幽门螺杆菌感染与胃癌局部浸润的相关性

Furazolidone-based first-line therapy for Helicobacter pylori infection in China: A meta-analysis

AIM

To evaluate the efficacy, safety and ulcer healing rate of furazolidone-based first-line therapy for Helicobacter pylori (H. pylori) infection in China.

METHODS

Randomized controlled trials (RCTs) of furazolidone-based first-line therapy for H. pylori infection were identified from PubMed (1990-01/2016-05), EMBASE (1990-01/2016-05), Wanfang Data (1990-01/2016-05) and VIP Data (1990-01/2016-05). The quality of included RCTs was assessed, and mea-analysis was conducted with RevMan5.2.4 software.

RESULTS

Among ten included RCTs involving 1904 patients, the H. pylori eradication rate was 84.66% in the furazolidone group and 81.92% in the control group (RR = 1.04, 95%CI: 1.00-1.08). For the per protocol (PP) analysis, the eradication rates of the furazolidone group and control group were 85.55% and 83.07%, respectively (RR = 1.03, 95%CI: 0.99-1.07). The incidence rate of side effects was 12.73% in the furazolidone group and 12.68% in the control group (RR = 1.00, 95%CI: 0.79-1.25, P = 0.97). The ulcer healing rates in the furazolidone group and control group were 91.92% and 92.78%, respectively (RR = 0.99, 95%CI: 0.96-1.02, P = 0.59).

CONCLUSION

With similar efficacy, safety and the ulcer healing rate as the control group has, the furazolidone-based therapy could be recommended as a first-line therapy for H. pylori infection in China. However, more high quality RCTs are needed to prove our finding.

Necessity of monitoring blood trace elements in children with Helicobacter pylori infection

AIM: To analyze the necessity of monitoring blood trace elements in children with Helicobacter pylori (H. pylori) infection, and assess the value of trace elements in the treatment of children with H. pylori infection.

METHODS: Eighty children without H. pylori infection (control group) and 80 children with H. pylori infection (observation group) were included. The children in the observation group all accepted triple therapy for two weeks, of whom 40 additionally accepted symptomatic treatment by zinc or iron supplementation (symptomatic treatment subgroup), and another 40 received simultaneous supplementation of zinc and iron (non-symptomatic treatment subgroup). The levels of zinc, iron, copper, calcium and magnesium and the incidence of anemia were compared between the observation group and control group, and H. pylori infection, trace elements, and anemia were compared between the two subgroups after 1 mo of treatment.

RESULTS: Zinc and iron levels were significantly higher in the observation group than in the control group (P < 0.05), although there were no statistically differences in copper, calcium or magnesium levels between the two groups (P > 0.05). In the observation group, the percentages of children with zinc or iron deficiency were significantly higher than those in the control group (31.25% vs 13.75%, 36.25% vs 17.50%, P < 0.01), although the percentages of children with deficiency of other elements had no significant differences (P > 0.05). The incidence of anemia was significantly higher in the observation group than in the control group (40.00% vs 18.75%, P < 0.01). The numbers of children with zinc deficiency, iron deficiency, H. pylori infection or anemia were significantly lower in the symptomatic treatment subgroup than in the non-symptomatic treatment subgroup (5 vs 16, 2 vs 13, 3 vs 11, 1 vs 6, P < 0.05 or P < 0.01).

CONCLUSION: H. pylori infection children may develop zinc or iron deficiency and have a higher incidence of iron-deficiency anemia. Zinc or iron supplementation during H. pylori eradication treatment is conducive to recovery in H. pylori infection children.

Proteomic analysis of Helicobacter pylori from patients with different gastric diseases in different regions of Jiangsu

AIM: To perform a proteomic analysis of Helicobacter pylori (H. pylori) from patients with different gastric diseases in different regions of Jiangsu.

METHODS: H. pylori strains were isolated from the endoscopic biopsy specimens of gastric mucosa of patients with gastritis or gastric cancer from areas of high (Taizhou) and low (Suzhou) incidence of gastric cancer, and whole-cell proteins of H. pylori were extracted and characterized by 2-dimensional electrophoresis (DE). Different protein spots were analyzed using PDQuest analysis software, identified by electrospray ionization quadruple time-of-flight mass spectrometry (ESI-Q-TOF-MS), and searched using the Mascot database.

RESULTS: Nine differentially expressed proteins were identified, including four up-regulated in gastric cancer (superoxide dismutase, urease subunit alpha, chaperone protein dnaK and DNA-directed RNA polymerase subunit alpha), two up-regulated in chronic gastritis (urease subunit alpha and nucleoside diphosphate kinase), and three only expressed in strains from one region (S-ribosyl homocysteine lyase, inorganic pyrophosphatase and 60 × 10³ chaperonin).

CONCLUSION: There are proteomic differences between H. pylori isolates from patients with gastritis and gastric cancer in areas of high and low incidents of gastric cancer. The protein spots overexpressed in gastric cancer in the area with high incidence of gastric cancer are more than those in the area with low incidence of gastric cancer.

Helicobacter pylori induces demethylation of the Calmodulin gene promoter in gastric cancer cells

AIM: To explore the expression of Calmodulin (CaM) gene in gastric cancer tissue and the relationship between the methylation level of the CaM gene promoter and Helicobacter pylori (H. pylori) infection.

METHODS: The expression of the CaM gene in 30 cases of gastric cancer and matched tumor-adjacent gastric tissue and metastatic lymph nodes was assessed by real-time fluorescence quantitative PCR. The relationship between CaM gene expression and H. pylori infection was analyzed. Methylation of CpG islands in the CaM gene promoter was measured by bisulfite modified sequencing method in gastric cancer cells infected with H. pylori and stably transfected with the H. pylori cytotoxin-associated protein A (cagA) gene.

RESULTS: The relative expression level of the CaM gene in cancer tissue was 2.08 times higher than that in tumor-adjacent gastric tissue (P < 0.05). The relative expression level of the CaM gene in H. pylori-positive gastric cancer was 6.11 times higher than that in the H. pylori-negative group (P < 0.05). The demethylation at -276 bp in the CaM gene promoter was detected in H. pylori-infected and cagA-overexpressed gastric cancer cells.

CONCLUSION: H. pylori, though secreting the virulence factor CagA, up-regulates the expression of the CaM gene in gastric cancer possibly by inducing the demethylation of the CaM promoter.