Pepsinogen Concentrations Research Articles

A DSC Test for the Early Detection of Neoplastic Gastric Lesions in a Medium-Risk Gastric Cancer Area.

In this study, we aimed to assess the accuracy of the proposed novel, noninvasive serum DSC test in predicting the risk of gastric cancer before the use of upper endoscopy. To validate the DSC test, we enrolled two series of individuals living in Veneto and Friuli-Venezia Giulia, Italy (n = 53 and n = 113, respectively), who were referred for an endoscopy. The classification used for the DSC test to predict gastric cancer risk combines the coefficient of the patient's age and sex and serum pepsinogen I and II, gastrin 17, and anti-Helicobacter pylori immunoglobulin G concentrations in two equations: Y1 and Y2. The coefficient of variables and the Y1 and Y2 cutoff points (>0.385 and >0.294, respectively) were extrapolated using regression analysis and an ROC curve analysis of two retrospective datasets (300 cases for the Y1 equation and 200 cases for the Y2 equation). The first dataset included individuals with autoimmune atrophic gastritis and first-degree relatives with gastric cancer; the second dataset included blood donors. Demographic data were collected; serum pepsinogen, gastrin G17, and anti-Helicobacter pylori IgG concentrations were assayed using an automatic Maglumi system. Gastroscopies were performed by gastroenterologists using an Olympus video endoscope with detailed photographic documentation during examinations. Biopsies were taken at five standardized mucosa sites and were assessed by a pathologist for diagnosis. The accuracy of the DSC test in predicting neoplastic gastric lesions was estimated to be 74.657% (65%CI; 67.333% to 81.079%). The DSC test was found to be a useful, noninvasive, and simple approach to predicting gastric cancer risk in a population with a medium risk of developing gastric cancer.

Evaluation of serum pepsinogen concentration for the diagnosis of type 1 abomasal ulcer in water buffalo

Evaluation of serum pepsinogen concentration for the diagnosis of type 1 abomasal ulcer in water buffalo

Evaluating Oxidative Stress Parameters, Pepsinogen, and Insulin-like Growth Factor-1 in Dairy Cows with Displacement of Abomasum

Introduction: Displacement of the abomasum (DA) frequently occurs in high-producing dairy cows. It is a multifactorial disease and has an economic impact on dairy farms. This study aimed to investigate the levels of pepsinogen, Insulin-Like Growth Factor-1, and oxidative stress parameters (malondialdehyde and nitric oxide) in DA cases. Materials and methods: Blood samples were taken from 51 dairy cows suspected of DA, referring to the Veterinary Clinic of Shiraz University, Shiraz, Iran, in the summer of 2021. Twenty of them had Left DA (LDA), 6 had Right DA (RDA), 13 had LDA with clinical signs of ulcer of the abomasum, 3 had RDA with clinical signs of ulcer of the abomasum, and 9 of them (3-5 years old) were clinically healthy as control. The serum concentration of pepsinogen, Insulin-Like Growth Factor-1, malondialdehyde, and nitric oxide were measured. Results: The result of the current study showed that the concentration of pepsinogen was higher in cows with DA compared to healthy cows. The concentrations of malonaldehyde, nitric oxide, and IGF-1 were higher in LDA with the abomasal ulcer, compared to other groups. Conclusion: Pepsinogen can be suggested as a predictor parameter for DA. Malonaldehyde, nitric oxide, and IGF-1 can be considered biomarkers in LDA with the abomasal ulcer. However, further studies are needed to find other effective parameters for predicting DA.

Evaluation of the Potential Protective Effects of Lactobacillus Strains against Helicobacter pylori Infection: A Randomized, Double-Blinded, Placebo-Controlled Trial.

Background The beneficial effects of probiotic supplementation standard antibiotic therapies for Helicobacter pylori infection have been verified, but the ability of probiotic monotherapy to eradicate H. pylori remains unclear. Aim To evaluate the accuracy and efficacy of specific Lactobacillus strains against H. pylori infection. Methods Seventy-eight patients with H. pylori infection were treated with strain L. crispatus G14-5M (L. crispatus CCFM1118) or L. helveticus M2-09-R02-S146 (L. helveticus CCFM1121) or L. plantarum CCFM8610 at a dose of 2 g twice daily for one month. 14C-urea breath test, the gastrointestinal symptom rating scale, serum pepsinogen concentrations, and serum cytokine concentrations of patients were measured at baseline and end-of-trial to analyze the effect of the Lactobacillus strains in eradicating H. pylori infection and reducing gastrointestinal discomfort in patients. In addition, the composition and abundance of the intestinal microbiota of patients were also measured at end-of-trial. Results The 14C-urea breath test value of the three Lactobacillus treatment groups had decreased significantly, and the eradication rate of H. pylori had increased by the end of the trial. In particular, the eradication rate in the G14-5M treatment group was significantly higher than the placebo group (70.59% vs. 15.38%, P=0.0039), indicating that one-month administration of the G14-5M regimen was sufficient to eradicate H. pylori infection. The ingestion of Lactobacillus strains also ameliorated the gastrointestinal symptom rating scale scores, and the serum interleukin-8 concentrations of H. pylori-infected patients appeared to modulate the gut microbiota of patients. However, none of the Lactobacillus strains had a significant effect on general blood physiological characteristics, serum tumor necrosis factor α concentrations, or serum pepsinogen concentrations in the patients. Conclusion Three Lactobacillus strains significantly alleviate the gastrointestinal discomfort and the gastric inflammatory response of H. pylori-infected patients. The activity of probiotics in eradicating H. pyloriinfection may be species/strain specific.

Gastrointestinal nematode and lungworm infections in organic dairy calves reared with nurse cows during their first grazing season in western France

The rearing system of dairy calves with nurse cows has been developing since 2010 in organic farms in western France. This system allows cow-calf contact until a weaning age close to the natural weaning for cattle and is characterized by an early turnout for calves at around one month of age with their nurse cows and a first grazing season with mixed grazing of calves and adults at a ratio of 2–4 calves per nurse cow. The objectives of this study were to assess the gastrointestinal (GIN) and lungworm infections in such reared calves and their variability during the first grazing season. Faecal egg count (FEC), pepsinogen (PEP) concentration and Ostertagia ELISA optical density ratio (ODR) were determined in calves (n = 497) at housing in 33 groups from 24 farms in 2018, and in calves (n = 405) and nurse cows (n = 199) throughout the 2019 grazing season in 41 groups from 20 farms. For lungworm infection, information was obtained during 2019 through the recording of coughing episodes along the grazing season and the Dictyocaulus ELISA ODR determination at housing both in calves and nurses. Results indicated that the level of GIN infection was overall low for calves during the first grazing season with PEP and Ostertagia ODR group-average values ranging from 0.97 to 1.6 U Tyr and 0.23 to 0.71 ODR respectively. No anthelmintic treatment being given in any group of calves. Ostertagia ODR values increased with the duration of the grazing season (>240 d) and with the ratio calves/nurse (>2). GIN parameters for nurses remained fairly stable during the grazing season with mean FEC, PEP and Ostertagia ODR group-average values of 13 epg, 2.28 U Tyr and 0.81 ODR, respectively. Antibodies against lungworms were detected in 3–62 % of calves depending on the duration of grazing, but only 6% of calves showed a coughing episode. The dilution effect due to the mixed grazing of resistant (nurse cows) and susceptible (calves) animals associated with predominant milk diet of calves during the first months of grazing in combination with protective grazing management allow calves to be turned out at an early age without using anthelmintic treatments. Further studies are needed to assess the GIN infection dynamics during the second grazing season in weaned heifers.

Helicobacter pylori infection and serum pepsinogen concentrations in an elderly population representative of Costa Rica

INTRODUCTION: Costa Rica has among the highest mortality rates from gastric cancer in the world, largely due to late detection. It is therefore important that economically and logistically sustainable screening is implemented in order to detect risk of developing cancer. We have previously shown that low pepsinogen (PG) values and infection with Helicobacter pylori-CagA+ are associated with risk of gastric atrophy and cancer in Costa Rican populations. OBJECTIVES: To determine how markers for gastric cancer risk are distributed in an elderly population representative of Costa Rica in order to design a screening strategy. METHODS: The population studied consists of 2,652 participants in a nationally representative survey of ageing. Information concerning epidemiologic, demographic, nutritional and life style factors is available. Serum PG concentrations as well as H. pylori and CagA status were determined by serology. Possible associations were determined by regression analyses. RESULTS: Antibodies to H. pylori were present in 72% of the population and of those, 58% were CagA positive. Infection with H. pylori was associated with higher PGI concentrations (p=0.000) and infection with H. pylori-CagA+ with lower PGI concentrations (p=0.025). Both showed association with lower PGI/PGII (p=0.006 and p=0.000). Higher age was associated with lower prevalence of H. pylori infection (OR=0.98; p=0.000) and CagA+ (OR=0.98; p=0.000) but not with PG values. Regions with high risk of gastric cancer showed lower PGI (p=0.004) and PGI/PGII values (p=0.021) as well as higher prevalence of H. pylori infection (OR=1.39; p=0.013) but not CagA+. Using cut-off values of PGI<100 µg/L and PGI/PGII<2.0, 2.5 and 3.0, 7-15% of the population would be considered at risk. CONCLUSIONS: H. pylori alone is not a useful marker for risk of gastric cancer. Screening using serum pepsinogen concentrations and infection with H. pylori-CagA+ is feasible in the general elderly population of Costa Rica but appropriate cut-off values have to be determined based on more clinical data and follow up capacity.

Helicobacter pylori infection and serum pepsinogen concentrations in an elderly population representative of Costa Rica

Helicobacter pylori infection and serum pepsinogen concentrations in an elderly population representative of Costa Rica

Subclinical nematode parasitism affects activity and rumination patterns in first-season grazing cattle

Sickness behaviour has been suggested as an applicable indicator for monitoring disease. Deviating feeding behaviour and activity can provide information about animals’ health and welfare status. Recent advances in sensor technology enable monitoring of such behaviours and could potentially be utilized as an indicator of gastrointestinal nematode (GIN) infections. This study investigated activity and rumination patterns in first-season grazing steers exposed to subclinical infection levels of the GIN Ostertagia ostertagi and Cooperia oncophora. At turnout, animals were allocated to one of four experimental groups and were faced with “high” (H1, n = 15; H2, n = 17) or “low” (L1, n = 17; L2, n = 11) levels of parasite exposure by grazing in similar enclosures contaminated with overwintering third stage (L3) GIN larvae. Animals in H1 and H2 (HP) received a 1:1 mix of approximately 10,000 O. ostertagi and C. oncophora L3 at turnout; whereas the animals in L1 and L2 (LP) were treated monthly with ivermectin. Activity and rumination patterns were monitored by fitting animals with leg- (IceQube) and neck-mounted (Heatime) sensors. BW was recorded every fortnight, whereas faecal and blood samples were examined every four weeks for nematode faecal egg count and serum pepsinogen concentrations (SPCs). There was an interaction effect of exposure level and period (P < 0.0001) on average lying daily time across the entire grazing time. A higher mean daily lying time (P = 0.0037) was found in HP compared with LP during the first 40 days on pasture. There was also interaction effects of treatment and day since turnout on rumination time (P < 0.0001) and rumination change (P = 0.0008). Also mean daily steps (P < 0.0001) and mean daily motion index (P < 0.0001) were markedly higher in HP during days 62–69, coinciding with peaking SPC in HP. Strongyle eggs were observed both in HP and LP from 31 days after turnout. Eggs per gram (EPG) differed between parasite exposure levels (P < 0.0001), with mean EPG remaining low in LP throughout the experiment. Similarly, an increase in SPC was observed (P < 0.0001), but only in HP where it peaked at day 56. In contrast, no difference in BW gain (BWG) (P = 0.78) between HP and LP was observed. In conclusion, this study shows that behavioural measurements monitored with sensors were affected even at low infection levels not affecting BWG. These combined results demonstrate the potential of automated behavioural recordings as a tool for detection of subclinical parasitism.

Pepsinogens and Gastrin Demonstrate Low Discrimination for Gastric Precancerous Lesions in a Multi-Ethnic United States Cohort

Early identification of gastric precancerous lesions, including atrophic gastritis (AG) and intestinal metaplasia (IM), may improve gastric cancer detection and prevention. Because AG and IM are generally asymptomatic, many of the estimated 15 million Americans who carry these lesions remain undiagnosed.1 AG and IM are associated with either active or prior Helicobacter pylori (Hp) infection. Hp infection leads to perturbations in the serum concentration of gastric hormones pepsinogen I (PGI), pepsinogen II, the pepsinogen I/II ratio (PGR), gastrin-17 (G-17), and Hp IgG.2,3 In East Asia and other regions with high burden of Hp infection and gastric cancer, these biomarkers have been used as screening tools for AG and IM.4 However, there exists limited data on the sensitivity and discrimination of these serologic markers in low-Hp-prevalence populations, such as the United States.

Serum pepsinogen and gastrin concentrations in South American camelids with and without gastrointestinal nematode infection

Abstract Endoparasitosis is one of the major health problems in South American camelids (SACs) often leading to massive damage of the gastric or intestinal mucosa. In ruminants this damage results in increased gastrin and pepsinogen concentrations in the peripheral blood. These values have been used as diagnostic parameters for subclinical gastrointestinal nematode infections in ruminants but have not been systemically studied in SACs. Serum pepsinogen and gastrin concentrations of 183 clinically healthy SACs with and without detectable parasitic egg excretion and the occurrence of occult blood in the faeces were determined. The median (1st/3rd quartile) of serum pepsinogen and gastrin were 1899.4 (1483.1/2749.4) ng/ml and 184.8 (121.8/340.5) pg/ml for alpacas; 1642.0 (1182.3/2608.7) ng/ml and 191.8 (142.2/287.6) pg/ml for llamas respectively. A sensitivity of 80.1 % and a specificity of 11.1 % for gastrin (cut off 402 pg/ml) and a sensitivity of 64.1 % and specificity of 88.9 % for pepsinogen with endoparasitosis (cut off 1996 ng/ml) were calculated. Based on our results, albeit on quite small numbers, determination of serum gastrin concentration does not seem to be a useful test for the detection of endoparasitic infection in SACs. In contrast, for pepsinogen a correlation was found between serum concentration and animals with and without endoparasitosis. Nevertheless further studies are necessary in order to investigate the diagnostic potential of pepsinogen serum concentration in relation to subclinical endoparasitosis.

Non-invasive laboratory markers assessing efficacy of Helicobacter pylori eradication therapy

Effective eradication of Helicobacter pylori infection is an important means to reduce the risk of precancerous changes in the gastric mucosa and prevention of gastric cancer. A search for non-invasive diagnostic tools for Helicobacter pylori infection, evaluation of the effectiveness of eradication remains of high importance.The aim of the study was to assess an informative value of detecting pepsinogen I and II as well as serum antibodies to Helicobacter pylori while assessing an efficacy of treated chronic Helicobacter gastritis and identifying preneoplastic changes in the stomach mucosa. There enrolled 113 male patients with chronic gastritis aged 41 to 76, average age- (56.7±0.7) years. Examination of patients was carried out at admission to the clinic, as well as at 2 and 12 months after administering a standard eradication therapy. It was found that Helicobacter pylori infection was detected in 101 (89.4%) patients. Groups of patients with effective eradication therapy were noted. A time-dependent level of antibodies to Helicobacter pylori, as well as measured concentration of pepsinogen I and II after the onset of eradication treatment were determined. Which were analyzed in connection with the results of histology examination of gastric mucosa biopsy specimens and expression of oncoproteins Ki-67, Bcl-2, c-erbB-2, p16 in the gastric mucosa depending on efficacy of eradication therapy. It is shown that effective eradication therapy was characterized by significantly decreased serum level of IgG antibodies to Helicobacter pylori 2 months after the onset of treatment. Moreover, a significantly decreased pepsinogen II and serum IgG antibodies to Helicobacter pylori during eradication therapy were accompanied by a significant decrease in Ki-67 expression in the gastric epithelium. Decreased concentration of pepsinogen II within the first year after Helicobacter pylori eradication therapy was due to a greater decrease in activity of inflammatory changes in the gastric mucosa than to dynamic changes in gastric atrophy and metaplasia. An inverse relation between the serum level of pepsinogen I and atrophy as well as intestinal metaplasia within the gastric mucosa were found.

Diagnostic performance of serum pepsinogen assay for the prediction of atrophic gastritis and gastric neoplasms: Protocol for a systematic review and meta-analysis.

Background:Serum pepsinogen assay (sPGA) combining concentration of pepsinogen I (PG I), and the ratio of PG I/II is the noninvasive biomarker for predicting chronic atrophic gastritis (CAG) and neoplasms reflecting mucosal secretory status. Although various cut-off values have been suggested, PG I ≤70 ng/mL and PG I/II ≤3 have been widely accepted. However, previous studies for diagnostic test accuracy presented only pooled outcomes, which cannot discriminate the diagnostic validity of sPGA with cut-off of PG I ≤70 ng/mL and PG I/II ≤3.Methods:We will search the core databases [MEDLINE (through PubMed), the Cochrane Library, and Embase] from their inception to December 2018 by 2 independent evaluators. The P.I.C.O. is as follows; Patients: who have histologically proven CAG or gastric neoplasms, Intervention: sPGA with cut-off of PG I ≤70 ng/mL and/or PG I/II ≤3, Comparison: none, Outcome: diagnostic performance indices of sPGA for CAG and gastric neoplasms (sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratios) (if, true/false positive, true/false negative values are presented, diagnostic performance indices will be calculated). All types of study design with full text will be sought and included. The risk of bias will be assessed using the QUADAS-2 tool. Descriptive data synthesis is planned and quantitative synthesis (bivariate and HSROC model) will be used if the included studies are sufficiently homogenous. Publication bias will be assessed.Results:The results will provide clinical evidence for diagnostic validity of sPGA.Conclusion:This study will provide evidence of sPGA for predicting CAG and gastric neoplasms.

Effects of nematode parasitism on activity patterns in first-season grazing cattle

We investigated the effects of gastrointestinal nematode (GIN) challenge on activity patterns in first season grazing (FSG) steers exposed to two different levels of Ostertagia ostertagi and Cooperia oncophora. At turn-out, experimental animals were allocated to one of two treatment groups grazing in different enclosures each with 32 animals. The first group (High) received 5000 third stage (L3) O. ostertagi (50%) and C. onchophora (50%) larvae; whereas the second group (Low) were dewormed monthly with 0.5 mg ivermectin (Noromectin®, Pour-on) per kg bodyweight. Activity patterns were monitored by fitting some animals in each group (High, n = 10; Low, n = 8) with leg mounted sensors (IceTag® 3D-accelerometers) during three two-week periods. In animals fitted with sensors body weight gain (BWG) was recorded every fortnight, whereas faecal and blood samples were collected every four weeks for nematode faecal egg count (FEC) and serum pepsinogen concentrations (SPC). Differences between the periods in daily (P = 0.046) and diurnal (P = 0.0502) activities were recorded between groups during the course of the study. A significant (P = 0.038) increase in the number of lying bouts was recorded in group High during the second period (days 74–86), which was correlated (r = 0.55, P = 0.018) to an increase in SPC ≈ 85 days after turn-out. BWG was reduced (P = 0.037) in group High compared to group Low, deviating from day 45. Strongyle nematode eggs were observed in both groups 29 days after turn-out, however the mean EPG remained low in group Low throughout the experiment. An increase in SPC was observed (P < 0.0038) in group High with levels peaking on day 58. In conclusion, our data supports that changes in activity patterns monitored with sensors could contribute to the identification of animals challenged with GIN, but also improve our understanding in the potential welfare impairments caused by such infections.

The diagnostic value of indicators of acid-forming and pepsinoguena functions of the stomach in the detection of precancerous changes of the gastric mucosa in patients with chronic gastritis

It was found that in patients with chronic atrophic gastritis, low gastric secretory functions are present in the localization of atrophy in the mucous membrane of the body of the stomach with a tendency to decrease in indices as the degree of atrophy increases and are not associated with the presence of disregenerative changes in the gastric mucosa (intestinal metaplasia and dysplasia). Reduced levels of pepsin in gastric juice and reduced levels of pepsinogen in the mucous membrane of the body of the stomach reliably reflect the presence of severe atrophy of the mucous membrane of the body of the stomach. However, neither the concentration of pepsinogen in the tissues of the mucous membrane of the body of the stomach nor the level of pepsin in the gastric juice make it possible to differentiate the degree of atrophy of the gastric mucosa. The most profound disregenerative changes in gastric mucosa such as colonic metaplasia or dysplasia were detected, accordingly in 18,4 and 10,5% of patients. The presence of intestinal metaplasia or dysplasia causes a low activity of pepsinogen-pepsin. It worth noting that in case of the presence of intestinal metaplasia and dysplasia there is a significant difference between indicators of the concentration of pepsinogen-pepsin and those at patients with chronic gastritis, but without disregenerative changes of the mucous membrane. Also was found an association between the severity of disregenerative changes in the gastric mucosa and the degree of the reduction of pepsin-forming function.

Live weight as a basis for targeted selective treatment of lambs post-weaning

Targeted selective treatment (TST) has been proposed as a sustainable method of gastrointestinal nematode control that reduces the number of anthelmintic treatments administered, thereby preserving a susceptible nematode population in refugia. In order to minimise the impact of withholding treatment on animal performance, animals that would benefit most should be selected for treatment. However, the most suitable criteria for selecting which animals to treat remain a subject of research. The impact of implementing a TST strategy based on lamb live weight was investigated, and whether heavy lambs were more resilient than light lambs if left untreated. The study was conducted using weaned lambs on 3 sheep farms, and over 2 years. On each farm lambs were weighed and divided into heavy, medium and light weight classes. Within the heavy (n = 225) and light (n = 218) weight classes lambs were randomly allocated to two treatments; anthelmintic treatment or no anthelmintic treatment. All lambs in the medium weight class were treated. Animal performance and parasitological parameters were assessed over a 28-day period. Anthelmintic treatment had a significant effect (P < 0.01) on faecal egg count, average daily weight gain, body condition score and dag score; there was no treatment by weight class interaction. Anthelmintic treatment had no effect on plasma pepsinogen concentration or on blood leukocyte numbers. Withholding anthelmintic treatment from lambs therefore had a negative effect on worm egg count and animal performance with no evidence that heavy lambs were more resilient than light lambs when left untreated.

Gastric Cancer Screening by Combined Determination of Serum Helicobacter pylori Antibody and Pepsinogen Concentrations: ABC Method for Gastric Cancer Screening.

Objective:Gastroscopy combined with gastric mucosa biopsies is currently regarded as a gold standard for diagnosis of gastric cancer. However, its application is restricted in clinical practice due to its invasive property. A new noninvasive population screening process combining the assay of anti-Helicobacter pylori antibody and serum pepsinogen (PG) (ABC method) is adopted to recognize the high-risk patients for further endoscopy examination, avoiding the unnecessary gastroscopy for most population and saving the cost consumption for mass screening annually. Nevertheless, controversies exist for the grouping of ABC method and the intervals of gastroscopy surveillance for each group. In this review, we summarized these popular concerned topics for providing useful references to the healthcare practitioner in clinical practice.Data Sources:The PubMed databases were systematically searched from the inception dates to November 22, 2017, using the keywords “Helicobacter pylori,” “Pepsinogens,” and “Stomach Neoplasms.”Study Selection:Original articles and reviews on the topics were selected.Results:Anti-H. pylori antibody and serum PG concentration showed significant changes under the different status of H. pylori infection and the progression of atrophic gastritis, which can be used for risk stratification of gastric cancer in clinic. In addition, anti-H. pylori antibody titer can be used for further risk stratification of gastric cancer contributing to determine better endoscopy surveillance interval.Conclusions:The early detection and diagnosis of gastric cancer benefit from the risk stratification, but the cutoff values for H. pylori antibody and serum PG concentration require further modification.

Weight gain and resistance to gastrointestinal nematode infections in two genetically diverse groups of cattle

Body weight gain (BWG) and gastrointestinal nematode challenge (GIN) were investigated in two genetically diverse groups of cattle. Thirty-two dairy calves (D = Swedish Red/Holstein) and 31 dairy × beef crosses (C = Swedish Red/Holstein × Charolais) pairwise matched by dam breed and birth dates, were monitored for ≈20 weeks on a pasture grazed by cattle in the previous year. At turn-out, animals (between 6 and 12 months age) from each genotype were either infected with 5000 third stage (L3) Ostertagia ostertagi (50%) and Cooperia oncophora (50%) larvae (H, high-exposure); or treated monthly with 0.5 mg ivermectin (Noromectin®, Pour-on) per kg bodyweight to remove worms ingested (L, low-exposure). Animals were weighed every fortnight and individual BWG was calculated. Faecal and blood samples were collected every four weeks throughout the experiment for nematode faecal egg counts (FEC) and larvae cultures and serum pepsinogen concentrations (SPC), respectively. Nematode eggs were observed 29 days post turn-out in both H groups. FEC peaked to around 200 eggs per gram (epg) on days 58 and 85 respectively in both H groups. FEC were also observed in the L groups at the same time, but mean epg remained very low (<20 epg) and constituted exclusively of C. oncophora. Although, there was no significant difference in SPC values in animals of the different genotypes, ten animals of CH showed a SPC >3.5 IU tyrosine whereas only six DH animals reached similar pepsinogen levels. The level of infection (H and L) significantly affected BWG in both genotypes. Even though there was no statistically significant genotype (C or D) × treatment (H or L) interaction, there was a larger difference in body weight of H and L in C (37 kg) compared to D (17 kg) genotypes at the end of the experiment. Our data collectively support the view crossbred (C) animals experience the impact of gastrointestinal parasitism more severely compared to pure dairy (D) first season grazers. The mechanisms that underpin this remains speculative.

Cost-effectiveness of combined serum anti-Helicobacter pylori IgG antibody and serum pepsinogen concentrations for screening for gastric cancer risk in Japan.

A combination of assays for the presence of serum anti-Helicobacter pylori IgG antibody (HPA) and serum pepsinogen (PG) concentrations can be used to screen for gastric cancer risk. In Japan, this "ABC method" is considered an effective means of stratifying gastric cancer risk. This study aimed to ascertain its cost-effectiveness for assessing gastric cancer risk. A Markov model was constructed to compare the cost-effectiveness of two strategies for gastric cancer-risk screening over a 30-year period: the ABC method, which uses a combination of assessing the presence of HPA and measuring serum PG concentrations and scheduling endoscopies accordingly, and annual endoscopic screening. Clinical and epidemiological data on variables in the model were obtained from published reports. Analyses were made from the perspective of the Japanese health care payer. According to base-case analysis, the ABC method cost less than annual endoscopic screening (64,489 vs. 64,074 USD) and saved more lives (18.16 vs. 18.30 quality-adjusted life years). One-way analyses confirmed the robustness of the cost-effectiveness results. The probability that the ABC method is cost-effective in Japanese individuals aged 50years was 0.997. A combination of HPA and serum PG assays, plus scheduling endoscopy accordingly, is a cost-effective method of screening for gastric cancer risk in Japan.

The Serum Pepsinogen Test as a Predictor of Kazakh Gastric Cancer

Gastric cancer (GC) is one of the most common malignant tumors and the Kazakh population in Xinjiang has been reported to be one of the highest incidence of GC in the world. Serum pepsinogen (PG) test provides a valuable method for detecting GC, but little study about the role of PG in Kazakh GC. Therefore, we aimed to investigate the role of PG in Kazakh GC and to elucidate the usefulness of the serum PG test method. The serum PG concentration were measured using the flow fluorescence assay and ELISA methods in patients with superficial gastritis, atrophic gastritis and GC. The most suitable cut off point was a PG I concentration ≤64 ng/ml and PG I/II ratio (PGR) ≤4.5. Using this cut off point, the sensitivity and specificity of pepsinogen screening for Kazakh GC were 80.5% and 89.8%, respectively. The area under the curve (AUC) of the PGR for GC diagnosis was 0.949, which was significantly higher than that of combined tumor markers. Moreover, PGR in Kazakh early GC was statistically significantly lower than in SG and AG. These findings suggest that serum PG test can serve as a noninvasive biomarker for the diagnosis of Kazakh GC.

Can the amount of digestible undegraded protein offered to ewes in late pregnancy affect the periparturient change in resistance to gastrointestinal nematodes?

Ewes experience a temporary decline in resistance to gastrointestinal nematodes (GIN) during the periparturient period, characterised by a rise in faecal egg count (FEC) that represents a major source of pasture contamination for naïve progeny. The aim of this study was to assess the effect of level of supplementation with digestible undegraded protein (DUP) during the last 6 weeks of pregnancy on periparturient FEC and the performance of ewes with a naturally acquired parasite infection. Eighty-five Belclare and Belclare x Scottish Blackface twin/triplet-bearing ewes were allocated to 1 of 4 dietary groups representing the combination of 2 concentrates (DUP concentration 29 and 94g/kg dry matter) with 2 levels of concentrate during the final 6 weeks of gestation (18 and 30kg in total for ewes with twins; 24 and 35kg for ewes with triplets). All ewes were housed during the pre-partum feeding period and offered grass silage ad libitum; food intake was recorded daily. The intake of DUP varied from 26 to 72g/d among treatments and was reflected in variation of 0.76 to 1.20 in metabolizable protein supply as a proportion of requirements. After lambing, ewes and lambs grazed on permanent sheep pasture, without concentrate supplementation, until weaning (14 weeks post lambing). The variables studied, from week 6 pre-lambing up to week 10 post-lambing, included: FEC, serum pepsinogen concentration, body weight (BW) and body condition score (BCS). The effect of week (relative to lambing date) on FEC was highly significant (P<0.001). However, diet did not influence FEC (P>0.05) at any stage either pre- or post-partum. Pepsinogen concentration also varied with time but was not influenced by dietary treatment (P>0.05). The changes in BW and BCS from 6 weeks before lambing to weaning were not affected by the concentration of DUP in the supplement but ewes on treatments involving the higher level of supplementation lost less BW and BCS (P<0.001). The results of this study indicate that the level of DUP supplementation during the last 6 weeks of pregnancy does not affect FEC, BW or BCS of housed ewes with a naturally acquired GIN infection.