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Minerva Biotecnologica 2019 September;31(3):100-7

DOI: 10.23736/S1120-4826.19.02555-2


language: English

Diagnosis of Helicobacter pylori infection: a look into molecular aspects of urea breath test

Chiara MARINONI 1, Davide G. RIBALDONE 2, Chiara ROSSO 1, Marco ASTEGIANO 3, Gian Paolo CAVIGLIA 1

1 Department of Medical Sciences, University of Turin, Turin, Italy; 2 Department of Surgical Sciences, University of Turin, Turin, Italy; 3 Unit of Gastroenterology, San Giovanni Antica Sede Hospital, Turin, Italy

Helicobacter pylori (H. pylori) is a bacterium that selectively colonizes gastric epithelium in more than 50% people over the world. The infection is usually acquired in early childhood and rarely resolved spontaneously; transmission is mostly person to person, and occurs by fecal-oral or oral-oral modality. Diagnosis and antibiotic treatment may lead to eradication of H. pylori, improving the prevention and the outcome of gastric and extragastric diseases. Many tests are currently available for the diagnosis of H. pylori infection and the choice depends on several clinical aspects including symptoms, age, indications for testing, concomitant medications and comorbidities. Invasive tests (i.e. endoscopy with histologic assessment) are considered the gold standard, but they are expensive and should be performed only in an appropriate context. The most common noninvasive tests are urea breath test (UBT), stool antigens test and serology. UBT is noninvasive, quick, safe, accurate and cheap. This test is performed mainly with 13C and is based on the presence of H. pylori urease, an enzyme that converts urea (labelled with an isotope) into CO2. Labelled CO2 is then exhaled and measured by dedicated spectrophotometers. This review analyses with special emphasis UBT, focusing on its molecular aspects.

KEY WORDS: Breath tests; Diagnosis; Helicobacter; Urease

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