Pylori Status Research Articles

Study of the FUT2 gene association with infection and clinical manifestations of <i>Helicobacter pylori</i> infection

The aim of the pilot study of a group of adolescents with H. pylori infection was to study the preliminary data obtained on the rs602662 locus of the FUT2 gene and to establish its role in the realization of clinical manifestations of chronic gastritis, gastric ulcer and duodenal ulcer associated with H. pylori.Methods: The study included 91 patients. The study for the presence of the polymorphic locus rs602662 of the FUT2 gene was carried out by the standard TaqMan PCR method on a Real-Time CFX96 Touch amplifier. The duration of the study was 6 months.Results: The main group included 25 adolescents aged 16 to 17 years 11 months, the control group included 20 patients. Patients infected with H. pylori more often noticed symptoms of dyspepsia - in 36%, compared with the control group - 9.7%. The presence of a family history in the main group for associated diseases had a significant difference, χ2 = 4.97, p <0.05.To assess the contribution of the genotype of the rs602662 locus of the FUT2 gene to the risk of clinical manifestations in H. pylori infection, the main group was divided into subgroups. In the distribution of alleles in these groups, statistically significant differences were revealed.Allele “A” has a protective effect against the onset of clinical symptoms of dyspepsia. The odds ratio (OR) with the carriage of allele “A” (genotypes A / A and G / A versus G / G) to have clinical symptoms with a positive H. pylori status was 0.175 (CI = [0.049-0.625] chi2 = 7.79 p = 0.0053).Conclusion. As a result of the study, we were unable to identify a significant association of alleles and genotypes of the rs602662 locus of the FUT2 gene with clinical manifestations of H. pylori infection. At the same time, carriers of the A allele have a pronounced association with the absence of clinical symptoms in patients with a positive H. pylori infection status of 0.175 (C.I. = [0.049-0.625] chi2 = 7.79 p = 0.0053).

<i>Helicobacter pylori</i> infection reduces the risk of gastroesophageal reflux disease

The aim is to study the effect of Helicobacter pylori infection on risk of developing gastroesophageal reflux disease. Materials and methods - cross-sectional observational study of 1007 patients with dyspepsia syndrome who underwent videoesophagogastroduodenoscopy with biopsy and histological examination of biopsy specimens of the gastric mucosa by OLGA-system. The age, gender, overweight, cigarette smoking, presence of Helicobacter pylori infection and gastritis stage were assessed. Results - the study showed a significant decrease in the incidence of gastroesophageal reflux disease in patients with positive H. Pylori status by 4% (RR 0,68; 95% CI, 0.49-0.94, p=0,041). The risk of developing gastroesophageal reflux disease significantly higher in overweight (RR 2,62; 95% CI 2,0-3,56; р<0,001) men (RR 1,76; 95% CI 1,33-2,32; р=0,0046) who smoked cigarettes (RR 3,23; 95% CI 2,45-4,24; р<0,001) and was not associated with the patient’s age and the stage of gastritis (р>0,05). Conclusion - a significant reduction in the frequency and risk of developing gastroesophageal reflux disease in patients with Helicobacter pylori infection is demonstrated.

Gastric Xanthoma Is Related to the Rapid Growth of Gastric Cancer.

Early detection of gastric cancer is important. However, rapid growth of gastric cancers that cannot be resected endoscopically occurs even with periodic check-ups. Accordingly, we assessed factors associated with the speed of gastric cancer growth by examining historical endoscopic images. A total of 1996 gastric cancer cases were screened, and characteristics of lesions with slow and rapid growth were assessed. A total of 114 lesions from 114 patients were included in the assessment. Sixty slow-growing and fifty-four rapidly growing gastric cancers were compared. Female sex and incidence of lesions in the lower part of the stomach were significantly less frequent in the rapid-growth group than in the slow-growth group. History of endoscopic treatment tended to be more frequent in the rapid-growth group. Age, body mass index, histology, Helicobacter pylori status, and medications did not differ significantly between groups. Xanthoma was significantly related to rapid growth of gastric cancer, and map-like redness tended to be more frequent in the rapid-growth group in univariate analysis. Xanthoma was significantly related to rapid growth of gastric cancer on multivariate analysis. Further studies are warranted to clarify the pathophysiological mechanisms involved in the speed of gastric cancer growth.

The Distinct Impact of TAM Infiltration on the Prognosis of Patients With Cardia and Non-Cardia Gastric Cancer and Its Association With H. pylori Infection.

BackgroundIn stage III gastric cancer (GC), the role of tumor-associated macrophages (TAMs) and Helicobacter pylori (H. pylori) infection impact tumor progression; however, the specific mechanisms remain controversial. We speculated whether this controversy is caused by differences in the location of TAM infiltration (in the core (CT) and invasive margin (MI) of primary tumors) and the topographical subsites of GC (cardia and non-cardia). Therefore, in this study, we investigated TAMs in different locations and H. pylori infection status as prognostic biomarkers for GC.MethodsImmunohistochemical staining for CD68 (pan-macrophage), CD163 (M2-like macrophage), and H. pylori in 200 samples (100 cases of cardia-GC [CGC] and 100 cases of non-cardia GC [NCGC]) was performed. We compared the number of CD68+ and CD163+ macrophages that infiltrated the CT and MI in patients with the prognosis of CGC and NCGC, respectively. In addition, we analyzed the relationship between H. pylori status and the prognosis of patients with GC in different locations, as well as the correlation with TAM infiltration.ResultsThe distribution of TAMs had distinct characteristics in CGC and NCGC, especially differences between CT and MI subtype. A Kaplan–Meier analysis showed that a high number of CD68+ macrophages that infiltrated the CT in CGC was associated with a better prognosis, whereas infiltration at the MI in NCGC indicated a poor prognosis. Furthermore, a high number of CD163+ macrophages infiltrating the MI resulted in a poor prognosis in CGC and NCGC cohorts. Considering the larger differences in the relationship between the infiltration of CD68+ macrophages at different locations and prognosis, we divided the GC cases into marginal and central GC, based on this difference. This resulted in an accurate estimation of the prognosis. Moreover, positive H. pylori status in central GC was significantly associated with a better prognosis and TAM infiltration.ConclusionTAMs in different locations and H. pylori status were identified as independent prognostic markers, with an obvious correlation between them. Therefore, it is important to clarify the impact of TAM location on the prognosis of patients with GC, which contributes to the development of potential therapeutic strategies.

A Link Between Platelet-to-Lymphocyte Ratio and Helicobacter pylori Infection

Abstract Background: Gastritis is a progressive disease that evolves from a non-atrophic to an atrophic state and progresses through intestinal metaplasia, even leading to gastric cancer. Gastritis is defined by an inflammatory process of the mucosal lining of the stomach. Aim: We aimed to identify any association between Helicobacter pylori (H. pylori)-positive gastritis and simple inflammatory markers derived from a complete blood count such as the platelet-to-lymphocyte ratio (PLR). Material and Methods: We performed a retrospective case-control study in which we included patients who underwent an upper digestive endoscopy with biopsy between January 2019 and December 2020 and were diagnosed with gastritis. H. pylori status was determined from the histopathological examination, and complete blood count was performed from venous blood samples. The final study group included 125 patients with H. pylori-positive chronic gastritis, and the control group was made up by 207 patients without H. pylori infection. Results: We found a higher value of the PLR in H. pylori-positive patients than in the control group, but the difference was not significant statistically. Conclusions: PLR levels could be a predictor of inflammation in H. pylori infection, but an extensive study is needed to confirm this theory.

Efficacy of Lactobacillus reuteri Supplementation in Eradication of H. pylori: A Comparison Study with Triple Drug Therapy

Helicobacter pylori (H. pylori) infections affect roughly one-half of the world’s population. Although many standard regimens, including triple-drug therapy, eradicate H. pylori, the success rate and efficacy have been declining due to associated side effects and symptom severity. The addition of probiotics to a standard regimen can considerably increase eradication rates. The objective is to find the efficacy of a probiotic Lactobacillus reuteri (L. reuteri) in eradicating human H. pylori infection and effect on symptoms regression and side effects associated with triple therapy. This prospective interventional study was conducted in 90 H. pylori-positive patients. 45 patients received standard triple treatment (group-I) for 14 days. Another 45 patients received a combination of standard triple therapy and L. reuteri (group-II) for 14 days. After the completion of treatment, H. pylori status was evaluated using a 13-C Urea-Breath Test (UBT). Each subject is interviewed with a validated Gastrointestinal Symptoms Rating Scale (GSRS) questionnaire to record symptoms and symptom severity before and after the therapy. Group-II patients showed a significantly higher eradication rate (86.67%) than group-I patients (66.67%). The absolute values of 13C-UBT (group-I: 14.02± 5.4, group-II: 11.9±3.73) revealed that a more substantial reduction in H. Pylori load was observed in group II. Statistical analysis proved that group II patients had a significant reduction in GSRS mean scores (baseline score: 15.39±4.52 to end score: 5.33±2.34) compared to group-I patients (baseline score: 14.47±3.67 to end score: 9.86±4.78). Addition of L. reuteri has reduced side effects associated with triple drug therapy except bloating. In conclusion, supplementation of L. reuteri to standard triple drug therapy significantly improved the eradication rate of H. pylori, reduced intensity of gastrointestinal symptoms and also treatment related side effects.

Coinfection of Helicobacter pylori and Hepatitis C Virus in the Development of Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis.

BackgroundThe relationship between Helicobacter pylori (H. pylori) and hepatocellular carcinoma (HCC) was firstly proposed in 1994 after Ward et al demonstrated the role of Helicobacter hepaticus in the development of HCC in mice. Studies also investigated the role of hepatitis B virus (HBV) and hepatitis C virus (HCV) coexisting with H. pylori in causing HCC. A causal relationship was never confirmed, and the relationship remains controversial. This meta-analysis aimed to summarize the research on this topic and investigate if a relationship exists between H. pylori infection and the development of HCC and if the presence of HCV and HBV along with H. pylori plays a role in liver carcinogenesis.MethodsFollowing PRISMA guidelines, we performed a systematic review of all relevant studies published in the literature using the keywords “Helicobacter pylori” and “hepatocellular carcinoma” on major literature databases, including PubMed, EMBASE, Web of Science, and Cochrane controlled trials register. A total of 656 research studies were identified between 1994 and 2020. Of those, 26 qualified under our selection criteria. Patients who were positive for HCC were classified as cases and those who did not have HCC were classified as controls. The H. pylori status and HCV status, if available, were identified for both groups. Statistical analysis was carried out by a biostatistician according to the Cochrane reviewer’s handbook.ResultsOut of the 26 studies included in the final analysis, 13 were retrospective case-control studies, 11 were cross-sectional studies, and two were prospective case-control and cohort studies. Overall, the prevalence of H. pylori infection was 64.78% (561 of 866) amongst HCC cases and 47.92% (1,718 of 3,585) in the non-HCC control group. The summary odds ratio (OR) for the association of H. pylori infection with the risk for HCC (using the random-effects model, which accounted for the heterogeneity across the 26 studies) was determined to be 4.75 (95% confidence interval (CI): 3.06 - 7.37, I2 = 63%). We also performed a subgroup analysis to determine the odds of developing HCC in the presence of H. pylori and HCV coinfection. The summary OR of it was 12.76 (95% CI: 4.13 - 39.41, I2 = 78%). The summary OR for the risk of developing HCC in the presence of HCV infection without H. pylori infection was 2.21 (95% CI: 0.70 - 6.94, I2 = 79%). Whereas, the odds of developing HCC in the presence of only H. pylori infection without HCV was found to be 0.54 (95% CI: 0.11 - 2.63, I2 = 80%). There was inconsistency in the data presented in some studies regarding HCV infection status. Since data were extracted from different study designs, subgroup analysis by study design was performed which showed no significant difference between the study groups (P = 0.5705).ConclusionThis meta-analysis demonstrates a positive association between H. pylori infection and the development of HCC. There is a significantly higher risk of developing HCC in the presence of HCV infection along with H. pylori. Further prospective cohort studies are needed to prove the causal relationship, especially in cases of HBV and HCV coinfection, and cirrhotic patients.

Association between regular arrangement of collecting venules and Helicobacter pylori status in routine endoscopy

BackgroundThe sensitivity of regular arrangement of collecting venules (RAC)-positive pattern for predicting Helicobacter pylori (H. pylori)-negative status greatly altered from 93.8 to 48.0% in recent two decades of various studies, while the reason behind it remained obscure. The aim of this study was to investigate the value of RAC as an endoscopic feature for judging H. pylori status in routine endoscopy and reviewed the underlying mechanism.MethodsA prospective study with high-definition non-magnifying endoscopy was performed. RAC-positive and RAC-negative patients were classified according to the collecting venules morphology of the lesser curvature in gastric corpus. Gastric biopsy specimens were obtained from the lesser and greater curvature of corpus with normal RAC-positive or abnormal RAC-negative mucosal patterns. Helicobacter pylori status was established by hematoxylin and eosin staining and immunohistochemistry.Results41 RAC-positive and 124 RAC-negative patients were enrolled from June 2020 to September 2020. The prevalence of H. pylori infection in patients with RAC-positive pattern and RAC-negative pattern was 7.3% (3/41) and 71.0% (88/124), respectively. Among all 124 RAC-negative patients, 36 (29.0%) patients were H. pylori-negative status. Ten patients (32.3%) demonstrated RAC-positive pattern in 31 H. pylori-eradicated cases. The sensitivity, specificity, positive predictive value, and negative predictive value of RAC-positive pattern for predicting H. pylori-negative status were 51.4% (95% CI, 0.395–0.630), 96.7% (95% CI, 0.900–0.991), 92.7% (95% CI, 0.790–0.981), and 71.0% (95% CI, 0.620–0.786), respectively.ConclusionsRAC presence can accurately rule out H. pylori infection of gastric corpus, and H. pylori-positive status cannot be predicted only by RAC absence in routine endoscopy.Trial registration The present study is a non-interventional trial.

S623 Changes in Demographics and Prevalence of Helicobacter pylori in Gastric and Duodenal Ulcers at an Urban Tertiary Care University Hospital

Introduction: Diagnosis and evaluation of peptic ulcer disease (PUD) is one of the most common indications for upper endoscopy, and Helicobacter pylori (HP) infection and NSAID use are the most common etiologies of the disease. HP incidence has declined worldwide, with more pronounced decreases in developed countries. We investigated whether a decline in HP infection occurred in our cohort of patients compared with nationally available estimates and if patient demographics, including race, were associated with HP incidence. Prior studies have cited the prevalence of HP in African Americans to be as high as 50-60% compared to the national US prevalence of 30%. Using data from patients seen at an academic medical center in an underserved area, we aim to elucidate the relationship between demographics and HP incidence. Methods: We retrospectively queried our electronic health record for patients aged 18 or older diagnosed with PUD by endoscopy during a single year between 2019 and 2020. We collected information including age, gender, race, inpatient/outpatient diagnosis, Forrest classification of ulcer, location of ulcer, and HP status. We assessed association between these characteristics and HP status using Chi-squared analysis. Results: 303 patients met inclusion criteria. 216 had gastric ulcers and 122 had duodenal ulcers. Among those, 34 patients had both gastric and duodenal ulcers. HP tests were performed on 227 patients, with 24.2% positivity. African American patients were most likely to have HP associated ulcers and White patients were least likely to have them (33.6% vs 3.8%, P< 0.001). There was no significant difference between HP prevalence based on age or ulcer location. Males were more likely to have HP ulcers than females (30.5% vs 18.9%, P=0.042). Conclusion: Prevalence of HP has decreased nationally over the last several years. However, as seen in our data, there has been a significant difference in the rate of HP affecting males and African Americans. Specifically, our data shows that HP rates have impacted these groups at a significantly higher rate than Caucasians and females. This data is especially significant at an inner-city hospital, where patients experience disparities in healthcare access. We aim to supplement this analysis with prior years’ data to further understand the differential decrease in HP amongst populations in our community. By doing so, we can better provide a framework for screening, treatment, and education of our patients who are at increased risk for HP.Table 1.: Frequencies of Recorded Variables by H Pylori Status

Role of Helicobacter pylori and Other Environmental Factors in the Development of Gastric Dysbiosis.

Microbiomes are defined as complex microbial communities, which are mainly composed of bacteria, fungi, and viruses residing in diverse regions of the human body. The human stomach consists of a unique and heterogeneous habitat of microbial communities owing to its anatomical and functional characteristics, that allow the optimal growth of characteristic bacteria in this environment. Gastric dysbiosis, which is defined as compositional and functional alterations of the gastric microbiota, can be induced by multiple environmental factors, such as age, diet, multiple antibiotic therapies, proton pump inhibitor abuse, H. pylori status, among others. Although H. pylori colonization has been reported across the world, chronic H. pylori infection may lead to serious consequences; therefore, the infection must be treated. Multiple antibiotic therapy improvements are not always successful because of the lack of adherence to the prescribed antibiotic treatment. However, the abuse of eradication treatments can generate gastric dysbiotic states. Dysbiosis of the gastric microenvironment induces microbial resilience, due to the loss of relevant commensal bacteria and simultaneous colonization by other pathobiont bacteria, which can generate metabolic and physiological changes or even initiate and develop other gastric disorders by non-H. pylori bacteria. This systematic review opens a discussion on the effects of multiple environmental factors on gastric microbial communities.

United European Gastroenterology (UEG) and European Society for Neurogastroenterology and Motility (ESNM) consensus on functional dyspepsia.

Functional dyspepsia (FD) is one of the most common conditions in clinical practice. In spite of its prevalence, FD is associated with major uncertainties in terms of its definition, underlying pathophysiology, diagnosis, treatment, and prognosis. A Delphi consensus was initiated with 41 experts from 22 European countries who conducted a literature summary and voting process on 87 statements. Quality of evidence was evaluated using the grading of recommendations, assessment, development, and evaluation (GRADE) criteria. Consensus (defined as >80% agreement) was reached for 36 statements. The panel agreed with the definition in terms of its cardinal symptoms (early satiation, postprandial fullness, epigastric pain, and epigastric burning), its subdivision into epigastric pain syndrome and postprandial distress syndrome, and the presence of accessory symptoms (upper abdominal bloating, nausea, belching), and overlapping conditions. Also, well accepted are the female predominance of FD, its impact on quality of life and health costs, and acute gastrointestinal infections, and anxiety as risk factors. In terms of pathophysiological mechanisms, the consensus supports a role for impaired gastric accommodation, delayed gastric emptying, hypersensitivity to gastric distention, Helicobacter pylori infection, and altered central processing of signals from the gastroduodenal region. There is consensus that endoscopy is mandatory for establishing a firm diagnosis of FD, but that in primary care, patients without alarm symptoms or risk factors can be managed without endoscopy. There is consensus that H. pylori status should be determined in every patient with dyspeptic symptoms and H. pylori positive patients should receive eradication therapy. Also, proton pump inhibitor therapy is considered an effective therapy for FD, but no other treatment approach reached a consensus. The long-term prognosis and life expectancy are favorable. A multinational group of European experts summarized the current state of consensus on the definition, diagnosis and management of FD.

Helicobacter pylori infection: place of serological and cultural diagnostics in clinical guidelines.

The purpose of this work was to familiarize doctors with the methods and significance of serological and cultural diagnostics of H. pylori infection on the example of the test for diagnosing the state of the gastric mucosa «Gastropanel». Blood serum tests were performed for 1057 patients and 122 healthy people aged 18-64 years: pepsinogen I (PG I), pepsinogen II (PG II), gastrin-17 (G-17), basal/stimulated), antibodies (IgGHp) to H. pylori (Biohit Oyj, Finland). The medians of the studied group indicators did not exceed the reference intervals. 398 (34%) patients have negative H. pylori status (IgGHp-). 275 (26%) patients with serum PG I≤70 mcg/ml were identified. The ratio of PG I/II≤3 in 84 (8%), 36 of them (43% of the group PG I/II≤3) - IgGHp-.

Assessment of Helicobacter pylori status by examination of gastric mucosal patterns: diagnostic accuracy of white-light endoscopy and narrow-band imaging

ObjectivesHelicobacter pylori infection is a common cause of chronic gastritis worldwide and an established risk factor for developing gastric malignancy. The endoscopic appearances predicting H. pylori status are an ongoing...

Evaluation of gastric endoscopic biopsy results in accordance with history of previous thyroidectomy

Objectives: This study aimed to establish a link between total thyroidectomy and Helicobacter pylori (H. pylori) infection, which is one of the most implicated risk factors that cause gastric intestinal metaplasia (GIM) and is also a risk factor for gastric adenocarcinoma. Materials and methods: This retrospective study was conducted at Giresun University. We retrospectively reviewed gastric biopsies from 78 thyroidectomized patients (41 males, 37 females; mean age: 64.5±8.5 years; range, 29 to 79 years) in a single center. A control group of 150 subjects (45 males, 105 females; mean age: 59±7.5 years; range, 32 to 78 years) was selected from age-matched dyspeptic subjects with no history of thyroidectomy. Results: There were no significant differences in baseline sociodemographic characteristics between groups. Histopathological analysis of gastric biopsy specimens showed that the rate of H. pylori infection was found to be significantly lower in the thyroidectomized group (43.3% vs. %60.8; p&lt;0.05). Although in multivariate analysis the relationship between atrophic gastritis and thyroidectomy was not statistically significant (p=0.857), there was a stronger correlation between GIM and thyroidectomy compared to the control group (13.3% vs. 3.3%; p&lt;0.05). Conclusion: To our knowledge, this is the first study comparing the gastric and endoscopic findings between thyroidectomized patients and those with non-thyroidectomized gastroesophageal reflux disease patients. Further studies are needed to determine a causal link between thyroidectomy and gastric intestinal metaplasia. Evidence has accumulated suggesting that autoimmune thyroid diseases increase the risk of gastric mucosal damage and adversely affect H. pylori status.

Higher Prevalence of Non-thyroidal-Illness Syndrome in Elderly Male Patients With Active Helicobacter pylori Infection

Objective: It is currently unclear whether the Helicobacter pylori (H. pylori) infection leads to associated alterations in thyroid functions and thyroidal illnesses. This study aims to analyse this relationship in an elderly male cohort over a five-year period.Design: A case retrospective study.Methods: A longitudinal study was designed to collect subjects (≥65 years old) receiving both a thyroid examination and H. pylori infection status determined by 13C-urea breath test in 2013 at our unit. Subjects were followed every 1 to 2 years until December 2017 for laboratory results, visits to outpatient clinics/emergency departments etc. Blood tests and thyroid ultrasonography were performed to determine thyroid function and morphology.Results: 356 male subjects with mean age 78.5 ± 9.8 years were included. Active H. pylori infection was positive in 88 subjects (24.7%). Thyroid function tests and ultrasonography showed similar patterns between H. pylori positive and negative groups. Non-thyroidal-illness syndrome (NTIS) was diagnosed in 30/210 (14%) patients who experienced acute illnesses and hospitalization over five-year follow-up. Notably, NTIS demonstrated significantly higher prevalence in the H. pylori positive group compared to the negative group (17.1 vs. 5.6%, P = 0.001). Multivariate analysis showed that when age, APACHE II score and hemoglobin levels were adjusted, H. pylori status still has significant interrelationship with NTIS (OR = 3.497, P = 0.003).Conclusions: There is a positive association between chronic active H. pylori infection and NTIS prevalence in this elderly male cohort. Further studies are needed to elucidate the role of H. pylori infection on NTIS in elderly male patients.

Follow-Up Study Confirms the Presence of Gastric Cancer DNA Methylation Hallmarks in High-Risk Precursor Lesions.

Simple SummaryIntestinal metaplasia confers an increased risk of progression to gastric cancer. However, some intestinal metaplasia patients do not develop cancer. The development of robust molecular biomarkers to stratify patients with advanced gastric precursor lesions at risk of cancer progression will contribute to guiding programs for prevention. Starting from a genome-wide methylation study, we have simplified the detection method regarding candidate-methylation tests to improve their applicability in the clinical environment. We identified CpG methylation at the ZNF793 and RPRM promoters as a common event in intestinal metaplasia and intestinal forms of gastric cancer. Furthermore, we also showed that Helicobacter pylori infection influences DNA methylation in early precursor lesions but not in intestinal metaplasia, suggesting that therapeutic strategies to prevent epigenome reprogramming toward a cancer signature need to be adopted early in the precursor cascade.To adopt prevention strategies in gastric cancer, it is imperative to develop robust biomarkers with acceptable costs and feasibility in clinical practice to stratified populations according to risk scores. With this aim, we applied an unbiased genome-wide CpG methylation approach to a discovery cohort composed of gastric cancer (n = 24), and non-malignant precursor lesions (n = 64). Then, candidate-methylation approaches were performed in a validation cohort of precursor lesions obtained from an observational longitudinal study (n = 264), with a 12-year follow-up to identify repression or progression cases. H. pylori stratification and histology were considered to determine their influence on the methylation dynamics. As a result, we ascertained that intestinal metaplasia partially recapitulates patterns of aberrant methylation of intestinal type of gastric cancer, independently of the H. pylori status. Two epigenetically regulated genes in cancer, RPRM and ZNF793, consistently showed increased methylation in intestinal metaplasia with respect to earlier precursor lesions. In summary, our result supports the need to investigate the practical utilities of the quantification of DNA methylation in candidate genes as a marker for disease progression. In addition, the H. pylori-dependent methylation in intestinal metaplasia suggests that pharmacological treatments aimed at H. pylori eradication in the late stages of precursor lesions do not prevent epigenome reprogramming toward a cancer signature.

ID: 3522949 ACCURACY OF HELICOBACTER PYLORI DETECTION UNDER WHITE LIGHT AND IMAGE-ENHANCED ENDOSCOPY (IEE): A PROSPECTIVE RANDOMIZED STUDY

H. pylori infection is the class I carcinogen which can lead to gastric cancer. Early diagnosis and eradication of H. pylori infection is important in eliminating gastric cancer risk. Real-time endoscopy such as conventional white light imaging (WLI), Narrow-band imaging (NBI), Linked color imaging (LCI) and Blue laser imaging (BLI) remain important role in clinical practice but need more information to identify H. pylori -infected status. This study aimed to determine diagnostic performance of H. pylori status between white light and image-enhanced endoscopy (IEE).

Helicobacter pylori infection as a potential favorable factor for immune checkpoint inhibitor therapy for gastric cancer.

Gastric cancer (GC) has the third highest rate of cancer incidence and mortality worldwide. First-line immune checkpoint inhibitor (ICI) therapy for advanced GC led to landmark breakthroughs, but which GC patients are most likely to benefit from ICI therapy needs to be investigated in depth and identified via valuable biomarkers. In this letter, we describe superior outcomes in Asian patients than in North American and European patients treated with ICI therapy, and we speculate that positive H. pylori status may be a beneficial prognostic factor for ICI therapy in patients with GC. Many studies have revealed that H. pylori-activated immune responses improve prognosis in patients with GC via increased PD-L1 expression and CD3+ T cells. We propose that H. pylori status should be emphasized in ongoing or forthcoming ICI therapy trials to maximize the benefits of treatment for patients with advanced GC. Further research is required to better understand the mechanisms of inflammation and cancer progression.

Helicobacter pylori infection is correlated with the incidence of erosive oral lichen planus and the alteration of the oral microbiome composition

BackgroundOral lichen planus (OLP), a common clinical oral disease, is associated with an increased risk of malignant transformation. The mechanism underlying the pathogenesis of OLP is unknown. Oral dysbacteriosis is reported to be one of the aetiological factors of OLP. Although Helicobacter pylori infection is associated with various oral diseases, the correlation between H. pylori infection and OLP is unclear. This study aimed to investigate the effect of H. pylori infection on OLP pathogenesis and oral microbiome composition in the Chinese population, which has a high incidence of H. pylori infection.ResultIn this study, saliva samples of 30 patients with OLP (OLP group) and 21 negative controls (NC group) were collected. H. pylori infection was detected using the carbon-13-labeled urea breath test (UBT). The saliva samples were divided into the following four groups based on the H. pylori status: H. pylori-positive OLP (OLP+), H. pylori-positive NC (NC+), H. pylori-negative OLP (OLP−), and H. pylori-negative NC (NC−). Oral microbiome compositions were significantly different between the OLP and NC groups and between the OLP− and OLP+ groups. Compared with those in the OLP− group, those in the OLP+ group had a higher incidence of erosive OLP and higher levels of salivary cytokines. In contrast, the oral microbiome composition and cytokine levels were not significantly different between the NC− and NC+ groups.ConclusionsThis is the first report to demonstrate that H. pylori infection is significantly correlated with the pathogenesis of erosive OLP.

Comprehensive analysis of the prognostic value of the chemokine-like factor-like MARVEL transmembrane domain-containing family in gastric cancer.

The chemokine-like factor (CKLF)-like MARVEL transmembrane domain-containing (CMTM) family refers to a family of transcriptional repressor genes. CMTMs are closely associated with the epigenetic regulatory mechanisms and development of multiple malignancies, including gastric cancer. However, their specific biological functions and prognostic values in gastric cancer have yet to be elucidated. Tumor sample datasets were retrieved and analyzed using databases including Oncomine, STRING, GEPIA2, cBioportal, and Kaplan-Meier plotter. To investigate the prognostic role of CMTMs in gastric cancer, we applied unsupervised hierarchical clustering analysis of CMTM gene expression patterns. While the mRNA levels of CMTM1/3/6/7/8 were upregulated in gastric cancer, CMTM2/4/5 showed no statistically significant difference at the mRNA level in patients with gastric cancer. Moreover, the mRNA expressions of different CMTMs exhibited strong correlations with various clinical parameters of patients with gastric cancer, including tumor stage, metastatic lymph node status, H. pylori status, and tumor grade. Also, the results suggested that elevated levels of CMTM3/5 mRNA had a significant association (P<0.05) with poor overall survival, progression-free survival, and post-progression survival. Conversely, elevated expression of CMTM2/4/6 mRNA had a significant association with better overall survival, progression-free survival, and post-progression survival. Unsupervised hierarchical clustering analysis successfully identified 2 major clusters of patients as follows: signature #1: CMTM4/6/8 and signature #2: CMTM1/2/3/5/7. Signature #2 was closely correlated with poorer overall survival, which indicated that the expression pattern of the CMTM family could be a novel prognostic factor for patients with gastric cancer. These results suggest that the expression levels of CMTM genes possibly have prognostic value as a biomarker of gastric cancer.