Article

How come I've got it? (A review of Helicobacter pylori transmission).

Gastro Enterology, CHU Univ. Brugmann ULB-VUB, Brussels, Belgium.
European Journal of Gastroenterology & Hepatology (Impact Factor: 2.15). 06/2000; 12(5):479-82.
Source: PubMed

ABSTRACT Numerous epidemiological studies have shown the two main risk factors for Helicobacter pylori acquisition: childhood and low socio-economic level both in developing and developed countries. Nevertheless, in the absence of ubiquitous extra-human reservoir(s), the route(s) for person-to-person transmission remains undetermined. Very recent data favour the oro-oral route: besides gastric mucosa, mouth might be a sanctuary site and the oro-oral transmission hypothesis seems applicable worldwide. Nevertheless, the gastro-oral route (vomiting, gastro-oesophageal reflux) is still possible and deserves further research. In developing countries, feco-oral transmission (perhaps through the water supply) might be a significant mechanism of human contamination both for primary infection in children and perhaps, reinfection in adults.

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    ABSTRACT: Helicobacter pylori (H. pylori), a common infectious bacterium, has been linked to chronic gastritis, peptic ulcer and gastric cancer. Several invasive and noninvasive techniques are currently used for detecting H. pylori infection. Molecular approaches based on DNA amplification by polymerase chain reaction (PCR) have been developed for the detection of H. pylori in clinical samples but are used only in the research setting. Our objective is to comparatively evaluate the efficiency of using PCR technique for diagnosis of H. pylori infection through determination of glmM gene, and the rapid urease test (RUT), with reference to histological detection of H. pylori as the gold standard. Two hundred gastric biopsy specimens from the antrum of 50 dyspeptic patients were subjected to histology, RUT and PCR; targeting the glmM gene. No age or gender difference regarding H. pylori infection was observed, H. pylori colonization was detected in 82% of cases. The sensitivity and specificity of the RUT and PCR for glmM methods in comparison to histology are as follows: 87.80% and 88.89%; 65.9% and 44.4%, respectively. Histology demonstrating the highest detection rate among cases with superficial gastritis and gastroduodenitis (82% and 80%) compared to RUT (65.5% and 70%) and glmM gene that was expressed in 41.4% and 40% respectively. Colonization of the gastric mucosa by H. pylori was detected in 61.9% of the patients with chronic superficial gastritis, While, RUT was positive in 38.1% of them. Nearly the same percentages were observed for histology and RUT in the other histopathological findings. Similar percentage for glmM gene as RUT was detected in chronic superficial gastritis and in 38.1%, 33.3% of intestinal metaplasia and gastric dysplasia, respectively, while it is not expressed in chronic gastric ulcer and atrophic gastritis. Therefore, we conclude that PCR for glmM gene could be a method with diagnostic value. Nevertheless, histology and RUT were found to be relatively reliable methods for examining gastric biopsy specimens. The low percentage of glmM gene reported here may be attributed to polymorphism and diversity of glmM gene of H. pylori. Therefore, further studies are required to search for the specific sequence of the glmM gene or the presence of mutation in H. pylori strains in Egypt.
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    ABSTRACT: Helicobacter pylori (H. pylori), a common infectious bacterium, has been linked to chronic gastritis, peptic ulcer and gastric cancer. Several invasive and noninvasive techniques are currently used for detecting H. pylori infection. Molecular approaches based on DNA amplification by polymerase chain reaction (PCR) have been developed for the detection of H. pylori in clinical samples but are used only in the research setting. Our objective is to comparatively evaluate the efficiency of using PCR technique for diagnosis of H. pylori infection through determination of glmM gene, and the rapid urease test (RUT), with reference to histological detection of H. pylori as the gold standard. Two hundred gastric biopsy specimens from the antrum of 50 dyspeptic patients were subjected to histology, RUT and PCR; targeting the glmM gene. No age or gender difference regarding H. pylori infection was observed, H. pylori colonization was detected in 82% of cases. The sensitivity and specificity of the RUT and PCR for glmM methods in comparison to histology are as follows: 87.80% and 88.89%; 65.9% and 44.4%, respectively. Histology demonstrating the highest detection rate among cases with superficial gastritis and gastroduodenitis (82% and 80%) compared to RUT (65.5% and 70%) and glmM gene that was expressed in 41.4% and 40% respectively. Colonization of the gastric mucosa by H. pylori was detected in 61.9% of the patients with chronic superficial gastritis, While, RUT was positive in 38.1% of them. Nearly the same percentages were observed for histology and RUT in the other histopathological findings. Similar percentage for glmM gene as RUT was detected in chronic superficial gastritis and in 38.1%, 33.3% of intestinal metaplasia and gastric dysplasia, respectively, while it is not expressed in chronic gastric ulcer and atrophic gastritis. Therefore, we conclude that PCR for glmM gene could be a method with diagnostic value. Nevertheless, histology and RUT were found to be relatively reliable methods for examining gastric biopsy specimens. The low percentage of glmM gene reported here may be attributed to polymorphism and diversity of glmM gene of H. pylori. Therefore, further studies are required to search for the specific sequence of the glmM gene or the presence of mutation in H. pylori strains in Egypt. Key Words: H. pylori; glmM gene; rapid urease test; PCR.
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