Intragastric pH and Bismuth Effect for H. Pylori Eradication
Status:
Completed
Trial end date:
2019-02-20
Target enrollment:
Participant gender:
Summary
Gastric cancer is one of the leading causes of cancer-related deaths worldwide. In Taiwan,
there are around 3800 fresh cases annually, with about 5% of total cancers cases. Gastric
cancer development is known to follow a multistate process from non-atrophic gastritis,
atrophic gastritis, intestinal metaplasia, dysplasia, and carcinoma; H. pylori infection
plays the key role of this carcinogenic process. Although H. pylori eradication would result
in a marked gastric cancer reduction, treatment success using standard regimens has become
more difficult in recent years, and increased antibiotic resistance is considered the most
important reason for decreased treatment efficacy. As no specific new medications have been
introduced in recent years, novel treatment regimens have been created using different
combinations, durations and sequences of available medications. The addition of bismuth
improved the cure rates despite a high prevalence of resistance, and resistance of H. pylori
to bismuth has not been reported. Bismuth absorption is not required for efficacy in H.
pylori treatment regimens, suggesting a local mechanism of action. The mechanisms of bismuth
with responsible for rapid destruction of H. pylori within the stomach remain unclear.
Knowledge of the mechanism of action of bismuth compounds against H. pylori would be
beneficial in the development of improved treatment regimens in this era of declining
eradication success rates. We conduct the pilot study to evaluate the bacteria fragments of
H. pylori in specimen through electron microscopy after bismuth therapy and provide insight
into the mechanism of action of pH on bismuth therapy. We also help to develop optimal H.
pylori therapeutic strategies.
Phase:
N/A
Details
Lead Sponsor:
National Taiwan University Hospital
Collaborator:
Ministry of Science and Technology, Taipei, Taiwan