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1. CLO test detects the urease enzyme of Helicobacter pylori in gastric mucosal biopsies

1. Product: CLO test Kokusai
   
2. Principle:
   H. pylori produces large amounts of urease enzymes. Although urease primarily allows H. pylori to utilise urea as a nitrogen source, the breakdown of urea also produces high local concentrations of ammonia, which enable the organism to tolerate low pH.
   CLO test is a sealed plastic slide holding an agar gel, which contains urea, phenol red (a pH indicator), buffers and bacteriostatic agents. If the urease enzyme of H. pylori is present in an inserted tissue sample, the resulting degradation of urea causes the pH to rise and the colour of the gel turns from yellow, to a bright magenta colour.
   
3. Features:
   Although H. pylori can be detected with histology or culture of gastric tissues, simple tests for the presence of urease enable more rapid and convenient diagnosis. Tests for gastric urease are specific for H. pylori because mammalian cells do not produce urease and, except for H. pylori, the stomach is usually sterile.
   - Simple operation
   - Helicobacter pylori can be detected in a short time.
   - All of the reagents required for the detection are set out in the slide.
   - A high correlation with culture method.
   
4. Reference:
   
   1. Marshall BJ, McGechie DB, Rogers PAR, Giancy RG, Pyloric Campylobacter infection and gastroduodenal disease. Med J Aust 1985; 149:439-44.
   2. Mobley HL, Cortesa MJ, Rosenthal LE, Jones BD. Characterisation of urease from Campylobacter pylori. J. Clin Microbiol 1988; 25(5):831-836.
   3. Marshall BJ, Warren JR, Fransis GJ, Langton SR, Goodwin CS, Blincow E, Rapid urease test in the management of Campylobacter pyloridis-associated gastrics. Am J Gastroenterol 1987; 82(3)200-210

2. For determination of pepsinogen I and II in the blood by EIA method

1. Product: SLEIA Pepsinogen I and SLEIA Pepsinogen II
   
2. Principle:
   EIA sandwich method using microplate solid phase.
   
3. Features:
   Pepsinogen is a precursor of pepsin, gastric digestive enzyme, of which pepsinogen I is found only in the area of true gastric glands and pepsinogen II is found in almost the whole areas including true gastric glands, pyloric glands and duodenal glands.
   With atrophy spreading on the gastric mucous membrane, the boundary between pyloric glands and true gastric glands moves toward cardiac glands.
   As atrophic gastritis advances, that is to say, pepsinogen value lowers and the comparison ratio of pepsinogen I/pepsinogen II, as atrophy rises, shows a gradual lowered value.
   - Useful for screening high risk group of gastric cancer ( atrophic gastritis).
   - Monitoring after removing Helicobacter pyroli is possible.
   
4. Reference:
   
   1. Matsubara Y. Yahagi N. Ichinose M. Miki K., Modern Medical Laboratory Vol. 25, No10, l997
   2. Miki K., Japan Medical Journal No3669, 1994

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