• Clinical relevance of Helicobacter pylori status in children with functional dyspepsia and chronic gastritis

Clinical relevance of Helicobacter pylori status in children with functional dyspepsia and chronic gastritis

PERINATOLOGIYA I PEDIATRIYA. 2017.2(70):140-146; doi 10.15574/PP.2017.70.140

Lukashuk V. D., Ali Sameh Ali, Shevtsova O. M., Babyak V. I., Palahniuk N. O.
Bogomolets National Medical University, Kyiv, Ukraine

Objective — to study non_invasive methods of detection of H. pylori antigen in stool specimens and anti-H. pylori antibodies in serum for appraisal H. pylori status in children with functional dyspepsia and chronic gastritis.

Materials and methods. Sixty children with H. pylori associated functional dyspepsia (I group) and 83 children with H. pylori associated chronic gastritis (II group) were examined. All patients were from 6 to 17 years of age. For the diagnosis of H. pylori infection, histological and bacterioscopic methods, three serological tests, as well as three tests for the detection of H. pylori anti-gen in stool specimens, were performed in all patients. The stool tests included PCR, the laboratory kits «CITO TEST — H. pylori Ag» by SerTest Biotec, S.L. and «CITO TEST — H. pylori Ag» by Pharmasco. The stool tests were also used to assess the post-eradication efficacy of anti-H. pylori therapy.

Results. In the first group, serum IgG anti-CagA antibodies were detected: 40 children had H. pylori CagA«+» status, and 20 children had H. pylori CagA«-» status. In the second group, 58 children had H. pylori CagA«+» status, and 25 children had H. pylori CagA«-» status. The above-mentioned tests for the detection of serum anti-CagA antibodies and H. pylori antigen in stool specimens showed high sensitivity and specificity. Based on the results of these non-invasive methods it is possible to define the H. pylori status of a child (H. pylori «+» or H. pylori«-» and H. pylori CagA«+» or H. pylori CagA«-»), the latter two can serve as predictors of the efficacy of anti-H. pylori therapy.

Conclusions. The comparative study of tests for the detection of H. pylori antigen in stool specimens of children with functional dyspepsia and chronic gastritis showed high sensitivity and specificity. Serological tests and stool antigen tests are interchangeable and can complement each other. It is recommended to define in a particular patient their H. pylori status or H. pylori CagA status on the basis of the results of non-invasive methods. The H. pylori CagA«+» status of children can serve as a criterion for initiation of anti-H. pylori therapy.

Key words: functional dyspepsia, chronic gastritis, H. pylori infection, stool antigen test, serum anti-H. pylori antibodies, H. pylori CagA status, children.

References
1. Abaturov O, Herasymenko OM. (2014). Molekulyarnі osoblyvostі rozvytku zapalennya slyzovoii obolonky shlunka u dіtey z khelіkobakternoyu іnfektsіyeyu, asotsyiovanoyu z CagA(+) shtamamy H. pylori. Gastroenterologіya. 1.

2. Beketova GV. (2009). Khronіchnі gastroduodenіty v dіtey і pіdlіtkіv. Sіmeyna medytsyna. 2: 52-57.

3. Bobrova VІ, P’yankova OV, Nadtochіy NІ. (2010). Epіdemіologіchnі aspekty perebіgu khronіchnoii gastroduodenal'noii patologii u dіtey. Suchasna gastroenterologіya. 2: 33-36.

4. Volosovets' OP, Saltanova SD. (2012). Vplyv provedennya antigelіkobakternoii terapii  H. pylori-іnfіkovanym bat'kam na rіven' reіnfektsіyi H. pylori u dіtey z dosyagnutoyu eradykatsіyeyu. Zdorov'ye rebenka. 2(37): 25-27.

5. Maev IV, Kucheryavyy DN, Andreev DN. (2013). Prychyny neeffektyvnosti antykhelikobakternoyi terapiyi. Ros zhurn gastroenterol, gepatol, koloproktol. 6(23): 62-72.

6. Maydannik VG. (2016). Rims'kі kriterії IV (2016): shcho novogo? Mіzhnarodniy zhurnal pedіatrіyi, akusherstva ta gіnekologіyi. 10; 1: 8-18.

7. Saltanova SD. (2012). Dіagnostychna efektyvnіst' neіnvazyvnykh metodіv vyznachennya Helicobacter pylori u dіtey. Іnfektsіynі khvoroby. 2(68): 59-63.

8. Olbermann P, Josenhans AC, Moodley Y et al. (2010). global overview of the genetic and functional diversity in the Helicobacter pylori cag pathogenicity island. PLoS Genet. 16; 8: 20-30. https://doi.org/10.1371/journal.pgen.1001069

9. Calvet X, Sanchez-Delgado J, Montserrat A et al. (2009). Accuracy of diagnostic tests for Helicobacter pylori: a reappraisal. Clin Infect Dis. 48; 10: 1385-1391. https://doi.org/10.1086/598198; PMid:19368506

10. Albrecht P, Kotowska M, Szajewska H. (2011, Jul). Sequential therapy compared with standard triple therapy for Helicobacter pylori eradication in children: a double-blind, randomized, controlled trial. J Pediatr. 159(l): 45-49. https://doi.org/10.1016/j.jpeds.2011.01.023; PMid:21371717

11. Couturier M. (2014). Helicobacter pylori diagnostics and treatment: could a lack of universal consensus be the best consensus? Clin Chem. 60; 4: 589-594. https://doi.org/10.1373/clinchem.2012.201475; PMid:23908455

12. Drossman DA. (2006). The functional gastrosntestinal disorders and the Rome III process. Gastroenterology. 130; 5: 1377-1390. https://doi.org/10.1053/j.gastro.2006.03.008; PMid:16678553

13. Drossman DA, Hasler WL. (2016). Rome IV — Functional GI Disorders: Disorders of Gut-Brain Interaction. Gastroenterology. 150(6): 1257-1261. https://doi.org/10.1053/j.gastro.2016.03.035; PMid:27147121

14. Koletzko S. Jones NL, Goodman KJ et al. (2011, Aug). Evidence-based guidelines from ESPGHAN and NASPGHAN for Helicobacter pylori infection in children. H. pylori Working Groups of ESPGHAN and NASPGHAN. J Pediatr Gastroenterol Nutr. 53(2): 230-243. PMid:21558964

15. Graham DY, Dore MP. (2016). Helicobacter pylori therapy: a paradigm shift. Expert Rev Anti Infect Ther. 14: 577–585. https://doi.org/10.1080/14787210.2016.1178065; PMid:27077447 PMCid:PMC4939773

16. Sugano K, Tack J, Kuipers EJ et al. (2015, Sep). Kyoto global consensus report on Helicobacter pylori gastritis. Faculty members of Kyoto Global Consensus Conference. Gut. 64(9): 1353-1367. https://doi.org/10.1136/gutjnl-2015-309252; PMid:26187502 PMCid:PMC4552923

17. Malfertheiner P, Megraud F, O’Morain CA et al. (2012). European Helicobacter Study Group. Management of Helicobacter pylori infection — the Maastricht IV. Florence Consensus Report. Gut. 61(5).

18. Megraud F. Lehours P. (2007). Helicobacter pylori detection and antimicrobial susceptibility testing. Clin Microbiol Rev. 20; 2: 280-322. https://doi.org/10.1128/CMR.00033-06; PMid:17428887 PMCid:PMC1865594

19. Raguza D, Granato CF, Kawakami E. (2005, Mar). Evaluation of the stool antigen test for Helicobacter pylori in children and adolescents. Dig Dis Sei. 50(3): 453-457. https://doi.org/10.1007/s10620-005-2457-4

20. Papa A. Danese S, Sgambato A et al. (2002, Apr). Role of Helicobacter pylori CagA+ infection in determining oxidative DNA damage in gastric mucosa. Scand J Gastroenterol. 37(4): 409-13. https://doi.org/10.1080/003655202317316033; PMid:11989831

21. Basso D, Stefani A, Brigato L et al. (1999). Serum antibodies anti-H.pylori and anti-CagA: a comparison between four different assay. J Clin Lab Anal. 13(4): 194-198. https://doi.org/10.1002/(SICI)1098-2825(1999)13:4<194::AID-JCLA9>3.0.CO;2-E

22. Iranikhah A, Ghadir MR, Sarkeshikian S et al. (2013, Apr). Stool antigen tests for the detection of Helicobacter pylori in children. Iran J Pediatr. 23(2): 138-142. PMid:23724172 PMCid:PMC3663302

Содержание журнала Full text of article