OBJECTIVETo evaluate the accuracy of the Helicobacter pylori (H. pylori) stool antigen (HpSA) test and ImmunoCard STAT HpSA in the primary diagnosis of H. pylori infection.

METHODSWe searched Medline (1966-2007.4), EMbase (1985-2007.4), Chinese Journals Full-text Database (CJFD) (1994-2007) etc. to identify Clinical Trials of ImmunoCard STAT HpSA for the primary diagnosis of H. pylori infection. Meta-analysis was conducted using the method recommended by The Cochrane Collaboration Center.

RESULTSEleven trials were included with pooled sensitivity, pooled specificity as 0.93 (95% CI: 0.91-0.94), 0.93 (95% CI: 0.90- 0.95), respectively. Pooled positive likelihood ratio and pooled negative likelihood ratio were 12.01 (95% CI: 8.90-16.19), 0.08 (95% CI: 0.07-0.11), respectively with the pooled diagnostic odds ratio as 160.14(95% CI :100.43-255.34). The area under the summary receiver operating characteristic (SROC) was 0.974 +/- 0.005.

CONCLUSIONImmunoCard STAT HpSA appeared to be an accurate non-invasive method for the initial diagnosis of H. pylori infection.

Antigens, Bacterial ; immunology ; Feces ; microbiology ; Helicobacter Infections ; diagnosis ; immunology ; Helicobacter pylori ; immunology ; isolation & purification ; pathogenicity ; Reagent Kits, Diagnostic ; Sensitivity and Specificity

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

Gastric cancer is the second most common cause of cancer-related death in the world. A growing body of evidence indicates that inflammation is closely associated with the initiation, progression, and metastasis of many tumors, including those of gastric cancer. In addition, approximately 60% of the world's population is colonized by Helicobacter pylori, which accounts for more than 50% of gastric cancers. While the role of inflammation in intestinal and colonic cancers is relatively well defined, its role in stomach neoplasia is still unclear because of the limited access of pathogens to the acidic environment and the technical difficulties isolating and characterizing immune cells in the stomach, especially in animal models. In this review, we will provide recent updates addressing how inflammation is involved in gastric malignancies, and what immune characteristics regulate the pathogenesis of stomach cancer. Also, we will discuss potential therapeutics that target the immune system for the efficient treatment of gastric cancer.
Adaptive Immunity/*immunology ; B-Lymphocytes/immunology ; Cytokines/immunology ; Gastritis/immunology ; Helicobacter Infections/immunology ; Helicobacter pylori/immunology ; Humans ; Immunity, Innate/*immunology ; Immunotherapy/methods ; Receptors, Cytokine/immunology ; Stomach Neoplasms/diagnosis/*immunology/therapy ; T-Lymphocytes/immunology ; Tumor Microenvironment/*immunology

A serologic test for antibodies is useful for diagnosis of Helicobacter pylori(H.pylori) infection in children. We evaluated the reliability of H.pylori IgG antibody titer in grading the severity of infection in children. We surveyed the sero-prevalence of H.pylori infection in 300 healthy school children (13 to 15 years old). Thirty-four percent(102 of 300 children) were sero-positive for H.pylori. Of the 102 sero-positive children, 70 underwent gastroscopic examination. Ninety percent of sero-positive children(63 of 70 children) were proven to be H.pylori infected. All children with H.pylori infection had histologically proven gastritis, and its severity did not correlate with the IgG antibody titer. Although a serologic test is useful to identify H.pylori infection in children, it can not predict the severity of H.pylori associated gastritis.
Adolescent ; Antibodies, Bacterial/*blood ; Gastritis/diagnosis/immunology/*microbiology ; Helicobacter Infections/diagnosis/*immunology ; Helicobacter pylori/*immunology ; Human ; Immunoglobulin G/*blood ; Support, Non-U.S. Gov't

OBJECTIVETo study the value of multiple Helicobacter pylori (H.pylori) antibody detection by protein array in the diagnosis of H.pylori infection in children.

METHODSBiopsy specimens obtained by gastroscopy from 120 children with digestive system symptoms were detected by rapid urease test (RUT) and modified Giemsa staining. Positivity in both RUT and Giemsa staining was the "gold criterion" of H.pylori infection. Serum samples of these patients were obtained and the antibodies against cytotoxin associated gene A protein (CagA), vacuolating toxin A (VacA), urease, heat shock protein 60 (Hsp60) and RdxA (nitroreductase) were detected by protein array technique.

RESULTSH.pylori infection was identified according to the "gold criterion" in 60 children. Compared with the "gold criterion", the goodness of fit and the coefficient of contingency in the diagnosis of H.pylori infection of the following four groups antibody detection were all statistically significant (P<0.001): anti-Ure antibody alone, anti-Ure antibody combined with anti-CagA antibody, anti-Ure antibody combined with anti-VacA antibody and anti-Ure antibody combined with anti-CagA and anti-VacA antibody. The sensitivity, specificity and accuracy of the detection of anti-Ure antibody combined with anti-CagA antibody for the diagnosis of H.pylori infection were 81.7%, 91.7% and 86.7%, respectively. The antibody detection showed a high positive predictive value (90.7%) and a high negative predictive value (83.3%).

CONCLUSIONSThe antibody detection by protein array, especially the detection of anti-Ure antibody combined with anti-CagA antibody, is valuable in the diagnosis of H.pylori infection.

Adolescent ; Antibodies, Bacterial ; blood ; Child ; Child, Preschool ; Female ; Helicobacter Infections ; diagnosis ; Helicobacter pylori ; immunology ; Humans ; Male ; Protein Array Analysis ; methods ; Sensitivity and Specificity

OBJECTIVETo study the correlation between the Th1/Th2 balance in the peripheral blood and Pi-Wei damp-heat syndrome (PDS) in chronic gastritis (CG).

METHODSFifty-one patients with CG of PDS were recruited, including 22 cases with predominant damp (PDS-D), 9 case with predominant heat (PDS-H), and 20 case with simultaneous onset of damp and Heat (PDS-DH). Besides, 10 healthy volunteers were recruited as the healthy control group. H. pylori (HP) infection was detected by fast urea enzyme, and the expressions of Th1 type cytokines interferon-gamma (IFN-gamma), interleukin-12 (IL-12), and Th2 type cytokines interleukin-4 (IL-4), interleukin-10 (IL-10) in serum were detected by luminex technology.

RESULTSThe HP infection rate was 41.18% (21/51) in the PDS patients, obviously higher than that in the healthy control group (10.00%,1/10), showing statistical difference (P<0.05). The HP infection rate was 45.45% (10/22) in PDS-D, 22.22% (2/9) in PDS-H, and 45.00% (9/20) in PDS-DH. The HP infection rate in PDS-D and PDS-DH was significantly higher than that of the healthy control group, showing statistical difference (P<0.05). There was no statistically significant difference in the expressions of peripheral blood IFN-gamma, IL-12, IL-4, and IL-10 between the PDS patient group and the healthy control group (P>0.05). But the expressions of IFN-gamma and IL-12 showed an increasing trend in the PDS patient group, while the expression of IL-4 showed a decreasing trend. The expressions of IFN-gamma, IL-12, IL-4, and the ratios of IFN-gamma/IL-4 and IL-12/IL-4 were also higher in PDS-DH group than in the PDS-D group and the PDS-H group, but with no statistical significance (P>0.05).

CONCLUSIONThe occurrence of Pi-Wei damp-heat CG was possibly correlated with the imbalance of Th1/Th2. Damp and heat pathogen might be important pathogenic factors leading to Th1 type cytokine immunoreaction.

Adult ; Case-Control Studies ; Chronic Disease ; Cytokines ; blood ; Female ; Gastritis ; diagnosis ; immunology ; pathology ; Helicobacter Infections ; diagnosis ; immunology ; pathology ; Humans ; Male ; Medicine, Chinese Traditional ; methods ; Th1 Cells ; immunology ; Th1-Th2 Balance ; Th2 Cells ; immunology

OBJECTIVETo prepare monoclonal antibodies against oh(8)dG and to evaluate the relationship between Hp infection and oxidative DNA damage by detecting oh8dG in gastric mucosa.

METHODSBALB/C mice were immunized with BSA-oh(8)dG conjugate, monoclonal antibodies were prepared by hybridoma technique, the biological characteristics of antibodies were analysed by competitive ELISA, Western blot and immunohistochemistry.

RESULTSTwo strains of hybridoma cell were obtained. ELISA and Western blot indicated that the antibodies were fairly specific for oh(8)dG. In immunohistochemistry,the positive rate of oh(8)dG expression in Hp positive tissues and Hp negative tissues was 55% and 5%, respectively(P<0.01).

CONCLUSIONThe prepared antibodies can specially recognize oh(8)dG and immunohistochemistry with the monoclonal antibodies showed Hp infection can increase oh(8)dG level in gastric mucosa.

Animals ; Antibodies, Monoclonal ; immunology ; Blotting, Western ; Deoxyguanosine ; analogs & derivatives ; analysis ; immunology ; Enzyme-Linked Immunosorbent Assay ; Female ; Gastric Mucosa ; chemistry ; Helicobacter Infections ; diagnosis ; Helicobacter pylori ; Immunohistochemistry ; Mice ; Mice, Inbred BALB C

BACKGROUND/AIMS: To evaluate a new monoclonal antibody for Helicobacter pylori urease in gastric tissue. METHODS: A total of 107 volunteers were enrolled. All subjects underwent a 13C-urea breath test and esophagogastroduodenoscopy. Gastric aspirates were analyzed for pH and ammonia. Six biopsy specimens in the gastric antrum and body were obtained for a rapid urease test and histology. The new monoclonal antibody-based H. pylori urease test (HPU) was performed to rapidly and qualitatively detect urease in two biopsy specimens. RESULTS: H. pylori infection was diagnosed in 73 subjects. The sensitivity and specificity of the HPU was 89% and 74%, respectively. The subjects were divided into two groups: one with true-positive and true-negative HPU results (n = 90) and the other with false-positive and false-negative HPU results (n = 17). Across all subjects, ammonia levels were 900.5 +/- 646.7 and 604.3 +/- 594.3 mumol/L (p > 0.05), and pH was 3.37 +/- 1.64 and 2.82 +/- 1.51 (p > 0.05). Sensitivity was higher in the presence of atrophic gastritis or intestinal metaplasia. CONCLUSIONS: HPU detected H. pylori in approximately 10 min. Gastric aspirate ammonia and pH levels did not affect the test results. Sensitivity was good in the presence of atrophic gastritis or intestinal metaplasia.
Adult ; Antibodies, Monoclonal/*immunology ; Bacterial Proteins/*analysis/immunology ; Biomarkers/analysis ; Biopsy ; False Negative Reactions ; False Positive Reactions ; Female ; Gastritis, Atrophic/*diagnosis/microbiology ; Helicobacter Infections/*diagnosis/microbiology ; Helicobacter pylori/*enzymology/immunology ; Humans ; *Immunologic Tests ; Male ; Metaplasia ; Middle Aged ; Predictive Value of Tests ; Pyloric Antrum/*microbiology/pathology ; Reproducibility of Results ; Time Factors ; Urease/*analysis/immunology ; Workflow

BACKGROUND/AIMS: Helicobacter pylori is a well known precursor to gastric cancer and gastric mucosa-associated lymphoid tissue lymphoma. This study was to determine whether H. pylori was associated with colorectal neoplasms in Korean subjects undergoing routine checkup. METHODS: A total of 10,082 subjects underwent routine checkups from January 2004 to April 2005. A H. pylori IgG test and stool occult blood test were included in the routine checkup program. Colonoscopy was performed if the stool occult blood test was positive or under subject request. Patients who underwent colonoscopy and had histologically confirmed cases of colorectal neoplasms were designanted as the subject group and those without as the control group. RESULTS: Of the 10,082 subjects, 597 had full colonoscopy. The results identified 9 colorectal carcinomas and 118 adenomas. H. pylori seropositivity was identified in 6 (66%) subjects with colorectal carcinoma, 81 (68.6%) with colorectal adenoma and 248 (52.8%) controls. Subjects having colorectal neoplasms had a significantly higher H. pylori seropositivity rate compared with the controls (OR 1.94, 95% CI 1.28-2.95). This remained significant after adjusting for age, sex, body mass index, HbA1c and total cholesterol (OR 1.90, 95% CI 1.23-2.93). Patients with distal neoplasms also had a significantly higher H. pylori seroposivity rate (OR 1.88, 95% CI 1.17-3.01) which persisted after multivariate adjustment (OR 1.79, 95% CI 1.10-2.94). CONCLUSIONS: Subjects with colorectal neoplasms present an increased H. pylori seroprevalence compared with controls.
Adenoma/*diagnosis/etiology ; Adult ; Age Factors ; Aged ; Body Mass Index ; Cholesterol/blood ; Colonoscopy ; Colorectal Neoplasms/*diagnosis/epidemiology/etiology ; Female ; Helicobacter Infections/complications/*diagnosis ; Helicobacter pylori/*immunology ; Hemoglobin A, Glycosylated/analysis ; Humans ; Immunoglobulin G/analysis ; Male ; Middle Aged ; Occult Blood ; Odds Ratio ; Retrospective Studies ; Risk Factors ; Sex Factors

To determine the approximate incidence and clinical features of pernicious anemia in a Korean population, we retrospectively analyzed clinical data for patients with pernicious anemia who were diagnosed between 1995 and 2010 at five hospitals in Chungnam province. Ninety-seven patients were enrolled, who accounted for 24% of patients with vitamin B12 deficiency anemia. The approximate annual incidence of pernicious anemia was 0.3 per 100,000. The median age was 66 (range, 32-98) yr, and the male/female ratio was 1.25. Anemia-associated discomfort was the most common symptom (79.4%), followed by gastrointestinal and neurological symptoms (78.4% and 38.1%, respectively). Pancytopenia was found in 36 patients (37.1%), and autoimmune disorders were found in 15 patients (15.5%). Antibody to intrinsic factor was detected in 62 (77.5%) of 80 patients examined, and antibody to parietal cells was detected in 35 (43.2%) of 81 patients examined. Of the 34 patients who underwent tests for Helicobacter pylori, 7 (12.5%) were positive. The anemia-associated and gastrointestinal symptoms resolved completely in all patients after intramuscular injection of cobalamin, whereas neurological symptoms remained in some. In conclusion, pernicious anemia is less frequent in Koreans than in Western populations; however, the clinical features of this disorder in Koreans do not differ from those of Western cases.
Adult ; Aged ; Anemia, Pernicious/complications/*diagnosis/epidemiology ; Asian Continental Ancestry Group ; Autoimmune Diseases/complications/epidemiology ; Female ; Gastrointestinal Diseases/complications/drug therapy/epidemiology ; Helicobacter Infections/diagnosis ; Helicobacter pylori ; Humans ; Isoantibodies/blood ; Male ; Middle Aged ; Nervous System Diseases/complications/epidemiology ; Parietal Cells, Gastric/immunology ; Republic of Korea/epidemiology ; Retrospective Studies ; Vitamin B 12/blood/therapeutic use