Real-time determination of gastric juice pH with EndoFaster® for atrophic gastritis assessment

Zullo, Angelo; Germanà, B.; Galliani, E.; Iori, Andrea; Pretis, G. De; Manfredi, Guido; Buscarini, Elisabetta; Ciuffi, Mario; Ignomirelli, Orazio; Farinati, Fabio; Savarino, Edoardo; Pallini, P.; Milan, Luisa; Conigliaro, Rita; Grande, Giuseppe; Cannizzaro, Renato; Maiero, Stefania; Pisani, Antonio; Marangi, Stefania; Manta, Raffaele; Morelli, Olivia; Peralta, Sergio; Mantia, Alessia La; Buonocore, Matteo Rossano; Khalaf, Kareem; Hassan, Cesare; Monica, Fabio

doi:10.1016/j.dld.2022.06.014

Cited by 8 publications

(9 citation statements)

References 23 publications

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“…2b). In an endoscopic setting where a 7% prevalence of diffuse precancerous lesions is present -as reported in recent, large study [27] -a positive result of EndoFaster for atrophy corresponds a 30% post-test probability of this condition, and a negative result to a 2% post-test probability (Fig. 2d).…”

Section: When Testing Gastric Juice Is Clinically Relevant?supporting

confidence: 69%

“…Successively, the performance of the device was improved so that the volume of gastric juice needed for the analysis was reduced to 6 mL, and the Endofaster received official CE approval. By using a > 62 ppm ammonium in gastric juice and 4.5 pH value as threshold, the tool was found to be highly accurate both in diagnosing H. pylori infection and in suspecting diffuse atrophy of gastric mucosa, respectively [25][26][27][28]. Finally, the last version of EndoFaster was further enhanced so that only 3 mL gastric juice are needed for the analysis, with the pH value measured within 15 s, and ammonium concentrations generally in 60 s, and at maximum within 90 s [29].…”

Section: How Endofaster Testing Gastric Juice?mentioning

confidence: 99%

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Gastric juice analysis in clinical practice: why, how, and when. The experience with EndoFaster

Zullo,

Annibale,

Dinis-Ribeiro

et al. 2023

European Journal of Gastroenterology &Amp; Hepatology

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Gastric juice analysis may be useful for clinical purposes, including the detection of H. pylori infection and diffuse atrophic gastritis on gastric mucosa. EndoFaster is a novel device which performs real-time analysis of gastric juice revealing the infection and hypochlorhydria by measuring ammonium concentrations and pH levels. This review aimed to evaluate the clinical applications of such a tool. By considering data from overall 11 studies, the values of sensitivity, specificity, positive predictive value, negative predictive value, accuracy, positive likelihood ratio, and negative likelihood ratio were 90%, 86%, 67%, 96%, 87%, 8.5, and 0.13, respectively, for H. pylori diagnosis, and 83%, 92%, 58%, 97%, 91%, 9.9 and 0.2, respectively, for suspecting diffuse atrophic gastritis. The very high value of negative predictive values for both H. pylori and mucosal atrophy would allow avoiding to perform useless negative gastric biopsies when the results of the test are negative. Some promising data suggest that gastric juice analysis may be useful also to diagnose H. pylori infection in patients with chronic active gastritis without evidence of bacteria at histology, as well as in predicting persistent acid reflux in patients on proton pump inhibitor therapy for reflux disease.

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Section: When Testing Gastric Juice Is Clinically Relevant?supporting

confidence: 69%

Section: How Endofaster Testing Gastric Juice?mentioning

confidence: 99%

Gastric juice analysis in clinical practice: why, how, and when. The experience with EndoFaster

Zullo,

Annibale,

Dinis-Ribeiro

et al. 2023

European Journal of Gastroenterology &Amp; Hepatology

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“…If probiotics enter the human body by mouth, it is necessary to resist the highly acidic environment of gastric fluids to give full play to the role of probiotics. Generally, the pH of human gastric fluid fluctuates between 1.5 and 5.0 . At the same time, food typically takes 2–3 h to pass through the stomach and be digested .…”

Section: Resultsmentioning

confidence: 99%

“…Generally, the pH of human gastric fluid fluctuates between 1.5 and 5.0. 43 At the same time, food typically takes 2−3 h to pass through the stomach and be digested. 44 Therefore, this experiment used SGFs to treat the microcapsule for 2 h. As shown in Figure 2A, the number of viable bacteria in the strain decreased over time.…”

Section: Stability Analysis In the In Vitro-simulated Gastrointestina...mentioning

confidence: 99%

Construction of Probiotic Double-Layered Multinucleated Microcapsules Based on Sulfhydryl-Modified Carboxymethyl Cellulose Sodium for Increased Intestinal Adhesion of Probiotics and Therapy for Intestinal Inflammation Induced by Escherichia coli O157:H7

Zhang

Liu

Fang

et al. 2023

ACS Appl. Mater. Interfaces

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The decreased number of viable bacteria and the ability of Bifidobacterium to adhere to and colonize the gut in the gastrointestinal environment greatly limit their efficacy. To solve this problem, thiolated carboxymethyl cellulose sodium (CMC) probiotic double-layered multinucleated microcapsules with Bifidobacterium adolescentis FS2-3 in the inner layer and Bacillus subtilis SN15-2 embedded in the outer layers were designed. First, the viable counts and release rates of microcapsules were examined by in vitro simulated digestion assays, and it was found that microcapsules were better protected from gastrointestinal digestion than the controls. Compared with free Bifidobacterium strains, double-layered multinucleated microcapsules have higher viable bacterial survival rates and storage stability. Second, through in vitro rheology, tensile tests, isotherm titration calorimetry, and adhesion tests, it was observed that thiolated CMC could enhance the strong interaction of Bifidobacterium with intestinal mucus and significantly promote the proliferation and growth of probiotics. Finally, double-layered multinucleated microcapsules containing B. adolescentis FS2-3 and B. subtilis SN15-2 modified with sulfhydryl-modified CMC were studied in the intestine. Alleviation of Escherichia coli O157:H7 induced intestinal inflammation. The results showed that microencapsulation could significantly increase the colon content of Bifidobacterium, relieve intestinal inflammation symptoms in mice with bacterial enteritis, and repair the intestinal microbiota disorder caused by inflammation. The probiotic double-layered multinucleated microcapsules prepared in this study can improve the survival rate of probiotics and promote proliferation, adhesion, and colonization of probiotics.

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“…Thus, gastric fluid appears as a promising source of biomarkers, since it reflects the functional state of the stomach, potentially complementing and enhancing the accuracy of endoscopy as the gold standard for precancerous stomach and GC detection and surveillance (11). In fact, a novel device that allows H. pylori detection and corpus AG diagnosis during endoscopy from gastric juice, regardless of proton inhibitor therapy or previous eradication, has been presented, positively impacting the use of health resources and patients comfort (201)(202)(203). Furthermore, a systematic review was recently published on the role of non-blood liquid biopsies in GC development and detection (11).…”

Section: Liquid Biopsies As a Promising Source Of Dysbiosis-derived B...mentioning

confidence: 99%

Linking dysbiosis to precancerous stomach through inflammation: Deeper than and beyond imaging

et al. 2023

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Upper gastrointestinal endoscopy is considered the gold standard for gastric lesions detection and surveillance, but it is still associated with a non-negligible rate of missing conditions. In the Era of Personalized Medicine, biomarkers could be the key to overcome missed lesions or to better predict recurrence, pushing the frontier of endoscopy to functional endoscopy. In the last decade, microbiota in gastric cancer has been extensively explored, with gastric carcinogenesis being associated with progressive dysbiosis. Helicobacter pylori infection has been considered the main causative agent of gastritis due to its interference in disrupting the acidic environment of the stomach through inflammatory mediators. Thus, does inflammation bridge the gap between gastric dysbiosis and the gastric carcinogenesis cascade and could the microbiota-inflammation axis-derived biomarkers be the answer to the unmet challenge of functional upper endoscopy? To address this question, in this review, the available evidence on the role of gastric dysbiosis and chronic inflammation in precancerous conditions of the stomach is summarized, particularly targeting the nuclear factor-κB (NF-κB), toll-like receptors (TLRs) and cyclooxygenase-2 (COX-2) pathways. Additionally, the potential of liquid biopsies as a non-invasive source and the clinical utility of studied biomarkers is also explored. Overall, and although most studies offer a mechanistic perspective linking a strong proinflammatory Th1 cell response associated with, but not limited to, chronic infection with Helicobacter pylori, promising data recently published highlights not only the diagnostic value of microbial biomarkers but also the potential of gastric juice as a liquid biopsy pushing forward the concept of functional endoscopy and personalized care in gastric cancer early diagnosis and surveillance.

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Real-time determination of gastric juice pH with EndoFaster® for atrophic gastritis assessment

Cited by 8 publications

References 23 publications

Gastric juice analysis in clinical practice: why, how, and when. The experience with EndoFaster

Gastric juice analysis in clinical practice: why, how, and when. The experience with EndoFaster

Construction of Probiotic Double-Layered Multinucleated Microcapsules Based on Sulfhydryl-Modified Carboxymethyl Cellulose Sodium for Increased Intestinal Adhesion of Probiotics and Therapy for Intestinal Inflammation Induced by Escherichia coli O157:H7

Linking dysbiosis to precancerous stomach through inflammation: Deeper than and beyond imaging

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