New immunoassay for the detection of Helicobacter pylori infection compared with urease test, 13C breath test and histology: validation in the primary care setting

Weijnen, Catherine F.; Hendriks, HG; Hoes, Arno W.; Verweij, Wim; Verheij, Theo; Wit, Niek J. de

doi:10.1016/s0167-7012(01)00275-5

Cited by 14 publications

(7 citation statements)

References 11 publications

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“…Although it has been recommended that antibody assays be evaluated locally (4,13), this has rarely been carried out for different age groups. Our results of the accuracy of the H. pylori IgG and IgA tests were superior to those reported earlier (3,11,12,24). To avoid any misjudgment in the validation of serological tests for H. pylori antibodies in adult subjects, the validation should be carried out separately for different age groups with special emphasis not only on the known H. pylori status but also on the presence of atrophic gastritis.…”

contrasting

confidence: 47%

Age-Dependent Accuracy of Helicobacter pylori Antibody Assays for Adults, with Special Emphasis on Atrophic Gastritis

Salomaa-Räsänen

Kosunen

Mattila

et al. 2004

Clin Vaccine Immunol

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The accuracy of Helicobacter pylori antibody assays for 561 consecutive adult outpatients who had undergone gastroscopy was studied. The sensitivity of an immunoglobulin G test was 99 to 100% for all age groups, but the specificity declined by age group, from 99% for those aged 15 to 49 years to 75% for those aged >65 years. The exclusion of false-positive results for patients with atrophic gastritis improved the specificity to 93 to 97% for the older age groups.Helicobacter pylori infection is associated with gastritis, peptic ulcer disease, and gastric malignancies (1). In about onethird or up to one-half of those infected with H. pylori, gastritis proceeds to atrophic gastritis, resulting in a loss of mucosal glands, decreased helicobacter colonization and, when affecting the corpus mucosa, decreased secretion of pepsinogen I (PGI) (10, 23).Most helicobacter-infected subjects have specific circulating immunoglobulin G (IgG) antibodies. However, IgA antibodies are found in approximately two-thirds of infected subjects (9). Of infected individuals, 2 to 7% show an elevated level of IgA antibody only (5, 9). Patients with atrophic corpus gastritis often have positive helicobacter serology, although microscopic examination (6, 22), culture of biopsy samples, and even the urea breath test remain helicobacter negative (8). These particular patients may still be infected, as shown by rapidly falling antibody titers after therapy (7).Enzyme immunoassay (EIA) is the most commonly used serological method for detecting antibodies to H. pylori. The best commercial kits have shown sensitivities and specificities of 90% to in excess of 95% (3, 12 Biopsy samples. Gastroscopies were performed by one of the authors (A.S.-R.) in a routine manner, with two biopsies from the gastric antrum (2 cm or more from the pylorus), two biopsies from the large curve of the gastric corpus for histological examination, and additional biopsies (one from the antrum and one from the corpus) for culture.Formalin-fixed biopsy specimens were embedded in paraffin. Tissue sections of 3 m were cut at three levels per biopsy and placed on one slide. The tissue sections were stained with hematoxylin and eosin, Alcian blue (pH 2.5)-periodic acidSchiff, and modified Giemsa. Gastritis was classified according to the Sydney System, in a blinded fashion, by one pathologist (J.M.) (20).The biopsies were mailed for culture in Transpocult tubes (Orion Diagnostica, Espoo, Finland). The specimens were cultured for H. pylori for up to 12 days on Brucella agar plates (Becton Dickinson, Sparks, Md.) (18) supplemented with whole horse blood (7%) and on selective Brucella agar plates containing Iso-Vitalex (1%), vancomycin (6 mg/liter), amphotericin B (2 mg/liter), and nalidixic acid (20 mg/liter).Results were considered helicobacter positive if culture or histology or both were positive.Serum tests. Serum samples were taken during each patient's visit to the endoscopic unit and were stored at Ϫ20°C until analyzed. Sera were tested for H. pylori IgG and IgA antibodie...

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contrasting

confidence: 47%

Age-Dependent Accuracy of Helicobacter pylori Antibody Assays for Adults, with Special Emphasis on Atrophic Gastritis

Salomaa-Räsänen

Kosunen

Mattila

et al. 2004

Clin Vaccine Immunol

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“…Serological tests continue to be evaluated. The new version of Pyloriset (EIA‐G III) (Orion, Finland) was shown to be a reliable test [57]. Defining new cut‐off values improved the performance of serology tests in Chinese populations [58].…”

Section: Diagnosismentioning

confidence: 99%

Epidemiology and diagnosis of Helicobacter pylori infection

Mitchell

Mégraud

2002

Helicobacter

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There have been no major breakthroughs in the field of epidemiology and diagnosis of Helicobacter pylori infection over the last year, thus for this reason, these two topics will be treated in the same chapter. Information on the incidence of infection, as in the study of Malaty et al. are now being published from long-term cohort follow-ups. The route of transmission of H. pylori remains controversial, with circumstantial evidence for infection via exposure to animals, contaminated water supplies and oral reservoirs being reported. The value of citric acid to improve urea breath test (UBT) results has been documented. A novel stool test has been released on the market and we are awaiting more information, while detection of antibodies in urine gave satisfactory results. However, the most interesting data comes from the study of McColl et al. who clearly proved on a large sample and a 1-year follow-up that the 'test and treat' strategy using UBT, as proposed in the Maastricht Consensus Report, is definitely the method to use.

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“…The new version of Pyloriset (EIA-G III) (Orion, Finland) has been shown to be reliable. 54 The immuno chromatographic flow-injection method, which allows the quantitation of specific IgG, has been developed as a new method for the serological diagnosis of H. pylori infection. This method is rapid, and is associated with minimal wastage of antigen, since the same immunosorbent reactor can be used for all tests.55 It has been reported that the sensitivity and specificity of ELISA may be higher when the Japanese strain of H. pylori is used as the antigen.…”

Section: Non-invasive Testsmentioning

confidence: 99%

Current consensus on the diagnosis and treatment of H. pylori-associated gastroduodenal disease

Suzuki¹,

Masaoka²,

Nomura

et al. 2003

Keio j. med

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Abstract. Helicobacter pylori (H. pylori) is a spiral shaped bacterium that resides in the stomach mucosa. Isolation of H. pylori from the stomach mucosa changed the erstwhile widely held belief that the stomach contains no bacteria and is actually sterile. Once H. pylori is safely ensconced in the mucus, it is able to neutralize the acid in the stomach by elaborating an enzyme called urease. Urease converts urea, of which there is an abundant supply in the stomach (derived from saliva and the gastric juice), into bicarbonate and ammonia, which are strong bases. These bases form a cloud of acid neutralizing chemicals in the vicinity of the organisms, protecting them from the acid in the stomach. This urea hydrolysis reaction is utilized for the diagnosis of H. pylori infection in the urea breath test (UBT) and the rapid urease test (RUT). In Japan, both invasive tests, such as bacterial culture, histopathology and RUT, and non-invasive tests such as UBT and serology are conducted for the diagnosis of H. pylori infection. For confirming the results of eradication therapy, UBT is considered to be the most sensitive and specific. In order to treat H. pylori infection, a new one-week triple therapy regimen (lansoprazole or omeprazole+amoxicillin+clarithromycin) has been approved for use in patients with peptic ulcer disease in Japan. As for H. pylori eradication in the case of other diseases in which the bacterium has been implicated (e.g., chronic atrophic gastritis, gastric MALT lymphoma, gastric cancer, non-ulcer dyspepsia, chronic urticaria, idiopathic thrombocytopenic purpura (ITP)), further basic and clinical investigation is required. (Keio J Med 52 (3): 163-173, September 2003)

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New immunoassay for the detection of Helicobacter pylori infection compared with urease test, 13C breath test and histology: validation in the primary care setting

Cited by 14 publications

References 11 publications

Age-Dependent Accuracy of Helicobacter pylori Antibody Assays for Adults, with Special Emphasis on Atrophic Gastritis

Age-Dependent Accuracy of Helicobacter pylori Antibody Assays for Adults, with Special Emphasis on Atrophic Gastritis

Epidemiology and diagnosis of Helicobacter pylori infection

Current consensus on the diagnosis and treatment of H. pylori-associated gastroduodenal disease

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