Efficacy of non-invasive ammonium test in diagnostic of Helicobacter pylori infection in patient with dyspepsia


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Detection of Helicobacter pylori (Hp) is mandatory examination for all patients with dyspepsia. An option for cost-effective non-invasive diagnosis of H. pylori infection is the HELIC® ammonium test (Association of Medicine and Analytics, St. Petersburg, Russia), based on the detection of ammonia (the second product of urea hydrolysis by Hp urease) in exhaled air in oral cavity. Material and methods. Three studies were conducted to assess the effectiveness of this test: 1. Evaluation of ammonia level increase in exhaled air before examination (basal level) and after direct infusion of 50 ml of 1% urea solution into stomach during endoscopic examination (loading level). In study, histological examination of stomach body and antrum biopsies was a reference comparison method. 2. Comparison of ammonium test results and histological method by independent researchers in different countries, 3. Analysis of the sensitivity and specificity of the ammonium test by independent researchers in different countries. Results. Eight patients out of nine with histologically confirmed Hp responded with a significant (p<0.001) increase in ammonia levels in oral cavity air after direct infusion of gastric mucosa with 1% urea solution. 2. The concordance of results of the ammonium test and histological examination occurred in 87.5% of cases in Russia (171 patients), 91.3% in Belarus (187patients), 92.4% in Azerbaijan (44 patients). 3. Sensitivity and specificity of the investigated method were 92% and 93% in Russia, 92.7% and 93.4% in Belarus, 91.5% and 92.6% in Azerbaijan, respectively. Conclusions. Non-invasive ammonium test has high level of sensitivity and specificity, high concordance of results with histological method results. Evidence has been obtained that ammonia formed in the stomach is transported through esophagus to the oral cavity where detection is available in a diagnostically significant amount. This test can be recommended for use in common clinical practice.

Full Text

Restricted Access

About the authors

N. V Baryshnikova

Acad. I.P. Pavlov First Saint Petersburg State Medical University Institute of Experimental Medicine

Email: baryshnikova_nv@mail.ru
Candidate of Medical Sciences, Associate Professor

References

  1. Агафонова О.В., Гриценко Т.А., Богданова Ю.В. и др. Поликлиническая терапия: Учебник. Под ред. Д.И. Давыдкина, Ю.В. Щукина. 2-е изд., перераб. и доп. М.: ГЭОТАР-Медиа, 2020; 840 с. doi: 10.33029/9704-5545-6-PLT-2020-1-840
  2. Ахметшина Э.И., Гибадуллина Г.Н. Прибор для выявления хеликобактер пилори-тест-система Хелик®-Скан. Автоматика и электронное приборостроение (АЭП-2017). Мат-лы Всеросс. молодежной научно-техн. конф., посвященной 85-летию КНИТУ-КАИ, 2017; с. 87-9
  3. Барышникова Н.В. Актуальные проблемы диагностики хеликобактериоза. Экспериментальная и клиническая гастроэнтерология. 2009; 2: 50-6
  4. Быков А.С., Быков С.Э., Барышникова М. и др. Модель транспорта аммиака из желудка в ротовую полость при гидролизе карбамида в присутствии гастральной уреазы. Практическая медицина. 2014; 1 (77): 133-7
  5. Дмитриенко М.А., Гинак А.И. Биотехнологическая модель процессов образования газообразных биомаркеров при персистировании инфекции Helicobacter pylori. Известия вузов. Прикладная химия и биотехнология. 2017
  6. (1): 133-9 [Dmitrienko MA, Ginak А.!. Processes of gaseous biomarkers formation in persistent Helicobacter pylori infection - biotechnological model. Izvestiya Vuzov.Prikladnaya Khimiya iBiotekhnologiya [Proceedings of Universities. Applied Chemistry and Biotechnology]. 2017; 7 (1): 133-9 (in Russ.)]. DOI: 10.21.285/2227-2925-2017-7-1-133-139
  7. Дорофеева С.Г., Шелухина А.Н., Конопля Е.Н. и др. Анализ использования теста «Хелик» для коррекции лечения язвенной болезни. Тверской медицинский журнал. 2016; 6: 124-7
  8. Конорев М.Р., Комлева Е.Н., Кухарев А.В. и др. Оценка эффективности аммиачного дыхательного теста ХЕЛИК® для диагностики Helicobacter pylori в желудке и некоторые ошибки при проведении исследования Витебский государственный медицинский университет, Беларусь [электронный ресурс] URL: helicotest. com.ua/wp-content/uploads/2014/12/ХЕЛИК-особенности-и-ошибки.pdf (Дата обращения / Access date: 28.05.2020).
  9. Лазебник Л.Б., Рустамов М.Н. Использование неинвазивного дыхательного ХЕЛИК-теста в диагностике инфекции Helicobacter pylori. Экспериментальная и клиническая гастроэнтерология. 2013; 10: 38-9 URL: https:// cyberleninka.ru/article/n/ispolzovanie-neinvazivnogo-dyhatelnogo-helik-testa-v-diagnostike-infektsii-helicobacterpylori (Дата обращения / Access date: 19.05.2020)
  10. Успенский Ю.П., Барышникова Н.В. Аммонийный тест в диагностике Helicobacter pylori: анализ эффективности. Мед алфавит. 2019; 3 (20): 41-4 [Uspenskiy Y.P., Baryshnikova N.V. Ammonium breath test in diagnostics of Helicobacter pylori infection: analysis of efficacy. Medical alphabet. 2019; 3 (20): 41-4 (in Russ.)]. https://doi.org/10.33667/2078-5631-2019-2-20(395)-41-44
  11. Baryshnikova N.V., Rustamov M.N., Abbasov M.K. et al. Comparative estimation of results of non-invasive ammonium test and histological method in diagnostic of Helicobacter pylori infection. Helicobacter. 2017; 22 (Suppl. 1): 22-3.
  12. Daino D.F., Soifer L., Pedesta J. et al. Pilot test for Helicobacter pylori detection with ammonia breath test. Acta Gastroenterol Latinoam. 2015; 45 (1): 12-7.
  13. Dmitrienko M.A., Dmitrienko V.S., Kornienko E.A. et al. Basic biochemical and clinical aspects of noninvasive tests Helic. Eksp Klin Gastroenterol. 2016; 8: 75-81.
  14. Dun C.D.R., Blac M., Cowell D.C. et al. Ammonia vapour in the mouth as a diagnostic marker for Helicobacter pylori infection: preliminary ‘proof of principle’ pharmacological investigations. Br J. Biomed Sci. 2001; 58 (2): 66-75.
  15. Kearney D.J., Hubbard T., Putnam D. Breath ammonia measurement in Helicobacter pylori infection. Dig Dis Sci. 2002; 47 (11): 2523-30. doi: 10.1023/a:1020568227868
  16. Levitt D.G., Levitt M.D. A model of blood-ammonia homeostasis based on a quantitative analysis of nitrogen metabolism in the multiple organs involved in the production, catabolism, and excretion of ammonia in humans. Clin Exp Gastroenterol. 2018; 11: 193-215. doi: 10.2147/CEG.S160921
  17. Magaly J., Torres V., Menacho V. Breathing test validation study.
  18. Malfertheiner P., Megraud F., O’Morain C.A. et al. Management of Helicobacter pylori infection-the Maastricht V/Florence Consensus Report. Gut. 2017; 66 (1): 6-30. doi: 10.1136/gutjnl-2016-312288
  19. Megraud F., Floch P., Labenz J. et al. Diagnostic of Helicobacter pylori infection. Helicobacter. 2016; 21 (Suppl. 1): 8-13. doi: 10.1111/hel.12333
  20. Sugano K. et al. Kyoto global consensus report on Helicobacter pylori gastritis. Gut. 2015; 64 (9): 1353-67. doi: 10.1136/gutjnl-2015-309252
  21. Warren J.R., Marshall B.J. Unindentified curved bacilli on gastric epithelium in chronic gastritis. Lancet. 1983; 1 (8336): 1273-5.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2020 Russkiy Vrach Publishing House

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies