Gastrin drives gastric cancer due to oxyntic atrophy also after Helicobacter pylori eradication

Constitutive programmed death ligand 1 expression protects gastric G-cells from Helicobacter pylori-induced inflammation

INTRODUCTION

Gastric intestinal metaplasia (GIM) is a premalignant lesion, highly associated with Helicobacter pylori infection. Previous studies have shown that H. pylori is able to induce the expression of programmed death ligand 1 (PD-L1), an inhibitory immune modulator, in gastric cells. Our aim was to investigate whether tissues from GIM patients may exploit PD-L1 expression upon H. pylori infection to evade immunosurveillance.

METHODS

Immunohistochemistry was performed for PD-L1 and enteroendocrine markers somatostatin and gastrin on samples derived from a cohort of patients with known GIM, both before and after H. pylori eradication. To determine the identity of any observed PD-L1-positive cells, we performed multiplex immunofluorescent staining and analysis of single-cell sequencing data.

RESULTS

GIM tissue was rarely positive for PD-L1. In normal glands from GIM patients, PD-L1 was mainly expressed by gastrin-positive G-cells. While the D-cell and G-cell compartments were both diminished 2-fold (p = .015 and p = .01, respectively) during H. pylori infection in the normal antral tissue of GIM patients, they were restored 1 year after eradication. The total number of PD-L1-positive cells was not affected by H. pylori, but the percentage of PD-L1-positive G-cells was 30% higher in infected subjects (p = .011), suggesting that these cells are preferentially rescued from destruction.

CONCLUSIONS

Antral G-cells frequently express PD-L1 during homeostasis. G-cells seem to be protected from H. pylori-induced immune destruction by PD-L1 expression. GIM itself does not express PD-L1 and is unlikely to escape immunosurveillance via expression of PD-L1.

Correlation analysis between characteristics under gastroscope and image information of tongue in patients with chronic gastriti

OBJECTIVE

To explore the correlation between diagnostic information of tongue and gastroscopy results of patients with chronic gastritis.

METHODS

Frequent pattern growth (FP-Growth), SPSS Modeler was used to analyze the correlation rules between the image information of tongue parameters and the characteristics of the stomach and duodenum seen under gastroscopy.

RESULTS

Ranking in order of confidence: cyanotic tongue, slippery fur, yellow fur and spotted tongue were sequently associated with both gastric antrum mucosal hyperemia or edema and gastric antrum mucosal erythema/macula. L, one value of tongue coating color, which counted among (30, 60), tooth-marked tongue and b, one value of tongue coating color, which counted in the range of (5, 20) were sequently associated with gastric antrum mucosal erythema /macula. A, one value of tongue body color, which counted in the range of (0, 20), was related to both gastric antrum mucosal hyperemia or edema and gastric antrum mucosal erythema /macula. a, one value of tongue coating color, which counted in the range of (15, 35), was associated with gastric antrum mucosal erythema / macula. There are a total of 9 strong correlation rules.

CONCLUSIONS

Cyanotic tongue, slippery fur, yellow fur, the CIE Lab value of tongue coating, a, the value of tongue body color, spotted tongue, and tooth-marked tongue are all related to the gastric antrum mucosal hyperemia or edema and gastric antrum mucosal erythema / macula. The conditions of gastric mucosa could be predicted by the examination of the above related image information of tongue.

Correct Identification of Cell of Origin May Explain Many Aspects of Cancer: The Role of Neuroendocrine Cells as Exemplified from the Stomach

Cancers are believed to originate from stem cells. Previously, the hypothesis was that tumors developed due to dedifferentiation of mature cells. We studied the regulation of gastric acid secretion and showed that gastrin through the gastrin receptor stimulates enterochromaffin-like (ECL) cell histamine release and proliferation. In animal and human studies, we and others showed that long-term hypergastrinemia results in ECL cell-derived tumor through a sequence of hyperplasia, dysplasia, neuroendocrine tumors (NETs), and possibly neuroendocrine carcinomas (NECs) and adenocarcinomas of diffuse type. Perhaps, other cancers may also have their origin in differentiated cells. Knowledge of the growth regulation of the cell of origin is important in cancer prophylaxis and treatment. Physiology plays a central role in carcinogenesis through hormones and other growth factors. Every cell division implies a small risk of mutation; thus mitogens are also mutagens. Moreover, metastasis of slow proliferating cells may also explain so-called tumor dormancy and late recurrence.