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New diagnostic perspectives related to Helicobacter pylori infection in children
Oana Cristina Marginean, Simona Stolnicu
Abstract: The Helicobacter pylori infection is one of the most widespread infections in the world, with the greatest incidence in developing and undeveloped countries (10%). It is approved today that Helicobacter pylori causes gastritis and peptic ulcer disease, and that the long-term infection is associated with a high risk for developing a gastric adenocarcinoma or malignant lymphoma. This infection is included by WHO in the 1st carcinogenetic group. The gold-standard in diagnosing the Helicobacter pylori infection is the gastric biopsy; the evaluation of treatments` efficacy involves urea breath test as well as the detection of stool antigens. The bases of the genetic predisposition depend on the genic susceptibility or on the DNA repairing mechanisms and carcinogenesis. The treatment response of the Helicobacter pylori infection has genic determinism. The polymorphism of the host, implying the genes CYP2C19 and MDR1, influences the pharmacokinetic and clinic efficacy of the treatment. The directions of fundamental research combine clinical aspects with endoscopical, histological and immunological examination. There are new innovative immunologic and genic methods to evaluate gastritis and ulcer associated with Helicobacter pylori in children. In order to elaborate new therapeutic protocols, it is important to make some correlations between the infection with Helicobacter pylori and the genic polymorphism. By means of molecular biology, scientists hope to identify the changes that determine resistance to antibiotics. The objective is to decrease the incidence in gastric malignancy in the adult period, diminishing the costs derived from malignacies, which could represent an important step forward in the practice of pediatric gastroenterology.
Keywords: Helicobacter pylori,gastritis,child
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