Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: EC:6.3.4.6 (urease)
 7,490 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Infection by Helicobacter pylori (HP) occurs all over the world and is related to the socio-economic development of the subject's country of residence and age. Various strains of HP can be identified on the basis of the microbiological characteristics of the bacterium and, in particular, or its antigenic profile, while the virulence factors are responsible for the damage that HP can cause. The virulence factors include components (flagellum and adhesin) and substances produced by bacterium (enzymes and cytotoxins), the most important among which are urease and the cytotoxins, CagA and VacA. It is the association of these virulence factors that is responsible for the different pathologies to which HP-positive subjects are prone. The link between HP and gastritis, peptic ulcer and gastric cancers (adenocarcinoma and lymphoma) is now proven. Whether there is a link between HP and RAP in young children is still a matter for debate; some Authors claim that there is, while others refute it.
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PMID:[Helicobacter pylori. I. Morphology, biochemistry, antigenic profile and correlated diseases]. 1006 80

A total of 40 children was recruited to assess the role of Helicobacter pylori infection in children with recurrent abdominal pain syndrome. Among 40 children, seven (17.5%) cases were confirmed to have H. pylori infection. All H. pylori-positive patients had active chronic gastritis histologic findings (p < 0.0001); however, the majority of the H. pylori-negative patients had minimal to mild gastritis histologic findings (p = 0.001). Grossly, chronic gastritis picture was present in all children infected with H. pylori and antral nodular gastropathy present in 43%. 71% of H. pylori-positive patients had elevated anti-H. pylori IgG titer; however, 15% in H. pylori-negative patients (p = 0.006). Serum H. pylori assay had a sensitivity of 71% and specificity of 85%; however, sensitivity and specificity of rapid urease test were 86% and 100% respectively. Antral nodularity is a specific, peculiar endoscopic finding of children infected with H. pylori (p = 0.004). Although the present study suggests that H. pylori-related chronic gastritis may play an etiological role in a subgroup of children with RAP syndrome, but the routine screening of H. pylori infection in children with RAP is not recommended, since no compelling data support the significant association between H. pylori infection and RAP syndrome.
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PMID:Helicobacter pylori infection in recurrent abdominal pain in children--a prospective study. 1172 3

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