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