Risk Of Gastritis Research Articles

Polymorphisms of Tumor Necrosis Factor Alpha in Moroccan Patients with Gastric Pathology: New Single-Nucleotide Polymorphisms in TNF-α(-193) (G/A).

Polymorphisms in tumor necrosis factor alpha (TNF-α) gene are emerging as key determinants of gastric diseases. The TNF-α −308 (G/A) and TNF-α −238 (G/A) single-nucleotide polymorphisms SNPs are the most extensively studied. However, all these studies are conducted in Caucasian and Asian populations. Thus, for the first time in Africa, we sought to investigate whether polymorphisms in TNF-α gene were associated with the development of gastric pathology in Morocco. Two SNPs located in the promoter region (positions −308 and −238) in TNF-α gene were genotyped in 244 individuals (170 patients and 74 healthy controls). Odds ratios (ORs) and 95% confidence intervals (CI) were estimated using logistic regression analysis. The TNF-α −238 (G/A) genotype was significantly associated with a high risk of gastritis and gastric cancer (GC) (P = 0.001 and P = 0.002, resp.). Furthermore, a new polymorphism located in the promoter region at position −193 in TNF-α gene was identified. The distribution of this SNP was markedly different in patients suffering from ulcers. The association between TNF-α −193 (G/A) genotype and high risk of ulcer was significant (P = 0.03). These results suggest that the TNF-α −193 (G/A) allele has a protective function against gastric cancer by developing ulcer.

PGC TagSNP and its interaction with H. pylori and relation with gene expression in susceptibility to gastric carcinogenesis.

BackgroundPepsinogen C (PGC) plays an important role in sustaining the cellular differentiation during the process of gastric carcinogenesis. This study aimed to assess the role of PGC tagSNPs and their interactions with Helicobacter pylori (H. pylori) in the development of gastric cancer and its precursor, atrophic gastritis.MethodsFour PGC tagSNPs (rs6941539, rs6912200, rs3789210 and rs6939861) were genotyped by Sequenom MassARRAY platform in a total of 2311 subjects consisting of 642 gastric cancer, 774 atrophic gastritis, and 895 healthy control subjects. The mRNA and protein expression levels of PGC in gastric tissues and in serum were respectively measured by quantitative reverse transcriptase–polymerase chain reaction (qRT-PCR), immunohistochemistry, and Eenzyme-linked immunoabsorbent assay (ELISA).ResultsWe found associations between PGC rs3789210 CG/GG genotypes and reduced gastric cancer risk and between PGC rs6939861 A variant allele and increased risks of both gastric cancer and atrophic gastritis. As for the haplotypes of PGC rs6941539-rs6912200-rs3789210-rs6939861 loci, the TTCA and TTGG haplotypes were respectively associated with increased and reduced risks of both gastric cancer and atrophic gastritis; additionally, the CTCA haplotype was associated with increased atrophic gastritis risk. Very interestingly, rs6912200 CT/TT genotypes had a positive interaction with H. pylori, synergistically elevating the gastric cancer risk. Moreover, healthy subjects who carried rs6912200 CT, TT and CT/TT variant genotypes had lower histological and serum expression levels of PGC protein.ConclusionsOur findings highlight an important role of PGC rs3789210 and rs6939861 in altering susceptibility to atrophic gastritis and/or gastric cancer. Moreover, people who carry rs6912200 variant genotypes exhibit higher gastric cancer risk in case of getting H. pylori infection, which strongly suggest a necessity of preventing and/or eliminating H. pylori infection in those individuals.

Recurrent pregnancy loss and obesity

Recurrent pregnancy loss (RPL) was defined as two or more miscarriages. Antiphospholipid syndrome, uterine anomalies, and parental chromosomal abnormalities, particularly translocation and abnormal embryonic karyotype, are identifiable causes of RPL. Obesity may increase the risk of sporadic miscarriage in pregnancies conceived spontaneously. Obesity with body mass index (BMI)>30 kg/m2 is an independent risk factor for further miscarriage with odds ratio 1.7-3.5 in patients with early RPL. Obesity is associated with euploid miscarriage. Unexplained RPL with euploid embryo might be a common disease caused by both polymorphisms of multiple susceptibility genes and lifestyle factors such as women's age, obesity, and smoking. Patients with a history of RPL were found to have a higher risk of cardiovascular disease, celiac disease, gastric ulcer, gastritis, and atopic dermatitis. No study has examined the effect of weight loss on the prevention of further miscarriage in patients with RPL.

Analysis of the genotypic diversity of strains of Helicobacter pylori isolated from pediatric patients in Mexico

Genotypic differences in Helicobacter pylori play an important role in infection. We characterized the diversity of the cagA, cagE, babA2, and vacA genes in H. pylori strains isolated from pediatric patients and the relationship between these genes and clinical disease. Additionally, we employed the Neighbor-net algorithm to predict the behavior of the genotypes of the strains isolated from patients. Of 93 patients analyzed, 32 were positive for infection. A total of 160 H. pylori strains (five isolates per positive patient) were analyzed. A total of 91% and 83% of strains possessed the cagA and cagE genes, respectively. For the vacA gene, 84% of strains possessed the s1 allele, 15% the s2 allele, 81% the m1 allele and 13.8% the m2 allele. The babA2 gene was present in 79% of strains. Infection with H. pylori strains with the vacA (s1m1) genotype was associated with risk of esophagitis and gastritis (p=0.0001). The combination of cagA and vacA (s1m1) was significantly associated with abdominal pain (p=0.002); however, EPIYA type was not significantly associated with abdominal pain. A total of 16 different genotypes were identified; the most common genotype was vacAs1m1cagA+cagE+babA2+ (47.5%). A total of 84% of pediatric patients were infected by at least two and up to five different genotypes. The network recovered two genotype groups (A: strains with vacAs1 and B: strains with vacAs2). The presence of multiple paths in the network suggests that reticulate events, such as recombination or reinfection, have contributed to the observed genotypic diversity.

Association of Cytokine Gene Polymorphisms with Gastritis in a Kazakh Population

Gastritis and gastric cancer are the most common diseases in the Kazakh population. Polymorphisms in genes coding of cytokines have been played important role with gastric disease risk. The risk alleles of cytokines in patients with gastritis can predict the risk of developing gastric cancer. The aim of this study was to investigate cytokine gene polymorphisms as risk factors for the development of gastritis in a case-control study with gastritis patients and healthy individuals from the Kazakh ethnic group, living in North Kazakhstan. The polymerase chain reaction followed by direct sequencing were used for detection of two functional polymorphisms in the IL1 gene family, and TaqMan SNP Genotyping Assay Sets were applied for three potentially functional polymorphisms in the IL10 gene, and one in the TNFA promoter. Association analysis of studied allelic variants and the development of gastritis in H. pylori- positive patients showed that IL1B -31C/C, IL1B -511T/T and IL1RN -2/2 allelic variants were associated with development of gastritis (OR=1.8 (1.07-3.16), p=0.025; OR=1.7 (1.04-2.99), p=0.035, and OR=4.92 (2.45-9.85), p<0.001) respectively. Haplotype C-T that combines both homozygous allelic variants of IL1B gene also had a statistically significant association with slightly higher OR (OR: 1.43, 95% CI: 1.08-1.88). The data from the current study showed that the genotype IL-1B -511T/-31C-IL1-RN-2 and H. pylori infection increase risk of gastritis in the Kazakh population. That genotype combination might be a factor increasing the risk of developing gastric cancer.

Epigenetic Modifications and Cell Signaling Pathways in GI Carcinogenesis and Prevention

Our team is the Innovation Team of Ministry of Education of China. We have bee engaged in studies on pathogenesis mechanism, prevention and treatment. We first established and verified a mathematical model for chronic atrophic gastritis risk screening. We also found that there are abnormal DNA methylation, histone modifications and non-coding RNAs during GI carcinogenesis. The result from RCT indicated that primary prevention with 1 mg d -1 folic acid supplementation could reduce the incidence of colorectal adenoma. Our group has received the National Second Prize for Progress in Science and Technology in 2008.

Gene polymorphism of interleukin 1 and 8 in chronic gastritis patients infected with Helicobacter pylori

BackgroundEpidemiological investigations have indicated that Helicobacter pylori induces inflammation in the gastric mucosa regulated by several interleukins. The genes IL1B and IL8 are suggested as key factors in determining the risk of gastritis. The aim of this paper was to evaluate the association of gene polymorphism of interleukin-1 and interleukin-8 with chronic gastrits in H. pylori infected patients. A total of 60 patients underwent endoscopic procedure. Biopsy samples were collected for urease test, histopathological and molecular exams. The DNA of theses samples was extracted for detection of H. pylori and analysis of the genes mentioned above. Patients with gastritis had a higher frequency of H. pylori-positive samples.ResultsH. pylori was detected in 30/60 patients (50%) by PCR. As for polymorphism of interleukin 8 (-251) gene we observed a statistical difference when analyzed TA (p = 0.039) and TT (p = 0.047) genotypes. In the IL1B31 there was a statistical difference in TT (p = 0.01) genotype and in the IL1B-511 there wasn’t any statistical difference.ConclusionOur results suggest a strong correlation between the presence of chronic gastritis and infection by H. pylori and that IL1B-31TT and IL8-251TT genotypes appear to act as protective factors against H. pylori infection while IL8-251TA genotype may comprise a risk factor for infection with this bacterium.

Pharmacokinetics and pharmacodynamics of famotidine and ranitidine in critically ill children

To characterize and compare acid suppression (pharmacodynamics) and pharmacokinetics of IV famotidine and ranitidine in critically ill children at risk for stress gastritis. Single-blind, randomized study in PICU patients 6 months to 18 years requiring mechanical ventilation with continuous gastric pH monitoring, randomized to IV famotidine 12 mg/m(2) or ranitidine 60 mg/m(2) when gastric pH < 4.0 >1 hour with serial blood sampling following first dose. Twenty-four children randomized to either famotidine (n = 12) or ranitidine (n = 12). Sixteen out of twenty-four completed both PK and PD study arms (7/12 famotidine; 4.7 ± 3.4 years; 9/12 ranitidine; 6.6 ± 4.7 years; p = 0.38). Time to gastric pH 4.0 and total time pH above 4.0 similar with no difference in pH at 6 and 12 hours (p > 0.2). No difference between drugs in clearance, volume of distribution and half-life (p > 0.05). Ratio of AUC pH to AUC drug concentration 0-12 hours after first dose was significantly greater for famotidine (0.06849 ± 0.01460 SD) than ranitidine (0.02453 ± 0.01448; p < 0.001) demonstrating greater potency of famotidine. pH lowering efficacy of both drugs is similar. Greater potency of famotidine may offer clinical advantage due to lower drug exposure and less frequent dosing to achieve same pH lowering effect.

PP54 Ethnic differences in Upper Gastrointestinal Disease in Scotland

BackgroundThere is a paucity of data assessing ethnic variations in upper gastrointestinal (GI) disease: we sought to study the incidence of upper GI diseases using adequate measure of ethnicity in...

Interleukin-1 Gene Polymorphisms in Chronic Gastritis Patients Infected with Helicobacter pylori as Risk Factors of Gastric Cancer Development

Epidemiological investigations indicated association of the Helicobacter pylori infections with the occurrence of inflammatory conditions of the gastric mucosa and development of chronic gastritis and intestinal type of gastric cancer. IL1A and IL1B genes have been proposed as key factors in determining risk of gastritis and malignant transformation. The aim of this paper was to evaluate association of interleukin-1 gene polymorphisms with chronic gastritis, atrophy, intestinal metaplasia, dysplasia and intestinal type of gastric cancer in H. pylori-infected patients. Patients subjected to analysis represent group of 144 consecutive cases that suffered from dyspepsia with coexisting infection of H. pylori and chronic gastritis, chronic atrophic gastritis, intestinal metaplasia, dysplasia or gastric cancer. Molecular studies involved analysis of –889C>T polymorphism of IL1A gene and +3954C>T polymorphism of IL1B gene. Statistical analysis of association of polymorphism –889C>T of gene IL1A with changes in gastric mucosa showed lack of significance, whereas +3954C>T polymorphism of IL1B gene showed significant association. Frequency of allele T of +3954C>T polymorphism of IL1B gene was higher in group of patients with chronic gastritis, atrophy, intestinal metaplasia, dysplasia or intestinal type of gastric cancer (32.1 %) as compared with population group (23 %), χ2 = 4.61 and p = 0.03. This corresponds to odds ratio: 1.58, 95 % CI: 1.04–2.4. Our results indicate that +3954C>T polymorphism of IL1B gene increase susceptibility to inflammatory response of gastric mucosa H. pylori-infected patients and plays a significant role in the development of chronic gastritis, atrophy, intestinal metaplasia, dysplasia and the initiation of carcinogenesis.

Prevalence ofHelicobacter pylori cagAandvacAallelic variants and associated disease outcomes in Kenyan patients with dyspepsia

Although Helicobacter pylori has been linked to various gastric disorders in Western countries and Asia, its aetiopathological role in African populations is controversial. The aim of this study was to investigate the role of H. pylori and its virulence genotypes in gastrointestinal diseases in Kenyan patients with dyspepsia. Gastric biopsy specimens were obtained for DNA isolation and histopathological analysis. Amplification was performed using specific oligonucleotide primers. H. pylori positivity was determined by H. pylori stool antigen test, rapid urease test, and histology and molecular diagnostic tools. H. pylori was detected with high frequency in patients with gastritis, peptic ulcer disease (PUD) and gastro-oesophageal reflux disease. This implies a significant risk of the development of these pathologies (p-value = 0.0000 in all cases). H. pylori strains with cagA occurred more frequently in PUD (65.2%). vacA s1a genotype appeared to play a more significant pathological role (82.6% PUD) than the other variants (p-value = 0.0142). The prevalence of vacA m1 was significantly higher in gastritis cases (p-value = 0.0253). vacA m2 was found to be significantly associated with gastritis (p-value = 0.0253). This finding may point to the fact that H. pylori vacA m1 and vacA m2 are independently associated with an increased risk for gastritis. Indications are that H. pylori prevalence in Kenya may be declining. The independently occurring H. pylori genotypes, as opposed to simultaneous carriage, could be the reason for the low distribution of H. pylori pathologies.

Irregular Meal Timing Is Associated with Helicobacter pylori Infection and Gastritis.

Helicobacter pylori (HP) is associated with chronic gastritis and gastric cancer, and more than half of the world's population is chronically infected. The aim of this retrospective study was to investigate whether an irregular meal pattern is associated with increased risk of gastritis and HP infection. The study involved 323 subjects, divided into three groups as follows: subjects with HP infection and gastritis, subjects with gastritis, and a control group. Subjects were interviewed on eating habits and meal timing. Multivariate logistic regression was used to compare groups. Adjusted odds ratios (OR) were derived controlling for gender, age, stress, and probiotic consumption. Subjects who deviated from their regular meals by 2 hours or more had a significantly higher incidence of HP infection with gastritis (adjusted OR = 13.3; 95% CI 5.3–33.3; P < 0.001) and gastritis (adjusted OR = 6.1; 95% CI 2.5–15.0; P < 0.001). Subjects who deviated their meals by 2 hours or more, twice or more per week, had an adjusted OR of 6.3 and 3.5 of acquiring HP infection with gastritis (95% CI 2.6–15.2; P < 0.001) and gastritis (95% CI 1.5–8.5; P < 0.001), respectively. Frequent deviation in meal timing over a prolonged period appears associated with increased risk of developing HP infection and gastritis.

Forty years without symptoms after choledochogastrostomy

Introduction: The preferred surgical procedures for internal biliary drainage are choledochojejunostomy and choledochoduodenostomy. Cholangiogastrostomy is not recommended because of the potential risk of bile gastritis, and because reflux of gastric fluid into the biliary tree might occur and cause complications in the long run. Cholangiogastrostomy by surgery, endoscopy or by a combined fluoroscopic, endoscopic and laparoscopic approach have been described. However, these procedures were mostly used in patients with advanced malignant diseases and therefore data concerning the long-term risks of biliary drainage into the stomach are limited. To our best knowledge this is the first report about a patient who was free of symptoms during a follow-up period of several decades after choledochogastrostomy.

고등학교 3학년 학생들이 인지한 위염 및 장염 관련요인 -2009년 청소년 건강행태 온라인 조사 자료를 중심으로-

이 연구는 2009년 청소년 건강행태온라인조사에 참여한 우리나라 고등학교 3학년 학생 11,753명을 대상으로 위염 및 장염에 영향을 미치는 관련 요인들을 알아보기 위해 SAS 9.2 version, E-Miner를 이용하여 서베이 로지스틱과 의사결정나무분석을 하였다. 대상자중 남자가 5,685명(47.6%), 여자가 6,068명(52.4%) 이었으며 '오랫동안 위염 및 장염을 앓고 있다'고 응답한 응답자는 8.7% 이었고, 여자가 위염 및 장염 발생률이 조금 더 높게 나타났다(P<.001). 위염 및 장염 발생에 스트레스 및 건강행태는 양의 상관관계가 있는 것으로 나타났으며 스트레스 인지가 높을수록, 주관적 건강상태가 좋지 않을수록, 흡연, 자살생각, 자살시도, 심한 음주나 13세 이전에 음주를 시작 할수록, 대상자의 위염 및 장염 발생에 유의하게 영향을 미치는 것으로 나타났다.(P<.001) 따라서 청소년의 위염 및 장염인지에 대한 호소에 관심과 면밀한 평가 및 관리에 대한 간호중재가 필요할 것으로 여겨진다. This study analyzed the related factors affecting to perceived gastritis or perceived enteritis for 11,753 Korean high school seniors who participated in the 2009 Korea Youth Risk Behavior Web-based Survey (KYHRBWS). Of the subjects, 5,685 (47.6%)were male and 6,068(52.4%) were female and 8.7% of the students responded that they had suffered from gastritis or enteritis for a long time and the females had a slightly higher attack rate of gastritis or enteritis. Survey logistic regression models and decision tree analysis were used to calculate odd ratios and 95% confidence intervals. As a result, there was affecting to their stress and health behaviors in the risk of gastritis and enteritis, and that their lower level perceived health, smoking, heavy drinking or starting drinking before they were 13 years old and a higher level of perceived stress significantly affected the risk of gastritis or enteritis in the subjects(p<.001).

IL-1ra anti-inflammatory cytokine polymorphism is associated with risk of gastric cancer and chronic gastritis in a Brazilian population, but the TNF-β pro-inflammatory cytokine is not

Genetic polymorphisms in genes that codify inflammatory cytokines have been associated with gastric carcinogenesis. This study evaluated polymorphisms IL-1RN VNTR and TNFB+252A/G in a population from Southeast Brazil with regard to the risk of chronic gastritis and gastric cancer and the presence of an association of gastric lesions with risk factors such as gender, age, smoking, drinking and Helicobacter pylori infection. In this case-control study, polymorphism at IL-1RN VNTR was investigated using the allele-specific polymerase chain reaction method, while the polymerase chain reaction-restriction fragment length polymorphism technique was used to identify the TNFB+252A/G genotype in 675 Brazilian individuals [229 with chronic gastritis (CG), 200 with gastric cancer (GC) and 246 healthy individuals as controls (C)]. Multiple logistic regression analysis (log-additive, dominant, and recessive models) have not showed association of the genotype frequencies for the SNP TNFB + 252A/G with risk of CG or GC. However, as for IL-1RN VNTR it was observed significant differences in all three analysis models, with higher values of OR in recessive model, both in the GC group (OR = 3.04, 95% CI = 1.41-6.56, p < 0.01) and CG (OR = 2.32, 95% CI = 1.10-4.90, p = 0.02) compared to the C group. In addition, the multiple logistic regression showed also an association with risk factors such as male gender, older age and alcohol intake regarded GC group. So, our results indicated that the IL-1RN*2 allele may increase the risk of gastric cancer and precancerous lesions in the Southeast Brazilian population, reinforcing the importance of host genetic factors in the susceptibility to gastric cancer and the participation of cytokines in both the inflammation and the carcinogenic process.

Identification of life habits factors as risk for gastritis and colitis occurrence in a mestizo population of Chabeklumil, Chiapas, M&amp;#233;xico

Aim: Gastric diseases are a recent trend in morbidity in México. We aimed to identify most frequent life habits factors as risk for gastritis and colitis occurrence, in a Mexican mestizo population in Chabeklumil, Chiapas. Population: This study was observational, descriptive, transversal and prospective; 346 questionnaires were applied to individuals of both genders from 11 years of age, with low income and socio-economic status, after they signed the informed consent. An individual file was created by the nurses in Chabeklumil. The predominant gender in the population was female (56.1%), with a distribution of 166 among adulthood (19 - 59 years of age); among males (43.9%), 133 included adults. Results: We identified the following environmental risk factors to develop gastritis and colitis: long periods of daily fasting > consumption of irritant food and drink > stress, in females; in contrast, males reported alcohol and tobacco consumption > irritant food and drink > long periods of daily fasting > stress. We found statistical differences (P < 0.05) in risk factors between females and males, in drugs and alcohol consumption, fasting, and stress, but not in consumption of irritant foods, nor in colitis and gastritis prevalence. Conclusions: Females are most affected by life habits risk factors for gastritis/colitis, which occurs mainly due to lifestyle and “macho” culture, since women are precluded of a better living standard, they work hard in the field, and start early in the day without consuming a meal, which they eat late in the day once arriving home. People in Chabeklumil eat/drink a lot of irritant food like hot pepper and coffee, which damage the gastrointestinal system leading to gastritis and colitis. Furthermore, men started to consume drugs at early ages, a condition also involved in developing gastritis.

Polymorphisms of theTLR2andTLR4genes are associated with risk of gastric cancer in a Brazilian population

To investigate toll-like receptor 2 (TLR2) -196 to -174 del, and TLR4 (+896A/G rs4986790 and +1196C/T rs4986791) polymorphisms at risk of chronic gastritis and gastric cancer in a Brazilian population and association of gastric lesions with risk factors such as smoking, alcohol intake and Helicobacter pylori infection. In this case-control study, polymorphism at TLR2 -196 to -174 del was investigated by using the allele-specific polymerase chain reaction (PCR) method, while the PCR-restriction fragment length polymorphism technique was carried out to identify the TLR4 (rs4986790 and rs4986791) genotypes in 607 Brazilian individuals (208 with chronic gastritis-CG, 174 with gastric cancer-GC and 225 controls -C). The single nucleotide polymorphisms TLR4+1196C/T was not associated with risk of chronic gastritis or gastric cancer and the homozygous genotypes TLR4+896GG and TLR4+1196TT were absent in the studied population. However, the frequency of TLR2 -196 to -174 ins/del + del/del and TLR4+896AG genotypes was significantly higher (P < 0.01 and P = 0.01, respectively) in the cancer group (33.4% and 11.5%, respectively) than in the control group (16.9% and 4.5%, respectively). It was also observed that the G-C haplotype of the TLR4+896A/G+1196C/T (P = 0.02) and the combination of variant alleles of the TLR2/TLR4+896G (P = 0.02) are associated with susceptibility to gastric cancer. In addition, the multiple logistic regression showed that male gender [odds ratio (OR) = 2.70; 95% CI: 1.66-4.41; P < 0.01], alcohol intake (OR = 2.93; 95% CI: 1.76-4.87; P < 0.01), TLR2 -196 to -174 del (OR = 2.64; 95% CI: 1.56-4.44; P < 0.01) and TLR4+896G (OR = 3.19; 95% CI: 1.34- 7.61; P < 0.01) polymorphisms were associated with a higher susceptibility to developing this neoplasm. Our data indicate that TLR2 -196 to -174 del and TLR4+896G may increase the risk of gastric cancer in a Brazilian population.

Lower Serum Level of Adiponectin Is Associated with Increased Risk of Endoscopic Erosive Gastritis

Obesity is recently known as a risk factor for endoscopic gastritis. Adiponectin is an anti-inflammatory cytokine secreted from fat tissue, and its serum concentrations are reduced in obesity. The relation between adiponectin and gastritis remains unclear. The aim of this study was to determine whether lower serum adiponectin level is associated with the risk of endoscopic gastritis. We analyzed medical records of participants of a routine health check-up examination. Association among endoscopic findings, serum adiponectin level, and other clinical factors including age, sex, alcohol habit, smoking habit, body mass index (BMI), blood pressure, cholesterol, triglyceride, glucose, and insulin were investigated. Endoscopic erosive gastritis was defined as a flat or minimally depressed white spot surrounded by a reddish area or small elevation with central umbilications mimicking octopus' suckers. A total of 2,400 participants were enrolled. BMI was significantly higher in gastritis-positive participants than in gastritis-negative participants. Serum adiponectin levels were significantly lower in gastritis-positive participants than in gastritis-negative participants. Multivariate logistic regression analysis revealed that lower serum adiponectin level (OR 0.96; 95% CI 0.93-0.99), smoking (OR 0.50; 95% CI 0.30-0.80), higher blood pressure (OR 1.02; 95% CI 1.01-1.03), and duodenitis (OR 1.8; 95% CI 1.00-3.09) were significantly associated with endoscopic erosive gastritis. Lower serum level of adiponectin may increase the risk of endoscopic erosive gastritis, independently of BMI. Our findings facilitate further study to clarify the role of hypoadiponectinemia in erosive gastritis.

Do We Need Multiple Biopsies for Assessing Gastric Cancer Risk?

It is widely accepted that differentiated-type gastric cancers evolve through a multistep process starting with Helicobacter pylori-associated superficial gastritis, followed by atrophy, intestinal metaplasia (IM), dysplasia, and finally carcinoma [1]. Thus, the identification of such precancerous condition and follow-up of patients in whom they are found could lead to the diagnosis of gastric cancer at early stage and improved patient survival. However, diagnosis of atrophy and IM by conventional white light endoscopy has high inter-observer variability [2] and a poor correlation with histological findings [3]. Consequently, the diagnosis of atrophy or IM is currently based on histology of biopsy specimens from certain anatomic locations of the gastric mucosa, i.e., the updated Sydney system [4]. This system recommends taking at least five biopsy specimens (two from the antrum, two from the corpus and one from the incisura angularis) to grade severity of neutrophils (activity) and lymphocytic infiltration (inflammation), glandular atrophy (atrophy), and intestinal metaplasia. A recent Western publication proposes a staging system to classify gastric cancer risk in clinical practice on the basis of the histological findings of multiple biopsies [5]. The reason for taking biopsies from multiple sites in the stomach is that the grade and distribution of gastritis are different at each site of the stomach in a patient with chronic atrophic gastritis. Mapping studies of biopsy findings suggested that chronic atrophic gastritis develops from the lesser curvature of the lower gastric body and extends upward and laterally in the corpus [6]; therefore, knowledge of the biopsy site is important to interpret histological finding of gastritis in multiple biopsy specimens. When we investigated association between gastric cancer risk and histological grade of gastritis at the each biopsy site in the stomach, the presence of IM in the lesser curvature of the corpus had the strongest association with cancer risk among other findings of gastritis in the other sites [7]. Although gastritis is regarded as a histological entity, many attempts have been made to diagnose the disease macroscopically during esophagogastroduodenoscopy (EGD). Kimura et al. [8] suggested that the endoscopic finding of atrophic mucosa was pale yellowish mucosa with increased mucosal vessel visibility, indicating that it was related to histological finding of atrophy of fundic gland (pseudo-pylorization) by step-wise biopsy across the endoscopic atrophic border. When the atrophic border remained on the lesser curvature of the corpus, the diagnosis was made as closed-type atrophic gastritis (antral predominant gastritis), whereas when the atrophic border no longer exists on the lesser curvature and extends along the anterior and posterior walls of the stomach, the diagnosis was made as open-type atrophic gastritis (pangastritis or corpus predominant gastritis). This endoscopic diagnostic criterion is commonly accepted and practically used for the diagnosis of chronic atrophic gastritis in Japan. Actually, Uemura et al. [9] indicated that extent of mucosal atrophy diagnosed by endoscopy was associated with risk for development of gastric cancer in a large-scale cohort study. In contrast to point evaluation of gastritis by biopsy, endoscopy is advantageous to evaluate the actual extent and distribution of atrophy or IM in the gastric mucosa that is related to gastric carcinogenesis. Ahn et al. [10] showed that mucosa in patients with open-type atrophic gastritis had more IM and Cdx2 N. Uedo (&) Department of Gastrointestinal Oncologym, Endoscopic Training and Learning Center, Osaka Medical Center for Cancer and Cardiovascular Diseases, 3-3 Nakamichi 1-chome, Higashinari-ku, Osaka 537-8511, Japan e-mail: uedou-no@mc.pref.osaka.jp

Association of IL1B -511C/-31T haplotype and Helicobacter pylori vacA genotypes with gastric ulcer and chronic gastritis

BackgroundThe association between proinflammatory cytokine gene polymorphisms and gastric diseases related to Helicobacter pylori varies by population and geographic area.Our objective was to determine if the IL-1B -511 T>C and -31 C>T polymorphisms and H. pylori vacA genotypes are associated with risk of chronic gastritis and gastric ulcer in a Mexican population.MethodsWe conducted endoscopic studies in 128 patients with symptoms of dyspepsia. We took two biopsies from the body, antrum, or ulcer edge from each patient, and classified our histopathological findings according to the Sydney System. H. pylori infection and vacA genotyping were accomplished via PCR from total DNA of the gastric biopsies. We confirmed the presence of anti-H. pylori serum IgG and IgM in 102 control subjects. In both case subjects and control subjects, the IL-1B -511 T>C polymorphism was genotyped by PCR-RFLPs and the IL-1B -31 C>T polymorphism was genotyped by pyrosequencing.ResultsSixty-two point seven (62.7%) of the 102 control subjects were H. pylori-seropositive. Among the case subjects, 100 were diagnosed with chronic gastritis and 28 with gastric ulcer. We found that 77% of the patients with chronic gastritis and 85.7% of the patients with gastric ulcer were H. pylori-positive. The predominant H. pylori genotype was vacA s1m1 (58.4%) and the most frequent subtype was vacA s1. The -511 TC, (rs16944 -511 T>C) genotype and the -511C allele were associated with chronic gastritis (OR = 3.1, 95% CI = 1.4-6.8 and OR = 3.0, 95% CI = 1.4-6.0, respectively). The subjects carrying -31T (rs1143627 -31 C>T) were found to be at a higher risk of having chronic gastritis (OR = 2.8, 95% CI = 1.3-5.8). The IL-1B -511C/-31T haplotype was associated with chronic gastritis (OR = 2.1, 95% CI = 1.2-3.8) but not with gastric ulcer.ConclusionsThe H. pylori vacA genotypes identified herein were similar to those reported for other regions of Mexico. The vacA s1m1 genotype was not associated with gastric ulcer. In the southern Mexican population, the IL-1B -511C and -31T alleles and the -511C/-31T and -511T/-31T haplotypes are associated with increased risk of chronic gastritis and gastric ulcer.