2014年12月Pubmed幽门螺杆菌相关文献汇总 上
1. 日本健康受试者人群中幽门螺杆菌的流行情况
日本人群的大规模幽门螺杆菌流行病学研究一直缺乏。本研究对21144例患者进行幽门螺杆菌感染流行病学的调查。并进行性别、年龄和地域的分层研究。结果显示日本的幽门螺杆菌感染率在2008年为27.5%，自2008年至2012年还在逐渐降低。
J Gastroenterol Hepatol. 2014 Dec;29 Suppl 4:16-9. doi: 10.1111/jgh.12795.
Prevalence of Helicobacter pylori infection with healthy subjects in Japan.
Hirayama Y1, Kawai T, Otaki J, Kawakami K, Harada Y.
Abstract
BACKGROUND AND AIM:
Only few large-scale epidemiological studies have examined the prevalence ofHelicobacter pylori (H. pylori) infection in Japan. The aim of the present study was to estimate the prevalence and incidence of H. pylori infection in Japan in terms of gender, age and region.
METHODS:
Serum anti-H. pylori antibody testing was included in workers' annual health checks conducted by T-company's health insurance association in 2008. The testing was continued for the next 5 years in 35-year-old subjects.
RESULTS:
The total number of subjects was 21 144 (18 398 males and 2746 females). Stratified for age, there were 5016 subjects (male : female = 4219:797) in their 30s, 8748 (7770:978) in their 40s, 5589 (4807:782) in their 50s, and 1769 (1584:185) in their 60s. The H. pylori seropositive rate (male : female) was 27.5% (27.5:27.7) overall, 18.0% (18.3:16.1) in subjects in their 30s, 22.9% (22.7:24.7) in those in their 40s, 37.4% (37.2:38.2) in those in their 50s, and 46.1% (45.7:49.2) in those in their 60s. The prevalence of H. pyloriseropositivity increased as age increased; however, no significant differences were seen between genders or among regions (χ(2) test). The numbers of 35-year-old subjects from 2008 to 2012 were 1072, 1107, 941, 1065, and 940, respectively. The corresponding H. pylori seropositive rates were 17.4, 17.4, 14.3, 13.3, and 14.0%, respectively.
CONCLUSION:
The Japanese H. pylori infection rate had already declined to 27.5% in 2008, with subjects in the 35-70 age range. The prevalence of H. pylori infection is also decreasing gradually from 2008 to 2012.
© 2014 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.
KEYWORDS:
Helicobacter pylori; anti-H.pylori antibody; infection rate
2. 幽门螺旋杆菌和大肠腺瘤的相关性研究：二者的相关性是否存在于美国的拉美裔人群中？
近些年的研究发现，在美国的白人和黑人人群中，结直肠腺瘤与幽门螺杆菌（幽门螺杆菌）二者具有一定的相关性。但是对于美国的拉美裔人群一直没有证实二者的相关性。本研究对1737例患者通过结肠镜的方式进行了检查和分析。结果没有发现在美国的拉美裔人群中二者具有相关性，还有待于更大规模人群的研究。
J Gastrointest Oncol. 2014 Dec;5(6):463-8. doi: 10.3978/j.issn.2078-6891.2014.074.
The association of H. pylori and colorectal adenoma: does it exist in the US Hispanic population?
Patel S1, Lipka S1, Shen H1, Barnowsky A1, Silpe J1, Mosdale J1, Pan Q1, Fridlyand S1, Bhavsar A1, Abraham A1,Viswanathan P1, Mustacchia P1, Krishnamachari B1.
Author information
Abstract
BACKGROUND:
Although data on the association between colorectal adenomas and Helicobacter pylori (H.pylori) exists in White and Black patients, there is no data on this association in a US Hispanic population. Our aim was to study the association of adenoma detection and biopsy proven H. pylori infection in a cohort of US Hispanics.
METHODS:
Data were collected from Nassau University Medical Center, a 530-bed tertiary care teaching hospital in East Meadow, New York. Patients who underwent both an esophagogastroduodenoscopy (EGD) and colonoscopy from July 2009 to March 2011 were pulled from an electronic database. A total of 1,737 patients completed colonoscopies during this time with 95 excluded: 17 inflammatory bowel disease, 12 malignancy, 22 prior history of colorectal adenoma, and 44 incomplete. Among the colonoscopies, 799 patients had EGD's performed prior to colonoscopies that were eligible for our study.
RESULTS:
H. pylori prevalence was highest in Hispanics 40.9%, followed by Blacks 29.1% (OR 0.59, 95% CI: 0.42-0.84), then Whites 7.9% (OR 0.12, 95% CI: 0.06-0.24). The adenoma detection rate was significantly higher in Whites 23.2% and Blacks 21.8% compared to Hispanics 14.5%, P=0.0002 respectively. Smoking and alcohol were lower in the H. pylori group, 18.6% (n=44) vs. 26.1% (n=147) for smoking (P=0.02) and 14.4% (n=34) vs. 19% (n=107) for alcohol (P=0.12), respectively. There was no evidence in the Hispanics for an association between adenoma detection and H. pylori infection. Furthermore size, location, and multiple polyps did not differ between the two groups.
CONCLUSIONS:
While data has shown an association between H. pylori and colorectal adenomas, we did not find this in our Hispanic population. With the growing population of Hispanics in the U.S, large scale studies are needed to conclusively characterize the role of H. pylori infection in colorectal adenoma and adenocarcinoma in this group of patients.
KEYWORDS:
Hispanic; colorectal adenoma; colorectal cancer; neoplasia
3. 应用四联补救方案治疗一线二线疗法根除失败的幽门螺杆菌感染患者：比较两种以四环素为基础的四联方案的治疗效果。
抗生素耐药常常会导致幽门螺杆菌的根除失败，而药敏试验又具有一定难度和局限性。本研究对比分析了两种以四环素为基础的四联补救方案的疗效，雷贝拉唑、铋剂、米诺环素联合利福布丁或替硝唑，结果显示，联合利福布汀和替硝唑方案的ITT根除率分别为77.7%和51.9%。
J Gastrointestin Liver Dis. 2014 Dec;23(4):367-70. doi: 10.15403/jgld.2014.1121.234.qrth.
Quadruple rescue therapy after first and second line failure for Helicobacter pyloritreatment: comparison between two tetracycline-based regimens.
Ierardi E1, Giangaspero A2, Losurdo G2, Giorgio F2, Amoruso A2, De Francesco V3, Di Leo A2, Principi M2.
Abstract
BACKGROUND AND AIMS:
Antibiotic resistance is the main reason for failure of Helicobacter pylori (H.pylori) treatment. Currently, guidelines recommend a treatment guided by antimicrobial susceptibility testing after two failures. However, microbial culture is not feasible everywhere, and the limited number of effective antibiotics against the bacterium narrows the options; thus a rescue therapy combining antibiotics with a low resistance may be fitting.
METHODS:
Patients who have failed a first-line treatment (either prolonged triple or sequential regimens) and, successively, a levofloxacin-based triple therapy were considered for the study. Subjects underwent urea breath test (UBT), stool antigen test (ST) and endoscopy/histology to confirm the diagnosis. Cytopenia and impaired liver and kidney function were exclusion criteria. Fifty-four subjects were randomized 1:1 to two regimens: RMB Rabeprazole/Rifabutin/Minocycline/Bismuth sub-citrate or MTB Rabeprazole/Tinidazole/Minocycline/Bismuth sub-citrate both for 10 days. The results were checked 6 weeks after the end of therapy with ST/UBT plus endoscopy when indicated.
RESULTS:
RMB eradicated the bacterium in 21 patients. Two subjects dropped out. The eradication rate was 77.7% (CI 62.0-93.4%) at intention-to-treat and 84.0% (CI 69.6-98.4%) at per-protocol analysis. MTB was successful in 14 patients (51.9%, CI 33.1-70.7%). No patient withdrew from the treatment for adverse events. Drug-related side effects were reported only in 3 subjects, but in all cases the treatment was carried on.
CONCLUSIONS:
The association minocycline/rifabutin seems to have a synergic effect and a good therapeutic outcome in patients who have failed at least two previous regimens, although a trial on a large population is needed.
4. 慢性胃炎患者中幽门螺杆菌感染导致巨噬细胞释放的细胞因子BAFF触发Th17细胞反应。
BAFF是影响先天性和适应性免疫细胞活性的关键细胞因子，可以促进Th17细胞在自身免疫性疾病的增殖。该研究发现在HP阳性的慢性胃炎患者的胃黏膜表面存在BAFF和IL-17的富集现象。研究证明这种富集现象与HP感染后单核细胞衍生为巨噬细胞的行为密切相关。
J Immunol. 2014 Dec 1;193(11):5584-94. doi: 10.4049/jimmunol.1302865. Epub 2014 Oct 22.
Cytokine BAFF released by Helicobacter pylori-infected macrophages triggers the Th17 response in human chronic gastritis.
Munari F1, Fassan M2, Capitani N3, Codolo G1, Vila-Caballer M1, Pizzi M4, Rugge M4, Della Bella C5, Troilo A5,D'Elios S5, Baldari CT6, D'Elios MM7, de Bernard M8.
Abstract
BAFF is a crucial cytokine that affects the activity of both innate and adaptive immune cells. It promotes the expansion of Th17 cells in autoimmune disorders. With this study, we investigated the BAFF/Th17 responses in Helicobacter pylori-induced gastritis in humans. Our results show that the mucosa from Helicobacter(+) patients with chronic gastritis is enriched in IL-17 and BAFF, whereas the two cytokines are weakly expressed in Helicobacter(-) patients with chronic gastritis; moreover, the expression of both BAFF and IL-17 decreases after bacteria eradication. We demonstrate that BAFF accumulates in macrophages in vivo and that it is produced by monocyte-derived macrophages in vitro, after Helicobacter stimulation. Application of BAFF on monocytes triggers the accumulation of reactive oxygen species that are crucial for the release of pro-Th17 cytokines, such as IL-23, IL-1β, and TGF-β. Moreover, BAFF directly promotes the differentiation of Th17 cells. In conclusion, our results support the notion that an axis BAFF/Th17 exists in chronic gastritis ofHelicobacter(+) patients and that its presence strictly depends on the bacterium. Moreover, we demonstrated that BAFF is able to drive Th17 responses both indirectly, by creating a pro-Th17 cytokine milieu through the involvement of innate immune cells, and directly, via the differentiation of T cells toward the specific profile. The results obtained in this study are of great interest for Helicobacter-related diseases and the development of novel therapeutic strategies based on the inhibition of the BAFF/IL-17 response.
Copyright © 2014 by The American Association of Immunologists, Inc.
5. 评价过氧化氢酶单克隆抗体法粪便抗原检测试验检测日本儿童和成人幽门螺杆菌感染的准确性，其敏感性和特异性分别为89.5%和100%。
J Med Microbiol. 2014 Dec;63(Pt 12):1621-5. doi: 10.1099/jmm.0.077370-0. Epub 2014 Oct 20.
Evaluation of a stool antigen test using a mAb for native catalase for diagnosis of Helicobacter pylori infection in children and adults.
Okuda M1, Osaki T2, Kikuchi S3, Ueda J3, Lin Y3, Yonezawa H2, Maekawa K1, Hojo F2, Kamiya S4, Fukuda Y1.
Author information
Abstract
Non-invasive diagnosis of Helicobacter pylori infection is important not only for screening of infection but also for epidemiological studies. Stool antigen tests are non-invasive and are convenient to identify H. pyloriinfection, particularly in children. We evaluated the stool antigen test, which uses a mAb for native catalase of H. pylori developed in Japan. A total of 151 stool samples were collected from participants (52 children and 99 adults) of the Sasayama Cohort Study and stored between -30 and -80 °C. The stool antigen test used was Testmate pylori antigen (TPAg), and was performed according to the manufacturer's instructions. Furthermore, we conducted a quantitative real-time PCR test and compared the PCR results with those of the TPAg test. When compared with the results in real-time PCR, the sensitivity of TPAg was 89.5 % overall, 82.7 % for children and 92.4 % for adults, and the specificity was 100 %. The accuracy was 93.4 % overall, 90.4 % for children and 94.9 % for adults, and there was no significant difference in the accuracy of TPAg between children and adults. Five of 28 children (18 %) and five of 38 adults (13 %) were PCR positive with negative TPAg results. Four of five children with positive PCR and negative TPAg results were given a (13)C-urea breath test and all four children tested negative. No significant correlation was observed between the TPAg results and DNA numbers of H. pylori in faeces among children or adults. A stool antigen test (TPAg) using a mAb for native catalase is useful for diagnosis of H. pylori in children and adults. Additionally, this test has particularly high specificity.
© 2014 The Authors.
6 幽门螺旋杆菌感染患儿消化溃疡的临床表现和黏膜免疫反应。
消化性溃疡（PUD）病常见于成人，儿童中一般少见。作为消化溃疡的重要病因，幽门螺杆菌感染却常在儿童期被获得。对307例3-18岁患儿通过内镜活检组织确定HP的感染和黏膜细胞因子的变化，结果显示在发展中国家儿童PUD，尤其是十二指肠溃疡（DU）的发生与HP的感染密切相关。T辅助细胞因子的平衡可能会影响儿童的临床结局。
J Pediatr Gastroenterol Nutr. 2014 Dec;59(6):773-8. doi: 10.1097/MPG.0000000000000500.
Peptic ulcer disease in Helicobacter pylori-infected children: clinical findings and mucosal immune response.
Hernández C1, Serrano C, Einisman H, Villagrán A, Peña A, Duarte I, Torres J, Riera F, Harris PR.
Author information
Abstract
OBJECTIVES:
Peptic ulcer disease (PUD) is highly prevalent among adults but less common in children.Helicobacter pylori infection, the main cause of PUD, is, however, acquired extremely early in life. The aim of the study was to analyze clinical characteristics of children with PUD in a country with a high prevalence of the disease and to evaluate which host factors could determine this clinical outcome.
METHODS:
Children referred for upper gastrointestinal (GI) endoscopy with suspicion of peptic diseases were included prospectively during an 8-year period. Antral biopsies were performed to determine H pylori presence and mucosal cytokines profile.
RESULTS:
A total of 307 children between 3 and 18 years old were enrolled. Of the total, 237 children (46% boys) with complete data were included. H pylori infection was confirmed in 133 (56.1%) participants. Duodenal ulcer (DU) was diagnosed in 32 patients (13.5%); among them 29 were infected with H pylori(90.6%). Infected children had a nodular appearance of the gastric mucosa more often than noninfected children. Noninfected children had fewer lymphoid follicles and less inflammatory infiltrate than infected children. Only mucosal polymorphonuclear cell infiltration was more intense in DU-infected children as compared with non-DU-infected children. DU-infected children had higher levels of mucosal interferon-γ than noninfected and non-DU-infected patients. Non-DU-infected children had also higher levels of mucosal interleukin-10 than noninfected patients (P < 0.05).
CONCLUSIONS:
PUD in children, especially DU, is strongly associated with H pylori infection in developing countries. There is no distinctive clinical presentation of children with PUD. T-helper cytokine balance may influence clinical outcomes in children.
7. 波兰胃肠病学会的专业小组：波兰人群中儿童与成年幽门螺杆菌血清阳性感染者的基因型和临床表型的差异。
幽门螺杆菌在儿童和成人上消化道疾病的发病机制中具有重要作用。本研究的目的是评估与HP相关的疾病在儿童和成人，其临床过程之间的差异。此外研究还对患者的临床症状、内镜和组织病理学表现、幽门螺旋杆菌cagA及vacA基因型以及菌株对抗生素的耐药率进行了分析研究。
J Physiol Pharmacol. 2014 Dec;65(6):801-7.
Task force of the Polish Society of Gastroenterology: genotypic and clinical differences of seropositive Helicobacter pylori children and adults in the Polish population.
Iwanczak B1, Laszewicz W, Iwanczak F, Dzierzanowska-Fangrat K, Rozynek M, Dzierzanowska D, Gosciniak G,Dlugosz J.
Abstract
Helicobacter pylori (H. pylori) plays an important role in the pathogenesis of the upper gastrointestinal tract diseases in both children and adults. The aim of this paper was to assess the differences between the clinical course of the disease in children and adults. This paper also presents an analysis of clinical symptoms, endoscopic and histopathological findings, H. Pylori cagA and vacA genotypes rates and analysis of the sensitivity of these strains to antibiotics in the Polish population, with possible practical and therapeutic implications. The multicenter study on the frequency of H. pylori infections assessed by the presence of antibodies in IgG class against H. pylori in serum was conducted in the years 2002 and 2003. The study group included 6565 children and adults, in 3827 of whom antibodies levels were above 24 U/mL. The authors analyzed clinical and endoscopic symptoms and in some patients with H. pylori seropositivity also histopathological changes, and cagA and vacA genes. Sensitivity of H. pylori strains to antibiotics were also analyzed. Differences between the frequency of infection between children and adults were determined. Endoscopic examination in adults revealed more frequent cases of gastropathy (P=0.003) and erosive gastritis (P=0.001), and in children-thick mucosal folds (P<0.0001). Histopathological examinations carried out in adults have revealed atrophic gastritis and intestinal metaplasia. In children, cagA(+) s1m1 was observed more frequently than in adults (34.0% versus 23.1%; P=0.02) contrary to cagA(-)s2m2 which occurred more frequently in adults (27.1% versus 14.0%; P=0.003). No effect of the infection on nausea, regurgitation, vomiting, heartburn, and abdominal pain in children was detected. However, adults infected with H. pylorisuffered from more frequent episodes of heartburn and abdominal pain. The H. pylori strain exhibited a high resistance to metronidazole (higher in adults: 41.7% versus 27.4%; P=0.002), and to clarithromycin (higher in children: 20.2% versus 15.4%; P>0.05), and dual resistance to metronidazole and clarithromycin (higher in children: 9.9% versus 8.4%; P>0.05). Resistance of the H. pylori to amoxicillin and tetracycline was not detected. The conducted study indicated clinical differences in the H. pylori infection in children and adults. Among the differences in children, especially the more frequent infections by the cagA(+)s1m1/m2 strain could have an influence on further consequences of the infection. The obtained results could be useful in therapeutic decisions.
重点介绍
8. 幽门螺杆菌: 必须菌和病原体之间的平衡作用。
虽然在过去的半个世纪内，从人类胃内分离出的幽门螺杆菌使人类对相关胃十二指肠疾病的认识发生了重大变化，但是近十几年的研究结果显示，幽门螺杆菌感染相关疾病往往只发生于40岁以上的人群，但缺乏幽门螺杆菌的定植亦与一些新的疾病的发生相关，尤其在青少年群体中。这些不同的作用结果导致了2个相反的概念，即“好的”和“坏的”幽门螺杆菌。我们需要对幽门螺杆菌重新认识，其有可能是古代人类胃微生物中的正常一员，至少随着环境的变化，它逐渐消失了。
Best Pract Res Clin Gastroenterol. 2014 Dec;28(6):1017-29. doi: 10.1016/j.bpg.2014.09.003. Epub 2014 Sep 28.
Helicobacter pylori: the balance between a role as colonizer and pathogen.
Otero LL1, Ruiz VE2, Perez Perez GI3.
Author information
Abstract
The isolation of Helicobacter pylori from the human stomach produced significant changes in how gastroenterologists, immunologists, epidemiologists, pathologists and microbiologists have approached gastro-duodenal diseases in the last half of the XX century. However, research of this organism has progressed greatly in the first decade of this century, evidence suggest that H. pylori is associated with disease only in humans older than 40 years, while, the lack of H. pylori colonization is associated with the emergence of new diseases, particularly in younger individuals. These differing effects of H. pylori colonization have created two contrasting concepts: the 'bad' and the 'good' Helicobacter. Following from renewed interest in the normal human microbiome, we need to reconsider our definitions and perhaps recognize that H. pylori might be a normal member of the human gastric microbiome in ancient humans that gradually, as results of the improvement in our environment, is disappearing.
Copyright © 2014 Elsevier Ltd. All rights reserved.
KEYWORDS:
Commensal; Gastric microbiome; Helicobacter pylori; Pathogen
9. 幽门螺旋杆菌的vacA ，cagA基因型和胃癌的临床相关性。
幽门螺杆菌感染是胃癌发生的一个重要致病因素，而幽门螺杆菌的毒力是其中一个非常重要的因素，不同基因型的幽门螺杆菌有不同的致病力，幽门螺旋杆菌的vacA ，cagA基因型有助于用于判断患者发生疾病的风险。
Best Pract Res Clin Gastroenterol. 2014 Dec;28(6):1003-15. doi: 10.1016/j.bpg.2014.09.004. Epub 2014 Oct 2.
Clinical relevance of Helicobacter pylori vacA and cagA genotypes in gastric carcinoma.
Ferreira RM1, Machado JC2, Figueiredo C3.
Author information
Abstract
Helicobacter pylori infection is the major etiological factor of gastric carcinoma. This disease is the result of a long, multistep, and multifactorial process, which occurs only in a small proportion of patients infected with H.pylori. Gastric carcinoma development is influenced by host genetic susceptibility factors, environmental factors, and H. pylori virulence. H. pylori is genetically highly variable, and variability that affects H. pylorivirulence factors may be useful to identify strains with different degrees of pathogenicity. This review will focus on VacA and CagA that have polymorphic regions that impact their functional properties. The characterization of H. pylori vacA and cagA-associated could be useful for identifying patients at highest risk of disease, who could be offered H. pylori eradication therapy and who could be included in programs of more intensive surveillance in an attempt to reduce gastric carcinoma incidence.
Copyright © 2014 Elsevier Ltd. All rights reserved.
KEYWORDS:
Gastric carcinoma; Genotypes; Helicobacter pylori; Virulence factors; cagA; vacA
10. 胃肠道微生物——胃和小肠之间的相互作用。
胃肠道(GI)是一个复杂的动态网络系统，这一生态系统具有非常重要的生理作用。共生菌群与宿主在胃肠道内是一个独特的完整的统一体，任何一方的变化都会影响整个的稳态平衡。在胃部幽门螺旋杆菌是一种革兰氏阴性病原菌,在世界各地普遍存在,感染了世界人口的50%以上。幽门螺杆菌感染与胃微环境的变化相关，进而影响胃的微生物群组成,也可能引发大的肠道菌群的变化。
Best Pract Res Clin Gastroenterol. 2014 Dec;28(6):995-1002. doi: 10.1016/j.bpg.2014.10.004. Epub 2014 Oct 16.
The gastrointestinal microbiome - functional interference between stomach and intestine.
Lopetuso LR1, Scaldaferri F2, Franceschi F3, Gasbarrini A4.
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Abstract
The gastrointestinal (GI) tract is a complex and dynamic network with interplay between various gut mucosal cells and their defence molecules, the immune system, food particles, and the resident microbiota. This ecosystem acts as a functional unit organized as a semipermeable multi-layer system that allows the absorption of nutrients and macromolecules required for human metabolic processes and, on the other hand, protects the individual from potentially invasive microorganisms. Commensal microbiota and the host are a unique entity in a continuum along the GI tract, every change in one of these players is able to modify the whole homeostasis. In the stomach, Helicobacter pylori is a gram-negative pathogen that is widespread all over the world, infecting more than 50% of the world's population. In this scenario, H. pylori infection is associated with changes in the gastric microenvironment, which in turn affects the gastric microbiota composition, but also might trigger large intestinal microbiota changes. It is able to influence all the vital pathways of human system and also to influence microbiota composition along the GI tract. This can cause a change in the normal functions exerted by intestinal commensal microorganisms leading to a new gastrointestinal physiological balance. This review focuses and speculates on the possible interactions between gastric microorganisms and intestinal microbiota and on the consequences of this interplay in modulating gut health.
Copyright © 2014 Elsevier Ltd. All rights reserved.
KEYWORDS:
Clostridia; Gastric intestinal interference; Gastric microbiota; Gastric modulation of Gut microbiota; Gut microbiota; Helicobacter pylori
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