BACKGROUND Endofaster is an innovative technology that can be combined with upper gastrointestinal endoscopy(UGE)to perform gastric juice analysis and real-time detection of Helicobacter pylori(H.pylori).AIM To assess...BACKGROUND Endofaster is an innovative technology that can be combined with upper gastrointestinal endoscopy(UGE)to perform gastric juice analysis and real-time detection of Helicobacter pylori(H.pylori).AIM To assess the diagnostic performance of this technology and its impact on the management of H.pylori in the real-life clinical setting.METHODS Patients undergoing routine UGE were prospectively recruited.Biopsies were taken to assess gastric histology according to the updated Sydney system and for rapid urease test(RUT).Gastric juice sampling and analysis was performed using the Endofaster,and the diagnosis of H.pylori was based on real-time ammonium measurements.Histological detection of H.pylori served as the diagnostic gold standard for comparing Endofaster-based H.pylori diagnosis with RUT-based H.pylori detection.RESULTS A total of 198 patients were prospectively enrolled in an H.pylori diagnostic study by Endofasterbased gastric juice analysis(EGJA)during the UGE.Biopsies for RUT and histological assessment were performed on 161 patients(82 men and 79 women,mean age 54.8±19.2 years).H.pylori infection was detected by histology in 47(29.2%)patients.Overall,the sensitivity,specificity,accuracy,positive predictive value,and negative predictive value(NPV)for H.pylori diagnosis by EGJA were 91.5%,93.0%,92.6%,84.3%,and 96.4%,respectively.In patients on treatment with proton pump inhibitors,diagnostic sensitivity was reduced by 27.3%,while specificity and NPV were unaffected.EGJA and RUT were comparable in diagnostic performance and highly concordant in H.pylori detection(κ-value=0.85).CONCLUSION Endofaster allows for rapid and highly accurate detection of H.pylori during gastroscopy.This may guide taking additional biopsies for antibiotic susceptibility testing during the same procedure and then selecting an individually tailored eradication regimen.展开更多
Autophagy is a highly-regulated,conserved cellular process for the degradation of intracellular components in lysosomes to maintain the energetic balance of the cell.It is a pro-survival mechanism that plays an import...Autophagy is a highly-regulated,conserved cellular process for the degradation of intracellular components in lysosomes to maintain the energetic balance of the cell.It is a pro-survival mechanism that plays an important role during development,differentiation,apoptosis,ageing and innate and adaptive immune response.Besides,autophagy has been described to be involved in the development of various human diseases,e.g.,chronic liver diseases and the development of hepatocellular carcinoma.The hepatitis C virus(HCV) is a major cause of chronic liver diseases.It has recently been described that HCV,like other RNA viruses,hijacks the autophagic machinery to improve its replication.However,the mechanisms underlying its activation are conflicting.HCV replication and assembly occurs at the so-called membranous web that consists of lipid droplets and rearranged endoplasmic reticulum-derived membranes including single-,doubleand multi-membrane vesicles.The double-membrane vesicles have been identified to contain NS3,NS5 A,viral RNA and the autophagosomal marker microtubuleassociated protein 1 light chain 3,corroborating the involvement of the autophagic pathway in the HCV lifecycle.In this review,we will highlight the crosstalk of the autophagosomal compartment with different steps of the HCV life-cycle and address its implications on favoring the survival of infected hepatocytes.展开更多
基金Supported by the Deutsches Zentrum für Infektionsforschung,Partner Site Munich,Germany,No.TTU 06.715_00the Bavarian Ministry of Science and the Arts within the framework of the Bavarian Research Network“New Strategies Against Multi-Resistant Pathogens by Means of Digital Networking–bayresq.net”.
文摘BACKGROUND Endofaster is an innovative technology that can be combined with upper gastrointestinal endoscopy(UGE)to perform gastric juice analysis and real-time detection of Helicobacter pylori(H.pylori).AIM To assess the diagnostic performance of this technology and its impact on the management of H.pylori in the real-life clinical setting.METHODS Patients undergoing routine UGE were prospectively recruited.Biopsies were taken to assess gastric histology according to the updated Sydney system and for rapid urease test(RUT).Gastric juice sampling and analysis was performed using the Endofaster,and the diagnosis of H.pylori was based on real-time ammonium measurements.Histological detection of H.pylori served as the diagnostic gold standard for comparing Endofaster-based H.pylori diagnosis with RUT-based H.pylori detection.RESULTS A total of 198 patients were prospectively enrolled in an H.pylori diagnostic study by Endofasterbased gastric juice analysis(EGJA)during the UGE.Biopsies for RUT and histological assessment were performed on 161 patients(82 men and 79 women,mean age 54.8±19.2 years).H.pylori infection was detected by histology in 47(29.2%)patients.Overall,the sensitivity,specificity,accuracy,positive predictive value,and negative predictive value(NPV)for H.pylori diagnosis by EGJA were 91.5%,93.0%,92.6%,84.3%,and 96.4%,respectively.In patients on treatment with proton pump inhibitors,diagnostic sensitivity was reduced by 27.3%,while specificity and NPV were unaffected.EGJA and RUT were comparable in diagnostic performance and highly concordant in H.pylori detection(κ-value=0.85).CONCLUSION Endofaster allows for rapid and highly accurate detection of H.pylori during gastroscopy.This may guide taking additional biopsies for antibiotic susceptibility testing during the same procedure and then selecting an individually tailored eradication regimen.
文摘Autophagy is a highly-regulated,conserved cellular process for the degradation of intracellular components in lysosomes to maintain the energetic balance of the cell.It is a pro-survival mechanism that plays an important role during development,differentiation,apoptosis,ageing and innate and adaptive immune response.Besides,autophagy has been described to be involved in the development of various human diseases,e.g.,chronic liver diseases and the development of hepatocellular carcinoma.The hepatitis C virus(HCV) is a major cause of chronic liver diseases.It has recently been described that HCV,like other RNA viruses,hijacks the autophagic machinery to improve its replication.However,the mechanisms underlying its activation are conflicting.HCV replication and assembly occurs at the so-called membranous web that consists of lipid droplets and rearranged endoplasmic reticulum-derived membranes including single-,doubleand multi-membrane vesicles.The double-membrane vesicles have been identified to contain NS3,NS5 A,viral RNA and the autophagosomal marker microtubuleassociated protein 1 light chain 3,corroborating the involvement of the autophagic pathway in the HCV lifecycle.In this review,we will highlight the crosstalk of the autophagosomal compartment with different steps of the HCV life-cycle and address its implications on favoring the survival of infected hepatocytes.
