Clinical Evaluation of a Novel Stool Antigen Test Using Bioluminescent Enzyme Immunoassay for Detecting Helicobacter pylori

Abstract

Background. BLEIA ™ “EIKEN” Helicobacter pylori antigen (B[EIA]) is based on the bioluminescent enzyme immunoassay (BLEIA) method that was newly developed with high sensitivity in detecting Helicobacter pylori (H. pylori) antigen in feces. Methods. In the project for H. pylori screening and treatment in Saga Prefecture in 2019, 141 students received the stool H. pylori antigen test as a secondary test. For 141 students, a comparative test was conducted between B (EIA) and extracorporeal diagnostic agents that were marketed in Japan as of 2019. The detection performance of H. pylori ATCC43504 standard strain and H. pylori antigen in commercial human fecal specimens were conducted. Results. The comparison of B (EIA) with Quick Chaser TMH. pylori (Q [IC]) revealed positive and negative concordance ratios of B (EIA) to Q (IC) of 100.0% (110/110) and 71.0% (22/31), respectively. A comparative test was conducted between B (EIA) and extracorporeal diagnostic agents that were marketed in Japan as of 2019, and B (EIA) was most sensitive on “detecting H. pylori antigen of ATCC43504 standard strain” and “detecting H. pylori antigen in commercial human fecal specimens,” compared with other kits. Nine dissociated specimens that were negative for Q (IC) and positive for B (EIA) were confirmed. The measured value of B (EIA) in the dissociation samples were 1.3–87.4 cutoff index in the range that can be evaluated as negative by other fecal H. pylori antigen test kits, all the dissociation samples were H. pylori antigen-positive cases, and finally the cause of result divergence was presumed as false negative due to insufficient sensitivity of Q (IC). Conclusion. B (EIA) that is based on the BLEIA method, which applies firefly luciferase luminescence, is more sensitive than stool antigen test kits that are currently marketed in Japan and is very useful in diagnosing H. pylori infection, especially in situations where noninvasive tests are preferred, such as in children.

Clinical Utility of <i>Helicobacter pylori</i> Stool Antigen Testing with a Bioluminescent Enzyme Immunoassay Using a Fecal Occult Blood Test Container

“…A BLEIA, although used less commonly than an EIA/ELISA, has been reported to have good sensitivity and specificity and is hardly affected by the presence of oral PPIs. Its main strength lies in its ability to accurately diagnose H. pylori (6,7). We hope that BLEIAs will be more widely used in the future to reduce the number of false-negative H. pylori stool antigen test results.…”

“…The BLEIA™ 'EIKEN' H. pylori antigen test (Eiken Chemical, Tokyo, Japan) is based on a bioluminescent enzyme immunoassay (BLEIA) and was developed to detect H. pylori antigens in feces with high sensitivity (5)(6)(7)(8). This method was reported to be largely unaffected by the oral administration of proton pump inhibitors (PPIs) (7), Despite its effectiveness, however, the BLEIA is not widely used because it requires the collection of stool samples in a dedicated stool collection container (BL-stool collection container or BL container, BL Sampling Bottle; Eiken Chemical).…”

Evaluation of the effects of a proton pump inhibitor on Helicobacter pylori stool antigen testing

“…BLEIA® is a laboratory‐based SAT that employs a bioluminescent enzyme immunoassay with high sensitivity to detect H . pylori catalase 12 . Stool samples were collected from each subject.…”

“…8 The 95% confidence interval (CI) (Z α/2 = 1.96) was used to ascertain the minimum predetermined value of sensitivity (or specificity) as per the published data H. pylori catalase. 12 Stool samples were collected from each subject.…”

Preliminary study assessing the agreement between a novel stool antigen test using bioluminescent enzyme immunoassay and a 13C-urea breath test for Helicobacter pylori infection

“…Noninvasive methods for diagnosis of H. pylori infection include the 13 C-urea breath test (UBT) and stool antigen test (SAT). In Japan, a novel SAT using bioluminescent enzyme immunoassay (BLEIA) was developed with high sensitivity in detecting H. pylori [3]. Therefore, the present study evaluated the accuracy of SAT using BLEIA compared with that of UBT.…”