OBJECTIVETo investigate the changes in serum pepsinogen (PG) I/II ratio induced by Helicobacter pylori (Hp) infection and assess the value of PG I/II test in evaluating organ damages in hypertensive patients.

METHODSThe serum total cholesterol, triglycerides, high density lipoprotein (HDL) and PG I/II ratio were tested in 288 hypertensive patients with or without Hp infection. The PG I/II ratio between the patients with different grade of hypertension, patients with and without hypertensive nephropathy, patients with and without hypertensive retinopathy. The relationship of PG I/II ratio with serum total cholesterol, triglycerides and HDL was analyzed with Pearson's correlation analysis and the effectiveness of PG I/II ratio in the the diagnosis of nephropathy and retinopathy was evaluated by receiver-operating characteristic curve (ROC) analysis.

RESULTSCompared with patients without Hp infection, the Hp-infected patients showed significantly decreased PG I/II ratio and increased total cholesterol and triglycerides (P<0.05), but their HDL levels, systolic pressure and diastolic pressure were comparable (P>0.05). PG I/II ratio was significantly decreased in patients with nephropathy and retinopathy compared with the patients without nephropathy and retinopathy (P<0.05), and was similar between patients with different grades of hypertension (P>0.05). PG I/II ratio was negatively correlated with serum total cholesterol and triglycerides in the hypertensive patients (P<0.05), and its area under curve (AUC) of ROC was 0.79 and 0.82 in the diagnosis of nephropathy and retinopathy, respectively.

CONCLUSIONSHypertensive patients with nephropathy and retinopathy have obviously decreased PG I/II ratio, which can be used for screening organ damages in hypertensive patients.

Helicobacter Infections ; blood ; Helicobacter pylori ; Humans ; Hypertension ; blood ; microbiology ; Pepsinogen A ; blood ; Pepsinogen C ; blood

The purpose of this study was to investigate whether the densities of antral gastrin and somatostatin-immunoreactive cells in Helicobacter pylori (H. pylori) infection were related to the bacterial expression of cytotoxin-associated gene A (CagA). 32 patients who had underwent diagnostic esophagogastroduodenoscopy were studied. On the histologic examination all patients had antral gastritis. We divided the subjects into three groups. Group I consisted of 6 patients who had chronic superficial gastritis, group II, 9 patients who had H. pylori-associated gastritis but with no expression of CagA, and group III, 17 patients who had H. pylori-associated gastritis with the expression of CagA. In group I and II, serum gastrin levels, and antral G cell and D-cell were measured. In group III, serum gastrin levels, and antral G cell and D-cell were measured, before and after the eradication of H. pylori. The results were as follows. Firstly, serum gastrin concentrations were significantly higher in the patients with H. pylori infection than in the negative controls. Nextly, there was no correlation between the changes in antral G or D-cell density and H. pylori infection. Thirdly, group III had a significant increase in serum gastrin concentrations and a significant decrease in antral D-cell density than group I. Forthly, eradication of H. pylori in group III showed a significantly increased antral D-cell density. Our results suggest that hypergastrinemia in H. pylori-associated gastritis is relevant to the presence of CagA, and the possible mechanism of hypergastrinemia may be related to antral D-cell deficiency, which is caused by H. pylori infection with the expression of CagA.
Adult ; Bacterial Proteins/genetics* ; Cell Count ; Female ; Gastrins/blood* ; Helicobacter Infections/genetics* ; Helicobacter Infections/blood* ; Helicobacter pylori* ; Human ; Male ; Middle Age ; Osmolar Concentration ; Pyloric Antrum/pathology*

ObjectiveGastroscopy combined with gastric mucosa biopsies is currently regarded as a gold standard for diagnosis of gastric cancer. However, its application is restricted in clinical practice due to its invasive property. A new noninvasive population screening process combining the assay of anti-Helicobacter pylori antibody and serum pepsinogen (PG) (ABC method) is adopted to recognize the high-risk patients for further endoscopy examination, avoiding the unnecessary gastroscopy for most population and saving the cost consumption for mass screening annually. Nevertheless, controversies exist for the grouping of ABC method and the intervals of gastroscopy surveillance for each group. In this review, we summarized these popular concerned topics for providing useful references to the healthcare practitioner in clinical practice.

Data SourcesThe PubMed databases were systematically searched from the inception dates to November 22, 2017, using the keywords "Helicobacter pylori," "Pepsinogens," and "Stomach Neoplasms."

Study SelectionOriginal articles and reviews on the topics were selected.

ResultsAnti-H. pylori antibody and serum PG concentration showed significant changes under the different status of H. pylori infection and the progression of atrophic gastritis, which can be used for risk stratification of gastric cancer in clinic. In addition, anti-H. pylori antibody titer can be used for further risk stratification of gastric cancer contributing to determine better endoscopy surveillance interval.

ConclusionsThe early detection and diagnosis of gastric cancer benefit from the risk stratification, but the cutoff values for H. pylori antibody and serum PG concentration require further modification.

Antibodies, Bacterial ; blood ; immunology ; Gastroscopy ; Helicobacter Infections ; blood ; immunology ; Helicobacter pylori ; immunology ; Humans ; Mass Screening ; methods ; Stomach Neoplasms ; blood ; microbiology

Serum gastrin and pepsinogen concentrations were measured in 51 children infected with Helicobacter pylori, to investigate the clinical significance and influence of CagA and VacA on serum concentrations of these peptides. CagA+ was 44/51 (86%) and VacA+ was 42/51 (82%). Type I (CagA+/VacA+) included 39/51 (76%), type II (CagA-/VacA-) was 4/51 (8%), and intermediate (CagA-/VacA+, CagA+/VacA-) was 8/51 (16%). There was no significant correlation between endoscopic diagnosis and the state of CagA/VacA. Serum gastrin concentrations were not significantly correlated with the state of CagA/VacA. Serum pepsinogen I and II concentrations were significantly higher in CagA+ than in CagA-, but there was no significant difference between VacA+ and VacA-, Serum pepsinogen I/II ratio was not significantly correlated with the state of CagA/VacA. There was no significant difference between serum concentrations of gastrin, pepsinogen I and H. pylori phenotypes. However, pepsinogen II concentration was significantly higher in type I than type II. Pepsinogen I/II ratio was significantly lower in type I and intermediate than in type II. These findings suggest that CagA positively and phenotype of H. pylori could play a role in the development of upper gastrointestinal diseases in children.
Adolescence ; Bacterial Proteins/physiology* ; Bacterial Proteins/blood ; Child ; Child, Preschool ; Female ; Gastrins/blood* ; Gastrointestinal Diseases/blood ; Helicobacter Infections/physiopathology ; Helicobacter Infections/blood* ; Helicobacter pylori*/genetics ; Human ; Male ; Osmolar Concentration ; Pepsinogens/blood* ; Phenotype

BACKGROUND/AIMS: Although several studies have claimed that Helicobacter pylori (H. pylori) infection is related to cardiovascular disease, it is still uncertain whether it is related to the acute process or the chronic inflammatory atherosclerotic changes. The aim of our study was to confirm the impact of active H. pylori infection on coronary heart disease, acute inflammatory factors, and the coagulation factors. METHODS: A total of 94 patients completed questionnaires about occupation, smoking, past medical history, and socio-economic status. The serum of the subjects was drawn for a low density lipoprotein test, white blood cell count, C reactive protein, fibrinogen, homocysteine, prothrombin time, activated partial thrombin time, plasminogen activator inhibitor type-1, and tissue-type plasminogen test. All of the subjects underwent a coronary angiography and an upper gastrointestinal endoscopy for the diagnosis of coronary heart disease and H. pylori infection, respectively. RESULTS: There was no significant difference in acute inflammatory factors, coagulation factors, atheromatous burden score, and Jeopardy score between the H. pylori-infected group and non-infected group. Odds ratio of H. pylori infection on coronary heart disease was 2.59 (95% CI, 0.80-6.17), but it diminished below 1.0 (95% CI, 0.14-1.36) after adjusting for conventional risk factors such as age, gender, diabetes, hypertension, smoking, body mass index and socio-economic status. CONCLUSIONS: H. pylori infection is not an independent risk factor for coronary heart disease, and it does not alter the coagulation system or evoke the systemic inflammatory response.
Aged ; Coronary Disease/blood/*microbiology ; Female ; Helicobacter Infections/*complications ; *Helicobacter pylori ; Humans ; Male ; Middle Aged ; Risk Factors

The possible association between Helicobacter pylori (H. pylori) infection and chronic idiopathic neutropenia (CIN) was investigated. A total of 78 subjects with CIN were recruited in this case-control study. As a control group, 40 subjects without CIN were selected for comparison with the case group. All participants were evaluated for the prevalence of H. pylori infection by 14C-urea breath test. The corrected splenic index (CSI) was calculated, and serum IL-6, IL-8, IL-10 and HsCRP levels were measured. The differences in CSI, serum IL-6, IL-8, IL-10 and HsCRP levels were compared between CIN patients and controls, as well as between subjects with and without H. pylori infection. The positive rate of H. pylori was 87.18% in CIN group and 52.50% in control group, showing a significant difference (Fisher's exact, P=0.000). CSI values, and serum IL-6 and HsCRP levels in H. pylori positive-CIN patients were significantly higher than those in negative subjects (Mann-whitney U-test, P=0.016, P=0.001 and P=0.000 respectively), while IL-10 level declined significantly in H. pylori negative-CIN patients (Mann-whitney U-test, P=0.000). In control group, serum IL-6 and HsCRP levels in H. pylori positive individuals were also increased significantly (Mann-whitney U-test, P=0.000), while IL-10 level declined (Mann-whitney U-test, P=0.018). Multivariate regression analysis revealed that H. pylori infection and IL-10 were significant risk factors for CIN with odds ratio (OR): 3.09, 95.0% CI: 1.22-6.93; P=0.019, and OR: 0.17, 95.0% CI: 0.05-0.94; P=0.021, respectively. This prospective study confirmed the existence of an association between H. pylori infection and CIN, suggesting the screening for H. pylori infection and eradicating bacterium in positive cases seem appropriate and beneficial for those patients with CIN diagnosis.
Adult ; China ; Cytokines ; blood ; Female ; Helicobacter Infections ; diagnosis ; immunology ; Helicobacter pylori ; Humans ; Male ; Neutropenia ; diagnosis ; immunology ; Prevalence ; Risk Assessment

OBJECTIVETo assess the prevalence rate of Helicobacter pylori (H. pylori) in blood serum, its affecting factors and isoforms (CagA,VacA )infection in the elderly people in Beijing.

METHODS2006 residents were investigated through household questionnaire in different areas of Beijing (urban, suburban and mountainous district), who were older than 60 years old. Serum H. pylori CagA, VacA and Ureas antibody was detected by immunoblotting.

RESULTSThe total H. pylori infection rate was 83.4% and the infectious rate of I form pathogenic H. pylori was 56.0%. The incidence rate in urban or suburban district was higher than that of in mountainous district (P < 0.001). I form H. pylori infection rate in people with heavy labor or young elderly were higher than that of intelegent work or older elderly (P < 0.05 ). I form H. pylori infection rate in people of low diet was higher than that of high protein diet (P < 0.001).

CONCLUSIONThe rate of H. pylori infection in blood serum was high among the elderly people in Beijing with most of it belonged to type I . However, significant differences were noticed on the distribution of isoforms in different age groups, areas, professions and diet habit.

Age Distribution ; Aged ; China ; epidemiology ; Diet ; Female ; Helicobacter Infections ; blood ; epidemiology ; Helicobacter pylori ; classification ; physiology ; Humans ; Male ; Occupations ; Seroepidemiologic Studies

OBJECTIVETo explore the characteristics of Helicobacter pylori (H. pylori) antigen in serum and to evaluate its clinical diagnostic value.

METHODSEnzyme-linked immunosorbant assay (ELISA) was developed to detect the soluble H. pylori antigen (S-Hp) and circulatory specific H. pylori antigen immunocomplexes (Hp-IC) in serum.

RESULTSThe positive rate of S-Hp was 90.91% from 66 patients with H. pylori infection, which was much greater than 0% found in 28 controls (P < 0.001). Moreover, its concentration closely reflected the number of H. pylori in the gastric mucosa layer. We also found that Hp-IC existed bound with IgG and/or IgA in patients with positive S-Hp. However, there is no evidence to show the concentration of S-Hp reduced significantly in followed-up subjects after effective therapy.

CONCLUSIONSThese methods as newly and noninvasive complementary tools can be used for clinical diagnosis of H. pylori infection. In addition, S-Hp and Hp-IC may be of importance in H. pylori pathogenesis.

Adult ; Antibody Specificity ; Antigen-Antibody Complex ; blood ; Antigens, Bacterial ; blood ; Female ; Helicobacter Infections ; immunology ; Helicobacter pylori ; immunology ; Humans ; Immunoglobulin A ; blood ; Immunoglobulin G ; blood ; Male

OBJECTIVETo explore the relationship between Helicobacter pylori (Hp) infection and iron status using serum ferritin (SF) as a marker for total iron and to identify the related factors of iron nutritional status among preschool children.

METHODSBy cluster sampling, we recruited 475 preschool children aged 2 to 7 years. A structured questionnaire and diet form were sent to the parents of these children to obtain related information about the socioeconomic level and dietary intakes. After collecting blood samples, the following indexes were measured. Hp IgG antibodies were measured with a dot enzyme-linked immunoassay; hemoglobin, Hct, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), red blood cell distribution width index (RDW) with automatic Complete Blood Count; SF with an immunoradiometric assay. Stool Hp antigen and occult bleeding were measured with ELISA among individuals who were Hp seropositive. Hp status was defined as positive when both serum and stool antigen tests were positive, Hp status was defined as negative when serum antigen test was negative; 24-hour weighting and recording methods were used to dietary survey for three days in May and December 2001, respectively, dietary intakes including energy, protein and micronutrient were calculated using nursery school nutrition software and evaluated by Chinese Dietary Reference Intakes (DRIs). Mann-Whitney test was used to compare mean ranks of SF in Hp-positive and Hp-negative children. To obtain an adjusted estimate of the impact of Hp infection on SF, a multivariate analysis of covariance was done to evaluate the different level of SF between Hp infected and non-infected status. The relationship between iron deficiency and gender, age, socioeconomic condition, iron intake, and calcium intake was assessed by univariate analysis. An unconditional multivariate logistic regression analysis was also performed. Iron deficiency status was dichotomized and placed as the dependent variable. Hp infection status was incorporated together with possible confounding factors as independent variables in a final logistic regression model. All the data were managed by EPI Info 5.01a and analyzed by SAS (Version 6.12).

RESULTSTotally 64 children were diagnosed as Hp-positive and 305 as Hp-negative. Mann-Whitney test and multivariate analysis of covariance both showed that SF concentration was significantly lower in Hp infected individuals than non-infected individuals. Adjusted mean level and 95% confidence interval of SF in infected and non-infected children was 23.62 microg/L (7.13 microg/L-78.26 microg/L), 33.48 microg/L (10.28 microg/L-109.06 microg/L), respectively. The relationship between Hp infection and iron deficiency status persisted in logistic regression analysis after adjusting for possible confounding factors (OR: 7.95; 95% CI 2.56 - 24.67).

CONCLUSIONIron nutritional status was reduced in Hp infected preschool children. Hp infection appears to be an independent risk factor or an added stressor on iron status among preschool children.

Antibodies, Viral ; blood ; Child ; Child, Preschool ; Erythrocyte Indices ; Female ; Ferritins ; blood ; Helicobacter Infections ; blood ; Helicobacter pylori ; immunology ; Hemoglobins ; analysis ; Humans ; Logistic Models ; Male ; Multivariate Analysis ; Nutrition Assessment

PURPOSE: The association between Helicobacter pylori (H. pylori) and blood ammonia levels in cirrhotic patients is controversial. We aimed to clarify this controvercy by performing a meta-analysis of published studies. MATERIALS AND METHODS: We searched PubMed, EMBASE and Cochrane library for studies which explored the association between H. pylori and blood ammonia levels in cirrhotic patients before May 2012. Six cohort studies involved in 632 H. pylori positive and 396 H. pylori negative cirrhotic patients were eligible for our analysis. The summary estimates were presented as standard means differences (SMD) and 95% confidence intervals (CI) from individual studies. RESULTS: Overall, there was significant association between H. pylori infection and the elevated blood ammonia levels in cirrhotic patients (SMD=0.34, 95% CI=0.21-0.47, I2=42.1%). Sensitivity analysis further confirmed this association. Subgroup analysis showed that the association was found only in Asian ethnicity, but not in Caucasian ethnicity. CONCLUSION: H. pylori infection is associated with elevated blood ammonia levels in cirrhotic patients, and more large scale studies and stratify analysis are warranted in order to further evaluate this association.
Ammonia/blood ; Asian Continental Ancestry Group ; European Continental Ancestry Group ; Helicobacter Infections/*blood ; Helicobacter pylori/pathogenicity ; Humans ; Liver Cirrhosis/*blood/*microbiology ; Publication Bias ; Regression Analysis