Pepsinogen Levels Research Articles

Helicobacter pylori, clinical, laboratory, and noninvasive biomarkers suggestive of gastric damage in healthy school-aged children: A case-control study

BackgroundHelicobacter pylori is acquired largely in early childhood, but its association with symptoms and indirect biomarkers of gastric damage in apparently healthy children remains controversial. We aimed to relate persistent H. pylori infection in apparently healthy school-aged children with clinical, laboratory, and noninvasive biomarkers suggestive of gastric damage using a case-control design. Materials and methodsWe followed up 83 children aged 4–5 years with persistent H. pylori infection determined by stool antigen detection and/or a urea breath test and 80 noninfected matched controls from a low-income to middle-income, periurban city in Chile for at least 3 years. Monitoring included clinical visits every 4 months and annual assessment by a pediatric gastroenterologist. A blood sample was obtained to determine laboratory parameters potentially associated with gastric damage (hemogram and serum iron and ferritin levels), biomarkers of inflammation (cytokines, pepsinogens I and II, and tissue inhibitor metalloproteinase 1), and expression of cancer-related genes KLK1, BTG3, and SLC5A8. ResultsPersistently infected children had higher frequency of epigastric pain on physical examination (40% versus 16%; P = 0.001), especially from 8 to 10 years of age. No differences in anthropometric measurements or iron-deficiency parameters were found. Persistent infection was associated with higher levels of pepsinogen II (median 12.7 ng/mL versus 9.0 ng/mL; P < 0.001); no difference was observed in other biomarkers or gene expression profiles. ConclusionsH. pylori infection in apparently asymptomatic school-aged children is associated with an increase in clinical symptoms and in the level of one significant biomarker, pepsinogen II, suggesting early gastric involvement.

Changes of serum pepsinogen level and ABC classification after bariatric surgery

Very few studies have explored the changes of serum pepsinogen after bariatric surgery and no research has evaluated the feasibility of ABC classification to predict gastric cancer risk after bariatric surgery. We enrolled 94 obese subjects that received bariatric surgery, including 41 sleeve gastrectomy (SG) and 53 Roux-en-Y gastric bypass (RYGB). The serum pepsinogen I (PGI), pepsinogen II (PGII), PGI/II ratio and seropositivity of Helicobacter pylori ( H. pylori ) were measured before and one year after surgery. Patients were classified according to ABC classification and post-operative change was evaluated. Preoperatively, four (4.2%) patients were classified into high risk group (classification C and D) for gastric cancer. Significant reduction of PGI, PGII and decrease of PGI/II ratio were noted after bariatric surgery. H. pylori seropositive patients had a greater postoperative change of PGI (-38.6μg/L vs -22.1μg/L, p=0.003) and PGII (-8.0μg/L vs -2.5μg/L, p <0.001) but a less postoperative change of PGI/II ratio (-0.6 vs -2.1, p =0.04) than H. pylori seronegative patients. One year after surgery, the portion of high risk group of ABC classification for gastric cancer increased markedly from 4.2% to 23.7%. Both of SG and RYGB resulted in significant reduction of serum PGI and PGII after bariatric surgery, and significantly influenced the ABC classification. The application of ABC classification for gastric cancer screening was limited after bariatric surgery.

Genetic polymorphism of the infl ammatory cytokines IL-1β and IL-6 in patients with serologically identifi ed atrophic gastritis

Background : some researchers have demonstrated a link between the genetic polymorphism of certain pro-infl ammatory cytokines (IL-1β, IL-6) and the risk of developing precancerous diseases of the stomach and gastric cancer (GC). Aim : to study the genotypes and alleles frequency of polymorphisms of –511C/T (rs16944) of the IL1B gene and 174G/C (rs1800795) of the IL6 gene in patients with serologically detected atrophic gastritis (AG) — the main precancerous lesions of the stomach. Materials and methods . the study included 55 people (45 females and10 males) with an average age of 58.2 ± 11.5 years with signs of obvious or possible atrophy of diff erent parts of the gastric mucosa revealed by enzyme-linked immunosorbent assay (ELISA) with determination of pepsinogen levels I (PGI), PGII, the PGI / PGII ratio, gastrin-17 and IgG antibodies to H. pylori using the “GastroPanel” diagnostic kit (Biohit Plc, Helsinski, Finland). DNA was isolated from venous blood using the phenol-chloroform extraction method. DNA samples were genotyped according to published methods. Results : in patients with severe AG (PGI level less than 30 μg/l), the combined variant with the rare T allele (T/T + C/T) was detected signifi cantly more often (68.8%) than the common homozygous C/C variant (31, 3%, p = 0.004). In individuals with a low PGI/PGII ratio (less than 3), which is also evidence of fundamental atrophy, the homozygous T/T variant was more common (29.6%) than the C/C genotype (7.4%, p = 0.04) The average PGI values were signifi cantly lower with the C/C genotype of the IL-6 gene compared with the heterozygous C/G variant (p = 0.03), however, in patients with morphologically confi rmed atrophy, the combined variant with the rare G allele (G/G + C/G) of the IL6 gene was more common than the homozygous C/C variant (71.4% versus 28.6%, p = 001). Conclusions : in patients with signs of corpus atrophy (low PGI, PGI PGII ratios), the homozygous variant with a rare T allele, which is associated with increased IL-1β production and the development of a hypoacid state, was 4 times more likely than the homozygous C/C variant (p = 0.04). The results obtained suggest a possible association of IL1B polymorphism (carriage of a rare T allele) with the formation of a cancer phenotype of gastritis. The contribution of IL6 polymorphism requires further refi nement.

Helicobacter pylori Infection and Serum Pepsinogen Level With the Risk of Gastric Precancerous Conditions: A Cross-sectional Study of High-risk Gastric Cancer Population in China.

Gastric precancerous conditions are generally considered to play an essential role in the gastric carcinogenesis cascade. This study identified risk factors of gastric precancerous conditions in a nationwide multicenter cross-sectional study. Individuals who made their visit to 115 hospitals in China for gastric cancer screening were recruited. Lifestyle habits and personal information were collected through a series of questionnaires. Serum biomarker test (pepsinogen I, pepsinogen II, gastrin-17, and anti-Helicobacter pylori immunoglobulin G antibody) and endoscopy were then performed. Risk factors for gastric precancerous conditions were identified by univariate and multivariate analyses. Of 14,929 subjects eligible for analysis, 4477 (30.0%) developed gastric precancerous conditions and 405 (2.71%) developed gastric cancer. In multiple logistic regression, precancerous conditions were associated with advanced age [odds ratio (OR)=1.027; 95% confidence interval (Cl), 1.023-1.032; P<0.001], male gender (OR=1.303; 95% Cl, 1.188-1.429; P<0.001), H. pylori infection (OR=1.377; 95% Cl, 1.272-1.490, P<0.001), and smoking (OR=1.142; 95% Cl, 1.005-1.298, P=0.004), whereas they were inversely correlated with white meat intake (OR=0.731; 95% Cl, 0.673-0.794; P<0.001) and pepsinogen I level (30 to 70 subgroup OR=1.536; 95% Cl, 1.163-2.028; P=0.002; <30 subgroup OR=1.354; 95% Cl, 1.206-1.520; P<0.001). Also, the authors observed a statistically lower prevalence of reflux esophagitis (2.8% vs. 4.7%) and of gastric polyps (11.0% vs. 13.7%) in H. pylori-infected population. Patients with H. pylori have a 1.4-fold higher risk of having gastric precancerous conditions. Besides, precancerous conditions were associated with advanced age, male gender, H. pylori infection, and smoking in a large population. However, regular white meat intake and higher pepsinogen I level were associated with reduced risk of having precancerous lesions.

Pre-existing Helicobacter pylori serum IgG enhances the vibriocidal antibody response to CVD 103-HgR live oral cholera vaccine in Malian adults

Accumulating evidence indicates that persistent Helicobacter pylori gastric infection influences immune responses to oral enteric vaccines. We studied the association between pre-existing H. pylori serum IgG and serum pepsinogens levels (PGs) as markers of gastric inflammation and the immune response to single-dose live oral cholera vaccine CVD 103-HgR in Malian adults. Baseline sera obtained during a phase 2 safety/immunogenicity clinical trial of cholera vaccine CVD 103-HgR among 93 healthy Malian adults were tested for H. pylori IgG antibodies and PGI and PGII levels using enzyme linked immunosorbent assays. Overall 74/93 (80%) vaccine recipients were H. pylori IgG seropositive at baseline. Vibriocidal antibody seroconversion (≥ fourfold increase 14 days following administration of CVD 103-HgR compared to baseline) among vaccine recipients was 56%. However, vibriocidal antibody seroconversion was markedly higher among H. pylori seropositives than seronegatives 64% vs. 26% (p = 0.004); adjusted relative risk: 2.20 (95% confidence intervals 1.00–4.80; p = 0.049). Among H. pylori seropositive vaccine recipients, there were no significant associations between PGI, PGII and PGI:PGII levels and vibriocidal seroconversion. The enhanced seroconversion to oral cholera vaccine CVD 103-HgR among H. pylori seropositive African adults provides further evidence of the immunomodulating impact of H. pylori on oral vaccine immunogenicity.

Systematic review and Meta-analysis of efficacy and safety of Yangwei Granules for chronic gastritis

To systematically evaluate the efficacy and safety of Yangwei Granules combined with conventional Western medicine for chronic gastritis. CNKI, SinoMed, WanFang, VIP, PubMed, Cochrane Library and EMbase database were electronically retrieved to collect randomized controlled trial(RCT) of Yangwei Granules combined with conventional Western medicine for chronic gastritis. Two reviewers independently screened out literatures according to the inclusion and exclusion criteria and extracted data, and evaluated the risk of bias of included studies. Meta-analysis was conducted by using RevMan 5.3 software. A total of 12 RCTs involving 1 164 patients were included. The results of Meta-analysis showed that:(1) The total effective rate of Yangwei Granules combined with conventional Western medicine for chronic gastritis was better than that of conventional Western medicine group, with a statistically significant difference(RR=1.24,95%CI[1.17,1.31],P&lt;0.000 01).(2) Compared with the conventional Western medicine group, the Yangwei Granules combined with conventional Western medicine group was conducive to improving the Hp eradication rate, with a statistically significant difference(RR=1.24,95%CI[1.15,1.34],P&lt;0.000 01).(3) The incidence of adverse reactions in Yangwei Granules combined with conventional Western medicine group was lower than that in the control group, but with no statistically significant diffe-rence(RR=0.83, 95%CI[0.39, 1.79], P=0.64).(4) Compared with the conventional Western medicine group, the Yangwei Granules combined with conventional Western medicine group was beneficial to the reduction of motilin level(MD=-17.31,95%CI[-21.83,-12.79],P&lt;0.000 01) and endothelin level(MD=-6.60,95%CI[-10.07,-3.13],P=0.000 2), while the increase of gastrin level(SMD=0.94,95%CI[0.50,1.38],P=0.003) was related to calcitonin gene the level of peptide(MD=5.82,95%CI[4.25,7.39],P&lt;0.000 01), with statistically significant differences.(5) Compared with conventional Western medicine group, Yangwei Granules combined with conventional Western medicine group could increase PGⅠ(MD=6.40,95%CI[4.26,8.54],P&lt;0.000 01) and PGR(MD=0.89,95%CI[0.71,1.07],P&lt;0.000 01), while decrease PGⅡ(MD=-1.24,95%CI[-2.15,-0.33],P=0.007), with statistically significant differences. Current evidence showed that the clinical efficacy and Hp eradication rate of Yangwei Granules combined with conventional Western medicine in the treatment of chronic gastritis were better than those of the conventional Western medicine group alone, and could effectively improve the level of gastrointestinal hormones, vasoactive peptide and the pepsinogen level in patients with chronic atrophic gastritis, without increasing the incidence of adverse reactions. However, due to the limited quality and quantity of included studies, the above conclusions need to be confirmed by more large-scale and high-quality RCTs.

Establish a Scoring Model for High-Risk Population of Gastric Cancer and Study on the Pattern of Opportunistic Screening.

Objective To investigate and study the related risk factors of gastric cancer (GC) patients, to establish a high-risk scoring model of GC by multiple logistic regression analysis, and to explore the establishment of a GC screening mode with clinical opportunistic screening as the main method, and by using the pattern of opportunistic screening to establish the screening of high-risk GC patients and the choice of screening methods in the clinical outpatient work. Methods Collected the epidemiological questionnaire of 99 GC cases and 284 non-GC patients (other chronic gastric diseases and normal) diagnosed by the General Hospital of Ningxia Medical University from October 2017 to March 2019. Serum pepsinogen (PG) levels were measured by enzyme-linked immunosorbent assay (ELISA) and confirmed Helicobacter pylori (Hp) infection in gastric mucosa tissues by Giemsa staining. Determined the high-risk factors and established a scoring model through unconditional logistic regression model analysis, and the ROC curve determined the cut-off value. Then, we followed up 26 patients of nongastric cancer patients constituted a validation group, which validated the model. Results The high-risk factors of GC included age ≥ 55, male, drinking cellar or well water, family history of GC, Hp infection, PGI ≤ 43.6 μg/L, and PGI/PGII ≤ 2.1. Established the high-risk model: Y = A × age + 30 × gender + 30 × drinking water + 30 × Hp infection + 50 × family history of GC + B × PG level. The ROC curve determined that the cut-off value for high-risk GC population was ≥155, and the area under the curve (AUC) was 0.875, the sensitivity and specificity were 87.9% and 71.5%. Conclusions According to the risk factors of GC, using statistical methods can establish a high-risk scoring model of GC, and the score ≥ 155 is divided into the screening cut-off value for high-risk GC population. Using this model for clinical outpatient GC screening is cost-effective and has high sensitivity and specificity.

Regional variations in Helicobacter pylori infection, gastric atrophy and gastric cancer risk: The ENIGMA study in Chile.

Regional variations in gastric cancer incidence are not explained by prevalence of Helicobacter pylori, the main cause of the disease, with several areas presenting high H. pylori prevalence but low gastric cancer incidence. The IARC worldwide H. pylori prevalence surveys (ENIGMA) aim at systematically describing age and sex-specific prevalence of H. pylori infection around the world and generating hypotheses to explain regional variations in gastric cancer risk. We selected age- and sex-stratified population samples in two areas with different gastric cancer incidence and mortality in Chile: Antofagasta (lower rate) and Valdivia (higher rate). Participants were 1-69 years old and provided interviews and blood for anti-H. pylori antibodies (IgG, VacA, CagA, others) and atrophy biomarkers (pepsinogens). H. pylori seroprevalence (Age-standardized to world population) and antibodies against CagA and VacA were similar in both sites. H. pylori seroprevalence was 20% among children <10 years old, 40% among 10-19 year olds, 60% in the 20-29 year olds and close to or above 80% in those 30+ years. The comparison of the prevalence of known and potential H. pylori cofactors in gastric carcinogenesis between the high and the low risk area showed that consumption of chili products was significantly higher in Valdivia and daily non-green vegetable consumption was more common in Antofagasta. Pepsinogen levels suggestive of gastric atrophy were significantly more common and occurred at earlier ages in Valdivia, the higher risk area. In a multivariate model combining both study sites, age, chili consumption and CagA were the main risk factors for gastric atrophy. The prevalence of H. pylori infection and its virulence factors was similar in the high and the low risk area, but atrophy was more common and occurred at younger ages in the higher risk area. Dietary factors could partly explain higher rates of atrophy and gastric cancer in Valdivia. The ENIGMA study in Chile contributes to better understanding regional variations in gastric cancer incidence and provides essential information for public health interventions.

Associations of Serum Pepsinogens and Helicobacter Pylori Infection with High-Sensitivity C-Reactive Protein in Medical Examination Population.

This study aimed to clarify the distribution characteristics of serum pepsinogen (PG) and Helicobacter pylori in the medical examination population and to explore the relationships of PG level and H. pylori infection status with the high-sensitivity C-reactive protein (hsCRP) level and their significance in health examination. We detected H. pylori infection by C13 urea breath test, the serum pepsinogen I (PGI) and pepsinogen II (PGII) contents were measured by chemiluminescence microparticle immunoassay, and the PGI/PGII ratio was calculated. In addition, the serum hsCRP level was determined by the Abbott C16000 automatic biochemical analyzer. The PGI and hsCRP levels were significantly higher in men than in women, and the PGII level was slightly higher in men than in women (both P <.05). The PGI, PGII, and hsCRP levels were positively correlated with age (r = 0.210, 0.287, and 0.133, respectively; P <.05), whereas the PGI/PGII ratio was negatively correlated with age (r = -0.190; P <.05). The positive H. pylori infection rate was 30.2% among the patients in this study; H. pylori infection was not related to sex (P >.05), and the difference in age stratification was not statistically significant (P >.05). The abnormal PGI/PGII ratio in the medical examination population was not correlated with sex (P >.05). In the H. pylori positive infection group, the proportion of PGI/PGII ratio <3, the PGI and PGII levels were significantly higher than those in the H. pylori negative infection group, and the PGI/PGII ratio was significantly lower than that in the negative group (both P <.05). The hsCRP level was not associated with H. pylori infection (P >.05), and it was significantly higher in the PGI/PGII ratio <3 group than in the PGI/PGII ratio ≥3 group (P <.05). The PGI and PGII levels and the PGI/PGII ratio are correlated with H. pylori infection. The abnormal PGI/PGII ratio is closely related to H. pylori infection and hsCRP level. Therefore, H. pylori infection status and hsCRP level should be considered when determining atrophic gastritis by the PGI/PGII ratio.

Type I and type II Helicobacter pylori infection status and their impact on gastrin and pepsinogen level in a gastric cancer prevalent area.

BACKGROUNDType I Helicobacter pylori (H. pylori) infection causes severe gastric inflammation and is a predisposing factor for gastric carcinogenesis. However, its infection status in stepwise gastric disease progression in this gastric cancer prevalent area has not been evaluated; it is also not known its impact on commonly used epidemiological gastric cancer risk markers such as gastrin-17 (G-17) and pepsinogens (PGs) during clinical practice.AIMTo explore the prevalence of type I and type II H. pylori infection status and their impact on G-17 and PG levels in clinical practice.METHODSThirty-five hundred and seventy-two hospital admitted patients with upper gastrointestinal symptoms were examined, and 523 patients were enrolled in this study. H. pylori infection was confirmed by both 13C-urea breath test and serological assay. Patients were divided into non-atrophic gastritis (NAG), non-atrophic gastritis with erosion (NAGE), chronic atrophic gastritis (CAG), peptic ulcers (PU) and gastric cancer (GC) groups. Their serological G-17, PG I and PG II values and PG I/PG II ratio were also measured.RESULTSA total H. pylori infection rate of 3572 examined patients was 75.9%, the infection rate of 523 enrolled patients was 76.9%, among which type I H. pylori infection accounted for 72.4% (291/402) and type II was 27.6%; 88.4% of GC patients were H. pylori positive, and 84.2% of them were type I infection, only 11.6% of GC patients were H. pylori negative. Infection rates of type I H. pylori in NAG, NAGE, CAG, PU and GC groups were 67.9%, 62.7%, 79.7%, 77.6% and 84.2%, respectively. H. pylori infection resulted in significantly higher G-17 and PG II values and decreased PG I/PG II ratio. Both types of H. pylori induced higher G-17 level, but type I strain infection resulted in an increased PG II level and decreased PG I/PG II ratio in NAG, NAGE and CAG groups over uninfected controls. Overall PG I levels showed no difference among all disease groups and in the presence or absence of H. pylori; in stratified analysis, its level was increased in GC and PU patients in H. pylori and type I H. pylori-positive groups.CONCLUSIONType I H. pylori infection is the major form of infection in this geographic region, and a very low percentage (11.6%) of GC patients are not infected by H. pylori. Both types of H. pylori induce an increase in G-17 level, while type I H. pylori is the major strain that affects PG I and PG IIs level and PG I/PG II ratio in stepwise chronic gastric disease. The data provide insights into H. pylori infection status and indicate the necessity and urgency for bacteria eradication and disease prevention in clinical practice.

Associations of Helicobacter pylori seropositivity and gastric inflammation with pediatric asthma.

Controversy exists regarding an association between Helicobacter pylori infection and asthma in children. We examined the hypotheses of inverse associations of H. pylori seroprevalence and pepsinogen (PG) levels, as markers of gastric inflammation, with asthma in children. A hospital-based case-control study was conducted among children aged 4.8 to 17.3 years in Israel. Confirmed asthma cases (n = 75) were recruited through a pulmonary clinic, and controls (n = 160) without asthma were enrolled. Using enzyme-linked immunosorbent assays we measured the presence of H. pylori immunoglobulin G (IgG) antibodies, IgG antibodies to cytotoxin-associated gene A antigen (CagA) (virulent factor), serum PG levels and exposure to other enteric pathogens (Shigella flexneri). Multivariable logistic regression models were applied. H. pylori IgG seropositivity was 25% and 40% among cases and controls, respectively (P = .03). H. pylori CagA IgG seropositivity was associated with reduced risk of asthma (adjusted odds ratio [OR], 0.33 [95% CI, 0.11-0.95] but not for the CagA negative serology (adjusted OR, 0.70 [95% CI, 0.32-1.54]). Children who were H. pylori seropositive with a PGI:PGII of ≤6.78 (severe gastric inflammation) had a lower likelihood of asthma (adjusted OR, 0.31 [95% CI, 0.10-0.89]) than did seronegative children. Exposure to Shigella flexneri did not differ between cases and controls, nor according to H. pylori seropositivity. Among the asthmatic children, pulmonary function did not differ according to H. pylori seropositivity. H. pylori infection and its related gastric inflammation may have a protective role in the risk of pediatric asthma and further research into a potential causal pathway is required.

The Role of Helicobacter pylori and Serum Pepsinogen Levels in Metachronous Gastric Cancer After Endoscopic Gastrectomy.

The current study aimed to explore the role of Helicobacter pylori (Hp) infection and serum pepsinogen (PG) levels in the occurrence of metachronous gastric cancer after endoscopic gastrectomy. Totally, 50 patients with metachronous gastric cancer, 50 patients with chronic atrophic gastritis and 50 healthy subjects were collected from October 2015 to October 2018. Patients in the gastric cancer group underwent endoscopic gastrectomy. Serum samples were collected for detection and correlation analysis of serum PG I, PG II, and Hp. In addition, the contents of serum PG and gastrin and postoperative adverse events were statistically analyzed. There was a statistically significant difference in serum PG I levels, positive Hp infection rate, the number of mast cells, plasma motilin levels and postoperative adverse events among the 3 groups (P<0.01). There was also a significant difference in PG II levels among the groups (P<0.05). On the basis of the results, the amount of inflammatory cells in the gastric cancer group was significantly higher than that in the gastritis group, and there was a remarkable difference in gastric cancer patients before and after operation. Through data analysis, it was found that the levels of PG I and II were the highest in the healthy control group and the lowest in the gastric cancer group, the number of mast cells was the largest in the gastric cancer group, and the level of motilin was the highest in the healthy control group. Hp infection and serum PG levels are associated with metachronous gastric cancer.

Anti-parietal cell antibodies seroconversion in patients with autoimmune atrophic gastritis: a prospective study

The purpose of the study was to evaluate the atrophic changes of body and antrum gastric mucosa, the occurrence of Helicobacter pylori infection and the possibility of seroconversion in patients with autoimmune gastritis throughout 10 years.&#x0D; Material and methods. 203 Chernobyl nuclear power plant accident recovery workers were included in the prospective study. Blood levels of anti-parietal cell antibodies, basal gastrin-17, pepsinogens I and II were evaluated in all the patients to diagnose autoimmune gastritis and to assess gastric mucosa non-invasively.&#x0D; Results. Anti-parietal cell antibodies were found in 34.5% of the patients. Eradication rates were low (32.850.0%) in the patients with atrophy of gastric mucosa in the first 3 years of observation. Statistically significant decrease in pepsinogen I and gastrin-17 serum levels was observed in the patients with H. pylori-associated autoimmune gastritis throughout first 46 years. In the next 710 years pepsinogen I and gastrin-17 serum levels were increasing possibly due to positive effect of H. pylori eradication therapy. Successful eradication leads to disappearance of anti-parietal cell antibodies in 33.4% of the patients by the 10th year of the observation.&#x0D; Conclusion. The obtained results show that H. pylori eradication therapy is effective in reducing atrophic changes of gastric mucosa in the patients with autoimmune gastritis. Against the background of successful treatment the levels of pepsinogen I and gastrin-17, the markers of body and antrum gastric mucosa atrophy, were increasing. In the patients with autoimmune gastritis but without H. pylori infection the following trend was not noticed.

Effects of temperature regime on growth and daily rhythms of digestive factors in Nile tilapia (Oreochromis niloticus) larvae

Environmental factors such as light and temperature present cyclic variations during the day. High temperatures occur during the light phase, whereas low temperatures take place at night (i.e. a daily thermocycle). Although applying thermocycles to fish larvae improves growth in some species, nothing is known about the impact during the early development of the digestive system. The aim of the present research was to investigate the effect of different temperature regimes, cycling versus constant, on the daily rhythms of digestive factors and growth of Nile tilapia (Oreochromis niloticus) larvae. For this purpose, fertilized eggs (stage 1) were divided into two groups: one under a thermocycle (TC) of 31 °C:25 °C day:night and another group at constant temperature of 28 °C (CTE). Photoperiod was set at 12:12 h light/dark cycle. Larvae length was measured on 4, 8 and 13 days post-fertilization (dpf) and samples were collected every 4 h during a 24-h cycle on these days. The expression levels of pepsinogen, chymotrypsinogen, trypsinogen, lipase, maltase, isomaltase, npy and cck were analyzed by qPCR. The results showed that growth was greater when larvae were reared at TC than at CTE. Moreover, on 13 dpf, most analyzed genes (chymotrypsinogen, lipase, maltase, isomaltase, npy and cck) displayed daily rhythms in the TC group but not in CTE, with most acrophases located around mealtime. These rhythms might explain the higher growth rate observed in the TC larvae due to improved synchronization of feed digestion and utilization. These findings could be useful for improving rearing protocols used in tilapia larviculture and enhancing production performance.

Seroprevalence of Helicobacter pylori/CagA Antibodies in Guatemalan Gastric Cancer Patients: Association of Seropositivity with Increased Plasma Levels of Pepsinogens but not Soluble Urokinase Plasminogen Activator Receptor.

Infection by Helicobacter pylori is a major risk factor for gastric cancer (GC), the second leading cause of cancer-related death worldwide. Although biomarkers such as pepsinogens (PGs) and soluble urokinase plasminogen activator receptor (suPAR) may have diagnostic and/or prognostic value in patients with GC, their levels may be affected by H. pylori infection. The aim of this study was to investigate the association of the presence of antibodies to H. pylori and cytotoxin-associated gene A (CagA) with plasma levels of PGs and suPAR in a cohort of Guatemalan GC patients and controls. To this end, levels of suPAR, Pepsinogens I and II (PGI and PGII), and antibodies to H. pylori and CagA toxin were determined by ELISA in plasma samples from 67 GC patients and 136 matched healthy controls. Seropositivity for CagA was significantly higher in patients with GC than in controls. Pepsinogens II and suPAR levels were higher and PGI/PGII ratios were lower in GC patients than in controls. There was a significant association of H. pylori seropositivity status with increased levels of PGII and lower PGI/PGII ratios, particularly in the control (non-GC) population. The levels of suPAR were not significantly affected by H. pylori or CagA seropositivity status. These results suggest that the seropositivity status for H. pylori and CagA need to be taken into account during the GC diagnostic process.

Pepsinogen Serology and Gastritis OLGA Staging in Mucosal Atrophy Assessment: A Cross-Sectional Study Involving East China Endoscopy Population.

The histological gastric stage (OLGA) plays an important role in evaluating gastric atrophy, a symptom which suggests a risk of gastric cancer (GC). However, gastroscopy is an invasive examination, which has limited application in populations undergoing physical examination. Serum pepsinogen (PG) and gastin-17 (G-17) levels are noninvasive indexes which are recommended when screening for GC. We aim to explore the correlation between PG/G-17 and OLGA stage, in order to provide reliable indexes for GC screening. The study included 453 asymptomatic individuals from East China undergoing physical examination, who then underwent endoscopy including collection of biopsy samples. Assays for serum PG, G-17, and Helicobacter pylori (Hp) were performed. Atrophy of gastric mucosa was graded according to OLGA for each individual. 453 participants, average age 52.46 ± 10.30 years, 253 male and 200 female, were included. In the asymptomatic physical examination population, serum PGI, PGII, and PGR levels decreased with increasing OLGA scores. PGI and PGR were inversely correlated with increasing OLGA stage in both Hp-positive and Hp-negative groups. The levels of serum PGI, PGII, and G-17 in the Hp-positive group were higher than those in the Hp-negative group; conversely, the PGR levels were lower. Furthermore, OLGA scores increased with age in the Hp-positive group. In conclusion, there is a significant correlation between OLGA stage and serum PG in populations from East China undergoing physical examination. Serum PG and G-17 combined with Hp test plays an important role in evaluating gastric atrophy.

Serum pepsinogens as a gastric cancer and gastritis biomarker in South and Southeast Asian populations.

Serum pepsinogens have been widely acknowledged as gastric mucosal biomarkers; however, a multicountry report on the benefits of pepsinogens as biomarkers has not yet been published. We analyzed 1,206 sera and gastric mucosal samples collected from Bangladesh, Bhutan, Indonesia, Myanmar, Nepal and Thailand then assessed the association between gastric mucosal changes and Helicobacter pylori infection. The new cutoff values for serum pepsinogen values were evaluated using a receiver operating characteristic analysis. The participants with H. pylori infection had significantly lower pepsinogen I and higher pepsinogen II values, but a lower pepsinogen I/II ratio than participants without the infection (all P < .001). The pepsinogen I and pepsinogen I/II values were significantly higher and lower, respectively, in individuals with atrophic gastritis than in those without (both P < .001). Among uninfected individuals, only the pepsinogen I/II ratio was significantly lower in atrophic individuals. Pepsinogen I/II ratio also were significantly different between disease among H. pylori-positive and H. pylori-negative individuals, suggesting the pepsinogen I/II ratio is a robust biomarker for determining both chronic and atrophic gastritis. The cutoffs for detecting chronic and atrophic gastritis for the pepsinogen I/II ratio were 4.65 and 4.95, respectively. In conclusion, pepsinogen levels are useful biomarker for both chronic gastritis and atrophic gastritis, but they should be used with caution. Population-based validation is necessary to determine the best cutoff values. Among all pepsinogen values, the pepsinogen I/II ratio was the most reliable gastric mucosal-change biomarker.

Long‐term follow up of serum pepsinogens in patients with gastric cancer or dysplasia after Helicobacter pylori eradication

Few studies have evaluated the change in serum pepsinogen (sPG) levels after the eradication of Helicobacter pylori. The aim of this study was to evaluate the effect of H.pylori eradication on sPG levels in patients with gastric cancer/dysplasia in comparison to a control group. We prospectively enrolled 368 patients with gastric cancer/dysplasia and 610 control subjects. H.pylori status and sPG levels were measured before and after eradication. The follow-up time points were classified as <12, 12-23, 24-35, and ≥36months. In 179 H.pylori-eradicated patients with gastric cancer/dysplasia and 168 control group subjects, sPG I significantly decreased, and the sPG I/II ratio significantly increased after eradication compared to baseline, and this improvement in sPG values was maintained during all follow-up time points. Significant differences in sPG I and the sPG I/II ratio were observed between the gastric cancer/dysplasia group and the control group <24months after eradication. However, these differences in sPG values disappeared after ≥24months of follow up. Moreover, significant differences in the intestinal metaplasia grade were observed between these two groups before eradication until <24months after eradication. However, these differences in the intestinal metaplasia grade disappeared after ≥24months of follow up in the corpus. The sPG values and intestinal metaplasia grade (corpus) in the gastric cancer/dysplasia group became similar to those in the control group at long-term follow up after H.pylori eradication. It might be related with the reduction of metachronous gastric neoplasm.

Diagnostic value of serum pepsinogen I, pepsinogen II, and gastrin-17 levels for population-based screening for early-stage gastric cancer.

ObjectiveDiagnosing gastric cancer (GC) at early stages is important for reducing its mortality. This study evaluated the diagnostic value of serum pepsinogen (PG) I, PGII, and gastrin-17 (G17) levels in screening for early-stage GC.MethodsSerum levels of PGI, PGII, and G17 were measured in patients with upper digestive tract symptoms or GC family histories, and the PGI to PGII ratio (PGR) was calculated. Receiver operator characteristic curves were used to determine the thresholds of PGI, PGR, and G17 for GC diagnosis.ResultsAmong the 949 patients examined by gastroscopy, 13 (1.37%) had GC, including five cases of early-stage GC and eight cases of progressive GC. PGI, PGR, and G17 showed good specificity and sensitivity for early-stage and progressive GC. The optimal thresholds of PGI, G17, and PGR were 71.85 μg/L, 15.65 pmol/L and 5.04 for the diagnosis of early-stage GC, respectively, and were 42.55 μg/L, 20.55 pmol/L, and 2.79 for the diagnosis of progressive GC, respectively.ConclusionCombining PG and G17 serum levels with gastroscopy could be a promising approach to screen for early-stage GC.

Risk for gastric cancer in patients with gastric atrophy: a systematic review and meta-analysis.

BackgroundThe risk for gastric cancer among patients with gastric atrophy is unclear. We investigated the association between the risk for gastric cancer and gastric atrophy.MethodsWe performed a comprehensive literature search in the PubMed and Embase databases and extracted relevant data from eligible studies. A fixed- or random-effects model was applied to pool study-specific risk according to heterogeneity across studies.ResultsThirteen cohort or nested case-control studies with 655,937 participants and 2,794 patients with gastric cancer were analyzed. The pooled results suggested that gastric atrophy was associated with an elevated risk for gastric cancer [pooled risk ratio (RR) =2.91, 95% confidence interval (CI): 2.58–3.27]. The pooled RR (3.10, 95% CI: 2.58–3.73) of studies that used serum levels of pepsinogen for diagnosis of gastric atrophy was similar to that of those that used (pooled RR =2.79, 95% CI: 2.37–3.27) (for endoscopy). Gastric atrophy was positively associated with the risk for gastric cancer in both prospective and retrospective studies. Moreover, the pooled RRs did not significantly vary by country of origin (Asia and Europe) or gastric cancer subtype (cardia and non-cardia).ConclusionsGastric atrophy is associated with an elevated risk for gastric cancer, and endoscopy and serum levels of pepsinogens can be used to predict the risk.