Evolution of Diagnostic Methods for Helicobacter pylori Infections: From Traditional Tests to High Technology, Advanced Sensitivity and Discrimination Tools

Abstract

Rapid diagnosis and treatment application in the early stages of H. pylori infection plays an important part in inhibiting the transmission of this infection as this bacterium is involved in various gastric pathologies such as gastritis, gastro-duodenal ulcer, and even gastric neoplasia. This review is devoted to a quick overview of conventional and advanced detection techniques successfully applied to the detection of H. pylori in the context of a compelling need to upgrade the standards of the diagnostic methods which are currently being used. Selecting the best diagnostic method implies evaluating different features, the use of one or another test depending on accessibility, laboratories equipment, and the clinical conditions of patients. This paper aims to expose the diagnosis methods for H. pylori that are currently available, highlighting their assets and limitations. The perspectives and the advantages of nanotechnology along with the concept of nano(bio)sensors and the development of lab-on-chip devices as advanced tools for H. pylori detection, differentiation, and discrimination is also presented, by emphasizing multiple advantages: simple, fast, cost-effective, portable, miniaturized, small volume of samples required, highly sensitive, and selective. It is generally accepted that the development of intelligent sensors will completely revolutionize the acquisition procedure and medical decision in the framework of smart healthcare monitoring systems.

Keywords: H. pylori; conventional tests; detection methods; high sensitivity; nanotechnology.

Figure 1

Invasive and noninvasive diagnostic tools for H. pylori.

Figure 2

(a) Gastric mucosa showing reduced cytoplasmic mucin (blue arrow), reactive epithelial changes (red arrow), and a mix between acute inflammatory cells and chronic inflammatory cells (H&E, ob100×); (b) Gastric mucosa showing reduced cytoplasmic mucin (blue arrow), lymphocytes, and plasma cells (red arrow). Histological imaging for H. pylori (yellow arrow). H&E, 200× ob; (c) Clusters of cells with intracellular H. pylori were widely distributed within the lamina propria (blue arrow) and were especially abundant just below the superficial epithelial cell layer of the gastric mucosa (red arrow). IHC 100× ob. Images from private collection, Prof. dr. Ovidiu Pop, unpublished.