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. 1993 Feb;34(2):181–186. doi: 10.1136/gut.34.2.181

Development of a 14C-urea breath test in ferrets colonised with Helicobacter mustelae: effects of treatment with bismuth, antibiotics, and urease inhibitors.

A A McColm 1, J A Bagshaw 1, C F O'Malley 1
PMCID: PMC1373966  PMID: 8432469

Abstract

A 14C-urea breath test analogous to its clinical counterpart is described for use in ferrets naturally or experimentally infected with Helicobacter mustelae. The test is performed within a sealed glass metabolism chamber through which air is drawn at a constant rate and expired breath collected into sodium hydroxide. Peak 14CO2 production occurred approximately 1 hour after substrate administration. Both inter- and intra-animal responses were highly reproducible, with mean coefficients of variation less than 10%. Other than enhancing peak 14CO2 levels very slightly, fasting had little influence on the response. In infant animals challenged with H mustelae, breath test activity increased linearly with the total count of culturable bacteria isolated from the antrum. Treatment of established infections with colloidal bismuth subcitrate (DeNol) for 4 weeks resulted in clearance of all detectable bacteria but retention of some breath test activity. Subsequent regrowth of bacteria was parallelled by an increase in the breath test response. Inclusion of amoxycillin and metronidazole in the treatment regimen, however, eradicated all the bacteria and almost totally eliminated 14CO2 production. This response parallels the clinically observed suppressive effect on H pylori achieved with bismuth alone relative to the total eradication seen with triple therapy. A single oral dose of the urease inhibitor, flurofamide, inhibited over 90% of the response for at least 24 hours. Acetohydroxamic acid was less effective. These findings suggest that in the ferret H mustelae model, breath test analysis can be a useful, non-invasive alternative to endoscopy for evaluation of agents affecting either growth of the organism or urease activity.

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Selected References

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  1. Arvind A. S., Cook R. S., Tabaqchali S., Farthing M. J. One-minute endoscopy room test for Campylobacter pylori. Lancet. 1988 Mar 26;1(8587):704–704. doi: 10.1016/s0140-6736(88)91501-2. [DOI] [PubMed] [Google Scholar]
  2. Bell G. D. Anti-Helicobacter pylori therapy: clearance, elimination, or eradication? Lancet. 1991 Feb 2;337(8736):310–311. doi: 10.1016/0140-6736(91)90933-g. [DOI] [PubMed] [Google Scholar]
  3. Bell G. D., Weil J., Harrison G., Morden A., Jones P. H., Gant P. W., Trowell J. E., Yoong A. K., Daneshmend T. K., Logan R. F. 14C-urea breath analysis, a non-invasive test for Campylobacter pylori in the stomach. Lancet. 1987 Jun 13;1(8546):1367–1368. doi: 10.1016/s0140-6736(87)90664-7. [DOI] [PubMed] [Google Scholar]
  4. Borody T. J., Cole P., Noonan S., Morgan A., Lenne J., Hyland L., Brandl S., Borody E. G., George L. L. Recurrence of duodenal ulcer and Campylobacter pylori infection after eradication. Med J Aust. 1989 Oct 16;151(8):431–435. doi: 10.5694/j.1326-5377.1989.tb101251.x. [DOI] [PubMed] [Google Scholar]
  5. Coghlan J. G., Gilligan D., Humphries H., McKenna D., Dooley C., Sweeney E., Keane C., O'Morain C. Campylobacter pylori and recurrence of duodenal ulcers--a 12-month follow-up study. Lancet. 1987 Nov 14;2(8568):1109–1111. doi: 10.1016/s0140-6736(87)91545-5. [DOI] [PubMed] [Google Scholar]
  6. Dill S., Payne-James J. J., Misiewicz J. J., Grimble G. K., McSwiggan D., Pathak K., Wood A. J., Scrimgeour C. M., Rennie M. J. Evaluation of 13C-urea breath test in the detection of Helicobacter pylori and in monitoring the effect of tripotassium dicitratobismuthate in non-ulcer dyspepsia. Gut. 1990 Nov;31(11):1237–1241. doi: 10.1136/gut.31.11.1237. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Dunn B. E., Sung C. C., Taylor N. S., Fox J. G. Purification and characterization of Helicobacter mustelae urease. Infect Immun. 1991 Sep;59(9):3343–3345. doi: 10.1128/iai.59.9.3343-3345.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Fox J. G., Cabot E. B., Taylor N. S., Laraway R. Gastric colonization by Campylobacter pylori subsp. mustelae in ferrets. Infect Immun. 1988 Nov;56(11):2994–2996. doi: 10.1128/iai.56.11.2994-2996.1988. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Fox J. G., Correa P., Taylor N. S., Lee A., Otto G., Murphy J. C., Rose R. Helicobacter mustelae-associated gastritis in ferrets. An animal model of Helicobacter pylori gastritis in humans. Gastroenterology. 1990 Aug;99(2):352–361. doi: 10.1016/0016-5085(90)91016-y. [DOI] [PubMed] [Google Scholar]
  10. Fox J. G., Edrise B. M., Cabot E. B., Beaucage C., Murphy J. C., Prostak K. S. Campylobacter-like organisms isolated from gastric mucosa of ferrets. Am J Vet Res. 1986 Feb;47(2):236–239. [PubMed] [Google Scholar]
  11. Goodwin C. S., Armstrong J. A., Marshall B. J. Campylobacter pyloridis, gastritis, and peptic ulceration. J Clin Pathol. 1986 Apr;39(4):353–365. doi: 10.1136/jcp.39.4.353. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Graham D. Y., Klein P. D., Evans D. J., Jr, Evans D. G., Alpert L. C., Opekun A. R., Boutton T. W. Campylobacter pylori detected noninvasively by the 13C-urea breath test. Lancet. 1987 May 23;1(8543):1174–1177. doi: 10.1016/s0140-6736(87)92145-3. [DOI] [PubMed] [Google Scholar]
  13. Logan R. P., Polson R. J., Misiewicz J. J., Rao G., Karim N. Q., Newell D., Johnson P., Wadsworth J., Walker M. M., Baron J. H. Simplified single sample 13Carbon urea breath test for Helicobacter pylori: comparison with histology, culture, and ELISA serology. Gut. 1991 Dec;32(12):1461–1464. doi: 10.1136/gut.32.12.1461. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Marshall B. J., Goodwin C. S., Warren J. R., Murray R., Blincow E. D., Blackbourn S. J., Phillips M., Waters T. E., Sanderson C. R. Prospective double-blind trial of duodenal ulcer relapse after eradication of Campylobacter pylori. Lancet. 1988 Dec 24;2(8626-8627):1437–1442. doi: 10.1016/s0140-6736(88)90929-4. [DOI] [PubMed] [Google Scholar]
  15. Marshall B. J., Plankey M. W., Hoffman S. R., Boyd C. L., Dye K. R., Frierson H. F., Jr, Guerrant R. L., McCallum R. W. A 20-minute breath test for helicobacter pylori. Am J Gastroenterol. 1991 Apr;86(4):438–445. [PubMed] [Google Scholar]
  16. Marshall B. J., Warren J. R. Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration. Lancet. 1984 Jun 16;1(8390):1311–1315. doi: 10.1016/s0140-6736(84)91816-6. [DOI] [PubMed] [Google Scholar]
  17. Mobley H. L., Cortesia M. J., Rosenthal L. E., Jones B. D. Characterization of urease from Campylobacter pylori. J Clin Microbiol. 1988 May;26(5):831–836. doi: 10.1128/jcm.26.5.831-836.1988. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Morris A., Nicholson G. Ingestion of Campylobacter pyloridis causes gastritis and raised fasting gastric pH. Am J Gastroenterol. 1987 Mar;82(3):192–199. [PubMed] [Google Scholar]
  19. O'Riordan T., Mathai E., Tobin E., McKenna D., Keane C., Sweeney E., O'Morain C. Adjuvant antibiotic therapy in duodenal ulcers treated with colloidal bismuth subcitrate. Gut. 1990 Sep;31(9):999–1002. doi: 10.1136/gut.31.9.999. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Otto G., Fox J. G., Wu P. Y., Taylor N. S. Eradication of Helicobacter mustelae from the ferret stomach: an animal model of Helicobacter (Campylobacter) pylori chemotherapy. Antimicrob Agents Chemother. 1990 Jun;34(6):1232–1236. doi: 10.1128/aac.34.6.1232. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Rauws E. A., Langenberg W., Houthoff H. J., Zanen H. C., Tytgat G. N. Campylobacter pyloridis-associated chronic active antral gastritis. A prospective study of its prevalence and the effects of antibacterial and antiulcer treatment. Gastroenterology. 1988 Jan;94(1):33–40. [PubMed] [Google Scholar]
  22. Rauws E. A., Royen E. A., Langenberg W., Woensel J. V., Vrij A. A., Tytgat G. N. 14C-urea breath test in C pylori gastritis. Gut. 1989 Jun;30(6):798–803. doi: 10.1136/gut.30.6.798. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Rauws E. A., Tytgat G. N. Cure of duodenal ulcer associated with eradication of Helicobacter pylori. Lancet. 1990 May 26;335(8700):1233–1235. doi: 10.1016/0140-6736(90)91301-p. [DOI] [PubMed] [Google Scholar]
  24. Tompkins D. S., Wyatt J. I., Rathbone B. J., West A. P. The characterization and pathological significance of gastric Campylobacter-like organisms in the ferret: a model for chronic gastritis? Epidemiol Infect. 1988 Oct;101(2):269–278. doi: 10.1017/s0950268800054182. [DOI] [PMC free article] [PubMed] [Google Scholar]

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