Amount of Helicobacter pylori in gastric mucus during anti‐H. pylori treatment

Abstract

Helicobacter pylori is present in infected patients not only on the gastric epithelial cell surface but also in gastric mucus. We developed a competitive polymerase chain reaction (cPCR) method for quantitative measurement of H. pylori in gastric mucus. The aim of this study was to determine the number of H. pylori in gastric mucus before and after anti-H. pylori treatment. Patients with duodenal ulcer were treated with lansoprazole alone (n = 11) or lansoprazole and amoxycillin (n = 12). The amount of H. pylori in gastric mucus was measured over time by a cPCR assay. Helicobacter pylori infection was also tested for using histology, culture, and the rapid urease test (RUT). Although most patients treated with lansoprazole alone had become H. pylori-negative by the end of treatment when tested by histology, RUT, and culture, a large number of H. pylori organisms were found in the gastric mucus at that time by cPCR. These patients returned to being H. pylori positive 1 to 12 months later on the basis of histology, RUT, and culture. However, cPCR results indicated eradication of H. pylori by the end of treatment in eight of the 12 patients treated with lansoprazole and amoxicillin, and these patients remained H. pylori negative on histology, RUT, culture, and cPCR 1 to 12 months later. Testing for H. pylori in gastric mucus is thus useful for precise determination of the success or failure of H. pylori eradication therapy.

Real-Time Quantitative PCR for Detection ofHelicobacter pylori

“…To isolate H. pylori DNA from fresh or frozen biopsy samples of the stomach, three methods have been used: kits from commercial companies, the proteinase K-phenol method, and a boiling-water method. The best of the three methods for obtaining a high yield or purity of H. pylori DNA has been shown to be the classical proteinase K-phenol method (10,18,19,25,44,51,56), which is supported by our results. Although we showed little difference in DNA degradation between DNA isolated with the commercial kit and that isolated with the revised proteinase K-phenol method, the revised proteinase K-phenol method produced a much higher yield.…”

Helicobacter pylori VacA Disrupts Apical Membrane-Cytoskeletal Interactions in Gastric Parietal Cells

“…pylori-induced gastritis is associated with a variety of clinical outcomes that include peptic ulcer disease (44) and gastric cancer (33). Patients with H. pylori-induced gastric ulcers or gastric cancer typically have corpus-predominant gastritis and low acid secretion due to functional inhibition of acid secretion (3,4,35). Gastric atrophy and hypochlorhydria are important and interdependent precursor abnormalities that significantly increase the risk of gastric cancer.…”

“…Infection with these organisms consistently results in gastric inflammation and is a risk factor for the development of peptic ulcer disease, distal gastric adenocarcinoma, and gastric lymphoma (1,2). Some individuals who are persistently infected with H. pylori develop a body-predominant atrophic gastritis and profound suppression of gastric acid secretion (3,4). Atrophic gastritis is considered a risk factor for the development of gastric adenocarcinoma (5).…”

Helicobacter pyloriDetection and Antimicrobial Susceptibility Testing

“…The quantity of H. pylori in gastric mucus correlated with other invasive tests as well as with the urea breath test (UBT) in a study by Furuta et al (152). They also used this method for patient posteradication follow-up with a high predictive value (153).…”

“…Gastric juice is well adapted for performance of quantitative culture and estimation of the potential for transmission of this organism (153,593). In the study of induced vomitus from infected subjects, H. pylori grew in high quantities (Ͼ10 3 CFU/ ml), while low quantities (50 to 500 CFU/ml) were found in postemesis saliva and cathartic stools (2,000 to 5,000 CFU/ml) in most of the subjects (434).…”