The Long‐term Impact of <i>Helicobacter pylori</i> Eradication on Gastric Histology: a Systematic Review and Meta‐analysis

Rokkas, Theodoros; Pistiolas, Dimitios; Sechopoulos, Panos; Robotis, Ioannis; Margantinis, Georgios

doi:10.1111/j.1523-5378.2007.00563.x

Cited by 212 publications

(154 citation statements)

References 31 publications

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“…The study reported that mass eradication of H.pylori was effective in significantly reducing the incidence of gastric atrophy resulting from chemoprevention (77.2%; 95% CI 72.3%-81.2%), although the reduction in incidence of intestinal metaplasia was not significant. (35) Similarly, two other meta-analyses, (36,37) which addressed the controversial issue regarding the impact of H. pylori eradication on gastric atrophy and intestinal metaplasia, showed significant improvement in gastric atrophy but not gastric intestinal metaplasia. Thus, gastric intestinal metaplasia is generally regarded as the point of irreversible histological change.…”

Section: H Pylori and Gastric Cancermentioning

confidence: 99%

“…Thus, gastric intestinal metaplasia is generally regarded as the point of irreversible histological change. (36,37) Uemura et al, (38) who were the first to provide evidence that H. pylori eradication has a direct impact on gastric cancer occurrence, conducted a non-randomised H. pylori eradication trial in patients with early gastric cancer treated by endoscopic resection. After a three-year follow-up period, 9% of the untreated patients developed metachronous gastric cancer, while none of the patients who underwent H. pylori eradication developed the disease.…”

Section: H Pylori and Gastric Cancermentioning

confidence: 99%

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Clinical epidemiology of gastric cancer

Ang

Fock

2014

smedj

316

223

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Gastric cancer is the second leading cause of cancer-related mortality and the fourth most common cancer globally. There are, however, distinct differences in incidence rates in different geographic regions. While the incidence rate of gastric cancer has been falling, that of gastric cardia cancers is reportedly on the rise in some regions. Helicobacter pylori (H. pylori) infection is a major risk factor of non-cardia gastric cancer, and data has emerged concerning the role of H. pylori eradication for primary prevention of gastric cancer. Dietary, lifestyle and metabolic factors have also been implicated. Although addressing these other factors may contribute to health, the actual impact in terms of cancer prevention is unclear. Once irreversible histological changes have occurred, endoscopic surveillance would be necessary. A molecular classification system offers hope for molecularly tailored, personalised therapies for gastric cancer, which may improve the prognosis for patients.

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Section: H Pylori and Gastric Cancermentioning

confidence: 99%

Section: H Pylori and Gastric Cancermentioning

confidence: 99%

Clinical epidemiology of gastric cancer

Ang

Fock

2014

smedj

316

223

View full text Add to dashboard Cite

show abstract

“…These cells are easily identified in the gastric mucosa since they are not present in the normal gastric mucosa and their identification presents high inter-observer agreement (18) . Although it also presents discordant studies, different studies and meta-analysis have been unable to demonstrate intestinal metaplasia regression after H pylori eradication (113,121,153,172,203,213) .…”

Section: Statement 16mentioning

confidence: 99%

3rd BRAZILIAN CONSENSUS ON Helicobacter pylori

Coelho

Maguinilk

Zaterka³

et al. 2013

Arq. Gastroenterol.

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Significant progress has been obtained since the Second Brazilian Consensus Conference on Helicobacter pylori Infection held in 2004, in São Paulo, SP, Brazil, and justify a third meeting to establish updated guidelines on the current management of H. pylori infection. The Third Brazilian Consensus Conference on H pylori Infection was organized by the Brazilian Nucleus for the Study of Helicobacter, a Department of the Brazilian Federation of Gastroenterology and took place on April 12-15, 2011, in Bento Gonçalves, RS, Brazil. Thirty-one delegates coming from the five Brazilian regions and one international guest, including gastroenterologists, pathologists, epidemiologists, and pediatricians undertook the meeting. The participants were allocated in one of the five main topics of the meeting: H pylori, functional dyspepsia and diagnosis; H pylori and gastric cancer; H pylori and other associated disorders; H pylori treatment and retreatment; and, epidemiology of H pylori infection in Brazil. The results of each subgroup were submitted to a final consensus voting to all participants. Relevant data were presented, and the quality of evidence, strength of recommendation, and level of consensus were graded. Seventy per cent and more votes were considered as acceptance for the final statement. This article presents the main recommendations and conclusions to guide Brazilian doctors involved in the management of H pylori infection.

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“…This result indicates that inhibitors of ADP ribosylation, for which safety data are now available due to their extensive testing in trials of metastatic breast and other cancers (19,20), might be useful compounds for the treatment of symptomatic H. pylori-infected patients. Most patients presenting with atrophic gastritis, metaplasia, or dysplasia are routinely subjected to eradication therapy targeting the underlying infection; however, eradication is only partly efficient in reversing atrophy and fails in the treatment of metaplasia and dysplasia (29). As patients with any of these conditions have an at least 10-fold increased risk of developing gastric cancer compared with histologically unapparent infected individuals, and are currently subjected to an unsatisfactory watch-and-wait strategy, there is a clear unmet need for new treatment options for this patient group.…”

Section: Discussionmentioning

confidence: 99%

“…S3C and D), indicating that Helicobacter eradication and the inhibition of ADP ribosylation have comparable effects in mice. In contrast, eradication therapy typically fails to cure the human counterpart lesions (29), suggesting that the consecutive treatment with antibiotics and ADP ribosylation inhibitors would have a beneficial effect over eradication therapy alone in humans.…”

Section: Inhibition Of Adp Ribosylation By Pj34 Reverses Preexisting mentioning

confidence: 99%

Inhibition of ADP Ribosylation Prevents and Cures Helicobacter-Induced Gastric Preneoplasia

et al. 2010

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Gastric adenocarcinoma develops as a consequence of chronic inflammation of the stomach lining that is caused by persistent infection with the bacterium Helicobacter pylori. Gastric carcinogenesis progresses through a sequence of preneoplastic lesions that manifest histologically as atrophic gastritis, intestinal metaplasia, and dysplasia. We show here in several preclinical models of Helicobacter-induced atrophic gastritis, epithelial hyperplasia, and metaplasia that the inhibition of ADP ribosylation by the small-molecule inhibitor PJ34 not only prevents the formation of gastric cancer precursor lesions, but also efficiently reverses preexisting lesions. PJ34 exerts its chemopreventive and therapeutic effects by impairing Helicobacterspecific T-cell priming and T H 1 polarization in the gut-draining mesenteric lymph nodes. The subsequent infiltration of pathogenic T cells into the gastric mucosa and the ensuing gastric T cell-driven immunopathology are prevented efficiently by PJ34. Our data indicate that PJ34 directly suppresses T-cell effector functions by blocking the IFN-γ production of mesenteric lymph node T cells ex vivo. Upon exposure to PJ34, purified T cells failed to synthesize ADP-ribose polymers and to activate the transcription of genes encoding IFN-γ, interleukin 2, and the interleukin 2 receptor α chain in response to stimuli such as CD3/ CD28 cross-linking or phorbol 12-myristate 13-acetate/ionomycin. The immunosuppressive and chemoprotective effects of PJ34 therefore result from impaired T-cell activation and T H 1 polarization, and lead to the protection from preneoplastic gastric immunopathology. In conclusion, ADP-ribosylating enzymes constitute novel targets for the treatment of Helicobacter-associated gastric lesions predisposing infected individuals to gastric cancer and may also hold promise for the treatment of other T cell-driven chronic inflammatory conditions and autoimmune pathologies. Cancer Res; 70(14); 5912-22. ©2010 AACR.

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The Long‐term Impact of Helicobacter pylori Eradication on Gastric Histology: a Systematic Review and Meta‐analysis

Abstract: The results showed significant improvement of GA, whereas improvement was not shown for IM.

Cited by 212 publications

References 31 publications

Clinical epidemiology of gastric cancer

Clinical epidemiology of gastric cancer

3rd BRAZILIAN CONSENSUS ON Helicobacter pylori

Inhibition of ADP Ribosylation Prevents and Cures Helicobacter-Induced Gastric Preneoplasia

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