素酶测试的结果,将患者分为幽门螺杆菌感染或非感染状态。已接受幽门螺杆菌根除治疗的患者被排除在外。采用京都胃炎分类法评估胃黏膜的内镜特征。结果:抓痕征在非感染患者中出现的频率高于目前感染状态的患者(分别为32.7%和10.6%;P<0.001)。多因素分析显示,只有粘性粘液的存在与抓痕征的存在显著相关。无抓痕征患者的开放型萎缩发生率更高,肠道发育不良、褶皱扩大和弥漫性发红,这反映了较高的Kyoto评分。结论:胃粘膜划痕征是一种新的内镜标志物,它表明幽门螺杆菌阴性,并且似乎与粘性粘液的存在呈负相关。除了胃炎的京都分类外,划痕征的检测可能有助于识别幽门螺杆菌感染状态。(韩国幽门螺杆菌研究杂志2023年8月30日。[印刷前的Epub])
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引用次数: 0
Endoscopic Findings of Common Gastritis in Koreans 韩国人常见胃炎的内镜表现
Pub Date : 2023-06-15 DOI: 10.7704/kjhugr.2023.0012
J. Oh
In 2013, the Japan Gastroenterological Endoscopy Society introduced the Kyoto classification of gastritis, which is useful to predict Helicobacter pylori infection based exclusively on endoscopic findings. Based on the Kyoto classification of gastritis, gastric mucosal atrophy, endoscopic intestinal metaplasia, hypertrophic gastric folds, nodularity, and diffuse redness may be associated with gastric cancer and H. pylori infection, which are common endoscopic findings in Koreans. Atrophy and intestinal metaplasia are associated with gastric cancer and therefore require attention. Hypertrophic gastric folds, nodularity, and diffuse redness can be associated with current H. pylori infection. The Kyoto scoring system, which is based on endoscopic findings is useful to predict current H. pylori infection and gastric cancer in the absence of biopsy evaluation in clinical settings. A therapeutic strategy for H. pylori infection based on the Kyoto score is expected to reduce the incidence of gastric cancer in Korea and Japan. In this study, we investigated the endoscopic findings commonly observed in Koreans among those defined by the Kyoto classification of gastritis.
2013年,日本胃肠道内窥镜学会引入了胃炎的京都分类法,该分类法可用于仅根据内窥镜检查结果预测幽门螺杆菌感染。根据胃炎的京都分类,胃粘膜萎缩、内镜肠化生、胃褶肥大、结节和弥漫性发红可能与癌症和幽门螺杆菌感染有关,这是韩国人常见的内镜表现。萎缩和肠化生与癌症相关,因此需要注意。胃皱襞肥大、结节性和弥漫性发红可能与当前幽门螺杆菌感染有关。Kyoto评分系统基于内窥镜检查结果,在临床环境中没有活检评估的情况下,可用于预测当前幽门螺杆菌感染和癌症。基于京都评分的幽门螺杆菌感染治疗策略有望降低韩国和日本癌症的发病率。在这项研究中,我们调查了在京都胃炎分类中韩国人常见的内镜检查结果。
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引用次数: 0
Bismuth, An Indispensable Component of Helicobacter pylori Eradication Therapy 铋,幽门螺杆菌根除治疗不可或缺的成分
Pub Date : 2023-06-15 DOI: 10.7704/kjhugr.2023.0028
Kyung Ho Song
The Korean Journal of Helicobacter and Upper Gastrointestinal Research is an Open-Access Journal. All articles are distributed under the terms of the Creative Commons Attribution Non-Commercial License (http:// creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. EDITORIAL ISSN 1738-3331 eISSN 2671-826X, https://doi.org/10.7704/kjhugr.2023.0028 The Korean Journal of Helicobacter and Upper Gastrointestinal Research, 2023;23(2):79-80
《韩国幽门螺杆菌与上消化道研究杂志》是一本开放获取期刊。所有文章都是根据《知识共享署名非商业许可证》(http://creativecommons.org/licenses/by-nc/4.0)的条款分发的,该许可证允许在任何媒体上进行不受限制的非商业使用、分发和复制,前提是正确引用了原作。编辑ISSN 1738-3331 eISSN 2671-826X,https://doi.org/10.7704/kjhugr.2023.0028《韩国幽门螺杆菌与上消化道研究杂志》,2023年;23(2):79-80
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引用次数: 0
Evidence-based Therapy: A Rational Approach to Helicobacter pylori Eradication 循证疗法:根除幽门螺杆菌的理性途径
Pub Date : 2023-06-15 DOI: 10.7704/kjhugr.2023.0027
Y. Kwon
The Korean Journal of Helicobacter and Upper Gastrointestinal Research is an Open-Access Journal. All articles are distributed under the terms of the Creative Commons Attribution Non-Commercial License (http:// creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. EDITORIAL ISSN 1738-3331 eISSN 2671-826X, https://doi.org/10.7704/kjhugr.2023.0027 The Korean Journal of Helicobacter and Upper Gastrointestinal Research, 2023;23(2):81-83
《韩国幽门螺杆菌与上消化道研究杂志》是一本开放获取期刊。所有文章都是根据《知识共享署名非商业许可证》(http://creativecommons.org/licenses/by-nc/4.0)的条款分发的,该许可证允许在任何媒体上进行不受限制的非商业使用、分发和复制,前提是正确引用了原作。编辑ISSN 1738-3331 eISSN 2671-826X,https://doi.org/10.7704/kjhugr.2023.0027《韩国幽门螺杆菌与上消化道研究杂志》,2023年;23(2):81-83
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引用次数: 0
期刊
The Korean Journal of Helicobacter and Upper Gastrointestinal Research
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