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Canadian Journal of Gastroenterology
Volume 17, Suppl B, Pages 58B-61B
http://dx.doi.org/10.1155/2003/585862

Can the Response to Eradication Therapy in Helicobacter pylori Infection be Predicted?

Robert Clancy,1 Thomas Borody,3 Zhigang Ren,2 and Gerald Pang1

1Discipline of Immunology and Microbiology, University of Newcastle, Newcastle, Australia
2Vasse Research Institute, Newcastle, Australia
3The Centre for Digestive Disease, Five Dock, New South Wales, Australia

Copyright © 2003 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The failure to eradicate Helicobacter pylori infection with antibiotic therapy has become a major clinical problem, not entirely accounted for by either poor compliance or antibiotic resistance. Recognition that failed eradication is one outcome of the host-parasite relationship focuses attention on impaired host protection as a determinant of nonresponse to antibiotics. A secreted interleukin (IL)-4 whole blood assay was developed to determine whether persistent infection was contributed to by impaired cytokine responses. The blood assay was shown to correlate well with mucosal organ cultures. Significantly lower levels of IL-4 were detected in the whole blood assays in 11 subjects with failed eradication compared with subjects with successful eradication (P<0.05). This latter group underwent a Th1 to Th0 ‘switch’, which appears to be important to successful eradication. Detection of subjects at risk for failing to eradicate infection with standard combination therapy, by virtue of low secreted IL-4 in whole blood cultures, may have clinical value.