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Tan R, Zhao D, Zhang X, Liu T, Han C, Li Z, Qi C, Wang Z. Gender and age differences in the global burden of peptic ulcers: an analysis based on GBD data from 1990 to 2021. Front Med (Lausanne) 2025; 12:1586270. [PMID: 40357292 PMCID: PMC12066501 DOI: 10.3389/fmed.2025.1586270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2025] [Accepted: 04/07/2025] [Indexed: 05/15/2025] Open
Abstract
Background Peptic ulcer (PU) is one of the most common gastrointestinal diseases worldwide. With advances in medical technology, the global disease burden of PU has been effectively controlled. However, the most recent evidence regarding the global burden of PU remains limited. Methods Using publicly available data from the Global Burden of Disease (GBD) study from 1990 to 2021, we analyzed the characteristics of the global burden of PU, including trends in incidence, prevalence, mortality, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs). We employed Joinpoint regression, age-period-cohort (APC) analysis, decomposition analysis, and autoregressive integrated moving average (ARIMA) modeling to evaluate changes and influencing factors for each indicator. Results The global number of PU cases increased from 2,570,413 in 1990 (95% CI: 2,161,831-2,997,880) to 2,854,370 in 2021 (95% CI: 2,438,231-3,264,252), representing a cumulative growth of 11.05%. However, the age-standardized incidence rate (ASIR) decreased from 57.14 (95% CI: 48.61-66.73) per 100,000 population in 1990 to 34.10 (95% CI: 29.13-38.97) per 100,000 population in 2021. The global number of deaths due to PU decreased from 273,872 in 1990 (95% CI: 247,312-299,718) to 230,217 in 2021 (95% CI: 193,005-270,858). Significant gender differences were observed, with the disease burden consistently higher in males than in females. After controlling for period and cohort effects, the onset of PU tended to occur at younger ages, and the number of cases declined across most age groups from 1990 to 2021. The highest incidence of PU was concentrated in individuals aged 90 years and older. In terms of future trends, the global incidence of PU is projected to continue decreasing over the next 15 years. The global prevalence is expected to improve, while PU-related mortality is likely to plateau without significant increases or decreases. Conclusion The global burden of PU has declined significantly over the past three decades. However, elderly individuals and males remain at higher risk and require continued attention in prevention and management efforts.
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Affiliation(s)
- Ruirui Tan
- College of Acupuncture and Massage, Changchun University of Chinese Medicine, Changchun, China
| | - Dan Zhao
- College of Acupuncture and Massage, Changchun University of Chinese Medicine, Changchun, China
| | - Xiaomei Zhang
- College of Acupuncture and Massage, Changchun University of Chinese Medicine, Changchun, China
| | - Tong Liu
- Department of Acupuncture and Moxibustion, Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine, Shenzhen, China
| | - Chao Han
- Department of Acupuncture and Moxibustion, Shenzhen Bao’an Authentic TCM Therapy Hospital, Shenzhen, China
| | - Zhongcheng Li
- Department of Acupuncture and Moxibustion, Shenzhen Bao’an Authentic TCM Therapy Hospital, Shenzhen, China
| | - Chenxi Qi
- Department of Traditional Chinese Medicine, Liaoning University of Traditional Chinese Medicine, Shenyang, China
| | - Zhaohui Wang
- Department of Acupuncture and Moxibustion, Shenzhen Bao’an Authentic TCM Therapy Hospital, Shenzhen, China
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Cui H, Xu C, Fan Y, Wang Z. Global, Regional, and National Incidence and Prevalence of Children With Peptic Ulcer Disease: A Temporal Trend and Bayesian Age-Period-Cohort Analysis Based on the 2021 Global Burden of Disease Study. J Paediatr Child Health 2025. [PMID: 40230188 DOI: 10.1111/jpc.70058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2025] [Revised: 03/31/2025] [Accepted: 04/02/2025] [Indexed: 04/16/2025]
Abstract
BACKGROUND Identifying temporal trends in children with peptic ulcer disease (PUD) could enhance public awareness and inform future policy development. METHODS Utilising data from GBD 2021, we analysed the incidence, prevalence and age-specific rates (ASR) of children with PUD from 1990 to 2021, conducting stratified analyses based on regional temporal variations. A Bayesian age-period-cohort (BAPC) model was employed to project the global burden of children with PUD over the next 15 years. RESULTS Globally, both the incidence and prevalence of children with PUD exhibited a marked decline, with incidence and prevalence cases decreasing by 0.93% and 3.67%, respectively. Regions with lower sociodemographic index (SDI) bore a heavier burden, with the highest incidence and prevalence observed in Oceania, Western sub-Saharan Africa and the Caribbean in 2021. By 2035, the global incidence and prevalence of children with PUD are projected to further decline. CONCLUSION While the global burden of children with PUD had significantly decreased, regional disparities persist. Low-SDI countries continue to face disproportionately high incidence and prevalence rates, warranting sustained attention and intervention.
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Affiliation(s)
- Haosen Cui
- Department of Obstetrics and Gynecology, Fuyang Hospital of Anhui Medical University, Fuyang, China
| | - Congfeng Xu
- Department of Pediatrics, Fuyang Hospital of Anhui Medical University, Fuyang, China
| | - Yue Fan
- Department of Obstetrics and Gynecology, Fuyang Hospital of Anhui Medical University, Fuyang, China
| | - Zhanyu Wang
- Department of Obstetrics and Gynecology, Fuyang Hospital of Anhui Medical University, Fuyang, China
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3
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Sirit IS, Peek RM. Decoding the Ability of Helicobacter pylori to Evade Immune Recognition and Cause Disease. Cell Mol Gastroenterol Hepatol 2025; 19:101470. [PMID: 39889829 PMCID: PMC11946503 DOI: 10.1016/j.jcmgh.2025.101470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2024] [Revised: 01/23/2025] [Accepted: 01/23/2025] [Indexed: 02/03/2025]
Abstract
Helicobacter pylori (H pylori) successfully and chronically colonizes the gastric mucosa of approximately 43% of the world's population. Infection with this organism is the strongest known risk factor for the development of gastric cancer, and disease development is dependent on several interactive components. One H pylori determinant that augments cancer risk is the strain-specific cag type IV secretion system, which not only translocates a pro-inflammatory and oncogenic protein, CagA, into host cells but also DNA, peptidoglycan, and a lipopolysaccharide intermediate, heptose-1,7-bisphosphate. However, cognate interactions between certain microbial and host constituents can also attenuate pro-inflammatory responses, and H pylori harbors multiple effectors that function differently than the respective counterparts in other mucosal pathogens. In this review, we discuss current data related to mechanisms utilized by H pylori to evade the immune response, sustain its longevity in the host, and further disease progression, as well as implications for developing targeted, immune-based eradication strategies.
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Affiliation(s)
- Isabella S Sirit
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee; Molecular Pathology and Immunology Training Program, Vanderbilt University, Nashville, Tennessee
| | - Richard M Peek
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
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4
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Cui Y, Li J, Zhao B, Liu J. Helicobacter pylori infection and inflammatory bowel disease: a 2-sample Mendelian randomization study. Front Microbiol 2024; 15:1384285. [PMID: 39498131 PMCID: PMC11533727 DOI: 10.3389/fmicb.2024.1384285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 10/07/2024] [Indexed: 11/07/2024] Open
Abstract
Introduction Observational studies have discovered a contradictory phenomenon between Helicobacter pylori (H. pylori) infection and inflammatory bowel disease (IBD). The study aimed to confirm the causal association between H. pylori and IBD, including ulcerative colitis (UC) and Crohn's disease (CD). Methods We conducted a Mendelian randomization (MR) study with two sample Genome-Wide Association Studies (GWAS) to determine whether there is a causal relationship between H. pylori infection and IBD, as well as the possible pathogenic factors that may be involved. The reliability of the main MR assumptions was examined through a series of sensitivity analyses. Results Two genetic variants (SNPs) previously identified were employed as instrumental variables (IVs) for H. pylori infection. GWAS data for IBD, UC, and CD were obtained from the recent DF10 release10 of the FinnGen study. Our findings indicated a significant association between H. pylori seropositivity and an increased risk of IBD and UC (IBD: OR: 1.16, 95% CI, 1.03-1.31, P < 0.05; UC: OR: 1.22, 95% CI, 1.08-1.37, P < 0.001) while no causal relationship with CD (P > 0.05). Analysis of the main virulence pathogenic factors revealed a causal relationship between cytotoxin-associated protein A (CagA) and IBD and UC (IBD: OR: 1. 06, 95% CI, 1.001-1.11, P < 0.05; UC: OR: 1.07, 95% CI, 1.004-1.14, P < 0.05), while no correlation was found for vacuolar cytotoxin A (VacA) (P > 0.05). After applying the False Discovery Rate (FDR) correction, the causal relationship between CagA and the risk of IBD or UC was no longer statistically significant. Conclusion This study suggests a potential causal relationship between H. pylori infection and IBD, particularly UC. The effect may be more pronounced in individuals with previous H. pylori infections.
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Affiliation(s)
- Yurong Cui
- Department of Digestive Diseases, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Jinxin Li
- The First Clinical Medical College, Henan University of Chinese Medicine, Zhengzhou, China
| | - Bing Zhao
- The First Clinical Medical College, Henan University of Chinese Medicine, Zhengzhou, China
| | - Junying Liu
- Department of Digestive Diseases, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
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Almadi MA, Lu Y, Alali AA, Barkun AN. Peptic ulcer disease. Lancet 2024; 404:68-81. [PMID: 38885678 DOI: 10.1016/s0140-6736(24)00155-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 09/22/2023] [Accepted: 01/24/2024] [Indexed: 06/20/2024]
Abstract
Annual prevalence estimates of peptic ulcer disease range between 0·12% and 1·5%. Peptic ulcer disease is usually attributable to Helicobacter pylori infection, intake of some medications (such as aspirin and non-steroidal anti-inflammatory medications), or being critically ill (stress-related), or it can be idiopathic. The clinical presentation is usually uncomplicated, with peptic ulcer disease management based on eradicating H pylori if present, the use of acid-suppressing medications-most often proton pump inhibitors (PPIs)-or addressing complications, such as with early endoscopy and high-dose PPIs for peptic ulcer bleeding. Special considerations apply to patients on antiplatelet and antithrombotic agents. H pylori treatment has evolved, with the choice of regimen dictated by local antibiotic resistance patterns. Indications for primary and secondary prophylaxis vary across societies; most suggest PPIs for patients at highest risk of developing a peptic ulcer, its complications, or its recurrence. Additional research areas include the use of potassium-competitive acid blockers and H pylori vaccination; the optimal approach for patients at risk of stress ulcer bleeding requires more robust determinations of optimal patient selection and treatment selection, if any. Appropriate continuation of PPI use outweighs most possible side-effects if given for approved indications, while de-prescribing should be trialled when a definitive indication is no longer present.
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Affiliation(s)
- Majid A Almadi
- Division of Gastroenterology, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia; Division of Gastroenterology, The McGill University Health Center, Montréal General Hospital, McGill University, Montréal, QC, Canada
| | - Yidan Lu
- Division of Gastroenterology, The McGill University Health Center, Montréal General Hospital, McGill University, Montréal, QC, Canada
| | - Ali A Alali
- Department of Medicine, Faculty of Medicine, Kuwait University, Jabriyah, Kuwait
| | - Alan N Barkun
- Division of Gastroenterology, The McGill University Health Center, Montréal General Hospital, McGill University, Montréal, QC, Canada; Division of Clinical Epidemiology, The McGill University Health Center, Montréal General Hospital, McGill University, Montréal, QC, Canada.
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Chew DCH, Yim CHH, Ali RA, El‐Omar EM. Epidemiology, Microbiome, and Risk Factors Involved in Carcinogenesis of Esophagus, Gastric, and Intestine. GASTROINTESTINAL ONCOLOGY ‐ A CRITICAL MULTIDISCIPLINARY TEAM APPROACH 2E 2024:2-22. [DOI: 10.1002/9781119756422.ch1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2025]
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Abstract
Gastric and small bowel emergencies are often seen in the emergency department and require rapid assessment and intervention as patients can deteriorate quickly. Some of the more frequently seen gastric emergencies include gastric volvulus and peptic ulcer disease, which can present with ischemia, strangulation, perforation, or severe bleeding. Swift diagnosis is crucial to ensuring the proper management whether that is endoscopic or with surgical exploration. Perforated peptic ulcers that are not contained will require surgical intervention, whereas bleeding ulcers can often be controlled with endoscopic interventions.
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Affiliation(s)
- Brianna S Williams
- Riverside Community Hospital, 4445 Magnolia Avenue, Riverside, CA 92501, USA
| | - Teresa A Huynh
- Riverside Community Hospital, 4445 Magnolia Avenue, Riverside, CA 92501, USA
| | - Ahmed Mahmoud
- University of California Riverside, Riverside Community Hospital, , 4445 Magnolia Avenue, Riverside, CA 92501, USA.
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O'Connor HJ. Forty years of Helicobacter pylori infection and changes in findings at esophagogastroduodenoscopy. Helicobacter 2023; 28:e13026. [PMID: 37818739 DOI: 10.1111/hel.13026] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/24/2023] [Accepted: 09/26/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND It is 40 years since the discovery of Helicobacter pylori infection. Over that time major changes have occurred in esophagogastroduodenoscopy (EGD) findings. The aim of this review is to describe these changes, and the important role H. pylori infection has played in their evolution. METHODS References were identified through searches of PubMed using the search terms-endoscopy time trends, peptic ulcer disease, gastroesophageal reflux disease, upper gastrointestinal cancer, gastric polyps, H. pylori, eosinophilic gastrointestinal disorders, and celiac disease, from 1970 through December 2021. RESULTS The prevalence of H. pylori infection has fallen and consequently, H. pylori-positive peptic ulcer disease has become rare. Gastroesophageal reflux disease is now the commonest disorder diagnosed at EGD, and Barrett's esophagus has increased in parallel. Cancer of the distal stomach has fallen while esophageal adenocarcinoma and reflux-related cardia cancer have risen. Gastric polyps have changed from hyperplastic and adenomas to sporadic fundic gland polyps. Antimicrobial resistance has made H. pylori infection more difficult to eradicate. Eosinophilic gastrointestinal disorders, particularly eosinophilic esophagitis, have emerged as important new allergic disorders. Celiac disease has changed and increased. CONCLUSIONS EGD findings appear to have changed from features suggesting a H. pylori-positive "phenotype" 40 years ago to a H. pylori-negative "phenotype" today. These changes have major implications for the management of gastrointestinal disorders.
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Affiliation(s)
- Humphrey J O'Connor
- Trinity Academic Gastroenterology Group, Trinity Centre for Health Sciences, The University of Dublin, Tallaght University Hospital, Dublin, Ireland
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9
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Yahya H. Change in Prevalence and Pattern of Peptic Ulcer Disease in the Northern Savannah of Nigeria: An Endoscopic Study. Ann Afr Med 2023; 22:420-425. [PMID: 38358140 PMCID: PMC10775940 DOI: 10.4103/aam.aam_144_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 01/04/2023] [Indexed: 02/16/2024] Open
Abstract
Background Peptic ulcer disease (PUD) is common worldwide. Its incidence and prevalence have been declining in recent years in developed countries, and a similar trend has been observed in many parts of Africa including Nigeria. Aim This study aimed to provide an endoscopic update on PUD in the Northern Savannah of Nigeria and compare with past reports from the region and recent reports from Nigeria, Africa, and the rest of the world. Methods Upper gastrointestinal endoscopy records of consecutive patients diagnosed with PUD between January 2014 and September 2022 at an endoscopy unit of a tertiary institution in North-West Nigeria were retrieved and demographic data, types of peptic ulcer, and their characteristics were extracted and analyzed. Results Over a 9-year period, 171/1958 (8.7%) patients were diagnosed with PUD: mean age 48.8 years (range 14-85), 68.4% male, and 70% >40 years. 59.6% were gastric ulcers (GU), 31.6% duodenal ulcers (DU), and 8.8% were both. The mean age of patients with GU was slightly higher than those with DU (49.9 years vs. 46.6 years, P = 0.29); patients aged <40 years were significantly more likely to be diagnosed with DU than GU (54.7% vs. 33.9%, P = 0.016) while those >40 years significantly more GU than DU (74.6% vs. 54.7%, P = 0.016). There were no significant gender differences between GU and DU. Conclusion The prevalence and pattern of PUD in Northern Savannah of Nigeria have changed - patients were predominantly male and older, and GU predominated.
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Affiliation(s)
- Husain Yahya
- Department of Internal Medicine, Barau Dikko Teaching Hospital, Kaduna State University, Kaduna, Nigeria
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10
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Laucirica I, García Iglesias P, Calvet X. [Peptic ulcer]. Med Clin (Barc) 2023; 161:260-266. [PMID: 37365037 DOI: 10.1016/j.medcli.2023.05.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 05/25/2023] [Accepted: 05/29/2023] [Indexed: 06/28/2023]
Abstract
Peptic ulcer disease is a frequent pathology; although the incidence has decreased in recent years, it continues to be an important cause of morbidity and mortality associated with high healthcare costs. The most important risk factors are Helicobacter pylori(H. pylori) infection and the use of non-steroidal anti-inflammatory drugs. Most patients with peptic ulcer disease remain asymptomatic, with dyspepsia being the most frequent and often characteristic symptom. It can also debut with complications such as upper gastrointestinal bleeding, perforation or stenosis. The diagnostic technique of choice is upper gastrointestinal endoscopy. Treatment with proton pump inhibitors, eradication of H. pylori and avoiding the use of non-steroidal anti-inflammatory drugs are the basis of treatment. However, prevention is the best strategy, it includes an adequate indication of proton pump inhibitors, investigation and treatment of H. pylori, avoiding non-steroidal anti-inflammatory drugs or using those that are less gastrolesive.
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Affiliation(s)
- Isabel Laucirica
- Servei d'Aparell Digestiu, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Departament de Medicina, Universitat Autònoma de Barcelona, Sabadell, España
| | - Pilar García Iglesias
- Servei d'Aparell Digestiu, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Departament de Medicina, Universitat Autònoma de Barcelona, Sabadell, España
| | - Xavier Calvet
- Servei d'Aparell Digestiu, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Departament de Medicina, Universitat Autònoma de Barcelona, Sabadell, España; Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, España.
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Wang H, Gu Y, Zhou G, Chen X, Zhang X, Shao Z, Zhang M. Helicobacter zhangjianzhongii sp. nov., isolated from dog feces. Front Genet 2023; 14:1240581. [PMID: 37823030 PMCID: PMC10562538 DOI: 10.3389/fgene.2023.1240581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 09/15/2023] [Indexed: 10/13/2023] Open
Abstract
In 2019, two distinct bacterial isolates were independently isolated from the fecal samples of separate dogs in Beijing, China. These cells exhibit microaerobic, are Gram-negative, motile, and possess a characteristic spiral shape with bipolar single flagellum. They display positive results for the oxidase test while being negative for both catalase and urease. These organisms measure approximately 0.2-0.3 μm in width and 4.5-6 μm in length. The colonies are wet, flat, grey, circular, and smooth with sizes ranging from 1 to 2 mm in diameter after 2 days of growth. However, strains may exhibit variations in size and morphology following extended incubation. Phylogenetic analyses based on the 16S rRNA gene and core genome indicated that these two isolates belong to the genus Helicobacter and formed a robust clade that was remains distinctly separate from currently recognized species. These two isolates shared low dDDH relatedness and ANI values with their closest species Helicobacter canis CCUG 32756T, with these values falling below the commonly cutoff values for strains of the same species. The genomic DNA G + C contents of strain XJK30-2 were 44.93 mol%. Comparing the phenotypic and phylogenetic features between these two isolates and their closely related species, XJK30-2 represents a novel species within the genus Helicobacter, for which the name Helicobacter zhangjianzhongii sp. nov. (Type strain XJK30-2T = GDMCC 1.3695T) is proposed.
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Affiliation(s)
| | | | | | | | | | | | - Maojun Zhang
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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12
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Wang M, Yang G, Tian Y, Zhang Q, Liu Z, Xin Y. The role of the gut microbiota in gastric cancer: the immunoregulation and immunotherapy. Front Immunol 2023; 14:1183331. [PMID: 37457738 PMCID: PMC10348752 DOI: 10.3389/fimmu.2023.1183331] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 05/11/2023] [Indexed: 07/18/2023] Open
Abstract
Gastric cancer (GC) is one of the most common cancers, leading to the deaths of millions of people worldwide. Therefore, early detection and effective therapeutic strategies are of great value for decreasing the occurrence of advanced GC. The human microbiota is involved not only in the maintenance of physiological conditions, but also in human diseases such as obesity, diabetes, allergic and atopic diseases, and cancer. Currently, the composition of the bacteria in the host, their functions, and their influence on disease progression and treatment are being discussed. Previous studies on the gut microbiome have mostly focused on Helicobacter pylori (Hp) owing to its significant role in the development of GC. Nevertheless, the enrichment and diversity of other bacteria that can modulate the tumor microenvironment are involved in the progression of GC and the efficacy of immunotherapy. This review provides systematic insight into the components of the gut microbiota and their application in GC, including the specific bacteria of GC, their immunoregulatory effect, and their diagnostic value. Furthermore, we discuss the relationship between the metabolism of microbes and their potential applications, which may serve as a new approach for the diagnosis and treatment of GC.
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Affiliation(s)
- Meiqi Wang
- Department of Gastrointestinal Colorectal and Anal Surgery, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
| | - Ge Yang
- College of Basic Medical Sciences and Key Laboratory of Pathobiology, Ministry of Education, Jilin University, Changchun, China
| | - Yuan Tian
- College of Basic Medical Sciences and Key Laboratory of Pathobiology, Ministry of Education, Jilin University, Changchun, China
| | - Qihe Zhang
- College of Basic Medical Sciences and Key Laboratory of Pathobiology, Ministry of Education, Jilin University, Changchun, China
| | - Zhuo Liu
- Department of Gastrointestinal Colorectal and Anal Surgery, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
| | - Ying Xin
- College of Basic Medical Sciences and Key Laboratory of Pathobiology, Ministry of Education, Jilin University, Changchun, China
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Hamashima C. Forthcoming Step in Gastric Cancer Prevention: How Can Risk Stratification Be Combined with Endoscopic Screening for Gastric Cancer? Gut Liver 2022; 16:811-824. [PMID: 35314519 PMCID: PMC9668507 DOI: 10.5009/gnl210313] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 10/29/2021] [Accepted: 11/12/2021] [Indexed: 11/04/2022] Open
Abstract
Although the concern for gastric cancer prevention has increased, gastric cancer has remained a heavy burden worldwide and is not just a local issue in East Asian countries. However, as several screening programs (listed below) have shown some success, it is important to determine whether the situation is changing in some other countries and whether similar methods should be recommended. Endoscopic screening has been performed as a national program in South Korea and Japan, and the results have shown a reduction in gastric cancer mortality. Although the efficacy of Helicobacter pylori eradication has been established, the efficacy of the screen-and-treat strategy is presently being evaluated in randomized controlled trials. The serum pepsinogen test and endoscopic examination can divide high-risk subjects with severe gastric atrophy from average-risk subjects. Risk stratification is anticipated to contribute to an efficient method of prediction of gastric cancer development when combined with endoscopic screening. Countries with a high incidence rate should realize the immediate need to reduce gastric cancer death directly by endoscopic screening and should recognize screen-and-treat as a second option to reduce future risk. However, all forms of gastric cancer prevention programs have some harms and potential to increase unnecessary examinations. A balance of the benefits and harms should be always considered. Although further study is needed to obtain sufficient evidence for gastric cancer prevention, the best available method should be examined in the context of each country.
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Affiliation(s)
- Chisato Hamashima
- Health Policy Section, Department of Nursing, Faculty of Medical Technology, Teikyo University, Tokyo, Japan
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Teng KW, Hsieh KS, Hung JS, Wang CJ, Liao EC, Chen PC, Lin YH, Wu DC, Lin CH, Wang WC, Chan HL, Huang SK, Kao MC. Helicobacter pylori employs a general protein glycosylation system for the modification of outer membrane adhesins. Gut Microbes 2022; 14:2130650. [PMID: 36206406 PMCID: PMC9553153 DOI: 10.1080/19490976.2022.2130650] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Helicobacter pylori infection is associated with the development of several gastric diseases including gastric cancer. To reach a long-term colonization in the host stomach, H. pylori employs multiple outer membrane adhesins for binding to the gastric mucosa. However, due to the redundancy of adhesins that complement the adhesive function of bacteria, targeting each individual adhesin alone usually achieves nonideal outcomes for preventing bacterial adhesion. Here, we report that key adhesins AlpA/B and BabA/B in H. pylori are modified by glycans and display a two-step molecular weight upshift pattern from the cytoplasm to the inner membrane and from the inner membrane to the outer membrane. Nevertheless, this upshift pattern is missing when the expression of some enzymes related to lipopolysaccharide (LPS) biosynthesis, including the LPS O-antigen assembly and ligation enzymes WecA, Wzk, and WaaL, is disrupted, indicating that the underlying mechanisms and the involved enzymes for the adhesin glycosylation are partially shared with the LPS biosynthesis. Loss of the adhesin glycosylation not only reduces the protease resistance and the stability of the tested adhesins but also changes the adhesin-binding ability. In addition, mutations in the LPS biosynthesis cause a significant reduction in bacterial adhesion in the in vitro cell-line model. The current findings reveal that H. pylori employs a general protein glycosylation system related to LPS biosynthesis for adhesin modification and its biological significance. The enzymes required for adhesin glycosylation rather than the adhesins themselves are potentially better drug targets for preventing or treating H. pylori infection.
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Affiliation(s)
- Kai-Wen Teng
- Institute of Molecular Medicine, College of Life Science, National Tsing Hua University, Hsinchu, Taiwan
| | - Kai-Siang Hsieh
- Institute of Molecular Medicine, College of Life Science, National Tsing Hua University, Hsinchu, Taiwan
| | - Ji-Shiuan Hung
- Institute of Molecular Medicine, College of Life Science, National Tsing Hua University, Hsinchu, Taiwan
| | - Chun-Jen Wang
- Institute of Molecular Medicine, College of Life Science, National Tsing Hua University, Hsinchu, Taiwan
| | - En-Chi Liao
- Institute of Bioinformatics and Structural Biology, College of Life Science, National Tsing Hua University, Hsinchu, Taiwan,Department of Medical Science, College of Life Science, National Tsing Hua University, Hsinchu, Taiwan
| | - Pei-Chun Chen
- Institute of Molecular Medicine, College of Life Science, National Tsing Hua University, Hsinchu, Taiwan
| | - Ying-Hsuan Lin
- Institute of Molecular Medicine, College of Life Science, National Tsing Hua University, Hsinchu, Taiwan
| | - Deng-Chyang Wu
- Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chun-Hung Lin
- Institute of Biological Chemistry, Academia Sinica, Taipei, Taiwan
| | - Wen-Ching Wang
- Institute of Molecular and Cellular Biology, College of Life Science, National Tsing Hua University, Hsinchu, Taiwan,Department of Life Science, College of Life Science, National Tsing Hua University, Hsinchu, Taiwan
| | - Hong-Lin Chan
- Institute of Bioinformatics and Structural Biology, College of Life Science, National Tsing Hua University, Hsinchu, Taiwan,Department of Medical Science, College of Life Science, National Tsing Hua University, Hsinchu, Taiwan
| | - Shau-Ku Huang
- National Institute of Environmental Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - Mou-Chieh Kao
- Institute of Molecular Medicine, College of Life Science, National Tsing Hua University, Hsinchu, Taiwan,Department of Life Science, College of Life Science, National Tsing Hua University, Hsinchu, Taiwan,CONTACT Mou-Chieh Kao Institute of Molecular Medicine, College of Life Science, National Tsing Hua University, 101, Section 2, Kuang-Fu Road, Hsinchu 300044, Taiwan
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15
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Klang E, Soffer S, Barash Y, Shachar E, Lahat A. Changes in Helicobacter pylori Treatment from Discovery to Nowadays: A High-Level Analysis of PubMed Publications. Clin Exp Gastroenterol 2022; 15:51-58. [PMID: 35330691 PMCID: PMC8939865 DOI: 10.2147/ceg.s342048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 03/03/2022] [Indexed: 11/23/2022] Open
Abstract
Background Since the discovery of Helicobacter pylori (H. pylori) 40 years ago, treatment options have changed dramatically adjacent to new drugs development and the emergence of multi-drug resistance. In this study, we aimed to assess published literature on treatment regimens for H. pylori in the past four decades, with regards to specific drug resistance and geographic distribution. Methods We have queried PubMed for all available H. pylori-related entries published during 1987–2020. For each entry, we retrieved the title, abstract, and keywords. Two gastrointestinal specialists decided in consensus on a list of terms to classify entries. The terms specify types of treatment and different types of regimens. Annual trends of publications were plotted for different treatment types and sub-analyses. Results Overall, 47,170 H. pylori-related entries were published between 1987 and 2020. Medication treatment showed the highest number of total publications 6183/47,170 (13.1%), followed by antibiotics 5493/47,170 (11.6%), and probiotic which was substantially lower (0.7%). For treatment regimens type, triple therapy had the highest number of publications 2400/47,170 (5.1%) followed by sequential therapy 342/47,170 (0.7%), and bismuth quadruple therapy 115/47,170 (0.2%). Analysis by antibiotic resistance showed that clarithromycin treatment had the highest number of publications 3537/47,170 (7.5%). Since 2013, there is a steep upward slope (5.1±0.7 publications/year, p < 0.001) for publications originating from China. Conclusion Our findings reflect the changes of the commonly prescribed regimens along the years, following the occurrence and the rise of H. pylori antibiotic resistance. In recent years, there is a steep rise in publications in countries with policies of screening and eradication for gastric cancer prevention, which is currently not applied in Western countries. A text-mining analysis of H. pylori publications contributes to the understanding of treatment options and development trends worldwide.
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Affiliation(s)
- Eyal Klang
- Department of Diagnostic Imaging, Sheba Medical Center, Ramat Gan, Israel
- Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
- DeepVision Lab, Sheba Medical Center, Ramat Gan, Israel
| | - Shelly Soffer
- DeepVision Lab, Sheba Medical Center, Ramat Gan, Israel
- Internal Medicine B, Samson Assuta Ashdod University Hospital, Ashdod, Israel
- Ben-Gurion University of the Negev, Be’er Sheva, Israel
- Correspondence: Shelly Soffer, Internal Medicine B, Samson Assuta Ashdod University Hospital, Ha-Refu’a St 7, Ashdod, 7747629, Israel, Tel +973-8-300-4100, Fax +972-3-5357315, Email
| | - Yiftach Barash
- Department of Diagnostic Imaging, Sheba Medical Center, Ramat Gan, Israel
- Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
- DeepVision Lab, Sheba Medical Center, Ramat Gan, Israel
| | - Eyal Shachar
- Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
- Department of Gastroenterology, Sheba Medical Center, Ramat Gan, Israel
| | - Adi Lahat
- Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
- Department of Gastroenterology, Sheba Medical Center, Ramat Gan, Israel
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16
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Xie X, Ren K, Zhou Z, Dang C, Zhang H. The global, regional and national burden of peptic ulcer disease from 1990 to 2019: a population-based study. BMC Gastroenterol 2022; 22:58. [PMID: 35144540 PMCID: PMC8832644 DOI: 10.1186/s12876-022-02130-2] [Citation(s) in RCA: 81] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 01/31/2022] [Indexed: 02/06/2023] Open
Abstract
Background Peptic ulcer disease (PUD) is a common digestive disorder, of which the prevalence decreased in the past few decades. However, the decreasing tendency has plateaued in recent years due to changes in risk factors associated with the etiology of PUD, such as non-steroidal anti-inflammatory drug use. In this study, we investigated the epidemiological and the sociodemographic characteristics of PUD in 204 countries and territories from 1990 to 2019 based on data from the Global Burden of Disease, Injuries and Risk Factors (GBD) Study. Methods Demographic characteristics and annual prevalence, incidence, mortality, disability-adjusted life years (DALYs) and age-standardized death rate (ASR) data associated with PUD were obtained and analyzed. According to the sociodemographic index (SDI), the numbers of patients, ASRs, estimated annual percentage changes and geographical distributions were assessed with a generalized linear model and presented in world maps. All evaluations of numbers and rates were calculated per 100,000 population with 95% uncertainty intervals (UIs). Results In 2019, the global prevalence of PUD was approximately 8.09 [95% UI 6.79–9.58] million, representing a 25.82% increase from 1990. The age-standardized prevalence rate was 99.40 (83.86–117.55) per 100,000 population in 2019, representing a decrease of 143.37 (120.54–170.25) per 100,000 population from 1990. The age-standardized DALY rate in 2019 was decreased by 60.64% [74.40 (68.96–81.95) per 100,000 population] compared to that in 1990. In both sexes, the numbers and ASRs of the prevalence, incidence, deaths and DALYs were higher in males than in females over 29 years. Regionally, South Asia had the highest age-standardized prevalence rate [156.62 (130.58–187.05) per 100,000 population] in 2019. A low age-standardized death rate was found in the high-income super-region. Among nations, Kiribati had the highest age-standardized prevalence rate [330.32 (286.98–379.81) per 100,000 population]. Regarding socioeconomic status, positive associations between the age-standardized prevalence, incidence, death rate, DALYs and SDI were observed globally in 2019. Conclusions Morbidity and mortality due to PUD decreased significantly from 1990 to 2019, while a gradual upward inclination has been observed in recent 15 years, which might be associated with changes in risk factors for PUD. Attention and efforts by healthcare administrators and society are needed for PUD prevention and control. Supplementary Information The online version contains supplementary material available at 10.1186/s12876-022-02130-2.
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Affiliation(s)
- Xin Xie
- Department of Surgical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China.,Department of Nuclear Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China
| | - Kaijie Ren
- Department of Surgical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China
| | - Zhangjian Zhou
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China
| | - Chengxue Dang
- Department of Surgical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China.,Clinical Medicine and Cancer Research Center of Shaanxi Province, Xi'an, 710061, Shaanxi, China
| | - Hao Zhang
- Department of Surgical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China. .,Clinical Medicine and Cancer Research Center of Shaanxi Province, Xi'an, 710061, Shaanxi, China.
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17
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Kumar S, Kumar A. Microbial pathogenesis in inflammatory bowel diseases. Microb Pathog 2022; 163:105383. [PMID: 34974120 DOI: 10.1016/j.micpath.2021.105383] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 12/23/2021] [Accepted: 12/28/2021] [Indexed: 12/20/2022]
Abstract
Inflammatory bowel disease (IBD) is a chronic inflammatory condition of the gastrointestinal system. Previously, it is considered the disease of the western world but now the incidence and prevalence of IBD are increasing globally with urbanization and modernization. Additionally, the major problem is the highest incidence of IBD among children and adolescents. The precise etiology of IBD is unknown and there is no cure for IBD, which is also the reason for increasing the number of cases worldwide. The IBD is a complex interplay of environment, immune system, and microbiota in a genetically susceptible host. Among these factors, the alteration in intestinal microbiota has been detected in IBD patients. The bacterial species associated with IBD include Mycobacterium paratuberculosis, adherent-invasive E. coli (AIEC), Helicobacter pylori, and Campylobacter concisus. Moreover, the efficacy of antibiotics and probiotics further suggests the role of microbes in IBD. However, no study confirmed the bacterial species as a cause of IBD as per Koch's postulates. Thus, still controversies exist regarding the role of microbes in IBD. Therefore, this paper aims to review the current literature to evaluate the role of microbes in IBD that would be a useful inventory of researchers working in this area.
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Affiliation(s)
- Sunil Kumar
- Faculty of Biosciences, Institute of Biosciences and Technology, Shri Ramswaroop Memorial University, Barabanki, Uttar Pradesh, India.
| | - Awanish Kumar
- Department of Biotechnology, National Institute of Technology, Raipur, Chhattisgarh, India.
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18
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Sonnenberg A. Epidemiology of Helicobacter pylori. Aliment Pharmacol Ther 2022; 55 Suppl 1:S1-S13. [PMID: 34989430 DOI: 10.1111/apt.16592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/14/2021] [Accepted: 08/17/2021] [Indexed: 12/21/2022]
Abstract
In many countries alike, the time trends of gastric cancer, gastric and duodenal ulcer, ulcerative colitis, Crohn's disease, and colorectal cancer are characterized by similar birth-cohort patterns. Mortality from these diagnoses rose in cohorts born during the 19th century and then fell in subsequent cohorts born during the 20th century.
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Affiliation(s)
- Amnon Sonnenberg
- Portland VA Medical Center, Oregon Health & Science University, Portland, Oregon, USA
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19
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Zhang W, Liang X, Chen X, Ge Z, Lu H. Time trends in the prevalence of Helicobacter pylori infection in patients with peptic ulcer disease: a single-center retrospective study in Shanghai. J Int Med Res 2021; 49:3000605211051167. [PMID: 34686094 PMCID: PMC8674481 DOI: 10.1177/03000605211051167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Objective The present study aimed to investigate the recent trends in
Helicobacter pylori infection associated with peptic
ulcer disease in a large population in Shanghai. Methods We analyzed the medical records of all patients who had undergone upper
gastrointestinal endoscopy (EGD) for uninvestigated dyspepsia at Ren Ji
Hospital between 2013 and 2019 to determine the prevalence of H.
pylori infection in patients with peptic ulcers. Results Peptic ulcers were found in 40,385 of the 383,413 patients who underwent EGD
during the study period. Over the 7-year study period, the annual prevalence
of H. pylori among patients receiving EGD declined from
32.2% to 26.5%. H. pylori was present in 60% of ulcers and
the incidence was higher (66.9%) in duodenal compared with gastric ulcers
(48.5%). The proportion of H. pylori-associated gastric
ulcers declined from 52.2% to 49.3% and that of H.
pylori-positive duodenal ulcers declined from 70.0% to 63.9%. Conclusion The prevalence of H. pylori-positive peptic ulcers, mainly
duodenal ulcers, fell from 2013 to 2019. However, the proportion of
non-H. pylori-associated peptic ulcer disease
increased, especially in elderly people, possibly due to the use of
nonsteroidal anti-inflammatory drugs. Further research is needed to confirm
this hypothesis.
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Affiliation(s)
- Wei Zhang
- Department of Gastroenterology and Hepatology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Digestive Disease, Key Laboratory of Gastroenterology & Hepatology, Ministry of Health, Shanghai, China
| | - Xiao Liang
- Department of Gastroenterology and Hepatology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Digestive Disease, Key Laboratory of Gastroenterology & Hepatology, Ministry of Health, Shanghai, China
| | - Xiaoyu Chen
- Department of Gastroenterology and Hepatology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Digestive Disease, Key Laboratory of Gastroenterology & Hepatology, Ministry of Health, Shanghai, China
| | - Zhizheng Ge
- Department of Gastroenterology and Hepatology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Digestive Disease, Key Laboratory of Gastroenterology & Hepatology, Ministry of Health, Shanghai, China
| | - Hong Lu
- Department of Gastroenterology and Hepatology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Digestive Disease, Key Laboratory of Gastroenterology & Hepatology, Ministry of Health, Shanghai, China
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20
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Weng CY, Xu JL, Sun SP, Wang KJ, Lv B. Helicobacter pylori eradication: Exploring its impacts on the gastric mucosa. World J Gastroenterol 2021; 27:5152-5170. [PMID: 34497441 PMCID: PMC8384747 DOI: 10.3748/wjg.v27.i31.5152] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 06/14/2021] [Accepted: 07/15/2021] [Indexed: 02/06/2023] Open
Abstract
Helicobacter pylori (H. pylori) infects approximately 50% of all humans globally. Persistent H. pylori infection causes multiple gastric and extragastric diseases, indicating the importance of early diagnosis and timely treatment. H. pylori eradication produces dramatic changes in the gastric mucosa, resulting in restored function. Consequently, to better understand the importance of H. pylori eradication and clarify the subsequent recovery of gastric mucosal functions after eradication, we summarize histological, endoscopic, and gastric microbiota changes to assess the therapeutic effects on the gastric mucosa.
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Affiliation(s)
- Chun-Yan Weng
- Department of Gastroenterology, The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
| | - Jing-Li Xu
- Department of Gastrointestinal Surgery, The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
| | - Shao-Peng Sun
- Department of Gastroenterology, The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
| | - Kai-Jie Wang
- Department of Gastroenterology, The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
| | - Bin Lv
- Department of Gastroenterology, The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
- Department of Gastroenterology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, Zhejiang Province, China
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21
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Gupta M, Gulati M, Kapoor B, Kumar B, Kumar R, Kumar R, Khurana N, Gupta R, Singh N. Anti-ulcerogenic effect of methanolic extract of Elaeagnus conferta Roxb. seeds in Wistar rats. JOURNAL OF ETHNOPHARMACOLOGY 2021; 275:114115. [PMID: 33852947 DOI: 10.1016/j.jep.2021.114115] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 02/22/2021] [Accepted: 04/05/2021] [Indexed: 06/12/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Elaeagnus conferta Roxb. (Elaeagnaceae) is a subtropical shrub mainly native to India, Vietnam, Malaysia and South China, whose various parts are used for treatment of diabetes, gastric ulcers, pain, oxidative stress and pulmonary disorders. Though the other parts of the plant have been reported for their ethnic use i.e. fruits as astringent locally and for cancer systemically, leaves for body pain and flowers for pain in chest and the seeds are mentioned as edible, there is no report per se on the medicinal use of seeds. Based on the fact that seeds of closely resembling species i.e. Elaeagnus rhamnoides has demonstrated significant anti-gastroulcerative property, the probability of the seeds of E. conferta possessing similar activity seemed quite significant. AIM OF THE STUDY Phytochemical investigation and assessment of pharmacological mechanism(s) involved in anti-ulcer effect of methanolic extract of the seeds of E. conferta. MATERIALS AND METHODS Bioactive phytoconstituents were isolated by column chromatography. These were identified by spectroscopic techniques including infrared (IR) spectroscopy, nuclear magnetic resonance (NMR) and mass spectrometry. Methanolic extract (MEC) of the seeds was prepared by cold maceration and its anti-ulcerogenic potential was evaluated using indomethacin (50 mg/kg) and water immersion stress models in male rats. The animals were pre-treated with different doses of MEC (400 and 800 mg/kg) and the therapeutic effect was compared with standard drug i.e. ranitidine (RANT; 50 mg/kg). The ameliorative effects of MEC were investigated on gastric juice pH, total acidity, free acidity and ulcer index. The assays of malionaldehyde (MDA), catalase (CAT), superoxide dismutase (SOD), glutathione (GSH) and pro-inflammatory cytokines i.e. interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) were carried out to find out the possible mechanism(s) of protection. Further, histopathological changes were also studied. RESULTS Chromatography studies and further confirmation by spectroscopic techniques revealed the presence of four different compounds in MEC i.e oleic acid (1), stearic acid (2), ascorbic acid (3) and quercetin (4). MEC exhibited anti-ulcerogenic effect in dose dependent manner which may be attributed to suppression of pro-inflammatory cytokines (IL-6, TNF-α) and MDA (112.7%), and up-regulation of protective factors such as CAT (90.48%), SOD (92.77%) and GSH (90.01%). Ulcer inhibition, reduction in total and free acidity and increase in gastric juice pH were observed in MEC treated rats as compared to disease control animals. Histopathological findings confirmed decreased cell infiltration, less epithelial cell damage and regeneration of gastric mucosa in dose dependent manner. CONCLUSIONS The anti-ulcer effect of MEC may be attributed to its ability to scavenge free radicals and anti-inflammatory property via suppression of TNF-α and IL-6, thus offers a complete and holistic approach for management of peptic ulcer.
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Affiliation(s)
- Mukta Gupta
- Research Scholar, I. K. Gujral Punjab Technical University, Kapurthala, Punjab, India; School of Pharmaceutical Sciences, Lovely Professional University, Punjab, India
| | - Monica Gulati
- School of Pharmaceutical Sciences, Lovely Professional University, Punjab, India
| | - Bhupinder Kapoor
- School of Pharmaceutical Sciences, Lovely Professional University, Punjab, India
| | - Bimlesh Kumar
- School of Pharmaceutical Sciences, Lovely Professional University, Punjab, India
| | - Rakesh Kumar
- School of Pharmaceutical Sciences, Lovely Professional University, Punjab, India
| | - Rajan Kumar
- School of Pharmaceutical Sciences, Lovely Professional University, Punjab, India
| | - Navneet Khurana
- School of Pharmaceutical Sciences, Lovely Professional University, Punjab, India
| | - Reena Gupta
- School of Pharmaceutical Sciences, Lovely Professional University, Punjab, India
| | - Naresh Singh
- Rayat Institute of Pharmacy, Railmajra, SBS Nagar, Punjab, India.
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22
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Effects of sex, age, size and location of perforation on the sensitivity of erect chest X-ray for gastroduodenal perforation. Radiography (Lond) 2021; 27:1158-1161. [PMID: 34247912 DOI: 10.1016/j.radi.2021.06.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 06/09/2021] [Accepted: 06/10/2021] [Indexed: 12/26/2022]
Abstract
INTRODUCTION This study aimed to evaluate the sensitivity of the erect chest X-ray for diagnosing subdiaphragmatic free air. Furthermore, we examined the effects of different parameters, including sex, age, size of perforation, and the location of perforation on the sensitivity of the erect CXR. METHODS This study included all patients with perforated peptic ulcer (107 cases) referred to the Shahid Rajaei hospital of Tonekabon from April 2015 to August 2020. The perforated peptic ulcer was confirmed by laparotomy, and the erect chest X-ray was performed as a preoperative procedure. The collected checklist was analyzed using the IBM SPSS Statistics V22.0 software. RESULTS Achieved results showed total sensitivity of 86% for the erect chest X-ray. The sensitivity of the erect CXR was calculated, 88.5% and 82.6% at males and females, respectively. However, the sensitivity for different age groups was about 86%. The larger perforations resulted in higher sensitivity. Furthermore, the erect chest X-ray sensitivity for duodenal perforations (92.5%) was significantly greater than the gastric perforations (75%). CONCLUSION Based on this study, the erect chest X-ray could be utilized as a preoperative procedure with total sensitivity of 86% for gastroduodenal perforations. Patients' age and sex have no significant impact on the sensitivity (P-value > 0.05). However, the size and location of perforation significantly influenced the sensitivity (P-value < 0.05). The results demonstrated that larger perforations and duodenal perforations lead to the higher erect CXR sensitivity. IMPLICATIONS FOR PRACTICE The erect chest X-ray is used as a routine procedure to detect subdiaphragmatic free air in gastroduodenal perforations. The effects of different factors such as age, sex, size of perforation, and the location of perforation on the sensitivity of the erect chest X-ray are discussed for the first time in this study.
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23
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Lei Y, Liu X, Liu J, Zhang M, Zhou Y, Yan W, Tian D, Zhang P, Han P. Inverse Association Between Helicobacter pylori Infection and Unexplained Isolated Terminal Ileitis: A Retrospective Study. J Inflamm Res 2021; 14:3015-3021. [PMID: 34262325 PMCID: PMC8274830 DOI: 10.2147/jir.s319561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 07/01/2021] [Indexed: 11/23/2022] Open
Abstract
Background Isolated terminal ileitis (ITI) is a phenomenon often observed during colonoscopy, but in most cases, the specific etiology of ITI is unclear. Helicobacter pylori (H. pylori) infection has been reported to be associated with a wide variety of diseases, especially gastrointestinal diseases. Here, we conducted a retrospective study to explore a potential correlation between H. pylori infection and unexplained ITI (UITI). Materials and Methods The retrospective study was conducted at Sino-French New City Branch of Tongji Hospital, Wuhan, China, from April 2017 to October 2020. All subjects underwent total colonoscopy, with the endoscope being inserted more than 10cm into the terminal ileum. Subjects also received a 13C-urea breath test (13C-UBT). Data on the age, gender, endoscopic manifestations, and main clinical symptoms of subjects were collected. The presence of H. pylori infection was defined as a positive 13C-UBT result. Logistic regression models were used to analyze the potential correlation between H. pylori infection and UITI. Results There were 247 subjects (25.1%) in the H. pylori (+) group and 739 subjects (74.9%) in the H. pylori (-) group. The prevalence of UITI in the H. pylori (+) group was significantly lower than that in the H. pylori (-) group (OR = 0.518; 95% CI 0.281-0.956; P = 0.035), and there was no difference in other clinical features between groups. Stratification analysis results showed that there was an inverse association between H. pylori infection and UITI in subjects with age <60 (P = 0.046). Conclusion These data showed that H. pylori infection was negatively correlated with UITI. Additional studies are needed to validate these findings in a larger cohort as well as to explore the underlying mechanisms.
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Affiliation(s)
- Yu Lei
- Department of Gastroenterology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei Province, People's Republic of China
| | - Xiaoyu Liu
- Department of Gastroenterology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei Province, People's Republic of China
| | - Jingmei Liu
- Department of Gastroenterology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei Province, People's Republic of China
| | - Min Zhang
- Department of Gastroenterology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei Province, People's Republic of China
| | - Yan Zhou
- Department of Gastroenterology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei Province, People's Republic of China
| | - Wei Yan
- Department of Gastroenterology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei Province, People's Republic of China
| | - Dean Tian
- Department of Gastroenterology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei Province, People's Republic of China
| | - Ping Zhang
- Department of Gastroenterology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei Province, People's Republic of China
| | - Ping Han
- Department of Gastroenterology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei Province, People's Republic of China
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Chiu SF, Teng KW, Wang PC, Chung HY, Wang CJ, Cheng HC, Kao MC. Helicobacter pylori GmhB enzyme involved in ADP-heptose biosynthesis pathway is essential for lipopolysaccharide biosynthesis and bacterial virulence. Virulence 2021; 12:1610-1628. [PMID: 34125649 PMCID: PMC8204981 DOI: 10.1080/21505594.2021.1938449] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Helicobacter pylori infection is linked to serious gastric-related diseases including gastric cancer. However, current therapies for treating H. pylori infection are challenged by the increased antibiotic resistance of H. pylori. Therefore, it is in an urgent need to identify novel targets for drug development against H. pylori infection. In this study, HP0860 gene from H. pylori predicted to encode a D-glycero-D-manno-heptose-1,7-bisphosphate phosphatase (GmhB) involved in the synthesis of ADP-L-glycero-D-manno-heptose for the assembly of lipopolysaccharide (LPS) in the inner core region was cloned and characterized. We reported HP0860 protein is monomeric and functions as a phosphatase by converting D-glycero-D-manno-heptose-1,7-bisphosphate into D-glycero-D-manno-heptose-1-phosphate with a preference for the β-anomer over the α-anomer of sugar phosphate substrates. Subsequently, a HP0860 knockout mutant and its complementary mutant were constructed and their phenotypic properties were examined. HP0860 knockout mutant contained both mature and immature forms of LPS and could still induce significant IL-8 secretion after gastric AGS cell infection, suggesting other enzymatic activities in HP0860 knockout mutant might be able to partially compensate for the loss of HP0860 activity. In addition, HP0860 knockout mutant was much more sensitive to antibiotic novobiocin, had decreased adherence abilities, and caused less classic hummingbird phenotype on the infected AGS cells, indicating H. pylori lacking HP0860 is less virulent. Furthermore, the disruption of HP0860 gene altered the sorting of cargo proteins into outer membrane vesicles (OMVs). The above findings confirm the importance of HP0860 in LPS core biosynthesis and shed light on therapeutic intervention against H. pylori infection.
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Affiliation(s)
- Sue-Fen Chiu
- Institute of Molecular Medicine, College of Life Science, National Tsing Hua University, Hsinchu, Taiwan
| | - Kai-Wen Teng
- Institute of Molecular Medicine, College of Life Science, National Tsing Hua University, Hsinchu, Taiwan
| | - Po-Chuan Wang
- Department of Gastroenterology, Hsinchu MacKay Memorial Hospital, Hsinchu, Taiwan
| | - Hsin-Yu Chung
- Institute of Molecular Medicine, College of Life Science, National Tsing Hua University, Hsinchu, Taiwan
| | - Chun-Jen Wang
- Institute of Molecular Medicine, College of Life Science, National Tsing Hua University, Hsinchu, Taiwan
| | - Hui-Chun Cheng
- Institute of Bioinformatics and Structural Biology, College of Life Science, National Tsing Hua University, Hsinchu, Taiwan.,Department of Life Science, College of Life Science, National Tsing Hua University, Hsinchu, Taiwan
| | - Mou-Chieh Kao
- Institute of Molecular Medicine, College of Life Science, National Tsing Hua University, Hsinchu, Taiwan.,Department of Life Science, College of Life Science, National Tsing Hua University, Hsinchu, Taiwan
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Zhang J, Diao P, Zhang L. Intravenous versus oral omeprazole on patients with high risk bleeding peptic ulcers: A prospective randomized clinical trial protocol. Medicine (Baltimore) 2021; 100:e25136. [PMID: 33832076 PMCID: PMC8036073 DOI: 10.1097/md.0000000000025136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 02/19/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Proton pump inhibitors (PPIs) decrease the rate of rebleeding following endoscopic hemostatic therapy in patients with bleeding peptic ulcers. This study compares the efficacy of oral omeprazole vs intravenous omeprazole in decrease of rebleeding of peptic ulcer patients. METHOD The present study was authorized by the local research ethics committee of Jiangjin District Central Hospital (2020120987) and informed consent was obtained from all patients. All adult patients who were admitted to medical emergency rooms of Jiangjin District Central Hospital due to upper gastrointestinal bleeding (as evidenced by hematemesis, melena or hematochezia) were considered for inclusion in the study. Endoscopy was performed within 24 hours after admission. Patients older than 18 years with successful endoscopic therapy of high risk ulcers [defined as active bleeding (Forrest IA, IB), non-bleeding visible vessel (NBVV, Forrest IIA) or adherent clots (Forrest IIB)] were enrolled. Patients with low risk ulcers (clean base, ulcers with a simple washable clot), suspicious malignant ulcer, bleeding tendency, uremia, liver cirrhosis, Mallory Weiss tear or already on PPI as an outpatient were excluded from study. All were managed endoscopically by injecting 5-30 ml of epinephrine (diluted 1:10000) around the ulcer crater. Cavitations or flattening of bleeding vessel and disappearance of NBVV was considered as established homeostasis. A biopsy was taken from antrum for evaluating Helicobacter pylori infection. Patient with unsuccessful endoscopic therapy were not enrolled and were referred to general surgeon. Information on demography, history of previous upper gastrointestinal bleeding, NSAID or ASA ingestion, ulcer location, bleeding stigmata and blood transfusion volume at entry were recorded in all patients. In the oral omeprazole group, the patients received 40 mg omeprazole orally twice daily for 72 hours. In intravenous omeprazole group, they received omeprazole 80 mg bolus and then 8 mg/hour infusion for 48-72 hours. Then, all patients received omeprazole 20 mg orally for 30 days. On the day of discharge Helicobacter pylori infected patients received standard regimens. RESULTS Figure 1 showed the primary and secondary end points. DISCUSSION Intravenous administration of PPIs has limitations. They are expensive, require a dedicated intravenous line, need nursing supervision and hospital admission. So, it would be reasonable to prescribe oral PPIs to patients with high risk bleeding ulcers provided that it is as effective as its intravenous counterpart. Oral PPIs have a high bioavailability. Its effect initiates one hour after ingestion and the maximal plasma concentration is achieved after 2-3 hours. However, there are few studies comparing oral and intravenous PPI in decreasing risk of rebleeding in peptic ulcer patients. More high quality randomized controlled trials are still necessary. REGISTRATION NUMBER researchregistry 6588.
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Hu S, Niu L, Wu L, Zhu X, Cai Y, Jin D, Yan L, Zhao F. Genomic analysis of Helicobacter himalayensis sp. nov. isolated from Marmota himalayana. BMC Genomics 2020; 21:826. [PMID: 33228534 PMCID: PMC7685656 DOI: 10.1186/s12864-020-07245-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 11/18/2020] [Indexed: 12/17/2022] Open
Abstract
Background Helicobacter himalayensis was isolated from Marmota himalayana in the Qinghai-Tibet Plateau, China, and is a new non-H. pylori species, with unclear taxonomy, phylogeny, and pathogenicity. Results A comparative genomic analysis was performed between the H. himalayensis type strain 80(YS1)T and other the genomes of Helicobacter species present in the National Center for Biotechnology Information (NCBI) database to explore the molecular evolution and potential pathogenicity of H. himalayensis. H. himalayensis 80(YS1)T formed a clade with H. cinaedi and H. hepaticus that was phylogenetically distant from H. pylori. The H. himalayensis genome showed extensive collinearity with H. hepaticus and H. cinaedi. However, it also revealed a low degree of genome collinearity with H. pylori. The genome of 80(YS1)T comprised 1,829,936 bp, with a 39.89% GC content, a predicted genomic island, and 1769 genes. Comparatively, H. himalayensis has more genes for functions in “cell wall/membrane/envelope biogenesis” and “coenzyme transport and metabolism” sub-branches than the other compared helicobacters, and its genome contained 42 virulence factors genes, including that encoding cytolethal distending toxin (CDT). Conclusions We characterized the H. himalayensis 80(YS1)T genome, its phylogenetic position, and its potential pathogenicity. However, further understanding of the pathogenesis of this potentially pathogenic bacterium is required, which might help to manage H. himalayensis-induced diseases. Supplementary Information The online version contains supplementary material available at 10.1186/s12864-020-07245-y.
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Affiliation(s)
- Shoukui Hu
- Department of Clinical Laboratory, Peking University Shougang Hospital, Beijing, 100144, China
| | - Lina Niu
- Department of Pathogen Biology, School of Basic Medicine and Lifescience, Hainan Medical University, Haikou, 571101, China
| | - Lei Wu
- Department of Clinical Laboratory, Peking University Shougang Hospital, Beijing, 100144, China
| | - Xiaoxue Zhu
- Department of Clinical Laboratory, Peking University Shougang Hospital, Beijing, 100144, China
| | - Yu Cai
- Department of Clinical Laboratory, Peking University Shougang Hospital, Beijing, 100144, China
| | - Dong Jin
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping, Beijing, 102206, China
| | - Linlin Yan
- Department of Clinical Laboratory, Peking University Shougang Hospital, Beijing, 100144, China.
| | - Fan Zhao
- Department of Clinical Laboratory, Peking University Shougang Hospital, Beijing, 100144, China.
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Ray-Offor E, Ada Opusunju K. Current status of peptic ulcer disease in Port Harcourt metropolis, Nigeria. Afr Health Sci 2020; 20:1446-1451. [PMID: 33402993 PMCID: PMC7751553 DOI: 10.4314/ahs.v20i3.50] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background Epidemiological studies on peptic ulcer disease (PUD) have shown a recent decrease in hospital admissions in Western countries. Objective This paper aimed to study the current status and risk factors of PUD in a Nigerian metropolis. Methods A cross-sectional study of symptomatic patients at upper gastrointestinal (GI) endoscopy diagnosed with PUD from February 2014 to September 2019 at a referral endoscopy facility in Port Harcourt, Niger delta region of Nigeria. The variables studied included demographics, symptoms and duration, blood group, chronic non-steroidal anti-inflammatory (NSAID) use, smoking, endoscopic and histology findings. Statistical analysis was performed using SPSS version 20. Results A total of 434 upper GI endoscopies were performed during the study period with thirty-one diagnosis of PUD made. The mean age of gastric ulcer (GU) and duodenal ulcer (DU) cases were 54.4 ± 20.2yrs and 48.1 ± 14.5yrs respectively (p = 0.367). GU to DU ratio was 1.4:1. H. pylori infection, chronic NSAID use and blood group O were seen in 7(22.5%), 8(25.8%) and 18(72.0%) respectively. Major indication in 21(67.7%) cases was gastrointestinal bleeding. Conclusion There is a low diagnostic rate of PUD (6.7%) with pre-pyloric antral gastric ulcers as most common type and multifactorial aetiology.
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Analysis of the Relation between Periodontitis and Chronic Gastritis/Peptic Ulcer: A Cross-Sectional Study Using KoGES HEXA Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124387. [PMID: 32570864 PMCID: PMC7344436 DOI: 10.3390/ijerph17124387] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 06/10/2020] [Accepted: 06/16/2020] [Indexed: 12/30/2022]
Abstract
The aim of the present study was to investigate the association between periodontitis and chronic gastritis/peptic ulcer using a cross-sectional study design. The present prospective cohort study used epidemiological data from the Korean Genome and Epidemiology Study (KoGES) recorded from 2004 to 2016. Among 173,209 participants, 9983 with periodontitis and 125,336 with no periodontitis were selected. Histories of chronic gastritis and peptic ulcer between periodontitis and no periodontitis participants were analyzed. The participants were questioned around any history of hypertension, diabetes mellitus, hyperlipidemia, cerebral stroke, ischemic heart disease, periodontitis, body mass index, smoking, alcohol consumption, nutritional intake, and financial income. Chi-square tests, independent t-tests, two-tailed analyses were used in statistical analysis of the data. The adjusted odds ratio of chronic gastritis was 2.22 (95% confidence interval [CI] = 2.10–2.34, p < 0.001) and that of peptic ulcer was 1.86 (95% CI = 1.74–1.98, p < 0.001) in model 2. This study demonstrated that periodontitis was associated with an increased risk of chronic gastritis/peptic ulcer. These findings provide additional evidence for an association between periodontitis and chronic gastritis/peptic ulcer.
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Howley IW, Bruns BR, Tesoriero RB, Vesselinov R, Kufera JA, Feliciano DV, Diaz JJ. Statewide Analysis of Peptic Ulcer Disease: As Hospitalizations Decrease, Procedural Volume Remains Steady. Am Surg 2020. [DOI: 10.1177/000313481908500948] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Hospitalizations for peptic ulcer disease (PUD) have decreased since the advent of specific medical therapy in the 1980s. The authors’ clinical experience at a tertiary center, however, has been that procedures to treat PUD complications have not declined. This study tested the hypothesis that despite decreases in PUD hospitalizations, the volume of procedures for PUD complications has remained consistent. The study population included all inpatient encounters in the state of Maryland from 2009 to 2014 with a primary ICD-9 diagnosis code for PUD. Data on annual patient volume, demographics, anatomic location, procedures, complications, and outcomes were collected, and PUD prevalence rates were calculated. The study population consisted of the state's entire population, not a sample; statistical analysis was not applied. Hospitalizations for PUD declined from 2,502 in 2009 to 2,101 in 2014, whereas the percentage of hospitalizations with procedures increased from 27.1 to 31.5 per cent. Endoscopy was performed in 19.8 per cent of hospitalizations, operation in 9.4 per cent, and angiography in 1.3 per cent. Of 13,974 inpatient encounters, 30 per cent had at least one inhospital complication. Overall inpatient mortality was 2.2 per cent. PUD hospitalizations are declining in Maryland, mirroring national trends. A subset of patients continue to need urgent procedures for PUD complications, including nearly 10 per cent needing operation. Inpatient mortality among patients admitted for PUD was 2.2 per cent, congruent with other studies. Despite the efficacy of modern medical therapy, these data underscore the importance of teaching surgical residents the cognitive and operative skills necessary to manage PUD complications.
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Affiliation(s)
- Isaac W. Howley
- R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland and
| | - Brandon R. Bruns
- R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland and
| | - Ronald B. Tesoriero
- R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland and
| | - Roumen Vesselinov
- the National Study Center for Trauma and Emergency Medical Systems, University of Maryland School of Medicine, Baltimore, Maryland
| | - Joseph A. Kufera
- the National Study Center for Trauma and Emergency Medical Systems, University of Maryland School of Medicine, Baltimore, Maryland
| | - David V. Feliciano
- R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland and
| | - Jose J. Diaz
- R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland and
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Ashktorab H, Brim H, Hassan S, Nouraie M, Gebreselassie A, Laiyemo AO, Kibreab A, Aduli F, Latella G, Brant SR, Sherif Z, Habtezion A. Inflammatory polyps occur more frequently in inflammatory bowel disease than other colitis patients. BMC Gastroenterol 2020; 20:170. [PMID: 32503428 PMCID: PMC7275388 DOI: 10.1186/s12876-020-01279-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 04/21/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Colitis is generally considered a risk factor for colon neoplasia. However, not all types of colitis seem to have equal neoplastic transformation potential. AIM To determine the prevalence of colorectal polyps in a predominantly African American population with inflammatory bowel disease (IBD) and Non-IBD/Non-Infectious Colitis (NIC). METHODS We retrospectively evaluated medical records of 1060 patients previously identified with colitis at Howard University Hospital, based on ICD-10 code. Among these, 485 patients were included in the study: 70 IBD and 415 NIC based on a thorough review of colonoscopy, pathology and clinical reports. Logistic regression analysis was applied to estimate the risk of polyps in patients with IBD compared to those with NIC after adjusting for age and sex. A subgroup analysis within the IBD group was performed. RESULTS Of the 485 patients, 415 were NIC and 70 were IBD. Seventy-three percent of the NIC patients and 81% of the IBD patients were African Americans. Forty six percent of IBD and 41% of NIC cases were male. IBD patients were younger than NIC patients (median age of 38 years vs. 50, P < 0.001). The prevalence of all types of polyps was 15.7 and 8.2% in the IBD and NIC groups, respectively (P = 0.045). Among patients with polyps, the prevalence of inflammatory polyps was higher in the IBD group (55%) compared to the NIC group (12%). After adjusting for age, sex and race, odds ratio of inflammatory polyps in IBD patients was 6.0 (P = 0.016). Adenoma prevalence was 4.3% (3/70) in IBD patients and 3.9% (16/415) in the NIC patients (p = 0.75). The anatomic distribution of lesions and colitis shows that polyps occur predominantly in the colitis field regardless of colitis type. More polyps were present in the ulcerative colitis patients when compared to Crohn's disease patients (27% vs. 5%, P < 0.001) within the IBD group. CONCLUSION Our study shows that inflammatory polyps are more common in IBD patients when compared to NIC patients. Most polyps were in the same location as the colitis.
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Affiliation(s)
- Hassan Ashktorab
- Department of Medicine, Department of Pathology and Cancer Center, Howard University Collerge of Medicine, 2041 Georgia Avenue, N.W., Washington, D.C, 20060, USA.
| | - Hassan Brim
- Department of Medicine, Department of Pathology and Cancer Center, Howard University Collerge of Medicine, 2041 Georgia Avenue, N.W., Washington, D.C, 20060, USA
| | - Sally Hassan
- Department of Medicine, Department of Pathology and Cancer Center, Howard University Collerge of Medicine, 2041 Georgia Avenue, N.W., Washington, D.C, 20060, USA
| | - Mehdi Nouraie
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Agazi Gebreselassie
- Department of Medicine, Department of Pathology and Cancer Center, Howard University Collerge of Medicine, 2041 Georgia Avenue, N.W., Washington, D.C, 20060, USA
| | - Adeyinka O Laiyemo
- Department of Medicine, Department of Pathology and Cancer Center, Howard University Collerge of Medicine, 2041 Georgia Avenue, N.W., Washington, D.C, 20060, USA
| | - Angesom Kibreab
- Department of Medicine, Department of Pathology and Cancer Center, Howard University Collerge of Medicine, 2041 Georgia Avenue, N.W., Washington, D.C, 20060, USA
| | - Farshad Aduli
- Department of Medicine, Department of Pathology and Cancer Center, Howard University Collerge of Medicine, 2041 Georgia Avenue, N.W., Washington, D.C, 20060, USA
| | | | - Steven R Brant
- Division of Gastroenterology and Hepatology, Department of Medicine, Rutgers Robert Wood Johnson Medical School, and and Department of Genetics and The Human Genetics Institute of New Jersey, Rutgers University, New Brunswick, New Jersey, USA
- Harvey M. and Lyn P. Meyerhoff Inflammatory Bowel Disease Center, Division of Gastroenterology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Zaki Sherif
- Department of Medicine, Department of Pathology and Cancer Center, Howard University Collerge of Medicine, 2041 Georgia Avenue, N.W., Washington, D.C, 20060, USA
| | - Aida Habtezion
- Gastroenterology division, Stanford University, School of Medicine, Palo Alto, California, USA
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Low Prevalence of Helicobacter pylori-Positive Peptic Ulcers in Private Outpatient Endoscopy Centers in the United States. Am J Gastroenterol 2020; 115:244-250. [PMID: 31972622 DOI: 10.14309/ajg.0000000000000517] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES During the past decades, the prevalence of gastric and duodenal ulcers, as well as Helicobacter pylori infection, has markedly declined. We hypothesized that the decline in H. pylori prevalence has decreased the fraction of H. pylori-positive gastric and duodenal ulcers. The present study was designed to test this hypothesis in a large US population undergoing esophagogastro-duodenoscopy in community-based endoscopy centers. METHODS The Inform Diagnostics database is a national electronic repository of histopathologic records of patients distributed throughout the United States. A cross-sectional study among 1,289,641 individual esophagogastro-duodenoscopy patients analyzed the prevalence of peptic ulcers stratified by age, sex, ethnicity, H. pylori status, year of diagnosis, and ulcer type. The joint influence of multiple predictor variables on the occurrence of gastric and duodenal ulcers was analyzed using multivariate logistic regression analysis. RESULTS Between 2009 and 2018, the general prevalence of H. pylori infection fell significantly from 11% to 9%. This decline was accompanied by a similar decline in the fraction of H. pylori-positive gastric ulcers from 17% to 14% and H. pylori-positive duodenal ulcers from 25% to 21%. Nowadays, only 17% of all patients with ulcer harbor H. pylori. The fraction of H. pylori-positive ulcers was significantly greater in duodenal than in gastric ulcers and in male than in female patients with ulcer. The prevalence of H. pylori was 2.6-fold higher among Hispanics and 3.2-fold higher among East Asians compared with the general population. The H. pylori prevalence fell from 24% to 22% among Hispanics and from 21% to 15% among East Asians. In East Asians and Hispanics, the fraction of H. pylori-positive gastric ulcers was 37% and 35%, respectively. DISCUSSION H. pylori infection continues to fall in the general population. Nowadays, even among patients with ulcer only a small minority harbors H. pylori infection.
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Tarasconi A, Coccolini F, Biffl WL, Tomasoni M, Ansaloni L, Picetti E, Molfino S, Shelat V, Cimbanassi S, Weber DG, Abu-Zidan FM, Campanile FC, Di Saverio S, Baiocchi GL, Casella C, Kelly MD, Kirkpatrick AW, Leppaniemi A, Moore EE, Peitzman A, Fraga GP, Ceresoli M, Maier RV, Wani I, Pattonieri V, Perrone G, Velmahos G, Sugrue M, Sartelli M, Kluger Y, Catena F. Perforated and bleeding peptic ulcer: WSES guidelines. World J Emerg Surg 2020; 15:3. [PMID: 31921329 PMCID: PMC6947898 DOI: 10.1186/s13017-019-0283-9] [Citation(s) in RCA: 150] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 12/18/2019] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Peptic ulcer disease is common with a lifetime prevalence in the general population of 5-10% and an incidence of 0.1-0.3% per year. Despite a sharp reduction in incidence and rates of hospital admission and mortality over the past 30 years, complications are still encountered in 10-20% of these patients. Peptic ulcer disease remains a significant healthcare problem, which can consume considerable financial resources. Management may involve various subspecialties including surgeons, gastroenterologists, and radiologists. Successful management of patients with complicated peptic ulcer (CPU) involves prompt recognition, resuscitation when required, appropriate antibiotic therapy, and timely surgical/radiological treatment. METHODS The present guidelines have been developed according to the GRADE methodology. To create these guidelines, a panel of experts was designed and charged by the board of the WSES to perform a systematic review of the available literature and to provide evidence-based statements with immediate practical application. All the statements were presented and discussed during the 5th WSES Congress, and for each statement, a consensus among the WSES panel of experts was reached. CONCLUSIONS The population considered in these guidelines is adult patients with suspected complicated peptic ulcer disease. These guidelines present evidence-based international consensus statements on the management of complicated peptic ulcer from a collaboration of a panel of experts and are intended to improve the knowledge and the awareness of physicians around the world on this specific topic. We divided our work into the two main topics, bleeding and perforated peptic ulcer, and structured it into six main topics that cover the entire management process of patients with complicated peptic ulcer, from diagnosis at ED arrival to post-discharge antimicrobial therapy, to provide an up-to-date, easy-to-use tool that can help physicians and surgeons during the decision-making process.
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Affiliation(s)
- Antonio Tarasconi
- Emergency Surgery Department, Parma University Hospital, Parma, Italy
| | - Federico Coccolini
- General, Emergency and Trauma Surgery Department, Pisa University Hospital, Pisa, Italy
| | | | - Matteo Tomasoni
- General, Emergency and Trauma Surgery Department, Bufalini hospital, Cesena, Italy
| | - Luca Ansaloni
- General, Emergency and Trauma Surgery Department, Bufalini hospital, Cesena, Italy
| | - Edoardo Picetti
- Department of Anesthesia and Intensive Care, Parma University Hospital, Parma, Italy
| | - Sarah Molfino
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | | | - Stefania Cimbanassi
- General Surgery and Trauma Team, ASST Niguarda Milano, University of Milano, Milan, Italy
| | - Dieter G. Weber
- Royal Perth Hospital, Perth, Australia & The University of Western Australia, Crawley, Australia
| | - Fikri M. Abu-Zidan
- Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates
| | - Fabio C. Campanile
- Division of Surgery, ASL VT - Ospedale “Andosilla”, Civita Castellana, Italy
| | - Salomone Di Saverio
- Cambridge Colorectal Unit, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Gian Luca Baiocchi
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Claudio Casella
- Department of Molecular and Translational Medicine, Surgical Clinic, University of Brescia, Brescia, Italy
| | - Michael D. Kelly
- Department of General Surgery, Albury Hospital, Albury, Australia
| | - Andrew W. Kirkpatrick
- General, Acute Care, Abdominal Wall Reconstruction, and Trauma Surgery, Foothills Medical Centre, Calgary, Alberta Canada
| | | | - Ernest E. Moore
- Ernest E Moore Shock Trauma Center at Denver Health, Denver, CO USA
| | - Andrew Peitzman
- University of Pittsburgh, School of Medicine, UPMC – Presbyterian, Pittsburgh, PA USA
| | - Gustavo Pereira Fraga
- Division of Trauma Surgery, School of Medical Sciences, University of Campinas, Campinas, SP Brazil
| | - Marco Ceresoli
- Department of General and Emergency Surgery, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Ronald V. Maier
- Department of Surgery, Harborview Medical Centre, University of Washington, Seattle, USA
| | - Imtaz Wani
- Department of Surgery, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
| | | | - Gennaro Perrone
- Emergency Surgery Department, Parma University Hospital, Parma, Italy
| | - George Velmahos
- Trauma, Emergency Surgery and Surgical Critical Care, Massachusetts General Hospital, Boston, USA
| | - Michael Sugrue
- Letterkenny University Hospital, Donegal Clinical Research Academy Centre for Personalized Medicine, Donegal, Ireland
| | | | - Yoram Kluger
- Department of General Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Fausto Catena
- Emergency Surgery Department, Parma University Hospital, Parma, Italy
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The Interaction of Helicobacter pylori with TFF1 and Its Role in Mediating the Tropism of the Bacteria Within the Stomach. Int J Mol Sci 2019; 20:ijms20184400. [PMID: 31500233 PMCID: PMC6769565 DOI: 10.3390/ijms20184400] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 08/27/2019] [Accepted: 09/06/2019] [Indexed: 02/07/2023] Open
Abstract
Helicobacter pylori colonises the human stomach and has tropism for the gastric mucin, MUC5AC. The majority of organisms live in the adherent mucus layer within their preferred location, close to the epithelial surface where the pH is near neutral. Trefoil factor 1 (TFF1) is a small trefoil protein co-expressed with the gastric mucin MUC5AC in surface foveolar cells and co-secreted with MUC5AC into gastric mucus. Helicobacter pylori binds with greater avidity to TFF1 dimer, which is present in gastric mucus, than to TFF1 monomer. Binding of H. pylori to TFF1 is mediated by the core oligosaccharide subunit of H. pylori lipopolysaccharide at pH 5.0–6.0. Treatment of H. pylori lipopolysaccharide with mannosidase or glucosidase inhibits its interaction with TFF1. Both TFF1 and H. pylori have a propensity for binding to mucins with terminal non-reducing α- or β-linked N-acetyl-d-glucosamine or α-(2,3) linked sialic acid or Gal-3-SO42−. These findings are strong evidence that TFF1 has carbohydrate-binding properties that may involve a conserved patch of aromatic hydrophobic residues on the surface of its trefoil domain. The pH-dependent lectin properties of TFF1 may serve to locate H. pylori deep in the gastric mucus layer close to the epithelium rather than at the epithelial surface. This restricted localisation could limit the interaction of H. pylori with epithelial cells and the subsequent host signalling events that promote inflammation.
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Worthman CM. Shared and local pathways in suffering and resilience: Keeping the body in mind. Transcult Psychiatry 2019; 56:775-785. [PMID: 31347474 DOI: 10.1177/1363461519862700] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Kim N. Chemoprevention of gastric cancer by Helicobacter pylori eradication and its underlying mechanism. J Gastroenterol Hepatol 2019; 34:1287-1295. [PMID: 30828872 DOI: 10.1111/jgh.14646] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Revised: 02/23/2019] [Accepted: 03/01/2019] [Indexed: 12/11/2022]
Abstract
The cascade of gastric cancer, a leading cause of cancer incidence and mortality, is multifactorial. Helicobacter pylori (HP) infection plays a major role in gastric cancer (GC), and there has been an accumulation of data regarding the chemopreventive effect of HP eradication. However, it remains unclear how HP infection causes GC and how HP eradication prevents GC. To clarify this issue, the following approaches were performed in this review article. First, how HP-induced atrophic gastritis (AG) and intestinal metaplasia (IM) provoke the development of GC is shown, followed by how long HP eradication takes to induce a reversible change in AG and IM. Second, epigenetic studies of PTPN6, MOS, DCC, CRK, and VAV1 were performed in noncancerous gastric specimens in terms of HP status. Among these genes, MOS was found to be a possible surrogate marker for GC development. HP eradication decreased aberrant DNA methylation in a gene-specific manner, and MOS played a role in metachronous gastric neoplasms. Third, transforming growth factor-β1 (TGF-β1) and TGF-β1-induced epithelial-mesenchymal transition (EMT) markers were investigated in gastric mucosa. HP infection triggered the TGF-β1-induced EMT pathway and caused the emergence of GC stem cells, such as CD44v8-10. When HP was eradicated, these two pathways were inhibited. Finally, a 2222 cohort study showed that HP eradication significantly decreased the risk of noncardiac GC. Taken together, HP eradication is effective as a primary GC prevention method, and its underlying mechanism includes reversibility of AG and IM, methylation, EMT, and stem cells.
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Affiliation(s)
- Nayoung Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.,Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, South Korea.,Tumor Microenvironment Global Core Research Center, Seoul National University, Seoul, South Korea
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Wawro N, Amann U, Butt J, Meisinger C, Akmatov MK, Pessler F, Peters A, Rathmann W, Kääb S, Waterboer T, Linseisen J. Helicobacter pylori Seropositivity: Prevalence, Associations, and the Impact on Incident Metabolic Diseases/Risk Factors in the Population-Based KORA Study. Front Public Health 2019; 7:96. [PMID: 31069210 PMCID: PMC6491664 DOI: 10.3389/fpubh.2019.00096] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 04/04/2019] [Indexed: 12/29/2022] Open
Abstract
Introduction: Helicobacter pylori (H. pylori) is a common infection and known risk factor for gastric cancer. We assessed cross-sectional and longitudinal associations to study the impact of H. pylori seropositivity on metabolic diseases. Methods: Helicobacter pylori seropositivity in serum samples of the KORA study was analyzed by multiplex serology. We calculated sex-specific prevalence of H. pylori seropositivity for the year 2007 based on the first follow-up survey (termed F4) of the KORA study S4. We identified factors associated with H. pylori seropositivity in the F4 survey. Further, we assessed relative risks of incident metabolic diseases/risk factors at the time of the second follow-up survey of S4 (termed FF4) and H. pylori seropositivity at the F4 survey as a determinant. Models were adjusted for age, sex, overweight status, physical activity, smoking status, education level, alcohol intake, and other metabolic diseases. Results: Based on 3,037 persons aged 32 to 82 years, the H. pylori prevalence for 2007 was 30.2% in men (n = 1,465) and 28.1% in women (n = 1,572). Increasing age, current smoking, low education and no alcohol intake were significantly associated with H. pylori seropositivity in the F4 survey. However, no association between H. pylori seropositivity and BMI, metabolic diseases (type 2 diabetes, hypertension and dyslipidemia, gout or increased uric acid) and gastrointestinal diseases (gastritis, inflammatory bowel disease, and gastric or duodenal ulcer) was observed. No significant associations between H. pylori seropositivity and one of the five investigated incident metabolic diseases/risk factors were detected in the longitudinal analysis. Conclusion: We identified associations between age, smoking, education and alcohol intake and H. pylori seropositivity but no impact of H. pylori seropositivity on incident metabolic diseases/risk factors.
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Affiliation(s)
- Nina Wawro
- German Research Center for Environmental Health (GmbH), Institute of Epidemiology II, Munich, Germany.,German Center for Diabetes Research (DZD e.V.), Munich, Germany.,Chair of Epidemiology, Ludwig-Maximilians-Universität München, UNIKA-T, Augsburg, Germany.,German Research Center for Environmental Health (GmbH), Independent Research Group Clinical Epidemiology, Munich, Germany
| | - Ute Amann
- German Research Center for Environmental Health (GmbH), Institute of Epidemiology II, Munich, Germany.,Chair of Epidemiology, Ludwig-Maximilians-Universität München, UNIKA-T, Augsburg, Germany
| | - Julia Butt
- Infections and Cancer Epidemiology, Infection, Inflammation and Cancer Program, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Christa Meisinger
- German Research Center for Environmental Health (GmbH), Institute of Epidemiology II, Munich, Germany.,Chair of Epidemiology, Ludwig-Maximilians-Universität München, UNIKA-T, Augsburg, Germany
| | - Manas K Akmatov
- TWINCORE, Centre for Experimental and Clinical Infection Research, Hanover, Germany.,Helmholtz-Zentrum für Infektionsforschung (HZI), Braunschweig, Germany
| | - Frank Pessler
- TWINCORE, Centre for Experimental and Clinical Infection Research, Hanover, Germany.,Helmholtz-Zentrum für Infektionsforschung (HZI), Braunschweig, Germany
| | - Annette Peters
- German Research Center for Environmental Health (GmbH), Institute of Epidemiology II, Munich, Germany.,German Center for Diabetes Research (DZD e.V.), Munich, Germany
| | - Wolfgang Rathmann
- Deutsches Diabeteszentrum, Institute for Biometrics and Epidemiology, Düsseldorf, Germany
| | - Stefan Kääb
- Medizinische Klinik und Poliklinik I, Campus Grosshadern, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Tim Waterboer
- Infections and Cancer Epidemiology, Infection, Inflammation and Cancer Program, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jakob Linseisen
- German Research Center for Environmental Health (GmbH), Institute of Epidemiology II, Munich, Germany.,Chair of Epidemiology, Ludwig-Maximilians-Universität München, UNIKA-T, Augsburg, Germany.,German Research Center for Environmental Health (GmbH), Independent Research Group Clinical Epidemiology, Munich, Germany
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Abstract
Peptic ulcer disease continues to be a source of significant morbidity and mortality worldwide. Approximately two-thirds of patients found to have peptic ulcer disease are asymptomatic. In symptomatic patients, the most common presenting symptom of peptic ulcer disease is epigastric pain, which may be associated with dyspepsia, bloating, abdominal fullness, nausea, or early satiety. Most cases of peptic ulcer disease are associated with Helicobacter pylori infection or the use of nonsteroidal anti-inflammatory drugs (NSAIDs), or both. In this review, we discuss the role of proton pump inhibitors in the management of peptic ulcer disease, highlight the latest guidelines about the diagnosis and management of H. pylori, and discuss the latest evidence in the management of complications related to peptic ulcer disease, including endoscopic intervention for peptic ulcer-related bleeding. Timely diagnosis and treatment of peptic ulcer disease and its sequelae are crucial in order to minimize associated morbidity and mortality, as is prevention of peptic ulcer disease among patients at high risk, including those infected with H. pylori and users of NSAIDs.
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Kuna L, Jakab J, Smolic R, Raguz-Lucic N, Vcev A, Smolic M. Peptic Ulcer Disease: A Brief Review of Conventional Therapy and Herbal Treatment Options. J Clin Med 2019; 8:179. [PMID: 30717467 PMCID: PMC6406303 DOI: 10.3390/jcm8020179] [Citation(s) in RCA: 150] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 01/30/2019] [Accepted: 01/31/2019] [Indexed: 02/06/2023] Open
Abstract
Peptic ulcer is a chronic disease affecting up to 10% of the world's population. The formation of peptic ulcers depends on the presence of gastric juice pH and the decrease in mucosal defenses. Non-steroidal anti-inflammatory drugs (NSAIDs) and Helicobacter pylori (H. pylori) infection are the two major factors disrupting the mucosal resistance to injury. Conventional treatments of peptic ulcers, such as proton pump inhibitors (PPIs) and histamine-2 (H2) receptor antagonists, have demonstrated adverse effects, relapses, and various drug interactions. On the other hand, medicinal plants and their chemical compounds are useful in the prevention and treatment of numerous diseases. Hence, this review presents common medicinal plants that may be used for the treatment or prevention of peptic ulcers.
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Affiliation(s)
- Lucija Kuna
- Department of Pharmacology and Biochemistry, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia.
| | - Jelena Jakab
- Department of Pathophysiology and Physiology with Immunology, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia.
- Department of Internal Medicine, Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia.
| | - Robert Smolic
- Department of Pathophysiology and Physiology with Immunology, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia.
- Department of Pharmacology, Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia.
- Department of Internal Medicine, University Hospital Osijek, 31000 Osijek, Croatia.
| | - Nikola Raguz-Lucic
- Department of Pharmacology and Biochemistry, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia.
| | - Aleksandar Vcev
- Department of Pathophysiology and Physiology with Immunology, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia.
- Department of Internal Medicine, University Hospital Osijek, 31000 Osijek, Croatia.
| | - Martina Smolic
- Department of Pharmacology and Biochemistry, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia.
- Department of Pharmacology, Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia.
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Abdul-Majeed Al-Razzuqi R, Rahma Abu-Rageef A, Sami Mehasin W, Rafi Abdul-Majeed Al-Razzuqi T. Evaluation of Gastroprotective Effect of Vanadyl Sulfate and Lycopene on rat model with Ethanol-Induced Gastric Mucosal Lesions. BIOMEDICAL AND PHARMACOLOGY JOURNAL 2018; 11:1291-1294. [DOI: 10.13005/bpj/1490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2025]
Abstract
Gastric ulcers result from an imbalance between endogenous defense mechanisms and certain aggressive agents. Many drugs were used to overcome this imbalance, but few literatures made on plants. Therefore, we try to evaluate the gastroprotective efficacy of two nutritional supplements (Vanadyl sulfate and Lycopene) in comparison to Lansoprazole. Five groups of seven healthy albino male rats each were received an oral daily dose of above agents for ten days. Then 1.25 ml of 95% ethanol orally used to induce mucosal injury and animals were sacrificed 1 hour later. Glutathione and malondialdehyde were estimated. A significant elevation in glutathione level found in Vanadyl and Lycopene-received groups in comparison to lansoprazole-received group (717.13±19.47 μmol/gm wet tissue, 609.55±17.6 μmol/gm wet tissue and 512.07±25.32 μmol/gm wet tissue respectively), with a significant reduction in malondialdehyde level (10.63±0.92 nmol/gm wet tissue, 12.66±0.56 nmol/g wet tissue and 14.90±0.33 nmol/gm wet tissue respectively). This revealed gastro-protective effects of Vanadyl and Lycopene in ameliorating the oxidative cellular damage.
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Affiliation(s)
| | - Ahmad Rahma Abu-Rageef
- Department of Pharmacology and Therapeutics, Al-Nahrain College of Medicine, Baghdad, Iraq
| | - Wesal Sami Mehasin
- Department of Clinical Pharmacy, Al-Ma'moon University College, Baghdad, Iraq
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Rowland M, Clyne M, Daly L, O'Connor H, Bourke B, Bury G, O'Dowd T, Connolly L, Ryan J, Shovlin S, Dolan B, Drumm B. Long-term follow-up of the incidence of Helicobacter pylori. Clin Microbiol Infect 2018; 24:980-984. [DOI: 10.1016/j.cmi.2017.10.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 10/18/2017] [Accepted: 10/20/2017] [Indexed: 12/30/2022]
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41
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Kuipers EJ. PPIs for prevention and treatment of peptic ulcer. Lancet Gastroenterol Hepatol 2018; 3:214-215. [DOI: 10.1016/s2468-1253(18)30047-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 02/09/2018] [Indexed: 01/15/2023]
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42
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Pérez-Arellano E, Rodriguez-Garcia MI, Galera Rodenas AB, de la Morena-Madrigal E. Erradicación de la infección por Helicobacter pylori con una nueva terapia cuádruple basada en bismuto en la práctica clínica. GASTROENTEROLOGIA Y HEPATOLOGIA 2018; 41:145-152. [DOI: 10.1016/j.gastrohep.2017.08.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 08/03/2017] [Accepted: 08/08/2017] [Indexed: 02/07/2023]
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43
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Hwang YJ, Kim N, Lee HS, Lee JB, Choi YJ, Yoon H, Shin CM, Park YS, Lee DH. Reversibility of atrophic gastritis and intestinal metaplasia after Helicobacter pylori eradication - a prospective study for up to 10 years. Aliment Pharmacol Ther 2018; 47:380-390. [PMID: 29193217 DOI: 10.1111/apt.14424] [Citation(s) in RCA: 117] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 07/31/2017] [Accepted: 10/27/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND Atrophic gastritis and intestinal metaplasia are premalignant conditions for gastric cancer. Their reversibility by Helicobacter pylori eradication remains controversial. AIM To evaluate the reversibility of atrophic gastritis and intestinal metaplasia by H. pylori eradication with long-term follow-up. METHODS 598 subjects were prospectively enrolled and followed for up to 10 years. They were categorised as H. pylori-negative (n = 65), H. pylori non-eradicated (n = 91), and H. pylori-eradicated (n = 442). Histological assessment was performed for antrum and corpus by Sydney classification. RESULTS Histological follow-up was performed regularly at 1, 2, 3-4 and ≥5 years, with mean follow-up of 1.07 ± 0.21, 2.29 ± 0.83, 3.93 ± 1.02, and 6.45 ± 1.28 years, respectively. Atrophic gastritis in antrum and corpus gradually and significantly (both P < .05 for all timepoints) improved only in the H. pylori-eradicated group compared to that at baseline. Significant difference in atrophic gastritis between H. pylori-eradicated and H. pylori-negative groups disappeared from 1-year follow-up. Similarly, intestinal metaplasia in antrum and corpus improved significantly (both P < .05 for all timepoints) only in the H. pylori-eradicated group in comparison with that at baseline. Significant difference in intestinal metaplasia between H. pylori-eradicated and H. pylori-negative groups disappeared from ≥5 years of follow-up in the antrum and from 3 years of follow-up in the corpus. CONCLUSION H. pylori eradication may be a preventative strategy for intestinal-type gastric cancer by regression of atrophic gastritis and intestinal metaplasia.
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Affiliation(s)
- Y-J Hwang
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam, South Korea
| | - N Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam, South Korea.,Department of Internal Medicine and Institute of Liver Research, Seoul National University College of Medicine, Seoul, South Korea
| | - H S Lee
- Department of Pathology, Seoul National University Bundang Hospital, Seoungnam, South Korea
| | - J B Lee
- Division of Statistics in Medical Research Collaborating Center, Seoul National University Bundang Hospital, Seoungnam, South Korea
| | - Y J Choi
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam, South Korea
| | - H Yoon
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam, South Korea
| | - C M Shin
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam, South Korea
| | - Y S Park
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam, South Korea
| | - D H Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam, South Korea.,Department of Internal Medicine and Institute of Liver Research, Seoul National University College of Medicine, Seoul, South Korea
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44
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Zhang SL, Wang SN, Miao CY. Influence of Microbiota on Intestinal Immune System in Ulcerative Colitis and Its Intervention. Front Immunol 2017; 8:1674. [PMID: 29234327 PMCID: PMC5712343 DOI: 10.3389/fimmu.2017.01674] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Accepted: 11/14/2017] [Indexed: 01/07/2023] Open
Abstract
Ulcerative colitis (UC) is an inflammatory bowel disease (IBD) with chronic and recurrent characteristics caused by multiple reasons. Although the pathogenic factors have not been clarified yet, recent studies have demonstrated that intestinal microbiota plays a major role in UC, especially in the immune system. This review focuses on the description of several major microbiota communities that affect UC and their interactions with the host. In this review, eight kinds of microbiota that are highly related to IBD, including Faecalibacterium prausnitzii, Clostridium clusters IV and XIVa, Bacteroides, Roseburia species, Eubacterium rectale, Escherichia coli, Fusobacterium, and Candida albicans are demonstrated on the changes in amount and roles in the onset and progression of IBD. In addition, potential therapeutic targets for UC involved in the regulation of microbiota, including NLRPs, vitamin D receptor as well as secreted proteins, are discussed in this review.
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Affiliation(s)
- Sai-Long Zhang
- Department of Pharmacology, Second Military Medical University, Shanghai, China
| | - Shu-Na Wang
- Department of Pharmacology, Second Military Medical University, Shanghai, China
| | - Chao-Yu Miao
- Department of Pharmacology, Second Military Medical University, Shanghai, China
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45
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Wang C, Nishiyama T, Kikuchi S, Inoue M, Sawada N, Tsugane S, Lin Y. Changing trends in the prevalence of H. pylori infection in Japan (1908-2003): a systematic review and meta-regression analysis of 170,752 individuals. Sci Rep 2017; 7:15491. [PMID: 29138514 PMCID: PMC5686167 DOI: 10.1038/s41598-017-15490-7] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 10/27/2017] [Indexed: 12/27/2022] Open
Abstract
Changing trends in the prevalence of H. pylori infection in the general population over time are thought to be the main driving force behind the declining gastric cancer mortality in Japan. However, whether the prevalence of H. pylori infection itself shows a birth-cohort pattern needs to be corroborated. We performed a systematic review of studies that reported the prevalence of H. pylori infection among Japanese individuals. Meta-regression was conducted in the framework of a generalized additive mixed model (GAMM) to account for heterogeneity in the prevalence of H. pylori infection as a function of birth year. The prevalence of H. pylori infection confirmed a clear birth cohort pattern: the predicted prevalence (%, 95% CI) was 60.9 (56.3–65.4), 65.9 (63.9–67.9), 67.4 (66.0–68.7), 64.1 (63.1–65.1), 59.1 (58.2–60.0), 49.1 (49.0–49.2), 34.9 (34.0–35.8), 24.6 (23.5–25.8), 15.6 (14.0–17.3), and 6.6 (4.8–8.9) among those who were born in the year 1910, 1920, 1930, 1940, 1950, 1960, 1970, 1980, 1990, and 2000, respectively. The present study demonstrated a clear birth-cohort pattern of H. pylori infection in the Japanese population. The decreased prevalence of H. pylori infection in successive generations should be weighed in future gastric cancer control programs.
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Affiliation(s)
- Chaochen Wang
- Department of Public Health, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan.,Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Takeshi Nishiyama
- Department of Public Health, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - Shogo Kikuchi
- Department of Public Health, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - Manami Inoue
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Norie Sawada
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Shoichiro Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Yingsong Lin
- Department of Public Health, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan.
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46
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Dolan B, Burkitt-Gray L, Shovelin S, Bourke B, Drumm B, Rowland M, Clyne M. The use of stool specimens reveals Helicobacter pylori strain diversity in a cohort of adolescents and their family members in a developed country. Int J Med Microbiol 2017; 308:247-255. [PMID: 29153619 PMCID: PMC5864523 DOI: 10.1016/j.ijmm.2017.11.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 10/31/2017] [Accepted: 11/12/2017] [Indexed: 12/19/2022] Open
Abstract
Helicobacter pylori infection occurs within families but the transmission route is unknown. The use of stool specimens to genotype strains facilitates inclusion of complete families in transmission studies. Therefore, we aimed to use DNA from stools to analyze strain diversity in H. pylori infected families. We genotyped H. pylori strains using specific biprobe qPCR analysis of glmM, recA and hspA. Concentration of H. pylori organisms before DNA isolation enhanced subsequent DNA amplification. We isolated H. pylori DNA from 50 individuals in 13 families. Tm data for at least 2 of the 3 genes and sequencing of the glmM amplicon were analyzed. Similar strains were commonly found in both mothers and children and in siblings. However, 20/50 (40%) individuals had multiple strains and several individuals harbored strains not found in other family members, suggesting that even in developed countries sources of infection outside of the immediate family may exist. Whether infection occurs multiple times or one transmission event with several strains occurs is not known but future studies should aim to analyze strains from children much closer to infection onset. The presence of multiple stains in infected persons has implications for antibiotic sensitivity testing and treatment strategies.
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Affiliation(s)
- Brendan Dolan
- School of Medicine, University College Dublin, Dublin, Ireland; Conway Institute of Biomolecular and Biomedical Science, University College Dublin, Dublin, Ireland.
| | - Lucy Burkitt-Gray
- School of Medicine, University College Dublin, Dublin, Ireland; Conway Institute of Biomolecular and Biomedical Science, University College Dublin, Dublin, Ireland.
| | | | - Billy Bourke
- School of Medicine, University College Dublin, Dublin, Ireland; Conway Institute of Biomolecular and Biomedical Science, University College Dublin, Dublin, Ireland; The National Childrens Research Centre, Crumlin, Dublin, Ireland.
| | - Brendan Drumm
- School of Medicine, University College Dublin, Dublin, Ireland.
| | - Marion Rowland
- School of Medicine, University College Dublin, Dublin, Ireland.
| | - Marguerite Clyne
- School of Medicine, University College Dublin, Dublin, Ireland; Conway Institute of Biomolecular and Biomedical Science, University College Dublin, Dublin, Ireland.
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47
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Abstract
The rapidly declining prevalence of Helicobacter pylori infection and widespread use of potent anti-secretory drugs means peptic ulcer disease has become substantially less prevalent than it was two decades ago. Management has, however, become more challenging than ever because of the threat of increasing antimicrobial resistance worldwide and widespread use of complex anti-thrombotic therapy in the ageing population. Peptic ulcers not associated with H pylori infection or the use of non-steroidal anti-inflammatory drugs are now also imposing substantial diagnostic and therapeutic challenges. This Seminar aims to provide a balanced overview of the latest advances in the pathogenetic mechanisms of peptic ulcers, guidelines on therapies targeting H pylori infection, approaches to treatment of peptic ulcer complications associated with anti-inflammatory analgesics and anti-thrombotic agents, and the unmet needs in terms of our knowledge and management of this increasingly challenging condition.
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Affiliation(s)
- Angel Lanas
- Service of Digestive Diseases, University Clinic Hospital Lozano Blesa, University of Zaragoza, IIS Aragón, CIBEREHD, Zaragoza, Spain.
| | - Francis K L Chan
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
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Lahat A, Kopylov U, Neuman S, Levhar N, Yablecovitch D, Avidan B, Weiss B, Ben-Horin S, Eliakim R. Helicobacter pylori prevalence and clinical significance in patients with quiescent Crohn's disease. BMC Gastroenterol 2017; 17:27. [PMID: 28193167 PMCID: PMC5307850 DOI: 10.1186/s12876-017-0588-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 02/10/2017] [Indexed: 12/14/2022] Open
Abstract
Background Helicobacter pylori (HP) infection is present in about 50% of the global population, and is associated with chronic gastritis, peptic disease and gastric malignancies. HP prevalence in Crohn’s disease (CD) patients was shown to be low compared to the general population, and its influence on disease activity is yet to be determined. Our aims were to determine the prevalence of HP in a selected group of CD patients with quiescent disease, and to assess the influence of its eradication on disease activity and endoscopic and laboratory activity measures. Methods Consecutive CD patients with quiescent disease underwent meticulous disease evaluation with MR enterography (MRE), video capsule endoscopy (VCE), CRP, fecal calprotectin and CDAI. All patients were tested for the presence of HP using stool antigen detection kit. Patients infected with HP were offered eradication treatment with sequential therapy. HP eradication was confirmed using urease breath test and stool antigen test. The influence of HP eradication on disease activity was assessed. Results Out of 56 patients enrolled, six patients (10.7%) had HP infection. Of them, five patients had gastro- duodenitis per VCE. All HP positive patients were offered eradication treatment and underwent successful eradication. Notably, 23 (50%) of patients had proximal disease per VCE, most of them (78%) were HP negative. CDAI, CRP, fecal calprotectin and VCE Lewis inflammatory score did not change significantly following HP eradication, Gastric findings on VCE were not impacted by HP eradication. Conclusions The prevalence of HP infection in patients with quiescent CD is relatively low. Eradication of the bacteria did not significantly change neither disease activity measures nor the presence of gastro- duodenitis per VCE, suggesting it might be part of proximal CD. The influence of HP on CD activity merits further investigation.
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Affiliation(s)
- Adi Lahat
- Department of Gastroenterology, Sheba Medical Center, Tel Hashomer, Tel Hashomer, Israel. .,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Uri Kopylov
- Department of Gastroenterology, Sheba Medical Center, Tel Hashomer, Tel Hashomer, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sandra Neuman
- Department of Gastroenterology, Sheba Medical Center, Tel Hashomer, Tel Hashomer, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nina Levhar
- Department of Gastroenterology, Sheba Medical Center, Tel Hashomer, Tel Hashomer, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Doron Yablecovitch
- Department of Gastroenterology, Sheba Medical Center, Tel Hashomer, Tel Hashomer, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Benjamin Avidan
- Department of Gastroenterology, Sheba Medical Center, Tel Hashomer, Tel Hashomer, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Batia Weiss
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.,Edmond and Lily Safra Children's Hospital, Tel Hashomer, Israel
| | - Shomron Ben-Horin
- Department of Gastroenterology, Sheba Medical Center, Tel Hashomer, Tel Hashomer, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Rami Eliakim
- Department of Gastroenterology, Sheba Medical Center, Tel Hashomer, Tel Hashomer, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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Sonnenberg A, Ajdacic-Gross V. Similar birth-cohort patterns in Crohn's disease and multiple sclerosis. Mult Scler 2017; 24:140-149. [PMID: 28155575 DOI: 10.1177/1352458517691620] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND The etiology of Crohn's disease and multiple sclerosis is unknown. Genetic susceptibility and environmental factors are believed to play a role in both diseases. OBJECTIVES To compare the long-term time trends of the two diseases and thus gain insight about their etiology. METHODS We analyzed mortality data of Crohn's disease and multiple sclerosis from Canada, England, Italy, the Netherlands, Switzerland, and the United States during the past 60 years. Age-period-cohort (APC) analyses based on logit models served to disentangle the separate influences of age, period, and cohort effects on the overall time trends. RESULTS The long-term time trends of Crohn's disease and multiple sclerosis have been shaped by strikingly similar birth-cohort patterns. In both diseases alike, mortality increased in all generations born prior to 1910. It peaked among generations born between 1910 and 1930 and then declined in all subsequent generations. Similar birth-cohort patterns of Crohn's disease and multiple sclerosis were found in each country analyzed separately. CONCLUSION The birth-cohort patterns indicate that the development of Crohn's disease and multiple sclerosis is influenced by exposure to environmental risk factors during an early period of life. These environmental risk factors may be similar or even identical in Crohn's disease and multiple sclerosis.
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Affiliation(s)
- Amnon Sonnenberg
- Division of Gastroenterology and Hepatology, Oregon Health & Science University, Portland, OR, USA
| | - Vladeta Ajdacic-Gross
- Swiss Multiple Sclerosis Registry (SMSR), Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
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Sonnenberg A, Turner KO, Spechler SJ, Genta RM. The influence of Helicobacter pylori on the ethnic distribution of Barrett's metaplasia. Aliment Pharmacol Ther 2017; 45:283-290. [PMID: 27862104 DOI: 10.1111/apt.13854] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 09/20/2016] [Accepted: 10/13/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND Environmental risk factors associated with ethnicity may contribute to the occurrence of Barrett's metaplasia. AIM To investigate the interaction between ethnicity and Helicobacter pylori infection in the occurrence of Barrett's metaplasia among patients undergoing oesophago-gastro-duodenoscopy. METHODS The Miraca Life Sciences Database is an electronic repository of histopathological patient records. A case-control study evaluated the influence of age, gender, ethnicity and histological diagnosis of H. pylori on the occurrence of Barrett's metaplasia. RESULTS The total study population comprised 596 479 subjects, of whom 76 475 harboured a diagnosis of Barrett's metaplasia. Male sex, age and H. pylori infection in declining order exerted the strongest influence on the occurrence of BM. In comparison with the population comprising Caucasians and African Americans, Barrett's metaplasia was less common among subjects of African (OR = 0.09, 95% CI = 0.01-0.43), Middle Eastern (0.26, 0.20-0.34), East Asian (0.35, 0.31-0.40), Indian (0.39, 0.32-0.47), Hispanic (0.62, 0.59-0.64) or Jewish descent (0.50, 0.45-0.54), but more common among subjects of Northern European descent (1.14, 1.03-1.26). With the exception of Jews and Northern Europeans, all other ethnic subgroups were characterised by a higher prevalence of H. pylori than the comparison group. A low prevalence of H. pylori was significantly associated with a high prevalence of Barrett's metaplasia (R2 = 0.82, P < 0.001), as well as dysplasia or oesophageal adenocarcinoma (R2 = 0.81, P < 0.001). CONCLUSION Our analysis reveals an inverse relationship between the prevalence of Barrett's metaplasia and H. pylori gastritis among different ethnic groups within the United States.
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Affiliation(s)
- A Sonnenberg
- Miraca Life Sciences, Irving, TX, USA.,Oregon Health & Science University, Portland, OR, USA
| | | | - S J Spechler
- VA North Texas Health Care System, Dallas, TX, USA
| | - R M Genta
- Miraca Life Sciences, Irving, TX, USA.,Baylor College of Medicine, Houston, TX, USA
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