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Helicobacter pylori strains and histologically‐related lesions affect the outcome of triple eradication therapy: a study from southern Italy
Author(s) -
Russo F.,
Berloco P.,
Cuomo R.,
Caruso M. L.,
Di Matteo G.,
Giorgio P.,
De Francesco V.,
Di Leo A.,
Ierardi E.
Publication year - 2003
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1046/j.1365-2036.2003.01443.x
Subject(s) - helicobacter pylori , clarithromycin , caga , medicine , lansoprazole , gastroenterology , breath test , amoxicillin , virulence , antibiotics , microbiology and biotechnology , gene , biology , biochemistry
Summary Background : Certain evidence suggests that Helicobacter pylori strains expressing genes for cytotoxin production show a higher sensitivity than non‐cytotoxic organisms to eradication treatment. No data are available on the involvement of bacterium‐related lesions in different therapeutic outcomes. Aims : (i) To investigate whether differences in eradication rates may be related to the different expression of virulent strains ( cagA , vacA , iceA ) in patients undergoing proton pump inhibitor‐based triple therapy, and (ii) to evaluate whether therapeutic outcome may be affected by bacterium‐induced gastric lesions. Methods : One hundred and ten H. pylori ‐positive subjects were enrolled. H. pylori was genotyped by polymerase chain reaction. Treatment consisted of lansoprazole–amoxicillin–clarithromycin, twice daily for 1 week. Eradication was checked by urea breath test. Results : The eradication rate was 70%, and the absence of cagA was associated with unsuccessful treatment. No difference between the groups with successful and unsuccessful eradication was found with regard to vacA and iceA . Lympho‐epithelial lesions and fibrosis were associated with unsuccessful treatment. Conclusions : The present data confirm the importance of cagA (but not vacA and iceA ) as a predictor of successful eradication. When fibrosis and lympho‐epithelial lesions are present, therapy appears to be less effective. Therefore, these histological features may be involved in an unsuccessful therapeutic outcome.