RESUMEN
Mucosa-associated lymphoid tissue (MALT) lymphoma is a B-cell tumour that develops over many decades in the stomachs of individuals with chronic Helicobacter pylori infection. We developed a new mouse model of human gastric MALT lymphoma in which mice with a myeloid-specific deletion of the innate immune molecule, Nlrc5, develop precursor B-cell lesions to MALT lymphoma at only 3 months post-Helicobacter infection versus 9-24 months in existing models. The gastric B-cell lesions in the Nlrc5 knockout mice had the histopathological features of the human disease, notably lymphoepithelial-like lesions, centrocyte-like cells, and were infiltrated by dendritic cells (DCs), macrophages, and T-cells (CD4+ , CD8+ and Foxp3+ ). Mouse and human gastric tissues contained immune cells expressing immune checkpoint receptor programmed death 1 (PD-1) and its ligand PD-L1, indicating an immunosuppressive tissue microenvironment. We next determined whether CD40L, overexpressed in a range of B-cell malignancies, may be a potential drug target for the treatment of gastric MALT lymphoma. Importantly, we showed that the administration of anti-CD40L antibody either coincident with or after establishment of Helicobacter infection prevented gastric B-cell lesions in mice, when compared with the control antibody treatment. Mice administered the CD40L antibody also had significantly reduced numbers of gastric DCs, CD8+ and Foxp3+ T-cells, as well as decreased gastric expression of B-cell lymphoma genes. These findings validate the potential of CD40L as a therapeutic target in the treatment of human gastric B-cell MALT lymphoma. © 2023 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.
Asunto(s)
Infecciones por Helicobacter , Helicobacter pylori , Linfoma de Células B de la Zona Marginal , Neoplasias Gástricas , Animales , Ratones , Linfocitos B , Ligando de CD40 , Factores de Transcripción Forkhead/metabolismo , Infecciones por Helicobacter/complicaciones , Infecciones por Helicobacter/tratamiento farmacológico , Helicobacter pylori/genética , Péptidos y Proteínas de Señalización Intracelular/metabolismo , Linfoma de Células B de la Zona Marginal/tratamiento farmacológico , Linfoma de Células B de la Zona Marginal/genética , Linfoma de Células B de la Zona Marginal/prevención & control , Neoplasias Gástricas/patología , Microambiente TumoralRESUMEN
Evidence on the effect of statin use on non-Hodgkin lymphoma (NHL) is not clear. We conducted a systematic review and meta-analysis to examine the associations between statin use and NHL risk and survival. We searched multiple literature sources up to October 2014 and identified 10 studies on the risk of diagnosis with NHL and 9 studies on survival. Random effects model was used to calculate pooled odds ratio (PORs) for risk and pooled hazard ratio (PHR) for survival. Heterogeneity among studies was examined using the Tau-squared and the I-squared (I2 ) tests. Statin use was associated with reduced risk for total NHL (POR = 0.82, 95% CI 0.69-0.99). Among statin users, there was a lower incidence risk for marginal zone lymphoma (POR = 0.54, 95% CI 0.31-0.94), but this was not observed for other types of NHL. However, statin use did not affect overall survival (PHR = 1.02, 95% CI 0.99-1.06) or event-free survival (PHR = 0.99, 95% CI 0.87-1.12) in diffuse large B-cell lymphoma. There is suggestive epidemiological evidence that statins decrease the risk of NHL, but they do not influence survival in NHL patients. Copyright © 2015 John Wiley & Sons, Ltd.
Asunto(s)
Inhibidores de Hidroximetilglutaril-CoA Reductasas/uso terapéutico , Linfoma no Hodgkin/prevención & control , Humanos , Linfoma de Células B de la Zona Marginal/prevención & control , Linfoma no Hodgkin/mortalidad , RiesgoRESUMEN
BACKGROUND: Helicobacter suis strain TKY infection has been strongly associated with the development of gastric mucosa-associated lymphoid tissue (MALT) lymphoma in a C57BL/6J mouse model. MATERIALS AND METHODS: 1. C57BL/6J mice were intragastrically administered Lactobacillus strains once daily with 10(8)-10(9) colony-forming units (CFU), starting 2 days before intragastric infection with H. suis TKY (approximately 1 × 10(4) copies of 16S rRNA genes) or H. pylori Sydney strain 1 (SS1; 3 × 10(8) CFU) and continuing for 14 days after infection. 2. C57BL/6J mice were given powdered feed mixed with lyophilized L. gasseri SBT2055 (LG2055) cells (5 × 10(8) CFU/g), starting 2 weeks before intragastric infection with H. suis TKY and continuing 12 months after infection. RESULTS: 1. Among the 5 Lactobacillus strains that we examined, only LG2055 exhibited significantly preventive efficacy against both H. suis TKY and H. pylori SS1 at day 15 after infection. 2. Dietary supplementation with LG2055 protected mice from the formation of round protrusive lesions in the gastric fundus 12 months after infection with H. suis TKY, whereas such lesions had developed in the gastric fundus of nonsupplemented mice 12 months after infection. In addition, the formation of lymphoid follicles in gastric mucus layers was suppressed by dietary LG2055 at 3 months after infection. CONCLUSIONS: LG2055 administration is effective for suppressing the progression of gastric MALT lymphoma by reducing H. suis colonization.
Asunto(s)
Infecciones por Helicobacter/prevención & control , Helicobacter heilmannii/patogenicidad , Lactobacillus/metabolismo , Linfoma de Células B de la Zona Marginal/prevención & control , Probióticos/uso terapéutico , Animales , Suplementos Dietéticos/microbiología , Modelos Animales de Enfermedad , Mucosa Gástrica/microbiología , Mucosa Gástrica/patología , Infecciones por Helicobacter/microbiología , Infecciones por Helicobacter/patología , Helicobacter pylori/patogenicidad , Linfoma de Células B de la Zona Marginal/microbiología , Linfoma de Células B de la Zona Marginal/terapia , Ratones , Ratones Endogámicos C57BLRESUMEN
The discovery of Helicobacter pylori (H. pylori) represents one of the most notable events in the field of experimental and clinical medicine with great impact to daily practice even to surgery. It has led to a paradigm shift in the treatment of peptic ulcer disease. For the time period of almost one century, several scientists had described spiral-shaped bacteria in the stomach of animals and humans. However, it lasted till the early 1980s when Robin Warren and Barry Marshall successfully cultured H. pylori and recognised its causal relationship to chronic gastritis and peptic ulcer disease. Since then, our knowledge about H. pylori and related diseases has been continuously growing. Today, the bacterium is known to be mainly responsible for the development of chronic gastritis, peptic ulcer disease, MALT lymphoma and is considered as the main risk factor for the development of gastric cancer - all this led to a switch in the basic aetiopathogenetic considerations. In particular, eradication of H. pylori helped to i) develop an aetiology-based therapeutic and preventive approach to the diseases listed above according and adapted to findings, stage and manifestation, and ii) define a new role of surgery in the treatment concept. In addition, more and more evidence is being gathered for a possible association between the bacterium and several extragastric diseases.
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Úlcera Duodenal/diagnóstico , Úlcera Duodenal/cirugía , Gastritis/diagnóstico , Gastritis/cirugía , Infecciones por Helicobacter/diagnóstico , Infecciones por Helicobacter/cirugía , Helicobacter pylori , Linfoma de Células B de la Zona Marginal/diagnóstico , Linfoma de Células B de la Zona Marginal/cirugía , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/cirugía , Úlcera Gástrica/diagnóstico , Úlcera Gástrica/cirugía , Progresión de la Enfermedad , Úlcera Duodenal/prevención & control , Gastritis/prevención & control , Infecciones por Helicobacter/prevención & control , Humanos , Linfoma de Células B de la Zona Marginal/prevención & control , Neoplasias Gástricas/prevención & control , Úlcera Gástrica/prevención & controlRESUMEN
Mucosa-associated lymphoid tissue (MALT) lymphomas are extra-nodal B-cell lymphomas arising from MALT, and the most commonly affected organ is the stomach. Helicobacter pylori (H. pylori) eradication therapy with proton-pump inhibitors and antibiotics is the first-line therapy for H. pylori-positive gastric MALT lymphomas, but the effectiveness of the therapy for H. pylori-negative gastric MALT lymphomas remains controversial. Hence, we aimed to evaluate the effectiveness of this eradication therapy for H. pylori-negative MALT lymphomas. The H. pylori infection status of 158 gastric MALT lymphoma patients followed in our unit was judged by urea breath test, rapid urease test, histology of the biopsy specimen taken from the stomach during endoscopy, and serum antibody against H. pylori. Seventeen patients that were negative for all four tests and did not have gastric mucosal atrophy were treated with antibiotic eradication therapy. The average age at diagnosis was 56.8 years old (range: 36-73 years), and the median follow-up period after H. pylori eradication in all 17 patients was 5.3 years (range: 0.3-12.7 years). Five patients (29.4%) achieved complete remission (CR) by eradication therapy alone. Comparison between the responding and non-responding patients revealed that the patients endoscopically diagnosed to have a single lesion of gastric MALT lymphoma were seen only in the responding group, whereas all non-responding patients had multiple lesions (P < 0.05). In conclusion, H. pylori eradication therapy achieved a favorable CR rate in H. pylori-negative gastric MALT lymphoma patients and could be considered as a first-line therapy, especially for patients with a single lesion.
Asunto(s)
Antibacterianos/uso terapéutico , Erradicación de la Enfermedad/métodos , Linfoma de Células B de la Zona Marginal/tratamiento farmacológico , Linfoma de Células B de la Zona Marginal/prevención & control , Adulto , Anciano , Endoscopía Gastrointestinal , Helicobacter pylori/aislamiento & purificación , Humanos , Hibridación Fluorescente in Situ , Linfoma de Células B de la Zona Marginal/microbiología , Linfoma de Células B de la Zona Marginal/patología , Persona de Mediana Edad , Reacción en Cadena de la Polimerasa , Tomografía de Emisión de Positrones , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
New therapeutic modalities for B-cell non-Hodgkin's lymphomas (B-NHL) are needed, especially for relapsing and aggressive subtypes. Toward this end, we previously generated a fully CD20-targeted and armed measles virus, and tested its efficacy in a xenograft model of mantle cell lymphoma (MCL). Here, we quantify its spread in peripheral blood mononuclear cells and/or tissue of patients with different histological subtypes of B-NHL, including splenic marginal zone lymphoma (SMZL). CD20-targeted MV efficiently infects lymphoma cells from SMZL and MCL while sparing most cells in the CD20-negative population, in contrast to the parental vaccine-lineage MV, which infects CD20-positive and CD20-negative cells equally. Rituximab therapy (4-8 months before relapse) did not interfere with the infectivity and specificity of MV(green)H(blind)antiCD20 in patient lymphoma samples. Thus, CD20-targeted oncolytic virotherapy is likely to be effective after previous antiCD20 therapy.
Asunto(s)
Antígenos CD20/uso terapéutico , Marcación de Gen/métodos , Linfoma de Células B de la Zona Marginal/prevención & control , Virus del Sarampión/metabolismo , Viroterapia Oncolítica/métodos , Antígenos CD20/metabolismo , Citometría de Flujo , Proteínas Fluorescentes Verdes/metabolismo , Humanos , Leucocitos Mononucleares/patología , Linfoma de Células B de la Zona Marginal/inmunologíaRESUMEN
BACKGROUND: Few studies have been carried out to date that have addressed the epidemiology of extranodal marginal zone lymphomas (EN-MZLs). PATIENTS AND METHODS: We carried out a population-based study to investigate incidence rates (IRs) and time trends of EN-MZL diagnosed in the province of Modena (Italy) from 1997 to 2007. RESULTS: One hundred and sixty-five cases were identified from the Modena Cancer Registry that corresponded to an age-standardized IR of 2.3 cases per 100 000. A bimodal distribution of age was shown with the group of young patients mostly represented by males with cutaneous lymphoma. No time trends were observed for the IR; the incidence of gastric mucosa-associated lymphoid tissue (g-MALT) lymphomas (N = 51) markedly declined during the study period, dropping from 1.4 in 1997 to 0.2 in 2002 and then remaining stable until 2007; the calculated annual percent change for g-MALT was -17.0% (95% confidence interval -26.6% to -6.2%). We also observed a significant decrease in the rate of g-MALT associated with Helicobacter pylori (HP) infection from 61% to 17% of patients diagnosed before and after 2002 (P = 0.007; P for trend = 0.016). CONCLUSION: This population-based study provides new insights into recent changes in the epidemiology of EN-MZL, mainly represented by the sharp reduced incidence of HP-positive g-MALT lymphomas.
Asunto(s)
Antibacterianos/uso terapéutico , Infecciones por Helicobacter/tratamiento farmacológico , Infecciones por Helicobacter/epidemiología , Linfoma de Células B de la Zona Marginal/epidemiología , Neoplasias Gástricas/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Infecciones por Helicobacter/complicaciones , Helicobacter pylori/efectos de los fármacos , Helicobacter pylori/fisiología , Humanos , Incidencia , Ganglios Linfáticos/patología , Linfoma de Células B de la Zona Marginal/etiología , Linfoma de Células B de la Zona Marginal/prevención & control , Masculino , Persona de Mediana Edad , Población , Sistema de Registros , Neoplasias Gástricas/etiología , Neoplasias Gástricas/prevención & control , Adulto JovenRESUMEN
This guideline updates a prior concensus recommendation of the German Society for Digestive and Metabolic Diseases (DGVS) from 1996. It was developed by an interdisciplinary cooperation with representatives of the German Society for Microbiology, the Society for Pediatric Gastro-enterology and Nutrition (GPGE) and the German Society for Rheumatology. The guideline is methodologically based on recommendations of the Association of the Scientific Medical Societies in Germany (AWMF) for providing a systematic evidence-based consensus guideline of S3 level and has also implemented grading criteria according to GRADE (Grading of Recommendations Assessment, Development and Evaluation). Clinical applicability of study results as well as specifics for Germany in terms of epidemiology, antibiotic resistance status, diagnostics and therapy were taken into account.
Asunto(s)
Gastritis/complicaciones , Infecciones por Helicobacter/complicaciones , Helicobacter pylori , Úlcera Péptica/etiología , Adolescente , Adulto , Anemia Ferropénica/etiología , Anemia Ferropénica/terapia , Niño , Dispepsia/etiología , Dispepsia/terapia , Medicina Basada en la Evidencia , Gastritis/epidemiología , Gastritis/microbiología , Gastritis/terapia , Alemania/epidemiología , Infecciones por Helicobacter/diagnóstico , Infecciones por Helicobacter/epidemiología , Infecciones por Helicobacter/terapia , Helicobacter pylori/aislamiento & purificación , Humanos , Linfoma de Células B de la Zona Marginal/prevención & control , Linfoma de Células B de la Zona Marginal/terapia , Úlcera Péptica/terapia , Prevalencia , Púrpura Trombocitopénica Idiopática/etiología , Púrpura Trombocitopénica Idiopática/terapia , Neoplasias Gástricas/prevención & control , Neoplasias Gástricas/terapiaAsunto(s)
Antibacterianos/uso terapéutico , Gastritis/tratamiento farmacológico , Infecciones por Helicobacter/tratamiento farmacológico , Helicobacter pylori , Úlcera Péptica/tratamiento farmacológico , Guías de Práctica Clínica como Asunto , Inhibidores de la Bomba de Protones/uso terapéutico , Farmacorresistencia Bacteriana , Farmacorresistencia Bacteriana Múltiple , Quimioterapia Combinada , Dispepsia/tratamiento farmacológico , Dispepsia/etiología , Gastritis/diagnóstico , Infecciones por Helicobacter/diagnóstico , Helicobacter pylori/efectos de los fármacos , Humanos , Linfoma de Células B de la Zona Marginal/prevención & control , Úlcera Péptica/diagnóstico , Neoplasias Gástricas/prevención & controlRESUMEN
Helicobacter pylori infection is ubiquitous, infecting close to one-half of the world's population, but its prevalence is declining in developed countries. Chronic H. pylori infection is etiologically linked to gastric adenocarcinoma, especially non-cardia type (63% of all stomach cancer or ~5.5% of the global cancer burden: ~25% of cancers associated with infectious etiology), and to gastric mucosal associated lymphoid tissue (MALT) lymphoma, which accounts for up to 8% of all non-Hodgkin lymphoma. Epidemiological, clinical, and animal studies have established a central role for H. pylori in gastric carcinogenesis and provided insights into the mechanisms and biologic relationships between bacterial infection, host genetics, nutrition, and environmental factors. These discoveries invite strategies to prevent infection to be the logical primary goals in a multi-pronged effort to curtail suffering and death from H. pylori infection-associated cancers.
Asunto(s)
Helicobacter pylori/patogenicidad , Linfoma de Células B de la Zona Marginal/epidemiología , Neoplasias Gástricas/epidemiología , Salud Global , Humanos , Incidencia , Linfoma de Células B de la Zona Marginal/microbiología , Linfoma de Células B de la Zona Marginal/prevención & control , Factores de Riesgo , Neoplasias Gástricas/microbiología , Neoplasias Gástricas/prevención & control , VirulenciaRESUMEN
This guideline updates a prior concensus recommendation of the German Society for Digestive and Metabolic Diseases (DGVS) from 1996. It was developed by an interdisciplinary cooperation with representatives of the German Society for Microbiology, the Society for Pediatric Gastroenterology and Nutrition (GPGE) and the German Society for Rheumatology. The guideline is methodologically based on recommendations of the Association of the Scientific Medical Societies in Germany (AWMF) for providing a systematic evidence-based consensus guideline of S 3 level and has also implemented grading criteria according to GRADE (Grading of Recommendations Assessment, Development and Evaluation). Clinical applicability of study results as well as specifics for Germany in terms of epidemiology, antibiotic resistance status, diagnostics and therapy were taken into account.
Asunto(s)
Antibacterianos/uso terapéutico , Antiulcerosos/uso terapéutico , Medicina Basada en la Evidencia , Infecciones por Helicobacter/tratamiento farmacológico , Helicobacter pylori , Úlcera Péptica/tratamiento farmacológico , Adolescente , Adulto , Niño , Estudios Transversales , Quimioterapia Combinada , Mucosa Gástrica/microbiología , Mucosa Gástrica/patología , Gastroscopía , Infecciones por Helicobacter/diagnóstico , Infecciones por Helicobacter/epidemiología , Humanos , Linfoma de Células B/patología , Linfoma de Células B/prevención & control , Linfoma de Células B de la Zona Marginal/patología , Linfoma de Células B de la Zona Marginal/prevención & control , Estadificación de Neoplasias , Úlcera Péptica/diagnóstico , Úlcera Péptica/epidemiología , Ensayos Clínicos Controlados Aleatorios como Asunto , Neoplasias Gástricas/patología , Neoplasias Gástricas/prevención & controlRESUMEN
PURPOSE OF REVIEW: Helicobacter pylori (H. pylori) infection induces a range of upper gastrointestinal diseases including chronic gastritis, peptic ulcer disease, mucosa-associated lymphatic tissue (MALT) lymphoma, and gastric adenocarcinoma with marked individual variability. In the present review, we survey the published reports on H. pylori infection in organ transplant recipients and summarize findings about the prevalence of H. pylori infection and outcomes such as peptic ulcer and MALT lymphoma induced by H. pylori infection after transplantation. RECENT FINDINGS: The prevalence of H. pylori infection in solid-organ transplant recipients is similar to that in nontransplant controls, but may be decreased after transplantation. H. pylori infection is associated with peptic ulcer disease and MALT lymphoma after solid-organ transplantation, but the incidence of these diseases does not increase under the immunosuppressive treatment after transplantation. The relationship of H. pylori infection to de-novo gastric cancer after transplantation has not been thoroughly investigated. SUMMARY: The best management for H. pylori infection in solid-organ transplant recipients has not been established. The association with peptic ulcer disease and MALT lymphoma indicates that H. pylori-positive recipients should be treated for the eradication of H. pylori to avoid upper gastrointestinal diseases after transplantation. However, the efficacy and efficiency of H. pylori eradication therapy before transplantation should be evaluated in future studies.
Asunto(s)
Infecciones por Helicobacter/microbiología , Helicobacter pylori/patogenicidad , Trasplante de Órganos/efectos adversos , Animales , Antibacterianos/uso terapéutico , Infecciones por Helicobacter/tratamiento farmacológico , Humanos , Linfoma de Células B de la Zona Marginal/microbiología , Linfoma de Células B de la Zona Marginal/prevención & control , Úlcera Péptica/microbiología , Úlcera Péptica/prevención & control , Neoplasias Gástricas/microbiología , Neoplasias Gástricas/prevención & controlRESUMEN
BACKGROUND: Eradication of Helicobacter pylori in gastric mucosa-associated lymphoid tumor can result in lymphoma remission. We prospectively identified/treated infections in nonbulky, advanced stage indolent lymphoma (follicular; nonfollicular lymphoma) eligible for observation. MATERIALS AND METHODS: Stool H. pylori, hepatitis C and Borrelia serologies, Borrelia and Chlamydia fixed tissue PCR, Chlamydia peripheral blood mononuclear cell PCR and hydrogen breath test for small bowel bacterial overgrowth (SBBO) were obtained. RESULTS: Fifty-six patients were enrolled. Positive infections: H. pylori (13); hepatitis C (3); SBBO (11). Negative: Borrelia (13); Chlamydophila psittaci (12, except one PCR). Lymphoma responses to antimicrobial therapy: H. pylori [one complete response (CR), 24+ months; one transient near CR]; hepatitis C [two CRs, 18+ and 30+ months; one partial response (PR) but hepatitis C virus persistent]; SBBO (one PR, 30+ months). Patients with associated infections, but without lymphoma CR, have required lymphoma treatment sooner than those without initial infections (treatment-free survival at 23.4 months median follow-up, 40.5% versus 74.7%, P = 0.01), indicating a different biology. CONCLUSION: Infections are common in advanced stage indolent lymphoma (37.5% in our series). Anecdotal lymphoma responses have been seen and three have been durable CRs (18 to 30+ months) with infection eradication alone. The identification and treatment of associated infections may be a first step towards developing a lymphoma prevention strategy.
Asunto(s)
Antibacterianos/uso terapéutico , Infecciones por Helicobacter/complicaciones , Infecciones por Helicobacter/tratamiento farmacológico , Linfoma de Células B de la Zona Marginal/tratamiento farmacológico , Linfoma de Células B de la Zona Marginal/prevención & control , Neoplasias Gástricas/prevención & control , Adulto , Anciano , Análisis de Varianza , Femenino , Estudios de Seguimiento , Mucosa Gástrica/efectos de los fármacos , Mucosa Gástrica/patología , Infecciones por Helicobacter/patología , Helicobacter pylori/efectos de los fármacos , Helicobacter pylori/aislamiento & purificación , Humanos , Inmunohistoquímica , Linfoma de Células B de la Zona Marginal/microbiología , Linfoma de Células B de la Zona Marginal/mortalidad , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Estudios Prospectivos , Medición de Riesgo , Estadísticas no Paramétricas , Neoplasias Gástricas/mortalidad , Neoplasias Gástricas/patología , Análisis de Supervivencia , Resultado del TratamientoRESUMEN
We have previously shown that long-term infection of BALB/c mice with gastric Helicobacter species results in the development of histopathological lesions that resemble those seen in patients diagnosed with gastric mucosa associated lymphoid tissue (MALT) lymphoma. This paper describes analysis of this disease at the molecular level through the use of microarray technology and immunohistochemical staining. We were able to monitor the genetic changes in the gastric mucosa characterized by distinct transcriptional signatures and correlate these with histological changes as the infection progressed from a chronic inflammatory infiltrate through to MALT lymphoma. This model system also enabled us to further dissect the role of antigen presentation and prophylactic immunization in the disease process. Antimicrobial therapy to eradicate the antigen correlated with significant reduction in pathology and major changes in the gene expression profile. Subsequent reintroduction of the antigen resulted in rapid tumor development which correlated with an increase in aggressively proliferating cells and changes in the cellular composition of the tumor. The response in vaccinated animals showed that the protected animals exhibited a strikingly different transcriptional profile compared to those of non-protected or control mice, indicating that the vaccination targeted the appropriate site leaving a long-lasting signature. The genes which were most significantly up-regulated included a number of adipocyte-specific factors, such as fat-cell specific cytokines and adipocyte surface markers. This study allowed for us to highlight the significance of antigen presentation in this disease and to hypothesis mechanisms associated with protective immunity.
Asunto(s)
Antígenos Bacterianos/inmunología , Vacunas Bacterianas/farmacología , Vacunas contra el Cáncer/farmacología , Mucosa Gástrica/microbiología , Perfilación de la Expresión Génica , Regulación Neoplásica de la Expresión Génica , Infecciones por Helicobacter/microbiología , Linfoma de Células B de la Zona Marginal/genética , Animales , Antiinfecciosos/farmacología , Modelos Animales de Enfermedad , Mucosa Gástrica/efectos de los fármacos , Mucosa Gástrica/inmunología , Regulación Neoplásica de la Expresión Génica/efectos de los fármacos , Infecciones por Helicobacter/tratamiento farmacológico , Infecciones por Helicobacter/genética , Infecciones por Helicobacter/inmunología , Inmunohistoquímica , Linfoma de Células B de la Zona Marginal/inmunología , Linfoma de Células B de la Zona Marginal/microbiología , Linfoma de Células B de la Zona Marginal/prevención & control , Ratones , Ratones Endogámicos BALB C , Análisis de Secuencia por Matrices de Oligonucleótidos , ARN Mensajero/metabolismoAsunto(s)
Vacunas Bacterianas/administración & dosificación , Cistitis Intersticial/tratamiento farmacológico , Infecciones por Helicobacter/prevención & control , Helicobacter pylori , Linfoma de Células B de la Zona Marginal/prevención & control , Modelos Biológicos , Neoplasias de la Vejiga Urinaria/prevención & control , Administración Intravesical , Enfermedad Crónica , HumanosRESUMEN
The gram-negative bacterium Helicobacter pylori is known as a persistent colonizer of the human stomach, and probably less known is that it is also involved in extraintestinal diseases. Public awareness of its contribution in the development of gastric cancer is less than 15 years old. The efficacy of the current therapies based on antibiotics against H. pylori has been limited by difficulties such as antibiotic resistance and recurrence. As a consequence, the development of promising vaccines was prompted as the best preventive measure. Unfortunately, so far vaccines failed the transition from animal models to human trials. This keynote presentation is to provide a bird's eye view of H. pylori-related gastric diseases, including gastric cancer, with a synthesis of the molecular mechanisms involved, and an exhaustive presentation and discussion of the current therapeutic guidelines and future strategies for prevention or therapy.
Asunto(s)
Antibacterianos/uso terapéutico , Gastritis/microbiología , Infecciones por Helicobacter/microbiología , Helicobacter pylori/fisiología , Linfoma de Células B de la Zona Marginal/microbiología , Úlcera Péptica/microbiología , Neoplasias Gástricas/microbiología , Antiulcerosos/uso terapéutico , Vacunas Bacterianas , Vacunas contra el Cáncer/uso terapéutico , Farmacorresistencia Bacteriana , Gastritis/diagnóstico , Gastritis/tratamiento farmacológico , Infecciones por Helicobacter/tratamiento farmacológico , Infecciones por Helicobacter/prevención & control , Helicobacter pylori/efectos de los fármacos , Humanos , Linfoma de Células B de la Zona Marginal/diagnóstico , Linfoma de Células B de la Zona Marginal/prevención & control , Úlcera Péptica/diagnóstico , Úlcera Péptica/tratamiento farmacológico , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/prevención & controlRESUMEN
A series of studies has shown that Helicobacter pylori eradication induces remission in most patients with low-grade gastric mucosa-associated lymphoid tissue (MALT) lymphoma. However, there have been few reports about the effect of bacterial treatment on the gastric MALT lymphoma in Korea, a well-known H. pylori endemic area. A total of 111 H. pylori-infected patients were prospectively enrolled in Seoul National University Hospital and 99 among them were completely followed up according to our protocol. After H. pylori eradication, tumoural response was evaluated by endoscopy and histopathology every 2-3 months till complete remission (CR) and every 6 months after achieving CR. Median follow-up period was 41 months (range, 11-125 months). Helicobacter pylori was successfully eradicated in all 99 patients and CR was obtained in 84 (84.8%) of 99 patients. The median time to reach CR was 3 months and 94% of CR is in continuous complete remission. Five patients with CR relapsed after 10-22 months without the evidence of H. pylori reinfection. Cumulative recurrence rate was 2.3, 7.7 and 9.3% at 1, 2 and 3 years, respectively. Tumours were mainly located in distal stomach (67.7%) and tumours in distal stomach were associated with more favourable response than those in proximal stomach (P=0.001). Majority of patients with low-grade gastric MALT lymphoma treated by exclusive H. pylori eradication have a favourable long-term outcome, offering a real chance of cure. Tumour location could be a predictive factor for remission following H. pylori eradication.
Asunto(s)
Antibacterianos/uso terapéutico , Mucosa Gástrica/patología , Infecciones por Helicobacter/prevención & control , Helicobacter pylori , Linfoma de Células B de la Zona Marginal/prevención & control , Neoplasias Gástricas/microbiología , Estudios de Seguimiento , Mucosa Gástrica/microbiología , Infecciones por Helicobacter/patología , Infecciones por Helicobacter/transmisión , Helicobacter pylori/efectos de los fármacos , Humanos , Linfoma de Células B de la Zona Marginal/microbiología , Linfoma de Células B de la Zona Marginal/patología , Estadificación de Neoplasias , Recurrencia , Neoplasias Gástricas/patología , Neoplasias Gástricas/prevención & controlAsunto(s)
Infecciones por Helicobacter/tratamiento farmacológico , Helicobacter pylori , Duodenitis/etiología , Estudios de Seguimiento , Reflujo Gastroesofágico/etiología , Infecciones por Helicobacter/complicaciones , Humanos , Linfoma de Células B de la Zona Marginal/tratamiento farmacológico , Linfoma de Células B de la Zona Marginal/etiología , Linfoma de Células B de la Zona Marginal/prevención & control , Úlcera Péptica/tratamiento farmacológico , Úlcera Péptica/epidemiología , Úlcera Péptica/etiología , Úlcera Péptica/prevención & control , Prevención Secundaria , Neoplasias Gástricas/tratamiento farmacológico , Neoplasias Gástricas/etiología , Neoplasias Gástricas/prevención & control , Factores de TiempoRESUMEN
Eight patients with ocular adnexal mucosal-associated lymphpid tissue (MALT) lymphoma were treated with rituximab, at diagnosis (n=5) or relapse (n=3). All untreated patients achieved lymphoma regression, while relapsing patients had no benefit. Four responding patients experienced early relapse. The median time to progression was 5 months. The efficacy of rituximab in ocular adnexal lymphoma is lower than that reported for gastric MALT lymphomas.
Asunto(s)
Anticuerpos Monoclonales/uso terapéutico , Neoplasias del Ojo/terapia , Linfoma de Células B de la Zona Marginal/tratamiento farmacológico , Adulto , Anciano , Anticuerpos Monoclonales de Origen Murino , Neoplasias del Ojo/patología , Neoplasias del Ojo/prevención & control , Femenino , Humanos , Linfoma de Células B de la Zona Marginal/patología , Linfoma de Células B de la Zona Marginal/prevención & control , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/prevención & control , RituximabRESUMEN
Last year there were a few important clinical data on long-term prognosis of mucosa-associated lymphoid tissue (MALT) lymphoma after eradication of Helicobacter pylori. Similarly, there were clinical data to support the role of eradication of H. pylori in the primary prevention of gastric cancer. We understand more about the host susceptibility as well as the pathogenetic mechanisms of the bacteria in the gastric mucosa. This article summarizes the important breakthroughs in H. pylori and gastric malignancies last year.