Novel Diagnostic Tests to Detect Helicobacter pylori Infection: A Pediatric Perspective

Canadian Journal of Gastroenterology and Hepatology, Sep 2018

Because of the widespread problem of Helicobacter pylori infections, there is an increased need for rapid, reliable and inexpensive diagnostic tests. Five recently developed tests that offer potential advantages because they are less invasive or permit easier acquisition of samples than available tests are assessed. The tests assessed are whole blood, saliva and urine assays that measure systemic antibody response to H pylori, stool tests that measure H pylori antigens and string tests that recover H pylori organisms.

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Novel Diagnostic Tests to Detect Helicobacter pylori Infection: A Pediatric Perspective

G:...Snyder.vp Wed Sep Helicobacter pylori infection: A pediatric perspective John D Snyder Sander Veldhuyzen van Zanten JD Snyder, S Veldhuyzen van Zanten. Novel diagnostic tests to detect Helicobacter pylori infection: A pediatric perspective. Can J Gastroenterol 1999;13(7):585-589. Because of the widespread problem of Helicobacter pylori infections, there is an increased need for rapid, reliable and inexpensive diagnostic tests. Five recently developed tests that offer potential advantages because they are less invasive or permit easier acquisition of samples than available tests are assessed. The tests assessed are whole blood, saliva and urine assays that measure systemic antibody response to H pylori, stool tests that measure H pylori antigens and string tests that recover H pylori organisms. Children; Enzyme-linked immunosorbant assay; Helicobacter pylori; Serological testing; Urease - CANADIAN HELICOBACTER CONSENSUS CONFERENCE ON PEDIATRIC ISSUES Helicobacter pylori is one of the most common bacterial in fections in humans, and has been found in differing rates in persons of all age groups, nationalities and socioeconomic classes ( 1 ). Because the role of H pylori in human disease continues to be explored, there is an increased need for rapid, reliable and inexpensive diagnostic tests ( 2,3 ). The most commonly used standard tests are listed in Table 1. To date, the only test that can detect infection and disease activity is endoscopy with biopsy, which is invasive and expensive. Five recently developed tests that offer potential advantages because they are less invasive or permit easier acquisition of samples are assessed. These tests are whole blood, saliva and urine assays that measure systemic antibody response to H pylori, stool tests that measure H pylori antigens and string tests that use methodology less invasive than upper gastrointestinal endoscopy to recover H pylori organisms. The tests are compared with current standard tests and Nouveaux tests diagnostiques pour déceler une infection à Helicobacter pylori : une perspective pédiatrique RÉSUMÉ : Étant donné l’importance du problème des infections à Helicobacter pylori, on a de plus en plus besoin de tests diagnostiques rapides, fiables et peu coûteux. On a évalué cinq tests récemment mis au point et qui présentent des avantages potentiels parce qu’ils sont moins effractifs ou qu’ils permettent de recueillir des échantillons plus facilement que les tests disponibles. Les tests évalués sont des dosages de sang entier, d’urine et de salive qui mesurent la réponse systémique des anticorps à H. pylori, des examens de selles qui mesurent les antigènes de H. pylori et des épreuves du fil qui recueillent H. pylori. criteria for optimal tests. The criteria are non- or minimally invasive nature; high sensitivity, specificity, and positive and negative predictive values in diagnosing infection and assessing disease activity and effectiveness of therapy; convenience, including ease of acquisition of samples and rapid determination of results; and low cost. WHOLE BLOOD ANTIBODY TESTS Background: Whole blood antibody tests are based on the fact that systemic antibodies to H pylori are found in whole blood, making testing possible in a primary care setting ( 2-9 ). Whole blood tests have several important potential advantages compared with standard serological tests; the samples are easier to obtain, testing can be done in an office setting and the results can be available within 10 mins. In addition, the cost is projected to be less than that for the standard serological tests. 1University of California San Francisco Medical Center, San Francisco, California, USA; 2Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia Correspondence: Dr John D Snyder, Department of Pediatrics, Box 0136, MU East 413, University of California San Francisco Medical Center, 500 Parnassus Avenue, San Francisco, California 94143, USA. Telephone 415-476-5892, fax 415-476-1343, e-mail 100 95 25 Snyder and Veldhuyzen van Zanten Methodology: Whole blood samples are obtained by finger prick yielding one to two drops of blood that are placed directly onto a test slide. The most effective assays measure immunoglobulin (Ig) G antibodies to highly specific H pylori antigens using ELISA techniques ( 2,3 ). Colorimetric results can usually be read in less than 10 mins. Several commercial kits are available (Table 2). Comparison with serological assays: Most of the studies evaluating whole blood antibody tests have been reported in abstract form and have used one standard test as the ‘gold standard’ to diagnose H pylori ( 4-9 ). Individual tests have not been validated formally by multiple investigators or evaluated in an office setting. Evaluation of these tests in pediatric populations is limited; preliminary data indicate that their performance is likely to be similar to that in adults (8). The sensitivity, specificity, and positive and negative p (...truncated)


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John D Snyder, Sander Veldhuyzen van Zanten. Novel Diagnostic Tests to Detect Helicobacter pylori Infection: A Pediatric Perspective, Canadian Journal of Gastroenterology and Hepatology, 13, DOI: 10.1155/1999/304679