搜索结果：Helicobacter

This study explored how implicit theories of health influence people's intention to undergo Helicobacter pylori screening, and the role of risk perception and self-efficacy in explaining the effect. 1085 Chinese adults participated in this study in April 2023. The results revealed that implicit theories of health positively predicted people's intention to undergo Helicobacter pylori screening. Risk perception and self-efficacy serially mediated the relationship between implicit theories of health and intention to undergo Helicobacter pylori screening. Implications of this study for increasing the screening rate of Helicobacter pylori and directions for future research are discussed.

Background:Helicobacter pylori (H. pylori) infection is an established risk factor for gastric cancer. However, treatment efficacy and the underlying mechanisms in elderly patients with H. pylori infection remain incompletely characterised. This study aimed to compare the eradication efficacy and safety of four amoxicillin-containing regimens for H. pylori infection in elderly patients. Methods: Elderly patients (age ≥ 60 years) with Helicobacter pylori infection treated at five hospitals in Beijing between January 2018 and June 2025 were enrolled. Participants were stratified into four groups according to the prescribed regimen: vonoprazan-amoxicillin (VA) dual therapy, rabeprazole-amoxicillin (RA) dual therapy, rabeprazole-Jinghua Weikang (a Chinese herbal medicine, granules)-amoxicillin-furazolidone (RJAF) quadruple therapy, and rabeprazole-bismuth-amoxicillin-furazolidone (RBAF) quadruple therapy. The primary endpoint was the eradication rate for each regimen. Secondary outcomes included the incidence of adverse events (AEs) and data on comorbidities. In addition, serological testing for H. pylori virulence-associated antibodies (CagA, VacA, UreA, and UreB) was performed in 32 patients at baseline, prior to treatment initiation. Results: A total of 312 patients were screened. The eradication rates with VA, RA, RJAF, and RBAF were 96.3%, 94.0%, 86.8%, and 86.6%, respectively (χ2 = 6.92, p = 0.075). The incidence of AEs was 13.8%, 15.5%, 17.9%, and 19.1% in the VA, RA, RJAF, and RBAF groups, respectively (p = 0.391). Conclusions: In elderly patients with Helicobacter pylori infection, dual therapy demonstrates non-inferior efficacy compared with triple therapy and conventional quadruple therapy. More complex regimens do not confer additional clinical benefit. Among the two dual-therapy regimens, VA dual therapy shows superior overall performance and is therefore recommended as the first-line treatment of choice.

This study evaluates the impact of Bacillus subtilis dual-strain enteric-coated capsules combined with vonoprazan-amoxicillin (VA) therapy on Helicobacter pylori (Hp) eradication rates, gastrointestinal symptoms, adverse events (AEs), and gut microbiota. 60 Hp-positive adults were enrolled, allocated to probiotic (n = 30) or placebo (n = 30) groups. Both groups received a 14-day VA dual therapy, with the probiotic group additionally receiving a 28-day Bacillus subtilis dual-strain capsule regimen and the placebo group receiving matched placebos. Outcomes included Hp eradication rates (intention-to-treat [ITT]/per-protocol [PP] analyses), Gastrointestinal Symptom Rating Scale (GSRS) scores, AEs, antibiotic susceptibility, and gut microbiota changes (16S rRNA sequencing). ITT analysis showed identical eradication rates (93.33%) in both groups; PP analysis revealed 96.67% (probiotic) versus 93.33% (placebo). The probiotic group exhibited significantly lower GSRS scores at weeks 4 (T2) and 8 (T3), particularly for diarrhea and acid reflux, with milder AEs (severity score: 5). Probiotic supplementation reduced Hp resistance to metronidazole (26.67% vs. 60.00%) without affecting other antibiotics. Microbiota analysis demonstrated post-eradication reductions in gastric pathogens (e.g., Helicobacter) and increased beneficial bacteria (e.g., Lactobacillus). The probiotic group showed faster restoration of gut α-diversity (higher at T2), enriched butyrate producers (e.g., Blautia, Anaerobutyricum), and decreased opportunistic pathogens (e.g., Klebsiella). Although Bacillus subtilis supplementation did not enhance Hp eradication rates, it significantly improved gastrointestinal symptoms, reduced AEs, increased Hp susceptibility to metronidazole, and accelerated microbiota recovery, supporting its role in microbiome modulation during Hp eradication therapy.

Metabolic reprogramming and epigenetic alterations play important roles in driving tumor microenvironment (TME) remodeling and immune evasion in gastric cancer (GC). Histone lactylation links glycolytic metabolism to transcriptional regulation, but its role in Helicobacter pylori (H. pylori)-associated GC progression remains largely elusive. Multiomics analysis (ChIP-seq and RNA-seq) with in vitro GC/CD8+ T-cell coculture systems and in vivo mouse xenograft models were employed in this study. Clinical GC tissue cohorts were analyzed to validate the clinical relevance of the identified signaling pathways. The epigenetic and immunological impacts of lactate metabolism were assessed using glycolysis inhibitors (2-DG and oxamate) and genetic silencing of LDHA and LDHB. Histone lactylation, specifically H3K18la, was significantly elevated in GC tissues and further elevated upon H. pylori infection. Pharmacological inhibition of glycolysis or LDHA/B double knockdown (DKD) markedly reduced H3K18la levels, suppressed GC cell proliferation, and restored CD8+ T cell-mediated cytotoxicity. Mechanistically, H3K18la directly bound to the HAS2 promoter, transcriptionally activating its expression. Upregulated HAS2 facilitated the nuclear translocation of c-MYC, which subsequently bound to the CD274 promoter to induce PD-L1 expression. Furthermore, c-MYC overexpression rescued PD-L1 levels and reversed the restored CD8+ T-cell cytotoxicity in LDHA/B-deficient GC cells. In vivo, the combination of oxamate and anti-PD-1 blockade synergistically enhanced CD8+ T-cell infiltration and exerted robust antitumor efficacy. H. pylori-associated lactate-driven H3K18la promotes GC progression and immune evasion through the HAS2/c-MYC/PD-L1 axis. These findings provide preclinical support for combining metabolic inhibition with PD-1 blockade in GC, particularly in H. pylori-associated disease.

Helicobacter pylori is a gram-negative bacterium infecting >50% of the world's population and is endemic in Pakistan, however reports on asymptomatic individuals are limited. The present study investigated the prevalence and associated risk factors of H. pylori infection in asymptomatic humans of Khyber Pakhtunkhwa Province in Pakistan, and an overview of previous records in Pakistan. Asymptomatic individuals (n&#xa0;=&#xa0;600) of age ranges 12-75&#xa0;years were interviewed using a structured questionnaire, and blood samples were taken for serological assay. The overall prevalence of H. pylori infection was 45% (270/600), significantly higher in males (157, 58%) than females (113, 42%) (P&#xa0;=&#xa0;0.0003), and peaked in the 31-50&#xa0;year's (145, 54%), with lowest prevalence in 11-30&#xa0;year's age group (43, 16%) (P&#xa0;=&#xa0;0.0001). Marital status was significantly correlated with the infection (P&#xa0;=&#xa0;0.0001). Higher prevalence was observed in the lower socioeconomic class (170, 63%) compared to middle (90, 33%) and upperclass (10, 4%) (P&#xa0;=&#xa0;0.0112). Risk was high in tap water (120, 44%) and well water drinkers (105, 39%) (P&#xa0;<&#xa0;0.0001). A non-significant association of infection was observed among the smokers (75, 28%) and non-smokers (195, 72%) (P&#xa0;=&#xa0;0.7608). Awareness level and education showed strong association, with infection higher in illiterates (143, 53%) and the lowest prevalence was found in individuals with higher education (23, 9%) (P&#xa0;<&#xa0;0.0001). Spatially, the infection was high in Swat (55, 20%), followed by Upper Dir, Lower Dir, and Buner (each 34, 13%), Malakand and Shangla (26, 10%), and Chitral (21, 8%) (P&#xa0;<&#xa0;0.05). Nationally, reported prevalence varies widely from <10% in selected groups to >80% in high-risk cohorts, with high infection rates in Karachi, Quetta, Peshawar, Islamabad, and Abbottabad. Serological assays are frequently used; however, histopathology, stool antigen test, and^13C-urea breath tests are sensitive and accurate for confirming active infection across Pakistan. Preventive measures on an urgent basis should be taken by the health authorities to diagnose and treat the infection at a very early stage.

Many studies have demonstrated that over half of the World's population is infected with Helicobacter pylori (H. pylori). To evaluate the current H. pylori seroprevalence in Bosnia and Herzegovina (B&amp;H), H. pylori antibodies (immunoglobulin G, IgG) from patients with suspected presence were analyzed. In total, 201/471 (42.7%) males and 270/471 (57.3%) females were enrolled between June 2024 and July 2024. They were tested using the enzyme-linked immunosorbent assay (ELISA) method. The overall seroprevalence of H. pylori infection was 214 (out of 471; 45.4%) and did not differ in relation to sex. The seroprevalence rate of H. pylori was highest in the 50&ndash;69 age group, 81 (out of 137; 59.1%; 95% CI: 2.2&ndash;5.6), followed by the &ge;70 age group, 17 (out of 31; 54.8%; CI: 2.0&ndash;6.7), and the 30&ndash;49 age group, 101 (out of 219; 46.1%; 95% CI: 1.7&ndash;4.3). The lowest seroprevalence rate was in the younger age group (&le;29) with 15 (out of 84; 17.8%). Older age groups were more likely to be H. pylori positive and equivocal, while younger age groups negative for H. pylori infection. This single-center study is the first study providing information on the H. pylori seroprevalence in the B&amp;H population and investigating its association with age and sex. Further research is needed to explore other risk factors and to develop effective ways to reduce the burden of this infection.

Bacteria-modulated gastric epithelial cells (GECs) play key roles in Helicobacter pylori-associated pathology. Here, we demonstrate both procolonization and proinflammation roles of GEC-derived PPFIA4 in H. pylori infection. PPFIA4 was elevated in GECs from gastric mucosa of H. pylori-infected patients and mice. PPFIA4 could be synergistically induced by H. pylori and IL-33 via the CagA/AP1 pathway. Human gastric PPFIA4 correlated with H. pylori colonization and the severity of gastritis, and H. pylori colonization and inflammation were attenuated in Ppfia4&#x394;GEC mice. Mechanistically, PPFIA4's SAM1 domain bound domains from CaMK to the first L27 of CASK and subsequently formed a PPFIA4/CASK/AKT1 complex to activate AKT1, resulting in NF-&#x3ba;B activation and MMP1/CXCL3 secretion. This not only led to decreased E-cadherin and ZO-1 by MMP1, thereby promoting gastric mucosal damage to foster H. pylori colonization, but also resulted in increased gastric influx of G-MDSCs via CXCL3-dependent migration, thereby promoting gastritis and impairing H. pylori-specific IFN-&#x3b3;-producing CD4+ T cell responses to foster H. pylori colonization. Furthermore, we identified a PPFIA4 inhibitor, kira6, which effectively inhibited GEC's MMP1/CXCL3 production and ameliorated gastric H. pylori colonization and gastritis. Overall, PPFIA4 could be a promising therapeutic target, as it collectively ensures H. pylori persistence and promotes gastritis.

The increasing antibiotic resistance of Helicobacter pylori (H. pylori) undermines empirical treatment efficacy. Rapid, non-invasive methods simultaneously detecting H. pylori and resistance mutations are needed. However, the clinical performance of multiplex fluorescent PCR kits on stool samples in Chinese populations remains under-evaluated. A total of 535 patients with suspected H. pylori infection were enrolled. Stool samples were tested by the new multiplex fluorescent PCR kit for H. pylori DNA and resistance mutations (23&#xa0;S rRNA and gyrA). Gastric biopsies were cultured for H. pylori and antimicrobial susceptibility testing (AST; disk diffusion). Stool DNA was also analyzed by Sanger sequencing for resistance mutations. A commercial H. pylori PCR kit was used as a comparator. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated against culture/AST and sequencing. Agreement with the comparator kit was assessed using kappa. Resistance mutation frequencies were summarized. Associations between H. pylori infection and demographic factors (age, gender) were assessed using chi-square tests. Culture confirmed H. pylori in 383/535 patients (71.6%). AST revealed high resistance rates: metronidazole 92.0%, levofloxacin 51.3%, clarithromycin 51.0%. The dominant clarithromycin resistance mutation was A2144G (81.2%). Against culture, the MFQ-PCR showed 99.5% sensitivity (95% CI: 98.3-99.9%) and 94.7% specificity (95% CI: 90.5-97.6%) for H. pylori detection. For clarithromycin resistance, sensitivity/specificity were 95.5%/95.7% vs. AST, and 97.5%/99.5% vs. sequencing. For quinolones, sensitivity/specificity were 94.4%/92.6% vs. AST, and 99.5%/95.9% vs. sequencing. Agreement with the comparator PCR kit was excellent (&#x3ba;&#x2009;=&#x2009;0.931). Age&#x2009;<&#x2009;40 years was associated with higher infection rate (P&#x2009;=&#x2009;0.012). This multiplex fluorescent PCR kit demonstrates high accuracy for non-invasive H. pylori detection and resistance profiling, supporting its utility as a first-line diagnostic tool, particularly in settings with limited laboratory resources for H. pylori isolation and AST.

Helicobacter pylori ( H. pylori ) infects the gastric epithelium of approximately half of the global population, and is a well-known risk factor for developing gastric cancer. Despite the clinical significance of H. pylori infection, many genetic factors that contribute to susceptibility remain unidentified. While it is well-established that H. pylori infection can result in gastritis and peptic ulcers, which may progress to gastric cancer, its causal link to other diseases remains unclear. We performed the genome-wide association study (GWAS) for anti- H. pylori IgG antibody titers, which were validated as a surrogate marker for H. pylori infection by the correlation with clinical traits, followed by gene-based and pathway analyses, involving up to 140,863 individuals. This included 56,967 in the discovery phase, and 68,211 in the replication phase from Japanese cohorts, and an additional 15,685 from European populations in a cross-ancestry meta-analysis. We reveal significant associations between H. pylori infection and polymorphisms in the Human Leukocyte Antigen (HLA) class II region within the Major Histocompatibility Complex (MHC), as well as genes related to innate immunity, including CCDC80 , NFKBIZ , TIFA , PSCA , and TRAF3 . Mendelian randomization (MR) analysis revealed that genetic liability to H. pylori infection has both positive and negative causal relationships with a variety of diseases, including autoimmune-related diseases such as Type 1 diabetes, Hashimoto's disease, atopic dermatitis, as well as traits like body height and weight. These genetic findings strongly support the notion that genetic liability to H. pylori infection influences not only gastrointestinal diseases, but also a broader spectrum of health issues, thereby providing valuable insights for public health strategies and personalized medicine approaches.

Chronic urticaria (CU) is a complex inflammatory skin disorder characterized by recurrent wheals and pruritus lasting longer than six weeks, often resulting in significant impairment in quality of life, sleep disturbance, and psychological distress. Although the majority of cases are classified as chronic spontaneous urticaria without identifiable triggers, a growing body of literature suggests that persistent infections may contribute to disease pathogenesis through immune-mediated mechanisms. Helicobacter pylori infection has been increasingly investigated because of its ability to induce chronic systemic inflammation, autoantibody production, and mast cell activation. We present a case of a 34-year-old male with a two-year history of recurrent urticaria that progressed to near-daily episodes over a three-month period. The patient also reported chronic dyspeptic symptoms including heartburn and epigastric discomfort. Laboratory investigations revealed normal complete blood count parameters, normal liver function tests, normal total IgE levels, and mildly elevated C-reactive protein. Stool antigen testing confirmed H. pylori infection and endoscopy demonstrated chronic gastritis. Following completion of eradication therapy, the patient remained symptom-free for two consecutive months, with subsequent stool antigen testing confirming successful eradication. This report highlights the potential pathogenetic role of H. pylori infection in selected patients with chronic urticaria and emphasizes the importance of targeted evaluation based on clinical presentation.

Helicobacter pylori &#xa0;infection is a major etiological factor in chronic gastritis and several gastroduodenal diseases. Although gastric biopsy remains the gold standard for diagnosis, it is invasive and not always suitable for screening or repeated monitoring. Saliva-based polymerase chain reaction (PCR) has emerged as a promising non-invasive diagnostic approach. The present study aimed to evaluate the diagnostic performance of salivary PCR for detecting H. pylori infection and to compare its findings with gastric biopsy results in patients with symptomatic gastritis. This diagnostic accuracy study included 40 patients with symptomatic gastritis who were referred for upper gastrointestinal endoscopy. Unstimulated saliva samples were collected from all participants and analyzed using PCR targeting the 16S rRNA gene of H. pylori. Gastric biopsy with histopathological examination served as the reference standard. Diagnostic performance of salivary PCR was evaluated by calculating sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy. Statistical analysis included the Chi-square test and receiver operating characteristic (ROC) curve analysis. Salivary PCR detected H. pylori deoxyribonucleic acid in 33 of 40 patients. When compared with biopsy findings, salivary PCR demonstrated a sensitivity of 88.8% and a specificity of 75.0%. The PPV was 96.96%, while the NPV was 42.85%. The overall diagnostic accuracy was 87.5%. Although PCR positivity was higher among biopsy-confirmed cases, the association between salivary PCR and biopsy findings was not statistically significant (&#x3c7;&#xb2;=1.85, p=0.17). ROC analysis demonstrated good diagnostic performance, with an area under the curve (AUC) of 0.82. Salivary PCR targeting the 16S rRNA gene demonstrates high sensitivity and good overall diagnostic accuracy for detecting H. pylori infection in patients with symptomatic gastritis. Although gastric biopsy remains the reference standard, salivary PCR represents a promising non-invasive adjunct that may be useful for screening and preliminary detection of H. pylori infection, particularly in settings where endoscopic evaluation is limited.

Polycystic ovary syndrome (PCOS) is a heterogeneous endocrine disorder in which hyperandrogenism represents a centralpathophysiological feature. Increasing attention has been directed toward chronic inflammatory factors that may modulate androgenexcess. Helicobacter pylori (H. pylori) infection is a prevalent chronic bacterial infection associated with systemic low-grade inflammation.However, its potential relationship with androgen-related hormonal parameters in PCOS remains poorly explored. This observational mini case series included seven women with PCOS diagnosed according to the Rotterdam criteriaand confirmed active H. pylori infection. Hormonal parameters including total testosterone, androstenedione, dehydroepiandrosteronesulfate (DHEAS), sex hormone-binding globulin (SHBG), anti-M&#xfc;llerian hormone (AMH), and free androgen index (FAI) were assessedduring active infection and after confirmed eradication. No hormonal contraception, antiandrogens, metformin, incretin-based therapies,or inositol supplements were used during the study period. Following successful H. pylori eradication, consistent changes in androgen-related parameters were observed. Median DHEAS,androstenedione, and total testosterone concentrations decreased, while SHBG levels increased. Consequently, the free androgen indexdecreased in all patients. AMH levels showed a downward trend after eradication. Due to the descriptive nature of the study, no inferentialstatistical analyses were performed. In this observational case series, H. pylori eradication was associated with coherent changes in androgen-related hormonal parameters and reduced androgen bioavailability in women with PCOS. Although causality cannot be established, these findings suggestthat chronic infection-related inflammation may influence the androgenic milieu in PCOS.

Helicobacter pylori (H. pylori) infection is a major cause of dyspeptic disorders and remains highly prevalent in Ghana. However, data on its epidemiology in northern Ghana are limited. The aim of the study was to determine the prevalence of H. pylori infection and identify associated predisposing factors among dyspeptic patients in the Upper East Region of northern Ghana. A multicenter cross-sectional study was conducted among 325 dyspeptic patients tested for H. pylori infection. Sociodemographic and clinical data were collected using a structured questionnaire, whereas stool samples were analyzed for H. pylori antigens using an immunoassay. Bivariate and multivariable logistic regression analyses were performed to identify factors associated with H. pylori infection. The overall prevalence of H. pylori infection was 65.8% (214/325), with the highest prevalence observed in patients within the age category 1-20 years (40.7%). Major predisposing factors included use of public toilets (57.0%), consumption of untreated water (66.4%), and rural residence (56.5%). Consumption of food from street vendors was associated with a 2.27-fold increased likelihood of infection (odds ratio [OR]&#xa0;=&#xa0;2.27), whereas intake of fresh fruits and vegetables increased the risk by 4.81-fold (OR&#xa0;=&#xa0;4.81). Patients from larger households (&#x2265;13 members) were at greater risk of infection compared with those from smaller households (1-6 members) (OR&#xa0;=&#xa0;0.31). The study reveals a high prevalence of H. pylori infection in Ghana's Upper East Region, which is strongly associated with poor sanitation and inadequate personal and food hygiene. Public health interventions aimed at improving sanitation, water quality, food safety, and living conditions are crucial for reducing transmission.

Proton pump inhibitor-based therapies remain the mainstream standard for Helicobacter pylori (H. pylori) eradication because of their lower cost and accessibility. Among these, 14-day sequential therapy (S-14) is a widely established and effective regimen with a relatively lower pill burden. Recently, 14-day vonoprazan-amoxicillin dual therapy (VA-14) has emerged as a promising alternative with similar therapeutic advantages. This study compared the efficacy and safety of VA-14 versus S-14 as first-line therapy. This single-center, prospective, randomized, non-inferiority trial enrolled 337 treatment-na&#xef;ve adults. Participants were assigned to VA-14 (vonoprazan 20&#xa0;mg plus amoxicillin 1000&#xa0;mg twice daily for 14 days) or S-14 (lansoprazole 30&#xa0;mg plus amoxicillin 1000&#xa0;mg twice daily for 7 days, followed by lansoprazole 30&#xa0;mg, clarithromycin 500&#xa0;mg, and metronidazole 500&#xa0;mg twice daily for 7 days). The primary endpoint was eradication rate assessed by urea breath test. Secondary outcomes included adverse events (AEs) and adherence. Intention-to-treat eradication rates were 83.9% with VA-14 and 74.0% with S-14. Per-protocol rates were 90.9% and 85.6%, respectively, demonstrating non-inferiority (P&#xa0;<&#xa0;0.001). AEs were significantly less frequent with VA-14 (42.8% vs 78.3%, P&#xa0;<&#xa0;0.01), including severe AEs (4.2% vs 14.3%, P&#xa0;<&#xa0;0.01). Full adherence was higher with VA-14 (93.8% vs 90.0%, P&#xa0;=&#xa0;0.04). Fourteen-day vonoprazan-amoxicillin dual therapy is non-inferior to sequential therapy for first-line H. pylori eradication and offers better tolerability and adherence, representing a simplified and viable low pill burden option. ClinicalTrials.gov, identifier NCT06156085.

Helicobacter pylori infection, a global health concern, is treated with various antibiotic regimens, but rising resistance causes variable outcomes. This meta-analysis evaluated the efficacy and safety of different eradication regimens. Methods PubMed, Embase, and Web of Science were searched from inception to October 2025. Randomized and observational studies reporting eradication rates or adverse events were included. Pooled estimates were calculated using random-effects models with subgroup analyses and meta-regression. Results Fifty-seven studies (19,941 participants, 127 arms) were included. The pooled eradication rate was 83.0% (95% CI: 81.4%-84.5%; I&#xb2;=87.3%). Egger's and Begg's tests indicated publication bias (both P<0.001); trim-and-fill adjusted rate was 78.1%. Subgroup analyses showed sequential (84.3%), quadruple (83.3%), and dual therapy (83.8%) achieved slightly higher rates than triple therapy (79.2%). PCAB-based regimens outperformed PPI-based (85.3% vs. 81.6%). Ten-day regimens yielded higher rates (85.9%) than 7-day (79.8%) or 14-day (82.7%). Regimens with three antibiotics (86.9%) or nitroimidazoles (84.8%) showed improved efficacy. Meta-regression identified publication year, continent, study design, and acid suppressant as heterogeneity sources (all P<0.01). For safety (54 studies, 119 arms, 5,202 events), pooled adverse event incidence was 26.1% (95% CI: 21.0%-31.9%; I&#xb2;=95.3%). Sequential therapy had the highest incidence (54.1%), dual therapy the lowest (15.8%). Regimens with three antibiotics (52.6%), macrolides (29.0%), or nitroimidazoles (37.1%) were associated with more adverse events. Conclusions Eradication regimens vary in efficacy and safety; treatment selection should balance these factors. Findings require confirmation due to high heterogeneity and between-study comparisons. CRD420251207695, https://www.crd.york.ac.uk/PROSPERO/view/CRD420251207695.

Background Helicobacter pylori&#xa0;(Hp) infection remains a major public health challenge in Colombia, a region with a high incidence of gastric cancer.&#xa0;Optimizing amoxicillin dosing and adherence to weight-based regimens are key modifiable factors to improve eradication. Objective This multicenter study aimed to evaluate real-world Hp eradication rates in Colombian children and identify independent predictors of treatment success. Methods Secondary analysis of the multicenter "LatamPed-Hp" REDCap registry in REDCap included 26 centers in 14 Colombian cities, including treatment-na&#xef;ve children with confirmed Hp infection. Demographic data, clinical symptoms, and pharmacological regimens were recorded. Eradication was confirmed after four weeks post-treatment primarily via non-invasive methods. Factors associated with success were analyzed using bivariate tests and a multivariable logistic regression model. Results A total of 330 patients were included (mean age 11.0 &#xb1; 3.8 years; 52.7% female). The overall eradication rate was 81.8% (270/330). Bivariate analysis showed that success was significantly associated with treatment adherence (p < 0.001), absence of non-gastrointestinal comorbidities (p = 0.005), and adequate amoxicillin dosing (p = 0.017). In the multivariable model, adequate weight-based amoxicillin dosing was a robust independent predictor of success (adjusted odds ratio (aOR) 2.76; 95% confidence interval (CI): 1.11-6.86; p = 0.028). Adherence remained the strongest protective factor (aOR 48.99; p < 0.001), while non-gastrointestinal comorbidities increased the odds of failure (aOR 0.21; p < 0.001). The model demonstrated high accuracy (84.59%) and sensitivity (98.31%). Conclusion Eradication rates in Colombian children remain below international targets. Pharmacological precision, specifically adequate amoxicillin dosing, is a critical modifiable factor for success. Ensuring strict adherence to weight-based protocols and improving treatment compliance are essential strategies to optimize Hp eradication and reduce long-term gastric cancer risk in this population.

Overview of: Jung YS, Tran MTX, Park B, et al Preventive Effect of Helicobacter pylori Treatment on Gastric Cancer Incidence and Mortality: A Korean Population Study. Gastroenterology 2025;169(2):251-260. e4. doi:10.1053/j.gastro.2025.03.036.

Type I Helicobacter pylori (H. pylori) strains exhibit high levels of virulence. In this study, a rapid, visual self-testing kit for H. pylori typing using one drop of finger blood was developed based on the latex agglutination test (LAT). A prospective multicenter diagnostic accuracy study (ChiCTR2400082329) was conducted to evaluate its performance. Each participant recruited from the Department of Gastroenterology or the Physical Examination Center of four centers performed the novel LAT and interpreted the results independently. The performance of the novel LAT for H. pylori typing in screening population (individuals voluntarily undergoing H. pylori infection screening, regardless of the presence of gastrointestinal symptoms) was evaluated using the consistent results of the 13C-urea breath test (13C-UBT), quantum dot-based immunofluorescence (QD) assay and immunoblotting (IB) assay conducted by professionals as the reference standard. This strict reference standard was adopted to ensure diagnostic accuracy for both active infection and strain typing. A total of 1,330 participants with consistent diagnostic data (13C-UBT, QD, and IB assays) were included in the final analysis. Compared with the reference standard, the novel LAT achieved a sensitivity, specificity, and accuracy of 93.67% [95% CI, 88.35%-96.75%], 97.86% [95% CI, 96.82%-98.59%], and 97.37% [95% CI, 96.44%-98.16%], respectively in identifying type I H. pylori infection. The novel LAT developed in this study can potentially be used for the identification of type I H. pylori infection in home self-screening and large-scale population screening.

Helicobacter pylori (H. pylori) is a primary pathogen associated with gastritis, peptic ulcers, and gastric cancer. Current eradication therapies are increasingly compromised by antibiotic resistance. Vitamin D3 (VD3) has shown potential as an adjunct therapy, yet its underlying mechanism remains unclear. This study evaluated the efficacy of VD3 combined with triple therapy on H. pylori eradication in mice, assessing pathological changes, infection and inflammation levels and epithelial cell death; furthermore, it explored the mechanism of the synergistic effect. An in vivo model was inoculated with H. pylori to establish in mice. After four weeks, mice were treated with VD3, triple therapy, quadruple therapy (omeprazole, amoxicillin, clarithromycin and bismuth potassium citrate), or their combinations for another four weeks. Hematoxylin and Eosin (H&E) staining, quantitative real-time PCR, colony formation, immunoblotting, enzyme-linked immunosorbent assay (ELISA), TUNEL staining, and caspase activity assays were used to evaluate the effect of VD3. Compared to triple therapy alone, the combination of VD3 and triple therapy reduced gastritis severity, H. pylori 16S rDNA expression, and bacterial colony counts in infected mice. It also decreased mRNA and protein levels of inflammatory cytokines IL-1&#x3b2;, IL-6, and TNF-&#x3b1;, reduced gastric epithelial cell apoptosis, and suppressed caspase-3/6/9 activities. VD3 treatment further enhanced c-Raf, MEK, and ERK phosphorylation in gastric tissues. Importantly, the ERK inhibitor U0126 abrogated the therapeutic benefits of VD3 combined with triple therapy, leading to increased gastritis severity, H. pylori 16S rDNA expression, bacterial colony counts, and caspase activity. Vitamin D3 synergizes with triple therapy to eradicate H. pylori infection by exhibiting antibacterial, anti-inflammatory, and cytoprotective effects through regulation of the c-Raf/MEK/ERK signaling pathway.