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World J Gastroenterol. Nov 7, 2021; 27(41): 7100-7112
Published online Nov 7, 2021. doi: 10.3748/wjg.v27.i41.7100
DNA diagnostics for reliable and universal identification of Helicobacter pylori
Pavol Sulo, Barbora Šipková
Pavol Sulo, Barbora Šipková, Department of Biochemistry, Comenius University, Bratislava 842 15, Slovakia
Author contributions: Sulo P designed the outline and wrote most of the manuscript; Šipková B summarized the data, prepared the figures and tables, and wrote some of the manuscript; both authors read and approved the final manuscript.
Supported by Slovak Research and Development Agency, No. PP-COVID-20-0051.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non-Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Pavol Sulo, PhD, Research Associate, Department of Biochemistry, Comenius University, Ilkovicova 6, Bratislava 842 15, Slovakia. pavol.sulo@uniba.sk
Received: March 20, 2021
Peer-review started: March 20, 2021
First decision: July 3, 2021
Revised: July 11, 2021
Accepted: September 19, 2021
Article in press: September 19, 2021
Published online: November 7, 2021
Core Tip

Core Tip: Polymerase chain reaction (PCR) is not endorsed for Helicobacter pylori (H. pylori) diagnostics due to nonspecific primers and the threat of false-positives. However, a nested PCR that is as specific and equally sensitive in biopsy samples as the 13C-urea breath test was developed. Due to the threshold of H. pylori abundance and the ability to survive in the oral cavity, it is not suitable for saliva samples. Despite DNA degradation in stool samples, nested PCR for a shorter 148 bp amplicon identified twice the number of positive samples as stool antigen test, indicating that many patients are misdiagnosed, not treated by antibiotics, explaining why their problems are interpreted as chronic.