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Wu F, Yang L, Hao Y, Zhou B, Hu J, Yang Y, Bedi S, Sanichar NG, Cheng C, Perez-Perez G, Tseng W, Tseng W, Tseng M, Francois F, Khan AR, Li Y, Blaser MJ, Shu XO, Long J, Li H, Pei Z, Chen Y. Oral and gastric microbiome in relation to gastric intestinal metaplasia. Int J Cancer 2022; 150:928-940. [PMID: 34664721 PMCID: PMC8770574 DOI: 10.1002/ijc.33848] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/26/2021] [Accepted: 08/09/2021] [Indexed: 12/14/2022]
Abstract
Evidence suggests that Helicobacter pylori plays a role in gastric cancer (GC) initiation. However, epidemiologic studies on the specific role of other bacteria in the development of GC are lacking. We conducted a case-control study of 89 cases with gastric intestinal metaplasia (IM) and 89 matched controls who underwent upper gastrointestinal endoscopy at three sites affiliated with NYU Langone Health. We performed shotgun metagenomic sequencing using oral wash samples from 89 case-control pairs and antral mucosal brushing samples from 55 case-control pairs. We examined the associations of relative abundances of bacterial taxa and functional pathways with IM using conditional logistic regression with and without elastic-net penalty. Compared with controls, oral species Peptostreptococcus stomatis, Johnsonella ignava, Neisseria elongata and Neisseria flavescens were enriched in cases (odds ratios [ORs] = 1.29-1.50, P = .004-.01) while Lactobacillus gasseri, Streptococcus mutans, S parasanguinis and S sanguinis were under-represented (ORs = 0.66-0.76, P = .006-.042) in cases. Species J ignava and Filifactor alocis in the gastric microbiota were enriched (ORs = 3.27 and 1.43, P = .005 and .035, respectively), while S mutans, S parasanguinis and S sanguinis were under-represented (ORs = 0.61-0.75, P = .024-.046), in cases compared with controls. The lipopolysaccharide and ubiquinol biosynthesis pathways were more abundant in IM, while the sugar degradation pathways were under-represented in IM. The findings suggest potential roles of certain oral and gastric microbiota, which are correlated with regulation of pathways associated with inflammation, in the development of gastric precancerous lesions.
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Affiliation(s)
- Fen Wu
- Department of Population Health, New York University School of Medicine, New York, New York, USA
| | - Liying Yang
- Department of Medicine, New York University School of Medicine, New York, New York, USA
| | - Yuhan Hao
- Department of Biology, New York University, New York, New York, USA
| | - Boyan Zhou
- Department of Population Health, New York University School of Medicine, New York, New York, USA
| | - Jiyuan Hu
- Department of Population Health, New York University School of Medicine, New York, New York, USA
| | - Yaohua Yang
- Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Sukhleen Bedi
- Department of Population Health, New York University School of Medicine, New York, New York, USA
| | - Navin Ganesh Sanichar
- Department of Population Health, New York University School of Medicine, New York, New York, USA
| | - Charley Cheng
- Department of Population Health, New York University School of Medicine, New York, New York, USA
| | - Guillermo Perez-Perez
- Department of Medicine, New York University School of Medicine, New York, New York, USA
| | - Wenche Tseng
- Department of Population Health, New York University School of Medicine, New York, New York, USA
| | | | - Mengkao Tseng
- Department of Medicine, New York University School of Medicine, New York, New York, USA
| | - Fritz Francois
- Department of Medicine, New York University School of Medicine, New York, New York, USA
| | - Abraham R Khan
- Department of Medicine, New York University School of Medicine, New York, New York, USA
| | - Yihong Li
- Department of Microbiology and Immunology, Cornell University Master of Public Health Program, Ithaca, New York, USA
| | - Martin J Blaser
- Center for Advanced Biotechnology and Medicine, Rutgers University, Piscataway, New Jersey, USA
| | - Xiao-Ou Shu
- Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jirong Long
- Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Huilin Li
- Department of Population Health, New York University School of Medicine, New York, New York, USA
| | - Zhiheng Pei
- Department of Medicine, New York University School of Medicine, New York, New York, USA.,Department of Pathology, New York University School of Medicine, New York, New York, USA.,Department of Pathology and Lab Service, Veterans Affairs New York Harbor Healthcare System, New York, New York, USA
| | - Yu Chen
- Department of Population Health, New York University School of Medicine, New York, New York, USA.,Department of Environmental Medicine, New York University School of Medicine, New York, New York, USA
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2
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Levican A, Perez-Perez G, Oleastro M, Fernández H, Ferreira S. Editorial: Current Perspectives of Antimicrobial Resistance in Campylobacteraceae and Helicobacteraceae. Front Cell Infect Microbiol 2022; 11:840456. [PMID: 35145927 PMCID: PMC8821808 DOI: 10.3389/fcimb.2021.840456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 12/29/2021] [Indexed: 11/29/2022] Open
Affiliation(s)
- Arturo Levican
- Sciences Faculty, School of Medical Technology, Pontificia Universidad Católica de Valparaíso, Valparaiso, Chile
- *Correspondence: Arturo Levican,
| | | | - Monica Oleastro
- Instituto Nacional de Saúde Doutor Ricardo Jorge (INSA), Lisboa, Portugal
| | - Heriberto Fernández
- Institute of Clinical Microbiology, Universidad Austral de Chile, Valdivia, Chile
| | - Susana Ferreira
- Centro de Investigação em Ciências da Saúde da Universidade da Beira Interior (CICS-UBI) Health Sciences Research Centre of University of Beira Interior, Covilhã, Portugal
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Ding L, Li Q, Chakrabarti J, Munoz A, Faure-Kumar E, Ocadiz-Ruiz R, Razumilava N, Zhang G, Hayes MH, Sontz RA, Mendoza ZE, Mahurkar S, Greenson JK, Perez-Perez G, Hanh NTH, Zavros Y, Samuelson LC, Iliopoulos D, Merchant JL. MiR130b from Schlafen4 + MDSCs stimulates epithelial proliferation and correlates with preneoplastic changes prior to gastric cancer. Gut 2020; 69:1750-1761. [PMID: 31980446 PMCID: PMC7377952 DOI: 10.1136/gutjnl-2019-318817] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 12/26/2019] [Accepted: 01/09/2020] [Indexed: 12/26/2022]
Abstract
UNLABELLED The myeloid differentiation factor Schlafen4 (Slfn4) marks a subset of myeloid-derived suppressor cells (MDSCs) in the stomach during Helicobacter-induced spasmolytic polypeptide-expressing metaplasia (SPEM). OBJECTIVE To identify the gene products expressed by Slfn4+-MDSCs and to determine how they promote SPEM. DESIGN We performed transcriptome analyses for both coding genes (mRNA by RNA-Seq) and non-coding genes (microRNAs using NanoString nCounter) using flow-sorted SLFN4+ and SLFN4- cells from Helicobacter-infected mice exhibiting metaplasia at 6 months postinfection. Thioglycollate-elicited myeloid cells from the peritoneum were cultured and treated with IFNα to induce the T cell suppressor phenotype, expression of MIR130b and SLFN4. MIR130b expression in human gastric tissue including gastric cancer and patient sera was determined by qPCR and in situ hybridisation. Knockdown of MiR130b in vivo in Helicobacter-infected mice was performed using Invivofectamine. Organoids from primary gastric cancers were used to generate xenografts. ChIP assay and Western blots were performed to demonstrate NFκb p65 activation by MIR130b. RESULTS MicroRNA analysis identified an increase in MiR130b in gastric SLFN4+ cells. Moreover, MIR130b colocalised with SLFN12L, a human homologue of SLFN4, in gastric cancers. MiR130b was required for the T-cell suppressor phenotype exhibited by the SLFN4+ cells and promoted Helicobacter-induced metaplasia. Treating gastric organoids with the MIR130b mimic induced epithelial cell proliferation and promoted xenograft tumour growth. CONCLUSION Taken together, MiR130b plays an essential role in MDSC function and supports metaplastic transformation.
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Affiliation(s)
- Lin Ding
- Internal Medicine-Gastroenterology, University of Michigan, Ann Arbor, Michigan, USA,Medicine, University of Arizona, Tucson, Arizona, USA
| | - Qian Li
- Department of Gastroenterology, Xiangya Hospital Central South University, Changsha, Hunan, China
| | - Jayati Chakrabarti
- Pharmacology and Systems Physiology, University of Cincinnati, Cincinnati, Ohio, USA
| | - Andres Munoz
- Medicine, University of Arizona, Tucson, Arizona, USA
| | | | - Ramon Ocadiz-Ruiz
- Internal Medicine-Gastroenterology, University of Michigan, Ann Arbor, Michigan, USA
| | - Nataliya Razumilava
- Internal Medicine-Gastroenterology, University of Michigan, Ann Arbor, Michigan, USA
| | - Guiying Zhang
- Department of Gastroenterology, Xiangya Hospital Central South University, Changsha, Hunan, China
| | - Michael H Hayes
- Internal Medicine-Gastroenterology, University of Michigan, Ann Arbor, Michigan, USA
| | - Ricky A Sontz
- Medicine, University of Arizona, Tucson, Arizona, USA
| | | | - Swapna Mahurkar
- Medicine-Digestive Diseases, UCLA, Los Angeles, California, USA
| | | | | | | | - Yana Zavros
- Pharmacology and Systems Physiology, University of Cincinnati, Cincinnati, Ohio, USA
| | - Linda C Samuelson
- Molecular and Integrative Physiology, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Juanita L Merchant
- Internal Medicine-Gastroenterology, University of Michigan, Ann Arbor, Michigan, USA .,Medicine, University of Arizona, Tucson, Arizona, USA.,Molecular and Integrative Physiology, University of Michigan, Ann Arbor, Michigan, USA
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4
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Muñoz-Ramirez ZY, Pascoe B, Mendez-Tenorio A, Mourkas E, Sandoval-Motta S, Perez-Perez G, Morgan DR, Dominguez RL, Ortiz-Princz D, Cavazza ME, Rocha G, Queiroz DMM, Catalano M, Palma GZD, Goldman CG, Venegas A, Alarcon T, Oleastro M, Vale FF, Goodman KJ, Torres RC, Berthenet E, Hitchings MD, Blaser MJ, Sheppard SK, Thorell K, Torres J. A 500-year tale of co-evolution, adaptation, and virulence: Helicobacter pylori in the Americas. ISME J 2020; 15:78-92. [PMID: 32879462 PMCID: PMC7853065 DOI: 10.1038/s41396-020-00758-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 07/27/2020] [Accepted: 08/24/2020] [Indexed: 02/07/2023]
Abstract
Helicobacter pylori is a common component of the human stomach microbiota, possibly dating back to the speciation of Homo sapiens. A history of pathogen evolution in allopatry has led to the development of genetically distinct H. pylori subpopulations, associated with different human populations, and more recent admixture among H. pylori subpopulations can provide information about human migrations. However, little is known about the degree to which some H. pylori genes are conserved in the face of admixture, potentially indicating host adaptation, or how virulence genes spread among different populations. We analyzed H. pylori genomes from 14 countries in the Americas, strains from the Iberian Peninsula, and public genomes from Europe, Africa, and Asia, to investigate how admixture varies across different regions and gene families. Whole-genome analyses of 723 H. pylori strains from around the world showed evidence of frequent admixture in the American strains with a complex mosaic of contributions from H. pylori populations originating in the Americas as well as other continents. Despite the complex admixture, distinctive genomic fingerprints were identified for each region, revealing novel American H. pylori subpopulations. A pan-genome Fst analysis showed that variation in virulence genes had the strongest fixation in America, compared with non-American populations, and that much of the variation constituted non-synonymous substitutions in functional domains. Network analyses suggest that these virulence genes have followed unique evolutionary paths in the American populations, spreading into different genetic backgrounds, potentially contributing to the high risk of gastric cancer in the region.
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Affiliation(s)
- Zilia Y Muñoz-Ramirez
- Unidad de Investigacion en Enfermedades Infecciosas, UMAE Pediatria, Instituto Mexicano del Seguro Social, Ciudad de México, Mexico.,Laboratorio de Bioinformática y Biotecnología Genómica, Escuela Nacional de Ciencias Biológicas, Unidad Profesional Lázaro Cárdenas, Instituto Politécnico Nacional, 11340, Mexico City, Mexico
| | - Ben Pascoe
- Department of Biology and Biochemistry, The Milner Centre for Evolution, University of Bath, Claverton Down, Bath, UK
| | - Alfonso Mendez-Tenorio
- Laboratorio de Bioinformática y Biotecnología Genómica, Escuela Nacional de Ciencias Biológicas, Unidad Profesional Lázaro Cárdenas, Instituto Politécnico Nacional, 11340, Mexico City, Mexico
| | - Evangelos Mourkas
- Department of Biology and Biochemistry, The Milner Centre for Evolution, University of Bath, Claverton Down, Bath, UK
| | - Santiago Sandoval-Motta
- Instituto Nacional de Medicina Genomica, Ciudad de México, México.,Consejo Nacional de Ciencia y Tecnologia, Catedras CONACYT, Ciudad de México, México
| | | | - Douglas R Morgan
- UAB Division of Gastroenterology and Hepatology, The University of Alabama at Birmingham, Birmingham, UK.,Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University, Nashville, TN, USA
| | - Ricardo Leonel Dominguez
- Western Honduras Gastric Cancer Prevention Initiative Hospital de Occidente Santa Rosa de Copan, Santa Rosa de Copan, Honduras
| | - Diana Ortiz-Princz
- Laboratorio de Microbiología Molecular, Servicio Instituto de Biomedicina MPPS-UCV, Caracas, Venezuela
| | - Maria Eugenia Cavazza
- Laboratorio de Microbiología Molecular, Servicio Instituto de Biomedicina MPPS-UCV, Caracas, Venezuela
| | - Gifone Rocha
- Faculdade de Medicina da UFMG, Belo Horizonte, Brazil
| | | | - Mariana Catalano
- Facultad de Medicina, Instituto de Microbiología y Parasitología Médica (IMPAM, UBA-CONICET), Universidad de Buenos Aires-Consejo Nacional de Investigaciones Científicas y Técnicas, Santa Rosa de Copan, Honduras
| | - Gerardo Zerbetto De Palma
- Instituto de Química y Fisicoquímica Biológicas "Prof. Alejandro C. Paladini", IQUIFIB UBA-CONICET, Santa Rosa de Copan, Honduras
| | - Cinthia G Goldman
- Facultad de Farmacia y Bioquímica, Cátedra de Física, Universidad de Buenos Aires, C1113AAD, Buenos Aires, Argentina.,National Scientific and Technical Research Council (CONICET), C1425FQB, Buenos Aires, Argentina
| | - Alejandro Venegas
- Laboratorio de Patogénesis Microbiana, Centro de Investigación Biomédica, Universidad Diego Portales, Ejército, 141, Santiago, Chile
| | - Teresa Alarcon
- Department of Microbiology, Hospital Universitario La Princesa, Instituto de Investigación Sanitaria Princesa, Madrid, Spain
| | - Monica Oleastro
- Host-Pathogen Interactions Unit, Faculty of Pharmacy, Research Institute for Medicines (iMed-ULisboa), Universidade de Lisboa, Lisboa, Portugal
| | - Filipa F Vale
- Host-Pathogen Interactions Unit, Faculty of Pharmacy, Research Institute for Medicines (iMed-ULisboa), Universidade de Lisboa, Lisboa, Portugal
| | - Karen J Goodman
- Division of Gastroenterology, Centre of Excellence for Gastrointestinal Inflammation & Immunity Research, University of Alberta, Edmonton, AB, Canada
| | - Roberto C Torres
- Unidad de Investigacion en Enfermedades Infecciosas, UMAE Pediatria, Instituto Mexicano del Seguro Social, Ciudad de México, Mexico
| | - Elvire Berthenet
- Swansea University Medical School, Swansea University, Swansea, UK
| | | | - Martin J Blaser
- Center for Advanced Biotechnology and Medicine, Rutgers University, New Brunswick, NJ, USA
| | - Samuel K Sheppard
- Department of Biology and Biochemistry, The Milner Centre for Evolution, University of Bath, Claverton Down, Bath, UK
| | - Kaisa Thorell
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. .,Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.
| | - Javier Torres
- Unidad de Investigacion en Enfermedades Infecciosas, UMAE Pediatria, Instituto Mexicano del Seguro Social, Ciudad de México, Mexico.
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5
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Talebi Bezmin Abadi A, Perez-Perez G. Role of dupA in virulence of Helicobacter pylori. World J Gastroenterol 2016; 22:10118-10123. [PMID: 28028359 PMCID: PMC5155170 DOI: 10.3748/wjg.v22.i46.10118] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 09/27/2016] [Accepted: 11/16/2016] [Indexed: 02/07/2023] Open
Abstract
Helicobacter pylori (H. pylori) is a gastric human pathogen associated with acute and chronic gastritis, 70% of all gastric ulcers, 85% of all duodenal ulcers, and both forms of stomach cancer, mucosal-associated lymphoid tissue (MALT) lymphoma and adenocarcinoma. Recently, attention has focused on possible relationship between presence of certain virulence factor and H. pylori-associated diseases. Some contradictory data between this bacterium and related disorders has been observed since not all the colonized individuals develop to severe disease. The reported diseases plausibility related to H. pylori specific virulence factors became an interesting story about this organism. Although a number of putative virulence factors have been identified including cytotoxin-associated gene a (cagA) and vacA, there are conflicting data about their actual participation as specific risk factor for H. pylori-related diseases. Duodenal ulcer promoting gene a (dupA) is a virulence factor of H. pylori that is highly associated with duodenal ulcer development and reduced risk of gastric cancer. The prevalence of dupA in H. pylori strains isolated from western countries is relatively higher than in H. pylori strains from Asian countries. Current confusing epidemiological reports will continue unless future sophisticated and molecular studies provide data on functional and complete dupA cluster in H. pylori infected individuals. This paper elucidates available knowledge concerning role of dupA in virulence of H. pylori after a decade of its discovery.
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6
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Njamkepo E, Fawal N, Tran-Dien A, Hawkey J, Strockbine N, Jenkins C, Talukder KA, Bercion R, Kuleshov K, Kolínská R, Russell JE, Kaftyreva L, Accou-Demartin M, Karas A, Vandenberg O, Mather AE, Mason CJ, Page AJ, Ramamurthy T, Bizet C, Gamian A, Carle I, Sow AG, Bouchier C, Wester AL, Lejay-Collin M, Fonkoua MC, Le Hello S, Blaser MJ, Jernberg C, Ruckly C, Mérens A, Page AL, Aslett M, Roggentin P, Fruth A, Denamur E, Venkatesan M, Bercovier H, Bodhidatta L, Chiou CS, Clermont D, Colonna B, Egorova S, Pazhani GP, Ezernitchi AV, Guigon G, Harris SR, Izumiya H, Korzeniowska-Kowal A, Lutyńska A, Gouali M, Grimont F, Langendorf C, Marejková M, Peterson LAM, Perez-Perez G, Ngandjio A, Podkolzin A, Souche E, Makarova M, Shipulin GA, Ye C, Žemličková H, Herpay M, Grimont PAD, Parkhill J, Sansonetti P, Holt KE, Brisse S, Thomson NR, Weill FX. Erratum: Global phylogeography and evolutionary history of Shigella dysenteriae type 1. Nat Microbiol 2016; 1:16209. [PMID: 27694821 DOI: 10.1038/nmicrobiol.2016.209] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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7
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Njamkepo E, Fawal N, Tran-Dien A, Hawkey J, Strockbine N, Jenkins C, Talukder KA, Bercion R, Kuleshov K, Kolínská R, Russell JE, Kaftyreva L, Accou-Demartin M, Karas A, Vandenberg O, Mather AE, Mason CJ, Page AJ, Ramamurthy T, Bizet C, Gamian A, Carle I, Sow AG, Bouchier C, Wester AL, Lejay-Collin M, Fonkoua MC, Le Hello S, Blaser MJ, Jernberg C, Ruckly C, Mérens A, Page AL, Aslett M, Roggentin P, Fruth A, Denamur E, Venkatesan M, Bercovier H, Bodhidatta L, Chiou CS, Clermont D, Colonna B, Egorova S, Pazhani GP, Ezernitchi AV, Guigon G, Harris SR, Izumiya H, Korzeniowska-Kowal A, Lutyńska A, Gouali M, Grimont F, Langendorf C, Marejková M, Peterson LAM, Perez-Perez G, Ngandjio A, Podkolzin A, Souche E, Makarova M, Shipulin GA, Ye C, Žemličková H, Herpay M, Grimont PAD, Parkhill J, Sansonetti P, Holt KE, Brisse S, Thomson NR, Weill FX. Global phylogeography and evolutionary history of Shigella dysenteriae type 1. Nat Microbiol 2016; 1:16027. [PMID: 27572446 DOI: 10.1038/nmicrobiol.2016.27] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2015] [Accepted: 02/03/2016] [Indexed: 11/09/2022]
Abstract
Together with plague, smallpox and typhus, epidemics of dysentery have been a major scourge of human populations for centuries(1). A previous genomic study concluded that Shigella dysenteriae type 1 (Sd1), the epidemic dysentery bacillus, emerged and spread worldwide after the First World War, with no clear pattern of transmission(2). This is not consistent with the massive cyclic dysentery epidemics reported in Europe during the eighteenth and nineteenth centuries(1,3,4) and the first isolation of Sd1 in Japan in 1897(5). Here, we report a whole-genome analysis of 331 Sd1 isolates from around the world, collected between 1915 and 2011, providing us with unprecedented insight into the historical spread of this pathogen. We show here that Sd1 has existed since at least the eighteenth century and that it swept the globe at the end of the nineteenth century, diversifying into distinct lineages associated with the First World War, Second World War and various conflicts or natural disasters across Africa, Asia and Central America. We also provide a unique historical perspective on the evolution of antibiotic resistance over a 100-year period, beginning decades before the antibiotic era, and identify a prevalent multiple antibiotic-resistant lineage in South Asia that was transmitted in several waves to Africa, where it caused severe outbreaks of disease.
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Affiliation(s)
- Elisabeth Njamkepo
- Institut Pasteur, Unité des Bactéries Pathogènes Entériques, 75724 Paris Cedex 15, France
| | - Nizar Fawal
- Institut Pasteur, Unité des Bactéries Pathogènes Entériques, 75724 Paris Cedex 15, France
| | - Alicia Tran-Dien
- Institut Pasteur, Unité des Bactéries Pathogènes Entériques, 75724 Paris Cedex 15, France
| | - Jane Hawkey
- Centre for Systems Genomics, University of Melbourne, Parkville, Victoria 3010, Australia.,Department of Biochemistry and Molecular Biology, Bio21 Molecular Science and Biotechnology Institute, University of Melbourne, Parkville, Victoria 3010, Australia.,School of Agriculture and Veterinary Science, University of Melbourne, Parkville, Victoria 3010, Australia
| | - Nancy Strockbine
- Centers for Disease Control and Prevention, Escherichia and Shigella Reference Unit, Atlanta, Georgia 30333, USA
| | - Claire Jenkins
- Public Health England, Gastrointestinal Bacteria Reference Unit, Colindale NW9 5HT, UK
| | - Kaisar A Talukder
- icddr,b, Enteric and Food Microbiology Laboratory, Dhaka 1212, Bangladesh
| | - Raymond Bercion
- Institut Pasteur de Bangui, BP 923, Bangui, République Centrafricaine.,Institut Pasteur de Dakar, BP 220, Dakar, Senegal
| | - Konstantin Kuleshov
- Federal Budget Institute of Science, Central Research Institute for Epidemiology, Moscow 111123, Russia
| | - Renáta Kolínská
- Czech National Collection of Type Cultures (CNCTC), National Institute of Public Health, Prague 10, Czech Republic
| | - Julie E Russell
- Public Health England, National Collection of Type Cultures, Porton Down SP4 0JG, UK
| | - Lidia Kaftyreva
- Pasteur Institute of St Petersburg, St Petersburg 197101, Russia
| | - Marie Accou-Demartin
- Institut Pasteur, Unité des Bactéries Pathogènes Entériques, 75724 Paris Cedex 15, France
| | - Andreas Karas
- Department of Medical Microbiology, University of KwaZulu-Natal, Durban 4041, South Africa
| | - Olivier Vandenberg
- Department of Microbiology, LHUB-ULB, Brussels University Hospitals Laboratory, 1000 Brussels, Belgium.,Environmental Health Research Centre, Public Health School, Université Libre de Bruxelles, 1070 Brussels, Belgium
| | - Alison E Mather
- Wellcome Trust Sanger Institute, Cambridge CB10 1SA, UK.,Department of Veterinary Medicine, University of Cambridge, Cambridge CB3 0ES, UK
| | - Carl J Mason
- Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok 10400, Thailand
| | - Andrew J Page
- Wellcome Trust Sanger Institute, Cambridge CB10 1SA, UK
| | | | - Chantal Bizet
- Institut Pasteur, Collection de l'Institut Pasteur (CIP), 75724 Paris Cedex 15, France
| | - Andrzej Gamian
- Polish Collection of Microorganisms, Institute of Immunology and Experimental Therapy, 53-114 Wroclaw, Poland
| | - Isabelle Carle
- Institut Pasteur, Unité des Bactéries Pathogènes Entériques, 75724 Paris Cedex 15, France
| | | | | | - Astrid Louise Wester
- Department of Foodborne Infections, Norwegian Institute of Public Health, Nydalen 0403, Oslo, Norway
| | - Monique Lejay-Collin
- Institut Pasteur, Unité des Bactéries Pathogènes Entériques, 75724 Paris Cedex 15, France
| | | | - Simon Le Hello
- Institut Pasteur, Unité des Bactéries Pathogènes Entériques, 75724 Paris Cedex 15, France
| | - Martin J Blaser
- Departments of Medicine and Microbiology, New York University Langone Medical Center, New York, New York 10016, USA
| | | | - Corinne Ruckly
- Institut Pasteur, Unité des Bactéries Pathogènes Entériques, 75724 Paris Cedex 15, France
| | - Audrey Mérens
- Biology Department and Infection Control Unit, Bégin Military Hospital, 94160 Saint-Mandé, France
| | | | - Martin Aslett
- Wellcome Trust Sanger Institute, Cambridge CB10 1SA, UK
| | | | - Angelika Fruth
- Divison of Enteropathogenic Bacteria and Legionella, Robert Koch Institut, 38855 Wernigerode, Germany
| | - Erick Denamur
- INSERM, IAME, UMR 1137, Univ. Paris Diderot, IAME, UMR 1137, Sorbonne Paris Cité, 75018 Paris, France
| | - Malabi Venkatesan
- Bacterial Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland 20910, USA
| | - Hervé Bercovier
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel
| | - Ladaporn Bodhidatta
- Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok 10400, Thailand
| | - Chien-Shun Chiou
- Center of Research and Diagnostics, Centers for Disease Control, Taichung 40855, Taiwan
| | - Dominique Clermont
- Institut Pasteur, Collection de l'Institut Pasteur (CIP), 75724 Paris Cedex 15, France
| | - Bianca Colonna
- Istituto Pasteur-Fondazione Cenci Bolognetti, Dipartimento di Biologia e Biotecnologie C Darwin, Sapienza Università di Roma, 00185, Roma, Italy
| | - Svetlana Egorova
- Pasteur Institute of St Petersburg, St Petersburg 197101, Russia
| | - Gururaja P Pazhani
- National Institute of Cholera and Enteric Diseases (NICED), Kolkata, West Bengal 700010, India
| | | | - Ghislaine Guigon
- Institut Pasteur, Genotyping of Pathogens and Public Health Platform, 75724 Paris Cedex 15, France
| | | | - Hidemasa Izumiya
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, 162-8640, Japan
| | | | - Anna Lutyńska
- Department of Sera and Vaccines Evaluation, National Institute of Public Health-National Institute of Hygiene, 00-791 Warsaw, Poland
| | - Malika Gouali
- Institut Pasteur, Unité des Bactéries Pathogènes Entériques, 75724 Paris Cedex 15, France
| | - Francine Grimont
- Institut Pasteur, Unité des Bactéries Pathogènes Entériques, 75724 Paris Cedex 15, France
| | | | - Monika Marejková
- National Reference Laboratory for E. coli and Shigella, National Institute of Public Health, Prague 10, Czech Republic
| | - Lorea A M Peterson
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba R3E 3R2, Canada
| | - Guillermo Perez-Perez
- Departments of Medicine and Microbiology, New York University Langone Medical Center, New York, New York 10016, USA
| | | | - Alexander Podkolzin
- Federal Budget Institute of Science, Central Research Institute for Epidemiology, Moscow 111123, Russia
| | - Erika Souche
- Institut Pasteur, Bioinformatics platform, 75724 Paris Cedex 15, France
| | - Mariia Makarova
- Pasteur Institute of St Petersburg, St Petersburg 197101, Russia
| | - German A Shipulin
- Federal Budget Institute of Science, Central Research Institute for Epidemiology, Moscow 111123, Russia
| | - Changyun Ye
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, China CDC, Beijing 102206, China
| | - Helena Žemličková
- Czech National Collection of Type Cultures (CNCTC), National Institute of Public Health, Prague 10, Czech Republic.,Department of Clinical Microbiology, Faculty of Medicine and University Hospital, Charles University, 500 05, Hradec Kralove, Czech Republic
| | - Mária Herpay
- Hungarian National Collection of Medical Bacteria, National Center for Epidemiology, H-1097 Budapest, Hungary
| | - Patrick A D Grimont
- Institut Pasteur, Unité des Bactéries Pathogènes Entériques, 75724 Paris Cedex 15, France
| | | | - Philippe Sansonetti
- Institut Pasteur, Unité de Pathogénie Microbienne Moléculaire, 75724 Paris Cedex 15, France
| | - Kathryn E Holt
- Centre for Systems Genomics, University of Melbourne, Parkville, Victoria 3010, Australia.,Department of Biochemistry and Molecular Biology, Bio21 Molecular Science and Biotechnology Institute, University of Melbourne, Parkville, Victoria 3010, Australia
| | - Sylvain Brisse
- Institut Pasteur, Genotyping of Pathogens and Public Health Platform, 75724 Paris Cedex 15, France.,Institut Pasteur, Microbial Evolutionary Genomics Unit, 75724 Paris Cedex 15, France.,CNRS, UMR 3525, 75015 Paris, France
| | - Nicholas R Thomson
- Wellcome Trust Sanger Institute, Cambridge CB10 1SA, UK.,London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - François-Xavier Weill
- Institut Pasteur, Unité des Bactéries Pathogènes Entériques, 75724 Paris Cedex 15, France.,Wellcome Trust Sanger Institute, Cambridge CB10 1SA, UK
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Mendoza E, Camorlinga-Ponce M, Perez-Perez G, Mera R, Vilchis J, Moran S, Rivera O, Coria R, Torres J, Correa P, Duque X. Present and past Helicobacter pylori infection in Mexican school children. Helicobacter 2014; 19:55-64. [PMID: 24165012 DOI: 10.1111/hel.12098] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND In developing countries, more than 50% of children have serological evidence of Helicobacter pylori infection. However, serological tests for H. pylori did not differentiate between active and past infection. The objectives of this study were to estimate the frequency of active and past H. pylori infection utilizing functional urea breath test (UBT) and serological tests and evaluate factors associated with the infection. METHODS A total of 675 school children, 6-13 years of age, participated. UBT was performed to detect active H. pylori infection. Blood samples were obtained to determine iron status and Immunoglobulin G (IgG) responses to the H. pylori whole-cell and to Cag A antigens by antigen-specific enzyme-linked immunosorbent assays. Weight, height, and sociodemographic characteristics were recorded. RESULTS A total of 37.9% (95% Confidence Intervals (CI): 34.2-41.6) of school children had active or past H. pylori infection; of them, 73.8% (CI95% 68.4-79.2) were carrying CagA-positive strain, 26.5% (CI95% 23.2-29.8) had active infection, and 11.4% (95%CI: 9.0-13.8) had evidence of past H. pylori infection. School children with iron deficiency and low height for age had higher risk of H. pylori infection: [OR to active or past infection was 2.30 (CI 95% 1.01-5.23) and to active infection it was 2.64 (CI 95% 1.09-6.44)] compared to school children with normal iron status and height for age or with normal iron status but low height for age or with iron deficiency and normal height for age. CONCLUSIONS The estimated prevalence of infection depends of the test utilized. Frequency of H. pylori infection and carrying CagA-positive strains was high in this population. Malnutrition was associated with active H. pylori infection.
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9
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Salazar CR, Sun J, Li Y, Francois F, Corby P, Perez-Perez G, Dasanayake A, Pei Z, Chen Y. Association between selected oral pathogens and gastric precancerous lesions. PLoS One 2013; 8:e51604. [PMID: 23308100 PMCID: PMC3538744 DOI: 10.1371/journal.pone.0051604] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Accepted: 11/02/2012] [Indexed: 12/13/2022] Open
Abstract
We examined whether colonization of selected oral pathogens is associated with gastric precancerous lesions in a cross-sectional study. A total of 119 participants were included, of which 37 were cases of chronic atrophic gastritis, intestinal metaplasia, or dysplasia. An oral examination was performed to measure periodontal indices. Plaque and saliva samples were tested with real-time quantitative PCR for DNA levels of pathogens related to periodontal disease (Porphyromonas gingivalis, Tannerella forsythensis, Treponema denticola, Actinobacillus actinomycetemcomitans) and dental caries (Streptococcus mutans and S. sobrinus). There were no consistent associations between DNA levels of selected bacterial species and gastric precancerous lesions, although an elevated but non-significant odds ratio (OR) for gastric precancerous lesions was observed in relation to increasing colonization of A. actinomycetemcomitans (OR = 1.36 for one standard deviation increase, 95% Confidence Interval = 0.87-2.12), P. gingivalis (OR = 1.12, 0.67-1.88) and T. denticola (OR = 1.34, 0.83-2.12) measured in plaque. To assess the influence of specific long-term infection, stratified analyses by levels of periodontal indices were conducted. A. actinomycetemcomitans was significantly associated with gastric precancerous lesions (OR = 2.51, 1.13-5.56) among those with ≥ median of percent tooth sites with PD ≥ 3 mm, compared with no association among those below the median (OR = 0.86, 0.43-1.72). A significantly stronger relationship was observed between the cumulative bacterial burden score of periodontal disease-related pathogens and gastric precancerous lesions among those with higher versus lower levels of periodontal disease indices (p-values for interactions: 0.03-0.06). Among individuals with periodontal disease, high levels of colonization of periodontal pathogens are associated with an increased risk of gastric precancerous lesions.
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Affiliation(s)
- Christian R. Salazar
- Department of Epidemiology and Health Promotion, New York University College of Dentistry, New York, New York, United States of America
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, United States of America
| | - Jinghua Sun
- Department of Basic Science and Craniofacial Biology, New York University College of Dentistry, New York, New York, United States of America
| | - Yihong Li
- Department of Basic Science and Craniofacial Biology, New York University College of Dentistry, New York, New York, United States of America
| | - Fritz Francois
- Department of Medicine, New York University School of Medicine, New York, New York, New York, United States of America
- New York University Cancer Institute, New York University School of Medicine, New York, New York, New York, United States of America
| | - Patricia Corby
- Department of Periodontology and Implant Dentistry, New York University College of Dentistry, New York, New York, New York, United States of America
| | - Guillermo Perez-Perez
- Department of Microbiology, New York University School of Medicine, New York, NY, United States of America
| | - Ananda Dasanayake
- Department of Epidemiology and Health Promotion, New York University College of Dentistry, New York, New York, United States of America
| | - Zhiheng Pei
- Department of Medicine, New York University School of Medicine, New York, New York, New York, United States of America
- Department of Pathology, New York University School of Medicine, New York, New York, New York, United States of America
| | - Yu Chen
- Department of Medicine, New York University School of Medicine, New York, New York, New York, United States of America
- New York University Cancer Institute, New York University School of Medicine, New York, New York, New York, United States of America
- Division of Epidemiology, Department of Environmental Medicine, New York University School of Medicine, New York, New York, New York, United States of America
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10
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Hendricks-Muñoz KD, Perez-Perez G, Xu J, Kim Y, Louie M. Maternal antenatal treatments influence initial oral microbial acquisition in preterm infants. Am J Perinatol 2013; 30:47-52. [PMID: 22814801 DOI: 10.1055/s-0032-1321499] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The purpose of this study was to analyze the association of maternal antenatal therapy on initial preterm infant oral microbial acquisition of gut metabolically important bacteria: Firmicutes, Bacteroidetes, Lactobacillus, Bifidobacterium, and Bacteroides species. STUDY DESIGN Infant oral samples were collected prefeeding at 24 hours and analyzed using group-specific primers by real-time 16S rRNA quantitative polymerase chain reaction with analysis of variance and logistic regression to evaluate effect of antenatal exposure. RESULTS Sixty-five infants < 34 weeks' gestational age (GA) were evaluated; mean GA was 28.6 ± 2.6 (standard deviation) weeks. Infants unexposed to antenatal treatment (n = 5) acquired < 1% Firmicutes, which was composed of 100% Lactobacillus species with no detectable Bifidobacterium, Bacteroidetes, or Bacteroides species. Infants exposed to antibiotics (n = 7), acquired fivefold less total bacterial density (TBD) with 45% Firmicutes 1.3% Lactobacillus species, 23.5% Bacteroidetes and rare Bacteroides. Compared with unexposed infants, steroids (n = 26) or steroid and antibiotics (n = 27) exposure led to an eightfold increase in TBD with < 1% Lactobacillus species and Bacteroides species 100% and 30%, respectively (p < 0.04). Bifidobacterium was undetectable in all groups. CONCLUSION Preterm infant exposure to routine maternal antenatal treatments influence early oral microbial acquisition during the primary hours related to establishment of gut commensal bacteria.
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Affiliation(s)
- Karen D Hendricks-Muñoz
- Division of Neonatal Medicine, Department of Pediatrics, Virginia Commonwealth University School of Medicine, Richmond, VA 23228, USA.
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11
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Salazar CR, Francois F, Li Y, Corby P, Hays R, Leung C, Bedi S, Segers S, Queiroz E, Sun J, Wang B, Ho H, Craig R, Cruz GD, Blaser MJ, Perez-Perez G, Hayes RB, Dasanayake A, Pei Z, Chen Y. Association between oral health and gastric precancerous lesions. Carcinogenesis 2012; 33:399-403. [PMID: 22139442 PMCID: PMC3384024 DOI: 10.1093/carcin/bgr284] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2011] [Revised: 11/18/2011] [Accepted: 11/25/2011] [Indexed: 01/05/2023] Open
Abstract
Although recent studies have suggested that tooth loss is positively related to the risk of gastric non-cardia cancer, the underlying oral health conditions potentially responsible for the association remain unknown. We investigated whether clinical and behavioral measures of oral health are associated with the risk of gastric precancerous lesions. We conducted a cross-sectional study of 131 patients undergoing upper gastrointestinal endoscopy. Cases were defined as those with gastric precancerous lesions including intestinal metaplasia or chronic atrophic gastritis on the basis of standard biopsy review. A validated structured questionnaire was administered to obtain information on oral health behaviors. A comprehensive clinical oral health examination was performed on a subset of 91 patients to evaluate for periodontal disease and dental caries experience. A total of 41 (31%) cases of gastric precancerous lesions were identified. Compared with non-cases, cases were significantly more likely to not floss their teeth [odds ratio (OR) = 2.89, 95% confidence interval (CI): 1.09-7.64], adjusting for age, sex, race, body mass index, smoking status, educational attainment and Helicobacter pylori status in serum. Among participants who completed the oral examination, cases (n = 28) were more likely to have a higher percentage of sites with gingival bleeding than non-cases [OR = 2.63, 95% CI: 1.37-5.05 for a standard deviation increase in bleeding sites (equivalent to 19.7%)], independent of potential confounders. Our findings demonstrate that specific oral health conditions and behaviors such as gingival bleeding and tooth flossing are associated with gastric precancerous lesions.
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Affiliation(s)
- Christian R. Salazar
- Department of Epidemiology and Health Promotion, New York University College of Dentistry, New York, NY 10003, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY 10032, USA
| | - Fritz Francois
- Department of Medicine
- New York University Cancer Institute, New York University School of Medicine, New York, NY 10016, USA
| | - Yihong Li
- Department of Basic Science and Craniofacial Biology
| | | | - Rosemary Hays
- Department of Dental Hygiene, New York University College of Dentistry, New York, NY 10010, USA
| | - Celine Leung
- Division of Epidemiology, Department of Environmental Medicine, New York University School of Medicine, New York, NY 10016, USA
| | - Sukhleen Bedi
- Division of Epidemiology, Department of Environmental Medicine, New York University School of Medicine, New York, NY 10016, USA
| | - Stephanie Segers
- Division of Epidemiology, Department of Environmental Medicine, New York University School of Medicine, New York, NY 10016, USA
| | - Erica Queiroz
- Bluestone Center for Clinical Research, New York University College of Dentistry, New York, NY 10010, USA
| | - Jinghua Sun
- Department of Basic Science and Craniofacial Biology
| | | | | | - Ronald Craig
- Department of Basic Science and Craniofacial Biology
- Department of Periodontology and Implant Dentistry
| | - Gustavo D. Cruz
- Department of Epidemiology and Health Promotion, New York University College of Dentistry, New York, NY 10003, USA
| | - Martin J. Blaser
- Department of Medicine
- Department of Microbiology, New York University School of Medicine, New York, NY 10016, USA
| | - Guillermo Perez-Perez
- Department of Medicine
- Department of Microbiology, New York University School of Medicine, New York, NY 10016, USA
| | - Richard B. Hayes
- New York University Cancer Institute, New York University School of Medicine, New York, NY 10016, USA
- Division of Epidemiology, Department of Environmental Medicine, New York University School of Medicine, New York, NY 10016, USA
| | - Ananda Dasanayake
- Department of Epidemiology and Health Promotion, New York University College of Dentistry, New York, NY 10003, USA
| | - Zhiheng Pei
- Department of Medicine
- Department of Pathology
| | - Yu Chen
- Department of Medicine
- New York University Cancer Institute, New York University School of Medicine, New York, NY 10016, USA
- Division of Epidemiology, Department of Environmental Medicine, New York University School of Medicine, New York, NY 10016, USA
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12
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Camorlinga-Ponce M, Perez-Perez G, Gonzalez-Valencia G, Mendoza I, Peñaloza-Espinosa R, Ramos I, Kersulyte D, Reyes-Leon A, Romo C, Granados J, Muñoz L, Berg DE, Torres J. Helicobacter pylori genotyping from American indigenous groups shows novel Amerindian vacA and cagA alleles and Asian, African and European admixture. PLoS One 2011; 6:e27212. [PMID: 22073291 PMCID: PMC3207844 DOI: 10.1371/journal.pone.0027212] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2010] [Accepted: 10/12/2011] [Indexed: 12/14/2022] Open
Abstract
It is valuable to extend genotyping studies of Helicobacter pylori to strains from indigenous communities across the world to better define adaption, evolution, and associated diseases. We aimed to genetically characterize both human individuals and their infecting H. pylori from indigenous communities of Mexico, and to compare them with those from other human groups. We studied individuals from three indigenous groups, Tarahumaras from the North, Huichols from the West and Nahuas from the center of Mexico. Volunteers were sampled at their community site, DNA was isolated from white blood cells and mtDNA, Y-chromosome, and STR alleles were studied. H. pylori was cultured from gastric juice, and DNA extracted for genotyping of virulence and housekeeping genes. We found Amerindian mtDNA haplogroups (A, B, C, and D), Y-chromosome DYS19T, and Amerindian STRs alleles frequent in the three groups, confirming Amerindian ancestry in these Mexican groups. Concerning H.pylori cagA phylogenetic analyses, although most isolates were of the Western type, a new Amerindian cluster neither Western nor Asian, was formed by some indigenous Mexican, Colombian, Peruvian and Venezuelan isolates. Similarly, vacA phylogenetic analyses showed the existence of a novel Amerindian type in isolates from Alaska, Mexico and Colombia. With hspA strains from Mexico and other American groups clustered within the three major groups, Asian, African or European. Genotyping of housekeeping genes confirmed that Mexican strains formed a novel Asian-related Amerindian group together with strains from remote Amazon Aborigines. This study shows that Mexican indigenous people with Amerindian markers are colonized with H. pylori showing admixture of Asian, European and African strains in genes known to interact with the gastric mucosa. We present evidence of novel Amerindian cagA and vacA alleles in indigenous groups of North and South America.
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Affiliation(s)
- Margarita Camorlinga-Ponce
- Unidad de Investigacion en Enfermedades Infecciosas, Instituto Mexicano del Seguro Social, Mexico D.F., Mexico
| | - Guillermo Perez-Perez
- School of Medicine, New York University, New York, New York, United States of America
| | - Gerardo Gonzalez-Valencia
- Unidad de Investigacion en Enfermedades Infecciosas, Instituto Mexicano del Seguro Social, Mexico D.F., Mexico
| | - Irma Mendoza
- Unidad de Investigacion en Enfermedades Infecciosas, Instituto Mexicano del Seguro Social, Mexico D.F., Mexico
| | - Rosenda Peñaloza-Espinosa
- Unidad de Investigacion en Genetica Humana, Instituto Mexicano del Seguro Social, Mexico D.F., Mexico
| | - Irma Ramos
- Unidad de Investigacion en Enfermedades Infecciosas, Instituto Mexicano del Seguro Social, Mexico D.F., Mexico
| | - Dangeruta Kersulyte
- Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Adriana Reyes-Leon
- Instituto Nacional de Pediatria, Secretaria de Salud, Mexico D.F., Mexico
| | - Carolina Romo
- Instituto Nacional de Pediatria, Secretaria de Salud, Mexico D.F., Mexico
| | - Julio Granados
- Instituto Nacional de la Nutricion y Ciencias Medicas, Secretaria de Salud, Mexico D.F., Mexico
| | - Leopoldo Muñoz
- Unidad de Investigacion en Enfermedades Infecciosas, Instituto Mexicano del Seguro Social, Mexico D.F., Mexico
| | - Douglas E. Berg
- Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Javier Torres
- Unidad de Investigacion en Enfermedades Infecciosas, Instituto Mexicano del Seguro Social, Mexico D.F., Mexico
- * E-mail:
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13
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Koshiol J, Flores R, Lam T, Taylor PR, Weinstein S, Virtamo J, Albanes D, Perez-Perez G, Caporaso NE, Blaser MJ. Abstract 1889: Helicobacter pylori seropositivity and risk of lung cancer. Cancer Res 2011. [DOI: 10.1158/1538-7445.am2011-1889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
BACKGROUND: Lung cancer is the leading cause of cancer mortality worldwide. Infections may contribute to lung carcinogenesis. Results from a few small studies have suggested that Helicobacter pylori (HP) may be a potential risk factor. However, these studies have been limited in size and in the evaluation of lung cancer histology and smoking.
METHODS: We conducted a study of 350 lung adenocarcinoma cases, 350 squamous cell carcinoma cases, and 700 controls nested within the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study (ATBC) cohort of male Finnish smokers. Controls were 1 to 1 matched by age (+/- 5 years) at and date (+/- 30 days) of baseline serum draw and had to be alive and cancer free at the date that the corresponding case was diagnosed. We used enzyme linked immunosorbent assays to detect immunoglobulin G antibodies against HP whole-cell and CagA antigens and calculated odds ratios (ORs) and 95% confidence intervals (95% CIs) for associations between HP seropositivity and lung cancer risk using conditional logistic regression.
RESULTS: 79% of cases and 78% of controls were seropositive for whole cell HP, and 43% of cases and 44% of controls were seropositive for the cytotoxin-associated gene (cagA) antigen. Whole cell seropositivity was not associated with lung adenocarcinoma (OR: 1.2, 95% CI: 0.80-1.8) or squamous cell carcinoma (OR: 1.1, 95% CI: 0.73-1.6) after adjusting for age at serum draw, date of serum draw, age at smoking initiation, pack-years, and cigarettes smoked per day. Similarly, CagA seropositivity was not associated with lung adenocarcinoma (OR: 1.1, 95% CI: 0.78-1.5) or squamous cell carcinoma (OR: 0.88, 95% CI: 0.63-1.2).
CONCLUSIONS: Despite earlier small studies suggesting that HP may contribute to lung carcinogenesis, HP seropositivity does not appear to be associated with lung cancer.
Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 1889. doi:10.1158/1538-7445.AM2011-1889
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Affiliation(s)
| | | | - Tram Lam
- 1National Cancer Institute, Bethesda, MD
| | | | | | - Jarmo Virtamo
- 2National Institute for Health and Welfare, Helsinki, Finland
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14
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Nagy TA, Allen SS, Wroblewski LE, Flaherty DK, Slaughter JC, Perez-Perez G, Israel DA, Peek RM. Helicobacter pylori induction of eosinophil migration is mediated by the cag pathogenicity island via microbial-epithelial interactions. Am J Pathol 2011; 178:1448-52. [PMID: 21406172 DOI: 10.1016/j.ajpath.2010.12.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2010] [Revised: 11/16/2010] [Accepted: 12/17/2010] [Indexed: 01/23/2023]
Abstract
The host immune response directed against Helicobacter pylori is ineffective in eliminating the organism and strains harboring the cag pathogenicity island augment disease risk. Because eosinophils are a prominent component of H. pylori-induced gastritis, we investigated microbial and host mechanisms through which H. pylori regulates eosinophil migration. Our results indicate that H. pylori increases production of the chemokines CCL2, CCL5, and granulocyte-macrophage colony-stimulating factor by gastric epithelial cells and that these molecules induce eosinophil migration. These events are mediated by the cag pathogenicity island and by mitogen-activated protein kinases, suggesting that eosinophil migration orchestrated by H. pylori is regulated by a virulence-related locus.
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Affiliation(s)
- Toni A Nagy
- Division of Gastroenterology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232-2279, USA
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15
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Sabbaghian MS, Ranaudo J, Zeng L, Alongi AP, Perez-Perez G, Shamamian P. Identification of Helicobacter spp. in bile and gallbladder tissue of patients with symptomatic gallbladder disease. HPB (Oxford) 2010; 12:129-33. [PMID: 20495657 PMCID: PMC2826671 DOI: 10.1111/j.1477-2574.2009.00148.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2009] [Accepted: 09/21/2009] [Indexed: 12/12/2022]
Abstract
BACKGROUND This experimental study was designed to determine if Helicobacter spp. contribute to benign gallbladder disease using polymerase chain reaction (PCR) methods. METHODS Patients with benign gallbladder disease scheduled for elective cholecystectomy at New York University Langone Medical Center were recruited from February to May 2008. Bile, gallbladder tissue and gallstones were collected. DNA was isolated from these specimens and amplified via PCR using C97F and C98R primers specific for Helicobacter spp. Appropriate positive and negative controls were used. Products were analysed with agarose gel electrophoresis, sequenced and results aligned using sequencher. Plasma was collected for detection of anti-Helicobacter pylori antibodies via enzyme-linked immunosorbent assay. RESULTS Of 36 patients, 12 patients' bile and/or tissue were positive for Helicobacter spp. by PCR. Species were most homologous with H. pylori, although other Helicobacter spp. were suggested. Six of 12 patients demonstrated anti-Helicobacter antibodies in plasma, suggesting that the remaining six might have demonstrated other species besides H. pylori. Four of six plasma samples with anti-Helicobacter antibodies were anti-CagA (cytotoxin associated gene) negative. DISCUSSION Helicobacter spp. can be detected in bile and gallbladder tissue of patients with benign gallbladder disease. The contribution of these bacteria to the pathophysiology of gallbladder disease and gallstone formation requires further study.
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Affiliation(s)
- M Shirin Sabbaghian
- Department of Surgery, New York University Langone Medical CenterNew York, NY
| | - Jeffrey Ranaudo
- Department of Surgery, New York University Langone Medical CenterNew York, NY
| | - Lin Zeng
- Department of Surgery, New York University Langone Medical CenterNew York, NY
| | - Alexandra P Alongi
- Department of Surgery, New York University Langone Medical CenterNew York, NY
| | | | - Peter Shamamian
- Department of Surgery, Ralph H. Johnson Veterans Affairs Medical Center, Charleston and the Medical University of South CarolinaCharleston, SC, USA
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16
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Hou L, Savage SA, Blaser MJ, Perez-Perez G, Hoxha M, Dioni L, Pegoraro V, Dong LM, Zatonski W, Lissowska J, Chow WH, Baccarelli A. Telomere length in peripheral leukocyte DNA and gastric cancer risk. Cancer Epidemiol Biomarkers Prev 2009; 18:3103-9. [PMID: 19861514 DOI: 10.1158/1055-9965.epi-09-0347] [Citation(s) in RCA: 95] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Telomere length reflects lifetime cumulative oxidative stress from environmental exposures, such as cigarette smoking and chronic inflammation. Shortened telomere length is thought to cause genomic instability and has been associated with several cancers. We examined the association of telomere length in peripheral leukocyte DNA with gastric cancer risk as well as potential confounding factors and risk modifiers for telomere length-related risk. In a population-based study of gastric cancer conducted in a high-risk population in Warsaw, Poland, between 1994 and 1996, we measured relative telomere length in 300 cases and 416 age- and gender-matched controls using quantitative real-time PCR. Among controls, telomeres were significantly shorter in association with aging (P < 0.001), increasing pack-years of cigarette smoking (P = 0.02), decreasing fruit intake (P = 0.04), and Helicobacter pylori positivity (P = 0.03). Gastric cancer cases had significantly shorter telomere length (mean +/- SD relative telomere length, 1.25 +/- 0.34) than controls (1.34 +/- 0.35; P = 0.0008). Gastric cancer risk doubled [odds ratio (OR), 2.04; 95% confidence interval (95% CI), 1.33-3.13] among subjects in the shortest compared with the highest quartile of telomere length (P(trend) < 0.001). Telomere length-associated risks were higher among individuals with the lowest risk profile, those H. pylori-negative (OR, 5.45; 95% CI, 2.10-14.1), nonsmokers (OR, 3.07; 95% CI, 1.71-5.51), and individuals with high intake of fruits (OR, 2.43; 95% CI, 1.46-4.05) or vegetables (OR, 2.39; 95% CI, 1.51-3.81). Our results suggest that telomere length in peripheral leukocyte DNA was associated with H. pylori positivity, cigarette smoking, and dietary fruit intake. Shortened telomeres increased gastric cancer risk in this high-risk Polish population.
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Affiliation(s)
- Lifang Hou
- Department of Preventive Medicine, Feinberg School of Medicine, and The Robert H Lurie Comprehensive Cancer Center, Northwestern University, Chicago, Illinois 60611, USA.
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Epplein M, Nomura AMY, Hankin JH, Blaser MJ, Perez-Perez G, Stemmermann GN, Wilkens LR, Kolonel LN. Association of Helicobacter pylori infection and diet on the risk of gastric cancer: a case-control study in Hawaii. Cancer Causes Control 2008; 19:869-77. [PMID: 18369531 PMCID: PMC2799111 DOI: 10.1007/s10552-008-9149-2] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2008] [Accepted: 03/15/2008] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The risk factors most strongly associated with gastric cancer are the gastric bacteria Helicobacter pylori and diet. Utilizing data from a case-control study among residents in Hawaii, we examined the association of diet, presence of H. pylori, and non-cardia gastric cancer risk. METHODS Serum taken at diagnosis for cases (n = 212) and at interview for controls (n = 336) was assayed for IgG antibodies to H. pylori group antigens and to a recombinant fragment of the cytotoxin-associated antigen A (CagA) protein, and subjects completed food frequency questionnaires. Risk measures were calculated using logistic regression. The likelihood ratio test was used to assess interactions. RESULTS Inverse associations were found between gastric cancer risk and increasing intake of several micronutrients and vegetables among all individuals. For H. pylori/CagA-positive subjects, significant trends were present for total, green, and yellow vegetables, while a significant trend was present only for yellow vegetables among H. pylori/CagA-negative individuals. For intestinal gastric cancer, there was a suggestion that intake of vegetables, especially cruciferous vegetables, had a stronger protective effect for the H. pylori/CagA-positive group. CONCLUSIONS Diet may play a greater role in the etiology of non-cardia gastric cancer among individuals with evidence of H. pylori infection than among those without.
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Affiliation(s)
- Meira Epplein
- Epidemiology Program, Cancer Research Center of Hawaii, 1236 Lauhala Street, Honolulu, HI 96813, USA.
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Perry S, de la Luz Sanchez M, Yang S, Haggerty TD, Hurst P, Perez-Perez G, Parsonnet J. Gastroenteritis and transmission of Helicobacter pylori infection in households. Emerg Infect Dis 2007; 12:1701-8. [PMID: 17283620 PMCID: PMC3372328 DOI: 10.3201/eid1211.060086] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The mode of transmission of Helicobacter pylori infection is poorly characterized. In northern California, 2,752 household members were tested for H. pylori infection in serum or stool at a baseline visit and 3 months later. Among 1,752 person considered uninfected at baseline, 30 new infections (7 definite, 7 probable, and 16 possible) occurred, for an annual incidence of 7% overall and 21% in children <2 years of age. Exposure to an infected household member with gastroenteritis was associated with a 4.8-fold (95% confidence interval [CI] 1.4-17.1) increased risk for definite or probable new infection, with vomiting a greater risk factor (adjusted odds ratio [AOR] 6.3, CI 1.6-24.5) than diarrhea only (AOR 3.0, p = 0.65). Of probable or definite new infections, 75% were attributable to exposure to an infected person with gastroenteritis. Exposure to an H. pylori-infected person with gastroenteritis, particularly vomiting, markedly increased risk for new infection.
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Affiliation(s)
- Sharon Perry
- Division of Infection Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California 94305, USA.
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19
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Cho A, Chaudhry A, Minsky-Primus L, Tso A, Perez-Perez G, Diehl D, Marcus SG, Gany FM. Acceptance of repeat esophagogastroduodenoscopy to detect gastric cancer in a Chinese immigrant cohort. J Clin Gastroenterol 2006; 40:606-11. [PMID: 16917402 DOI: 10.1097/00004836-200608000-00009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
GOAL To study the feasibility of using repeat esophagogastroduodenoscopy (EGD) to screen for Helicobacter pylori infection and gastric cancer in an Asian immigrant cohort. BACKGROUND Immigrants in the United States (US) from countries with high per capita rates of gastric cancer remain at higher risk for gastric cancer. The existence of the possibly modifiable risk factor of H. pylori infection and the poor outcomes associated with late-stage disease make screening higher-risk groups with EGD an appealing possibility. It is unknown whether Asian immigrants in the US would accept an EGD-based strategy for gastric cancer screening. STUDY Cross-sectional study of adult Chinese immigrants in New York City with dyspepsia who underwent EGD in an earlier gastric cancer detection study, who were offered a second EGD four years later. Our main outcome measure was acceptance or refusal of repeat EGD. RESULTS Seventy-three of the 115 Chinese participants in the earlier study were successfully contacted for this current study. Twenty-three of 73 (32%) underwent repeat EGD. Leading reasons given for declining were lack of symptoms and lack of time. Significantly associated with acceptance of repeat EGD was the belief that EGD will find stomach cancer "nearly always" in someone who has it (P=0.0054; odds ratio=14.0, 2.1 to 94.2 95% confidence interval). CONCLUSIONS Acceptance of repeat EGD for gastric cancer detection in a cohort of Chinese immigrants was relatively low despite the mitigation of cost and language factors, 2 major barriers to healthcare access. Relocation seemed to be a factor as well. In this population, perceptions of the benefits of EGD may influence acceptance of testing for cancer detection purposes.
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Affiliation(s)
- Alex Cho
- Center for Health Services Research in Primary Care, Durham VA Medical Center, Durham, NC, USA.
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20
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Bhat N, Gaensbauer J, Peek RM, Bloch K, Tham KT, Blaser MJ, Perez-Perez G. Local and systemic immune and inflammatory responses to Helicobacter pylori strains. Clin Diagn Lab Immunol 2006; 12:1393-400. [PMID: 16339062 PMCID: PMC1317075 DOI: 10.1128/cdli.12.12.1393-1400.2005] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Colonization with Helicobacter pylori eventuates in varied clinical outcomes, which relate to both bacterial and host factors. Here we examine the relationships between cagA status, serum and gastric juice antibody responses, and gastric inflammation in dyspeptic patients. Serum, gastric juice, and gastric biopsy specimens were obtained from 89 patients undergoing endoscopy. H. pylori colonization and cagA status were determined by histology, culture, and PCR methods, and acute inflammation and chronic inflammation in the gastric mucosa were scored by a single pathologist. Serum and gastric juice antibodies to H. pylori whole-cell and CagA antigens were determined by enzyme-linked immunosorbent assay. Relationships between variables were sequentially analyzed using univariate and multivariate statistical methods. Of the 89 subjects, 62 were colonized by H. pylori. By univariate analyses, levels of serum immunoglobulin G (IgG) and IgA and gastric juice IgA antibodies against whole-cell and CagA antigens each were significantly higher in the H. pylori-positive group than in the H. pylori-negative group (P<0.001). H. pylori and CagA sero-positivities were both significantly associated with enhanced inflammation in gastric antrum and body (P<0.02). The presence of gastric juice antibodies to H. pylori antigens was associated with more severe gastric inflammation. However, in multivariate analyses, only the presence of serum antibodies against CagA and, to a lesser extent, whole-cell antigens remained significantly associated with acute and chronic inflammation in antrum and body (P<0.05). Thus, serum antibody response to CagA correlates with severity of gastric inflammation. Furthermore, given the relationships demonstrated by multivariate analysis, determination of gastric juice antibodies may provide a better representation of serum, rather than secretory, immune response.
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Affiliation(s)
- Niranjan Bhat
- Division of Infectious Diseases, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
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Bik EM, Eckburg PB, Gill SR, Nelson KE, Purdom EA, Francois F, Perez-Perez G, Blaser MJ, Relman DA. Molecular analysis of the bacterial microbiota in the human stomach. Proc Natl Acad Sci U S A 2006; 103:732-7. [PMID: 16407106 PMCID: PMC1334644 DOI: 10.1073/pnas.0506655103] [Citation(s) in RCA: 713] [Impact Index Per Article: 39.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The microbiota of the human stomach and the influence of Helicobacter pylori colonization on its composition remain largely unknown. We characterized bacterial diversity within the human gastric mucosa by using a small subunit 16S rDNA clone library approach and analyzed 1,833 sequences generated by broad-range bacterial PCR from 23 gastric endoscopic biopsy samples. A diverse community of 128 phylotypes was identified, featuring diversity at this site greater than previously described. The majority of sequences were assigned to the Proteobacteria, Firmicutes, Actinobacteria, Bacteroidetes, and Fusobacteria phyla. Ten percent of the phylotypes were previously uncharacterized, including a Deinococcus-related organism, relatives of which have been found in extreme environments but not reported before in humans. The gastric clone libraries from 19 subjects contained H. pylori rDNA; however, only 12 of these subjects tested positive for H. pylori by conventional laboratory methods. Statistical analysis revealed a large degree of intersubject variability of the gastric ecosystem. The presence of H. pylori did not affect the composition of the gastric community. This gastric bacterial rDNA data set was significantly different from sequence collections of the human mouth and esophagus described in other studies, indicating that the human stomach may be home to a distinct microbial eco-system. The gastric microbiota may play important, as-yet-undiscovered roles in human health and disease.
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Affiliation(s)
- Elisabeth M Bik
- Department of Microbiology and Immunology, Stanford University School of Medicine, Fairchild Science Building, 299 Campus Drive, Stanford, CA 94305, USA.
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22
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Cho A, Chaudhry A, Minsky-Primus L, Tso A, Perez-Perez G, Diehl DL, Marcus SG, Gany FM. Follow-up care after a diagnosis of Helicobacter pylori infection in an Asian immigrant cohort. J Clin Gastroenterol 2006; 40:29-32. [PMID: 16340630 DOI: 10.1097/01.mcg.0000190755.33373.f9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
GOAL To study the rate at which Helicobacter pylori infection is treated in an immigrant cohort after diagnosis by esophagogastroduodenoscopy (EGD). BACKGROUND Gastric cancer is the second leading cause of cancer death worldwide, and is especially prevalent in East Asia; immigrants from this part of the world remain at higher risk. Infection with H. pylori is a known risk factor for gastric cancer. There have been no studies of completion of H. pylori treatment in immigrant populations. STUDY Prospective cohort study of East Asian immigrants diagnosed with H. pylori infection who underwent EGD in a gastric cancer screening protocol. Our primary outcome was self-report or chart evidence of completion of treatment of H. pylori. RESULTS Sixty-eight of the 126 participants (54%) tested positive for H. pylori infection on EGD. Forty-nine (72%) were seen for a follow-up visit at one of the clinics involved in the study. According to clinic records, 39 of these 49 participants (57% of all H. pylori-positive participants) were prescribed treatment. Only 31 participants (46%) completed treatment. Of possible explanatory factors, only having a "regular doctor" was significantly associated with treatment completion (odds ratio=5.6; 95% confidence interval, 1.2-25.0). CONCLUSIONS In a sample of Asian immigrants, the rate of treatment of H. pylori infection, a potentially modifiable risk factor, was lower than expected. Having a "regular doctor" appeared to increase the likelihood of receiving appropriate follow-up care.
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Affiliation(s)
- Alex Cho
- Center for Health Services Research in Primary Care, Durham VA Medical Center, Durham, NC 27705, and Division of General Internal Medicine, Johns Hopkins Medicine, Baltimore, MD, USA.
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Harris P, Perez-Perez G, Zylberberg A, Rollán A, Serrano C, Riera F, Einisman H, García D, Viviani P. Relevance of adjusted cut-off values in commercial serological immunoassays for Helicobacter pylori infection in children. Dig Dis Sci 2005; 50:2103-9. [PMID: 16240223 DOI: 10.1007/s10620-005-3015-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2004] [Accepted: 01/18/2005] [Indexed: 12/16/2022]
Abstract
We assessed the sensitivity and specificity of H. pylori IgG and IgA with a commercial immunoassay performed in Chile and a second non-commercial immunoassay performed in a reference laboratory in the United States, in serum of 80 children and adults referred for gastrointestinal endoscopies in a developing country. Overall, 56% of the patients were infected with H. pylori based on rapid urease test and staining techniques on gastric biopsies. When Receiver Operator Curves (ROC) were developed, the sensitivity and specificity were similar for IgG and IgA. Both immunoassays exhibited better specificity, positive and negative predictive value (NPV) in children than in adults when cut-off values were corrected according to the local population than when they were assessed using the cut-off values pre-defined in other populations. These results underline the need to establish more precise cut-off values corrected in the local populations where assessments of antibodies as diagnostic markers of H. pylori infection are planning.
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Affiliation(s)
- Paul Harris
- Department of Pediatrics, Pontificia Universidad Catolica de Chile, School of Medicine, Santiago, Chile
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Haggerty TD, Perry S, Sanchez L, Perez-Perez G, Parsonnet J. Significance of transiently positive enzyme-linked immunosorbent assay results in detection of Helicobacter pylori in stool samples from children. J Clin Microbiol 2005; 43:2220-3. [PMID: 15872245 PMCID: PMC1153794 DOI: 10.1128/jcm.43.5.2220-2223.2005] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
In young children, the significance of stool samples transiently positive for Helicobacter pylori antigen is unknown. As part of a larger prospective study on enteric infections, stool samples were obtained from 323 children at two time points 3 months apart and tested for H. pylori antigen using a commercially available enzyme-linked immunosorbent assay (ELISA) test. Seminested PCR for a Helicobacter-specific 16S rRNA gene was performed on all 26 pairs reverting from positive to negative (transient positives), all 4 persistent antigen-positive pairs, and 10 randomly selected persistent antigen-negative pairs. Helicobacter species were amplified from the first stool samples of 15/26 (58%) of the transient positives and 1 (25%) of 4 persistent positives. No Helicobacter species were amplified from the 10 persistent negatives. Among the 15 amplicons from transient-positive stool, H. pylori was sequenced and identified from 12 (80%; 95% confidence interval, 52% to 96%) and other Helicobacter spp. were identified from three (Helicobacter canis, Helicobacter winghamensis, and MIT 99-5504). Four of the 15 remained positive by PCR for the second (antigen-negative) stool sample, including all 3 initially identified as non-H. pylori. Helicobacter bilis was amplified from the second sample of a persistent positive. Two of eight transient positives from whom serum was available had accompanying transient elevations in anti-H. pylori antibodies. Transiently positive stool ELISAs for H. pylori are common and represent H. pylori in the majority of cases where sequences can be obtained. A not-insignificant percentage of antigen-positive stools, however, may represent other Helicobacter species.
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Affiliation(s)
- Thomas D Haggerty
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, 300 Pasteur Dr., Stanford, CA 94305-5107, USA.
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25
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Harris PR, Godoy A, Arenillas S, Riera F, García D, Einisman H, Peña A, Rollán A, Duarte I, Guiraldes E, Perez-Perez G. CagA antibodies as a marker of virulence in chilean patients with Helicobacter pylori infection. J Pediatr Gastroenterol Nutr 2003; 37:596-602. [PMID: 14581804 DOI: 10.1097/00005176-200311000-00018] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
BACKGROUND The bacterial and host factors that influence the clinical outcomes of the Helicobacter pylori infection have not been fully identified. Cytotoxin-associated gene product (CagA), one of the virulence factors, has been associated with a more aggressive form of infection. The authors studied the relationship between CagA status and clinical outcome in Chilean children and adults with H. pylori infection. METHODS One hundred eighty consecutive patients undergoing upper gastrointestinal endoscopic analysis were enrolled after informed consent was obtained. Rapid urease test and histologic analysis were used to detect H. pylori infection. IgA and IgG antibodies to H. pylori whole cell antigen preparation and IgG antibodies to CagA were measured by enzyme-linked immunosorbent assay (ELISA). RESULTS H. pylori infection was detected in 42% of the patients by biopsy or urease test and in 38% and 20% of patients by IgG and IgA antibodies, respectively. The prevalence of H. pylori either by the invasive or the serologic tests was directly related to patient age. Among patients with H. pylori, there was no significant association between age and prevalence of CagA. Nearly 70% of the patients with H. pylori and peptic ulcer disease had CagA-positive strains. In contrast, only 49% of the patients with chronic gastritis alone had CagA-positive strains (P < 0.05). CONCLUSIONS In Chile, patients infected with H. pylori have a proportion of CagA-positive strains similar to that reported in developed countries. CagA prevalence was not significantly different in adults and children infected with H. pylori, suggesting that variations in clinical outcome may be related to host immune or environmental factors.
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Affiliation(s)
- Paul R Harris
- Department of Pediatrics, School of Medicine, Pontificia Universidad Católica, Santiago, Chile.
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Dourado ME, Duarte RC, Ferreira LC, Queiroz JW, Illa I, Perez-Perez G, Guerrant RL, Jerônimo SMB. Anti-ganglioside antibodies and clinical outcome of patients with Guillain-Barré Syndrome in northeast Brazil. Acta Neurol Scand 2003; 108:102-8. [PMID: 12859286 DOI: 10.1034/j.1600-0404.2003.00103.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The goal of this study was to investigate the frequency of GM1 antibodies and to assess whether exposure to Campylobacter jejuni was associated with a distinct clinical variant of Guillain-Barré Syndrome (GBS) or disease outcome in Rio Grande do Norte, Brazil. MATERIAL AND METHODS Forty-one patients with a presumed diagnosis of GBS were enrolled and prospectively studied between June 1994 and November 1999. RESULTS Anti-GM1 was present in 51.2% (n = 21) of patients. The presence of anti-GM1 was significantly associated with acute axonal motor neuropathy when compared to acute inflammatory demyelinating polyneuropathy (P = 0.01). Patients with anti-GM1 antibodies presented distal muscle involvement and fewer sensory deficits. Age, time to nadir and ventilatory assistance were not associated with anti-GM1 antibodies. Eight out of 21 patients (32%) presented with anti-C. jejuni antibodies. Clinical features were similar for patients with GBS with positive and negative C. jejuni antibodies. Anti-GM1 antibodies were associated with C. jejuni infection (P = 0.0005). Presence of anti-GM1 and C. jejuni antibodies did not indicate a worse prognosis. CONCLUSION Patients with GBS and anti-GM1 antibodies had more distal muscle weakness, fewer sensory deficits, more axonal degeneration and C. jejuni infection, but these findings were not associated with a worse prognosis.
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Affiliation(s)
- M E Dourado
- Departamento de Bioquímica, Centro de Biociências, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
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Belongia EA, Chyou PH, Greenlee RT, Perez-Perez G, Bibb WF, DeVries EO. Diarrhea incidence and farm-related risk factors for Escherichia coli O157:H7 and Campylobacter jejuni antibodies among rural children. J Infect Dis 2003; 187:1460-8. [PMID: 12717628 DOI: 10.1086/374622] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2002] [Accepted: 12/13/2002] [Indexed: 11/03/2022] Open
Abstract
Serum samples were obtained from 215 farm-resident children and 396 non-farm-resident children living in a defined rural Wisconsin population. Antibodies to Campylobacter jejuni and Escherichia coli O157:H7 lipopolysaccharide (O157 LPS) immunoglobulin G were measured, and the incidence of clinic visits for diarrheal illness was determined. Risk factors were assessed in a telephone interview. There were 363 children (59%) with C. jejuni antibodies (seropositive for >or=2 immunoglobulin classes) and 86 (14%) with O157 LPS antibodies. Increasing age and farm residence were independently associated with C. jejuni seropositivity by multivariate analysis. O157 LPS antibodies were independently associated with increasing age, female sex, manure contact, and sheep contact. The incidence of clinically recognized diarrhea was similar among children with and without antibodies to C. jejuni and O157 LPS, but the clinic visit rate for diarrhea was 46% lower among farm-resident children. These results are consistent with reduced occurrence of clinical illness from repeated antigenic stimulation in a farm environment.
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Affiliation(s)
- Edward A Belongia
- Epidemiology Research Center, Marshfield Clinic Research Foundation, Marshfield, Wisconsin 54449, USA.
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Levine SM, Perez-Perez G, Olivares A, Yee H, Hanna BA, Blaser MJ. PCR-based detection of Bacillus anthracis in formalin-fixed tissue from a patient receiving ciprofloxacin. J Clin Microbiol 2002; 40:4360-2. [PMID: 12409432 PMCID: PMC139675 DOI: 10.1128/jcm.40.11.4360-4362.2002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We demonstrate that Bacillus anthracis may be detected from a formalin-fixed, paraffin-embedded biopsy specimen, even after the patient has received antibiotic treatment. Although traditional PCR methods may not be sufficiently sensitive for anthrax detection in such patients, cycle numbers can be increased or PCR can be repeated by using an aliquot from a previous PCR as the template.
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Affiliation(s)
- Steven M Levine
- Departments of Medicine. Microbiology. Pathology, New York University School of Medicine. Veterans Affairs Medical Center, New York, New York 10016, USA
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Groves FD, Perez-Perez G, Zhang L, You WC, Lipsitz SR, Gail MH, Fraumeni JF, Blaser MJ. Serum antibodies to Helicobacter pylori and the CagA antigen do not explain differences in the prevalence of precancerous gastric lesions in two Chinese populations with contrasting gastric cancer rates. Cancer Epidemiol Biomarkers Prev 2002; 11:1091-4. [PMID: 12376512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
Abstract
Incidence and mortality rates for gastric cancer in rural People's Republic of China differ greatly over short distances. In Shandong Province, we studied asymptomatic adult subjects from Bei Duan village (n = 196) in Linqu County (a high-risk area for gastric cancer) and from Shi Huang village (n = 192) in Cangshan County (a low-risk area for gastric cancer). The prevalence of advanced precancerous gastric lesions (APGL) was assessed by microscopic examination of endoscopic stomach biopsies. ELISAs were used to detect serum IgG to Helicobacter pylori whole-cell antigen and to the CagA protein. A logistic regression model was used to quantify the role of the two H. pylori seromarkers in explaining the differences in prevalence of APGL between the two villages after adjusting for age and sex. The prevalence of APGL was much greater in Bei Duan than in Shi Huang. Although H. pylori seroprevalence by the whole-cell ELISA was similar in the two populations, seroprevalence of CagA was significantly greater in Bei Duan. Although age, sex, and both H. pylori seromarkers were associated with APGL in the logistic regression model, the effect of village of residence remained strong after adjustment for all four covariates. Only a relatively small proportion of the difference in prevalence of APGL between these two rural Chinese populations can be explained by differences in H. pylori or CagA seroprevalence.
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Affiliation(s)
- Frank D Groves
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland 20892-7244, USA.
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Abstract
Background serological assays for Helicobacter pylori are commonly used without knowledge of reliability. This information is needed to define the ability of serological tests to determine either new cases of infection or loss of infection in longitudinal studies. We evaluated the reproducibility and the interrelationships of serological test results for H. pylori and cytotoxin-associated gene product A (CagA) enzyme-linked immunoassays within a subset of participants in a population-based study. Stored samples from 1,229 participants in the third U.S. National Health and Nutrition Examination Survey were replicate serologically tested for H. pylori and CagA. Overall disagreement was 3.4% between duplicate tests for H. pylori (or 2.3% if equivocal results were disregarded). Six percent of samples positive on the first test had an immune serum ratio at least 30% lower on repeat testing. The odds ratio for H. pylori seropositivity on retesting was 2.8 (95% confidence interval [CI] = 1.8 to 4.5) when CagA serology was positive versus when it was negative. CagA antibody was found among 47.8% of H. pylori-equivocal and 7.0% of H. pylori-negative samples. CagA-positive yet H. pylori-negative samples were more likely to occur among Mexican Americans (odds ratio, 5.2; 95% CI = 2.4 to 11.4) and non-Hispanic blacks (odds ratio, 5.5; 95% CI = 2.3 to 13.0) than among non-Hispanic whites. Relying on repeated H. pylori serological tests over time to determine infection rates may result in misinterpretation due to limits in test reproducibility. CagA testing may have a role in verifying infection.
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Affiliation(s)
- James E Everhart
- Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland 20892-5450, USA.
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Freedman A, Afonja O, Chang MW, Mostashari F, Blaser M, Perez-Perez G, Lazarus H, Schacht R, Guttenberg J, Traister M, Borkowsky W. Cutaneous anthrax associated with microangiopathic hemolytic anemia and coagulopathy in a 7-month-old infant. JAMA 2002; 287:869-74. [PMID: 11851579 DOI: 10.1001/jama.287.7.869] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
A 7-month-old infant with cutaneous anthrax developed severe systemic illness despite early treatment with antibiotics. The infant displayed severe microangiopathic hemolytic anemia with renal involvement, coagulopathy, and hyponatremia. These findings are unusual with cutaneous anthrax, but have been described in illness resulting from spider toxin and may delay correct diagnosis. The systemic manifestations of the disease persisted for nearly a month despite corticosteroid therapy, but resolved.
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Affiliation(s)
- Abigail Freedman
- Department of Pediatrics, New York University Medical Center, 550 First Ave, New York, NY 10016, USA
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Torres J, Camorlinga-Ponce M, Perez-Perez G, Muñoz L, Muñoz O. Specific serum immunoglobulin G response to urease and CagA antigens of Helicobacter pylori in infected children and adults in a country with high prevalence of infection. Clin Diagn Lab Immunol 2002; 9:97-100. [PMID: 11777836 PMCID: PMC119889 DOI: 10.1128/cdli.9.1.97-100.2002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Few studies have analyzed the immune response to Helicobacter pylori CagA and urease antigens across age groups in the same population. The aim of this study was to analyze the serologic immunoglobulin G (IgG) response to CagA and urease proteins in children and adults with gastrointestinal symptoms and belonging to the same population and similar socioeconomic levels. The serologic response was studied in 352 children and 293 adults with gastrointestinal symptoms. IgG antibodies against CagA and urease were tested by enzyme-linked immunosorbent assay methods using highly purified recombinant antigens. H. pylori infection was defined as a positive result in a serologic assay using whole-cell H. pylori extracts as the antigen. We found, in H. pylori-positive children, a seroprevalence of 46.9% to CagA and 16.2% to urease, whereas in H. pylori-positive adults, a seroprevalence of 78.9% to CagA and 59% to urease was found. In children, the magnitude of the response to CagA was significantly higher and the response to urease was significantly lower than those in adults. The kinetics of serologic response to CagA and to urease across age groups was contrastably different. Whereas CagA is a strong immunogen, urease is a poor immunogen during natural infection. These differences in the humoral response may be important for the short-term or long-term outcome of the infection. These results add to our knowledge of the epidemiology of H. pylori infection.
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Affiliation(s)
- Javier Torres
- Unidad de Investigacion en Enfermedades Infecciosas, Hospital de Pediatría, CMN SXXI, Instituto Mexicano del Seguro Social (IMSS), Av. Cuauhtemoc 330, Mexico D.F., 06720 Mexico City, Mexico.
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Stolzenberg-Solomon RZ, Blaser MJ, Limburg PJ, Perez-Perez G, Taylor PR, Virtamo J, Albanes D. Helicobacter pylori seropositivity as a risk factor for pancreatic cancer. J Natl Cancer Inst 2001; 93:937-41. [PMID: 11416115 DOI: 10.1093/jnci/93.12.937] [Citation(s) in RCA: 132] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Pancreatic cancer is among the most fatal cancers worldwide and one for which few preventable risk factors have been established. Gastric carriage of Helicobacter pylori, particularly cytotoxin-associated gene-A-positive (CagA+) strains, is known to be a risk factor for peptic ulcer disease and gastric cancer and may have a similar etiologic relationship with pancreatic cancer. METHODS We investigated the association of H. pylori carriage and exocrine pancreatic cancer in a nested case-control study within the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study cohort of 29 133 male Finnish smokers aged 50-69 years at baseline. Case subjects (n = 121) were matched on date of baseline serum collection, study center, age, trial intervention, and completion of the dietary questionnaire to 226 control subjects who were alive at the time the matching case subject was diagnosed and who remained free of cancer, during up to 10 years of follow-up. Levels of immunoglobulin G antibodies to H. pylori whole-cell and CagA+ antigens from stored baseline serum were measured by enzyme-linked immunosorbent assay. Smoking-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated by use of conditional logistic regression. Statistical tests were two-sided. RESULTS Seroprevalence of H. pylori was 82% and 73% among case and control subjects, respectively. Compared with seronegative subjects, those with H. pylori or CagA+ strains were at statistically significantly elevated risk of pancreatic cancer (OR = 1.87 [95% CI = 1.05 to 3.34]; OR = 2.01 [95% CI = 1.09 to 3.70], respectively). CONCLUSIONS Our findings support a possible role for H. pylori carriage in the development of exocrine pancreatic cancer.
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Affiliation(s)
- R Z Stolzenberg-Solomon
- Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics and Cancer Prevention Studies Branch, Division of Clinical Sciences, National Cancer Institute, Bethesda, MD 20892, USA.
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Figueiredo C, Quint W, Nouhan N, van den Munckhof H, Herbrink P, Scherpenisse J, de Boer W, Schneeberger P, Perez-Perez G, Blaser MJ, van Doorn LJ. Assessment of Helicobacter pylori vacA and cagA genotypes and host serological response. J Clin Microbiol 2001; 39:1339-44. [PMID: 11283053 PMCID: PMC87936 DOI: 10.1128/jcm.39.4.1339-1344.2001] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Helicobacter pylori strains can be distinguished by genotyping of virulence-associated genes, such as vacA and cagA. Because serological discrimination between strain types would reduce the need for endoscopy, 61 patients carrying H. pylori were studied by vacA and cagA genotyping of H. pylori in gastric biopsy specimens and by detection of specific serum antibodies. Serological responses to H. pylori were determined by Helicoblot (versions 2.0 and 2.1). Antibodies to CagA also were determined by a rapid anti-CagA assay (Pyloriset screen CagA) as well as by two noncommercially developed enzyme immunoassays, each using a recombinant CagA protein. Assessment of performance of the Helicoblot assays indicated substantial interobserver variation, with kappa values between 0.20 and 0.93. There was no relationship between the serological profiles on the Helicoblot and the genotypes from the same patients, except for strong associations between the presence of anti-CagA and the cagA-positive and vacA s1 H. pylori genotypes. Detection of anti-CagA by the five different assays varied considerably, with kappa values ranging from 0.21 to 0.78. Using the cagA genotype as the "gold standard," the sensitivity and specificity of the anti-CagA assays varied from 71.4 to 85.7% and from 54.2 to 100%, respectively. Thus, serological profiles of antibodies to H. pylori are heterogeneous and, with the exception of anti-CagA antibodies, show no relation to the H. pylori vacA and cagA genotypes. Detection of anti-CagA antibodies is strongly dependent on the test used.
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Affiliation(s)
- C Figueiredo
- Delft Diagnostic Laboratory, Delft, The Netherlands
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Limburg P, Qiao Y, Mark S, Wang G, Perez-Perez G, Blaser M, Wu Y, Zou X, Dong Z, Taylor P, Dawsey S. Helicobacter pylori seropositivity and subsite-specific gastric cancer risks in Linxian, China. J Natl Cancer Inst 2001; 93:226-33. [PMID: 11158192 DOI: 10.1093/jnci/93.3.226] [Citation(s) in RCA: 79] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Helicobacter pylori carriage (i.e., persistent exposure to the organism without gastric epithelial cell invasion) is an established risk factor for noncardia gastric cancer. However, its association with the risk of cancer of the gastric cardia is controversial. Consequently, we designed this prospective, nested case-control study to further explore the subsite-specific gastric cancer risks associated with H. pylori seropositivity (a surrogate marker for persistent exposure). METHODS A total of 99 patients with gastric cardia cancer, 82 patients with noncardia gastric cancer, and 192 cancer-free subjects were selected from among the participants (n = 29 584) of a nutrition intervention trial previously conducted in Linxian, China. H. pylori seropositivity was determined by assaying for the presence of H. pylori whole cell and CagA antibodies in baseline serum samples from all subjects. Seropositivity was defined as one or both serum assays being positive. Odds ratios (ORs) for subsite-specific gastric cancer were estimated by multivariate logistic regression analyses. All statistical comparisons were two-sided (alpha =.05). RESULTS H. pylori seropositivity rates for subjects with gastric cardia cancer, noncardia gastric cancer, and gastric cardia and noncardia cancers combined were 70% (P =.02), 72% (P: =.01), and 71% (P =.003) compared with 56% for cancer-free control subjects. OR estimates for H. pylori seropositivity were 1.87 (95% confidence interval [CI] = 1.10 to 3.17) for gastric cardia cancer, 2.29 (95% CI = 1.26 to 4.14) for noncardia gastric cancer, and 2.04 (95% CI = 1.31 to 3.18) for gastric cardia and noncardia cancers combined. CONCLUSIONS H. pylori seropositivity was associated with increased risks for both gastric cardia cancer and noncardia gastric cancer in this well-characterized cohort. Thus, H. pylori carriage may increase the risk of cancer throughout the stomach.
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Affiliation(s)
- P Limburg
- Cancer Prevention Studies Branch, Division of Clinical Sciences, National Cancer Institute, Bethesda, MD, USA.
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Abstract
BACKGROUND Between 1976 and 1987, 35 cases of acute gastritis with hypochlorhydria (AGH) were seen in our research laboratory. The aims of this study were to determine the natural history of AGH and the role of Helicobacter pylori in its pathogenesis. METHODS Archived serum and gastric biopsy samples obtained from AGH subjects were examined for evidence of H pylori colonisation. Twenty eight of 33 (85%) surviving AGH subjects returned a mean of 12 years after AGH for follow up studies, including determination of H pylori antibodies, basal and peak acid output, endoscopy, and gastric biopsies. A matched control group underwent the same studies. RESULTS Archived material provided strong evidence of new H pylori acquisition in a total of 14 subjects within two months, in 18 within four months, and in 22 within 12 months of recognition of AGH. Prevalence of H pylori colonisation at follow up was 82% (23 of 28) in AGH subjects, significantly (p<0.05) higher than in matched controls (29%). Basal and peak acid output returned to pre-AGH levels in all but two subjects. CONCLUSIONS One of several possible initial manifestations of H pylori acquisition in adults may be AGH. While H pylori colonisation usually persists, hypochlorhydria resolves in most subjects.
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Affiliation(s)
- W V Harford
- Department of Internal Medicine, University of Texas Southwestern Medical School, Dallas, Texas, USA,
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Riveron AM, Lopez-Canovas L, Baez-Camargo M, Flores E, Perez-Perez G, Luna-Arias JP, Orozco E. Circular and linear DNA molecules in the Entamoeba histolytica complex molecular karyotype. Eur Biophys J 2000; 29:48-56. [PMID: 10826778 DOI: 10.1007/s002490050250] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Entamoeba histolytica genome was analysed by pulsed field gel electrophoresis under conditions to separate linear chromosomes in the 170-1400 kb range. We identified linear DNA molecules of 227, 366, 631, 850, 1112 and 1361 kb (mean sizes obtained by three different methods) and we estimated their reorientation times and migration velocities at various experimental conditions. DNA shift mobility assays, using ethidium bromide, suggested that bands migrating at 227 and 631 kb contain linear and circular DNA, whereas a band at 436 kb has only circular DNA. We obtained a regression equation relating sizes of supercoiled DNA molecules with their migration velocities during a pulse at constant electric field and temperature. We also developed a computer program (EHPATTERNS) that predicts the migration per pulse and the resolution order of circular and linear E. histolytica DNA at different pulse times and constant driving and frictional forces. The simulation showed that linear DNA molecules frequently co-migrate with circular molecules, but circular molecules change when the pulse time varies. This molecular mixture generates broad bands and difficulties in the interpretation of the molecular karyotype of E. histolytica.
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Affiliation(s)
- A M Riveron
- Department of Molecular Biology, National Center for Scientific Research, Havana, Cuba
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Keenan J, Day T, Neal S, Cook B, Perez-Perez G, Allardyce R, Bagshaw P. A role for the bacterial outer membrane in the pathogenesis of Helicobacter pylori infection. FEMS Microbiol Lett 2000; 182:259-64. [PMID: 10620676 DOI: 10.1111/j.1574-6968.2000.tb08905.x] [Citation(s) in RCA: 122] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Helicobacter pylori infection in humans is associated with diverse of clinical outcomes which are partly attributed to bacterial strain differences. Secreted bacterial products are thought to be involved in the pathogenesis caused by this non-invasive bacterium. Electron microscopy of gastric biopsies from infected individuals revealed blebbing of the H. pylori outer membrane, similar to the process of outer membrane vesicle shedding which occurs when the bacterium is grown in broth. Porins, a class of proinflammatory proteins, were observed in the outer membrane vesicles. The VacA cytotoxin, which is produced by 50-60% of H. pylori strains and associated with increased pathogenesis of infection, was also found to be vesicle-associated and biologically active. This supports the hypothesis that these vesicles represent a vehicle for the delivery of damaging bacterial products to the gastric mucosa.
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Affiliation(s)
- J Keenan
- Department of Surgery, Christchurch School of Medicine, P.O. Box 4345, Christchurch, New Zealand.
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Leal-Herrera Y, Torres J, Perez-Perez G, Gomez A, Monath T, Tapia-Conyer R, Muñoz O. Serologic IgG response to urease in Helicobacter pylori-infected persons from Mexico. Am J Trop Med Hyg 1999; 60:587-92. [PMID: 10348233 DOI: 10.4269/ajtmh.1999.60.587] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Helicobacter pylori urease is required to counteract acidity during colonization of the stomach, and has been suggested as a major immunodominant antigen. The aim of this study was to determine the anti-urease response in a representative national serologic survey in Mexico. The population surveyed included persons 1-90 years of age from all socioeconomic levels and geographic zones of the country. Helicobacter pylori status was determined by ELISA serology. The IgG anti-urease was studied by ELISA using a recombinant apoenzyme. We found that 2,930 of the 7,720 infected patients (38%) were seropositive for IgG urease. The rate of IgG anti-urease positivity increased with age; in children < 10 years old it was < 20% and in persons > 40 years old it was > 50%. Age and a region with a high level of development were risk factors for seropositivity, whereas gender, educational level, crowding, and socioeconomic level were not associated with seropositivity. In conclusion, in natural infection with H. pylori, the response to urease is poor, mainly during the first years of infection. This inconsistent immune response to the enzyme may favor persistence of infection. A vaccine eliciting a consistent anti-urease response might overcome immune evasion and enhance clearance of bacteria after exposure.
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Affiliation(s)
- Y Leal-Herrera
- Unidad de Investigación Médica en Enfermedades Infecciosas, Coordinación de Investigación, Instituto Mexicano del Seguro Social, Mexico City
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Torres J, Leal-Herrera Y, Perez-Perez G, Gomez A, Camorlinga-Ponce M, Cedillo-Rivera R, Tapia-Conyer R, Muñoz O. A community-based seroepidemiologic study of Helicobacter pylori infection in Mexico. J Infect Dis 1998; 178:1089-94. [PMID: 9806039 DOI: 10.1086/515663] [Citation(s) in RCA: 133] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A nationwide community-based survey for Helicobacter pylori infection had not been done. This study sought to determine the seroprevalence of infection in Mexico, and the socioeconomic and demographic variables that are risk factors for infection. The survey assessed 11,605 sera from a sample population representing persons ages 1-90 years from all socioeconomic and demographic levels and from all regions of Mexico. Antibodies against H. pylori were studied by ELISA using whole cell antigen. Among the findings were that 66% of the population was infected and that age was the strongest risk factor for infection. By age 1 year, 20% were infected and by age 10 years, 50% were infected. Crowding (odds ratio [OR], 1.4), low educational level (OR, 2.42), and low socioeconomic level (OR, 1.43) were risk factors for infection. Prevalence was similar in urban and in rural communities (OR, 0.95). This study is the largest community-based seroepidemiologic study of H. pylori to date.
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Affiliation(s)
- J Torres
- Unidad de Investigación Médica en Enfermedades Infecciosas, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
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Camorlinga-Ponce M, Torres J, Perez-Perez G, Leal-Herrera Y, Gonzalez-Ortiz B, Madrazo de la Garza A, Gomez A, Muñoz O. Validation of a serologic test for the diagnosis of Helicobacter pylori infection and the immune response to urease and CagA in children. Am J Gastroenterol 1998; 93:1264-70. [PMID: 9707049 DOI: 10.1111/j.1572-0241.1998.00407.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Little is known about Helicobacter pylori infections and the immune response to urease and CagA in pediatric populations. Our aims were: 1) to validate serological assays for antibodies against whole cell extract, CagA, and urease of H. pylori; 2) to examine their role in diagnosis of infection in children with recurrent abdominal pain (RAP); and 3) to examine the antibody responses to CagA and urease in children. METHODS An enzyme-linked immunosorbent assay (ELISA) for diagnosis of H. pylori infection using whole cell extracts was validated in 50 children with biopsy-confirmed infection. The IgG and IgA antibody responses against recombinant CagA and urease were compared by ELISA in 82 children with RAP and in 246 age- and sex-matched healthy children. RESULTS The whole-cell extract ELISA had a sensitivity of 85 % and specificity of 87%. Children with RAP were more infected with H. pylori than were healthy control subjects; however, IgG and IgA CagA seropositivity was lower among those with RAP than among asymptomatic children (34% and 23% vs 76% and 55%, respectively; p < 0.0001). In both groups of children, the immune response to urease was low. CONCLUSION A serodiagnosis of H. pylori infection using native strains was developed. The difference in the immune response between children with RAP and control subjects suggests that RAP occurs during the acute phase of H. pylori infection. Our results also suggest that urease is a poor immunogen.
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Affiliation(s)
- M Camorlinga-Ponce
- Unidad de Investigación Médica en Enfermedades Infecciosas, Coordinación de Investigación, Instituto Mexicano del Seguro-Social, México, D.F
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Ellison RT, Perez-Perez G, Welsh CH, Blaser MJ, Riester KA, Cross AS, Donta ST, Peduzzi P. Risk factors for upper gastrointestinal bleeding in intensive care unit patients: role of helicobacter pylori. Federal Hyperimmune Immunoglobulin Therapy Study Group. Crit Care Med 1996; 24:1974-81. [PMID: 8968264 DOI: 10.1097/00003246-199612000-00008] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To determine the role of preexisting Helicobacter pylori infection in the development of acute upper gastrointestinal (GI) hemorrhage in intensive care unit (ICU) patients in relation to other potential predisposing risk factors. DESIGN Prospective, multicenter, cohort study. SETTING Medical and surgical ICUs in six tertiary care Department of Veterans Affairs Medical Centers. PATIENTS Eight-hundred seventy-four patients without previous GI bleeding or peptic ulcer disease who were enrolled in a multicenter, randomized, controlled trial of prophylactic intravenous immunoglobulin to prevent ICU-associated infections. INTERVENTIONS This substudy of the larger intravenous immunoglobulin study only involved data analysis and had no intervention. All patients were enrolled in the larger study where they received intravenous immunoglobulin or placebo as intervention. MEASUREMENTS AND MAIN RESULTS Patients were prospectively evaluated for the development of acute upper GI hemorrhage while in an ICU. Anti-H. pylori immunoglobulin G and immnoglobulin A concentrations were determined by enzyme immunoassay on preintervention serum samples. Seventy-six (9%) patients had over upper GI bleeding and a mortality rate of 49%, as compared with a 15% mortality rate in patients who did not bleed (p < .001). By logistic regression analysis, the following factors were associated with an increased risk of bleeding: acute hepatic failure, prolonged duration of nasogastric tube placement, alcoholism, and an increased serum concentration of anti-H. pylori immunoglobulin A. CONCLUSIONS Increased anti-H. pylori immunoglobulin A concentrations, prolonged nasogastric intubation, alcoholism, and acute hepatic failure were found to be independently correlated with the development of acute GI bleeding in an ICU setting. These observations should be prospectively confirmed in an independent population before being used for treatment guidelines.
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Affiliation(s)
- R T Ellison
- Department of Veterans Affairs Medical Center, Denver, CO, USA
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Shabib S, Laxer R, Silverman E, Perez-Perez G, Blaser M, Sherman P. Seroprevalence of Helicobacter pylori infection is not increased in pediatric inflammatory arthritides. J Rheumatol 1994; 21:1548-52. [PMID: 7983663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To determine the seroprevalence of H. pylori infection among children with inflammatory arthritides receiving antiinflammatory drug therapy. METHODS An enzyme linked immunosorbent assay (ELISA) was used to detect H. pylori specific immunoglobulin G antibody in 95 children with inflammatory arthritides, 53 children with chronic inflammatory bowel diseases and 47 parents of children with inflammatory arthritis. RESULTS The frequency of seropositivity in children with arthritis (9/95, 9.5%) was not significantly higher than in children with chronic inflammatory bowel diseases (1/53, 1.9%; p = 0.16). Serum samples from parents were positive in 16 of 47 (34%), including 4 parents with children who also demonstrated a positive immune response. CONCLUSION These data do not provide evidence for an increased frequency of H. pylori infection among children with inflammatory arthritides. The therapeutic use of ulcerogenic medications is likely to be an independent risk factor predisposing to dyspeptic symptoms and gastritis in this patient population.
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Affiliation(s)
- S Shabib
- Division of Gastroenterology, Hospital for Sick Children, Toronto, ON, Canada
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Strauss RM, Wang TC, Kelsey PB, Compton CC, Ferraro MJ, Perez-Perez G, Parsonnet J, Blaser MJ. Association of Helicobacter pylori infection with dyspeptic symptoms in patients undergoing gastroduodenoscopy. Am J Med 1990; 89:464-9. [PMID: 2220879 DOI: 10.1016/0002-9343(90)90377-p] [Citation(s) in RCA: 58] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
PURPOSE To determine the prevalence of Helicobacter pylori in patients with non-ulcer dyspepsia and ulcer disease as well as in a control population undergoing endoscopic retrograde cholangiopancreatography (ERCP) for suspected pancreatic or biliary disease. PATIENTS AND METHODS Forty-six eligible patients undergoing upper endoscopy at Massachusetts General Hospital were studied over a period of 18 months, as well as 24 patients undergoing ERCP for presumed pancreatic or biliary disease. Two biopsy specimens from the fundus and two from the antrum were taken for microbiologic and histopathologic analysis. Sera were examined by enzyme-linked immunoabsorbent assay. All specimens were processed in a blind fashion. Chi-square test with Yates' correction was used for statistical analysis. RESULTS H. pylori was found in 31 of 46 (67%) study patients and in six of 24 (25%) control patients (by microbiologic or histologic techniques) (p less than 0.01). H. pylori was found in all patients with peptic ulcer disease and in 60% of patients without ulcers. No association between H. pylori and any specific gastrointestinal symptom was observed. H. pylori was identified in the fundus as often as in the antrum, although in the antrum the organism was more often associated with histologic gastritis. Compared with histology, serologic assays for IgG and IgA antibodies to H. pylori had sensitivities of 100% and 94%, and specificities of 86% and 76%, respectively. Reexamination of selected specimens without knowledge of their identity revealed that the specificity of serology exceeded 94% while the sensitivity of histologic and microbiologic studies may have been closer to 80%. CONCLUSIONS H. pylori was more common in dyspeptic patients than in our control subjects undergoing ERCP. Multiple biopsy sites from fundus and antrum are required to exclude infection. Serologies of IgG and IgA were sensitive and specific for H. pylori, suggesting a possible role for non-endoscopic diagnosis of this infection. The frequent association of H. pylori with active inflammation rather than with quiescent gastritis is consistent with a pathologic role of this organism.
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Affiliation(s)
- R M Strauss
- Gastrointestinal Unit, Massachusetts General Hospital, Boston
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Finch MJ, Valdespino JL, Wells JG, Perez-Perez G, Arjona F, Sepulveda A, Bessudo D, Blake PA. Non-01 Vibrio cholerae infections in Cancun, Mexico. Am J Trop Med Hyg 1987; 36:393-7. [PMID: 3826498 DOI: 10.4269/ajtmh.1987.36.393] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
To determine the role of Vibrio cholerae as a cause of diarrheal illness in Cancun, Mexico, an investigation was conducted in July and August 1983. Although toxigenic V. cholerae 01 were not found, non-01 V. cholerae were isolated from 22 (16%) of 134 stools from persons with diarrheal illness and none of 22 stools from well persons; 58 (92%) of 63 sewage samples; 12 (86%) of 14 untreated well water samples; a home storage tank for treated water; and 5 (21%) of 24 samples of raw seafood. None of the V. cholerae isolates from patients were toxigenic. The illness occurred mainly in small children, and were characterized principally by diarrhea and abdominal pain. No patient was seriously ill, and all recovered without sequelae. Seven different serotypes of non-01 V. cholerae were isolated from the stool specimens, and Smith serotype 12 accounted for 10 (46%) of the 22 isolates. A matched-pair case-control study found that cases were more likely than controls to have eaten home prepared gelatin (P = 0.03, OR = 5/0) and seafood (P = 0.06, OR = 4/0).
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