Relationship between Helicobacter Pylori and Male Infertility / 中山大学学报(医学科学版)

Helicobacter pylori （H.pylori） is a gram-negative， spiral-shaped bacillus and it is the only bacteria known in medicine that can live in the stomach， with a high infection rate in the population. Besides its confirmed link to peptic ulcer and chronic gastritis， H.pylori has recently been found to be associated with many extragastric diseases， including male infertility. The incidence of male factor infertility keeps rising， but some reasons remain unclear. This paper summarized the research on H.pylori and infertility abroad in recent years in order to speculate and explore the possible relationship between them.

Análisis molecular de Helicobacter pylori (genes de patogenicidad) en biopsias gástricas de pacientes de la Sierra y Oriente Ecuatorianos / Molecular analysis of Helicobacter pylori (pathogenicity genes) in gastric biopsies of patients from the Ecuadorian Sierra and Oriente

Antecedentes: Helicobacter pylori es una bacteria Gram negativa, reconocida como la causa de la úlcera péptica (UP) y cáncer el gástrico (CG). Se han identificado genes de virulencia asociados con la patogenicidad del H. pylori incluyendo la isla de patogenicidad cagA y la citotoxina vacuolizante A (vacA). La frecuencia de los genes de patogenicidad se ha asociado con la localización geográfica y condiciones de vida de las personas. Pocos estudios en el Ecuador, han demostrado la relación entre los genes de patogenicidad de H. pylori y regiones geográficas de diferente altitud. Este estudio analizó los genes de patogenicidad de biopsias gástricas dos parroquias del Ecuador: una ubicada en la altura, Zumbahua (Sierra Central) y otra a nivel del mar, Shushufindi (Amazonía). Métodos: Se obtuvieron 127 muestras de biopsias gástricas embebidas en parafina de sujetos provenientes de Zumbahua (n = 90) y Shushufindi (n = 37). Mediante un análisis histopatológico se determinó la presencia de la infección y alteraciones patológicas tisulares. Se seleccionaron las muestras de los pacientes con mayor índice de infección por H. pylori (++ y +++ en el examen histopatológico) para el análisis molecular del H. pylori; se aisló su ADN y se evaluaron los genes de patogenicidad por PCR. Resultados: Se determinó la presencia de 5 casos de cáncer gástrico en la parroquia de Zumbahua, con mayor frecuencia en hombres que en mujeres. En la parroquia de Sushufindi hubo mayor prevalencia de infección por H. pylori comparada con Zumbahua. El análisis molecular de los genes de patogenicidad determinó que hubo una mayor expresión de estos en las muestras provenientes de la parroquia de Zumbahua; el 20% de las muestras amplificaron para vacAm1, 8.57% para vacAs1 y el 20% para vacAs2; mientras que para Shushufindi, únicamente el 8.0% amplificó para el gen vacAm1. Conclusiones: La prevalencia de infección por H. pylori en las muestras de las parroquias estudiadas es alta. Los genes de patogenicidad asociados con mayor virulencia provinieron de Zumbahua así como también las muestras con cáncer. Por otro lado, en las muestras de Shushufindi los genes de patogenicidad fueron menos virulentos y no hubo casos de malignidad. Es necesario establecer sistemas de tamizaje tanto para detectar cepas de H. pylori con genes de virulencia como para la detección temprana del cáncer gástrico.

Construction and immunological protection analysis of attenuated Salmonella typhimurium harbouring Helicobacter pylori oipA DNA vaccine / 中国免疫学杂志

Objective: To optimize Helicobacter pylori(H.pylori)oipA gene and develop strain of vaccine in Attenuated Salmonella typhimurium SL7207 haxboring recombinant plasmid pVAX1-oipA and pVAX1-optioipA, then to study its protection against H.pylori in C57BL/6 mice.Methods: oipA gene was modified by codon optimization,inserting the Kozak sequence and engineering CpG motifs.The optioipA gene and oipA gene was inserted into the eukaryotic expressing vector pVAX1 respectively to develop recombinant plasmid pVAX1-optioipA and pVAX1-oipA.The AGS cells were transfected by pVAX1-oipA,pVAX1-optioipA and pVAX1 respectively.Then the OipA protein expression was confirmed by Western blot.pVAX1-oipA,and pVAX1-optioipA were converted to LB5000 for methylation and then the modified eukaryoticvector was electrotransfered to final host SL7207 respectively, SL7207/pVAX1-oipA, SL7207/pVAX1-optioipA was identified with PCR and enzyme digestion.Specific serum IgG antibody was detected by indirect ELISA after oral inoculation with vaccine strains.Mice were challenged with live Sydney strain(SS1)three times at 0,2,4 d(5 × 10~8CFU/each mouse).Fonr weeks after challenge, the mice were sacrificed.The colonization of H.pylori in gastric mucosa were detected by rapid urease test and quantitative culture of H.pylori.Results: The AGS cells transfected with pVAX1-oipA and pVAX1-optioipA had expressed corresponding production, moreover, the expression level of pVAX1-optioipA was higher than those of pVAX1-oipA,SL7207/pVAX1-oipA and SL7207/pVAX1-optioipA confirmed with PCR,enzyme digestion;Two weeks after last immunization,immunized mice.were induced to produce anti-OipA IgG antibodies, and the levels of anti-OipA IgG antibody in pVAX1-optioipA group was obviously higher than in pVAX1-oipA group(P＜0.01); After challenged with SS1, the infection rate of pVAX1-oipA and pVAX1-optioipA group was 60%(9/15)and 26.67%(4/15), which was significantly lower than 100%(10/10)in the control group(P＜0.01).Conclusion:Attenuated Salmonella typhimurium SL7207 containing pVAX1-oipA, pVAX1-optioipA is successfully constructed.It can protect mice from H pylori infection and optimizing oipA gene can enhance the protection efficiency.

The Diagnostic Usefulness of Endoscopic Findings and Detection Rates of CLO and HpKit Test for Helicobacter pylori Infection in Children

PURPOSE: We performed this study to evaluate the diagnostic usefulness of endoscopic finding of nodular gastritis, CLO and HpKit test for H. pylori infection in children. METHODS: Gastroduodenal endoscopy and mucosal biopsy were performed on 212 children who visited our hospital between Jul. 1999 and May 2000 due to abdominal pain. We performed CLO and HpKit test for H. pylori with the time interval of 15, 30 minutes, 1, 2, 3, 24, 48, 72, 96, 120 and 144 hours. Histological examination of H. pylori was made by H-E or Alcian yellow stain with biopsy specimens. Sensitivity, specificity, positive predictive and negative predictive value of nodular gastritis, CLO and HpKit test were calculated from the analysis of above data. RESULTS: Sensitivity and specificity of 3 hour-CLO test was 68.4% and 100% respectively. Sensitivity and specificity of 3 hour-HpKit test was 65.8% and 100% respectively. No significant difference in sensitivity and specificity was found between in 3 hour-CLO and HpKit test(P>0.05). Sensitivity of CLO test increased as time lapsed, but corresponding specificity did not decrease as time lapsed(sensitivity and specificity at 144 hours : 89.5% and 94.8% respectively). However, sensitivity of HpKit test increased as time lapsed, but specificity markedly decreased. Sensitivity and specificity of the nodular gastritis was 78.9% and 93.7% respectively. CONCLUSION: Both CLO and HpKit test have relatively low sensitivity and specificity for the detection of H. pylori in 3 hours of testing in children. The endoscopic finding of nodular gastritis is another good standard in the diagnosis of H. pylori infection in children.

The Role of Helicobacter pylori in Cirrhotic Patients with Peptic Ulcers / 대한소화기내시경학회지

BACKGROUND AND AIMS: The overall age-matched incidence of gastroduodenal ulcers was considerably higher in cirrhotic patients compared to the general population. There are several possible underlying mechanisms which may explain the ulcerogenic factors in cirrhotic patients. Recently, Helicobacter pylori (H. pylori) was proven as the cause of peptic ulcer disease in the general population. But the role of H. pylori infection in the pathogenesis of peptic ulcers of cirrhotic patients has not been clearly elucidated. The purpose of this study was to determine the role of H. pylori infection in cirrhotic patients with peptic ulcers. METHODS: From 1995 to 1997, 105 patients with histologically or radiologically proven liver cirrhosis (LC) who received panendoscopic examination due to presence of any upper gastrointestinal symptoms were studied. During endoscopic examination, a CLO (campylobacter like organism) test or gastric antral mucosal biopsy was performed in all patients. The severity of LC assessed by Child's criteria revealed that 31 patients had Child's A, 26 patients Child's B, and the remain 48 patients, Child's C. Child B or C was classified as decompensated LC. An esophageal varix was present in 73 patients or absent in 32. RESULTS: There was no statistical difference in the H. pylori prevalance between the ulcer group and non-ulcer group (67% vs 52%). In Child A group, the H. pylori prevalence was significantly higher in the ulcer group when compared with the non-ulcer group (87% vs 50%, p<0.05). In contrast, in the Child B or C group, there was no statistical difference between the ulcer group and non-ulcer group. In the abscence of esophageal varix, the ulcer group showed significantly higher prevalence of H. pylori than the non-ulcer group (87% vs 59%, p<0.05). But in the esophageal variceal group, there was no significant difference in the H. pylori prevalence between the ulcer and non-ulcer group (60% vs 40%). CONCLUSIONS: These observations suggest that H. pylori infection may play a role in the pathogenesis of peptic ulcer in compensated cirrhotic patients. However, in cirrhotic patients with decompensation or an esophageal varix, the association between H. pylori infection and peptic ulcers was weak, so other factors (portal hypertension etc.) should be considered as more potent etiology of peptic ulcers in cases of decompensated cirrhosis.

Clinical Usefulness of Helicobacter pylori IgG Ab Assay: Comparison of Six Commercial Kits / 대한임상병리학회지

BACKGROUND: The diagnostic significance of the serological detection of antibodies to Helicobacter pylori (H. pylori) has been reported by many investigators. But the comparison data between the various serological kits were not established in Korea. METHODS: Forty nine patients with upper gastrointestinal symptoms were studied from June 1997 to September 1997 in Yonsei University College of Medicine, Severance hospital. Endoscopic gastric biopsy specimens were obtained for microscopic examination of the bacteria and rapid urease test (CLO test). The sera of these patients were obtained for the serological test at the same time. The six commercial kits (Cobas Core II, G.A.P. test IgG, PYLORAGEN, QuickVue, BIOCARD Helicobacter pylori IgG, EZ-H.P.) for the detection H. pylori antibodies were evaluated for diagnosis and screening of H. pylori infection. RESULTS: Sensitivities for the six kits were from 71% to 96%, specificities were from 24% to 71%, positive predictive values were from 68% to 81%, negative predictive values were from 60% to 80%, respectively. There were statistically significant differences in four groups, between G.A.P. test and Cobas Core, G.A.P. test and PYLORAGEN, QuickVue and Cobas Core, QuickVue and PYLORAGEN. CONCLUSIONS: Sensitivities and specificities obtained in different studies revealed as great differences in the results with the same kits as between the results obtained with different kits in the same study. So, the serologic method alone for the diagnosis of H. pylori infection is not recommended. But in the screening of H. pylori infection, it can be used, because sensitivities and negative predictive values are relatively high.