Cause Of Gastritis Research Articles

Tissue transglutaminase activity in human gastric mucosa according to Helicobacter pylori infection.

Tissue transglutaminase (t-TG) is unique among TG enzymes because of its additional role in several physiological and pathological activities, including inflammation, fibrosis, and wound healing. The presence of t-TG has previously been described in the intestine of human and animal models, yet studies on t-TG activity in human gastric mucosa are missing. Helicobacter pylori infection is the major cause of gastritis and peptic ulcers. For the first time, our results show that t-TG activity was significantly higher in antral specimens of patients with chronic active gastritis associated with H. pylori infection compared to H. pylori negative chronic gastritis and normal antral mucosa. These findings suggest that t-TG has a role in the natural history of human gastritis, which requires further investigation but may be an avenue for new therapeutic options.

Factors Associated with Gastric Disease Among Students of Hawassa University: The Case of College of Agriculture Students

Gastritis affect a person in any sex, age, race and living status even if it is common among adolescent. Unless treated promptly and completely, it can continue to cause problems throughout the person’s life. This study aimed to measure the prevalence of gastritis and assessed associated factors in Hawassa University of College of Agriculture. Cross-sectional study design was used and 174 regular students was taken using questionnaire. Then data was analyzed using descriptive statistics and inferential statistics like chi-square and logistic regression model with help of SPSS. The result of the study indicated that the prevalence of gastritis was 41.4. Problem of anxiety/stress, use of hot drinks like coffee, tea etc. and frequent use of anti-inflammatory drugs such as aspirin, ibuprofen etc. had statistically significant association with gastritis. This happens due to the fact that anti-inflammatory drugs can result in infection with the bacteria, Helicobacter pylori. Infection with Helicobacter pylori (HP) can usually cause chronic gastritis. Over use of hot drinks and stress/anxiety had also similar effect on gastritis. Thus, the researcher recommends the university and other stakeholders to minimize the incidence through awareness creation about the causes of gastritis.

Pathologic Features of Infectious Gastritis.

This manuscript presents a review of infectious causes of gastritis aimed at the practicing anatomic pathologist. We shall highlight unique histologic findings and clinical attributes that will assist those analyzing endoscopically obtained mucosal biopsies of the stomach or resection specimens.

Association of Helicobacter Pylori Infection with Portal Hypertensive Gastropathy in Liver Cirrhosis

AbstractBackground: Portal hypertensive gastropathy (PHG) is an important cause of morbidity in patients with Liver cirrhosis (LC). Helicobacter pylori (HP) infection is a common cause of gastritis and is an endemic disease in Egypt.Aim of the Work: To study the presence of H. pylori infection in cases of LC with and without PHG.Material and Methods: Fifty patients with LC including 25 cases with PHG and 25 cases without PHG who attended Sohag Faculty Hospital during the period 9/2016-3/2017 were examined for the presence of H pylori infection histologically using Hematoxyline and Eosin and Geimsa stains. The corre-lation between H pylori infection and the severity of PHG was studied statistically.Results: H. pylori were detected in 76% of cases of LC (72% in LC with PHG and 80% of cases LC without PHG). Although there was an association between H pylori infection and the severity of PHG (5/7 cases), there was no statistically significant difference between H pylori infection and PHG.Conclusion: H. pylori infection can be seen in cases of LC irrespective of the presence or absence of PHG more than in general population.

Management of Helicobacter pylori in Piedmont, Italy.

Helicobacter pylori (H. pylori) is a Gram-negative bacterium, usually acquired during childhood, whose natural habitat is the gastric lumen. H. pylori is accepted as the most important cause of gastritis and peptic ulcer in humans. Nevertheless, its important role in the pathogenesis of gastric cancer as well as in several extra-gastroduodenal diseases has been confirmed. The aim of this work is to discuss, for the first time in a single article, all publications concerning H. pylori infection arising from Piedmont region, Italy, where in 1893 Giulio Bizzozero was the first who observed and described spiral organisms in the stomach of animal models. A systematic review of all publications on the management of H. pylori in adults in Piedmont, based on a PubMed and a Scopus research from 1965 to 2017 was performed. The discussed aspects are the epidemiology, the study on gastric and extragastric diseases related to H. pylori, the diagnostic methods, the treatment of H. pylori infection, and the possibility of reinfection. In conclusions, with almost 70 publications, Piedmont has proudly maintained the tradition of the father of the H. pylori.

Evidence-Based Strategies to Improve Treatment Outcomes for Helicobacter pylori Infection

Introduction:Helicobacter pylori is the causative agent of one of the most common infectious diseases and is the main cause of gastritis and gastric cancer. The empirical eradication strategies for H. pylori have proven to be ineffective due to a variety of environmental factors and patient attributes. Our hypothesis is that the treatment outcome in a patient can be optimized by accounting for various factors that influence bacterial resistance to antibiotics. We aimed to create a globally applicable, evidenced-based algorithm to design customized therapies for effective eradication of antibiotic resistant strains of H. pylori based on analyzed patient data. Implementation of this algorithm will help to alleviate the economic burden of H. pylori-related diseases, and reduce the incidence of peptic ulcer and gastric cancer. Methods: We carried out an extensive survey of literature and compiled a list of fifteen variables that are involved in the emergence of antibiotic resistance of H. pylori (Table 1). We then collected data from over 2000 patients with H. pylori infection with respect to each of these factors. Patients treated for H. pylori infection in past 5 years were included. Patients (i) lost to follow up, (ii) with incomplete course of treatment or inadequate documentation were excluded.Table: Table. Factors that contribute to H. pylori antibiotic resistanceResults: Our data showed a clear pattern of H. pylori prevalence and antibiotic resistance in our study population. We observed that 80% of patients were over the age of 40, and 62% of patients were women. The prevalence of infection was higher in the African American (30%) and Hispanic populations (36%) compared to the Caucasian population (20%). Patients with a median income of less than $54,000 and smokers had a 19% and 19.5% decreased chance of eradication, respectively. Previous omeprazole use increased the chance of eradication two-fold. Previous use of nitrofurantoin and cefepime significantly decreased the chance of eradication by 48% and 70%, respectively. We have already created a partial algorithm (Figure 1) using predictive markers that emerged through our analysis.Figure: Algorithm for predicting antibiotic resistance of H. pylori.Conclusion: Our final proposed algorithm will be comprehensive as it is based on a number of environmental factors, variations in patient attributes and data from a large number of patients.Itwill be useful to formulate customized treatments with predicted outcomes, which will minimize failures. Accuracy of algorithm will be further tested using patient stool samples.

Role of Panchakarma intervention in Amlapitta (Gastritis): A Critical Review

Amlapiita is a very common disease of present era and a disease of Annavaha Strotas, and is commonly observed in these days of modernization and industrialization. 30% of the general population is suffering from gastro-oesophageal reflux and gastritis resulting in heartburn. It is very troublesome disease and can give rise to many serious problems if not treated in time. Signs and symptoms of Amlapiita are very similar to gastritis or hyperacidity. According to conventional medical science the most common causes of gastritis are H. pylori infections and prolonged use of Non-Steroidal Anti Inflammatory Drugs (NSAIDS). Gastritis is believed to affect about half of people worldwide. In 2015 there were approximately 90 million new cases of this condition. As people get older the disease becomes more common. It, along with a similar condition in the first part of the intestines known as duodenitis, resulted in 50,000 deaths in 2017. The five procedure of Panchakarma done through several procedures purify the body system by removing morbid Doshas from the body. These purification methods are essential components of the curative management of these diseases that are not controlled by palliative management.

A unique polysaccharide purified from Hericium erinaceus mycelium prevents oxidative stress induced by H2O2 in human gastric mucosa epithelium cell.

Hericium erinaceus (HE) has been used both as a traditional Chinese medicine and home remedy for treatment of gastric and duodenal ulcers and gastritis. EP-1, a purified polysaccharide isolated from HE mycelium, has recently been identified as the active component responsible for HE anti-gastritis activity. Because oxidative stress has been implicated as a pathogenic cause of gastritis and gastric ulcers, EP-1 antioxidant properties were systematically examined in vitro using the human gastric mucosal epithelial cell line, GES-1. Results showed that EP-1 possessed higher oxygen radical absorbance capacity (ORAC) and 2–3 times higher ability to scavenge 2,2-diphenyl-1-picrylhydrazyl (DPPH), superoxide and hydroxyl radicals than a hot water extract of commercially available HE fruiting body. A crude mycelial polysaccharide (CMPS) extract of HE, from which EP-1 was purified, showed slightly stronger radical scavenging activity and ORAC than EP-1, with the exception of DPPH-scavenging activity. Antioxidant activities of these extracts were further studied using hydrogen peroxide (H2O2)-abused GES-1 cells; EP-1 dose-dependently preserved cell viability of abused cells as assessed via MTT assay. Moreover, FACS analysis revealed that EP-1 prevented H2O2-induced apoptotic cell death by inhibiting activation of apoptotic cellular signals within mitochondria-dependent apoptotic pathways. CMPS also prevented H2O2-induced oxidative stress, but to a lesser degree than did EP-1, even though CMPS exhibited comparable or stronger in vitro antioxidant activity than did EP-1.

The increasing prevalence of HIV/Helicobacter pylori co-infection over time, along with the evolution of antiretroviral therapy (ART).

Helicobacter pylori (H. pylori) is one of the most common human bacterial infections with prevalence rates between 10–80% depending upon geographical location, age and socioeconomic status. H. pylori is commonly found in patients complaining of dyspepsia and is a common cause of gastritis. During the course of their infection, people living with HIV (PLHIV) often have a variety of gastrointestinal symptoms including dyspepsia and while previous studies have reported HIV and H. pylori co-infection, there has been little data clarifying the factors influencing this. The aim of this case-control study was to document the prevalence of H. pylori co-infection within the HIV community as well as to describe endoscopic findings, gastritis topography and histology, along with patient demographic characteristics across three different periods of time during which antiretroviral therapy (ART) has evolved, from pre- highly active antiretroviral therapy (HAART) to early and modern HAART eras. These data were compared to well-matched HIV negative controls. Two hundred and twelve PLHIV were compared with 1,617 controls who underwent their first esophagogastroduodenoscopy (EGD) to investigate dyspepsia. The prevalence of H. pylori co-infection among PLHIV was significantly higher in the early (30.2%) and modern HAART period (34.4%) compared with those with coinfection from the pre-HAART period (18.2%). The higher rates seen in patients from the HAART eras were similar to those observed among HIV negative controls (38.5%). This prevalence increase among co-infected patients was in contrast to the fall in prevalence observed among controls, from 60.7% in the early period to 52.9% in the second observed period. The three PLHIV co-infected subgroups differed regarding gastritis topography, morphology and pathology. This study suggests that ART has an important impact on the endoscopic and histological features of gastritis among HIV/H. pylori co-infected individuals, raising the possibility that H. pylori-induced gastritis could be an immune restoration disease.

Gastrin and Gastric Cancer.

Gastric cancer although occurring in reduced frequency is still an important disease, partly because of the bad prognosis when occurring in western countries. This decline in occurrence may mainly be due to the reduced prevalence of Helicobacter pylori (Hp) infection, which is the most important cause of gastric cancer. There exist many different pathological classifications of gastric carcinomas, but the most useful seems to be the one by Lauren into intestinal and diffuse types since these types seldom transform into the other and also have different epidemiology. During the nearly 30 years that have passed since the groundbreaking description of Hp as the cause of gastritis and gastric cancer, a continuous search for the mechanism by which Hp infection causes gastric cancer has been done. Interestingly, it is mainly atrophic gastritis of the oxyntic mucosa that predisposes to gastric cancer possibly by inducing hypoacidity and hypergastrinemia. There are many arguments in favor of an important role of gastrin and its target cell, the enterochromaffin-like cell, in gastric carcinogenesis. The role of gastrin in gastric carcinogenesis implies caution in the long-term treatment with inhibitors of gastric acid secretion inducing secondary hypergastrinemia, in a common disease like gastroesophageal reflux disease.

Brief Review on the Causes, Diagnosis and Therapeutic Treatment of Gastritis Disease

Gastritis represent a state of inflammation, irritation, or erosion of the stomach lining which may occur suddenly (acute) or gradually (chronic). Generally there is no universally accepted classification of gastritis and early classification was based mainly on the morphology, but recently pathogenic mechanisms have also been incorporated. The gastric mucosa is continuously exposed to many noxious factors, and Gastric protection aimed mainly to reduce or prevent the chemically induced acute hemorrhagic erosions which is exerted by compounds such as prostaglandins (PG) and SH derivatives without inhibiting acid secretion. Common causes of gastritis are excessive alcohol consumption or prolonged use of non-steroidal antiinflammatory drugs (NSAIDs) such as aspirin or ibuprofen. It may also develop after major surgery, traumatic injury, burns, or severe infections. Chronic causes are infection with bacteria, primarily Helicobacter pylori (HP), chronic bile reflux, stress additionally certain autoimmune disorders can cause gastritis as well. The most common symptom is abdominal upset or pain, indigestion, abdominal bloating, nausea, vomiting and pernicious anemia. The current study here is focusing on the causes, clinical profile, inflammatory, immune response and autoimmune atrophic gastritis in affected individuals. Additional focuses are on different diagnostic tools for Helicobacter pylori infection (HP) and current therapeutic treatment.

Assessing the Reliability of PCR, Microbiological and Histologic Methods in Detecting Helicobacter pylori in Gastric Biopsies

Background: Helicobacter pylori is currently recognized as one of the most common chronic bacterial infections worldwide. It is the cause of gastritis, peptic ulcer, gastric cancers and gastric malt lymphoma. Reliable methods of detecting this bacterium will help in successful eradication and/or reduction in the risk of gastric carcinoma. Methods: Upper endoscopy was performed on 80 patients referred for endoscopy and gastric biopsies taken from the antrum and tested by PCR, histology, urease, ELISA and culture using standard techniques. Results: The yield of Helicobacter pylori by different diagnostic methods in the study indicated that Urease had the highest positivity of 91.25% while culture was the least with 1.25%. PCR of 16S rRNA gene was the gold standard. Immunohistochemistry and SYBR Green had almost perfect agreement with PCR (kappa value=0.840; p<0.001, kappavalue= 0.88; p=0.001 respectively), Giemsa had a substantial agreement with PCR (kappa=0.770; p<0.001); ELISA had a fair agreement (kappa-value=0.220; p=0.002) while culture had a slight agreement (kappa-value=0.057; p=0.120). Conclusion: All the test methods used in the study had a significant agreement with PCR which was used as the gold standard except ELISA and culture.

TINGKAT PENGETAHUAN PASIEN TENTANG PERAWATAN GASTRITIS DI RS UMUM BANGKATAN BINJAI TAHUN 2016

Gastritis is an inflammation that affects the gastric mucosa. This inflammation can result in coagulation of the gastric mucosa until the release of the superficial mucosal epithelium is the most important cause of digestive tract disorders. Epithelial release will stimulate the onset of the inflammatory process in the stomach.Gastritis or dyspepsia or a term known by the community as an ulcer or stomach disease is a collection of symptoms that are felt as pain, especially in the pit of the stomach, people who are attacked by this disease are usually often nausea, vomiting, feeling full and feeling uncomfortable. The cause of gastritis is the use of non-steroidal anti-inflammatory drugs such as aspirin, mafenamat acid, in large quantities, excessive alcohol consumption, lots of smoking, chemotherapy testing, severe stress, consumption of oral chemicals that are acid-base and ischemic shock. The purpose of this study is to determine the level of patient's knowledge about the treatment of gastritis (ulcer).The research method used is descriptive quantitative method, taking samples using accidental sampling techniques. As many as 30 people with questionnaire data collection instruments. The data obtained are grouped based on the level of patient's knowledge of gastritis. Based on the level of knowledge of patients about gastritis treatment, there were 13 people (43%), quite 12 people (40%), and less as many as 5 people (17%) so that it can be concluded that the patient's knowledge of gastritis treatment at Binjai City General Hospital is classified well. But it is not applied in everyday life.Keywords: Patient Knowledge, Gastritis, Gastritis Treatment.

Protection Effect of Punicalagin Isolated from Pomegranate on Inflammation and Ethanol‐induced Gastric Mucosal Injury

Excessive alcohol consumption is one of the most common causes of gastritis. The activation of cyclooxygenase‐2 (COX‐2), associated with reactive oxygen species, is a key process in the inflammatory response of ethanol‐induced gastritis. Punicalagin, a naturally occurring active ingredient of pomegranate, is a potential antioxidant. In this study, pomegranate extract and punicalagin exhibited free radical scavenging activity in a dose‐dependent manner. Pretreatment with pomegranate extract also exerted gastroprotective effects by reducing the inflammatory response to ethanol‐induced gastric mucosal damage. Furthermore, punicalagin inhibited the expression of inflammatory COX‐2 by suppressing the activation of mitogen‐activated protein kinases in lipopolysaccharide‐induced inflammation. These findings suggest that punicalagin may be beneficial for the prevention and/or treatment of gastric inflammation.

Evaluation of histology as a Helicobacter pylori detection method and analysis of associated problems

Helicobacter pylori is regarded as a common cause of gastritis and peptic ulcer disease. The most commonly used H. pylori detection method in Sri Lanka is histology. However, the detection rate of H. pylori in routine histology practice is low. Therefore, we conducted the following study to evaluate the diagnostic efficacy of histology and to analyze the possible problems associated with H. pylori detection. Multiple endoscopic gastric biopsies were obtained from a sample of 205 patients detected to have endoscopic gastric erythema or ulcers. Biopsies were formalin fixed and paraffin embedded and stained with haematoxylin and eosin, toluidine blue and immunohistochemistry. Serum was collected for screening of anti H. pylori antibodies using an immunochromatography based kit method. Diagnostic efficacy of histology was evaluated against immunohistochemistry as the gold standard. Inter observer variation among four pathologists was assessed using the intraclass correlation coefficient. Haematoxylin and eosin showed a sensitivity of 100% and specificity of 99% and toluidine blue had 100% sensitivity and 98.5% specificity. Average measures of intra class correlation coefficient for H&E was 0.428 (95% CI 0.228 – 0.588) and for toluidine blue stain 0.320 (95% CI 0.085 0.513). The sero prevalence of anti – H. pylori antibodies was 4.9%. In conclusion, sensitivity, specificity and negative predictive values of histology in detecting H. pylori are shown to be high. Main limitations were, low positive predictive value and unsatisfactory interobserver agreement. Sampling errors and exposure to antibiotics appeared to be an unlikely cause of the low detection rate with histology.

Epidemiological Studies on Helicobacter Pylori in Some Animals and Humans

Helicobacter pylori is one of the most frequently diagnosed bacterium as the major cause of gastritis and duodenal ulcer among Egyptian patients. In the current study, 100 human serum samples and 80 human stool samples were collected. In addition, 100 bovine serum samples and 143 fecal samples of bovines and pet animals were collected. The detection of antibodies and antigens specific to H. pylorii?½in serum and feces respectively was carried out by using an immunochromatographic rapid test device method. Out of the 100 human serum samples examined, 42 (42%) resulted positive for the presence of IgG and IgM specific to H. pylori. Statistical analysis of the available data was carried out using Chi-square test which revealed that H. pylorii?½prevalence is higher in people suffering from GIT disorders (60%) than apparently healthy people (34.3%) and the value was 5.70 (P

Comparative Genomics of H. pylori and Non-Pylori Helicobacter Species to Identify New Regions Associated with Its Pathogenicity and Adaptability.

The genus Helicobacter is a group of Gram-negative, helical-shaped pathogens consisting of at least 36 bacterial species. Helicobacter pylori (H. pylori), infecting more than 50% of the human population, is considered as the major cause of gastritis, peptic ulcer, and gastric cancer. However, the genetic underpinnings of H. pylori that are responsible for its large scale epidemic and gastrointestinal environment adaption within human beings remain unclear. Core-pan genome analysis was performed among 75 representative H. pylori and 24 non-pylori Helicobacter genomes. There were 1173 conserved protein families of H. pylori and 673 of all 99 Helicobacter genus strains. We found 79 genome unique regions, a total of 202,359bp, shared by at least 80% of the H. pylori but lacked in non-pylori Helicobacter species. The operons, genes, and sRNAs within the H. pylori unique regions were considered as potential ones associated with its pathogenicity and adaptability, and the relativity among them has been partially confirmed by functional annotation analysis. However, functions of at least 54 genes and 10 sRNAs were still unclear. Our analysis of protein-protein interaction showed that 30 genes within them may have the cooperation relationship.

An update of laboratory diagnosis of Helicobacter pylori in the Kingdom of Saudi Arabia.

Helicobacter pylori is a micro-aerophilic, slow-growing, Gram-negative spiral bacterium that colonizes the mucous lining of the human stomach. Infection with this bacterium has been identified as a cause of gastritis, peptic ulcer disease, and gastric mucosa-associated lymphoid tissue lymphoma. Globally, the prevalence of H. pylori-related infection is high compared to any other infectious diseases, and the rate of prevalence much higher in developing countries than in developed nations. This review article aims to describe the trend of H. pylori-related works in the Kingdom of Saudi Arabia (KSA) and the use of various laboratory tests for the diagnosis of H. pylori-related infections in adults and children. Therefore, published literature was referenced in the explanation and discussion of the different methods used to diagnose H. pylori-related disease, including papers published in the KSA and other Middle Eastern countries. The PubMed (http://www.ncbi.nlm.nih.gov/pubmed?cmd=search) search engine was used extensively. Culture and histopathology tests have been employed widely to detect this pathogen at the early stage. However, over the years, an array of tests including the rapid urease test, serology, the urea breath test, the fecal antigen test, and molecular testing have been developed to diagnose and better manage H. pylori-associated diseases since the discovery of this novel pathogen.

First ultrastructural observations on gastritis caused by Physaloptera clausa (Spirurida: Physalopteridae) in hedgehogs (Erinaceus europeaus).

Ultrastructural changes of gastritis due to infection with Physaloptera clausa in 12 fresh carcasses of euthanized European hedgehogs (Erinaceus europaeus) collected from different part of Urmia, Iran, in which they were highly populated with this animal, six females and six males were subjected to detail necropsy with special reference to the stomach. Macroscopic changes of stomach were recorded and some of the worms collected. Based on number of parasites present in the stomach, they were divided into light infection, mild infection, and severe infection. Parasites were collected, and worms identification of the species was confirmed on the basis of light microscope examination with reference to keys. Tissues fixed in 3% glutaraldehyde, post-fixed in 1% osmium tetroxide and processed and plastic embedded; ultrathin sections of 60-70 nm were cut and stained with uranyl acetate and lead citrate; electron microscopic observations showed that, in light infection some changes were observed in gastric cells such as dilatation and vesiculation of the endoplasmic reticulum, large numbers of lipid granules, mitochondrial swelling, nuclear chromatin margination, and some nucleus showed washed out appearance. Other cells showed some alterations in mitochondria, dilatation of smooth endoplasmic reticulum, loss of both free and bound ribosomes, vesiculation in cytoplasm, and increase Golgi apparatus and secretory vesicles. The inflammatory cells including lymphocytes, macrophages, mast cells, and predominantly eosinophils were identified. In moderate infection, the cellular pattern of gastric mucosa replaced with inflammatory cells. The marked increase of macrophages and other inflammatory cell was observed. A particular finding in our study was the presence of globule leukocyte in the moderate stage. Moreover, scant formation and distribution of collagen fibers as well as fibroblasts were also noted. In severe infection, the most obvious observation was marked distribution of collagen fibers around the mucosal cells. The fibroblastic cells with elongated nucleus and extensive indentation were noticed. In conclusion, the result of our study revealed P. clausa could be a cause of gastritis and according to cellular pattern of inflammatory reaction, with the increase of worm burden and development of infection, chronic gastritis was stabilized. Present investigation documented the ultrastructural changes during verminous gastritis in hedgehogs.

Compound 13, an α1-selective small molecule activator of AMPK, inhibits Helicobacter pylori-induced oxidative stresses and gastric epithelial cell apoptosis

Half of the world's population experiences Helicobacter pylori (H. pylori) infection, which is a main cause of gastritis, duodenal and gastric ulcer, and gastric cancers. In the current study, we investigated the potential role of compound 13 (C13), a novel α1-selective small molecule activator of AMP-activated protein kinase (AMPK), against H. pylori-induced cytotoxicity in cultured gastric epithelial cells (GECs). We found that C13 induced significant AMPK activation, evidenced by phosphorylation of AMPKα1 and ACC (acetyl-CoA carboxylase), in both primary and transformed GECs. Treatment of C13 inhibited H. pylori-induced GEC apoptosis. AMPK activation was required for C13-mediated GEC protection. Inhibition of AMPK kinase activity by the AMPK inhibitor Compound C, or silencing AMPKα1 expression by targeted-shRNAs, alleviated C13-induced GEC protective activities against H. pylori. Significantly, C13 inhibited H. pylori-induced reactive oxygen species (ROS) production in GECs. C13 induced AMPK-dependent expression of anti-oxidant gene heme oxygenase (HO-1) in GECs. Zinc protoporphyrin (ZnPP) and tin protoporphyrin (SnPP), two HO-1 inhibitors, not only suppressed C13-mediated ROS scavenging activity, but also alleviated its activity in GECs against H. pylori. Together, these results indicate that C13 inhibits H. pylori-induced ROS production and GEC apoptosis through activating AMPK–HO–1 signaling.