Development Of Peptic Ulcer Research Articles

Diagnosis of Helicobacter pylori Using Invasive and Noninvasive Approaches.

Helicobacter pylori (H. pylori) as gram-negative and spiral microorganism is responsible for colonization in the gastric microniche for more than 50% of world population. Recent studies have shown a critical role of H. pylori in the development of peptic ulcers, gastric mucosa-associated lymphoid tissue (MALT) lymphoma, and gastric cancer. Over the past decade, there has been a sharp interest to use noninvasive tests in diagnosis of the H. pylori infection. During the years after discovery by Marshall and Warren, it has been frequently declared that the rapid urease test (RUT) is one of the cheapest and rapid diagnostic approaches used in detecting the infection. Although the specificity and sensitivity are durable for this test, clinical experiences had shown that the ideal results are only achieved only if we take biopsies from both corpus and antrum at the same time. Given the diagnosis of the H. pylori in clinical samples, gastroenterologists are facing a long list of various molecular and nonmolecular tests. We need more in-depth researches and investigations to correctly generalize rapid and accurate molecular tests determining both bacterial identity and antibiotic resistance profile.

Association of Helicobacter pylori infection with Toll-like receptor-4 Thr399Ile polymorphism increased the risk of peptic ulcer development in North of Iran.

Toll-like receptor-4 (TLR4) polymorphisms may influence host immune response against Helicobacter pylori (H.pylori). This study aimed to investigate whether TLR4 polymorphisms are associated with H.pylori susceptibility and risk of peptic ulcer development or not. The TLR4+3725G/C polymorphism was studied using polymerase chain reaction with confronting two-pair primers (PCR-CTPP). In addition, TLR4 Asp299Gly and Thr399Ile polymorphisms were evaluated by PCR-restriction fragment length polymorphism (RFLP). There was no significant difference in TLR4+3725G/C and Asp299Gly genotype frequencies between non-peptic ulcer (NPUD) and peptic ulcer (PUD) individuals in the context of peptic ulcer development and susceptibility to infection with H.pylori. Nevertheless, a significant association with increased risk for PUD development was observed for polymorphism TLR4 Thr399Ile [odds ratio (OR)=4.2; 95% confidence interval (CI)=1.35-13.26; p=0.01]. Correspondingly, TLR4 Thr399Ile polymorphism was associated with H.pylori susceptibility (OR=0.27; 95% CI=0.08-0.88; p=0.04). In addition, TLR4 Thr399Ile polymorphism increased 4.2-fold, the risk of peptic ulcer development in individuals infected by H.pylori carrying CT+TT genotype. Our results showed that TLR4 Thr399Ile polymorphism along with H.pylori infection may play critical roles in peptic ulcer development in North of Iran.

Urinary incontinence is associated with the development of peptic ulcers in adult women: Data from the KNHANES IV.

The aim of this study was to investigate the association between urinary incontinence (UI) and peptic ulcer (PU) and how this is related to psychological stress in Korean women by analyzing the data from the Korea National Health and Nutrition Examination Survey IV (KNHANES).A nationally representative sample of data on 7475 Korean women ≥19 years of age from the KNHANES 2008 to 2010 was included. Physician-diagnosed UI and PU were assessed using questionnaires and surveys. Psychological stress was assessed through a questionnaire using a 4-point Likert scale. Data were analyzed using logistic regression to determine the association between UI and PU according to the level of psychological stress perception.PU was found in 1.41% of the total population. Breaking this down by the existence of UI, PU was found in 3.5% of the population with UI, and 1.4% of the population without UI, which showed a significant difference. A statistically significant trend for increasing prevalence of UI and PU with increasing psychological stress perception levels was found among the study population. Multivariable logistic regression analyses for PU showed that UI was significantly associated with a higher probability of PU in an adjusted model, which means that members of the population with UI were more likely to have PU than those without UI. A higher level of psychological stress perception was also significantly associated with increased odds of PU in the adjusted model.UI could potentiate the development of PU through increasing levels of psychological stress perception.

TLR2 Arg677Trp but not TLR2 -196 to -174 ins/del and Arg753Gln polymorphism alter the risk of peptic ulcer in north of Iran

BackgroundMost polymorphisms that occur in TLR-2 are associated with gastrointestinal disorders such as peptic ulcer disease (PUD). Hence, in current study, association between TLR2-196 to -174 ins/del, Arg753Gln and Arg677Trp polymorphisms and risk of PUD development in north of Iran was evaluated. MethodsThis case-control study included 50 patients with PUD as cases and 50 people without peptic ulcer as control group. Blood and endoscopic biopsies were collected. Helicobacter pylori infection was screened by rapid urease test, specific IgG measurement and specific PCR for glmM gene. Then, TLR2-196 to -174 ins/del polymorphism was assessed by using allele-specific PCR. The Arg753Gln and Arg677Trp polymorphism in TLR2 gene were analyzed by the PCR-restriction fragment length polymorphism (RFLP). ResultsThere was no significant difference in the allele and genotype frequencies of polymorphisms in the TLR2-196 to -174 ins/ins and Arg753Gln genes between controls and patients, respectively. However, an association with increased risk for PUD was observed for polymorphism TLR-2 Arg677Trp (odds ratio [OR] = 7.9; 95% confidence interval [CI] = 0.94–67.5). Further analysis showed that H. pylori infection was associated with a significant difference in genotype and allele frequencies of TLR2-196 to -174 ins/ins and Arg753Gln polymorphism, respectively. Furthermore, there was no association between variant haplotypes and PUD development in H. pylori infected subjects. However, no association was detected between gender and genotypic frequencies of all polymorphisms in TLR2. ConclusionOur findings showed that TLR2 Arg677Trp polymorphism and H. pylori infection may play crucial roles in peptic ulcer development respectively in north of Iran.

Effect of Helicobacter pylori infection on the link between GLP-1 expression and motility of the gastrointestinal tract.

BackgroundAlthough Helicobacter pylori (H. pylori) infection is closely associated with the development of peptic ulcer, its involvement in pathophysiology in the lower intestinal tract and gastrointestinal (GI) motility remains unclear. Glucagon-like peptide-1 (GLP-1) is a gut hormone produced in the lower intestinal tract and involved in GI motility. Here, we investigated the effect of H. pylori infection on the link between GLP-1 expression and motility of the GI tract.MethodsC57BL/6 mice were inoculated with a H. pylori strain. Twelve weeks later, the H. pylori-infected mice underwent H. pylori eradication treatment. GI tissues were obtained from the mice at various time intervals, and evaluated for the severity of gastric inflammatory cell infiltration and immunohistochemical expression of GLP-1 and PAX6 in the colonic mucosa. Gastrointestinal transit time (GITT) was measured by administration of carmine-red solution.ResultsGLP-1 was expressed in the endocrine cells of the colonic mucosa, and PAX6 immunoreactivity was co-localized in such cells. The numbers of GLP-1- and PAX6-positive cells in the colon were significantly increased at 12 weeks after H. pylori infection and showed a positive correlation with each other. The GITT was significantly longer in H. pylori-infected mice than in non-infected controls and showed a positive correlation with GLP-1 expression. When H. pylori-infected mice underwent H. pylori eradication, GITT and PAX6/GLP-1 expression did not differ significantly from those in untreated H. pylori-infected mice.ConclusionsH. pylori infection may impair GI motility by enhancing the colonic GLP-1/PAX6 expression.

Pleiotropic cytotoxicity of VacA toxin in host cells and its impact on immunotherapy.

Introduction: In the recent decades, a number of studies have highlighted the importance of Helicobacter pylori in the initiation and development of peptic ulcer and gastric cancer. Some potential virulence factors (e.g., urease, CagA, VacA, BabA) are exploited by this microorganism, facilitating its persistence through evading human defense mechanisms. Among these toxins and enzymes, vacuolating toxin A (VacA) is of a great importance in the pathogenesis of H. pylori. VacA toxin shows different pattern of cytotoxicity through binding to different cell surface receptors in various cells. Methods: To highlight attempts in treatment for H. pylori infection, here, we discussed the VacA potential as a candidate for development of vaccine and targeted immunotherapy. Furthermore, we reviewed the related literature to provide key insights on association of the genetic variants of VacA with the toxicity of the toxin in cells. Results: A number of investigations on the receptor(s) binding of VacA toxin confirmed the pleiotropic nature of VacA that uses a unique mechanism for internalization through some membrane components such as lipid rafts and glycophosphatidylinositol (GPI)-anchored proteins (GPI-AP). Considering the high potency of VacA toxin in the clinical presentations in infection and assisting persistence and colonization of H. pylori, it is considered as one of the pivotal components in production vaccines and monoclonal antibodies (mAbs). Conclusion: It is possible to generate mAbs with a considerable potential to convert into secretory immunoglobulins that could penetrate into the niche of H. pylori and inhibit its normal functionalities. Further, conjugation of H. pylori targeting Ab fragments with the toxic agents or drug delivery systems (DDSs) offers new generation of H. pylori treatments.

Is Metothrexate so Harmless in Patients with Autoimmune Disorders?

The incidence of autoimmune diseases increasing nowdays. Despite of the development of diagnosis and management of diseases, they remained chronic diseases. The patient’s lifespan expansion requires long-term treatment with harmful agents, such as Metothrexate or other immunosuppressive drugs. The Metothrexate toxicities are based on the duration and cumulative dosing of drug, and the combination with other drugs. Myelosuppression and consequent pancytopenia is the most frequent hematologic toxicity, which occur mostly later during low dose Metothrexate administration. We demonstrate three cases of low dose metothrexate toxicity in older patients with rheumatoid arthritis and psoriasis. All patients were treated with low dose Metothrexate along more than one year continuously. Two old patients with RA and another with psoriasis developed pancytopenia causing severe neutropenia, cutaneous bleeding, and bruising and septic condition. They required intravenous antibiotic therapy, corticosteroids and limited transfusion dependence as a result of low dose methotrexate. We have assessed the possible causes of Metothrexate toxicities and found that all patients used non-steroid anti-inflammatory drugs because of pain and proton-pump inhibitor to avoid development of peptic ulcer. Two patients recovered, another died in septic condition. We would like to drawn attention of haematologists, dermatologists and rheumatologists to the harmful effect of low dose methotrexate in this patient population and emphasize the role of rigorous and consequent hematologic testing to avoid these severe late complications.

The Hematologic Toxicity of Methotrexate in Patients with Autoimmune Disorders

The incidence of auto-immune diseases is increasing nowa- days. Despite of the development of diagnosis and management of diseases, they remained chronic diseases. The patient’s lifespan expansion requires long-term treatment with harmful agents, such as Methotrexate or other immuno-suppressive drugs. The Methotrexate toxicities are based on the duration and cumulative dosing of drug, and the combination with other drugs. Myelosuppression and consequent pancytopenia is the most frequent hematologic toxicity, which occur mostly later during low dose methotrexate administration. We demonstrate three cases of low dose Methotrexate toxicity in older patients with rheumatoid arthritis and psoriasis. All patients were treated with low dose Methotrexate along more than one year continuously. Two old patients with RA and another with psoriasis developed pancytopenia causing severe neutropenia, cutaneous bleeding, and bruising and septic condition. They required intravenous antibiotic therapy, corticosteroids and limited transfusion dependence as a result of low dose Methotrexate. We have assessed the possible causes of Methotrexate toxicities and found that all patients used non-steroid anti-inflammatory drugs because of pain and protonpump inhibitor to avoid development of peptic ulcer. Two patients recovered, another died in septic condition. We would like to drawn attention of hematologists, dermatologists and rheumatologists to the harmful effect of low dose methotrexate in this patient population and emphasize the role of rigorous and consequent hematologic testing to avoid these severe late complications.

Development of an arCagA Antigen-Based Assay for the Detection of Helicobacter pylori in Stool Specimens

Background: Helicobacter pylori infection can lead to the development of gastritis and peptic ulcer in humans. Two categories of diagnostic methods are generally used for the detection of H. pylori infection. Particularly, non-invasive methods are recognized as practical, feasible, and sensitive diagnostic tests for the detection of H. pylori infection. Objectives: This study was designed with the aim to develop an assay, based on cytotoxin-associated gene A (CagA) antigen through western blotting method for the detection of H. pylori in fecal samples. Methods: The antigenic region of CagA (arCagA) gene was amplified by polymerase chain reaction (PCR) method and cloned to pET32a plasmid. Isopropyl β-D-1-thiogalactopyranoside (IPTG) was used to induce gene expression, and Escherichia coli BL21 (DE3) pLysS was transformed into pET32a-arCagA. Afterwards, the recombinant protein was purified by Ni-NTA resin. The rats were immunized by the purified arCagA protein for the production of antibodies. For the detection of H. pylori infection, stool samples from 80 patients were evaluated, using Western blot analysis and rat anti-arCagA antibody. The antigenic recombinant CagA region was expressed in E. coli, and CagA protein was produced and purified. Rat anti-CagA antibody was produced after immunization with the recombinant antigenic protein. Results: We investigated CagA protein, using the immunoblotting method in stool samples, which were already identified as positive by the application of a commercial kit. The developed test showed sensitivity of 87% and specificity of 90% in the patients. Conclusions: Based on the findings, application of recombinant arCagA antigen for the detection of H. pylori infection is a simple, rapid, and brief non-invasive method. Therefore, it can be suggested as an appropriate antigen for H. pylori detection kits.

Peptic ulcers: causes, prevention, perforation and treatment

Peptic ulcer disease (PUD) is a sore on the lining of stomach or duodenum. In some cases, a peptic ulcer may develop just above stomach in esophagus, i.e. esophageal ulcer. Peptic ulcer has always been the most common etiology underlying upper gastrointestinal perforation, while gastric perforation represents 10-15% of all peptic ulcers. Alternation in balance between aggressive and protective factors at the luminal surface of the epithelial cells, leads to development of peptic ulcer. Aggressive factors include Helicobacter pylori, hydrochloric acid, pepsins, nonsteroidal anti-inflammatory drugs (NSAIDs), bile acids, ischemia, hypoxia, smoking and alcohol. On the other hands, bicarbonate, mucus layer, mucosal blood flow, prostaglandins (PGs) and growth factors are the most known defensive factors. The shared symptoms include a dull or burning pain in middle or upper stomach between meals or at night, bloating, heartburn, nausea and vomiting are among the most common symptom of peptic ulcer. Some other symptoms in severe cases are dark or black stool (due to bleeding), vomiting blood, weight loss and pain in the mid to upper abdomen. An ulcer may or may not have all or some of the symptoms. In general, ulcers are best diagnosed by instrumental procedures depending on the case and the available facilities in the centre. The most reliable tests include, I) sophagogastroduodenoscopy (EGD), a thin tube with a camera inserted through the mouth into GIT. A biopsy is also taken during an EGD to be examined for H. pylori, II), X-ray for the upper GIT taken after drinking a thick barium salt, III) blood test to check if there is anemia and IV) detection of blood in the stool. Perforation is the major complication of PUD and the perforated peptic ulcer needs the use of surgical intervention. About 80% of the indications for peptic ulcer surgery are related to perforate peptic ulcers. Most cases are treated by simple suture of the perforated intestinal wall. In most cases, the best treatment is surgical or laparoscopic suture closure of the perforated ulcer. Natural products have found a special place in the treatment plans for peptic ulcer disease. They exhibit their antiulcerogenic activities by various mechanisms either prophylactic or therapeutic or both. The prophylactic products have considerable antioxidant and anti-inflammatory activities. On the other hand, therapeutic agents possess antisecretory or healing effects. The anti-H.pylori activity of some plant extracts, however, may explain their antiulcerogenic activity.

RECURRENCE RATE OF HELICOBACTER PYLORI IN PATIENTS WITH PEPTIC ULCER FIVE YEARS OR MORE AFTER SUCCESSFUL ERADICATION.

Infection with Helicobacter pylori is highly prevalent worldwide, especially in developing countries. Its presence in the gastroduodenal mucosa is related with development of peptic ulcer and other illnesses. The eradication of H. pylori improves mucosal histology in patients with peptic ulcers. This study was aimed to verify if H. pylori recurrence occurs five years or more after confirmed eradication in patients with peptic ulcer. Moreover, we sought to determine the recurrence rate. Retrospective and longitudinal, this study was based on a sample of 201 patients from western Paraná, Brazil. The patients were diagnosed with peptic ulcer disease, in the period of 1990-2000, and followed for five years or more after successful H. pylori eradication. Patients with early recurrence - prior to five years after eradication - were excluded from the sample. During an average follow-up of 8 years, 180 patients (89.55%) remained negative, and 21 (10.45%) became positive for H. pylori infection. New ulcers appeared in two-thirds of the patients with H. pylori recurrence. The recurrence of H. pylori in patients with peptic ulcer can occur in the long-term - even if the infection had been successfully eradicated and the patients had remained free of recurrence in the first years of follow-up.

Efficacy of Albis for the Prevention of Gastric Mucosal Injury Concomitant with the Use of Low-Dose Aspirin: A Prospective, Randomized, Placebo-Controlled Study.

Background/AimsLong-term use of aspirin can be a risk factor of peptic ulcer diseases. The aim of this study was to evaluate the efficacy of Albis (Daewoong Pharmaceutical Co., Ltd.) for the prevention of gastric mucosal injury caused by aspirin.MethodsAspirin users were enrolled and randomized into the Albis or placebo group. Screening and follow-up endoscopy were performed for modified Lanza scores (MLSs). Primary outcome was measured by the incidence rate of peptic ulcer, and secondary outcomes were measured by the incidence rate of gastritis, improvement in MLS and subjective symptoms.ResultsIn total, 81 aspirin users were randomized, 43 in the Albis group and 38 in the placebo group. There was no incidence of peptic ulcer in both groups. The incidence of gastritis was significantly higher in the placebo group (44.4% vs. 10.0%, p=0.003); however, the scores of mucosal edema, hyperemia and hemorrhage were not statistically different between the two groups (p>0.05). The frequency of subjective symptoms were more improved in the Albis group than in the placebo group (p=0.023).ConclusionsThe incidence of gastritis was lower in the group that received low-dose aspirin and Albis. The development of peptic ulcer due to long-term use of aspirin might be prevented with concomitant use of Albis.

Helicobacter pylori Infection and Dietary Factors Act Synergistically to Promote Gastric Cancer.

However, the incidence of gastric cancer (GC) has been decreased in past decades; GC is the second cause of cancer related death in the world. Evidence has illustrated that several factors including Helicobacter pylori (H. pylori) infection, host genetics, and environmental factors (smoking and particularly diet) may play a crucial role in gastric carcinogenesis. It has been demonstrated that high consumption of fresh fruits, vegetables, high level of selenium and zinc in drinking water, sufficient iron, and cholesterol protect against GC, while; smoked , pickled, and preserved foods in salt, and nitrites increase the risk of GC. Epidemiological studies have also proved that H. pylori infection and a high salt diet could independently induce atrophic gastritis and intestinal metaplasia. Recently, studies have been demonstrated that dietary factors directly influence H. pylori virulence. The use of appropriate diet could reduce levels of H. pylori colonization or virulence and prevent or delay development of peptic ulcers or gastric carcinoma. This is attractive from a number of perspectives including those of cost, treatment tolerability, and cultural acceptability. This review will describe new insights into the pathogenesis of H. pylori in relation to environmental factors, especially dietary, not only to find the developed means for preventing and treating GC, but also for understanding the role of chronic inflammation in the development of other malignancies.

Role of nitrite, urate and pepsin in the gastroprotective effects of saliva

Dietary nitrate is now recognized as an alternative substrate for nitric oxide (•NO) production in the gut. This novel pathway implies the sequential reduction of nitrate to nitrite, •NO and other bioactive nitrogen oxides but the physiological relevance of these oxidants has remained elusive. We have previously shown that dietary nitrite fuels an hitherto unrecognized nitrating pathway at acidic gastric pH, through which pepsinogen is nitrated in the gastric mucosa, yielding a less active form of pepsin in vitro. Here, we demonstrate that pepsin is nitrated in vivo and explore the functional impact of protein nitration by means of peptic ulcer development. Upon administration of pentagastrin and human nitrite-rich saliva or sodium nitrite to rats, nitrated pepsin was detected in the animal's stomach by immunoprecipitation. •NO was measured in the gastric headspace before and after nitrite instillation by chemiluminescence. At the end of each procedure, the stomach's lesions, ranging from gastric erosions to haemorrhagic ulcers, were scored. Nitrite increased gastric •NO by 200-fold (p<0.05) and nitrated pepsin was detected both in the gastric juice and the mucosa (p<0.05). Exogenous urate, a scavenger of nitrogen dioxide radical, blunted •NO detection and inhibited pepsin nitration, suggesting an underlining free radical-dependent mechanism for nitration. Functionally, pepsin nitration prevented the development of gastric ulcers, as the lesions were only apparent when pepsin nitration was inhibited by urate. In sum, this work unravels a novel dietary-dependent nitrating pathway in which pepsin is nitrated and inactivated in the stomach, preventing the progression of gastric ulcers.

Altered Th17 Cytokine Expression in Helicobacter pylori Patients with TLR4 (D299G) Polymorphism

ABSTRACTHelicobacter pylori (H. pylori) is associated with gastric ulcer and gastric adenocarcinoma. Polymorphisms in the host genes coding for Toll-like receptors (TLRs) may influence the innate and adaptive immune response to the infection, affecting the susceptibility to H. pylori or the disease outcomes. However, the details and association with different polymorphism and clinical expression of infection remain unclear. A case-control study consisting of 58 patients with H. pylori infection and 44 H. pylori uninfection was conducted. Genomic DNA was extracted and genotypes of TLR4 Asp299Gly polymorphism were assessed through polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Mucosal cytokines expression in H. pylori-infected and uninfected gastric biopsies was determined by real-time PCR. The expression of IL-6, IL-17, IL-21, IL-23 and TGF-β1 was significantly higher in patients with D299G polymorphism in TLR4. But the expression of IL-18 between patients with single-nucleotide polymorphisms (SNPs) in TLR4 and patients with the wild-type allele was not significant. In H. pylori-infected patients with gastritis, SNPs in TLR4 may alter cytokine expression toward Th17 immune response in the gastric mucosa and may have increased risk for the development of peptic ulcer.

Therapeutic efficacy of oral immunization with a non-genetically modified Lactococcus lactis-based vaccine CUE-GEM induces local immunity against Helicobacter pylori infection.

The gastric bacterial pathogen Helicobacter pylori persistently colonizes the gastric mucosa of humans and plays a critical role in the development of gastritis, peptic ulceration and gastric adenocarcinoma. Consequently, the eradication of H. pylori might contribute to the prevention of H. pylori-associated gastric diseases. In this study, a multi-epitope vaccine CTB-UE (CUE) was displayed on the surface of non-genetically modified Lactococcus lactis particles (GEM) to enhance immunogenicity. This particulate vaccine CUE-GEM induced serum and mucosal specific antibody responses against native H. pylori urease and provided potent protection to eliminate H. pylori colonization and relieve gastritis in an H. pylori-infected BALB/c mouse model. The immuno-protective mechanisms are highly associated with CD4(+) Th cell-mediated and humoral immunity, especially local immunity. There might be two main aspects of this association. One aspect is related to the suppression of urease activity by promotion of the production of specific mucosal neutralizing antibody. The other aspect is correlated with alleviating gastritis by regulating the gastric pro-inflammatory cytokine profile, especially IFN-γ and IL-17. These results demonstrated that conjugating antigen vaccines with GEM particles could lead to promising oral therapeutic vaccine formulations against H. pylori infection.

Incidence of peptic ulcer in bronchial asthma and chronic obstructive pulmonary disease and its relation to Helicobacter pylori infection

Background: Asthma and chronic obstructive pulmonary disease (COPD) are characterized by a progressive airflow limitation. COPD is considered the fourth leading cause of death worldwide. Helicobacter pylori is a Gram-negative bacteria are closely associated with peptic ulcer development. Aims and Objectives: This study aimed to compare the incidence of peptic ulcer disease between asthmatic and COPD group of patients and evaluation of its relation to H. pylori infection. Materials and Methods: This study includes 50 patients with COPD from both sexes (M: 35/F:15), 50 patients with bronchial asthma from both sexes (M: 30/F: 20) from King Abdul-Aziz Hospital, Taif area, and 25 healthy control volunteers (M: 17/F: 8) matched in age and sex. Total immunoglobulin E (IgE), pH, pO2, pCO2, forced vital capacity (FVC), forced expiratory volume in first second (FEV1)/FVC, and forced expiratory flow (FEF) 25-75 were measured and matched between various groups. Results: Total serum IgE T-IgE showed a non-significant increase in COPD patients compared to control (68.33 ± 16.74) while it increased significantly in asthmatic patients (243.65 ± 120.54) compared to control. Regarding pH, pO2, and pCO2 relation between control and asthmatic patients, the results are non-significant while it was significant (P < 0.05) for pH between control and COPD patients and was highly significant (P < 0.001) for pO2 and pCO2 in the two groups. For FVC, FEV1/FVC, and FEF 25-75 between control and asthma patients, results considered highly significant (P < 0.001) while it showed a significant difference (P < 0.05) for FEV1 in both groups. For FVC, FEV1/FVC, and FEF 25-75 between control and COPD patients, the results are considered highly significant (P < 0.001), and a very highly significant difference (P < 0.05) for control and COPD. Conclusion: Close interaction between the incidence of peptic ulcer disease with asthma and COPD group of patients in relation to H. pylori infection was confirmed.

Inocuidad citotóxica y mutagénica de los aceites esenciales de Rosmarinus officinalis L. y Ruta graveolens L. promisorios para el tratamiento complementario de la infección por Helicobacter pylori

Helicobacter pylori infection affects approximately half of world’s population, is acquired in infancy and has been associated with the development of chronic gastritis, peptic ulcers and stomach cancer in adulthood. The usual treatment that includes two or three antibiotics has led to problems of bacterial resistance, decreased effectiveness, price and safety; showing the need to develop alternative therapies. The Public Health Research Group of the University of Narino (Pasto, Colombia) found that essential oils of Rosmarinus officinalis (L.) and Ruta graveolens (L.) have anti-H. pylori activity in vitro; however, their innocuousness for human consumption was not examined. This study evaluated the cytotoxicity of both oils in human lymphocytes maintained in culture and their mutagenicity by the Ames test with the Salmonella typhimurium strain TA-100. The essential oil of R. officinalis did not present cytotoxic or mutagenic effects in any concentration compared to controls. Pure concentrate of the R. graveolens essential oil was cytotoxic (cell viability 40% lower); however, in dilutions of 10-1 to 10-5, this oil was shown to be safe in both assay systems. These results show that both extracts are promissory for human consumption and in the future, could be considered as an option for complimentary treatment for H. pylori.

Assessment of TNFA polymorphisms at positions -857 and -863 in Polish peptic ulcer patients

PurposePeptic ulceration connected with chronic inflammation in gastrointestinal mucosa could be induced by Helicobacter pylori infection. Tumor necrosis factor alpha (TNF-α) encoded by TNFA gene is a key mediator in the inflammation process. There are several polymorphisms in the promoter of TNFA influencing its transcriptional activity. -857C>T (rs1799724) and -863C>A (rs1800630) substitutions may be responsible for increased TNFA transcription and TNF-α production. The association of these two polymorphisms with peptic ulceration and the development of H. pylori infection in peptic ulcer patients in Poles were evaluated. Material and methodsPolymorphisms were assessed by PCR-RFLP in 203 peptic ulcer patients. H. pylori infection was confirmed by rapid urease test. The results of genotyping were compared with those obtained for 248 healthy Polish individuals. ResultsThere were no significant differences in genotype and allele frequencies for both investigated polymorphisms between peptic ulcer patients and healthy individuals. No associations between frequencies of particular genotypes and alleles for both SNPs and the presence of H. pylori infection in peptic ulcer patients and in subgroups of peptic ulcer women and men were confirmed. ConclusionsThe investigated SNPs are not risk factors for peptic ulcer development. They are not risk factors for H. pylori infection in ulcer patients.

ABCG2 in peptic ulcer: gene expression and mutation analysis.

The aim of this study was to evaluate the participation of polymorphism at position C421A and mRNA expression of the ABCG2 gene in the development of peptic ulcers, which is a very common and severe disease. ABCG2, encoded by the ABCG2 gene, has been found inter alia in the gastrointestinal tract, where it plays a protective role eliminating xenobiotics from cells into the extracellular environment. The materials for the study were biopsies of gastric mucosa taken during a routine endoscopy. For genotyping by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) at position C421A, DNA was isolated from 201 samples, while for the mRNA expression level by real-time PCR, RNA was isolated from 60 patients. The control group of healthy individuals consisted of 97 blood donors. The dominant genotype in the group of peptic ulcer patients and healthy individuals was homozygous CC. No statistically significant differences between healthy individuals and the whole group of peptic ulcer patients and, likewise, between the subgroups of peptic ulcer patients (infected and uninfected with Helicobacter pylori) were found. ABCG2 expression relative to GAPDH expression was found in 38 of the 60 gastric mucosa samples. The expression level of the gene varies greatly among cases. The statistically significant differences between the intensity (p = 0.0375) of H. pylori infection and ABCG2 gene expression have been shown. It was observed that the more intense the infection, the higher the level of ABCG2 expression.