Can the Response to Eradication Therapy in Helicobacter pylori Infection be Predicted?
The failure to eradicate Helicobacter pylori infection with antibiotic therapy has become a major clinical problem, not entirely accounted for by either poor compliance or antibiotic resistance. Recognition that failed eradication is one outcome of the host-parasite relationship focuses attention on...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2003-01-01
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| Series: | Canadian Journal of Gastroenterology |
| Online Access: | http://dx.doi.org/10.1155/2003/585862 |
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| Summary: | The failure to eradicate Helicobacter pylori infection with antibiotic
therapy has become a major clinical problem, not entirely accounted
for by either poor compliance or antibiotic resistance. Recognition
that failed eradication is one outcome of the host-parasite relationship
focuses attention on impaired host protection as a determinant
of nonresponse to antibiotics. A secreted interleukin (IL)-4 whole
blood assay was developed to determine whether persistent infection
was contributed to by impaired cytokine responses. The blood assay
was shown to correlate well with mucosal organ cultures.
Significantly lower levels of IL-4 were detected in the whole blood
assays in 11 subjects with failed eradication compared with subjects
with successful eradication (P<0.05). This latter group underwent a
Th1 to Th0 ‘switch’, which appears to be important to successful
eradication. Detection of subjects at risk for failing to eradicate infection
with standard combination therapy, by virtue of low secreted
IL-4 in whole blood cultures, may have clinical value. |
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| ISSN: | 0835-7900 |