Synergistic effect of photodynamic therapy at 400 nm and doxycycline against Helicobacter pylori.

Aim: The objective of this study was to investigate the possible synergy between doxycycline and photodynamic therapy against Helicobacter pylori and to evaluate the possible side effects on adenocarcinoma gastric cells with and without protoporphyrin IX. Materials & methods: Three H. pylori strains (ATCC 700392, 43504 and 49503) were grown on solid medium either with, or without, doxycycline at subinhibitory concentrations, and irradiated for 10, 20 and 30 minutes with a 400 nm-peaked light source. The phototoxicity tests on AGS cells were evaluated by MTT assay. Results: The photodynamic therapy and doxycycline combination showed an antibacterial synergistic effect with no significant toxicities. Conclusion: The synergistic treatment could be considered as an interesting therapeutic option.

Iodine-131 in Helicobacter pylori-positive patients: preliminary accidental finding and in differentiated thyroid cancer.

OBJECTIVE: To investigate the eradicate effect of Helicobacter pylori in differentiated thyroid cancer patients who underwent I therapy. MATERIALS AND METHODS: A total of 130 patients with differentiated thyroid cancer underwent I treatment. None of the patients had a history of stomach-related diseases. The C-urea breath test (UBT) was carried out for H. pylori examination before I treatment. The cut-off value for C-UBT was 4%. For H. pylori test-positive patients, a second C-UBT was performed 4-6 weeks after I treatment. T-tests were used to compare the difference before and 4-6 weeks after I treatment. RESULTS: A total of 42 of 130 (32.31%) patients were H. pylori positive. The average value of H. pylori was 28.36% before I, whereas the value was 18.18% after I therapy. A significant decrease in C-UBT was found after I treatment compared with before therapy (P<0.01). CONCLUSION: Our preliminary data showed that I exerts certain eradication effects on H. pylori, which could provide a new approach to multidrug resistance pathogens. As the exact molecular mechanism of this phenomenon is still unclear, future clinical applications of this anecdotal finding require further assessments.

The effect of radioactive iodine treatment on 14C urea breath test results in patients with hyperthyroidism.

PURPOSE: Radioactive Iodine therapy (RAIT) plays a major role in the treatment of hyperthyroidism. In addition to the thyroid gland, significant amounts of radioactive iodine are maintained in the stomach. The aim of this study was to determine if RAIT has any effect on Helicobacter pylori infection, based on the C urea breath test (UBT). MATERIALS AND METHODS: The study included 85 patients with hyperthyroidism scheduled to undergo RAIT and 69 hyperthyroid subjects in whom methimazole treatment was planned. All subjects had pretreatment-positive UBT results, and the test was repeated on the first and third months after RAIT and methimazole treatment. RESULTS: After a mean RAIT dose of 15 mCi (range, 10-20 mCi), UBT became negative in 13 (15.3%) of 85 patients on the first month and 18 (21.2%) of 85 patients on the third month. All subjects treated with methimazole remained UBT positive on the first and third months of methimazole treatment (100%). Reduction in the number of UBT-positive patients on both the first and the third months after RAIT was statistically significant (P < 0.001). Distribution of hyperthyroidism etiologies and thyroid autoantibody levels in subjects with UBT that became negative and in subjects with UBT that remained positive were similar in the RAIT group (P > 0.05). Urea breath test negativity rates did not differ according to the radioiodine dose. CONCLUSIONS: Our findings indirectly showed that RAIT might have an antimicrobial effect on H. pylori. Clinical applications of this beneficial effect of RAIT on H. pylori should be further evaluated.

What is the effect of radioiodine therapy on Helicobacterpylori infection?

BACKGROUND/AIM: Helicobacter pylori is an important human pathogen associated with gastric and duodenal ulcers, gastric mucosa- associated lymphoid tissue lymphoma, and adenocarcinoma. Radioiodine (RAI) treatment plays an important role in the management of differentiated thyroid cancer and primary hyperthyroidism. It is known that during RAI treatment, a considerable amount is absorbed by the stomach as well. In this study we aimed to reveal any therapeutic impact of RAI on H. pylori infections. MATERIALS AND METHODS: Eighty-seven patients who were hospitalized for RAI treatment were consecutively included in this study. Of those, 76 patients had differentiated thyroid cancer and 11 had primary hyperthyroidism. The urea breath test (UBT) was performed on the day before RAI, and the test was repeated after 2 months. RESULTS: The dose of RAI was 115 ± 3.3 mCi (range: 100-150 mCi) in the patients with malignant disease and 22.7 ± 1.4 mCi (range: 20-30 mCi) in the remaining patients. Among the patients with differentiated thyroid cancer, 44 (57%) had positive and 32 (43%) had negative UBT tests prior to RAI. Four (36%) patients with hyperthyroidism had pretreatment positive UBT tests and 7 (64%) had negative tests. The results of UBT conducted 2 months after RAI therapy were identical in every patient, which means that none of the patients with positive UBT became UBT-negative (P = 1). CONCLUSION: RAI does not have any therapeutic effect on H. Ovlori infection.

[Application of low-intensive laser irradiation in the treatment of perforative gastroduodenal ulcers].

Comparative analysis of results of surgical treatment, performed for perforative gastroduodenal ulcers in the patients, lacking H. pylori (control group) and owing this etiologic factor (main group), was conducted. Together with other conventional schemes of medicinal treatment in the early postoperative period a low-intensive irradiation of He-Ne laser was applied. Complete eradication of H. pylori was noted in 95.8% patients of the main group. In a late follow-up period (in 1-5 yrs observation terms) the frequency of recurrence, hemorrhage, pyloroduodenal stenosis and other surgical complications, occurring in the main group, was lesser than in a control one.

[The laser chromoendoscopy eradication of Helicobacter pylori].

35 patients with absence of positive dynamics after course of treatment of diseases associated with Helicobacter pylori infection and without achievement of eradication are surveyed. The original technique of Helicobacter pylori endoscopy eradication with use of the therapeutic laser in length of a wave of 660 nanometers is offered. Carrying out of rate laser chromoendoscopy eradication considerably reduces terms of healing of inflammatory-destructive changes of stomach and duodenum mucous membrane allows achieving of Helicobacter pylori eradication.

[Gastric MALT-type lymphoma. Pathology, pathogenesis, diagnostics and therapy]. / Magenlymphome vom MALT-Typ. Pathologie, Pathogenese, Diagnostik und Therapie.

Helicobacter pylori infection plays a central role in the development of gastric MALT-type (mucosa-associated lymphoid tissue) lymphoma. Infection results in chronic H. pylori gastritis and stimulates together with antigens or autoantigens proliferation of B-lymphocytes which is the basis for the neoplastic transformation. Histology of MALT-type lymphoma is architecturally similar to the physiological MALT. Invasion and destruction of the gastric epithelium with development of so-called lympho-epithelial lesions is the most important diagnostic criterion. Cytologically MALT-lymphoma resembles centrocytes and monocytes. For definitive lymphoma diagnosis and for the differential diagnosis from other small cell lymphomas in the stomach immunohistochemistry can be helpful. The phenotype of MALT-type lymphoma is identical to non-neoplastic B-lymphocytes of the marginal zone (CD20+, CD5-, CD10- and CD23-). Individual therapy is strongly dependent from histological type and lymphoma stadium. Therapy modalities are H. pylori eradication, radiochemotherapy, surgery or a combination of these. Aim of the therapy is the complete lymphoma regression and cure of the disease.

Radio-iodine therapy and Helicobacter pylori infection.

BACKGROUND: Helicobacter pylori is the most important cause of gastritis and related morbidities. Following consumption, radioactive iodine accumulates considerably in the stomach. On the basis of this observation, we decided to determine whether the high radiation induced by radio-iodine in the stomach is effective in the eradication of this infection. METHODS: All consecutive patients with differentiated thyroid carcinoma, who were referred for radio-iodine therapy [dose 117.1 +/- 24.4 mCi (4.3 +/- 0.9 GBq), range 100-200 mCi (3.7-7.4 GBq)], were enrolled. To detect H. pylori infection, the urease breath test (UBT) was performed 1-2 h before radio-iodine consumption and the test was repeated 2 months later. RESULTS: Of 88 patients, 71 had pre-treatment positive UBT. Of these, 23 patients had negative post-treatment result, which means a significant reduction (26.1%, 95% CI 16.8-35.5%) in the number of positive UBT results in our treated population (32.4% of UBT-positive cases became UBT-negative). CONCLUSIONS: Considering the high prevalence of reinfection in developing countries, the therapeutic benefit would have been more considerable if the second UBT had been done with a lag time of less than 2 months. Although radio-iodine therapy is not a logical method for the treatment of patients suffering from H. pylori, our finding provides indirect evidence about the radiosensitivity of bacteria, the future clinical applications of which need to be further evaluated. Also this finding can be useful for the food industry, where radiation is used widely to sterilize food. Regarding the possibility of H. pylori suppression, we recommend not using UBT for screening for the infection for at least within 2 months following radio-iodine therapy.

Low-grade non-hodgkin lymphomas.

The most common low-grade non-Hodgkin lymphomas are of B-cell origin. This review will focus on follicular lymphomas and extranodal marginal zone lymphomas, also known as mucosa-associated lymphoid tissue (MALT) lymphomas. These are radiation-sensitive lymphomas. Moderate doses (30-35 Gy) for these stage I and II low-grade lymphomas result in long-term local control and possible cure. Involved-field radiation therapy is the standard approach and produces minimal morbidity. However, a significant proportion of patients relapse with systemic disease outside of radiation fields. For follicular lymphoma, this occurs in approximately 50% of patients after 15 years and for nongastric MALT lymphoma 30% to 40% after 10 years. Patients with relapsed disease are not curable with chemotherapy, but the disease often remains indolent and prolonged survival is observed. For gastric MALT lymphomas associated with Helicobacter pylori but which did not respond to antibiotic therapy, radiation treatment is indicated and almost always curative. For localized MALT lymphomas not related to microorganisms, radiation therapy is the initial standard therapy regardless of anatomic location. Patients with stage III and IV low-grade lymphoma and local symptoms are often successfully palliated with a low dose regimen of 2 x 2 Gy (total dose 4 Gy).

[Clinical and immunological aspects of low-intensity laser irradiation in patients with gastroduodenal ulcers]. / Kliniko-immunologicheskie aspekty nizkointensivnogo lazernogo izlucheniia u bol'nykh iazvennoi bolezn'iu gastroduodenal'noi zony.

Laser iridotherapy was carried out simultaneously with irradiation of immuno-competent zones on the integument of the human body in patients with stomach and duodenal ulcers. As a result of such treatment, it was discovered that laser therapy has immunomodulating action leading to the reduction of the ulcer cicatrisation period.

[State of humoral immunity and phagocytic activity of neutrophils in patients with ulcer and effect of low-intensity laser therapy]. / Sostoianie gumoral'nogo immuniteta i fagotsitarnoi aktivnosti neitrofilov u bol'nykh iazvennoi bolezn'iu i vliianie na nikh nizkointensivnoi lazernoi terapii.

The aim of our investigation was to study the influence of low-intensity laser therapy at the immunologic parameters and Helicobacter pylori (HP) microbial contamination in patients with exacerbation of peptic and duodenal ulcer. 100 patients aged 18-65 were examined and divided into 2 groups. The experimental group (75 patients) underwent a complex drug and laser therapy of various therapeutic techniques. The control group (25 patients) underwent only drug therapy. The results of this study show the immunocorrective effect of different methods of low-intensity laser therapy in the exacerbation period and more essential decrease of HP microbial contamination in the experimental group.

Photoeradication of Helicobacter pylori using 5-aminolevulinic acid: preliminary human studies.

BACKGROUND AND OBJECTIVES: Helicobacter pylori (HP) is an endemic pathogenic bacterium causing gastritis and gastroduodenal ulceration in humans and is linked to the development of gastric malignancies. These first human in vivo studies investigated the photoeradication of HP using laser and white light. STUDY DESIGN/MATERIALS AND METHODS: In 13 HP-positive volunteers, a zone of gastric antrum was irradiated with laser (410 nm, 50 J/cm(2)) or endoscopic white light (10 J/cm(2)) 45 minutes after oral 5-aminolevulinic acid (5-ALA) 20 mg/kg. HP-eradication was assessed by biopsy urease test and HP-culture from irradiated and control zones 5 minutes, 4 and 48 hours post-irradiation. RESULTS: A maximum eradication effect was achieved at 4 hours post-irradiation when 85% of biopsies in the monochromatic and 66% in the white light exposed zones, and 58 and 33% in the respective control zones were HP-negative. CONCLUSIONS: HP numbers were greatly reduced following exposure to 5-ALA and either laser or white light in vivo. Photoeradication appears feasible, but further light dosimetry and the development of convenient application methods is required.

[The effect of superhigh-frequency electromagnetic radiation on the course of Helicobacter pylori-associated peptic ulcer]. / Vplyv elektromahnitnoho vyprominennia nadvysokoï chastoty na perebih vyrazkovoï khvoroby, asotsiiovanoi z Helicobacter pylori.

The authors studied effects of microwave electromagnetic irradiation on the course of peptic ulcers and dissemination with Helicobacter pylori in 60 patients with various severity of the disease. Microwave irradiation not only hastens clinico-endoscopical remission of the disease but also considerably reduces dissemination of mucosa with Helicobacter pylori.