ANTI-HELICOBACTER PYLORI SPECIFIC ANTIBODY IMMUNOHISTOCHEMISTRY IMPROVES THE DIAGNOSTIC-ACCURACY OF HELICOBACTER-PYLORI IN BIOPSY SPECIMEN FROM PATIENTS TREATED WITH TRIPLE THERAPY

Citation
L. Marzio et al., ANTI-HELICOBACTER PYLORI SPECIFIC ANTIBODY IMMUNOHISTOCHEMISTRY IMPROVES THE DIAGNOSTIC-ACCURACY OF HELICOBACTER-PYLORI IN BIOPSY SPECIMEN FROM PATIENTS TREATED WITH TRIPLE THERAPY, The American journal of gastroenterology, 93(2), 1998, pp. 223-226
Citations number
27
Categorie Soggetti
Gastroenterology & Hepatology
ISSN journal
00029270
Volume
93
Issue
2
Year of publication
1998
Pages
223 - 226
Database
ISI
SICI code
0002-9270(1998)93:2<223:APSAII>2.0.ZU;2-N
Abstract
Objective: To investigate the effectiveness of immunohistochemical tec hnique to detect Helicobacter pylori (H. pylori) in patients treated w ith triple therapy. Methods: Forty patients (18 men, 22 women, mean ag e 43 years) with active antral gastritis, H. pylori positive at urease test, culture, and histology, were treated for 1 wk with omeprazole, amoxicillin, and metronidazole. Gastritis was scored according to Sydn ey criteria. Two months after the end of therapy, endoscopy, urease te st, culture, and histology were repeated. Results: Culture and histolo gy were negative in 32 (80%) of treated cases, Biopsy specimens of the eradicated group were stained with immunohistochemical technique usin g an anti-H. pylori specific polyclonal antibody. In 12 of 32 (37.5%) patients, clusters of round or vibrio-shaped bacteria, unidentified at histology, were stained by the specific anti-H. pylori antibody. Afte r triple therapy, at histology all patients were found with improved g astritis. In six patients however, mucosal-associated lymphoid tissue (MALT) appearance, present before therapy, persisted after therapy. In five of six patients with MALT, immunostaining with anti-H. pylori an tibody was positive. Conclusions: The immunohistochemical technique is more accurate than classical methods in identifying H. pylori after s pecific therapy. This method should, therefore, be used in all studies that aim to achieve eradication. Whether the H. pylori identified at immunohistochemistry is able to reactivate and induce recrudescence of infection remains to be clarified. (C) 1998 by Am. Cell. of Gastroent erology).