Dyspeptic symptoms need early attention- domestic innovations GastroPanel®, ColonView-FIT® and Acetium® will help

The newspaper Helsingin Sanomat (HS) recently published an article entitled “Acid-free stomach can remain asymptomatic for long”, that included information that promotes patient safety e.g. by describing that upper abdominal symptoms (dyspepsia) are accompanied by acid-free stomach which can increase the risk of memory disorders and gastric cancer (1). Dyspeptic symptoms are common, and particularly among elderly subjects, are frequently of helicobacter origin (2,3) as described in the article.

Helicobacter induced - or autoimmune-type (frequently asymptomatic) atrophic gastritis (atrophy of the stomach mucosa) remains frequently undetected by the tests recommended for the primary diagnosis by the best practice guidelines ”Dyspepsia and reflux symptoms” (4,5). Exactly as stated in the news (1), this leads to situation where atrophic gastritis and eventual gastric cancer remain to be detected on gastroscopy. In Finland 1016 people fell ill and 785 died of stomach and esophageal cancer in 2021.

In 2005, Finnish Medical Journal (Lääkärilehti) published an opinion paper stating that a simple blood test - GastroPanel®- is applicable for risk stratification of asymptomatic patients with the primary intent to detect the subjects with atrophic gastritis, as a part of gastric cancer prevention  (6). In its laboratory manual, HUSLAB lists the indications of gastric biomarker test (GastroPanel) as follows:  ”The test is used for assessment of the symptoms in dyspeptic patients , in diagnosis of helicobacter infection as well as in early detection of  atrophic gastritis” (7). In 2012, sixteen international expert gastroenterologists from twelve countries launched an expert opinion stating that  GastroPanel biomarkers interpreted by the GastroSoft® application (www.gastropanel.com ) give valuable information about the stomach mucosal health and function, comprising a non-invasive tool for diagnosis and screening of helicobacter infection, atrophic gastritis and acid-free stomach (8). In the current HS-news, the author instructs differently by stating that: ”Helicobacter can be easily detected by currently used testing of stool samples” (1).

The stool antigen test (SAT) mentioned in the HS-news (1) similar to the 13C urea breath test (UBT), can give a substantial proportion of false negative results on helicobacter infections particularly in cases where the tested subject has atrophic gastritis, MALT-lymphoma, bleeding peptic ulcer or ongoing antibiotic- or PPI therapy. In addition, neither of the two tests detects atrophic gastritis with associated risks. The two most important risk conditions for stomach cancer are helicobacter and atrophic gastritis (2-5).

Apart from the risk of gastric cancer, atrophic gastritis and acid-free stomach are associated with several other risks, including malabsorption of vitamin-B12, iron, calcium, magnesium and zinc, as well as certain medicines. Deficiency of the above can promote the development of memory disorders, dementia, neurological complications, anemia and osteoporosis. Particularly among elderly people, the risk due to atrophic gastritis increases also the risk of severe infections in the gastrointestinal and respiratory tract (2,3). It is reasonable to suspect that due to atrophic gastritis and its sequels, also the risk of coronavirus infection and its severe forms is increased. Because of this, it would be useful to supplement coronavirus testing with GastroPanel particularly among elderly people (9-12). 

The SAT- and UBT helicobacter tests recommended by the best practice guidelines ”Dyspepsia and reflux symptoms”, do not help diagnosing atrophic gastritis or high acid output, the latter  predisposing to gastro-esophageal reflux disease (GERD), which can be accompanied by erosive esophagitis, Barrett’s esophagus and lower esophageal cancer (2-4). If GastroPanel-test would be used for screening of the risk of gastric- and esophageal cancer eg. for 10 age cohorts (65–74-year-old), approximately 600 000 people in our country, one would promote early detection of the risks of several disease conditions and one would reach savings in the life-time health care costs of these people of possibly up to 800 million euro (2,3,13). 

Particularly among elderly people, upper abdominal symptoms can frequently be of intestinal origin as well. The immunochemical test ColonView-FIT®, specific to human blood, helps in early detection of colorectal cancer precursor lesions (polyps, adenomas) in the stool samples (www.colonview.com ). GastroPanel- and ColonView-FIT-test should be implemented in nationwide use for early diagnosis and screening of dyspeptic symptoms and reflux disease, which would enable primary prevention of several conditions, improve patient safety and save health care costs.

It might be possible to reduce the risk of stomach cancer associated with atrophic gastritis, for which there is no specific treatment, and long-term PPI medication by binding the carcinogenic acetaldehyde produced in an acid-free stomach with L-cysteine, which dissolves in the Acetium capsule (www.acetium.com). Tentative evidence suggests that a regular long-term use of Acetium-capsules does have a favorable impact on stomach mucosa in patients suffering from atrophic gastritis (24,25).

This invention has been granted a patent in 43 countries (2,14,18-20,22,23,28-30). Biohit Oyj is currently looking for partners to conduct new clinical trials, to provide additional proof on the inhibitory effects of Acetium-capsules in progression of atrophic gastritis and in promoting the  mucosal recovery, when carcinogenic acetaldehyde is being eliminated by the daily use of Acetium-capsules (31).

Additional information:

www.biohithealthcare.com

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Biohit in brief

Biohit Oyj is a globally operating Finnish biotechnology company. Biohit mission is “Innovating for Health” – we produce innovative products and services to promote research and early diagnosis. Biohit is headquartered in Helsinki, Finland, and has subsidiaries in Italy and the UK. Biohit Series B share (BIOBV) is quoted on Nasdaq Helsinki in the Small cap/Healthcare group. www.biohithealthcare.com

References

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2. https://www.biohithealthcare.com/additional-information 
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5. www.biohithealthcare.com  /News/Links: Dear Colleague 2006
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