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Research | DOI: https://doi.org/10.31579/2768-0487/191
1Department of Medical Laboratory Science, Imo State University, Owerri Nigeria.
2Department of Pharmacology and Therapeutics. Institution: David Umahi Federal University of Health sciences, Uburu Ebonyi state.
*Corresponding Author: Nnodim Johnkennedy., Department of Medical Laboratory Science, Imo State University, Owerri Nigeria.
Citation: Nwachukwu U. Christiantus., Nwadike Constance N., Johnkennedy N., Mgbeosuru B Chikodi., Arinzechi E Ginika., et al. (2025), Association of h. Pylori infection with changes in molecular markers of inflammation in patients with incident hypertension attending federal university teaching hospital owerri, imo state, Journal of Clinical and Laboratory Research, 8(5); DOI:10.31579/2768-0487/191
Copyright: © 2025, Nnodim Johnkennedy. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 24 September 2025 | Accepted: 10 October 2025 | Published: 24 October 2025
Keywords: pylori infection; inflammation; hypertension owerri
Helicobacter pylori (H. pylori) infection and hypertension are associated with chronic inflammation. This study investigates the association of molecular markers of inflammation in H. pylori-infected patients with incident hypertension attending selected hospitals in Imo State, Nigeria. A total of 100 adult participants (aged 20-60 years) were recruited and categorized into four groups (n 25 each): Group 1 (Control): Normotensive, H. pylori-negative. Group 2: Hypertensive, H. pylori-positive. Group 3: Hypertensive, H. pylori-negative. Group 4: Normotensive, H. pylori-positive. Parameters assessed included: C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-a), Immunoglobulin M(IgM), Immunoglobulin G(IgG). Data were analyzed using one-way ANOVA (p<0.05). Group 2 (hypertensive, H. pylori+) consistently showed the most elevated values across inflammatory and lipid markers but a decreased patelet values. Key findings (mean ± SD) include:. CRP (mg/L): G1: 2.10 ± 0.51; G2: 6.78 ± 0.87; G3: 5.96 ± 0.79; G4: 4.84 ± 0.69. IL-6 (pg/mL): G1: 3.44±0.62; G2: 8.76 ± 0.91; G3: 7.10 ±0.80; G4: 6.34±0.74. TNF-a (pg/mL): G1: 4.26 ± 0.58; G2: 9.12 ± 1.04; G3: 8.02 ± 0.88; G4: 6.98 ±0.81. IgM(mg/dl): G1:93.08±17.59; G2:134.44±13.48;G3:97.80±16.76;G4:118.20±16.83.IgG(mg/dl):
G1:1174.84±153.28;G2:1705.40±143.21;G3:1275.36±161.83;G4:1649.68±110.16.
Statistical analysis revealed significant differences across all groups in all parameter (p<0.05), with Group 2 showing the most pronounced elevations in inflammatory. The combination of H. pylori infection and hypertension is associated with significant upregulation of molecular markers of inflammation. Group 2 displayed a synergistic exacerbation of systemic inflammation, suggesting an increased risk of cardiovascular events.
The World Health Organisation has classified Helicobacter pylori as a group I carcinogen, and the estimated 50% global burden of Helicobacter pylori infection makes the bacterium a pathogen of concern. The World Health Organisation has classified Helicobacter pylori as a group I carcinogen, and the estimated 50% global burden of Helicobacter pylori infection makes the bacterium a pathogen of concern. [1] A gram-negative, spiral-shaped bacterium called Helicobacter pylori (H. Pylori) colonises the human stomach and, if left unchecked, can often last a lifetime. Affecting over 44% of the world's population, it is one of the most prevalent illnesses worldwide. Because of variations in socioeconomic level, hygienic habits, and availability to healthcare, prevalence rates range greatly between locations, with greater rates in underdeveloped nations (70–90%) compared to industrialised nations (20–40%) [2]. Numerous studies have documented the prevalence of H. pylori infection in Nigeria throughout time, taking into account variations in the country's population, age groups, occupation, gender, marital status, educational attainment, and illness state. It has been demonstrated that the largest frequency of H. pylori infection occurs in the northern region of the nation [3]. Despite the fact that more than half of the world's population has an H. pylori infection, the majority of people do not exhibit any symptoms. Numerous gastric and non-gastric illnesses can be brought on by persistent colonisation with increasingly aggressive bacteria. Inflammation of the stomach lining, or gastritis, is the first of the infection-related gastric illnesses. Chronic gastritis will develop from the protracted inflammation caused by a persistent infection. Although this will initially be non-atrophic gastritis, the duodenum (the closest portion of the intestine) or the stomach itself may develop atrophic gastritis and ulcers as a result of the damage to the stomach lining [4]. The chance of getting stomach cancer is high at this point. However, there is a significantly lower risk of cancer when a duodenal ulcer develops. Helicobacter pylori is a class 1 carcinogen, and it can cause stomach cancer and mucosa-associated lymphoid tissue (MALT) lymphoma. An estimated 89% of all stomach cancers are caused by H. pylori infection, which is also connected to the development of 5.5% of all cancer cases globally. H. pylori is the only known bacterium that causes cancer. [5] Anaemia from iron or vitamin B12 deficiency, diabetes mellitus, cardiovascular disease, and several neurological conditions are examples of extragastric problems that have been connected to H. pylori. [6] In Sub-Saharan Africa, hypertension is a major contributor to non-communicable morbidity. According to recent research, hypertension is becoming more common in rural Sub-Saharan Africa. Hypertension is a worldwide public health issue that increases the risk of heart disease, stroke, renal failure, and other illnesses. It is seen as a complex causative disorder that is impacted by the interplay of numerous factors, including genetics, bad eating habits, hazardous alcohol consumption, physical inactivity, and tobacco use. [8] Because of its high incidence, role in the burden of disease, and substantial economic impact, hypertension—also known as high blood pressure—is a serious global public health concern. Known as the "Silent Killer," it is characterised by a persistent blood pressure reading of 140/90 mmHg or above and is frequently asymptomatic. [9] One of the biggest risk factors for many serious illnesses, such as heart disease, stroke, and renal failure, is still high blood pressure. Systemic inflammation has been linked to H. pylori infection and may have a role in the development of hypertension. By triggering immunological responses and releasing inflammatory cytokines like interleukin-6 (IL-6), tissue necrosis factor-alpha (TNF-α), and C-reactive proteins (CRP), the bacterium creates a persistent inflammatory state. Endothelial dysfunction, a crucial factor in hypertension, can result from this inflammatory mediation's disruption of vascular haemostasis [10]. In order to comprehend disease causes, facilitate early detection, and create tailored therapeutics, molecular makers of inflammation are essential. These biomarkers, which include cytokines, chemokines, and other signalling molecules, provide important insights into disease processes by reflecting the dynamic interaction between the immune system and physiological homeostasis [11]. The identification of chronic inflammatory problems, such as infections, autoimmune disorders, and cardiovascular diseases, depends on inflammatory markers including interleukin-6 (IL-6), C-reactive protein (CRP), tumour necrosis factor-alpha (TNF-α), interleukin-8, interleukin-10, and interferon-gamma, among others. Since elevated levels of these indicators frequently occur before clinical symptoms appear, early detection and intervention are made possible. [12] Chronic gastritis brought on by Helicobacter pylori infection can develop into serious gastroduodenal diseases such as peptic ulcers, gastric cancer, and gastric mucosa-associated lymphoid tissue lymphoma. In addition to its well-established function in gastrointestinal problems, Helicobacter pylori infection has been linked to a number of non-gastric systemic disorders, such as inflammatory syndromes, metabolic disorders, and cardiovascular diseases. Although some research has looked into the possible connection between H. pylori and hypertension, nothing is known about how it affects haemostasis and inflammatory markers. It is well recognised that inflammatory indicators such C-reactive protein (CRP), interleukin-6 (IL-6), and tumour necrosis factor-alpha (TNF-a) are important in the pathophysiology of hypertension as well as chronic infections [13]. However, not enough research has been done on how much an H. pylori infection affects these markers in people who have incident hypertension. Even though earlier studies may have examined the connection between H. pylori infection and hypertension, more research is necessary given the recent rise in H. pylori-associated stomach ulcers and the rising incidence of early-onset hypertension in young adults, particularly in the study area. Evaluating whether H. pylori infection contributes to inflammatory and homeostatic abnormalities that may predispose people to hypertension is crucial given the changing epidemiological patterns. Knowing this link may help identify new risk factors and possible treatment targets for hypertension, especially in populations where the prevalence of both illnesses is high [14, 15]. By assessing the relationship between H. pylori infection and certain inflammatory markers in individuals with incident hypertension, this study seeks to close the current knowledge gap. For those impacted by both illnesses, the results may have implications for risk assessment, early diagnosis, and the creation of integrated management plans. Establishment [1] A gram-negative, spiral-shaped bacterium called Helicobacter pylori (H. Pylori) colonises the human stomach and, if left unchecked, can often last a lifetime. Affecting over 44% of the world's population, it is one of the most prevalent illnesses worldwide. Because of variations in socioeconomic level, hygienic habits, and availability to healthcare, prevalence rates range greatly between locations, with greater rates in underdeveloped nations (70–90%) compared to industrialised nations (20–40%) [2]. Numerous studies have documented the prevalence of H. pylori infection in Nigeria throughout time, taking into account variations in the country's population, age groups, occupation, gender, marital status, educational attainment, and illness state. It has been demonstrated that the largest frequency of H. pylori infection occurs in the northern region of the nation [3]. Despite the fact that more than half of the world's population has an H. pylori infection, the majority of people do not exhibit any symptoms. Numerous gastric and non-gastric illnesses can be brought on by persistent colonisation with increasingly aggressive bacteria. Inflammation of the stomach lining, or gastritis, is the first of the infection-related gastric illnesses. Chronic gastritis will develop from the protracted inflammation caused by a persistent infection. Although this will initially be non-atrophic gastritis, the duodenum (the closest portion of the intestine) or the stomach itself may develop atrophic gastritis and ulcers as a result of the damage to the stomach lining [4]. The chance of getting stomach cancer is high at this point. However, there is a significantly lower risk of cancer when a duodenal ulcer develops. Helicobacter pylori is a class 1 carcinogen, and it can cause stomach cancer and mucosa-associated lymphoid tissue (MALT) lymphoma. An estimated 89% of all stomach cancers are caused by H. pylori infection, which is also connected to the development of 5.5% of all cancer cases globally. H. pylori is the only known bacterium that causes cancer. [5] Anaemia from iron or vitamin B12 deficiency, diabetes mellitus, cardiovascular disease, and several neurological conditions are examples of extragastric problems that have been connected to H. pylori. [6] In Sub-Saharan Africa, hypertension is a major contributor to non-communicable morbidity. According to recent research, hypertension is becoming more common in rural Sub-Saharan Africa. Hypertension is a worldwide public health issue that increases the risk of heart disease, stroke, renal failure, and other illnesses. It is seen as a complex causative disorder that is impacted by the interplay of numerous factors, including genetics, bad eating habits, hazardous alcohol consumption, physical inactivity, and tobacco use. [8] Because of its high incidence, role in the burden of disease, and substantial economic impact, hypertension—also known as high blood pressure—is a serious global public health concern. Known as the "Silent Killer," it is characterised by a persistent blood pressure reading of 140/90 mmHg or above and is frequently asymptomatic. [9] One of the biggest risk factors for many serious illnesses, such as heart disease, stroke, and renal failure, is still high blood pressure. Systemic inflammation has been linked to H. pylori infection and may have a role in the development of hypertension. By triggering immunological responses and releasing inflammatory cytokines like interleukin-6 (IL-6), tissue necrosis factor-alpha (TNF-α), and C-reactive proteins (CRP), the bacterium creates a persistent inflammatory state. Endothelial dysfunction, a crucial factor in hypertension, can result from this inflammatory mediation's disruption of vascular haemostasis [10]. In order to comprehend disease causes, facilitate early detection, and create tailored therapeutics, molecular makers of inflammation are essential. These biomarkers, which include cytokines, chemokines, and other signalling molecules, provide important insights into disease processes by reflecting the dynamic interaction between the immune system and physiological homeostasis [11]. The identification of chronic inflammatory problems, such as infections, autoimmune disorders, and cardiovascular diseases, depends on inflammatory markers including interleukin-6 (IL-6), C-reactive protein (CRP), tumour necrosis factor-alpha (TNF-α), interleukin-8, interleukin-10, and interferon-gamma, among others. Since elevated levels of these indicators frequently occur before clinical symptoms appear, early detection and intervention are made possible. [12] Chronic gastritis brought on by Helicobacter pylori infection can develop into serious gastroduodenal diseases such as peptic ulcers, gastric cancer, and gastric mucosa-associated lymphoid tissue lymphoma. In addition to its well-established function in gastrointestinal problems, Helicobacter pylori infection has been linked to a number of non-gastric systemic disorders, such as inflammatory syndromes, metabolic disorders, and cardiovascular diseases. Although some research has looked into the possible connection between H. pylori and hypertension, nothing is known about how it affects haemostasis and inflammatory markers. It is well recognised that inflammatory indicators such C-reactive protein (CRP), interleukin-6 (IL-6), and tumour necrosis factor-alpha (TNF-a) are important in the pathophysiology of hypertension as well as chronic infections [13]. However, not enough research has been done on how much an H. pylori infection affects these markers in people who have incident hypertension. Even though earlier studies may have examined the connection between H. pylori infection and hypertension, more research is necessary given the recent rise in H. pylori-associated stomach ulcers and the rising incidence of early-onset hypertension in young adults, particularly in the study area. Evaluating whether H. pylori infection contributes to inflammatory and homeostatic abnormalities that may predispose people to hypertension is crucial given the changing epidemiological patterns. Knowing this link may help identify new risk factors and possible treatment targets for hypertension, especially in populations where the prevalence of both illnesses is high [14, 15]. By assessing the relationship between H. pylori infection and certain inflammatory markers in individuals with incident hypertension, this study seeks to close the current knowledge gap. For those impacted by both illnesses, the results may have implications for risk assessment, early diagnosis, and the creation of integrated management plans.
Study Area
The study was conducted between February, 2025 to April, 2025 at the Federal University Teaching Hospital, Owerri, Imo State, Nigeria.
Ethics Advocacy and pre survey contacts
An ethical approval was obtained from the Federal University teaching Hospital Owerri Imo State for the collection of samples. Those who qualified to participate in the study were given an informed consent letter and those who have their consent by signing the letter were recruited as participants and a day was fixed for sample collection.
Study Population/ sample size
Study population
This case study comprises a total of 100 adult men and women between the age of 20-60yrs attending the out-patient department(OPD),Federal University teaching Hospital Owerri Imo State. Participants are divided equally or proportionally (25 participants per group) into four (4 ) groups
Participants assigned to one of four groups based on their hypertension status and H. pylori infection status:
Group 1: Normotensive, H.pylori negative subjects, serves as the control group.
Group 2: Hypertensive, H.pylori positive subjects.
Group 3: Hypertensive, H.pylori negative subjects.
Group 4: Normotensive, H.pylori positive subjects.
Sample Size Determination
Sample technique used was targeted random sampling.The sample size was calculated using the formula given below at 95% confidence interval (CI) level = 1.96, an expected prevalence of 0.5% and 9.8% marginal error.
N= Z2P(1-P)
d2
Where N= Sample size
Z= degree of confidence=1.96
P= expected prevalence= 0.098
d= maximum tolerated error= 0.05
N = (1.96)2 ×0.54(1-0.54))
(0.098)2
3.84 ×0.25 = 3.84(0.54)
0.0009604 0.0009604 =
0.9604
0.0009604 = 99.4
However, for this study, 100 participants were recruited.
Selection Criteria
Inclusion Criteria
Exclusion Criteria
Study Design
This is a comparative, cross-sectional case-control study designed to evaluate the association between Helicobacter pylori infection with changes in markers of inflammation and hemostasis in patients with incident hypertension. This case study comprises of a total of 100 adult men and women between the age of 20-60yrs attending the out-patient department(OPD),Federal University teaching Hospital Owerri Imo State. Participants are divided equally or proportionally (25 participants per group) into four (4) groups Participants assigned to one of four groups based on their hypertension status and H. pylori infection status:
Group 1: Normotensive, H.pylori negative subjects, serves as the control group.
Group 2: Hypertensive, H.pylori positive subjects.
Group 3: Hypertensive, H.pylori negative subjects.
Group 4: Normotensive, H.pylori positive subjects.
Sample Collection
Participants were informed to fast for 8-12 hours before sample collection, other procedures for the study were communicated to participants using a questionnaire method and their consents were obtained
Volume of blood: 10ml
Collection site: median cubital vein (antecubital fossa).
Procedure:
The puncture site was cleaned with 70% alcohol in an absorbent cooton wool and allowed to dry. Vacutainer needle was used to draw blood into appropriate tubes: EDTA tube (for platelet count), Citrate tube (for fibrinogen and vWF analysis), Plain tube( for CRP, IL-6,TNF-a,H.Pylori, IgM, IgG and Lipid profile). The various tubes were labelled appropriately, the samples in plain tube centrifuged within 2hrs of collection at 3000rpm for 10-15minutes accordingly and serum stored at -20oC or -80oC until analysis
Laboratory Investigation
All reagents were commercially purchase and the manufacturer’s standard operating procedures were strictly adhered to.
Interleukin 6 (IL-6) estimation using ELISA
The human interleukin-6 ELISA standards and samples are incubated in microplate wells pre-coated with monoclonal anti-human IL-6 antibody. After another washing, streptavidin-HRP conjugate is added. After 30 minutes of incubation and the last washing step, the remaining conjugate is allowed to react with the substrate solution 3,3’5,5’ tetramethyl-benzidine (TMB). The reaction is stopped by addition of acidic solution and absorbance of the resulting yellow product is measured. The absorbance is proportional to the concentration of IL-6. A standard curve is constructed by plotting absorbance values against concentration of standards, and concentration of unknown samples are determined using this standard curve
C- Reactive Proteins using ELISA
Principle
The essential reagents required for an immunoenzymometric assay include high affinity and specificity antibodies (enzyme and immobilized), with different and distinct epitope recognition, in excess, and native antigens. In this procedure, the immobilization takes place during the assay at the surface of the microplate well through the interaction of streptavidin coated on the well and exogenous added biotinylated monoclonal anti – CRP antibody. Upon mixing monoclonal biotinylated antibody, the enzyme-labelled antibody and a serum containing the native antigen, reaction occurs between the native antigen and antibodies, without competition or steric hinderance, to form a soluble sandwich complex. After equilibrium is attained, the antibody bound fraction is separated from the unbound antigen by decantation or aspiration. The enzyme activity in the antibody bound fraction is directly proportional to the native antigen concentration. By utilizing several different serum references of known antigen values, a dose response curve can be generated from which the antigen concentration of an unknown can be ascertained (Kimberly et al., 2003).
Determination of Serum Immunoglobulin IgG
This test was carried out using Enzyme-linked Immunosorbent Assay Technique according to (Sood, 2006) as modified by Affymetrixe Bioscience, North America.
Principle
An anti-human total IgG coating antibody is adsorbed onto micro wells. Human total IgG present in the sample or standard binds to antibodies adsorbed to the micro wells and a HRP- conjugated anti-human total IgG antibody is added and binds to human total IgG captured by the first antibody. Following incubation unbound HRP- conjugated anti-human total IgG antibody is removed during a wash step, and substrate solution reactive with HRP is added to the wells. A coloured product is formed in proportion to the amount of human total IgG present in the sample or standard. The reaction is terminated by addition of acid and absorbance is measured at 450 nm. A standard curve is prepared from 7 human total IgG standard dilutions and human total IgG sample concentration determined.
Determination of Tumor Necrosis factor alpha(TNF-α) using ELISA
Principle
The Human TNF Alpha (TNF-α) ELISA employs the quantitative sandwich enzyme immunoassay technique. A monoclonal antibody specific for TNF-α has been pre-coated onto a microplate. Standards and samples are pipetted into the wells and any TNF-α present is bound by the immobilized antibody. Following incubation unbound samples are removed during a wash step, and then a detection antibody specific for TNF-α is added to the wells and binds to the combination of capture antibody- TNF-α in sample. Following a wash to remove any unbound combination, and enzyme conjugate is added to the wells. Following incubation and wash steps a substrate is added. A colored product is formed in proportion to the amount of TNF-α present in the sample. The reaction is terminated by addition of acid and absorbance is measured at 450nm. A standard curve is prepared from seven TNF-α standard dilutions and TNF-α sample concentration determined.
Statistical analysis of results obtained was analyzed using the SPSS version 21. The means and standard deviations was calculated for all parameters under investigation. Statistical differences between the experimental and control groups were determined using one-way ANOVA analysis of variance followed by student t-test. Values were considered significant at p˂0.05
| VARIABLE (UNITS) | |||||
| Groups | CRP (mg/dl) | IL-6 (pg/m) | TNF-α (pg/m) | IgM (mg/dl) | IgG (mg/dl) |
| Group 1 | 1.96±0.87 | 4.16±1.03 | 4.28±1.36 | 93.08±17.59 | 1174.84±153.28 |
| Group 2 | 5.54±1.52 | 8.10±1.80 | 9.98±1.26 | 134.44±13.48 | 1705.40±143.21 |
| Group 3 | 4.81±0.97 | 7.07±1.09 | 7.15±1.00 | 97.80±16.76 | 1275.36±161.83 |
| Group 4 | 4.10±0.88 | 6.31±1.49 | 8.04±0.98 | 118.20±16.83 | 1649.68±110.16 |
| F-value | 58.29 | 34.66 | 45.45 | 35.01 | 91.20 |
| P-value | 0.00009* | 0.0007* | 0.00001* | 0.00003* | 0.0845 |
| G1 Vs G2 | 0.00001* | 0.00001* | 0.00001* | 0.00001* | 0.00001* |
| G1 Vs G3 | 0.00001* | 0.00001* | 0.00001* | 0.17267 | 0.0019* |
| G1 Vs G4 | 0.00001* | 0.00046* | 0.00001* | 0.00001* | 0.00001* |
| G2 Vs G3 | 0.17474 | 0.10497 | 0.00030* | 0.00001* | 0.00001* |
| G2 Vs G4 | 0.00952* | 0.01451* | 0.00119* | 0.00001* | 0.03160* |
| G3 Vs G4 | 0.07371 | 0.16788 | 0.05965 | 0.00001* | 0.00001* |
Table 1: Mean±SD for molecular markers (CRP, IL-6, TNF-α, IgM and IgG) in hypertensive patients with H.pylori infection.
Key: Group 1 (normotensive, H.pylori negative participants) serves as control
Group 2 (Hypertensive, H.pylori positive participants).
Group 3 (hypertensive, H.pylori negative participants).
Group 4(normotensive, H.pylori positive participants).
* = statistically significant (P<0>
Table 1: shows the mean, standard deviation, F-value, post-hoc pairwise comparison (student t-test) and p-value for molecular markers (C-reactive protein, Interleukin-6, Tissue Necrosis Factor-α, Imunoglobin M, Imuniglobin G). Group 2 – 4 mean and standard deviation for C-reactive Protein (5.54±1.52, 4.81±0.97 and 4.10±0.88 respectively), Interleukin-6 (8.10±1.80, 7.07±1.09 and 6.31±1.49 respectively) and Tisuue necrosis factor-alpha (9.98±1.26, 7.15±1.00 and 8.04±0.98 respectively) increased as compared to the control (1.96±0.87,4.16±1.03 and 4.28±1.36 respectively). Also groups 2-4 mean and standard deviation Imunoglobin M (134.44±13.48, 97.80±16.76 and 118.20±16.83 respectively) shows a statistically significant difference as compared to the control group 1 (93.08±17.59). There is no significant difference observed for Imunoglobin G, the mean and standard deviation for groups 2 – 4 (1705.40±143.21, 1275.36±161.83 and 1649.68±110.16 respectively) as compared with the control group 1(117.84±153.28). Post hoc anaylsis using student t-test shows significant difference between group 1 and all other group for CRP, IL-6, TNF-α, IgM, IgG (except G1vsG3 for IgG) (p<0>
Interleukin 6 (IL-6), tissue necrosis factor Alpha (TNF-α), C-reactive protein (CRP), and immunoglobulins (1gG, 1gM) are among the molecular indicators evaluated. Group 2 (hypertensive + H.pylori positive) had considerably higher levels of the pre-inflammatory cytokines (TNF-α, IL-6), whereas Group 4 (normotensive + H.pylori positive) had mild increases, while Group 1 (controls) showed no significant increase. The pathophysiology of hypertension has been linked to nitric oxide production factors, endothelial function, and chronic low-grade inflammation, as well as increased cytokines such TNF-α and IL-6 [15, 16]. This is consistent with research on clinical hypertension and animals that demonstrates the role of cytokines in vascular and metabolic processes. [17] In comparison to controls, C-Reaction Protein (CRP) was greatest in Group 2, elevated in Group 3, and moderately elevated in Group 4. Elevated CRP and IL-6 are independent of BMI predictors of the onset of hypertension, according to multiple meta-analyses. Higher serum CRP is associated with H. pylori infection. This result is consistent with [18,19].
This study shows a strong correlation between Helicobacter pylori infection, hypertension, and negative alterations in inflammatory markers (TNF-α, IL-6, and CRP). It shows that hypertension patients with an H. pylori infection have an inflated rise in pro-inflammatory markers. The bacterial infection may result in a persistent inflammatory state. Hypertension (Group 2) and H. pylori infection work together to create a synergistic inflammatory effect that raises the risk of cardiovascular problems.
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Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
I would like to offer my testimony in the support. I have received through the peer review process and support the editorial office where they are to support young authors like me, encourage them to publish their work in your esteemed journals, and globalize and share knowledge globally. I really appreciate your journal, peer review, and editorial office.
Dear Agrippa Hilda- Editorial Coordinator of Journal of Neuroscience and Neurological Surgery, "The peer review process was very quick and of high quality, which can also be seen in the articles in the journal. The collaboration with the editorial office was very good."
I would like to express my sincere gratitude for the support and efficiency provided by the editorial office throughout the publication process of my article, “Delayed Vulvar Metastases from Rectal Carcinoma: A Case Report.” I greatly appreciate the assistance and guidance I received from your team, which made the entire process smooth and efficient. The peer review process was thorough and constructive, contributing to the overall quality of the final article. I am very grateful for the high level of professionalism and commitment shown by the editorial staff, and I look forward to maintaining a long-term collaboration with the International Journal of Clinical Case Reports and Reviews.
To Dear Erin Aust, I would like to express my heartfelt appreciation for the opportunity to have my work published in this esteemed journal. The entire publication process was smooth and well-organized, and I am extremely satisfied with the final result. The Editorial Team demonstrated the utmost professionalism, providing prompt and insightful feedback throughout the review process. Their clear communication and constructive suggestions were invaluable in enhancing my manuscript, and their meticulous attention to detail and dedication to quality are truly commendable. Additionally, the support from the Editorial Office was exceptional. From the initial submission to the final publication, I was guided through every step of the process with great care and professionalism. The team's responsiveness and assistance made the entire experience both easy and stress-free. I am also deeply impressed by the quality and reputation of the journal. It is an honor to have my research featured in such a respected publication, and I am confident that it will make a meaningful contribution to the field.
"I am grateful for the opportunity of contributing to [International Journal of Clinical Case Reports and Reviews] and for the rigorous review process that enhances the quality of research published in your esteemed journal. I sincerely appreciate the time and effort of your team who have dedicatedly helped me in improvising changes and modifying my manuscript. The insightful comments and constructive feedback provided have been invaluable in refining and strengthening my work".
I thank the ‘Journal of Clinical Research and Reports’ for accepting this article for publication. This is a rigorously peer reviewed journal which is on all major global scientific data bases. I note the review process was prompt, thorough and professionally critical. It gave us an insight into a number of important scientific/statistical issues. The review prompted us to review the relevant literature again and look at the limitations of the study. The peer reviewers were open, clear in the instructions and the editorial team was very prompt in their communication. This journal certainly publishes quality research articles. I would recommend the journal for any future publications.
Dear Jessica Magne, with gratitude for the joint work. Fast process of receiving and processing the submitted scientific materials in “Clinical Cardiology and Cardiovascular Interventions”. High level of competence of the editors with clear and correct recommendations and ideas for enriching the article.
We found the peer review process quick and positive in its input. The support from the editorial officer has been very agile, always with the intention of improving the article and taking into account our subsequent corrections.
My article, titled 'No Way Out of the Smartphone Epidemic Without Considering the Insights of Brain Research,' has been republished in the International Journal of Clinical Case Reports and Reviews. The review process was seamless and professional, with the editors being both friendly and supportive. I am deeply grateful for their efforts.
To Dear Erin Aust – Editorial Coordinator of Journal of General Medicine and Clinical Practice! I declare that I am absolutely satisfied with your work carried out with great competence in following the manuscript during the various stages from its receipt, during the revision process to the final acceptance for publication. Thank Prof. Elvira Farina
Dear Jessica, and the super professional team of the ‘Clinical Cardiology and Cardiovascular Interventions’ I am sincerely grateful to the coordinated work of the journal team for the no problem with the submission of my manuscript: “Cardiometabolic Disorders in A Pregnant Woman with Severe Preeclampsia on the Background of Morbid Obesity (Case Report).” The review process by 5 experts was fast, and the comments were professional, which made it more specific and academic, and the process of publication and presentation of the article was excellent. I recommend that my colleagues publish articles in this journal, and I am interested in further scientific cooperation. Sincerely and best wishes, Dr. Oleg Golyanovskiy.
Dear Ashley Rosa, Editorial Coordinator of the journal - Psychology and Mental Health Care. " The process of obtaining publication of my article in the Psychology and Mental Health Journal was positive in all areas. The peer review process resulted in a number of valuable comments, the editorial process was collaborative and timely, and the quality of this journal has been quickly noticed, resulting in alternative journals contacting me to publish with them." Warm regards, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. I appreciate the journal (JCCI) editorial office support, the entire team leads were always ready to help, not only on technical front but also on thorough process. Also, I should thank dear reviewers’ attention to detail and creative approach to teach me and bring new insights by their comments. Surely, more discussions and introduction of other hemodynamic devices would provide better prevention and management of shock states. Your efforts and dedication in presenting educational materials in this journal are commendable. Best wishes from, Farahnaz Fallahian.
Dear Maria Emerson, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. I am delighted to have published our manuscript, "Acute Colonic Pseudo-Obstruction (ACPO): A rare but serious complication following caesarean section." I want to thank the editorial team, especially Maria Emerson, for their prompt review of the manuscript, quick responses to queries, and overall support. Yours sincerely Dr. Victor Olagundoye.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. Many thanks for publishing this manuscript after I lost confidence the editors were most helpful, more than other journals Best wishes from, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Agrippa Hilda, Editorial Coordinator, Journal of Neuroscience and Neurological Surgery. The entire process including article submission, review, revision, and publication was extremely easy. The journal editor was prompt and helpful, and the reviewers contributed to the quality of the paper. Thank you so much! Eric Nussbaum, MD
Dr Hala Al Shaikh This is to acknowledge that the peer review process for the article ’ A Novel Gnrh1 Gene Mutation in Four Omani Male Siblings, Presentation and Management ’ sent to the International Journal of Clinical Case Reports and Reviews was quick and smooth. The editorial office was prompt with easy communication.
Dear Erin Aust, Editorial Coordinator, Journal of General Medicine and Clinical Practice. We are pleased to share our experience with the “Journal of General Medicine and Clinical Practice”, following the successful publication of our article. The peer review process was thorough and constructive, helping to improve the clarity and quality of the manuscript. We are especially thankful to Ms. Erin Aust, the Editorial Coordinator, for her prompt communication and continuous support throughout the process. Her professionalism ensured a smooth and efficient publication experience. The journal upholds high editorial standards, and we highly recommend it to fellow researchers seeking a credible platform for their work. Best wishes By, Dr. Rakhi Mishra.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. The peer review process of the journal of Clinical Cardiology and Cardiovascular Interventions was excellent and fast, as was the support of the editorial office and the quality of the journal. Kind regards Walter F. Riesen Prof. Dr. Dr. h.c. Walter F. Riesen.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. Thank you for publishing our article, Exploring Clozapine's Efficacy in Managing Aggression: A Multiple Single-Case Study in Forensic Psychiatry in the international journal of clinical case reports and reviews. We found the peer review process very professional and efficient. The comments were constructive, and the whole process was efficient. On behalf of the co-authors, I would like to thank you for publishing this article. With regards, Dr. Jelle R. Lettinga.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, I would like to express my deep admiration for the exceptional professionalism demonstrated by your journal. I am thoroughly impressed by the speed of the editorial process, the substantive and insightful reviews, and the meticulous preparation of the manuscript for publication. Additionally, I greatly appreciate the courteous and immediate responses from your editorial office to all my inquiries. Best Regards, Dariusz Ziora
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation, Auctores Publishing LLC, We would like to thank the editorial team for the smooth and high-quality communication leading up to the publication of our article in the Journal of Neurodegeneration and Neurorehabilitation. The reviewers have extensive knowledge in the field, and their relevant questions helped to add value to our publication. Kind regards, Dr. Ravi Shrivastava.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, Auctores Publishing LLC, USA Office: +1-(302)-520-2644. I would like to express my sincere appreciation for the efficient and professional handling of my case report by the ‘Journal of Clinical Case Reports and Studies’. The peer review process was not only fast but also highly constructive—the reviewers’ comments were clear, relevant, and greatly helped me improve the quality and clarity of my manuscript. I also received excellent support from the editorial office throughout the process. Communication was smooth and timely, and I felt well guided at every stage, from submission to publication. The overall quality and rigor of the journal are truly commendable. I am pleased to have published my work with Journal of Clinical Case Reports and Studies, and I look forward to future opportunities for collaboration. Sincerely, Aline Tollet, UCLouvain.
Dear Ms. Mayra Duenas, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. “The International Journal of Clinical Case Reports and Reviews represented the “ideal house” to share with the research community a first experience with the use of the Simeox device for speech rehabilitation. High scientific reputation and attractive website communication were first determinants for the selection of this Journal, and the following submission process exceeded expectations: fast but highly professional peer review, great support by the editorial office, elegant graphic layout. Exactly what a dynamic research team - also composed by allied professionals - needs!" From, Chiara Beccaluva, PT - Italy.
Dear Maria Emerson, Editorial Coordinator, we have deeply appreciated the professionalism demonstrated by the International Journal of Clinical Case Reports and Reviews. The reviewers have extensive knowledge of our field and have been very efficient and fast in supporting the process. I am really looking forward to further collaboration. Thanks. Best regards, Dr. Claudio Ligresti
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation. “The peer review process was efficient and constructive, and the editorial office provided excellent communication and support throughout. The journal ensures scientific rigor and high editorial standards, while also offering a smooth and timely publication process. We sincerely appreciate the work of the editorial team in facilitating the dissemination of innovative approaches such as the Bonori Method.” Best regards, Dr. Matteo Bonori.
I recommend without hesitation submitting relevant papers on medical decision making to the International Journal of Clinical Case Reports and Reviews. I am very grateful to the editorial staff. Maria Emerson was a pleasure to communicate with. The time from submission to publication was an extremely short 3 weeks. The editorial staff submitted the paper to three reviewers. Two of the reviewers commented positively on the value of publishing the paper. The editorial staff quickly recognized the third reviewer’s comments as an unjust attempt to reject the paper. I revised the paper as recommended by the first two reviewers.
Dear Maria Emerson, Editorial Coordinator, Journal of Clinical Research and Reports. Thank you for publishing our case report: "Clinical Case of Effective Fetal Stem Cells Treatment in a Patient with Autism Spectrum Disorder" within the "Journal of Clinical Research and Reports" being submitted by the team of EmCell doctors from Kyiv, Ukraine. We much appreciate a professional and transparent peer-review process from Auctores. All research Doctors are so grateful to your Editorial Office and Auctores Publishing support! I amiably wish our article publication maintained a top quality of your International Scientific Journal. My best wishes for a prosperity of the Journal of Clinical Research and Reports. Hope our scientific relationship and cooperation will remain long lasting. Thank you very much indeed. Kind regards, Dr. Andriy Sinelnyk Cell Therapy Center EmCell
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. It was truly a rewarding experience to work with the journal “Clinical Cardiology and Cardiovascular Interventions”. The peer review process was insightful and encouraging, helping us refine our work to a higher standard. The editorial office offered exceptional support with prompt and thoughtful communication. I highly value the journal’s role in promoting scientific advancement and am honored to be part of it. Best regards, Meng-Jou Lee, MD, Department of Anesthesiology, National Taiwan University Hospital.
Dear Editorial Team, Journal-Clinical Cardiology and Cardiovascular Interventions, “Publishing my article with Clinical Cardiology and Cardiovascular Interventions has been a highly positive experience. The peer-review process was rigorous yet supportive, offering valuable feedback that strengthened my work. The editorial team demonstrated exceptional professionalism, prompt communication, and a genuine commitment to maintaining the highest scientific standards. I am very pleased with the publication quality and proud to be associated with such a reputable journal.” Warm regards, Dr. Mahmoud Kamal Moustafa Ahmed
Dear Maria Emerson, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews’, I appreciate the opportunity to publish my article with your journal. The editorial office provided clear communication during the submission and review process, and I found the overall experience professional and constructive. Best regards, Elena Salvatore.
Dear Mayra Duenas, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews Herewith I confirm an optimal peer review process and a great support of the editorial office of the present journal
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. I am really grateful for the peers review; their feedback gave me the opportunity to reflect on the message and impact of my work and to ameliorate the article. The editors did a great job in addition by encouraging me to continue with the process of publishing.
Dear Cecilia Lilly, Editorial Coordinator, Endocrinology and Disorders, Thank you so much for your quick response regarding reviewing and all process till publishing our manuscript entitled: Prevalence of Pre-Diabetes and its Associated Risk Factors Among Nile College Students, Sudan. Best regards, Dr Mamoun Magzoub.
