Evaluation of the acid-neutralizing and cytotoxicity properties of novel plant mucilage used as an alternative treatment for peptic ulcers and as antacids in Namibia

Hypersecretion of gastric acid damages the stomach lining, causing the formation of peptic ulcers. Mucilage from medicinal plants offers a relaxing and soothing effect to the endodermal lining of the gut and has antacid properties, which can protect the mucosal lining from gastric acidity. This is the first report aimed to evaluate the physicochemical characteristics, acid-neutralizing, and cytotoxicity properties of traditionally used aqueous mucilage from Asparagus exuvialis and Sesamum capense. The physicochemical properties were determined by biochemical methods. Acid neutralizing and buffering capacities were determined by titration methods. Normal mouse embryonic fibroblast cells were used for cytotoxicity evaluation by MTT assay. The physicochemical characterization confirmed the presence of carbohydrates, alkaloids, saponins, proteins, tannins, flavonoids, and glycosides. Sesamum capense mucilage exhibited the most potent artificial gastric juice neutralizing capacity pH of 4.62±0.01, 8.0±0.00 acid neutralization capacity per gram of acid, and 30 minutes duration of acid neutralization. The aqueous mucilage from S. capense did not cause any significant cytotoxicity to 3T3 cell lines showing an IC50 value of 91.5 ± 0.06 µg mL-1, confirming the safe nature of the mucilage. These findings revealed that S. capense has the potential to neutralize gastric acid responsible for ulceration and can be safely consumed.(AU)

Gastrointestinal nematodes in ostriches, Struthio camelus, in different regions of the state of Rio de Janeiro, Brazil / Nematoides gastrintestinais em avestruzes, Struthio camelus, de diferentes regiões do Estado do Rio de Janeiro, Brasil

The ratite group is composed of ostriches, rheas, emus, cassowaries and kiwis. Little research has been done on parasitism in these birds. The aim of this study was to determine the distribution of infections by gastrointestinal nematodes in ostriches in the state of Rio de Janeiro. For this, fecal samples were collected from 192 on 13 farms. From each sample, four grams of feces were used to determine the eggs per gram of feces (EPG) count, by means of the McMaster technique. Part of the feces sample was used for fecal cultures, to identify 100 larvae per sample. The results were subjected to descriptive central trend and dispersion analysis, using confidence intervals at the 5% error probability level in accordance with the Student t distribution, and Tukeys test with a 95% confidence interval. The mean EPG in the state was 1,557, and the municipality of Três Rios had the lowest average (62). The city of Campos dos Goytacazes presented the highest mean EPG of all the municipalities analyzed. The northern region presented the highest mean EPG, followed by the southern, metropolitan, coastal lowland and central regions. Libyostrongylus species were observed on all the farms: L. douglassii predominated, followed by L. dentatus and Codiostomum struthionis. .(AU)

O grupo das ratitas é composto pelas avestruzes, emas, emús, cassuares e kiwi. São poucas as pesquisas sobre as parasitoses nessas aves. O objetivo deste estudo foi determinar a distribuição de infecções por nematóides gastrintestinais em avestruzes no Estado do Rio de Janeiro. Para tanto, foram coletadas amostras fecais de 192 avestruzes de 13 propriedades. De cada amostra, quatro gramas foram utilizados para a contagem de ovos por grama de fezes (OPG), pela da técnica de McMaster. Parte das fezes foi utilizada para cultivos fecais para identificação de 100 larvas por amostra. Os resultados foram submetidos à análise descritiva de tendência central e de dispersão, utilizando-se o intervalo de confiança ao nível de 5% de probabilidade de erro de acordo com a distribuição t de Student e teste de Tukey com intervalo de confiança de 95%. A média de OPG no Estado foi de 1.557, e o município de Três Rios obteve a menor média (62). A cidade de Campos dos Goytacazes teve a maior média de OPG de todos os municípios analisados. A Região Norte teve a maior média de OPG, seguida das regiões Sul, Metropolitana, Baixada Litorânea e Central. As espécies de Libyostrongylus foram observadas em todas as propriedades, predominando L. douglassii, seguido de L. dentatus e Codiostomum struthionis.(AU)

Prevalence of Helicobacter pylori in children in eastern Turkey and molecular typing of isolates

The objectives of the present study were to determine Helicobacter pylori via culture, polymerase chain reaction and histopathological diagnosis in 101 children ranging in age from 4 to 18 years, to identify the association among restriction fragment length polymorphism types and clinical disease and to investigate the relationships among different isolates of H. pylori in different age groups. We observed a high prevalence of H. pylori infections in children between the ages of 13 and 18 (75.8%), while children aged 4 to 6 years had the lowest prevalence of infection (40%). H. pylori was detected in 30.7% (31 of 101), 66.3% (67 of 101) and 63.2% (60 of 95) of children as determined by culture methods, PCR and histological examination, respectively. H. pylori isolates with RFLP types I and III were the most common among children with antral nodularity, whereas RFLP types II and IV were the least detected types. Interestingly, all isolates from peptic ulcer patients were type III. Although our results show a high prevalence of H. pylori infections in the pediatric population in eastern Turkey, no association was identified between H. pylori infection with antral nodularity and recurring abdominal pain. In addition, we found low genetic variation among H. pylori isolates from children and no association between RFLP types and antral nodularity (p > 0.05). Additionally, we found that H. pylori isolates with specific RFLP types were predominant in different age groups.(AU)

Association among H. pylori virulence markers dupA, cagA and vacA in Brazilian patients

Only a few Helicobacter pylori-infected individuals develop severe gastric diseases and virulence factors of H. pylori appear to be involved in such clinical outcomes. Duodenal ulcer promoting gene A (dupA) is a novel virulence factor of Helicobacter pylori that is associated with duodenal ulcer development and reduced risk for gastric carcinoma in some populations. The aims of the present study were to determine the presence of dupA gene and evaluate the association among dupA and other virulence factors including cagA and vacA in Brazilian patients. Gastric biopsies were obtained from 205 dyspeptic patients (100 children and 105 adults). DNA was extracted and analyzed for the presence of H. pylori and its virulence factors using the polymerase chain reaction method.(AU)

Association among H. pylori virulence markers dupA, cagA and vacA in Brazilian patients

Only a few Helicobacter pylori-infected individuals develop severe gastric diseases and virulence factors of H. pylori appear to be involved in such clinical outcomes. Duodenal ulcer promoting gene A (dupA) is a novel virulence factor of Helicobacter pylori that is associated with duodenal ulcer development and reduced risk for gastric carcinoma in some populations. The aims of the present study were to determine the presence of dupA gene and evaluate the association among dupA and other virulence factors including cagA and vacA in Brazilian patients. Gastric biopsies were obtained from 205 dyspeptic patients (100 children and 105 adults). DNA was extracted and analyzed for the presence of H. pylori and its virulence factors using the polymerase chain reaction method.

Investigation of the association between clinical outcome and the cag pathogenicity-island and other virulence genes of Helicobacter pylori isolates from patients with dyspepsia in Eastern Turkey

The aims of our work were to determine the presence of the cag pathogenicity-island (cag PAI) and other virulence genes of Helicobacter pylori recovered from patients with gastritis and peptic ulcer, and to investigate the correlation of these virulence genes with clinical outcome. The presence of the cagA, the promoter regions of cagA, cagE, cagT, and the left end of cag-PAI (LEC), cag right junction (cagRJ), the plasticity region open reading frames (ORFs), vacA and oipA genes among 69 H. pylori isolates were determined by polymerase chain reaction. Intact cag PAI was detected in only one (1.4%) isolate. The cagA gene was identified in 52.1% and 76.2% of isolates from patients with dyspepsia (gastritis and peptic ulcer), respectively. The plasticity region ORFs i.e. JHP912 and JHP931 were predominantly detected in isolates from peptic ulcer. Less than 25% of the isolates carried other ORFs. Types I, II and III were the most commonly found among the isolates. None of the isolates possessed type Ib, 1c, IIIb, IV and V motifs. The most commonly vacA genotypes were s1am1a and s1m2 in isolates with peptic ulcer and gastritis, respectively. The results confirmed that the prevalence of oipA (Hp0638) gene was 75% and 85.7% in patients with gastritis and peptic ulcer, respectively. Furthermore, vacA s1am1a positivity was significantly related to peptic ulcer (p 0.05).

Perfuração de úlcera gastroduodenal em felino – relato de caso / Gastroduodenal perfuration ulcer in a cat – case report

As úlceras gastroduodenais são incomuns em gatos e suas causas ainda não estão bem esclarecidas (LIPTAK et al., 2002; CARIOU et al., 2010). Contudo, elas podem estar associadas a neoplasias, anti-inflamatórios não esteroidais, estresse, hiperacidez gástrica, hipovolemia, falência renal, endoparasitas e intoxicações (LIPTAK et al., 2002; NELSON e COUTO, 2006; CARIOU et al., 2010). O presente estudo tem como objetivo relatar um caso de úlcera gastroduodenal em felino.

Perfuração de úlcera gastroduodenal em felino relato de caso / Gastroduodenal perfuration ulcer in a cat case report

As úlceras gastroduodenais são incomuns em gatos e suas causas ainda não estão bem esclarecidas (LIPTAK et al., 2002; CARIOU et al., 2010). Contudo, elas podem estar associadas a neoplasias, anti-inflamatórios não esteroidais, estresse, hiperacidez gástrica, hipovolemia, falência renal, endoparasitas e intoxicações (LIPTAK et al., 2002; NELSON e COUTO, 2006; CARIOU et al., 2010). O presente estudo tem como objetivo relatar um caso de úlcera gastroduodenal em felino.(AU)

Perfuração gástrica em um canino induzida por nimesulida / Gastric perforation in a canine induced by nimesulide

Os anti-inflamatórios não esteroides (AINEs) têm sido muito utilizados na clínica de pequenos animais (FOX e JOHNSTON, 1997). Esses medicamentos possuem excelentes efeitos terapêuticos no alívio da dor e no tratamento de processos inflamatórios, no entanto possuem efeitos adversos especialmente no trato gastrointestinal onde podem promover o aparecimento de úlceras focais. As úlceras são lesões caracterizadas pela destruição da mucosa do trato gastroentérico (WILLARD, 2003). O objetivo deste trabalho é relatar o tratamento cirúrgico de um canino diagnosticado com úlcera gástrica perfurante devido ao uso de nimesulida.

Perfuração gástrica em um canino induzida por nimesulida / Gastric perforation in a canine induced by nimesulide

Os anti-inflamatórios não esteroides (AINEs) têm sido muito utilizados na clínica de pequenos animais (FOX e JOHNSTON, 1997). Esses medicamentos possuem excelentes efeitos terapêuticos no alívio da dor e no tratamento de processos inflamatórios, no entanto possuem efeitos adversos especialmente no trato gastrointestinal onde podem promover o aparecimento de úlceras focais. As úlceras são lesões caracterizadas pela destruição da mucosa do trato gastroentérico (WILLARD, 2003). O objetivo deste trabalho é relatar o tratamento cirúrgico de um canino diagnosticado com úlcera gástrica perfurante devido ao uso de nimesulida.(AU)

Gastroduodenal lesions in racehorses: evaluation and mapping according to the Updated Sidney System and Equine Gastric Ulcer Syndrome Council Classification

Gastroduodenal ulceration is found in 90% of Thoroughbred race horses. The clinical and economical importance of gastric ulcers and the scarce information about the subject in Brazil make this investigation essential. The aim of this study was to evaluate and map grossly and microscopically the gastroduodenal lesions in race horses according to the Updated Sidney System and the Equine Gastric Ulcer Syndrome Council (EGUSC) Classification. Necropsy was performed in 14 horses and macroscopy was described. Samples of the gastric regions (14 animals - nonglandular fundus, glandular fundus, margo plicatus, antrum and pylorus) and duodenum (9 animals) were obtained and processed for routine histopathology. Macroscopic evaluation of the lesions based on the Updated Sidney System showed that 100% of the horses had gastric ulcers or erosions, mainly located at the margo plicatus. The Updated Sidney System also allowed a macroscopic gastritis classification and revealed that seven horses had enanthematous gastritis (50%), four had hemorrhagic gastritis (28, 6%), and three had erosive gastritis (21, 4%). Based on the EGUSC Classification, the most frequent score is 2 (50%). The score 3 was found in 35,7% of the horses and the scores 1 and 4 in 7,1% each. The score 0 which means intact epithelium, was not seen in any of the horses. Histopathological evaluation based on the Updated Sidney System revealed mild to severe lymphoplasmacytic infiltrate, sometimes with areas of neutrophilic infiltrate, demonstrating some activity mainly in the injured mucosa. Lymphoid follicles were found in 92.9% of the animals. This study confirms that gastric ulceration in Brazilian race horses is common, and the majority consists of chronic ulceration of the margo plicatus. The use of the histopathological division of the Updated Sidney System demonstrated that chronic gastritis was predominant and the majority of cells in the inflammatory infiltrate were lymphocytes and plasmocytes. This study also showed that the association of the Updated Sidney System and the EGUSC Classification is feasible and leads to a better understanding of equine gastroduodenal ulceration. Although usually neglected, these lesions may be involved in low performance rates and therefore other investigations are necessary for the elucidation of the etiology and pathogenesis of these ulcers.(AU)

Prevalence of genotypes in Helicobacter pylori isolates from patients in eastern Turkey and the association of these genotypes with clinical outcome

There is not much information available regarding the prevalence of the genotypes of Helicobacter pylori isolates in Turkey, particularly in eastern Turkey. The aims of this study were to detect the prevalence of different genotypes of H. pylori in Turkish patients with gastrointestinal complaints and to determine the relationship of these genotypes with clinical outcome and sex. One hundred forty H. pylori isolates were examined for the presence of its genotypes by the PCR. We found that the prevalence of vacA s1, vacA s2, cagA, cagE, iceA1, iceA2 and babA2 genes were 88.6%, 11.4%, 71.4%, 35.7%, 41.4%, 58.6%, and 62.1%, respectively. The most predominant vacA subtype was s1a (81.4%). The most vacA allelic combination detected were vacA s1m1 (65.2%)and s1m2 (53.9%) in patients with peptic ulcer and gastritis, respectively. The only vacA s1 isolate was significantly associated with gastritis and peptic ulcer (p<0.05). The vacA s1a, ml, slml and babA2 genes were significantly associated with peptic ulcer (p<0.05), whereas m2 gene was significantly associated with only gastritis (p<0.05). The difference between sex and genotypes was statistically significant among the cagA, vacA s1, iceA2 and babA2 genes. This study reported for the first time the prevalence of H. pylori genotypes in patients with gastrointestinal complaints in eastern Turkey. Further studies are needed to understand epidemiological importance of the genotypes of H. pylori isolates in this region and the association between the virulence genes and clinical outcome in different regions.(AU)

Evaluation of diagnostic methods for the detection of Helicobacter pylori in gastric biopsy specimens of dyspeptic patients

Helicobacter pylori infects nearly 50% of the world's population. This microorganism is accepted as the most important agent of gastritis and as a risk factor for peptic ulcer disease and gastric adenocarcinoma. Currently many diagnostic methods exist for detecting H. pylori, however they all have limitations, thus it is recommend a combination of at least two methods. The aim of this study was to evaluate diagnostic methods, such as in-house urease test, culture and Polymerase Chain Reaction (PCR), for the detection of the H. pylori in gastric biopsy specimens of 144 dyspeptic patients, using as gold standard the association between histology and rapid urease test. According to the gold standard used in this study, 48 (33.3%) patients were infected with H. pylori, while 96 (66.7%) were classified as not infected. The in-house urease test and the PCR were the most sensitive methods (100%), followed by culture (85.4%). However, the in-house urease test and the culture were the most specific (100%), followed by PCR (75%). In conclusion, this study showed that, in comparison with the combination of histology and rapid urease test, the in-house urease test and the PCR presented 100% of sensitivity in the diagnosis of gastric infection by H. pylori, while the in-house urease test and the culture reached 100% of specificity. These finding suggest that the combination of two or more methods may improve the accuracy of the H. pylori detection.

Characterization of virulence genes cagA and vacA in Helicobacter Pylori and their prevalence in gastrointestinal disorders

Prevalence of H. pylori infection was determined using cultures of gastric biopsy samples of patients attended at the academic hospital of the Federal University of Paraná, Curitiba, Paraná, Brazil. Molecular methods were used to characterize the cagA and vacA genes from bacterial isolates associated with different diseases presented by patients. Out of a total of 81, forty-two gastric biopsy samples tested were positive for H. pylori, with a prevalence of 51.9%. No significant difference was found with regard to the gender (p=0.793) and age (p=0.183) of the patients. Genotype s1m1 vacA gene was found in 67% of the cases of peptic ulcer investigated (p=1.0), despite the limited number of patients with this disease (n=3). A correlation between the presence of less virulent strains (s2m2) and reflux esophagitis was found in the majority of the cases (45%), but without statistical significance. An association between the prevalence of cagA gene, found in 92% of isolates, and peptic ulcer was not observed (p=1.0), suggesting that this gene cannot be considered a specific marker of severity in our environment. The results reinforce the importance of conducting regional studies and the need to characterize H. pylori virulence genes associated with different diseases.

ABO blood groups and Helicobacter pylori cagA infection: evidence of an association

Diseases resulting from Helicobacter pylori infection appear to be dependent on a host of genetic traits and virulence factors possessed by this microorganism. This paper aimed to investigate the association between the ABO histo-blood groups and H. pylori cagA infections. Genomic DNA samples (n = 110) of gastric biopsies obtained from patients with endoscopic diagnosis of peptic ulcers (n = 25) and chronic active gastritis (n = 85) were analyzed by PCR using specific primers for the cagA gene. Of the samples, 66.4 percent (n = 73) tested positive and 33.6 percent (n = 37) negative for the gene. The cagA strain was predominant in peptic ulcers (n = 21; 84.0 percent) compared with chronic active gastritis (n = 52; 61.2 percent) (p = 0.05; OR 3.332; 95 percent CI: 1.050-10.576). Additionally, the cagA strain was prevalent in the type O blood (48/63; 76.2 percent) compared with other ABO phenotypes (25/47; 53.2 percent) (p = 0.01; OR 2.816; 95 percent CI: 1.246-6.364). These results suggest that H. pylori cagA infection is associated with the O blood group in Brazilian patients suffering from chronic active gastritis and peptic ulcers.(AU)

AVALIAÇÃO DA MUCOSA GÁSTRICA DE CÃES COM SINAIS CLÍNICOS GASTROINTESTINAIS CRÔNICOS E DA INFECÇÃO NATURAL POR HELICOBACTER SP POR MEIO DA ENDOSCOPIA DIGESTIVA ALTA, HISTOPATOLOGIA E IMUNOMARCAÇÃO PARA CD3 E HER-2 Niterói

A bactéria Helicobacter pylori é considerado, em seres humanos, como o principal agente causador da úlcera péptica e também o principal fator associado ao desenvolvimento do câncer gástrico. A patogenicidade de H. pylori já é bem caracterizada. Porém a patogenicidade do gênero Helicobacter como um todo permanece desconhecida. O objetivo desse estudo foi identificar a presença de Helicobacter sp. em cães (Canis familiaris) por meio da endoscopia digestiva alta, para coleta de material e realização de teste da urease, histopatologia com coloração de Hematoxilina Eosina, Giemsa modificado e impregnação pela prata - Whartin Starry (WS) e imuno-histoquímica com marcação anti CD3 e anti HER-2. Foi realizada avaliação macro e microscopica da mucosa gástrica dos cães com sinais clínicos gastrintestinais crônicos e associou a presença da bactéria com alterações inflamatórias e a superexpressão da oncoproteina HER-2. Foram incluídos no estudo 103 cães sendo 50 fêmeas (48%) e 53 machos (52%) com média de idade de 6,3 ± 0,394 (1 a 16 anos). Foi encontrado correlação estatística entre a presença de Helicobacter sp com a presença de sangue nas fezes (p=0,001); na avaliação endoscópica com o edema de antro (p=0,001) e com enantema no duodeno (p=0,001); na histopatologia com infiltrado inflamatório (p=0,049) e com edema (p=0,033) e na imuno-histoquímica com a superexpressão do anti corpo anti-HER-2 na superfície epitelial (p=0,047). O presente estudo concluiu que a presença de Helicobacter sp na mucosa gástrica de cães com sinais gastrintestinais crônicos está relacionada a gastrite e é provável que está bactéria desempenhe um importante papel na patogênese do câncer gástrico.

The bacterium Helicobacter pylori is considered in humans, as the main causative agent of peptic ulcer and also the main factor associated with the development of gastric cancer. The pathogenicity of H. pylori has been well characterized. However pathogenicity of Helicobacter genus as a whole remains unknown. The aim of this study was to identify the presence of Helicobacter sp. in dogs (Canis familiaris) through endoscopy, for collection of material and test realization of urease, histopathology with staining hematoxylin eosin, modified Giemsa and silver impregnation - Whartin Starry (WS) and immunohistochemistry with antibody anti CD3 and anti-HER-2. Macro and microscopic evaluation was performed the gastric mucosa of dogs with chronic gastrointestinal clinical signs and the presence of bacteria associated with inflammatory changes and overexpression of HER-2 oncoprotein. The study included 103 dogs and 50 females (48%) and 53 males (52%) with a mean age of 6.3 ± 0.394 (1-16 years). It has been found a statistical correlation between the presence of Helicobacter sp by the presence of bloody stools (P = 0.001); in endoscopic evaluation with the den of edema (p = 0.001) and enanthema the duodenum (p = 0.001); with inflammatory infiltration in histology (p =0.049) and edema (p = 0.033) and immunohistochemistry with overexpression of HER-2 anti-anti body on the epithelial surface (p = 0.047). This study concluded that the presence of Helicobacter sp in the gastric mucosa of dogs with chronic gastrointestinal signs is associated gastritis and it is probable that bacteria play an important role in the pathogenesis of gastric cancer.

Estenose de piloro em eqüino adulto / Pyloric stenosis in a mature horse

Neste trabalho, é descrito um caso de estenose hipertrófica de piloro diagnosticado por gastroscopia em um eqüino Quarto de Milha, de quatro anos de idade, que apresentava inapetência, emagrecimento progressivo, cólica, bruxismo e sialorréia. A gastroduodenite ulcerativa crônica e os espasmos prolongados foram as supostas causas da hipertrofia da musculatura circular do piloro, causando a estenose. O tratamento com substâncias antiulcerativas é paliativo e o acesso cirúrgico ao piloro no animal adulto é complexo, sendo o prognóstico duvidoso.(AU)

A case of hypertrophic pyloric stenosis diagnosed by gastroscopy was reported in a 4-years-old Quarter Horse gelding, with signs of inappetence, chronic weight loss, colic, bruxism and sialorrhea. Gastroduodenal ulceration and spasms were supposed as causes of pyloric muscular hypertrophy and stenosis. Antiulcerative medications are merely palliative and the complex surgical approach to the site of stenosis makes the prognostic to be doubtful.(AU)

Perforated duodenal ulcer associated with nonsteroidal anti-inflammatory drug administration in a dairy cow

A case report of perforated duodenal ulcer in a 4.5 year-old Holstein cow is presented. The cow was treated with an overdose of diclofenac sodium. Necropsy findings included diffuse fibrinous peritonitis and microscopically there was severe necrosis and acute inflammation of the duodenum at the margin of the ulcer. Although gastrointestinal ulcers are often associated with non-steroidal anti-inflammatory drugs in others species, it is rarely described in cattle.

Comparison of histological and molecular diagnosis of Helicobacter pylori in benign lesions and gastric adenocarcinoma

Helicobacter pylori colonization is associated with chronic gastritis, peptic ulcers, intestinal metaplasia, adenocarcinoma and lymphoma of the stomach. The objective of this study was to compare the results of the routinely used histology with molecular diagnosis for the detection of H. pylori. Eighty samples from gastric lesions (chronic gastritis, atrophic gastritis, gastric ulcer, and intestinal metaplasia), 18 gastric adenocarcinoma and 10 normal mucosa H. pylori-negative (control) samples were obtained. All samples were examined histologically (hematoxylin-eosin and Giemsa staining), and PCR amplifications of the species-specific antigen gene (H3H4) and urease A gene segment (H5H6) of H. pylori were made, using the human gene CYP1A1 for DNA quality control. In the benign lesion and adenocarcinoma the infection was detected in 43% (42/98) and 71% (70/98) by histological and molecular diagnosis (p = 0.0001), respectively. The PCR test detected H. pylori in 27.5% (22/80) of the benign gastric lesions and in 50% (9/18) of the gastric adenocarcinoma cases, the histological diagnosis being negative for this bacterium. About 2.5% of the samples, exclusively from benign lesions and with a positive histological diagnosis, showed negative molecular results for both primers. Statistically significant differences were found between the histological and the molecular method in intestinal metaplasia (p = 0.0461) and gastric adenocarcinoma (p = 0.0011), due to underdetection of H. pylori by the histological method, which is probably due to the low density of the bacterium as a consequence of the severe atrophy of the gastric mucosa. Our findings suggest that PCR is the more efficient method for the assessment of H. pylori infection, especially in metaplasia and gastric adenocarcinoma.

A colonização do Helicobacter pylori está associada com gastrite crônica, úlcera péptica, metaplasia intestinal, adenocarcinoma e linfoma gástrico. O objetivo desse estudo foi comparar os resultados do diagnóstico histológico usado de rotina na detecção do H. pylori com o diagnóstico molecular. Foram utilizadas amostras de 80 lesões gástricas (gastrite crônica, gastrite atrófica, úlcera gástrica e metaplasia intestinal), 18 amostras de adenocarcinoma gástrico e 10 amostras de mucosa gástrica normal H. pylori negativas (controle). Todas as amostras foram avaliadas histologicamente (coloração com hematoxilina-eosina e Giemsa) e pela PCR com a amplificação dos genes antígeno espécie-específico (H3H4) e urease A (H5H6) do H. pylori e pelo gene humano CYP1A1, como controle da qualidade do DNA. Nas amostras de lesão benigna e adenocarcinoma gástrico, a infecção foi detectada em 43% (42/98) e 71% (70/98), respectivamente, para os diagnósticos histológico e molecular (p = 0,0001). O teste de PCR detectou o H. pylori em 27,5% (22/80) das lesões gástricas benignas e em 50% (9/18) dos adenocarcinomas gástricos, com diagnóstico histológico negativo para essa bactéria. Cerca de 2,5% das amostras, exclusivamente de lesões benignas, com diagnóstico histológico positivo apresentaram resultado molecular negativo, para ambos os primers. Diferenças estatisticamente significantes foram encontradas entre os métodos histológico e molecular, em metaplasia intestinal (p = 0,0461) e adenocarcinoma gástrico (p = 0,0011), devido à subdetecção do H. pylori pelo método histológico, e provavelmente pela baixa densidade da bactéria conseqüente à atrofia severa da mucosa gástrica, nesses dois tipos de lesões. Nossos achados demonstram que o método de PCR é mais eficaz para diagnosticar a infecção por H. pylori, principalmente, em metaplasia intestinal e adenocarcinoma gástrico.

Fate of Helicobacter pylori artificially inoculated in lettuce and carrot samples

Helicobacter pylori is known, worldwide, as the causative agent of gastric diseases. However, its transmission route has not been completely understood. To evaluate the survival of H. pylori (a clinical and a reference strain) artificially inoculated on lettuce and carrot samples, portions of 25 g were inoculated with approximately 10(6) CFU/g of H. pylori and packed under normal and/or modified atmosphere (3% oxygen, 10% carbon dioxide, and 87% nitrogen). The inoculated food samples were stored at 8ºC, with daily enumeration of H. pylori populations on Columbia blood agar (CBA) and/ or Helicobacter pylori Special Peptone Agar (HPSPA). When CBA with antibiotics was used, the clinical isolate H. pylori HP1 was detected for up to 72 h in sanitized lettuce and carrot. In sterilized carrot samples, H. pylori HP1 remained viable for up to 96 h. The CBA without antibiotics allowed the recovery of H. pylori ATCC 43629, from carrot samples stored in both atmospheres tested, for up to 120 hours. Our results reinforce that foodborne transmission of H. pylori cannot be disregarded yet.

H. pylori é o agente da maioria dos casos de gastrites e úlceras pépticas. Entretanto, sua forma de transmissão não foi completamente elucidada. Para avaliar a sobrevivência de H. pylori (uma cepa de referência e uma clínica), artificialmente inoculado em amostras de cenoura e alface, porções de 25g das amostras receberam aproximadamente 10(6) UFC/g de H. pylori, e foram embaladas em atmosfera normal e/ou modificada (3% oxigênio, 10% dióxido de carbono, e 87% nitrogênio). Em seguida, foram armazenadas a 8ºC, com enumeração diária da população de H. pylori em ágar Columbia sangue (CBA) e/ou Helicobacter pylori Special Peptone Agar (HPSPA). Quando usamos CBA com antibióticos, o isolado clínico de H. pylori (HP1) foi detectado por até 72 horas nas amostras de alface e cenoura sanitizadas. Em amostras de cenoura esterilizadas, H. pylori HP1 permaneceu viável por até 96 horas. CBA sem antibióticos permitiu a recuperação de H. pylori ATCC 43629, a partir de amostras de cenoura embaladas em ambas as atmosferas, por até 120 horas. Nossos resultados reforçam que a transmissão de H. pylori, através do consumo de água e alimento contaminados, ainda não pode ser descartado.