Regression of gastric intestinal metaplasia after the eradication of Helicobacter pylori infection in a hospital in Mexico

Cuén, Jaime Alberto Sánchez; Cabrales, Ana Bertha Irineo; Magaña, Gregorio Bernal; Peraza-Garay, Felipe de Jesús

doi:10.17235/reed.2016.4194/2016

Cited by 10 publications

(7 citation statements)

References 18 publications

(15 reference statements)

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“…In a previous study in which 192 patients with Hp-positive AG were treated with bismuth-based triple regimens, an overall eradication rate of 70.8% was achieved[ 14 ]. In another study, of 57 patients with intestinal metaplasia receiving standard triple therapy, the infection was successfully cured in 49 patients (eradication rate 85.9%)[ 55 ]. Less recent Japanese studies achieved eradication rates of 82.2% and 70.5%[ 56 , 57 ].…”

Section: Proposed Eradication Regimensmentioning

confidence: 99%

Treatment of Helicobacter pylori infection in atrophic gastritis

Lahner¹,

Carabotti²,

Annibale³

2018

WJG

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Helicobacter pylori (Hp) is a major human pathogen causing chronic, progressive gastric mucosal damage and is linked to gastric atrophy and cancer. Hp-positive individuals constitute the major reservoir for transmission of infection. There is no ideal treatment for Hp. Hp infection is not cured by a single antibiotic, and sometimes, a combined treatment with three or more antibiotics is ineffective. Atrophic gastritis (AG) is a chronic disease whose main features are atrophy and/or intestinal metaplasia of the gastric glands, which arise from long-standing Hp infection. AG is reportedly linked to an increased risk for gastric cancer, particularly when extensive intestinal metaplasia is present. Active or past Hp infection may be detected by conventional methods in about two-thirds of AG patients. By immunoblotting of sera against Hp whole-cell protein lysates, a previous exposure to Hp infection is detected in all AG patients. According to guidelines, AG patients with Hp positivity should receive eradication treatment. The goals of treatment are as follows: (1) Cure of infection, resolution of inflammation and normalization of gastric functions; (2) possible reversal of atrophic and metaplastic changes of the gastric mucosa; and (3) prevention of gastric cancer. An ideal antibiotic regimen for Hp should achieve eradication rates of approximately 90%, and complex multidrug regimens are required to reach this goal. Amongst the factors associated with treatment failure are high bacterial load, high gastric acidity, Hp strain, smoking, low compliance, overweight, and increasing antibiotic resistance. AG, when involving the corporal mucosa, is linked to reduced gastric acid secretion. At a non-acidic intra-gastric pH, the efficacy of the common treatment regimens combining proton pump inhibitors with one or more antibiotics may not be the same as that observed in patients with Hp gastritis in an acid-producing stomach. Although the efficacy of these therapeutic regimens has been thoroughly tested in subjects with Hp infection, there is a paucity of evidence in the subgroup of patients with AG. Bismuth-based therapy may be an attractive treatment in the specific setting of AG, and specific studies on the efficacy of bismuth-based therapies are needed in patients with AG.

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Section: Proposed Eradication Regimensmentioning

confidence: 99%

Treatment of Helicobacter pylori infection in atrophic gastritis

Lahner¹,

Carabotti²,

Annibale³

2018

WJG

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“…The progression of H. pylori -associated IM could be halted by the eradication of this bacterium. However, studies suggest that the regression of IM after H. pylori eradication is still highly questionable [ 21 , 22 ]. Regular surveillance in high-risk patients and the prevention of IM is one of the main management methods recommended by the guidelines.…”

Section: Introductionmentioning

confidence: 99%

Molecular Alterations in Gastric Intestinal Metaplasia

Jonaitis

Kupčinskas

2021

IJMS

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Gastric cancer (GC) remains one of the most common causes of mortality worldwide. Intestinal metaplasia (IM) is one of the preneoplastic gastric lesions and is considered an essential predisposing factor in GC development. Here we present a review of recent most relevant papers to summarize major findings on the molecular alterations in gastric IM. The latest progress in novel diagnostic methods allows scientists to identify various types of molecular alterations in IM, such as polymorphisms in various genes, changes in the expression of micro-RNAs and long noncoding RNAs, and altered microbiome profiles. The results have shown that some of these alterations have strong associations with IM and a potential to be used for screening, treatment, and prognostic purposes; however, one of the most important limiting factors is the inhomogeneity of the studies. Therefore, further large-scale studies and clinical trials with standardized methods designed by multicenter consortiums are needed. As of today, various molecular alterations in IM could become a part of personalized medicine in the near future, which would help us deliver a personalized approach for each patient and identify those at risk of progression to GC.

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“…One year following the treatment, it was observed that IM regressed in 54.3% of the patients. [ 22 ] This shows that HP is closely related with IM. Similar to the literature, we too had found higher rates of severe gastritis, chronic atrophy, and IM in HP (+) cases.…”

Section: Discussionmentioning

confidence: 91%

The role of the PLR–NLR combination in the prediction of the presence of Helicobacter pylori and its associated complications

Kaplan¹,

Ateş²,

Yüksel³

et al. 2018

Saudi J Gastroenterol

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Background/Aim:The aim of this study was to investigate the role of the platelet-to-lymphocyte ratio (PLR)–neutrophil-to-lymphocyte ratio (NLR) combination, in the prediction of the presence of Helicobacter pylori (HP) and its associated complications in the gastrointestinal system.Patients and Methods:In all, 1289 patients who underwent esophagogastroduodenoscopy and biopsy for HP were included in the study.Results:The ratio of patients with moderate and severe chronic gastritis was higher in HP (+) group than HP (−) group. The ratio of patients with levels 1–3 atrophy and intestinal metaplasia was higher in HP (+) group. Compared with HP (−) group, HP (+) had higher PLR and NLR levels. The ratio of HP (+) patients was higher in high-risk group compared with low- and medium-risk groups. HP invasion stage, the intestinal metaplasia level, and the ratio of patients with atrophy level “3” were higher in high-risk group compared with low- and medium-risk groups. Regression analysis showed that the PLR–NLR combination was an independent risk factor for both HP presence and moderate and severe chronic gastritis.Conclusion:We found the PLR–NLR combination to be a good predictor of HP presence and gastrointestinal complications associated with HP.

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Regression of gastric intestinal metaplasia after the eradication of Helicobacter pylori infection in a hospital in Mexico

Cited by 10 publications

References 18 publications

Treatment of Helicobacter pylori infection in atrophic gastritis

Treatment of Helicobacter pylori infection in atrophic gastritis

Molecular Alterations in Gastric Intestinal Metaplasia

The role of the PLR–NLR combination in the prediction of the presence of Helicobacter pylori and its associated complications

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