Researchers have introduced a novel diagnostic method for identifying Helicobacter pylori (H. pylori) and its antibiotic-resistance mutations, offering a cost-effective solution for patients in rural areas with limited access to diagnostic facilities. This advancement, developed using CRISPR-based technologies, holds promise for addressing global health challenges posed by the bacterium.
H. pylori infections affect over 43% of the global population and are associated with a range of gastrointestinal conditions, including peptic ulcers, gastritis, dyspepsia, and gastric cancer. A significant challenge in managing these infections is resistance to clarithromycin, driven by specific mutations in the bacterium’s 23S ribosomal RNA gene. Such resistance often necessitates repeated diagnostic tests and multiple antibiotic treatments, complicating eradication efforts.
The research team, led by Dr Shraddha Chakraborty of IIT Delhi in collaboration with CSIR-IGIB and AIIMS, has utilised a modified CRISPR-based technique to detect H. pylori and its mutations. The study explored the capabilities of en31-FnCas9, an engineered Cas9 protein derived from Francisella novicida, to identify mutations in the 23S rDNA of H. pylori.
This approach, combined with a lateral flow assay (FELUDA), offers a sequencing-free molecular diagnostic tool, providing rapid visual results. The method was tested on gastric biopsy samples from dyspeptic patients, demonstrating its effectiveness in identifying the bacterium and its resistance mutations.
The clinical aspects of the study were carried out in collaboration with gastroenterology and microbiology experts from AIIMS New Delhi and Bhubaneswar. The results, published in the Microchemical Journal, underline the potential of this technology to deliver accurate, timely reports on antibiotic resistance patterns in H. pylori, even in resource-poor settings.
The integration of en31-FnCas9-based diagnostics with FELUDA provides a practical solution for remote healthcare facilities, enabling tailored treatment strategies and reducing reliance on costly sequencing methods.
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This study marks the first use of en31-FnCas9 in the molecular diagnosis of H. pylori mutations linked to clarithromycin resistance. Its successful deployment in clinical settings could significantly improve the management of H. pylori infections, particularly in rural and resource-limited regions.
By facilitating rapid and accurate diagnosis, the method addresses key concerns surrounding antibiotic resistance and the associated risks of gastric cancer. Researchers emphasise the importance of integrating such innovative tools into healthcare systems to enhance treatment outcomes and tackle global public health challenges.
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