Helicobacter pylori patří stále mezi celosvětově nejčastější bakteriální infekce, a to i přes pokles v posledních čtyřech dekádách (v současné době činí cca 40–50 %). Infekce je častější v rozvojových zemích ve srovnání se zeměmi vyspělými. Intenzivní výzkum této chronické infekce objasnil patogenezi řady chorob žaludku i onemocnění extragastrických, včetně karcinomu. Tento článek přináší přehled poznatků o roli Helicobacter pylori u různých maligních chorob žaludku. Chronická infekce Helicobacter pylori je etiologickým faktorem karcinomu žaludku distálně od kardie (non-cardia gastric cancer) a většiny případů žaludečního MALT-lymfomu nízkého stupně. Byla ale popsána inverzní asociace helikobakterové infekce s ostatními žaludečními malignitami, jako jsou karcinom kardie nebo vzácný hereditární syndrom GAPPS (gastric adenocarcinoma and proximal polyposis of the stomach). Dosud nebyla definitivně zodpovězena klíčová otázka, zda časná eradikace infekce Helicobacter pylori je účinnou prevencí vzniku karcinomu žaludku v budoucnosti. S jistou mírou spolehlivosti je možno konstatovat, že cílené vyšetřování a eradikace Helicobacter pylori snižuje incidenci a mortalitu karcinomu žaludku asijské populace. Tato zjištění dosud nelze beze zbytku aplikovat na populaci evropskou nebo americkou. Indikace eradikace Helicobacter pylori musí být zvažována uvážlivě, v souladu s principy personalizované medicíny.
Helicobacter pylori belongs to the most common bacterial infections worldwide; despite its decreasing prevalence during the past four decades (currently ~ 40–50%), it is more prevalent in developing countries compared to developed ones. Intensive research of chronic Helicobacter pylori infection clarified the pathogenesis of several gastric and extragastric diseases, including different cancers. This review pointed out the role of Helicobacter pylori in different gastric malignancies. Chronic Helicobacter pylori infection is an etiological factor in non--cardia gastric cancer and most cases of low-grade MALT lymphoma of the stomach. However, there is an inverse association of Helicobacter pylori infection with other gastric malignancies, like cardia gastric cancer or rare hereditary Gastric Adenocarcinoma and Proximal Polyposis of the Stomach syndrome (GAPPS). A crucial issue has not been definitely solved yet: whether early eradication of Helicobacter pylori could prevent sporadic gastric cancer in the future? There is moderate evidence that searching for and eradicating Helicobacter pylori reduces the incidence of gastric cancer and death from gastric cancer in healthy asymptomatic infected Asian individuals, although data cannot necessarily be extrapolated to European or US populations so far. Indication for the eradication of Helicobacter pylori must now be considered with caution, on an individual basis of personalized medicine.
- MeSH
- Helicobacter pylori * patogenita MeSH
- infekce vyvolané Helicobacter pylori epidemiologie farmakoterapie komplikace MeSH
- lidé MeSH
- lymfom z B-buněk marginální zóny etiologie patologie MeSH
- nádory žaludku * etiologie patologie prevence a kontrola MeSH
- rizikové faktory MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
- přehledy MeSH
Gastric cancer is a leading cause of cancer-related deaths in China. Affecting more than 40% of the world's population, Helicobacter pylori is a major risk factor for gastric cancer. While previous clinical trials indicated that eradication of H. pylori could reduce gastric cancer risk, this remains to be shown using a population-based approach. We conducted a community-based, cluster-randomized, controlled, superiority intervention trial in Linqu County, China, with individuals who tested positive for H. pylori using a 13C-urea breath test randomly assigned to receiving either (1) a 10-day, quadruple anti-H. pylori treatment (comprising 20 mg of omeprazole, 750 mg of tetracycline, 400 mg of metronidazole and 300 mg of bismuth citrate) or (2) symptom alleviation treatment with a single daily dosage of omeprazole and bismuth citrate. H. pylori-negative individuals did not receive any treatment. We examined the incidence of gastric cancer as the primary outcome. A total of 180,284 eligible participants from 980 villages were enrolled over 11.8 years of follow-up, and a total of 1,035 cases of incident gastric cancer were documented. Individuals receiving anti-H. pylori therapy showed a modest reduction in gastric cancer incidence in intention-to-treat analyses (hazard ratio 0.86, 95% confidence interval 0.74-0.99), with a stronger effect observed for those having successful H. pylori eradication (hazard ratio 0.81, 95% confidence interval 0.69-0.96) than for those who failed treatment. Moderate adverse effects were reported in 1,345 participants during the 10-day treatment. We observed no severe intolerable adverse events during either treatment or follow-up. The findings suggest the potential for H. pylori mass screening and eradication as a public health policy for gastric cancer prevention. Chinese Clinical Trial Registry identifier: ChiCTR-TRC-10000979 .
- MeSH
- antibakteriální látky terapeutické užití aplikace a dávkování MeSH
- dospělí MeSH
- Helicobacter pylori * účinky léků MeSH
- infekce vyvolané Helicobacter pylori * farmakoterapie epidemiologie mikrobiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- metronidazol terapeutické užití aplikace a dávkování MeSH
- nádory žaludku * prevence a kontrola epidemiologie mikrobiologie MeSH
- omeprazol * terapeutické užití aplikace a dávkování MeSH
- organokovové sloučeniny terapeutické užití aplikace a dávkování MeSH
- senioři MeSH
- tetracyklin terapeutické užití aplikace a dávkování MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- randomizované kontrolované studie MeSH
- Geografické názvy
- Čína MeSH
BACKGROUND: Helicobacter pylori may be found during upper gastrointestinal endoscopy (UGE) performed to diagnose celiac disease (CeD), inflammatory bowel disease (IBD), and eosinophilic esophagitis (EoE). We aimed to describe the frequency of H. pylori in children undergoing UGE for CeD, IBD, and EoE and the number of children receiving eradication treatment. MATERIALS AND METHODS: A retrospective multicenter study from 14 countries included pediatric patients diagnosed with CeD, IBD, and EoE between January 2019 and December 2021. DATA COLLECTED: age, gender, hematologic parameters, endoscopic, histologic, and H. pylori culture results, and information on eradication treatment. RESULTS: H. pylori was identified in 349/3890 (9%) children [167 (48%) male, median 12 years (interquartile range 8.1-14.6)]. H. pylori was present in 10% (173/1733) CeD, 8.5% (110/1292) IBD and 7.6% (66/865) EoE patients (p = NS). The prevalence differed significantly between Europe (Eastern 5.2% (28/536), Southern 3.8% (78/2032), Western 5.6% (28/513)) and the Middle East 26.6% (215/809) [odds ratio (OR) 7.96 95% confidence interval (CI) (6.31-10.1) p < 0.0001]. Eradication treatment was prescribed in 131/349 (37.5%) patients, 34.6% CeD, 35.8% IBD, and 56.1% EoE. Predictors for recommending treatment included erosions/ulcers [OR 6.45 95% CI 3.62-11.47, p < 0.0001] and nodular gastritis [OR 2.25 95% CI 1.33-3.81, p 0.003]. Treatment rates were higher in centers with a low H. pylori prevalence (<20%) [OR 3.36 95% CI 1.47-7.66 p 0.004]. CONCLUSIONS: Identifying H. pylori incidentally during UGE performed for the most common gastrointestinal diseases varies significantly among regions but not among diseases. The indications for recommending treatment are not well defined, and less than 40% of children received treatment.
- MeSH
- celiakie * diagnóza epidemiologie MeSH
- dítě MeSH
- eozinofilní ezofagitida * epidemiologie diagnóza MeSH
- gastrointestinální endoskopie MeSH
- Helicobacter pylori * izolace a purifikace MeSH
- idiopatické střevní záněty * epidemiologie diagnóza mikrobiologie MeSH
- infekce vyvolané Helicobacter pylori * diagnóza epidemiologie farmakoterapie MeSH
- lidé MeSH
- mladiství MeSH
- předškolní dítě MeSH
- prevalence MeSH
- retrospektivní studie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- Geografické názvy
- Evropa MeSH
The prevalence of Helicobacter pylori remains high in the older population. Specific age-related peculiarities may impact the outcomes of H. pylori treatment. The aim of the study was to evaluate the diagnostics and effectiveness of H. pylori eradication between the younger and older European populations. "European Registry on H. pylori Management (Hp-EuReg)" data from 2013 to 2022 were analyzed. Patients were divided into older (≥ 60 years) and younger (18-59 years) groups. Modified intention-to-treat (mITT) and per-protocol (PP) analysis was performed. 49,461 patients included of which 14,467 (29%) were older-aged. Concomitant medications and penicillin allergy were more frequent among the older patients. Differences between younger and older populations were observed in treatment duration in first-line treatment and in proton pump inhibitors (PPIs) doses in second-line treatment. The overall incidence of adverse events was lower in the older adults group. The overall first-line treatment mITT effectiveness was 88% in younger and 90% in the older patients (p < 0.05). The overall second-line mITT treatment effectiveness was 84% in both groups. The effectiveness of the most frequent first- and second-line triple therapies was suboptimal (< 90%) in both groups. Optimal efficacy (≥ 90%) was achieved by using bismuth and non-bismuth-based quadruple therapies. In conclusion, the approach to the diagnostics and treatment of H. pylori infection did not generally differ between younger and older patients. Main differences were reported in the concurrent medications, allergy to penicillin and adverse events both in first- and second-line treatment. Optimal effectiveness rates were mostly achieved by using bismuth and non-bismuth-based quadruple therapies. No clinically relevant differences in the effectiveness between the age groups were observed.
- MeSH
- alergie * farmakoterapie MeSH
- antibakteriální látky škodlivé účinky MeSH
- bismut terapeutické užití MeSH
- Helicobacter pylori * MeSH
- infekce vyvolané Helicobacter pylori * farmakoterapie epidemiologie MeSH
- inhibitory protonové pumpy škodlivé účinky MeSH
- kombinovaná farmakoterapie MeSH
- lidé MeSH
- peniciliny terapeutické užití MeSH
- senioři MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Introduction: Helicobacter pylori (H. pylori) infection is common in developing countries such as Benin. This germ may cause the development of gastroduodenal diseases, ranging from gastritis to gastric cancer. Several studies on this bacterium carried out in Benin have used serology, anatomopathological examination of biopsies or antigen detection test on stool sample collections. The purpose of this study was to assess the prevalence of H. pylori infection and factors associated with H. pylori infection using a respiratory test. The bacterium could cause chronic inflammation of the gastric mucosa and peptic ulcer disease or, more rarely, gastric cancer or lymphoma. Methods: we conducted a prospective, descriptive study of 150 patients who performed carbon-14 urea breath test. Only patients admitted for respiratory test and who gave their consent were included. A survey was completed by all patients during the study. Simple univariate logistic regression analysis identified factors associated with H. pylori infection at a threshold of 0.05. Multivariate analysis included in the model all variables with a p-value less than 0.20. Manual top-down procedure was used until the final model was obtained, which allowed the retention of adjusted odds ratios for factors associated. Results: the average age of patients was 44.4±15.8 years, ranging from 5 to 84 years; men accounted for 54% of the study population. Of the 150 subjects, 82 (57.8%) had higher education level, compared with 8 (5.6%) who were not educated, 116 (80.6%) lived with a partner, 24 (36%) lived in a room with more than 10 people and 84 (59.6%) were christians. The main reasons why respiratory tests were performed were: poorly systematized abdominal pain (53.3%; 70/150), epigastric induced pain (35.3%; 53/150), epigastralgia (20.7%; 31/150), ulcer syndrome (16%; 24/150). Respiratory test showed that the prevalence of H. pylori in the study population was 34.7% (52/150). In multivariate analysis, the variables significantly associated with H. pylori infection were: mean age [aOR (95% CI) = 1.02; OR (95% CI) = 1.00-1.05 and p = 0.01] and prior treatment for H. pylori eradication [aOR (95% CI) = 4.79; OR (95% CI) = 1.50-13.86 and p = 0.006]. No comorbidity was associated with H. pylori infection in our series. Conclusion: the prevalence of H. pylori using this method was low (34.7%). It was significantly associated with mean age and prior treatment for H. pylori eradication.
- MeSH
- dechové testy MeSH
- dospělí MeSH
- Helicobacter pylori * MeSH
- infekce vyvolané Helicobacter pylori * komplikace diagnóza epidemiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- močovina analýza MeSH
- prevalence MeSH
- prospektivní studie MeSH
- radioizotopy uhlíku MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
OBJECTIVE: Oropharyngeal/laryngeal carcinoma are common cancers of the upper aerodigestive system. Human papillomavirus (HPV) is described as the most frequent in the cancer of unknown primary. The presence of Helicobacter pylori (HP) in the oral cavity is discussed in some papers. THE AIM OF STUDY: To analyze the incidence of HPV and HP in oropharyngeal/laryngeal cancer persons versus persons with chronic tonsillar inflammation and healthy persons. METHODS: The samples were taken in three groups: (1) tissue of oropharynx/larynx cancer (103 specimens); (2) tissue of palatine tonsils (85 specimens); and (3) healthy control group (50 specimens). We analyzed the presence of HP (PCR) and HPV genomic DNA (Sacace HPV High-Risk Screen Real-TM Quant) in the samples. RESULTS: HP was detected in 86 samples (83.5%) and high-risk HPV in 62 samples (60.2%). We found a very high incidence of HP. In the cancer group, HP was detected in 82.5% cases and HPV positivity in 57.8%. In total, 7.2% of the cancer patients were negative for HP and HPV together. In turn, 53.6% of the cancer patients were positive for HP and HPV together. Four cases (4.2%) were positive for HPV only. VacA positivity was detected in 82 (79.6%) of the cancer cases and VacA negativity in 21 (20.4%) if the cancer cases. The incidence of HP in chronic inflammation (n = 85) was 65 cases (76.5%) and the incidence of HPV was 38 cases (44.7%). VacA positivity was detected in 59 (69.4%) of the chronic inflammation cases and VacA negativity was found in 26 (30.6%) of the chronic inflammation cases. Regarding the control group, we found HP positivity in 5 cases (11.1%) and HPV positivity in 19 cases (42.2%). There was VacA positivity in 6 cases (50.0%) of the control group. Statistically significantly lower prevalence of HP (p < 0.001) and HPV (p = 0.006) was found in the control group. CONCLUSIONS: We suggest that the palatine tonsils are colonized by HP. In our study, HP was present in oropharyngeal cancer in more cases in comparison with HPV infection. The presence of VacA from HP can have an influence on the human epithelial and immune cells' regulation ways. Our results do not support idea that the CagA-positive HP is a primary carcinogen in oropharyngeal area.
- MeSH
- Alphapapillomavirus * MeSH
- Helicobacter pylori * genetika MeSH
- infekce papilomavirem * epidemiologie MeSH
- infekce vyvolané Helicobacter pylori * epidemiologie MeSH
- lidé MeSH
- nádory hrtanu * MeSH
- orofarynx MeSH
- Papillomaviridae genetika MeSH
- séroskupina MeSH
- zánět MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
BACKGROUND: Antimicrobial resistance of Helicobacter pylori can result in eradication failure. Metadata on the antimicrobial resistance of H pylori in Iran could help to formulate H pylori eradication strategies in Iran. METHODS: A systematic review was performed after searching in MEDLINE, Scopus, Embase, Web of Science, and the Cochrane Library. A meta-analysis was performed, and a comparison of the rates between children and adults; time periods (1999-2010, 2011-2016, 2017-2019); and the methods used was carried out. RESULTS: A total of 66 studies investigating 5936 H pylori isolates were analyzed. The weighted pooled resistance (WPR) rates were as follows: clarithromycin 21% (95% CI 16-26), metronidazole 62% (95% 57-67), clarithromycin in combination with metronidazole 16% (95% CI 10-23), ciprofloxacin 24% (95% CI 15-33), levofloxacin 18% (95% CI 9-30), erythromycin 29% (95% CI 12-50), furazolidone 13% (95% CI 4-27), tetracycline 8% (95% CI 5-13), and amoxicillin 15% (95% CI 9-22). During the three time periods, there was an increased resistance to amoxicillin, clarithromycin, ciprofloxacin, furazolidone, and tetracycline (P ˂ .05). Furazolidone and a clarithromycin/metronidazole combination had the higher resistance rates in children (P ˂ .05). CONCLUSION: An increasing rate of resistance to amoxicillin, clarithromycin, ciprofloxacin, furazolidone, and tetracycline in Iranian H pylori isolates was identified. In children, the resistance to furazolidone and a combination of clarithromycin and metronidazole is higher compared to adults. As a stable, high resistance to metronidazole was found in children and adults in all Iranian provinces, we suggest that metronidazole should not be included in the Iranian H pylori eradication scheme.
- MeSH
- antibakteriální látky terapeutické užití MeSH
- bakteriální léková rezistence účinky léků MeSH
- Helicobacter pylori účinky léků MeSH
- infekce vyvolané Helicobacter pylori * farmakoterapie epidemiologie MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- metaanalýza MeSH
- systematický přehled MeSH
- Geografické názvy
- Írán MeSH
OBJECTIVE: The epidemiology of uninvestigated dyspepsia was studied in the Czech Republic for the first time in 2001. The aim of the current multicenter prospective study was to evaluate dyspepsia using the same methods in a representative sample of general unselected population from the same geographical areas 10 years later. PARTICIPANTS AND METHODS: A total of 38 147 individuals comprised the general population for a random two-step selection process. A total of 1836 participants (863 males and 973 females; aged 5-98 years) took part in the questionnaire-based study. Helicobacter pylori status was investigated in all participants by means of C-urea breath test. RESULTS: The overall prevalence of dyspepsia was 2.6% among children and adolescents aged 5-17 years and 16.0% among adults aged 18-98 years. We did not detect any statistically significant sex differences in the prevalence of total dyspepsia or its subtypes. Overall, 2.4% of H. pylori-negative children and adolescents aged less than 18 years reported dyspepsia, and 16.8% of H. pylori-negative adults reported it. Among H. pylori-positive children and adolescents and adults, dyspepsia was present in 8.3 and 15.8%, respectively. Type A dyspepsia (as the only long-lasting symptom) was statistically significantly associated with H. pylori status among children and adolescents. Among adults aged 18 years or older, we noted a lower prevalence of dyspepsia in adults with elementary education compared with university education. Current use of antibiotics was associated with an increased prevalence of dyspepsia in adults. CONCLUSION: Despite the substantial decrease of H. pylori infection in the Czech Republic over the past 10 years, the prevalence and sociodemographic determinants of uninvestigated dyspepsia did not change significantly.
- MeSH
- antibakteriální látky terapeutické užití MeSH
- časové faktory MeSH
- charakteristiky bydlení MeSH
- dítě MeSH
- dospělí MeSH
- dyspepsie diagnóza epidemiologie mikrobiologie MeSH
- Helicobacter pylori izolace a purifikace MeSH
- infekce vyvolané Helicobacter pylori diagnóza epidemiologie mikrobiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- předškolní dítě MeSH
- prevalence MeSH
- prognóza MeSH
- prospektivní studie MeSH
- rizikové faktory MeSH
- rozložení podle pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- sexuální faktory MeSH
- socioekonomické faktory * MeSH
- stupeň vzdělání MeSH
- věkové faktory MeSH
- věkové rozložení MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- Geografické názvy
- Česká republika epidemiologie MeSH
- MeSH
- dechové testy metody MeSH
- faktory virulence MeSH
- Helicobacter pylori izolace a purifikace patogenita MeSH
- infekce vyvolané Helicobacter pylori * epidemiologie komplikace patofyziologie MeSH
- lidé MeSH
- nádory žaludku etiologie imunologie MeSH
- peptický vřed mikrobiologie MeSH
- prevalence MeSH
- Check Tag
- lidé MeSH
- MeSH
- biopsie MeSH
- chromatografie afinitní MeSH
- feces chemie MeSH
- gastrointestinální endoskopie MeSH
- Helicobacter pylori * patogenita MeSH
- infekce vyvolané Helicobacter pylori * diagnóza epidemiologie farmakoterapie MeSH
- lidé MeSH
- polymerázová řetězová reakce MeSH
- prevalence MeSH
- sérologické testy MeSH
- směrnice pro lékařskou praxi jako téma MeSH
- Check Tag
- lidé MeSH