Systematic review and meta‐analysis: importance of CagA status for successful eradication of Helicobacter pylori infection

Abstract

SUMMARY BackgroundSome, but not all studies have provided evidence that the CagA status of Helicobacter pylori strains is a predictive factor for the outcome of eradication therapy.

Elevated Serum anti-Helicobacter pylori IgG Levels is a Predictor of Successful Eradication Therapy

“…Although a negative UBT can also include false positives [18] , these patients were evaluated in the same condition and we did not wait for a second eradication because delayed second eradication increases eradication failure [19] . The overall success rate of primary H. pylori eradication therapy in the present study is 62%, which is relatively low compared with large studies from other countries [5,20] , but similar to another large Japanese study [21] . Stringent policies for the use of antibiotics have not been distributed in Japan.…”

“…Serum IgG can be measured by a simple blood test in routine clinical practice. There have been several reports regarding a predictor of successful primary H. pylori eradication therapy [2,3,5,7,8] . However, most of the previously reported predictors involve measurements that are not evaluated in routine clinical practice.…”

“…The serum IgG level is considered to be an indicator of immune status for specific pathogens, and reflects bacterial proliferation and activity. Suzuki et al reported that a cagA positive status reflects the high proliferative rate of H. pylori with an increased success rate for primary H. pylori eradication [5] . Generally, more proliferative bacteria are more sensitive to antibiotics.…”

“…For primary eradication therapy, triple drug therapy including a proton pump inhibitor (PPI), clarithromycin and amoxicillin for one week is the approved regimen. Despite more patients undergoing this eradication regimen in Japan, the success rate of primary H. pylori eradication has been decreasing over the last decade because of emerging antibiotic resistance Factors which predict successful H. pylori eradication therapy have been reported, including the absence of antibiotic resistance [2] , poor metabolism of PPI due to CYP2C19 polymorphism [3,4] , and positive cytotoxin-associated gene A (cagA) status [5] . These factors are generally not evaluated in routine clinical practice, but require a research setting.…”

Helicobacter and Salmonella Persistent Infection Strategies

“…CagA affects multiple host cell signaling pathways, which are the subject of many reviews. However, the functions of CagA that benefit the bacteria have only recently been described (Hatakeyama 2004;Peek 2005;Suzuki et al 2006;Handa et al 2007;Hatakeyama 2008;Backert et al 2010Murata-Kamiya 2011). Using a polarized epithelium model system, CagA was found to play an important role in enabling H. pylori colonization of the epithelium (Tan et al 2009).…”