Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound   Target Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound

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Query: EC:6.3.4.6 (urease)
7,490 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This study investigated whether the serum nitrite concentration reflects Helicobacter pylori-induced inflammation and atrophic changes of gastric mucosa. Ninety-seven patients underwent biopsy of both antrum and fundus. Samples were analyzed by the rapid urease test and histopathological examination according to the updated Sydney system. Fasting serum samples from each subject were analyzed for specific IgG Helicobacter pylori antibodies, pepsinogen I and II concentrations, and NO2-/NO3- content. Eleven patients had H. pylori eradicated with proton pump-based triple therapy. There was a strong positive correlation between the Helicobacter pylori density in the gastric mucosa and the serum nitrite concentration, but a negative correlation existed between the atrophic grade of the gastric mucosa and both serum nitrite concentration and Helicobacter pylori density in the gastric mucosa. Serum nitrite concentrations decreased significantly after successful eradication of Helicobacter pylori. Therefore, serum nitrite concentration may be a useful marker for oxidative DNA damage and apoptosis associated with Helicobacter pylori infection.
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PMID:Does serum nitrite concentration reflect gastric carcinogenesis in Japanese Helicobacter pylori-infected patients? 1183 8

Gastroduodenal disease associated with Helicobacter pylori infection are reviewed as well as the diagnostic approach. Generally, there are by and large two ways in which a diagnosis of infection by Helicobacter pylori can be made: by using either an invasive or non-invasive procedure. The invasive procedures involve endoscopy and biopsy Biopsy is essential since the mucosa may often appear macroscopically normal but, nevertheless, be inflamed. Once a biopsy is obtained histological examination, culture, polymerase chain reaction, detection of the presence of urease activity can be detected. The non-invasive tests that can be used to diagnose the infection are: serology, detection of labelled metabolic products of urea hydrolysis either in the breath (13CO2, 14CO2), the urine or the blood, detection of Helicobacter pylori antigen in stool specimen. At present, no single test is sufficiently reliable to definitely detect colonisation by Helicobacter pylori, and a combination of two is recommended, if feasible. Choice of the test to be used is not straightforward and relies on a series of situations, i. e., clinical setting and local expertise and availability, that the clinician must consider to obtain the best diagnostic yeld. The challenge of Helicobacter pylori eradication is not very easy to obtain. The possible scenario and the use of a new proton pump inhibitor (esomeprazole) are reviewed and discussed.
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PMID:Helicobacter pylori: diseases, tests and treatment. 1183 15

The prevalence of Helicobacter pylori infection increases with age world-wide, reaching levels of 40-60% in asymptomatic elderly subjects and over 70% in elderly patients with gastroduodenal diseases. However, the percentage of H. pylori-positive elderly patients who are treated for their infection remains very low. Data are now available that demonstrate the benefit of curing H. pylori infection in elderly patients with H. pylori-associated peptic ulcer disease and severe chronic gastritis. Furthermore, the cure of H. pylori may prevent the progression of intestinal metaplasia and gastric atrophy. New studies are needed to clarify the role of eradication in elderly patients with non-ulcer dyspepsia and gastro-oesophageal reflux disease and in those who use non-steroidal anti-inflammatory drugs. H. pylori infection may be easily diagnosed by histological evaluation, rapid urease test or culture performed on gastric biopsies taken during endoscopy. However, the biopsy site must be carefully selected in elderly patients. For non-invasive monitoring of H. pylori infection after treatment, the 13C-urea breath test has significantly higher accuracy than serology in the elderly; further studies are needed to clarify the role of the H. pylori stool antigen test in old age. One-week proton pump inhibitor-based triple therapy regimens, including clarithromycin, amoxicillin and/or nitroimidazoles, are highly effective and well tolerated in elderly patients. Low doses of both proton pump inhibitors and clarithromycin (in combination with standard doses of amoxicillin or nitroimidazoles) are sufficient. Low compliance and antibiotic resistance are the main factors related to treatment failure in old age.
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PMID:Review article: an approach to Helicobacter pylori infection in the elderly. 1192 85

Several diagnostic tests are available for evaluating Helicobacter pylori (H. pylori) infection: histological examination, culture of gastric biopsy specimens, rapid urease test, urea breath test and serology. In this study, we assessed the reliability of a newly developed enzyme immunoassay HpSA (H. pylori Stool Antigen) kit for detecting H. pylori antigen in stool. Eighty-five patients (50 males, 35 females; mean age 41.6 +/- 9.8 years) with dyspeptic symptoms who were examined by upper gastrointestinal endoscopy. The patients with a history of previous treatment with proton pump inhibitors, bismuth compounds or antibiotics were excluded. During the endoscopic examination biopsies were taken from antrum and corpus for rapid urease test and histological examination. Stool specimens were submitted to the laboratory and HpSA test was performed. H. pylori was considered in condition with rapid urease test and histopathological examination for H. pylori positive. Forty-six of 85 patients were positive and remaining 39 patients were negative for H. pylori with the rapid urease test and pathologic evaluation. When 0.160 was adopted as the cut-off value, in accordance with the manufacturer's recommendations; stool antigen has been detected in 45 of the 46 H. pylori positive patients. The sensitivity and specificity of HpSA test were 97.8%, 94.9% respectively. These results indicate that HpSA is a highly reliable diagnostic method for H. pylori infection.
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PMID:Usefulness of the Helicobacter pylori stool antigen test for detection Helicobacter pylori infection. 1214 41

Histology has been recognized as the gold standard for the diagnosis of Helicobacter pylori (Hp) infection in children. For ethical reasons, the number of mucosal biopsies obtained during endoscopic procedures is limited in the pediatric population. The aim of this study was to identify the optimal location where Hp organisms are colonized. Children who were scheduled for upper endoscopic procedures were prospectively recruited for the study. At least 2 mucosal biopsy samples were obtained from the following anatomic locations: greater curvature (mid-fundus [B3], mid-body [B1], and mid-antrum [A1] and lesser curvature mid-body [B2], incisura angularis [A3], and mid-antrum [A2]). In addition, a biopsy sample for a rapid urease test was obtained. The biopsy samples were stained with hematoxylin and eosin and Giemsa for the detection of inflammation and Hp colonization. The degree of mucosal inflammation and Hp colonization was assessed. The study group comprised 206 children, of whom 16 (8%) were positive for Hp infection. Hp colonization was significantly greater in the antral locations (A1, A2, and A3) than the body locations (B1, B2, and B3) (P <.001). The degree of mucosal inflammation correlated with the presence of Hp organisms, Hp density, and antral location. The mid-antrum location (A2) was superior for the detection of Hp organisms. The antrum, especially mid-antrum, at the lesser curvature is the best location in which to detect Hp organisms in children who have not recently used antibiotics or proton pump inhibitor medications.
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PMID:Distribution of Helicobacter pylori organisms in the stomachs of children with H. pylori infection. 1245 19

The aim of the paper is to present the triple therapy results combined with the application of proton pump inhibitors with amoxicillin and tynidazole in treatment of the contagion caused by Helicobacter pylori. The therapy was carried out among 108 people after realization of endoscopic biopsy and with quick urease test. In the endoscopic investigation 72 people were found to have duodenum ulceration. Inflammation of mucous duodenum was found in 36 patients. Among 108 people under investigation 51.85% were men and 48.15% women. These people were aged between 15-81 (the average age was 44). After the use of eradication 99 out of 108 patients (91.66%) were cured. The lack of improvement was found in 9 people (8.34%). The age of these people varied from 18 to 75, which gives the average age 54.5 (this age is about 10 years and a half higher in relation to the average age of the examined group of patients). The results prove high efficiency of this schema of treatment in relation to comparatively low costs. They also indicate greater efficiency of the treatment of contagious caused by Helicobacter pylori in younger people.
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PMID:Efficacy of the triple therapy: proton pomp inhibitors, amoxicillin and tynidazole in Helicobacter pylori infection treatment. 1289 19

H. pylori infects the gastric mucosa and causes many digestive disorders such as peptic ulcer, chronic gastritis and gastric cancer. H. pylori infection relates neither to functional health status, nor to intensity of dyspepsia. There is evidence that in most patients with H. pylori positive functional dyspepsia do not improve with eradication of the organism.This study evaluated the diagnostic accuracy of HpSA by determining the sensitivity and specificity of the stool antigen test in predicting successful eradication during and after anti microbial therapy. The work was conducted on patients who underwent upper gastrointestinal endoscopy at Al-Azhar University hospitals. Fifty patients (34 male & 16 female) with dyspepsia were selected, the exclusion criteria included use of antibiotics and proton pump inhibitors up to one month before the study. All cases were submitted to, full history, general and local examination and upper gastrointestinal endoscopy. Biopsies were taken from the antrum and body of the stomach for rapid urease test and histopathology. Stool samples were taken to detect H. pylori stool antigen. Positive patients received eradication treatment for one month and H. pylori status was re-determined by rapid urease test, histological examination and HpSA test one month later. H. pylori was detected by rapid urease test in 29 (58%) dyspeptic patient by histology in 26(52%) dyspeptic patient, while H. pylori was detected by HpSA immunoassay in 16 (32%) dyspeptic patient. The sensitivity and specificity of HpSA were 57.7% and 95.8% respectively. After successful eradication of H. pylori, reassessment by rapid urease test and histology revealed curative rate of 86.2% and 84.6% respectively, while HpSA immunoassay revealed curative rate 75%. Based on these results, the HpSA immunoassay gave sensitivity (75%) and specificity (100%). The H. pylori stool test represents an accurate and novel non-invasive concept for diagnosis of infection and can be used for daily routine in clinical practice. HpSA is a promising non-invasive test for diagnosis of H. pylori infection but may be hampered by low patient acceptability. So, HpSA is a valuable test in the pre-and post eradication assessment of infection. HpSA can be profitably employed in the primary diagnosis of H. pylori infection. This non invasive test could be very useful in investigating dyspeptic young patients. Also, it could be used profitably in epidemiological studies to determine the prevalence of H. pylori infection in the asymptomatic subjects in different communities.
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PMID:Evaluation of a new enzyme immunoassay for the detection of Helicobacter pylori in stool specimens. 1470 61

H pylori infection is highly prevalent in asymptomatic children and it varies between countries and often within a country as well. Initial infection probably occurs at an early age and prevalence increases with age. Ethnic and racial factors, socio-economic status and living conditions affect the prevalence of infection. Long term population based studies are needed to identify the exact prevalence and clinical significance in Indian children. There is strong evidence for an association between H pylori infection and antral gastritis and duodenal ulcer disease in children, but it's association with recurrent abdominal pain needs further evaluation. Diagnostic tests for H pylori are based either on direct demonstration of the organism or indirectly by detecting a by-product (of the urease reaction) or by demonstrating antibodies. Histopathological identification of H pylori in [table: see text] antral biopsy specimen is by far the best method and is currently regarded as gold standard. Serological tests detecting IgG and IgA are possible tools for diagnosis but have many drawbacks. They may be useful for population surveys where invasive tests are not feasible. These tests should be standardized for the population for which they are going to be used. Urea breath test is a highly sensitive non-invasive test for H pylori infection and can be used even in a field setting. Urea Breath test needs to be standardized in tropical countries with high rates of dental colonization and duodenal microbial contamination. Newer diagnostic tests for H pylori infection are emerging but most have not been validated in various populations. Routine testing for H pylori is not indicated in children or adults. The decision to perform a diagnostic test has often to be linked with a therapeutic proposal. The only condition for which H pylori treatment is indicated is duodenal ulcer which is very uncommon in children. Treatment for RAP or even dyspepsia is not warranted on clinical grounds. There are several treatment regimens available, but it appears that at least three drugs including two antibiotics and a proton pump inhibitor are required for satisfactory eradication. In developing countries where the prevalence of infection is very high, well-planned double blind cross-over studies are needed before an evidence based answer can be provided for an optimal therapeutic strategy.
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PMID:Helicobacter pylori infection in children: a review. 1497 81

We previously reported that a trifluoromethyl ketone derivative, 1-(2-benzoxazolyl)-3,3,3-trifluoro-2-propanone (TF18), exhibited the potent antibacterial activity against Helicobacter pylori, but had no urease activity. In order to clarify the mechanism of anti-H. pylori action of TF18, we evaluated the growth and motility of TF18 on clarithromycin-susceptible H. pylori (CSHP) and -resistant H. pylori (CRHP). An effective proton pump inhibitor (TF18) had remarkable dose-dependent antibacterial activity and was able to inhibit the flagellar motor of both CSHP and CRHP isolates. The antimotility effect of TF18 was more pronounced at subinhibitory concentration in CRHP than in CSHP. The swimming (the forward motion) was more sensitive to the inhibition than the tumbling. Based on the results, it is supposed that TF18 works as an uncoupler similar to the 'clutch' in a biological motor, in which counterclockwise rotation is more sensitive to the effect of TF18 than the clockwise rotation.
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PMID:Inhibitory action of a new proton pump inhibitor, trifluoromethyl ketone derivative, against the motility of clarithromycin-susceptible and-resistant Helicobacter pylori. 1519 36

Helicobacter pylori (H. pylori) is among the most common bacterial infections in humans. In 1982, H. pylori was discovered by Marshal and Warren, demonstrating an association between H. pylori and ulcer disease. H. pylori is a gram-negative, S-shaped rod that produces enzymes like urease, catalase and oxidase. The mechanism of acquisition and transmission of H. pylori is unclear, although the most likely mode of transmission is fecal-oral and oral-oral. The mode of transmission is supported by studies that demonstrate viable H. pylori organisms can be cultured from the stool or vomitus of infected patients. Risk factors such as minimal education and low socio-economic status during childhood affect the prevalence. Children infected with H. pylori develop histologic chronic active gastritis despite the fact that they are generally asymptomatic. A small percentage of these children will go on to develop peptic ulcer disease, and even gastric cancer. In contrast, the association of abdominal pain and H. pylori infection remains controversial. In the year 2000, the North American Society of Pediatric Gastroenterology guidelines on H. pylori reported that there is no evidence demonstrating a link between H. pylori-associated gastritis and abdominal pain, except in rare cases in which gastric or duodenal ulcer disease is present. Currently, treatment with a combination of two antimicrobial agents in conjunction with a proton pump inhibitor (PPI) continues to be recommended for the treatment of H. pylori associated peptic ulcer disease.
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PMID:Treatment of Helicobacter pylori in Pediatrics. 1534 11


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