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Zhang J, Hu Y, Wu L, Zeng Q, Hu B, Luo Z, Wang Y. Causal effect of gut microbiota on Gastroduodenal ulcer: a two-sample Mendelian randomization study. Front Cell Infect Microbiol 2023; 13:1322537. [PMID: 38156322 PMCID: PMC10753992 DOI: 10.3389/fcimb.2023.1322537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 11/20/2023] [Indexed: 12/30/2023] Open
Abstract
Background Gastroduodenal ulcers are associated with Helicobacter pylori infection and the use of nonsteroidal anti-inflammatory drugs (NSAIDs). However, the causal relationship between gastroduodenal ulcers and gut microbiota, especially specific gut microbiota, remains unclear. Methods We conducted an analysis of published data on the gut microbiota and Gastroduodenal ulcer using genome-wide association studies (GWAS). Two-sample Mendelian randomization (MR) analysis was performed to determine the causal relationship between gut microbiota and Gastroduodenal ulcer. Sensitivity, heterogeneity, and pleiotropy analyses were conducted to confirm the accuracy of the research findings. Results Our study showed that the abundance of Enterobacteriaceae, Butyricicoccus, Candidatus Soleaferrea, Lachnospiraceae NC2004 group, Peptococcus, and Enterobacteriales was negatively correlated with the risk of Gastroduodenal ulcer. Conversely, the abundance of Streptococcaceae, Lachnospiraceae UCG010, Marvinbryantia, Roseburia, Streptococcus, Mollicutes RF9, and NB1n was positively correlated with the risk of Gastroduodenal ulcer. MR analysis revealed causal relationships between 13 bacterial genera and Gastroduodenal ulcer. Conclusion This study represents a groundbreaking endeavor by furnishing preliminary evidence regarding the potentially advantageous or detrimental causal link between the gut microbiota and Gastroduodenal ulcer, employing Mendelian Randomization (MR) analysis for the first time. These discoveries have the potential to yield fresh perspectives on the prevention and therapeutic approaches concerning Gastroduodenal ulcer, with a specific focus on the modulation of the gut microbiota.
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Affiliation(s)
- Jing Zhang
- Department of Emergency, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Jiangxi Province, China
| | - Yingqiu Hu
- Department of Emergency, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Jiangxi Province, China
| | - Lidong Wu
- Department of Emergency, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Jiangxi Province, China
| | - Qi Zeng
- Queen Mary University of London, Nanchang University, Jiangxi Province, China
| | - Bin Hu
- Department of Emergency, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Jiangxi Province, China
| | - Zhiqiang Luo
- Department of Emergency, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Jiangxi Province, China
| | - Yibing Wang
- Department of Emergency, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Jiangxi Province, China
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Kondo M, Torisu T, Ihara Y, Kawasaki K, Umeno J, Kawatoko S, Tsuchimoto A, Nakano T, Okabe Y, Kitazono T. Clinical Features of Gastroduodenal Ulcers in Kidney Transplant Patients. Intern Med 2023; 62:3437-3443. [PMID: 37062748 PMCID: PMC10749817 DOI: 10.2169/internalmedicine.1508-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 02/26/2023] [Indexed: 04/18/2023] Open
Abstract
Objective The risk of developing peptic ulcers and gastrointestinal bleeding is high in patients with chronic kidney disease (CKD). Whether or not kidney transplant patients, who are treated with multiple medications, including immunosuppressive drugs, are at an increased risk of developing peptic ulcers is unclear. Methods In this retrospective study, we compared the clinical and endoscopic features of gastroduodenal ulcers between kidney transplant patients and CKD patients. The subjects underwent upper gastrointestinal endoscopy between January 2015 and March 2021. Results Gastroduodenal ulcers were observed more frequently (6.5%) in kidney transplant patients than in CKD patients (2.1%) (p=0.026). Due in part to the lower median age in the kidney transplant ulcer group than in the CKD ulcer group (59 vs. 70 years old, p=0.016), the rates of atrophic gastritis and Helicobacter pylori infection were also lower in the kidney transplant ulcer group than in the CKD ulcer group. Significantly more kidney transplant patients were treated with acid secretion inhibitors than CKD ulcer patients (100% vs. 34.8%, p=0.0005). Peptic ulcers were observed frequently in kidney transplant patients, even though common risk factors for gastroduodenal ulcers other than immunosuppressive drugs were few. All kidney transplant patients were taking immunosuppressive medications, and tacrolimus, mycophenolate mofetil, and methylprednisolone were taken more frequently than others. Conclusion Kidney transplant patients have a high risk of developing gastroduodenal ulcers. All kidney transplant patients take immunosuppressive medications, so there may be an association between immunosuppressive medications and gastroduodenal ulcer development.
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Affiliation(s)
- Masahiro Kondo
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Japan
| | - Takehiro Torisu
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Japan
| | - Yutaro Ihara
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Japan
| | - Keisuke Kawasaki
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Japan
| | - Junji Umeno
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Japan
| | - Shinichiro Kawatoko
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Japan
- Department of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences, Kyushu University, Japan
| | - Akihiro Tsuchimoto
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Japan
| | - Toshiaki Nakano
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Japan
| | - Yasuhiro Okabe
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Japan
| | - Takanari Kitazono
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Japan
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Yu Q, Funaki B, Navuluri R, Zangan S, Zhang A, Cao D, Leef J, Ahmed O. Empiric Transcatheter Embolization for Acute Arterial Upper Gastrointestinal Bleeding: A Meta-Analysis. AJR Am J Roentgenol 2021; 216:880-93. [PMID: 33566631 DOI: 10.2214/AJR.20.23151] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE. The purpose of this study was to conduct a meta-analysis to assess the safety and efficacy of empiric embolization compared with targeted embolization in the treatment of acute upper gastrointestinal bleeding (UGIB). MATERIALS AND METHODS. We searched the PubMed and Cochrane Library databases for studies performed without language restrictions from January 2000 to November 2019. Only clinical studies with a sample size of five or more were included. Clinical success, rebleeding and complication rates, survival rates, bleeding cause, embolic materials, and vessels embolized were recorded. Empiric embolization and targeted embolization (i.e., embolization performed based on angiographic evidence of ongoing bleeding) were compared when possible. Meta-analysis was performed. RESULTS. Among 13 included studies (12 retrospective and 1 prospective), a total of 357 of 725 patients (49.2%) underwent empiric embolization for UGIB. The clinical success rate of empiric embolization was 74.7% (95% CI, 63.1-86.3%) among the 13 studies, and the survival rate was 80.9% (95% CI, 73.8-88.0%) for 10 studies. On the basis of comparative studies, no statistically significant difference was observed between empiric and targeted embolization in terms of rebleeding rate in 111 studies (36.5% vs 29.6%; odds ratio [OR], 1.13; 95% CI, 0.77-1.65; p = .53), mortality in eight studies (23.3% vs 18.0%; OR, 1.44; 95% CI, 0.89-2.33; p = .14), and need for surgery to control rebleeding in four studies (17.8% vs 13.4%; OR, 1.34; 95% CI, 0.58-3.07; p = .49). The pooled embolization-specific complications were 1.9% (empiric) and 2.4% (targeted). CONCLUSION. According to all available published evidence, empiric embolization assessed with endoscopic or preprocedural imaging findings (or both) appears to be as effective as targeted embolization in preventing rebleeding and mortality in patients with angiographically negative acute UGIB. Because of its favorable safety profile, empiric embolization should be considered for patients in this clinical scenario.
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Chen F, Jiang H, Xu J, Wang S, Meng D, Geng P, Dai D, Zhou Q, Zhou Y. In Vitro and In Vivo Rat Model Assessments of the Effects of Vonoprazan on the Pharmacokinetics of Venlafaxine. Drug Des Devel Ther 2020; 14:4815-4824. [PMID: 33204067 PMCID: PMC7667002 DOI: 10.2147/dddt.s276704] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 10/14/2020] [Indexed: 12/23/2022]
Abstract
Purpose The purpose of the present study was to investigate the effects of vonoprazan on the pharmacokinetics of venlafaxine in vitro and in vivo. Methods The mechanism underlying the inhibitory effect of vonoprazan on venlafaxine was investigated using rat liver microsomes. In vitro, the inhibition was evaluated by determining the production of O-desmethylvenlafaxine. Eighteen male Sprague–Dawley rats were randomly divided into three groups: control group, vonoprazan (5 mg/kg) group, and vonoprazan (20 mg/kg) group. A single dose of 20 mg/kg venlafaxine was administrated to rats orally without or with vonoprazan. Plasma was prepared from blood samples collected via the tail vein at different time points and concentrations of venlafaxine and its metabolite, O-desmethylvenlafaxine, were determined by ultra-performance liquid chromatography-tandem mass spectrometry. Results We observed that vonoprazan could significantly decrease the amount of O-desmethylvenlafaxine (IC50 = 5.544 μM). Vonoprazan inhibited the metabolism of venlafaxine by a mixed inhibition, combining competitive and non-competitive inhibitory mechanisms. Compared with that in the control group (without vonoprazan), the pharmacokinetic parameters of venlafaxine and its metabolite, O-desmethylvenlafaxine, were significantly increased in both 5 and 20 mg/kg vonoprazan groups, with an increase in MRO-desmethylvenlafaxine. Conclusion Vonoprazan significantly alters the pharmacokinetics of venlafaxine in vitro and in vivo. Further investigations should be conducted to check these effects in humans. Therapeutic drug monitoring of venlafaxine in individuals undergoing venlafaxine maintenance therapy is recommended when vonoprazan is used concomitantly.
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Affiliation(s)
- Feifei Chen
- The Laboratory of Clinical Pharmacy, The Sixth Affiliated Hospital of Wenzhou Medical University, The People's Hospital of Lishui, Lishui, Zhejiang 323000, People's Republic of China
| | - Hui Jiang
- The Laboratory of Clinical Pharmacy, The Sixth Affiliated Hospital of Wenzhou Medical University, The People's Hospital of Lishui, Lishui, Zhejiang 323000, People's Republic of China
| | - Jia Xu
- The Laboratory of Clinical Pharmacy, The Sixth Affiliated Hospital of Wenzhou Medical University, The People's Hospital of Lishui, Lishui, Zhejiang 323000, People's Republic of China
| | - Shuanghu Wang
- The Laboratory of Clinical Pharmacy, The Sixth Affiliated Hospital of Wenzhou Medical University, The People's Hospital of Lishui, Lishui, Zhejiang 323000, People's Republic of China
| | - Deru Meng
- The Laboratory of Clinical Pharmacy, The Sixth Affiliated Hospital of Wenzhou Medical University, The People's Hospital of Lishui, Lishui, Zhejiang 323000, People's Republic of China
| | - Peiwu Geng
- The Laboratory of Clinical Pharmacy, The Sixth Affiliated Hospital of Wenzhou Medical University, The People's Hospital of Lishui, Lishui, Zhejiang 323000, People's Republic of China
| | - Dapeng Dai
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Beijing Hospital, National Center of Gerontology, National Health Commission, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, People's Republic of China
| | - Quan Zhou
- The Laboratory of Clinical Pharmacy, The Sixth Affiliated Hospital of Wenzhou Medical University, The People's Hospital of Lishui, Lishui, Zhejiang 323000, People's Republic of China
| | - Yunfang Zhou
- The Laboratory of Clinical Pharmacy, The Sixth Affiliated Hospital of Wenzhou Medical University, The People's Hospital of Lishui, Lishui, Zhejiang 323000, People's Republic of China
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Iwamoto J, Murakami M, Monma T, Ueda H, Tamamushi M, Konishi N, Yara SI, Hirayama T, Ikegami T, Honda A, Mizokami Y. Current states of prevention of drug-induced gastroduodenal ulcer in real clinical practice: a cross-sectional study. J Clin Biochem Nutr 2020; 66:158-162. [PMID: 32231413 DOI: 10.3164/jcbn.19-66] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 07/26/2019] [Accepted: 12/04/2019] [Indexed: 02/06/2023] Open
Abstract
Non-steroidal anti-inflammatory drugs (NSAIDs) or low-dose aspirin (LDA) are the most common causes of drug-induced gastroduodenal ulcer and We investigated preventive treatment with use of concomitant anti-ulcer drugs and the clinical features of gastroduodenal ulcer in cases treated with these drugs. Patients with gastroduodenal ulcer and patients with bleeding were classified into 3 groups: LDA, non-aspirin NSAIDs, and those taking neither aspirin nor NSAIDs. Chronological changes over the past 16 years (1st-5th period) were investigated. The status of prevention of ulcer and clinical features were examined. From January 2002 to December 2018, the ratio of all patients taking NSAIDs and LDA increased significantly until 3rd period (p<0.05), but then started to decrease in 4th period; and the percentage of all patients taking NSAIDs and LDA decreased significantly (p<0.05) until 5th period. Among the 292 patients with gastroduodenal ulcer and the 121 patients with a bleeding ulcer taking NSAIDs and LDA, 16 (5.5%) and 9 (7.4%), respectively, were receiving preventive treatment with concomitant anti-ulcer drugs. The percentages of patients taking LDA and other antiplatelet drugs in patients with bleeding gastroduodenal ulcer were significantly higher than those in patients with non-bleeding. In conclusion, although the percentages of patients with gastroduodenal ulcer taking NSAIDs or LDA have not recently increased in real-world practice, preventive treatment in these patients is still low. This low rate of prevention suggests the need to enlighten physicians about preventive treatment because drug withdrawal of LDA has a high risk of cardiovasculr and cerebrovascular events.
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Affiliation(s)
- Junichi Iwamoto
- Department of Gastroenterology, Tokyo Medical University Ibaraki Medical Center, Chuo 3-20-1, Ami, Inashiki, Ibaraki 300-0395, Japan
| | - Masashi Murakami
- Department of Gastroenterology, Tokyo Medical University Ibaraki Medical Center, Chuo 3-20-1, Ami, Inashiki, Ibaraki 300-0395, Japan
| | - Tadakuni Monma
- Department of Gastroenterology, Tokyo Medical University Ibaraki Medical Center, Chuo 3-20-1, Ami, Inashiki, Ibaraki 300-0395, Japan
| | - Hajime Ueda
- Department of Gastroenterology, Tokyo Medical University Ibaraki Medical Center, Chuo 3-20-1, Ami, Inashiki, Ibaraki 300-0395, Japan
| | - Makoto Tamamushi
- Department of Gastroenterology, Tokyo Medical University Ibaraki Medical Center, Chuo 3-20-1, Ami, Inashiki, Ibaraki 300-0395, Japan
| | - Naoki Konishi
- Department of Gastroenterology, Tokyo Medical University Ibaraki Medical Center, Chuo 3-20-1, Ami, Inashiki, Ibaraki 300-0395, Japan
| | - Sho-Ichiro Yara
- Department of Gastroenterology, Tokyo Medical University Ibaraki Medical Center, Chuo 3-20-1, Ami, Inashiki, Ibaraki 300-0395, Japan
| | - Takeshi Hirayama
- Department of Gastroenterology, Tokyo Medical University Ibaraki Medical Center, Chuo 3-20-1, Ami, Inashiki, Ibaraki 300-0395, Japan
| | - Tadashi Ikegami
- Department of Gastroenterology, Tokyo Medical University Ibaraki Medical Center, Chuo 3-20-1, Ami, Inashiki, Ibaraki 300-0395, Japan
| | - Akira Honda
- Department of Gastroenterology, Tokyo Medical University Ibaraki Medical Center, Chuo 3-20-1, Ami, Inashiki, Ibaraki 300-0395, Japan.,Joint Research Center, Tokyo Medical University Ibaraki Medical Center, Chuo 3-20-1, Ami, Inashiki, Ibaraki 300-0395, Japan
| | - Yuji Mizokami
- Department of Gastroenterology, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki 305-8577, Japan
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Chitapanarux T, Lertprasertsuke N, Kongnak A. Teprenone for the prevention of low-dose aspirin-induced gastric mucosal injury in Helicobacter pylori-negative patients. Scand J Gastroenterol 2019; 54:1199-1204. [PMID: 31591940 DOI: 10.1080/00365521.2019.1672781] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 02/04/2023]
Abstract
Objectives: Low-dose aspirin is the standard treatment for the prevention of cardiovascular events in at-risk patients. We performed a randomized, placebo-controlled study to determine the efficacy of teprenone for primary prevention of gastrointestinal injury in patients taking LDA for vascular protection.Methods: Patients were eligible for enrollment if they required aspirin 100 mg/day. Aspirin- naïve patients without gastroduodenal ulcer and Helicobacter pylori infection were randomized to receive teprenone 150 mg/day or placebo for 12 weeks. Primary outcome was assessed by the incidence rate of gastroduodenal ulcer. Secondary outcomes were assessed by the incidence rate of gastric mucosal injury, the improvement in modified Lanza score (MLS), gastrointestinal symptom rating scale (GSRS) and the change of gastric immunohistochemical expression for COX-1.Results: Total of 130 patients were randomized, 64 in teprenone group and 66 in placebo group. There was no incidence of ulcer after 12 weeks in both groups. Incidence of gastric mucosal injury was higher in placebo group than in teprenone group (40.0 vs. 13.38%, p = .039). Mean change of MLS was higher in placebo group than in teprenone group (0.767 ± 0.467 vs. 0.271 ± 0.158, p = .003). Scores of mucosal edema, hyperemia and hemorrhage and the change of GSRS were not different between the two groups. Change of COX-1 immunoreactive score was higher in placebo group than in teprenone group (2.433 ± 1.476 vs. 1.233 ± 0.955, p = .001). There were no treatment-related adverse events.Conclusions: Teprenone is effective in preventing gastric mucosal injury in patients taking LDA. Preventive effects of teprenone on LDA-related gastroduodenal ulcers require further investigation.
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Affiliation(s)
- Taned Chitapanarux
- Gastrohepatology Unit, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.,Northern Thai Research Group of Radiation Oncology (NTRG-RO), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nirush Lertprasertsuke
- Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Acharaporn Kongnak
- Gastrohepatology Unit, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Fomina LA. Comorbid for gastroduodenal ulcers in the aspect of calcium imbalance and blockers of slow calcium channels in their treatment. TERAPEVT ARKH 2018; 90:28-34. [PMID: 30701769 DOI: 10.26442/terarkh201890228-34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
AIM Find out the calcium content of the blood reflecting its balance and functional status the calcium regulatory system when it is comorbid for gastroduodenal ulcers (GDU), developed on the background of chronic erosive gastritis (CEG), chronic erosive duodenitis (CED), arterial hypertension (AH) and osteo-articular pathology with the use of nonsteroidal anti-inflammatory drugs (NSAIDs), and the impact of his changes on the activity ulzerogennogo process, the state of regional microcirculation and the functions of the stomach. To determine the pathogenetic justification for and effectiveness of blockers of slow calcium channels (BSCaC) in complex treatment. MATERIALS AND METHODS Examined 132 patients with GDU. All patients were divided into groups: the 1st (n=49) - patients with recurrent of peptic ulcer disease (PUD) and CEG/CED; the 2nd (n=23) - with recurrence of PUD and AH, the 3rd (n=14) - with GDU and osteoarticular pathology, taking NSAIDs. Patients of these three groups for the treatment of erosive ulcerous lesions of gastroduodenal zone (GDZ) has been appointed complex therapy with inclusion of nifedipine. The 4th (control) group consisted of 56 patients with recurrent BU without concomi- tant pathology, applying integrated therapy with nifedipine. RESULTS The PU relapse, comorbid her over with erosive gastroduodenitis, hypertension, GDU with of osteoarticular pathology and taking NSAIDs is accompanied by a calcium imbalance with increased levels of calcium in the blood, contributing to increase of acid-peptic factor in the formation of hypermotor dyskinesia stomach, disruption of regional microcirculation and repair processes, activa- tion of ulcerogenesis in GDZ. Inclusion in the complex therapy of GDU of nifedipine leads to the recovery of calcium balance, functions of the stomach and regional mi- crocirculation, accelerates the timing and increases the percentage of scarring ulcers. CONCLUSION GDU accompanied by dysfunction the calcium regulatory system with increasing levels of blood calcium, contributing to the for- mation of the major pathogenetic mechanisms of ulcerogenesis. BSCaC application in complex therapy of GDU is pathogenetically justified and clinically effective, reduces the excessive drug treatment in the treatment.
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Affiliation(s)
- L A Fomina
- Tver State Medical University, Ministry of Health of Russia, Tver, Russia
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Alkebsi L, Ideno Y, Lee JS, Suzuki S, Nakajima-Shimada J, Ohnishi H, Sato Y, Hayashi K. Gastroduodenal Ulcers and ABO Blood Group: the Japan Nurses' Health Study (JNHS). J Epidemiol 2017; 28:34-40. [PMID: 29093357 PMCID: PMC5742377 DOI: 10.2188/jea.je20160204] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Background Although several studies have shown that blood type O is associated with increased risk of peptic ulcer, few studies have investigated these associations in Japan. We sought to investigate the association between the ABO blood group and risk of gastroduodenal ulcers (GDU) using combined analysis of both retrospective and prospective data from a large cohort study of Japanese women, the Japan Nurses’ Health Study (JNHS; n = 15,019). Methods The impact of the ABO blood group on GDU risk was examined using Cox regression analysis to estimate hazard ratios (HRs) and 95% confidence intervals (CI), with adjustment for potential confounders. Results Compared with women with non-O blood types (A, B, and AB), women with blood type O had a significantly increased risk of GDU from birth (multivariable-adjusted HR 1.18; 95% CI, 1.04–1.34). Moreover, the highest cumulative incidence of GDU was observed in women born pre-1956 with blood type O. In a subgroup analysis stratified by birth year (pre-1956 or post-1955), the multivariable-adjusted HR of women with blood type O was 1.22 (95% CI, 1.00–1.49) and 1.15 (95% CI, 0.98–1.35) in the pre-1956 and post-1955 groups, respectively. Conclusion In this large, combined, ambispective cohort study of Japanese women, older women with blood type O had a higher risk of developing GDU than those with other blood types.
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Affiliation(s)
- Lobna Alkebsi
- Department of Laboratory Sciences, Graduate School of Health Sciences, Gunma University
| | - Yuki Ideno
- Big Data Centre for Integrative Analysis, Gunma University Initiative for Advanced Research
| | - Jung-Su Lee
- Department of Health Promotion Science, Graduate School of Medicine, The University of Tokyo
| | - Shosuke Suzuki
- Professor Emeritus, Gunma University and NPO International Eco-Health Research Group
| | - Junko Nakajima-Shimada
- Department of Molecular and Cellular Parasitology, Graduate School of Health Sciences, Gunma University
| | - Hiroshi Ohnishi
- Department of Laboratory Sciences, Graduate School of Health Sciences, Gunma University
| | - Yasunori Sato
- Department of Global Clinical Research, Graduate School of Medicine, Chiba University
| | - Kunihiko Hayashi
- Department of Basic Medical Sciences, Graduate School of Health Sciences, Gunma University
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Tsongo L, Nakavuma J, Mugasa C, Kamalha E. Helicobacter pylori among patients with symptoms of gastroduodenal ulcer disease in rural Uganda. Infect Ecol Epidemiol 2015; 5:26785. [PMID: 26560860 PMCID: PMC4641891 DOI: 10.3402/iee.v5.26785] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 09/30/2015] [Accepted: 10/08/2015] [Indexed: 12/18/2022] Open
Abstract
Introduction To meet key millennium development goals, the rural population needs to be reached for health assessment and service delivery. Gastroduodenal ulcer disease is a common ailment affecting the health of people in Uganda. A cross-sectional study was conducted at Bwera Hospital in Kasese district of western Uganda, to establish the prevalence and predisposing factors of Helicobacter pylori among gastroduodenal ulcer disease patients. Methods A sample of 174 patients with symptoms of gastroduodenal ulcer disease was purposively obtained. Using two laboratory test methods, the prevalence of H. pylori among these patients was determined. A structured questionnaire was administered to participants to establish their demographic background and selected aspects of their lifestyle. Finally, the results obtained by enzyme-linked immunosorbent assay (ELISA) and immunochromatographic rapid test (IRT) were compared. Results We established the prevalence of H. pylori as 29.9% (52/174) by ELISA and 37.4% (65/174) by IRT. Cigarette smoking, poor sanitation, and lack of formal education were the significant predisposing factors with p-values <0.05. The two tests gave identical results in 87.9% of the patients. Discussion The prevalence of H. pylori by IRT and ELISA test methods was similar to what has been reported elsewhere in developed countries; but was lower than previously reported in developing countries including Uganda. The previous studies in Uganda were carried out in the urban population and on young children; and some used antibody-detection methods only, therefore leading to different prevalence as a result of difference in study population and methods.
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Affiliation(s)
- Lawrence Tsongo
- College of Veterinary Medicine, School of Biosafety, Biosecurity and Biomedical Laboratory Sciences, Makerere University, Kampala, Uganda.,School of Allied Health Sciences, International Health Sciences University, Kampala, Uganda.,Department of Health Sciences (Biomedical Sciences), Kisubi Brothers University College, Entebbe, Uganda;
| | - Jessica Nakavuma
- College of Veterinary Medicine, School of Biosafety, Biosecurity and Biomedical Laboratory Sciences, Makerere University, Kampala, Uganda
| | - Claire Mugasa
- College of Veterinary Medicine, School of Biosafety, Biosecurity and Biomedical Laboratory Sciences, Makerere University, Kampala, Uganda
| | - Edwin Kamalha
- Faculty of Engineering, Busitema University, Tororo, Uganda.,The GEMTEX Laboratory, Lille 1 University of Science and Technology-ENSAIT, Lille North, France
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Ito Y, Sasaki M, Noguchi S, Yamaguchi S, Okaniwa N, Tanabe A, Noda H, Yanamoto K, Tamura Y, Kondo Y, Masui R, Izawa S, Iida A, Mizuno M, Ogasawara N, Funaki Y, Kasugai K. Effect of aspirin cessation before endoscopy in Japanese patients with low-dose-aspirin-associated gastroduodenal mucosal injury. United European Gastroenterol J 2014; 1:259-64. [PMID: 24917970 DOI: 10.1177/2050640613491254] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [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: 02/28/2013] [Accepted: 04/28/2013] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The incidence of upper gastrointestinal injury by low-dose aspirin (LDA) has increased. OBJECTIVE We aimed to clarify the risk factors and prevention strategies associated with LDA-induced gastroduodenal ulcer in Japanese patients. METHODS A retrospective study involving 284 LDA users who underwent oesophagogastroduodenoscopy between January and December 2010 were included. We investigated the patients' clinical characteristics and endoscopic findings. RESULTS Of 284 patients, 29 (10.2%) had gastro and/or duodenal ulcers. Male gender, peptic ulcer history, abdominal symptoms, half-dose proton pump inhibitors (PPIs), complete-dose PPIs, and nonsteroidal anti-inflammatory drugs were significantly associated with LDA-induced gastro and/or duodenal ulcers: odds ratio (95% confidence interval) 3.62 (1.06-12.27), 6.60 (1.84-23.62), 3.06 (1.12-8.40), 0.16 (0.03-0.94), 0.07 (0.01-0.61), and 9.68 (1.64-57.18), respectively. PPI significantly reduced gastric ulcers and/or duodenal ulcers (p = 0.03). The modified Lanza score for gastric mucosal lesion in the LDA cessation group was significantly lower than in the LDA noncessation group (0.53 vs. 1.02; p = 0.008). CONCLUSIONS Half-dose PPIs as well as complete-dose PPIs were effective for preventing LDA-induced gastric and/or duodenal ulcers. The cessation of LDA before endoscopy may lead to an underestimation of LDA-induced gastric injury.
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Affiliation(s)
- Yoshitsugu Ito
- Aichi Medical University School of Medicine, Nagakute, Japan
| | - Makoto Sasaki
- Aichi Medical University School of Medicine, Nagakute, Japan
| | - Seiji Noguchi
- Aichi Medical University School of Medicine, Nagakute, Japan
| | | | - Noriko Okaniwa
- Aichi Medical University School of Medicine, Nagakute, Japan
| | - Atsushi Tanabe
- Aichi Medical University School of Medicine, Nagakute, Japan
| | - Hisatsugu Noda
- Aichi Medical University School of Medicine, Nagakute, Japan
| | | | - Yasuhiro Tamura
- Aichi Medical University School of Medicine, Nagakute, Japan
| | - Yoshihiro Kondo
- Aichi Medical University School of Medicine, Nagakute, Japan
| | - Ryuta Masui
- Aichi Medical University School of Medicine, Nagakute, Japan
| | - Shinya Izawa
- Aichi Medical University School of Medicine, Nagakute, Japan
| | - Akihito Iida
- Aichi Medical University School of Medicine, Nagakute, Japan
| | - Mari Mizuno
- Aichi Medical University School of Medicine, Nagakute, Japan
| | | | - Yasushi Funaki
- Aichi Medical University School of Medicine, Nagakute, Japan
| | - Kunio Kasugai
- Aichi Medical University School of Medicine, Nagakute, Japan
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11
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Bontems P, Aksoy E, Burette A, Segers V, Deprez C, Mascart F, Cadranel S. NF-κB activation and severity of gastritis in Helicobacter pylori-infected children and adults. Helicobacter 2014; 19:157-67. [PMID: 24661597 DOI: 10.1111/hel.12118] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [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: 12/15/2022]
Abstract
BACKGROUND In contrast to adults, Helicobacter pylori gastritis in children is reported as milder and ulcer disease as uncommon, but unequivocal data are lacking. OBJECTIVES To compare the frequency of gastro-duodenal ulcers in children and adults as well as the proportion of Helicobacter pylori infection in these patients and to study the effect of chronological age on NF-κB activation and on severity of gastritis. DESIGN Patients referred in one pediatric and one adult facility for upper GI endoscopy were included. Gastric biopsies were obtained in consecutive Helicobacter pylori-infected patients and age-matched negative controls for immunohistochemistry and electrophoresis mobility shift assay. Three age groups were defined: younger than 8 years, 8-17 years, and adults. RESULTS Peptic ulcer disease was less frequent in children and less frequently associated with Helicobacter pylori infection. When comparing infected subjects to controls, densities of neutrophils and CD20 cells in the lamina propria increased in all age groups, CD3 cells increasing only in patients older than 8 years and CD8 cells only in adults. NF-κB-p65-positive cells were also increased only in infected adults as well as NF-κB-binding activity. A positive correlation was found between age and densities of neutrophils and CD3, but not of CD8 or CD20 cells. CONCLUSION Peptic ulcer disease was less frequent in children and less frequently caused by Helicobacter pylori infection. The different clinical outcome of the infection in children can be the consequence of the lower mucosal immune response.
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Affiliation(s)
- Patrick Bontems
- Paediatric Gastroenterology-Hepatology, Queen Fabiola Children's University Hospital, Université Libre de Bruxelles, Av JJ Crocq 15, 1020, Brussels, Belgium; Laboratory of Vaccinology and Mucosal Immunity, Université Libre de Bruxelles, Route de Lennik 808, 1070, Brussels, Belgium
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12
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Uemura N, Sugano K, Hiraishi H, Shimada K, Goto S, Uchiyama S, Okada Y, Origasa H, Ikeda Y; MAGIC Study Group. Risk factor profiles, drug usage, and prevalence of aspirin-associated gastroduodenal injuries among high-risk cardiovascular Japanese patients: the results from the MAGIC study. J Gastroenterol 2014; 49:814-24. [PMID: 23754512 DOI: 10.1007/s00535-013-0839-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Accepted: 05/16/2013] [Indexed: 02/04/2023]
Abstract
BACKGROUND Low-dose aspirin is widely used for the prevention of cardiovascular events. The prevalence of gastroduodenal injuries and the risk factor profile including gastroprotective drug therapy needs to be clarified in Japanese patients taking daily aspirin for cardioprotection. METHODS This Management of Aspirin-induced Gastro-Intestinal Complications (MAGIC) study was conducted with a prospective nationwide, multicenter, real-world registry of Japanese patients at high-risk of cardiovascular diseases who were taking regular aspirin (75-325 mg) for 1 month or more. All patients underwent endoscopic examination for detection of gastroduodenal ulcer and mucosal erosion. The risk factor profiles including the concurrent drug therapy were compared for those patients with gastroduodenal problems and those without. RESULTS Gastroduodenal ulcer and erosion were detected in 6.5, and 29.2% of the 1,454 patients receiving aspirin, respectively. H. pylori infection was associated with an increased risk for ulcer: OR 1.83 (1.18-2.88 p = 0.0082). Risk of erosion was lower with enteric-coated aspirin than with buffered aspirin: odds ratio (OR) 0.47 (0.32-0.70, p = 0.0002). Patients receiving proton pump inhibitors had lower risks for both gastroduodenal ulcer and erosion: OR 0.34 (0.15-0.68, p = 0.0050) and 0.32 (0.22-0.46, p < 0.0001), respectively. However, those receiving histamine 2-receptor antagonists had reduced risks for erosion but not for ulcer: OR 0.49 (0.36-0.68, p < 0.0001). CONCLUSION Gastroduodenal ulcer and erosion are common in Japanese patients taking low dose aspirin for cardioprotection. Proton pump inhibitors reduce the risk of gastroduodenal mucosal injury.
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13
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Mine T, Murata S, Nakazawa K, Onozawa S, Ueda T, Miyauchi M, Morita S, Kumita S. Glue embolization for gastroduodenal ulcer bleeding: contribution to hemodynamics and healing process. Acta Radiol 2013; 54:934-8. [PMID: 23612428 DOI: 10.1177/0284185113484644] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Although the morbidity of bowel ischemic events after glue embolization has been suggested, a causal relationship between glue and ischemia has not been clearly established. PURPOSE To evaluate the efficiency and safety of transcatheter arterial embolization with n-butyl cyanoacrylate (NBCA-TAE) for upper gastrointestinal hemorrhage (GIH). MATERIAL AND METHODS Between October 2006 and October 2012, 21 patients with upper GIH underwent NBCA-TAE, and endoscopic data were obtained within 30 days of follow-up. Shock index prior to and immediately after NBCA-TAE were compared to determine changes in hemodynamics. Days to Forrest type III, as assessed by follow-up endoscopy, was used as an indicator of the healing process. Other clinical outcomes included days for starting ingestion and for hospital discharge. RESULTS Sixteen gastric and five duodenal ulcers, classified into Forrest type I, were treated. Immediate hemostasis was achieved in all the patients, and no re-bleeding occurred within the follow-up period. Shock index significantly (P < 0.001) improved from before (0.99 ± 0.076) to immediately after NBCA-TAE (0.67 ± 0.038). Sequential mucosal healing processes were observed in all the patients, and the number of days to Forrest type III was 9.6 ± 7.1. The number of days for starting ingestion and hospital discharge was 9.0 ± 4.5 and 15 ± 7.7 days, respectively. CONCLUSION NBCA-TAE is an effective and safe method for the control of nonvariceal upper GIH, in terms of contribution to hemodynamics and healing process of the gastroduodenal mucosa.
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Affiliation(s)
- Takahiko Mine
- Department of Radiology/Center for Advanced Medical Technology, Nippon Medical School, Tokyo
| | - S Murata
- Department of Radiology/Center for Advanced Medical Technology, Nippon Medical School, Tokyo
| | - K Nakazawa
- Department of Radiology/Center for Advanced Medical Technology, Nippon Medical School, Tokyo
| | - S Onozawa
- Department of Radiology/Center for Advanced Medical Technology, Nippon Medical School, Tokyo
| | - T Ueda
- Department of Radiology/Center for Advanced Medical Technology, Nippon Medical School, Tokyo
| | - M Miyauchi
- Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo
| | - S Morita
- Department of Gastrointestinal Internal Medicine, Fujisawa City Hospital, Kanagawa, Japan
| | - S Kumita
- Department of Radiology/Center for Advanced Medical Technology, Nippon Medical School, Tokyo
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14
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El Mekkaoui A, Saâda K, Mellouki I, El Yousfi M, Aqodad N, El Abkari M, Ibrahimi A, Benajah DA. [Epidemiological differences in upper gastrointestinal bleeding between men and women]. Pan Afr Med J 2012; 12:94. [PMID: 23077715 PMCID: PMC3473980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Accepted: 07/26/2012] [Indexed: 12/03/2022] Open
Abstract
Introduction Des différences épidémiologiques, étiologique voire pronostique des hémorragies digestives hautes (HDH) entre les deux sexes opposés ont été cité par différentes études. Méthodes Nous avons essayé de déceler ces différences à travers une analyse rétrospective nichée sur une étude prospective sur les hémorragies digestives hautes ayant inclus 945 patients. Résultats Six cents trente-sept patients étaient des hommes (67,4% Vs 32,6%). Un antécédent d'HDH était trouvé chez 24,2% des cas sans différence significative entre les deux sexes. L'âge de survenue de l'hémorragie était plus élevé chez les femmes que chez les hommes : 51,5 ans ± 18,8 Vs 47,8 ans ± 18,3 (p : 0,003). Les étiologies de l'HDH étaient différentes entre les deux sexes. Alors que l'hémorragie liée à l'HTP était la première cause chez la femme (38 % Vs 23,5 % chez l'homme, p<0,0001), c'est la pathologie ulcéreuse qui venait en premier chez l'homme (62 % Vs 36,7 % chez la femme, p<0,0001). Un besoin transfusionnel était noté chez 42,4 % des patients de sexe masculin contre 35,4 % des patientes avec un p = 0,03. Le taux de récidive et de décès global étaient de 7,5 % et de 5,7 % des cas respectivement, sans différence significative entre les deux sexes. Conclusion L'étude trouve un profil épidémiologique, clinique et étiologique différent selon le sexe des patients.
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Affiliation(s)
- Amine El Mekkaoui
- Service d'Hépato-gastro-entérologie, CHU Hassan II - Faculté de Médecine et de Pharmacie de Fès - Université Sidi Mohammed Ben Abdellah de Fès, Maroc,Corresponding author: Amine El Mekkaoui, Service d'Hépato-gastro-entérologie, CHU Hassan II - Faculté de Médecine et de Pharmacie de Fès - Université Sidi Mohammed Ben Abdellah de Fès, Maroc
| | - Kaoutar Saâda
- Service d'Hépato-gastro-entérologie, CHU Hassan II - Faculté de Médecine et de Pharmacie de Fès - Université Sidi Mohammed Ben Abdellah de Fès, Maroc
| | - Ihssane Mellouki
- Service d'Hépato-gastro-entérologie, CHU Hassan II - Faculté de Médecine et de Pharmacie de Fès - Université Sidi Mohammed Ben Abdellah de Fès, Maroc
| | - Mounia El Yousfi
- Service d'Hépato-gastro-entérologie, CHU Hassan II - Faculté de Médecine et de Pharmacie de Fès - Université Sidi Mohammed Ben Abdellah de Fès, Maroc
| | - Nourdin Aqodad
- Service d'Hépato-gastro-entérologie, CHU Hassan II - Faculté de Médecine et de Pharmacie de Fès - Université Sidi Mohammed Ben Abdellah de Fès, Maroc
| | - Mohammed El Abkari
- Service d'Hépato-gastro-entérologie, CHU Hassan II - Faculté de Médecine et de Pharmacie de Fès - Université Sidi Mohammed Ben Abdellah de Fès, Maroc
| | - Adil Ibrahimi
- Service d'Hépato-gastro-entérologie, CHU Hassan II - Faculté de Médecine et de Pharmacie de Fès - Université Sidi Mohammed Ben Abdellah de Fès, Maroc
| | - Dafr-Allah Benajah
- Service d'Hépato-gastro-entérologie, CHU Hassan II - Faculté de Médecine et de Pharmacie de Fès - Université Sidi Mohammed Ben Abdellah de Fès, Maroc
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15
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Matsukura N, Onda M, Kato S, Hasegawa H, Okawa K, Shirakawa T, Tokunaga A, Yamashita K, Hayashi A. Cytotoxin genes of Helicobacter pylori in chronic gastritis, gastroduodenal ulcer and gastric cancer: an age and gender matched case-control study. Jpn J Cancer Res 1997; 88:532-6. [PMID: 9263529 PMCID: PMC5921470 DOI: 10.1111/j.1349-7006.1997.tb00415.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Helicobacter pylori (H. pylori) infection is involved in many gastrointestinal diseases, such as chronic gastritis (CAG), peptic ulcer and gastric cancer (GCA). Both host factors and H. pylori strain differences may contribute to differences in the diseases. Thus, we conducted an age and gender matched case-control study of 35 patients each with CAG, gastric ulcer (GUL), duodenal ulcer (DUL) and gastric cancer (GCA) to examine the role of strain differences of the H. pylori cytotoxin genes cagA and vacA in these diseases. We employed polymerase chain reaction to examine the gastric juice for H. pylori DNA. The test was positive for 26 (74.3%) CAG, 29 (82.9%) GUL, 28 (80.0%) DUL and 27 (77.1%) GCA patients, showing no statistically significant difference among the diseases (P = 0.84). cagA and vacA genes (picked up by using a vacA1 + vacA2 primer pair which detected non-variable regions of the vacA gene) were detected by PCR in the H. pylori DNA-positive cases as follows: CAG, 92.3% and 76.9%; GUL, 100% and 86.2%; DUL, 89.3% and 89.3%; GCA, 92.6% and 85.2%, respectively. No statistically significant differences were found in the frequencies of these cytotoxin genes in H. pylori-positive cases among the various gastric diseases (P = 0.39 for cagA and P = 0.64 for vacA).
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Affiliation(s)
- N Matsukura
- First Department of Surgery, Nippon Medical School, Tokyo
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