Fundic Research Articles

Anatomical Studies of the Gastrointestinal Tract of snake Malpolon monspessulanus insignitus (Geoffroy, 1809)

Studies aim to study the morphometrical and anatomical features of a gastrointestinal tract of Malpolon insignitus, and compared with that of other examined reptiles So, It is clear that the tissues in the gastrointestinal tract adapt to feed the meat. The wall of the esophagus, stomach, small intestine, and large intestine is a buildup of four layers from outside inwards are serosa, muscularies, submucosa and mucosa. The esophagus was longer than the stomach and It may measure one-quarter the body length of the snake it is highly stretch to facilitate movement the food to the stomach. The mucosal epithelium was consist of simple and compound stomach glands and consist of three types of glands; they are the cardiac glands, pyloric glands, and fundus glands. The majority of the mucosal folds were primary folds as for secondary folds were rare. The small intestine is long on and that of the animal is purely carnivorous. The small intestine is composed of short transverse loops in snakes. The intestine consists of many longitudinal folds that allow the surface area to increase digestion. The mucosa of the small intestine members in the form of leaf like villi provided with shallow branched Lieberkühn crypts at their bases. It consists of three types of cells; the endocrine cells, the goblet and the absorptive. The large intestine is short and has a larger diameter and consists of colon and rectum. The mucous membrane of the colon consists of cavernous and vertical cells, while that of the rectum is, straight and is rich in lymph spaces and goblet cells.

A Comparative Histomorphological and Histochemical Study of the Ventriculus between Iraqi Adult Geese (Anser anser) and Guinea fowls (Numidia meleagris)

The present study aimed to describe and compare the histomorphological and histochemical structures to ventriculus in Goose(Anser anser) and Guinea fowls (Numidia meleagris). The work was carried out on twenty apparently clinically healthy birds obtained from a supplier in Baghdad city. They were allocated in two equal groups of each type of bird. The two groups were utilized for histological and histochemical investigations of their ventriculus organ. After anesthesia and killing birds, their abdominal cavity was dissected, their ventriculus was identified and proper specimens from its walls were prepared. The samples designated for histochemical staining were fixed in a solution of bruin's fixative, while the others for general histological examination were fixed in (10%) neutral buffered formalin. After processing, the sections were stained with (2.5 PH) Alcian- PAS combination, periodic acid Schiff, Masson Trichrome, and Hematoxylin and Eosin stains. This study elucidates that the microscopic construct of the ventriculus was similar for the two species. The ventriculus consists of three tunicates (serosa, muscularis, and mucosa), whereas the submucosa is absent. The wall showed some significant differences in morphometric measurements. The mucosa of the ventriculus is coated with a thick layer of cuticles organized as a wavy clear pink line parallel to the mucosal surface and mucosal folds. The simple cuboidal-columnar epithelium covered the mucosa, which showed many folds. The proprial glands (simple tubular type) are lined by simple cuboidal epithelium, which opens into the crypts between the folds. A well-developed muscular comprised of smooth muscle fibers as two layers of inner circular and outer longitudinal. Serosa is composed of loose connective tissue coated by mesothelium. The Mean thickness of Cuticle, length of folds, mucosa and muscular in goose were significantly higher than that in guinea fowl; these differences may be due to variation in their diet. PAS and AB-PAS combined (2.5-PH) stains, cuticle layer, epithelium lining, and gastric glands showed a positive reaction with these stains. This study aimed to Study the normal histomorphological histochemical and structure of Gizzard in two avian species, local male guinea fowl (Numidia meleagris) and male geese (Anser anser). Also aimed to Comparative histomorphological, histomorphometric measurements and histochemical study of the Gizzard of two different local male avian species (Guinea fowl and geese). Keywords: Histomorphological, Histochemical, Ventriculus, Guinea fowls, Geese

Incidence and natural history of gastric high-grade dysplasia in patients with familial adenomatous polyposis syndrome

Familial adenomatous polyposis (FAP) is characterized by high risks of colonic and extracolonic tumors. Recent studies have suggested a rising risk for gastric cancer (GC). We sought to define the spectrum of premalignant gastric polyps in FAP, focusing on high-grade dysplasia (HGD). The gastric phenotypes of 118 patients diagnosed with FAP or attenuated FAP in our Hereditary Gastrointestinal Cancer Registry were retrospectively reviewed. To analyze the clinical features associated with the diagnosis of HGD, we established an age- and sex-matched control group of FAP patients from our cohort without gastric HGD in a 4:1 ratio. The spectrum and frequency of gastric polyps in individuals with FAP included fundic gland polyps (67.9%), hyperplastic polyps/foveolar hyperplasia (19.6%), tubular adenomas (15.2%), foveolar adenomas (10.7%), and pyloric gland adenomas (6.3%). Ten patients (8.9%) exhibited gastric HGD at a mean age of 55 ± 13 years, and HGD was seen in all polyp types. When compared with control subjects, HGD was associated with a high diversity of gastric polyp histology, prior low-grade dysplasia, severe gastric polyposis, and prior Whipple surgery (P= 2.0E-5, .003, .024, and .04, respectively). Two patients (1.7%) with HGD were diagnosed with GC. However, the remaining 8 patients with HGD have been under surveillance for an average of 5.8 ± 4.5 years without progression to GC. Gastric HGD in FAP may be more common than previously appreciated. The natural history of HGD is variable, and most patients with HGD do not appear to progress to GC.

α1,4-Linked N-acetylglucosamine suppresses gastric cancer development by inhibiting Mucin-1-mediated signaling.

Gastric cancer is the second leading cause of cancer deaths worldwide, and more understanding of its molecular basis is urgently needed. Gastric gland mucin secreted from pyloric gland cells, mucous neck cells, and cardiac gland cells of the gastric mucosa harbors unique O-glycans carrying terminal α1,4-linked N-acetylglucosamine (αGlcNAc) residues. We previously reported that αGlcNAc loss correlated positively with poor outcomes for patients with differentiated-type gastric cancer. However, the molecular mechanisms underlying these outcomes remained poorly understood. Here, we examined the effects of upregulated αGlcNAc expression on malignant phenotypes of the differentiated-type gastric cancer cell lines, AGS and MKN7. Upregulation of αGlcNAc following ectopic expression of its biosynthetic enzyme attenuated cell proliferation, motility, and invasiveness of AGS and MKN7 cells in vitro. Moreover, AGS cell tumorigenicity was significantly suppressed by αGlcNAc overexpression in a xenograft model. To define the molecular mechanisms underlying these phenotypes, we investigated αGlcNAc binding proteins in AGS cells and identified Mucin-1 (MUC1) and podocalyxin. Both proteins were colocalized with αGlcNAc on human gastric cancer cells. We also found that αGlcNAc was bound to MUC1 in murine normal gastric mucosa. When we assessed the effects of αGlcNAc binding to MUC1, we found that αGlcNAc blocked galectin-3 binding to MUC1, phosphorylation of the MUC1 C-terminus, and recruitment of Src and β-catenin to that C-terminus. These results suggest that αGlcNAc regulates cancer cell phenotypes by dampening MUC1 signal transduction.

Effects of Granule Dendrobii on chronic atrophic gastritis induced by N-methyl-N'-nitro-N-nitrosoguanidine in rats.

BACKGROUND Dendrobium officinale is an herb of Traditional Chinese Medicine (TCM) commonly used for treating stomach diseases. One formula of Granule Dendrobii (GD) consists of Dendrobium officinale and American Ginseng (Radix Panacis quinquefolii), and is a potent TCM product in China. Whether treatment with GD can promote gastric acid secretion and alleviate gastric gland atrophy in chronic atrophic gastritis (CAG) requires verification.AIMTo determine the effect of GD treatment on CAG and its potential cellular mechanism.METHODSA CAG model was induced by feeding rats N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) for 12 wk. After oral administration of low, moderate, and high doses of GD in CAG rats for 8 wk, its effects on body weight, gastric mucosa histology, mucosal atrophy, intestinal metaplasia, immunohistochemical staining of proliferating cell nuclear antigen (PCNA) and B-cell lymphoma-2, and hemoglobin and red blood cells were examined.RESULTSThe body weights of MNNG-induced CAG model rats before treatment (143.5 ± 14.26 g) were significantly lower than that of healthy rats (220.2 ± 31.20 g, P < 0.01). At the 8th week of treatment, the body weights of rats in the low-, moderate-, and high-dose groups of GD (220.1 ± 36.62 g) were significantly higher than those in the untreated group (173.3 ± 28.09 g, all P < 0.01). The level of inflammation in gastric tissue of the high-dose group (1.68 ± 0.54) was significantly reduced (P < 0.01) compared with that of the untreated group (3.00 ± 0.00, P < 0.05). The number and thickness of gastric glands in the high-dose group (31.50 ± 6.07/mm, 306.4 ± 49.32 µm) were significantly higher than those in the untreated group (26.86 ± 6.41/mm, 244.3 ± 51.82 µm, respectively, P < 0.01 and P < 0.05), indicating improved atrophy of gastric mucosa. The areas of intestinal metaplasia were significantly lower in the high-dose group (1.74% ± 1.13%), medium-dose group (1.81% ± 0.66%) and low-dose group (2.36% ± 1.08%) than in the untreated group (3.91% ± 0.96%, all P < 0.01). The expression of PCNA in high-dose group was significantly reduced compared with that in untreated group (P < 0.01). Hemoglobin level in the high-dose group (145.3 ± 5.90 g/L), medium-dose group (139.3 ± 5.71 g/L) and low-dose group (137.5 ± 7.56 g/L) was markedly increased compared with the untreated group (132.1 ± 7.76 g/L; P < 0.01 or P < 0.05).CONCLUSIONTreatment with GD for 8 wk demonstrate that GD is effective in the treatment of CAG in the MNNG model by improving the histopathology of gastric mucosa, reversing gastric atrophy and intestinal metaplasia, and alleviating gastric inflammation.

The gastric proton pump in gobiid and mudskipper fishes. Evidence of stomach loss?

Stomach loss has occurred independently multiple times during gnathostome evolution with notable frequency within the Teleostei. Significantly, this loss of acid-peptic digestion has been found to correlate with the secondary genomic loss of the gastric proton pump subunits (atp4a, atp4b) and pepsinogens/pepsins (pga, pgc). Gastric glands produce gastric juice containing the acid and pepsin and thus their presence is a hallmark feature of a digestive system capable of acid-peptic digestion. However, in gobiid fishes although oesogaster and gastric glands have been identified histologically, their functional significance has been questioned. In the present study we address whether the gastric proton pump is present and expressed in gastric glands of the goby Neogobius species (Gobiidae) and in members of the family Oxudercidae, a group of amphibious gobiid fishes commonly known as mudskippers (genera: Periophthalmus, Boleophthalmus, Periophthalmodon and Scartelaos). We confirmed the presence of gastric glands and have immunohistochemically localized gastric proton pump expression to these glands in Neogobius fluviatilis and Periophthalmus novemradiatus, Periophthalmus barbarus and Boleophthalmus boddarti. Genome analysis in Neogobius melanostomus, Periophthalmus magnuspinnatus, Scartelaos histophorus, Boleophthalmus pectinirostris, and Periophthalmodon schlosseri revealed the presence of both atp4a and atp4b subunit orthologues in all species in a conserved genomic loci organization. Moreover, it was possible to deduce that the complete open reading frame and the key functional amino acid residues are present. The conserved expression of the gastric proton pump provides clear evidence of the potential for gastric acid secretion indicating that acid digestion is retained in these gobiid fishes and not lost.

Effect of electroacupuncture combined with Zhuang-medicine-thread moxibustion on oxidative stress in gastric antrum of diabetic gastroparesis rats

To observe the effect of electroacupuncture (EA) combined with Zhuang-medicine-thread moxibustion on oxidative stress-related indicators in diabetic gastroparesis (DGP) rats, so as to explore its mechanism underlying improvement of DGP. Male SD rats were randomly divided into normal, model, medication, EA, Zhuang-medicine-thread moxibustion (moxibustion) and EA+Zhuang-medicine-thread moxibustion (combination) groups (15 rats in each group). The DGP model was established by intraperitoneal injection of streptozotocin (STZ). Rats of the medication group were treated by gavage of 0.15 mg/mL mosapride citrate suspension（10 mL/kg）. EA (10 Hz/50 Hz, 2 mA, 20 min) or Zhuang-medicine-thread moxibustion (3 cones) was applied to "Zhongwan" (CV12), bilateral "Neiguan" (PC6) and bilateral "Sanyinjiao" (SP6) of the related groups, once a day for 3 weeks. The body weight, blood glucose, gastric emptying rate and intestinal propulsion rate of rats were measured. The serum malondialdehyde (MDA) content was measured by thiobarbituric acid method, the serum supero-xide dismutase (SOD) activity was measured by xanthine oxidase method, and the serum reactive oxygen species (ROS) activity was detected by ELISA. HE staining was used to observe the pathological changes of gastric antrum. The expression of heme oxygenase-1 (HO-1), nuclear factor erythroid 2-related factor 2 (Nrf2), nicotin-amide adenine dinucleotide phosphate oxidases (NOX4), peroxisome proliferators activated receptor-gamma coactivator 1α(PGC-1α) proteins and mRNAs in gastric antrum was detected by Western blot and real-time quantitative PCR, respectively. Compared with the normal group, the body weight, gastric emptying rate, intestinal propulsion rate, serum SOD activity, the expressions of HO-1, PGC-1α, total Nrf2 proteins and mRNAs, and Nrf2 nuclear translocation in gastric antrum were decreased (P<0.01), while the blood glucose, serum MDA content and ROS activity, NOX4 protein and mRNA expressions in gastric antrum were increased (P<0.01) in the model group. Compared with the model group, the blood glucose was decreased in the EA, moxibustion and combination groups (P<0.01); the body weight, gastric emptying rate, intestinal propulsion rate, and the expressions of HO-1 and PGC-1α mRNAs in gastric antrum were all increased in the four treatment groups (P<0.01, P<0.05), while the serum MDA content and ROS activity, NOX4 protein and mRNA expressions in gastric antrum were all decreased (P<0.01); the serum SOD activity and total Nrf2 protein expression in gastric antrum were increased in medication, moxibustion and combination groups (P<0.01, P<0.05); the expressions of HO-1 and PGC-1α proteins, and Nrf2 nuclear translocation in gastric antrum were increased in medication and combination groups (P<0.05, P<0.01); the expression of Nrf2 mRNA was increased in the medication, EA and combination groups (P<0.01, P<0.05). Compared with the combination group, the body weight, gastric emptying rate and intestine propulsion rate were decreased in the medication, EA and moxibustion groups(P<0.01, P<0.05), and the blood glucose increased (P<0.01); the serum MDA content and ROS activity, NOX4 protein and mRNA expressions in gastric antrum were increased (P<0.01, P<0.05), serum SOD activity, and the expressions of total Nrf2 protein, PGC-1α protein and mRNA, HO-1 mRNA in gastric antrum were decreased (P<0.01, P<0.05) in the EA and moxibustion groups; the expression of Nrf2 mRNA was decreased in the moxibustion group (P<0.05). HE staining showed a large number of inflammatory cell infiltration in the lamina propria and submucosa, and the gastric glands in the lamina propria were significantly expanded, the submucosa was severely edematous in the model group, which were relative milder in the four treatment groups. EA combined with Zhuang-medicine-thread moxibustion can effectively improve the activity of antioxidant enzymes, reduce the production of lipid peroxide, and regulate the expression of antioxidant related proteins and genes, which may be one of the mechanisms in treating DGP.

Gel immersion endoscopic mucosal resection for a gastric neoplasm with a background of fundic gland polyposis.

Gel immersion endoscopic mucosal resection for a gastric neoplasm with a background of fundic gland polyposis.

Sporadic and Familial Adenomatous Polyposis-associated Foveolar-type Adenoma of the Stomach.

Gastric foveolar-type adenoma (FA) is a rare benign neoplasm occurring either sporadically or in patients with familial adenomatous polyposis (FAP). However, the molecular features of FA and the relationship between sporadic and syndromic lesions remain unclear. In this study, we performed clinicopathological, immunohistochemical, and genetic analyses of 18 sporadic and 30 FAP-associated FAs. Most sporadic and FAP-associated FAs were located in the upper or middle third of the stomach, on a background of fundic gland mucosa. Most lesions were low-grade, but 3 lesions had a high-grade component. Sporadic FAs included 2 morphologically distinct subtypes, that is, flat and raspberry-like FAs, which we distinguished based on the endoscopic features. Seven lesions were regarded as flat FAs, appearing as large, slightly elevated lesions and measuring 11 to 87mm in size. Conversely, 10 raspberry-like FAs were small bright-red polyps, measuring 2 to 8mm in size. FAP-associated FAs, particularly larger lesions, exhibited morphologic features resembling flat FAs but varied significantly in size (2 to 103mm). Mutation analysis identified APC and KRAS mutations in all flat FAs but never in raspberry-like FAs. Remarkably, somatic APC and KRAS mutations were also detected in 19 (63%) and 27 (90%) of FAP-associated FAs, respectively. This indicates that they are genetically equivalent to sporadic, flat FAs. This study showed that sporadic FA includes at least 2 morphologically and genetically distinct subtypes: flat and raspberry-like FA. Furthermore, flat FA represents a sporadic counterpart of FAP-associated FA.

Importance of Gastroduodenal Endoscopic Findings in Patients with Classic Familial Adenomatous Polyposis Syndrome

Background: Familial adenomatous polyposis (FAP) is an autosomal dominant disorder caused by a mutation in the adenomatous polyposis coli (APC) gene. FAP is characterized by development of multiple adenomatous polyps (&gt;100) in the colon. The aim of this study was to evaluate the prevalence of gastroduodenal polyps in FAP patients referred to the Taleghani hospital, a teaching referral center in Tehran, Iran. Materials and Methods: Front-view and side-view endoscopies were performed in 33 FAP patients. Papillary biopsies were taken for all patients. Site of polyps, their number and size, histologic findings, patient general information (gender, age and family history of FAP/colorectal cancer/gastroduodenal polyps) were collected and reported. 28 patients of the study were evaluated using upper GI endoscopy again after 5 years for changes in characteristics and probable transformation of polyps into cancer. Results: Gastric polyps were seen in 42.4 % of patients. 76.45% of the patients had fundic gland polyps and hyperplastic polyps were noticed in 39.93% of them. Duodenal adenomas were found in 30.3% of patients which were reported to be tubular adenomas with low grade dysplasia and tubulovillous adenomas with low grade dysplasia in 60% and 45% of patients, respectively. Conclusions: Findings of this study bespeak the high prevalence of gastroduodenal polyps and the presence of dysplasia in duodenal polyps among FAP patients referred to the hospital. Therefore, it appears that routine gastroduodenal endoscopy in FAP patients is necessary.

Overgrowth of Squamocolumnar Junction and Dysregulation of Stem Cell Lineages in the Stomach of Vitamin A-Deficient Mice

Junctional epithelia are common sites for pathological transformations. In mice, the stratified epithelium of the forestomach joins the simple glandular epithelium of the cardia at the limiting ridge. We previously demonstrated the expression of vitamin A receptors in the gastric stem/progenitor cells and their progeny and found that excess retinoic acid enhances cellular dynamics of gastric epithelium. This study examines how deficiency of vitamin A would alter gastric epithelial stem cell lineages. Three-week-old mice of both genders were weaned and fed with a vitamin A deficient (VAD) diet for 4 or 8 months. Sex- and weight-matched littermate mice received a standard (control) diet. To label S-phase cells, all mice received a single intraperitoneal injection of 5-bromo-2-deoxyuridine before being euthanized. Stomach tissues were processed for microscopic examination and protein analysis to investigate stem cell lineages using different stains, lectins, or antibodies. The Student’s t-test was used to compare quantified data showing differences between control and VAD groups. Eight-month-vitamin-A deficiency caused enlarged forestomach and overgrowth of the squamocolumnar junction with metaplastic and dysplastic cardiac glands, formation of intramucosal cysts, loss of surface mucosal integrity, increased amount of luminal surface mucus, and upregulation of trefoil factor 1 and H+,K+-ATPase. These changes were associated with decreased cell proliferation and upregulation of p63. In conclusion, vitamin A is necessary for maintaining gastric epithelial integrity and its deficiency predisposes the mouse stomach to precancerous lesions.

An Unusual Duodenal Finding

Question: A 72-year-old woman with a medical history of gastroesophageal reflux disease, obesity, acquired hypothyroidism, diabetes mellitus, hypertension, and diverticulosis presented with proton pump inhibitor–refractory dyspepsia. Esophagogastroduodenoscopy demonstrated a normal esophagus and stomach, but an unusual 20 × 18 mm glandular Paris IIa lesion was found in the duodenal bulb with a normal second portion of the duodenum. Endoscopic and histologic findings are shown in Figures A and B. What was the most likely diagnosis? Look on page 195 for the answer and see the Gastroenterology website (www.gastrojournal.org) for more information on submitting to Gastro Curbside Consult. Gastric heterotopia (GH) is a rare congenital condition where gastric tissue is found at a location outside the stomach. It may be found anywhere in the GI tract from mouth to anus and is found in the duodenal bulb in 0.5%-2% of individuals, where it most commonly appears as single or multiple asymptomatic polypoid lesions.1Khan S. Niaz S. Khan M. et al.A case of heterotopic gastric tissue in duodenal bulb: an interesting endoscopic finding.Cureus. 2022; 14e24271Google Scholar Large lesions may ulcerate (secondary to acid secretion), bleed, intussuscept, or obstruct, but that is uncommon. Histologically, GH shows aggregates of oxyntic glands composed of chief and parietal cells, and the overlying surface often exhibits gastric foveolar mucinous epithelium (apical mucin cap),2Maione F. Chini A. Gennarelli N. et al.Endoscopic resection of a large polypoid gastric heterotopia of duodenum: a case report.Clin Case Rep. 2021; 9e04633Crossref Google Scholar as demonstrated in the left portion of Figure B. The right portion of Figure B demonstrates normal duodenal mucosa (villi lined by goblet cells, absorptive epithelium, and rare Brunner’s glands). It is important to distinguish GH from the more common acquired condition gastric metaplasia (GM). GM involves the villous surface epithelium of the duodenum, and the metaplastic cells contain small apical vacuoles, similar to gastric foveolar cells, also known as gastric foveolar metaplasia. GM is a reactive process, often associated with duodenal mucosal injury/inflammation, which may or may not be due to Helicobacter pylori (HP) infection. In contrast, GH is not associated with HP, it shows normal duodenal mucosa in the background, and has an association with fundic gland polyps, possibly due to an indirect association through PPI therapy enhancing the endoscopic prominence of GH.3Narang Natasha et al.Gastric tissue in the duodenal bulb: heterotopia or metaplasia?.Am J Gastroenterol. 2020; 115: S1446Crossref Google Scholar Importantly, oxyntic glands characteristic of GH are not identified in GM. Finally, GH often manifests as nodular mucosa endoscopically, whereas GM is detected microscopically. It has been suggested that GH may have neoplastic potential.3Narang Natasha et al.Gastric tissue in the duodenal bulb: heterotopia or metaplasia?.Am J Gastroenterol. 2020; 115: S1446Crossref Google Scholar Therefore, accurate endoscopic and pathologic identification may be important, although it will require further investigation to determine if endoscopic surveillance is warranted.

6′-O-Galloylpaeoniflorin attenuates Helicobacter pylori-associated gastritis via modulating Nrf2 pathway

As a common disease of the digestive system, chronic gastritis is inflammation of the gastric mucosa caused by various factors. Helicobacter pylori (H. pylori) is one of the main causes of chronic gastritis, which can lead to gastric mucosal damage and gland atrophy, thereby promoting gastrocarcinogenesis. Oxidative stress and the inflammatory response are important mechanisms of H. pylori-induced gastritis. 6′-O-Galloylpaeoniflorin (GPF) is a substance isolated from peony root with antioxidant and anti-inflammatory activities. However, its role and mechanism in the pathogenesis of H. pylori-induced chronic gastritis remain unclear. This study explored the effects of GPF on H. pylori-induced gastric mucosal oxidative stress and inflammation using flow cytometry, western blotting, real-time quantitative PCR, and immunohistochemistry. We found that H. pylori infection increased oxidative stress and expression of inflammatory cytokines in vitro and in vivo and that these outcomes were inhibited by GPF. Furthermore, GPF activated nuclear factor erythroid-related factor-2 (Nrf2) and its downstream target genes in H. pylori-infected GES-1 cells and mice. The anti-inflammatory and antioxidant effects of GPF on H. pylori-infected cells were attenuated by an Nrf2 inhibitor. Taken together, these data suggest that GPF reduces H. pylori-induced gastric mucosa injury by activating Nrf2 signaling and that GPF is a potential candidate for the treatment of H. pylori-associated gastritis.

Extra virgin olive oil inhibits Helicobacter pylori growth in vitro and the development of mice gastric mucosa lesions in vivo.

Helicobacter pylori infection is widespread worldwide, with more than a half of the world population infected. H. pylori antibiotic-resistant strains and non-compliance to therapy are the major causes of H. pylori eradication failure. The search for new therapies based on plant extracts is a scientific interest field. The present study was conducted to evaluate the effect in vitro of extra virgin olive oil (EVOO), hydroxytyrosol (HT), and oleuropein (Olp) against two H. pylori strains and the effect in vivo of the oral administration of EVOO on the gastric mucosa of BALB/c mice infected with this microorganism. The broth microdilution method assayed the antibacterial in vitro activity of EVOO, HT, and Olp against H. pylori strains. For in vivo studies, male BALB/c mice were infected orally with an H. pylori suspension every 72 h. Four groups were used: (1) Control, (2) H. pylori-infected (HP), (3) EVOO, and (4) HP + EVOO. Mice were sacrificed at 7, 15, and 30 days. The stomachs were removed and observed under a microscope. Scoring of the degree of erosion was determined. Samples were processed by histological techniques for light microscopy. Macroscopic analysis showed that the presence of small erosions increased, both in number and size, in the infected group. Animals infected and treated with EVOO exhibited the presence of fewer erosions, which decreased in number as the treatment progressed. The mucosa of the control and EVOO groups showed normal histological characteristics at the three times studied. The mucosa of animals infected with H. pylori showed disruptions of the lining epithelium, damage to gastric glands, and vasodilation. The mucosa of animals infected with H. pylori and treated with EVOO showed morphological characteristics similar to those of normal and EVOO mucosa. For the first time, the current study showed the effect in vitro and in vivo of EVOO and combined administration of HT and Olp against H. pylori using an animal model. Future studies are needed to establish the mechanism of EVOO’s action at the gastric mucosa level to propose this product as a natural antimicrobial agent for the treatment of gastric H. pylori infections.

Endoscopic submucosal dissection for protruding Helicobacter pylori-negative mucosa-associated lymphoid tissue lymphoma of the stomach: a case report

Gastric mucosa-associated lymphoid tissue (MALT) lymphomas have various endoscopic appearances. We report a case of Helicobacter pylori-negative gastric MALT lymphoma with a protruding morphology similar to that of submucosal tumors. A 51-year-old man with a protruding tumor in the gastric cardia was referred to our hospital. Biopsy specimens showed no malignant epithelial tumors or lymphoid hyperplasia. Endoscopic submucosal dissection was performed and the patient was diagnosed with gastric MALT lymphoma. Lymphoma cells were present in the lamina propria mucosae and the submucosa under the non-atrophic fundic gland mucosa, with a feature of homogenous and monotonous growths, which was speculated to have resulted in a protruding morphology similar to that of submucosal tumors. Endoscopic submucosal dissection can be an alternative diagnostic option for gastric MALT lymphoma when the initial pathological diagnosis based on biopsy specimens is difficult.

Physiology of the Vagus Nerve: Basic Medical Research from the Past to the Present

The vagus nerve, which is the 10th cranial nerve, exits from the medulla and distributes widely to the visceral organs. Although it contains the motor, somatic, and sympathetic nerves, the main component is the parasympathetic nerve, which acts as the core of homeostasis. The vagal efferent regulates the cardiac muscle, striated muscle and glands, while the vagal afferent sends the information from the visceral organs to the brain. The vagus nerve is also responsible for the gut-brain axis.

Identifying factors associated with detection of sessile gastric polyps in patients with familial adenomatous polyposis.

Background and study aims Gastric cancer (GC) is increasingly reported and a leading cause of death in patients with familial adenomatous polyposis (FAP). Identifying features in patients with FAP who harbor sessile gastric polyps, likely precursors to GC, may lead to alterations in endoscopic surveillance in those patients and allow endoscopic intervention to decrease the risk of GC. The aim of this study was to identify demographic and clinical factors in patients with FAP who harbor sessile gastric polyps. Patients and methods We retrospectively compared demographic, clinical, and endoscopic features in consecutive adult patients with FAP who presented for a surveillance endoscopy at a tertiary-care center with a FAP registry who harbor sessile gastric polyps to those without them. Sessile gastric polyps included pyloric gland adenomas, gastric adenomas, hyperplastic polyps, and fundic gland polyps with high-grade dysplasia. We also display the location of germline APC pathogenic variants in patients with and without sessile gastric polyps. Results Eighty patients with FAP were included. Their average age was 48 years and 70 % were male . Nineteen (24 %) had sessile gastric polyps. They were older ( P < 0.03), more likely to have a family history of GC ( P < 0.05), white mucosal patches in the proximal stomach ( P < 0.001), and antral polyps ( P < 0.026) compared to patients without a gastric neoplasm. No difference in Spigelman stage, extra-intestinal manifestations, or surgical history was note. 89 % of patients with a gastric neoplasm had an APC pathogenic variant 5’ to codon 1309. Conclusions Specific demographic, endoscopic, and genotypic features are associated with patients with FAP who harbor sessile gastric polyps. We recommend heightened awareness of these factors when performing endoscopic surveillance of the stomach with resection of gastric neoplasia when identified.

Long-term changes in serum gastrin levels during standard dose vonoprazan therapy

Background Long-term acid suppression during vonoprazan therapy causes hypergastrinemia which may induce gastric mucosal changes such as fundic gland and hyperplastic polyps. The aim of this study is to clarify the long-term changes in serum gastrin levels and risk factors for hypergastrinemia. Methods From July 2016 to April 2020, 48 patients receiving vonoprazan 10 mg once daily for more than one year were reviewed. Serum gastrin level was evaluated by radioimmunoassay in a fasting condition (reference range 37–172 pg/ml). Results The baseline median gastrin level was 100 (range, 54–415) pg/ml. The gastrin level over 4 years was 700–1200 pg/ml, which plateaued at 1.5 years. Multivariate analysis revealed factors associated with gastrin levels 12 months after starting vonoprazan and identified severe gastric atrophy as a significant positive risk factor (p = .046). The gastrin level over 4 years in patients with severe gastric atrophy and no atrophy was approximately 900–1500 and 500–1000 pg/ml, respectively. Female gender was also identified as a positive factor, although it was not statistically significant (p = .087). The gastrin level over 4 years in females was approximately 900–1300 pg/ml, greater than in males (500–900 pg/ml). Conclusion A continued increase in gastrin levels was not found during long-term vonoprazan therapy. Severe gastric atrophy is a significant risk factor for hypergastrinemia.

Gastric Duplication in a Preterm Neonate

Background: Gastrointestinal (GI) duplication is defined as a spherical structure with a muscular coat and is lined by a mucous membrane. It is a rare congenital anomaly. Clinical Description: A preterm baby born, delivered at 31 weeks, was diagnosed with respiratory distress syndrome and managed as per hospital protocol. While being weaned off from nasal continuous positive airway pressure, feeding was started. He developed vomiting and epigastric distension within 6 h. Management: The baby was investigated for the cause, and an early-onset sepsis was excluded. X-ray abdomen showed distended stomach and gas shadows in the bowel loops. Ultrasound did not reveal any gastric outlet obstruction, but significant gaseous distension of the stomach prompted us to make a dye study of the upper GI tract, which revealed cystic outpouching of the stomach that communicated with the gastric lumen. Similar findings were seen on computed tomographic scanning. Exploratory laparotomy performed revealed a large cyst communicating with the stomach at the lesser curvature. This was dissected out entirely from the margin of the stomach. Histopathology revealed highly congested cyst wall with an inner lining of gastric epithelium and gastric glands and an outer smooth muscle coat, confirming a gastric duplication cyst. Conclusion: Gastric duplication should be considered as a differential in newborns with feed intolerance, epigastric distension, and significant distension of the stomach. Although serial radiological investigations provide supportive evidence for this condition, the diagnostic confirmation is obtained by gross inspection and histopathology. In view of high risk of malignant transformation, surgical resection of the entire cyst remains the most definitive management.

Clinicopathological characteristics of signet-ring cell carcinoma derived from gastric fovelar epithelium.

We aimed to investigate the immunophenotype, differential diagnosis, and clinicopathological characteristics of signet-ring cell carcinoma (SRCC) derived from gastric foveolar epithelium. Clinical characteristics, endoscopic findings, histopathological features, and follow-up data of seven cases of SRCC derived from gastric foveolar epithelium with small intramucosal lesions were analyzed. Seven patients with a mean age of 38.3 years were diagnosed with SRCC derived from gastric foveolar epithelium and small intramucosal lesions, all of them were negative for CDH-1 germline mutation. The glands proliferated and expanded, and then morphologically transformed into signet-ring cells and formed clonal hyperplastic SRCC, which expanded laterally along the gastric foveolar cells to a length of 3-6 mm. Periodic acid Schiff staining was positive, while CK7 and MUC6 were negative, in all cases. Ki-67-positive cells ranged 37%-60%. During a follow-up period of 6-30 months, no patients experienced tumor recurrence or metastasis. SRCC derived from gastric foveolar epithelium is originated from the proliferative region of the bottom of the gastric pit and gland neck. It is easily missed diagnosed or misdiagnosed as it grows laterally along the gastric foveolar cells. Biological behavior, genetics, and etiology of such SRCC, as well as the clinicopathological characteristics, need to be further studied.