Long-term Response of <i>Helicobacter pylori</i> Antibody Titer After Eradication Treatment in Middle-aged Japanese: JPHC-NEXT Study

Abstract

Background: Helicobacter pylori (H. pylori) is an established causative factor of gastric cancer. Although the expansion of insurance coverage has led to an increase in the number of patients treated for H. pylori, the population impact of eradication treatment for H.pylori has been scarcely investigated. This study aimed to clarify the long-term responses of H. pylori antibody titer after eradication treatment using large scale cross-sectional data from the Japan Public Health Center-based Prospective Study for the Next Generation (JPHC-NEXT Study).Methods: A total of 55,282 Japanese participants aged 40 to 74 years residing in 16 areas provided blood samples between 2011 and 2016. From these, treated (n=6,276) and untreated subjects who were seropositive for H. pylori or had serological atrophy (n= 22,420) formed the study population (n=28,696). Seropositivity was defined as an anti-H. pylori IgG titer of ≥10 U/mL. Antibody level was compared among subjects according to self-reported treatment history as untreated, and treated for less than one year (<1Y), one to five years (1-5Y), and more than six years ago (6Y+).

Genomic features of Helicobacter pylori‐naïve diffuse‐type gastric cancer

“…HP infection status was assessed and classified using the following criteria: (1) history of HP eradication therapy (i.e. previous treatment with antibiotics elsewhere); (2) endoscopic findings for mucosal atrophy (pale mucosa, submucosal vessel prominence, and loss of regular arrangement of collecting venules in the lower gastric body) or gastritis (diffuse or spotty redness, fold enlargement, sticky mucus, xanthoma, and intestinal metaplasia) [ 26 , 27 , 28 ]; (3) histopathologic findings for evidence of mucosal atrophy (loss of glandular cells), the presence of HP bacterial cells, or gastritis (inflammatory‐cell infiltration in mucosa and intestinal metaplasia) [ 5 , 26 , 27 ]; and (4) laboratory tests (serum anti‐HP antibody [ 7 , 8 ], serum pepsinogen [ 9 ], and urea breath test [ 10 ]; see also Supplementary materials and methods and supplementary material, Table S1 ). HP‐naïve cases were defined as those with no history of HP eradication, no sign of atrophic gastritis or HP infection in endoscopic and histopathologic examinations, and one or more negative results in laboratory tests.…”

“…HP‐naïve gastric cancer is a heterogeneous entity, and includes sporadic DGC, hereditary DGC, and gastric adenocarcinoma of the fundic gland type [ 5 ]. Stringent criteria are used to confirm HP negativity in HP‐naïve gastric cancers, relying on multimodal findings from endoscopy, histopathology, and laboratory tests for serum anti‐HP IgG antibody levels [ 7 , 8 ], serum pepsinogen levels [ 9 ], and urea breath test results [ 5 , 10 ]. Recent efforts have identified several clinicopathological features to be associated with sporadic HP‐naïve DGC: young age of onset, signet‐ring histology with gastric‐type mucin expression, localization in the lower and middle regions of the body of the stomach, and early‐stage cancer; this is presumably due to its indolent progression and slow proliferative capacity [ 5 , 11 , 12 ].…”

Anti-Helicobacter pylori antibody status is associated with cancer mortality: A longitudinal analysis from the Japanese DAIKO prospective cohort study

“…To reduce these symptoms and risk, HP eradication therapy has been conducted in Japan [35]. The chronological change in anti-HP antibodies has been considered to be a potential predictor of successful HP eradication therapy, although the immunological significance of antibody titer remains to be elucidated [36]. A recent study from a large-scale cohort study in Japan suggested that the majority of patients who received eradication therapy had reduced anti-HR antibody levels within one year [36].…”

“…The chronological change in anti-HP antibodies has been considered to be a potential predictor of successful HP eradication therapy, although the immunological significance of antibody titer remains to be elucidated [36]. A recent study from a large-scale cohort study in Japan suggested that the majority of patients who received eradication therapy had reduced anti-HR antibody levels within one year [36]. In the present study, we compared the measured urine anti-HP antibody levels and self-reported HP eradication history.…”

“…available for the present cohort. Of note, if the eradication therapy was conducted within one year, one to five years, and more than 6 years before the cohort enrollment, it was reported that anti-HP antibody titer was decreased by 76.8%, 88.2%, and 91.5%, respectively [36]. Furthermore, information about the antibiotics used for the eradication was not available.…”