Introduction: H. pylori is a bacterial pathogen associated with gastric cancer. Changes in the glycosylation patterns on cells and specific glycotransferases are reportedly related to cell ...proliferation, differentiation, tissue adhesion, and carcinogenesis. There is no report that described changes of glycosylation in H. pylori infection and after eradication. Thus, in the present study, we used a lectin microarray system to analyze relationship of the gastric mucosal glycosylation and H. pylori infection. Methods: We selected 10 H. pylori uninfected patients, 10 H. pylori infected patients and 6 H. pylori eradicated gastric cancer patients who underwent gastric mucosal biopsy by endoscopy in our institute. In H. pylori infected patients, we performed biopsy again one year after H. pylori eradication. We collected the gastric mucosal cells by using LCM(Laser Capture Microdissection) and extracted protein. Results: In the gasric antrum, the expression of 3 lectins, SNA(Sambucus nigra), TJA-I(Trichosanthes japonica agglutinin I) and ACG(Agrocybe cylindracea galectin) were increased significantly in H. pylori infected mucosa compared with that in H. pyloriuninfected. In contrast, the expression of 2 lectins, Jacalin and MPA(Maclura pomifera agglutinin) were decreased(Fig.1). Interestingly, after H. pylori eradication, the decreased expression of these lectins were recovered(Fig.1). In the gastric body, the expression of 3 lectins, SNA, SSA(Sambucus sieboldiana) and TJA-I were increased. After H. pylori eradication, the increased expression of these lectins were recovered. However, in H. pylorieradicated gastric cancer patients, the expression of two lectins; SSA and TJA-I were similar to those of H. pylori infected patients(Fig.2). Conclusion: This study shows that the expression of 6 lectins were changed significantly by H. pylori infection. The expression of Jacalin and MPA were decreased by H. pylori infection, and was increased by eradication. Furthermore, the expression of SSA and TJA-I were increased in H. pylori infection and gastric cancer which found after H. pylori eradication group. eradication It is suggested that these lectins are associated with H. pylori infection.
INTRODUCTION:
Persistent
Helicobacter pylori
(
H. pylori
) infection begins during childhood and can cause peptic ulcers and gastric cancer. It can also cause extra-gastric organ disease, including ...idiopathic thrombocytopenic purpura. Although some studies have indicated a correlation between
H. pylori
infection and the risk of colorectal neoplasms, these findings have not been consistent and are controversial. This case-control study aimed to investigate the association between
H. pylori
-associated endoscopic gastric mucosal atrophy (GMA) and colorectal polyp occurrence.
METHODS:
Records of 7394 participants who underwent colonoscopy examinations from August 2008 to July 2018 were reviewed retrospectively. Saved images of endoscopic examinations were used to evaluate the colorectal polyps and GMA. Adjusted odds ratios for predictors of colorectal polyps were computed by using the multiple logistic regression model.
RESULTS:
A total of 2404 subjects were registered; 1565 (65.1%) were in the GMA-positive group and 1138 (47.3%) had colorectal polyps. The multivariate analysis adjusted by age, sex, smoking habits, alcohol habits, serum lipid levels, hemoglobin A1c (HbA1c), blood pressure, and body mass index indicated that patients in the GMA-positive group more frequently had colorectal polyps compared with patients in the GMA-negative group (odds ratio OR, 3.27; 95% confidence interval CI, 2.68–4.01;
P
< 0.001). An analysis of the association between GMA degree and colorectal polyp status indicated that, compared with mild GMA, severe GMA was associated with a higher risk of proximal colon polyps (OR, 1.47; 95% CI, 1.05–2.07;
P
= 0.024) and two or more colorectal polyps (OR, 1.80; 95% CI, 1.30–2.49;
P
< 0.001).
CONCLUSION:
Colonoscopy examination is useful for discovering colorectal disease, including polyps; however, the examination is more burdensome than esophagogastroduodenoscopy for patients because of the required preparation and invasiveness. This study showed
H. pylori
-associated GMA found during endoscopy indicated an increased risk for colorectal polyps. Moreover, it also showed severe GMA indicated risks for proximal colon polyps and multiple polyps. These results allow physicians to recommend colonoscopy examinations for specific patients.
Helicobacter pylori (H. pylori) infection has been clearly shown to be a cause of gastric cancer, and the incidence of gastric cancer has been shown to decrease with eradication. However, few reports ...have described the utility of eradication therapy in elderly people. Thus, an investigation focusing on how much actual histological improvement is obtained with eradication therapy in elderly people was conducted.
This was a retrospective study conducted using medical information of patients diagnosed with H. pylori-associated gastritis and who underwent eradication therapy. The histological improvement was assessed based on changes in the atrophy and intestinal metaplasia scores of the Updated Sydney system from before to after eradication. We investigated the rates of histological improvement in atrophy and intestinal metaplasia one year after and long term more than five years after H. pylori eradication in an elderly group and a younger group.
This study included 221 patients (elderly group 123, younger group 98). In histological atrophy, higher rates of improvement were seen in the corpus than in the antrum, and the rates of cure in the antrum were lower in elderly group than in younger group (p = 0.0282). With regard to intestinal metaplasia, the rates of improvement in the antrum were lower in elderly group than in younger. In long term observation, although the rates of cure in the antrum were lower in elderly, improvements were seen in atrophy scores in most of the patients and intestinal metaplasia scores in about half of patients.
Though there is more obvious improvement in the gastric mucosa when H. pylori eradication therapy is performed at a young age, some mucosal improvement can be expected in about half of patients after eradication, even in elderly people.
Stratification of gastric cancer risk by measuring serological biomarkers is useful for screening of gastric cancer. However, this method has problem such as overlooking past infected patients. We ...aimed to evaluate the association between Helicobacter pylori infection status and serological biomarkers. We divided 5,268 patients according to Helicobacter pylori infection status and past infected patients were divided into 12 groups according to time elapsed since eradication. We analyzed mean serum H. pylori immunoglobulin G antibody, pepsinogen titers, histological and endoscopic atrophy score of each group. Mean H. pylori immunoglobulin G antibody showed a decreasing tendency, there was no significant difference from the uninfected group at 11 years after eradication (p = 0.19). PGI, PGII decreased in short term after eradication. However, both PGI and PGII gradually increased as long-term changes after eradication, became comparable to those in the uninfected group (p = 0.41, p = 0.37, respectively). Histological atrophy improved gradually, became equivalent to uninfected group. Endoscopic atrophy score did not improve for long term after eradication. In conclusion, patients with long term after eradication reach the uninfected condition serologically, histologically. Endoscopic assessment of gastric mucosal atrophy may be useful for accurate assessment of gastric cancer risk.
Eosinophilic granulomatosis with polyangiitis (EGPA) is a systemic disorder characterized by tissue eosinophilic infiltration and vasculitis. Although EGPA causes multiple organ damage, it causes ...cholecystitis less frequently. We herein report a case of acute cholecystitis associated with EGPA in which successful treatment with glucocorticoid therapy allowed surgery to be avoided. EGPA can present as acute cholecystitis. It is important not to overlook acute cholecystitis associated with EGPA in patients with abdominal pain with peripheral eosinophilia. Furthermore, in cases of mild cholecystitis associated with EGPA that are diagnosed preoperatively, cholecystectomy might be avoided with conservative glucocorticoid treatment.
