Is saliva serology useful for the diagnosis of Helicobacter pylori?

Christie, Jane; McNulty, C.; Shepherd, Neil A.; Valori, Roland

doi:10.1136/gut.39.1.27

Cited by 46 publications

(37 citation statements)

References 15 publications

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“…These patients may be histopathologically and culture negative for H pylori, yet remain seropositive (14). As anticipated by the poor sensitivity and specificity values, the PPV (66.0%) and NPV (66.6%) were low, thus reducing the utility of this easily administered, noninvasive diagnostic test.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Salivary and Serum Enzyme Immunoassays for the Diagnosis ofHelicobacter pyloriInfection

Embil

Choudhri

Smart³

et al. 1998

Canadian Journal of Infectious Diseases

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JM Embil, SH Choudhri, G Smart, et al. Comparison of salivary and serum enzyme immunoassays for the diagnosis of Helicobacter pylori infection. Can J Infect Dis 1998;9(5):277-280.Infection with Helicobacter pylori has been established as an important risk factor for the development of peptic ulcer disease, gastritis and gastric cancer. The diagnosis of H pylori infection can be established by invasive or noninvasive techniques. Two noninvasive enzyme immunoassays (EIAs) for antibody detection -HeliSal and Pylori Stat -were compared with histology. Both assays detect immunoglobulin (Ig) G directed against purified H pylori antigen. The test populations consisted of 104 consecutive patients scheduled for upper gastrointestinal endoscopy. Of these patients, 97 (93%) had symptoms compatible with peptic ulcer disease. Saliva and serum were collected simultaneously at the time of endoscopy. Salivary EIA had a sensitivity of 66%, specificity of 67%, positive predictive value of 67% and negative predictive value of 66% compared with the serum EIA, where the results were 98%, 48%, 64% and 96%, respectively. Although the salivary EIA is an appealing noninvasive test, it was not a sensitive and specific assay. The serum EIA also lacked specificity, but was highly sensitive with a good negative predictive value. Although a negative serum EIA rules out H pylori infection, a positive result must be interpreted in the clinical context and confirmed with a more specific measure. elicobacter pylori is a motile, microaerophilic, curved Gram-negative rod which has been established as an important risk factor for the development of peptic ulcer disease (PUD) and gastritis (1). The National Institute of Health, Bethesada, Maryland have recommended that all patients with PUD infected with H pylori should receive antimicrobial therapy because cure of this infection leads to markedly reduced ulcer recurrence rates (1).The diagnosis of H pylori infection can be made either invasively by means of endoscopy and histological analysis of the biopsied tissue or noninvasively by the urea breath test and antibody detection in serum. Enzyme immunoassays (EIAs) that detect immunoglobulin (Ig) G in saliva have been developed as an alternative to the aforementioned techniques (2). Anti-H pylori IgG is found in saliva, and the advantage of the currently available salivary assay for H pylori is its ease of administration. If the salivary EIA is to be an effective noninvasive screening tool for H pylori-induced disease, it must be sensitive (2-6), specific and compare favourably with other already established noninvasive and invasive techniques, such as the urea breath test and serology (7-9). The objectives of this study were to determine the sensitivity, specificity, positive (PPV) and negative predictive values (NPV), and test accuracy of the Helisal (Axcan Pharma) Salivary EIA for diagnosing H pylori in comparison with the 'gold standard' of endoscopic biopsy for histology, as well as with a standard serum EIA (Pylori Stat, Bio-Whittaker, Marylan...

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Section: Discussionmentioning

confidence: 99%

Comparison of Salivary and Serum Enzyme Immunoassays for the Diagnosis ofHelicobacter pyloriInfection

Embil

Choudhri

Smart³

et al. 1998

Canadian Journal of Infectious Diseases

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“…It has been shown that H. pylori status as determined by serology predicts endoscopic findings more accurately than formal questioning. 8 In this study, we have proposed a novel, rapid, reliable, and accurate test for diagnosing H. pylori infection which could be efficacious for screening dyspeptic patients prior to a referral for endoscopy. 8 …”

Section: Introductionmentioning

confidence: 99%

A novel one-step Helicobacter pylori saliva antigen test

Yang

Yeh

Kwong

et al. 2015

Journal of the Chinese Medical Association

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The one-step HPS test exhibited a high sensitivity and low specificity compared with the other tests, indicating that it is not sufficiently accurate for use in a clinical setting for diagnosing H. pylori infection. However, the test is simple to use (requiring only a saliva sample), inexpensive, and noninvasive in its application, and thus appealing for use in population-based prevalence surveys of the epidemiology of H. pylori infection.

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“…Systemic antibodies to H pylori are found in saliva (2)(3)(4)(10)(11)(12)(13)(14)(15). Saliva samples are easier to obtain than serum samples, do not require separation steps and can be refrigerated for storage.…”

Section: Saliva Antibody Tests Backgroundmentioning

confidence: 99%

“…The testing requires laboratory conditions equivalent to those of standard ELISAs, and takes the same amount of time to perform. Comparison with serological assays: As with whole blood tests, many of the reports of saliva antibody assays are available in abstract form only (10)(11)(12)(13)(14)(15). The overall sensitivity, specificity, and positive and negative predictive values of these tests are not as high as those of serological testing, and preclude the current tests from being clinically relevant.…”

Section: Saliva Antibody Tests Backgroundmentioning

confidence: 99%

Novel Diagnostic Tests to DetectHelicobacter pyloriInfection: A Pediatric Perspective

1999

Canadian Journal of Gastroenterology

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Helicobacter pylori is one of the most common bacterial infections in humans, and has been found in differing rates in persons of all age groups, nationalities and socioeconomic classes (1). Because the role of H pylori in human disease continues to be explored, there is an increased need for rapid, reliable and inexpensive diagnostic tests (2,3). The most commonly used standard tests are listed in Table 1. To date, the only test that can detect infection and disease activity is endoscopy with biopsy, which is invasive and expensive.Five recently developed tests that offer potential advantages because they are less invasive or permit easier acquisition of samples are assessed. These tests are whole blood, saliva and urine assays that measure systemic antibody response to H pylori, stool tests that measure H pylori antigens and string tests that use methodology less invasive than upper gastrointestinal endoscopy to recover H pylori organisms.The tests are compared with current standard tests and criteria for optimal tests. The criteria are non-or minimally invasive nature; high sensitivity, specificity, and positive and negative predictive values in diagnosing infection and assessing disease activity and effectiveness of therapy; convenience, including ease of acquisition of samples and rapid determination of results; and low cost. WHOLE BLOOD ANTIBODY TESTS Background:Whole blood antibody tests are based on the fact that systemic antibodies to H pylori are found in whole blood, making testing possible in a primary care setting (2-9). Whole blood tests have several important potential advantages compared with standard serological tests; the samples are easier to obtain, testing can be done in an office setting and the results can be available within 10 mins. In addition, the cost is projected to be less than that for the standard serological tests. CANADIAN HELICOBACTER CONSENSUS CONFERENCE ON PEDIATRIC ISSUES

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Is saliva serology useful for the diagnosis of Helicobacter pylori?

Cited by 46 publications

References 15 publications

Comparison of Salivary and Serum Enzyme Immunoassays for the Diagnosis ofHelicobacter pyloriInfection

Comparison of Salivary and Serum Enzyme Immunoassays for the Diagnosis ofHelicobacter pyloriInfection

A novel one-step Helicobacter pylori saliva antigen test

Novel Diagnostic Tests to DetectHelicobacter pyloriInfection: A Pediatric Perspective

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