Title: Long-Term Assessment of Helicobacter pylori cagA EPIYA Motif Changes and
Pathology Outcomes in Gastric Biopsies of Dyspeptic Patients: 10-year Follow-up
Version: 3 Date: 13 Sep 2024
Reviewer:  Panagiotis Tsibouris
Reviewer's report:
Abstract Percentages should be given apart from crude numbers Risk factors for change cag A
pattern through gastritis evolution should be given before reporting connection of those changes
with clinical presentation and pathology  Methods Definition of dyspepsia should be provided
at least as a reference Preferably Rome IV criteria should have been applied or definition
could be adapted if data are available A standard scale to weight dyspetic symptoms should
have been used Use of PPIs should also be an exclusion criterion Also H. pylori eradication
during the follow-up period  Also collection of data affecting H. pylori could be collected
and  evaluated as a possible risk factor for CagA motif evolution Smoking habits and alcohol
cosumption definitions should be provided Data on study population demographics belong to
the results session Biopsies from gastric corpus and incisura should have been taken according
to Sidney protocol Thus gastric pathology cannot be properly evaluated based only to antral
biopsies Moreover since atrophic gastritis starts for the antrum and incisura H. pylori status can
be misjudjed based only in antral biospies Method of DNA extraction and analysis should be
described in full details Uni-multivriated analysis is more appropriated to define the specific
weight of each risk factor Results Patients demographics should be given intially  Thereafter
changes in cagA motif should follow and risk factors determining changes And then changes in
gastric pathology and their relation to changes in cagA motif should follow Finally changes in
patients symptoms and their relation to cagA motif changes should follow
Title: Long-Term Assessment of Helicobacter pylori cagA EPIYA Motif Changes and
Pathology Outcomes in Gastric Biopsies of Dyspeptic Patients: 10-year Follow-up
Version: 3 Date: 13 Sep 2024
Reviewer:  Panagiotis Tsibouris
Reviewer's report:
Abstract Percentages should be given apart from crude numbers Risk factors for change cag A
pattern through gastritis evolution should be given before reporting connection of those changes
with clinical presentation and pathology  Methods Definition of dyspepsia should be provided
at least as a reference Preferably Rome IV criteria should have been applied or definition
could be adapted if data are available A standard scale to weight dyspetic symptoms should
have been used Use of PPIs should also be an exclusion criterion Also H. pylori eradication
during the follow-up period  Also collection of data affecting H. pylori could be collected
and  evaluated as a possible risk factor for CagA motif evolution Smoking habits and alcohol
cosumption definitions should be provided Data on study population demographics belong to
the results session Biopsies from gastric corpus and incisura should have been taken according
to Sidney protocol Thus gastric pathology cannot be properly evaluated based only to antral
biopsies Moreover since atrophic gastritis starts for the antrum and incisura H. pylori status can
be misjudjed based only in antral biospies Method of DNA extraction and analysis should be
described in full details Uni-multivriated analysis is more appropriated to define the specific
weight of each risk factor Results Patients demographics should be given intially  Thereafter
changes in cagA motif should follow and risk factors determining changes And then changes in
gastric pathology and their relation to changes in cagA motif should follow Finally changes in
patients symptoms and their relation to cagA motif changes should follow
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Title: Long-Term Assessment of Helicobacter pylori cagA EPIYA Motif Changes and
Pathology Outcomes in Gastric Biopsies of Dyspeptic Patients: 10-year Follow-up
Version: 3 Date: 13 Sep 2024
Reviewer:  Panagiotis Tsibouris
Reviewer's report:
Abstract Percentages should be given apart from crude numbers Risk factors for change cag A
pattern through gastritis evolution should be given before reporting connection of those changes
with clinical presentation and pathology  Methods Definition of dyspepsia should be provided
at least as a reference Preferably Rome IV criteria should have been applied or definition
could be adapted if data are available A standard scale to weight dyspetic symptoms should
have been used Use of PPIs should also be an exclusion criterion Also H. pylori eradication
during the follow-up period  Also collection of data affecting H. pylori could be collected
and  evaluated as a possible risk factor for CagA motif evolution Smoking habits and alcohol
cosumption definitions should be provided Data on study population demographics belong to
the results session Biopsies from gastric corpus and incisura should have been taken according
to Sidney protocol Thus gastric pathology cannot be properly evaluated based only to antral
biopsies Moreover since atrophic gastritis starts for the antrum and incisura H. pylori status can
be misjudjed based only in antral biospies Method of DNA extraction and analysis should be
described in full details Uni-multivriated analysis is more appropriated to define the specific
weight of each risk factor Results Patients demographics should be given intially  Thereafter
changes in cagA motif should follow and risk factors determining changes And then changes in
gastric pathology and their relation to changes in cagA motif should follow Finally changes in
patients symptoms and their relation to cagA motif changes should follow
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