title: On the importance of developing a new generation of breath tests for Helicobacter pylori detection.
abstract: 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).
authors.affiliation: SI 'Institute for Children and Adolescents Health Care' of NAMS of Ukraine, 52-A 50 let VLKSM Avenue, Kharkov 61153, Ukraine.
authors.forename: Ievgeniia
authors.initials: I
authors.lastname: Kushch
authors.forename: Nikolai
authors.initials: N
authors.lastname: Korenev
authors.forename: Lyudmila
authors.initials: L
authors.lastname: Kamarchuk
authors.forename: Alexander
authors.initials: A
authors.lastname: Pospelov
authors.forename: Andrey
authors.initials: A
authors.lastname: Kravchenko
authors.forename: Leonid
authors.initials: L
authors.lastname: Bajenov
authors.forename: Mels
authors.initials: M
authors.lastname: Kabulov
authors.forename: Anton
authors.initials: A
authors.lastname: Amann
authors.forename: Gennadii
authors.initials: G
authors.lastname: Kamarchuk
mesh_terms: D000293:Adolescent; D000942:Antigens, Bacterial / Q000378:metabolism; D001426:Bacterial Proteins / Q000378:metabolism; D001944:Breath Tests / Q000379:methods*; D004415:Dyspepsia / Q000150:complications / Q000453:epidemiology; D004797:Enzyme-Linked Immunosorbent Assay; D016481:Helicobacter Infections / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D009570:Nitriles / Q000378:metabolism; D010437:Peptic Ulcer / Q000150:complications; D014508:Urea / Q000032:analysis
chemical_list: D000942:Antigens, Bacterial; D001426:Bacterial Proteins; D009570:Nitriles; C080866:cagA protein, Helicobacter pylori; C013703:tetracyanoquinodimethane; D014508:Urea