Kushch Ievgeniia, Korenev Nikolai, Kamarchuk Lyudmila, Pospelov Alexander, Kravchenko Andrey, Bajenov Leonid, Kabulov Mels, Amann Anton, Kamarchuk Gennadii
SI 'Institute for Children and Adolescents Health Care' of NAMS of Ukraine, 52-A 50 let VLKSM Avenue, Kharkov 61153, Ukraine.
J Breath Res. 2015 Dec 15;9(4):047111. doi: 10.1088/1752-7155/9/4/047111.
State-of-the-art methods for non-invasive detection of the Helicobacter pylori (H. pylori) infection have been considered. A reported global tendency towards a non-decreasing prevalence of H. pylori worldwide could be co-influenced by the functional limitations of urea breath tests (UBTs), currently preferred for the non-invasive recognition of H. pylori in a clinical setting. Namely, the UBTs can demonstrate false-positive or false-negative results. Within this context, limitations of conventional clinically exploited H. pylori tests have been discussed to justify the existing need for the development of a new generation of breath tests for the detection of H. pylori and the differentiation of pathogenic and non-pathogenic strains of the bacterium. This paper presents the results of a pilot clinical study aimed at evaluating the development and diagnostic potential of a new method based on the detection of the non-urease products of H. pylori vital activity in exhaled gas. The characteristics of breath of adolescents with H. pylori-positive and H. pylori-negative functional dyspepsia, together with a consideration of the cytotoxin-associated gene A (CagA) status of H. pylori-positive subjects, have been determined for the first time using innovative point-contact nanosensor devices based on salts of the organic conductor tetracyanoquinodimethane (TCNQ). The clinical and diagnostic relevance of the response curves of the point-contact sensors was assessed. It was found that the recovery time of the point-contact sensors has a diagnostic value for differentiation of the H. pylori-associated peptic ulcer disease. The diagnostically significant elongation of the recovery time was even more pronounced in patients infected with CagA-positive H. pylori strains compared to the CagA-negative patients. Taking into account the operation of the point-contact sensors in the real-time mode, the obtained results are essential prerequisites for the development of a fast and portable breath test for non-invasive detection of cytotoxic CagA strains of H. pylori infection. The relaxation time of the point-contact nanosensors could be selected as a diagnostic criterion for non-invasive determination of H. pylori-associated destructive lesions of the gastroduodenal area in adolescents, using the point-contact spectroscopic concept of breath analysis. This can subsequently be implemented into a 'test-and-treat' approach for the management of uninvestigated dyspepsia in populations with a high prevalence of H. pylori (according to the Maastricht III and IV Consensus recommendations).
已对用于非侵入性检测幽门螺杆菌（H. pylori）感染的先进方法进行了研究。据报道，全球范围内H. pylori患病率呈非下降趋势，这可能受到尿素呼气试验（UBT）功能限制的共同影响，目前UBT在临床环境中是用于非侵入性识别H. pylori的首选方法。也就是说，UBT可能会出现假阳性或假阴性结果。在此背景下，讨论了传统临床应用的H. pylori检测方法的局限性，以证明开发新一代用于检测H. pylori以及区分该细菌致病菌株和非致病菌株的呼气试验的必要性。本文介绍了一项初步临床研究的结果，该研究旨在评估一种基于检测呼出气体中H. pylori生命活动的非尿素产物的新方法的开发情况及其诊断潜力。首次使用基于有机导体四氰基对苯二醌二甲烷（TCNQ）盐的创新型点接触纳米传感器设备，确定了H. pylori阳性和H. pylori阴性功能性消化不良青少年的呼气特征，并考虑了H. pylori阳性受试者的细胞毒素相关基因A（CagA）状态。评估了点接触传感器响应曲线的临床和诊断相关性。发现点接触传感器的恢复时间对于区分H. pylori相关消化性溃疡疾病具有诊断价值。与CagA阴性患者相比，感染CagA阳性H. pylori菌株的患者恢复时间的诊断性显著延长更为明显。考虑到点接触传感器的实时操作模式，所获得的结果是开发用于非侵入性检测H. pylori感染细胞毒性CagA菌株的快速便携式呼气试验的重要前提条件。利用呼气分析的点接触光谱概念，点接触纳米传感器的弛豫时间可被选作非侵入性确定青少年胃十二指肠区域H. pylori相关破坏性病变的诊断标准。随后，这可被应用于一种“检测即治疗”方法，用于管理H. pylori高流行人群中未经调查的消化不良（根据马斯特里赫特III和IV共识建议）。
