Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 31
Filtrar
Mais filtros

Intervalo de ano de publicação
2.
Helicobacter ; 25(1): e12667, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31702083

RESUMO

BACKGROUND: IL-27 has dual roles in the immune response either stimulating Th1 or inhibiting Th17 cells. Because there is a particular link of IL-23/Th17 axis in the development of cancer and IL-27 has been considered a potential treatment for cancer, we evaluated the gastric and serum concentrations of IL-27 in two mutually exclusive Helicobacter pylori-associated diseases, gastric cancer (GC) and duodenal ulcer (DU). MATERIAL AND METHODS: We prospectively studied 110 H pylori-positive patients and 40 healthy blood donors. Serum and gastric concentrations of IL-27 and cytokines of the Th1/Th17 cells were assessed by ELISA. RESULTS: IL-27 was not detected in GC patients, but the cytokine concentration was very high in the patients with DU. IL-27 was also detected in the gastritis patients and in the H pylori-positive blood donors. IL27RA mRNA expression in peripheral blood mononuclear cells, evaluated by rt-PCR, was stimulated by H pylori strains. The cytokine concentration positively correlated with the Th1 and negatively with Th17 cell representative cytokine levels. Gastric IL-27 concentrations were positively correlated with increased degree of mononuclear and polymorphonuclear cells on the antral gastric mucosa of DU patients in consonance with the DU gastritis pattern. IL-12p70 and IFN-γ gastric concentrations were significantly higher in DU than in GC. Conversely, gastric concentrations of Th17 cell-associated cytokines (IL-1ß, IL-6, IL-17A, IL-23, and TGF-ß) were significantly higher in GC than in DU patients. CONCLUSION: Although H pylori infection is able to elicit IL-27 and IL-27Rα secretion, DU and GC have diametrically opposed cytokine patterns.


Assuntos
Infecções por Helicobacter/genética , Helicobacter pylori/fisiologia , Interleucina-27/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Úlcera Duodenal/genética , Úlcera Duodenal/imunologia , Úlcera Duodenal/microbiologia , Feminino , Infecções por Helicobacter/imunologia , Infecções por Helicobacter/microbiologia , Helicobacter pylori/genética , Humanos , Interleucina-17/genética , Interleucina-17/imunologia , Interleucina-27/imunologia , Leucócitos Mononucleares/imunologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Neoplasias Gástricas/genética , Neoplasias Gástricas/imunologia , Neoplasias Gástricas/microbiologia , Células Th1/imunologia , Células Th17/imunologia , Adulto Jovem
3.
Curr Opin Clin Nutr Metab Care ; 20(5): 420-425, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28617708

RESUMO

PURPOSE OF REVIEW: The aim of this study was to review the most recent aspects of nutrition and its impact on health-related quality of life (HRQOL) in patients with chronic hepatitis C (CHC). RECENT FINDINGS: Low HRQOL scores have been found in all stages of hepatitis C virus (HCV) infection. Of the factors linked to HRQOL, three aspects should be emphasized, nutritional status, physical activity and mental health status. Regarding the nutrition and metabolic conditions, a broad spectrum of nutritional disorders may impact on HRQOL of patients with CHC. SUMMARY: Malnutrition, which is a significant comorbidity in end-stage of all chronic liver diseases, has been recognized as a significant factor related to poor HRQOL. Of note, in individuals chronically infected with HCV, low muscle skeletal mass, an early indicator of undernourishment, precedes the development of cirrhosis. Because of the strict linkage between HRQOL, nutrition and physical activity, the assessment of the musculoskeletal system abnormalities in every patient with CHC, independently of the stage of the liver disease, is of utmost relevance. Maintenance of healthy skeletal muscle is essential to reduce the negative effects of sarcopenia on HRQOL. Otherwise, overweight/obesity and chronic HCV infection can cause insulin resistance, which has been associated with HRQOL impairment.


Assuntos
Dieta Saudável , Medicina Baseada em Evidências , Hepatite C Crônica/fisiopatologia , Estado Nutricional , Cooperação do Paciente , Medicina de Precisão , Qualidade de Vida , Comorbidade , Efeitos Psicossociais da Doença , Exercício Físico , Nível de Saúde , Estilo de Vida Saudável , Hepatite C Crônica/epidemiologia , Hepatite C Crônica/psicologia , Humanos , Desnutrição/epidemiologia , Desnutrição/prevenção & controle , Saúde Mental , Sarcopenia/epidemiologia , Sarcopenia/prevenção & controle , Índice de Gravidade de Doença , Estresse Psicológico/epidemiologia , Estresse Psicológico/prevenção & controle
4.
Br J Haematol ; 168(3): 421-8, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25257094

RESUMO

Helicobacter pylori eradication induces platelet recovery in a subgroup of patients with chronic immune thrombocytopenia (cITP), but the mechanisms involved are still not understood. We aimed to evaluate the effect of H. pylori eradication on platelet response and to identify the associated serum cytokine profile in 95 patients with cITP. Serum cytokine concentrations were determined by enzyme-linked immunosorbent assay prior to and 6 months after H. pylori eradication. Remission of cITP was observed in 17 (28·8%) of 59 patients in whom the bacterium was eradicated. Six months after treatment, a significant reduction in the concentrations of T-helper (Th) 1 and Th17 cells and an increase in T regulatory (Treg) and Th2-cell commitment cytokines were observed in patients who recovered, but not in those whose platelet count did not recover. Patients who had a platelet response to eradication of the bacteria had higher pre-treatment serum levels of γ-interferon (IFNG, IFN-γ), transforming growth factor-ß (TGFB1, TGF-ß) and interleukin 17 (IL17A, IL-17) than patients who did not respond, but only higher pre-treatment TGFB1 levels was independently associated with platelet response. In conclusion, amelioration of cITP after eradication of H. pylori was linked to a more efficient suppression of Th1 and Th17 response and a more pronounced Treg cell response.


Assuntos
Citocinas/sangue , Infecções por Helicobacter/complicações , Helicobacter pylori , Púrpura Trombocitopênica Idiopática/imunologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Quimioterapia Combinada , Feminino , Infecções por Helicobacter/tratamento farmacológico , Humanos , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Contagem de Plaquetas , Estudos Prospectivos , Púrpura Trombocitopênica Idiopática/sangue , Púrpura Trombocitopênica Idiopática/microbiologia , Indução de Remissão , Linfócitos T Reguladores/imunologia , Células Th1/imunologia , Células Th17/imunologia , Fator de Crescimento Transformador beta1/sangue , Adulto Jovem
5.
BMC Cancer ; 15: 528, 2015 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-26186918

RESUMO

BACKGROUND: Because to date there is no available study on STAT3 polymorphism and gastric cancer in Western populations and taking into account that Helicobacter pylori CagA EPIYA-C segment deregulates SHP-2/ERK-JAK/STAT3 pathways, we evaluated whether the two variables are independently associated with gastric cancer. METHODS: We included 1048 subjects: H. pylori-positive patients with gastric carcinoma (n = 232) and with gastritis (n = 275) and 541 blood donors. Data were analyzed using logistic regression model. RESULTS: The rs744166 polymorphic G allele (p = 0.01; OR = 1.76; 95 % CI = 1.44-2.70), and CagA-positive (OR = 12.80; 95 % CI = 5.58-19.86) status were independently associated with gastric cancer in comparison with blood donors. The rs744166 polymorphism (p = 0.001; OR = 1.64; 95 % CI = 1.16-2.31) and infection with H. pylori CagA-positive strains possessing higher number of EPIYA-C segments (p = 0.001; OR = 2.28; 95 % CI = 1.41-3.68) were independently associated with gastric cancer in comparison with gastritis. The association was stronger when host and bacterium genotypes were combined (p < 0.001; OR = 3.01; 95 % CI = 2.29-3.98). When stimulated with LPS (lipopolysaccharide) or Pam3Cys, peripheral mononuclear cells of healthy carriers of the rs744166 GG and AG genotypes expressed higher levels of STAT3 mRNA than those carrying AA genotype (p = 0.04 for both). The nuclear expression of phosphorylated p-STAT3 protein was significantly higher in the antral gastric tissue of carriers of rs744166 GG genotype than in carriers of AG and AA genotypes. CONCLUSIONS: Our study provides evidence that STAT3 rs744166 G allele and infection with CagA-positive H. pylori with higher number of EPIYA-C segments are independent risk factors for gastric cancer. The odds ratio of having gastric cancer was greater when bacterium and host high risk genotypes were combined.


Assuntos
Antígenos de Bactérias/genética , Proteínas de Bactérias/genética , Gastrite/microbiologia , Infecções por Helicobacter/genética , Polimorfismo de Nucleotídeo Único , Fator de Transcrição STAT3/genética , Neoplasias Gástricas/microbiologia , Adulto , Antígenos de Bactérias/sangue , Proteínas de Bactérias/sangue , Biomarcadores , Feminino , Gastrite/genética , Estudos de Associação Genética , Infecções por Helicobacter/sangue , Infecções por Helicobacter/microbiologia , Helicobacter pylori/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Fator de Transcrição STAT3/metabolismo , Neoplasias Gástricas/genética
6.
Helicobacter ; 19(4): 272-9, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24750275

RESUMO

BACKGROUND: In endemic settings, Helicobacter pylori infection can occur shortly after birth and may be associated with a reduction in childhood growth. MATERIALS AND METHODS: This study investigated what factors promote earlier age of first H. pylori infection and evaluated the role of H. pylori infection in infancy (6-11 months) versus early childhood (12-23 months) on height. We included 183 children near birth from a peri-urban shanty town outside of Lima, Peru. Field-workers collected data on socioeconomic status (SES), daily diarrheal and breast-feeding history, antibiotic use, anthropometrics, and H. pylori status via carbon 13-labeled urea breath test up to 24 months after birth. We used a proportional hazards model to assess risk factors for earlier age at first detected infection and linear mixed-effects models to evaluate the association of first detected H. pylori infection during infancy on attained height. RESULTS: One hundred and forty (77%) were infected before 12 months of age. Lower SES was associated with earlier age at first detected H. pylori infection (low vs middle-to-high SES Hazard ratio (HR) 1.59, 95% CI 1.16, 2.19; p = .004), and greater exclusive breast-feeding was associated with reduced likelihood (HR 0.63, 95% CI 0.40, 0.98, p = .04). H. pylori infection in infancy was not independently associated with growth deficits (p = .58). However, children who had their first detected H. pylori infection in infancy (6-11 months) versus early childhood (12-23 months) and who had an average number of diarrhea episodes per year (3.4) were significantly shorter at 24 months (-0.37 cm, 95% CI, -0.60, -0.15 cm; p = .001). DISCUSSION: Lower SES was associated with a higher risk of first detected H. pylori infection during infancy, which in turn augmented the adverse association of diarrheal disease on linear growth.


Assuntos
Desenvolvimento Infantil , Deficiências do Desenvolvimento/epidemiologia , Diarreia/complicações , Infecções por Helicobacter/complicações , Helicobacter pylori/isolamento & purificação , Animais , Testes Respiratórios , Pré-Escolar , Deficiências do Desenvolvimento/etiologia , Diarreia/epidemiologia , Feminino , Infecções por Helicobacter/epidemiologia , Humanos , Lactente , Recém-Nascido , Masculino , Peru/epidemiologia , Gravidez , Fatores de Risco , Classe Social , População Suburbana , Ureia/análise
7.
Helicobacter ; 17(3): 176-80, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22515354

RESUMO

BACKGROUND: The detection of the putative disease-specific Helicobacter pylori marker duodenal ulcer promoting gene A (dupA) is currently based on PCR detection of jhp0917 and jhp0918 that form the gene. However, mutations that lead to premature stop codons that split off the dupA leading to truncated products cannot be evaluated by PCR. METHODS: We directly sequence the complete dupA of 75 dupA-positive strains of H. pylori isolated from patients with gastritis (n = 26), duodenal ulcer (n = 29), and gastric carcinoma (n = 20), to search for frame-shifting mutations that lead to stop codon. RESULTS: Thirty-four strains had single nucleotide mutations in dupA that lead to premature stop codon creating smaller products than the predicted 1839 bp product and, for this reason, were considered as dupA-negative. Intact dupA was more frequently observed in strains isolated from duodenal ulcer patients (65.5%) than in patients with gastritis only (46.2%) or with gastric carcinoma (50%). In logistic analysis, the presence of the intact dupA independently associated with duodenal ulcer (OR = 5.06; 95% CI = 1.22-20.96, p = .02). CONCLUSION: We propose the primer walking methodology as a simple technique to sequence the gene. When we considered as dupA-positive only those strains that carry dupA gene without premature stop codons, the gene was associated with duodenal ulcer and, therefore, can be used as a marker for this disease in our population.


Assuntos
Códon sem Sentido , Infecções por Helicobacter/microbiologia , Helicobacter pylori/genética , Polimorfismo de Nucleotídeo Único , Fatores de Virulência/genética , Adulto , Idoso , Úlcera Duodenal/microbiologia , Feminino , Gastrite/microbiologia , Helicobacter pylori/isolamento & purificação , Helicobacter pylori/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Gástricas/microbiologia , Fatores de Virulência/metabolismo
8.
Helicobacter ; 17(1): 23-9, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22221612

RESUMO

BACKGROUND: Helicobacter pylori infection is acquired predominantly in childhood. There is also evidence that children loss the infection. Therefore, factors that account for children remain infected need to be investigated because once established the infection persists throughout the life unless treated. METHODS: This study aimed to evaluate the H. pylori infection in children of a low-income community at baseline and 8years later to determine the predictor factors linked to the maintenance, acquisition, and loss of the infection using regression models of generalized estimating equations. H. pylori status was determined by (13) C-urea breath test. RESULTS: Data from 37.7% (133/353) of the children were available. No difference between the characteristics of the included and nonincluded children was observed. The prevalence of infection increased from 53.4 to 64.7%. Thirty-nine children (29.3%) remained noninfected, 47.4% remained infected, 17.3% became infected, and 6.0% lost the infection. Factors associated with to remain infected compared with to remain noninfected included the age, increased number of children in the household, and the use of well water instead of municipal water. The acquisition of the infection was associated with the male gender. CONCLUSION: Factors linked to remain and to gain H. pylori infection in a poor region were increased number of children in the household and the male gender. Also, the acquisition rates were higher than the loss rates, which lead to an increase in the infection prevalence with age.


Assuntos
Infecções por Helicobacter/epidemiologia , Infecções por Helicobacter/patologia , Brasil/epidemiologia , Testes Respiratórios , Criança , Estudos de Coortes , Características da Família , Feminino , Seguimentos , Helicobacter pylori/patogenicidade , Humanos , Masculino , Prevalência , Fatores de Risco , Fatores Socioeconômicos
9.
BMC Gastroenterol ; 12: 107, 2012 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-22891666

RESUMO

BACKGROUND: To evaluate the prevalence of more virulent H. pylori genotypes in relatives of gastric cancer patients and in patients without family histories of gastric cancer. METHODS: We evaluated prospectively the prevalence of the infection by more virulent H. pylori strains in 60 relatives of gastric cancer patients comparing the results with those obtained from 49 patients without family histories of gastric cancer. H. pylori status was determined by the urease test, histology and presence of H. pylori ureA. The cytotoxin associated gene (cagA), the cagA-EPIYA and vacuolating cytotoxin gene (vacA) were typed by PCR and the cagA EPIYA typing was confirmed by sequencing. RESULTS: The gastric cancer relatives were significant and independently more frequently colonized by H. pylori strains with higher numbers of CagA-EPIYA-C segments (OR = 4.23, 95%CI = 1.53-11.69) and with the most virulent s1m1 vacA genotype (OR = 2.80, 95%CI = 1.04-7.51). Higher numbers of EPIYA-C segments were associated with increased gastric corpus inflammation, foveolar hyperplasia and atrophy. Infection by s1m1 vacA genotype was associated with increased antral and corpus gastritis. CONCLUSIONS: We demonstrated that relatives of gastric cancer patients are more frequently colonized by the most virulent H. pylori cagA and vacA genotypes, which may contribute to increase the risk of gastric cancer.


Assuntos
Antígenos de Bactérias/metabolismo , Proteínas de Bactérias/metabolismo , Carcinoma/microbiologia , Infecções por Helicobacter/microbiologia , Helicobacter pylori/patogenicidade , Neoplasias Gástricas/microbiologia , Adulto , Sequência de Aminoácidos , Antígenos de Bactérias/genética , Proteínas de Bactérias/genética , Sequência de Bases , Carcinoma/epidemiologia , Carcinoma/metabolismo , Carcinoma/patologia , Família , Feminino , Infecções por Helicobacter/epidemiologia , Infecções por Helicobacter/patologia , Helicobacter pylori/genética , Helicobacter pylori/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Dados de Sequência Molecular , Fosforilação , Prevalência , Estudos Prospectivos , Análise de Sequência de DNA , Neoplasias Gástricas/epidemiologia , Neoplasias Gástricas/metabolismo , Neoplasias Gástricas/patologia , Urease/análise
10.
Mem Inst Oswaldo Cruz ; 107(4): 561-3, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22666872

RESUMO

Helicobacter pylori causes chronic gastric inflammation and significantly increases the risk of duodenal and gastric ulcer disease and distal gastric carcinoma. In this study, we evaluated the Helicobacter pylori vacA and cagA genotypes in patients from a Brazilian region where there is a high prevalence of gastric cancer. Polymerase chain reaction (PCR) was used to investigate vacA mosaicism and cagA status in the gastric mucosa of 134 H. pylori-positive patients, including 76 with gastritis: 28 with peptic ulcer disease and 30 with gastric cancer. The s1m1 variant was the predominant vacA genotype observed, whereas the s1 allele was more frequently observed in patients with more severe diseases associated with H. pylori infection [p = 0.03, odds ratio (OR) = 5.72, 95% confidence interval (CI) = 1.15-38.60]. Furthermore, all of the s1 alleles were s1b. Mixed vacA m1/m2 strains were found more frequently in patients with gastric cancer and a cagA-positive status was significantly associated with gastric cancer (p = 0.016, OR = 10.36, 95% CI = 1.35-217.31). Patients with gastric cancer (21/21, 100%, p = 0.006) or peptic ulcers (20/21, 95%, p = 0.02) were more frequently colonised by more virulent H. pylori strains compared to gastritis patients (41/61, 67.2%). In conclusion, in the northeastern of Brazil, which is one of the regions with the highest prevalence of gastric cancer in the country, infection with the most virulent H. pylori strains, carrying the cagA gene and s1m1 vacA alleles, predominates and is correlated with more severe H. pylori-associated diseases.


Assuntos
Antígenos de Bactérias/genética , Proteínas de Bactérias/genética , Infecções por Helicobacter/microbiologia , Helicobacter pylori/genética , Adulto , Brasil , Feminino , Gastrite/microbiologia , Genótipo , Helicobacter pylori/isolamento & purificação , Helicobacter pylori/patogenicidade , Humanos , Masculino , Pessoa de Meia-Idade , Úlcera Péptica/microbiologia , Reação em Cadeia da Polimerase , Neoplasias Gástricas/microbiologia
11.
Int J Med Microbiol ; 301(3): 225-8, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21050811

RESUMO

The dupA of Helicobacter pylori has been suggested as a virulence marker associated with the development of duodenal ulcer disease. However, the studies performed in different geographical areas have shown that there are variations in the prevalence of dupA and its association with H. pylori clinical outcomes. Our group did not observe associations between the presence of dupA and H. pylori clinical outcomes in Brazil. On the other hand, we observed 2 mutations in the sequence of dupA that lead to stop codons: a deletion of an adenine at position 1311 and an insertion of an adenine at position 1426 of the gene. Our aim was to evaluate associations of the presence of dupA with duodenal ulcer and gastric cancer, considering dupA-positive only those H. pylori strains that do not have the mutations in the gene sequence. We also evaluated the effect of infection with a strain carrying an intact dupA on the gastric mucosa histology and IL-8 gastric levels. Colonization with strains that had the intact dupA was negatively associated with gastric carcinoma (p=0.001, OR=0.32, 95% CI=0.16-0.66). The presence of dupA was also associated with an increased degree of antral mucosa inflammation (p=0.01) and with decreased corpus atrophy (p<0.01) as well as with increased gastric mucosa IL-8 levels (p=0.04). In conclusion, the infection with a H. pylori strain containing the dupA without the stop codon polymorphisms is associated with a lower risk of development of gastric carcinoma in Brazilian subjects.


Assuntos
Úlcera Duodenal/epidemiologia , Infecções por Helicobacter/complicações , Helicobacter pylori/patogenicidade , Polimorfismo Genético , Neoplasias Gástricas/epidemiologia , Fatores de Virulência/genética , Adulto , Idoso , Brasil/epidemiologia , Úlcera Duodenal/microbiologia , Feminino , Mucosa Gástrica/patologia , Infecções por Helicobacter/microbiologia , Infecções por Helicobacter/patologia , Helicobacter pylori/genética , Humanos , Interleucina-8/metabolismo , Masculino , Pessoa de Meia-Idade , Neoplasias Gástricas/microbiologia
12.
BMC Microbiol ; 11: 61, 2011 Mar 24.
Artigo em Inglês | MEDLINE | ID: mdl-21435255

RESUMO

BACKGROUND: Helicobacter pylori infection is one of the most common infections worldwide and is associated with gastric cancer and peptic ulcer. Bacterial virulence factors such as CagA have been shown to increase the risk of both diseases. Studies have suggested a causal role for CagA EPIYA polymorphisms in gastric carcinogenesis, and it has been shown to be geographically diverse. We studied associations between H. pylori CagA EPIYA patterns and gastric cancer and duodenal ulcer, in an ethnically admixed Western population from Brazil. CagA EPIYA was determined by PCR and confirmed by sequencing. A total of 436 patients were included, being 188 with gastric cancer, 112 with duodenal ulcer and 136 with gastritis. RESULTS: The number of EPIYA C segments was significantly associated with the increased risk of gastric carcinoma (OR=3.08, 95% CI=1.74 to 5.45, p<10-3) even after adjustment for age and gender. Higher number of EPIYA C segments was also associated with gastric atrophy (p=0.04) and intestinal metaplasia (p=0.007). Furthermore, patients infected by cagA strains possessing more than one EPIYA C segment showed decreased serum levels of pepsinogen I in comparison with those infected by strains containing one or less EPIYA C repeat. Otherwise, the number of EPIYA C segments did not associate with duodenal ulcer. CONCLUSIONS: Our results demonstrate that infection with H. pylori strains harbouring more than one CagA EPIYA C motif was clearly associated with gastric cancer, but not with duodenal ulcer.Higher number of EPIYA C segments was also associated with gastric precancerous lesions as demonstrated by histological gastric atrophic and metaplastic changes and decreased serum levels of pepsinogen I.


Assuntos
Antígenos de Bactérias/genética , Proteínas de Bactérias/genética , Úlcera Duodenal/epidemiologia , Infecções por Helicobacter/complicações , Helicobacter pylori/genética , Helicobacter pylori/patogenicidade , Neoplasias Gástricas/epidemiologia , Adulto , Idoso , Antígenos de Bactérias/metabolismo , Proteínas de Bactérias/metabolismo , Brasil/epidemiologia , DNA Bacteriano/química , DNA Bacteriano/genética , Úlcera Duodenal/microbiologia , Infecções por Helicobacter/microbiologia , Humanos , Pessoa de Meia-Idade , Fosforilação , Reação em Cadeia da Polimerase , Polimorfismo Genético , Análise de Sequência de DNA , Neoplasias Gástricas/microbiologia
13.
Mem Inst Oswaldo Cruz ; 105(5): 657-60, 2010 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-20835612

RESUMO

Helicobacter pylori infection is associated with peptic ulcer and gastric carcinoma. The oral cavity may be a reservoir for H. pylori; however, the results of studies on this subject are controversial. We employed single-step and nested polymerase chain reactions (PCR) to detect the presence of the vacA, ureA and 16S rDNA genes of H. pylori in the stomach, saliva and dental plaque of 30 subjects. The results were confirmed by sequencing. Nested 16S rDNA and ureA amplification was achieved in 80% of gastric, 30% of saliva and 20% of dental plaque specimens. Sequencing of 10, seven and four 16S rDNA products from stomach, saliva and dental plaque, respectively, showed > 99% identity with H. pylori. Sequencing of the other four oral cavity PCR products showed similarity with Campylobacter and Wolinella species. Additionally, the vacA genotype identified in the samples of different sites was the same within a given subject.H. pylori may be found in the oral cavity of patients with gastric infection, thus it could be a source of transmission. However, results obtained with detection methods based only on PCR should be interpreted with caution because other microorganisms that are phylogenetically very close to H. pylori are also present in the mouth.


Assuntos
Placa Dentária/microbiologia , Dispepsia/microbiologia , Infecções por Helicobacter/diagnóstico , Helicobacter pylori/isolamento & purificação , Saliva/microbiologia , Estômago/microbiologia , Proteínas de Bactérias/análise , Proteínas de Bactérias/genética , Biópsia , DNA Bacteriano/genética , DNA Ribossômico/genética , Feminino , Infecções por Helicobacter/transmissão , Helicobacter pylori/genética , Humanos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase/métodos , RNA Ribossômico 16S/genética , Análise de Sequência de DNA
14.
Int J Med Microbiol ; 298(3-4): 223-30, 2008 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-17897881

RESUMO

Duodenal ulcer-promoting gene (dupA) was recently described as a new putative Helicobacter pylori virulence marker associated with an increased risk for duodenal ulcer and reduced risk for gastric carcinoma in Japan and Korea. Since differences regarding the association among H. pylori markers and H. pylori-associated diseases have been demonstrated around the world, we evaluated the presence of the gene in 482 strains from Brazilian children (34 with duodenal ulcer and 97 with gastritis) and adults (126 with duodenal ulcer, 144 with gastritis and 81 with gastric carcinoma) by PCR using the described primers and an additional set of primers based on Brazilian strain sequences. The results were confirmed by sequencing. The presence of cagA was investigated by PCR and also included in the analysis. dupA was present in 445 (92.32%) and absent in 29 (6.02%) strains. All samples from children with and without duodenal ulcer were dupA-positive (p=1.0). No association was observed among the strains from adults with gastritis (92.36%), duodenal ulcer (87.30%, p=0.30) and gastric carcinoma (87.65%, p=0.31). Conversely, cagA-positve status remained independently associated with duodenal ulcer (children: odds ratios (OR)=5.58, 95% confidence intervals (CI)=1.67-18.50; adults: OR=3.33, 95% CI=2.14-5.19) and gastric carcinoma (OR=6.58, 95% CI=3.51-12.30) in multivariate analyses. The presence of dupA was significantly higher in strains from children than in those from adults (p=0.01). In conclusion, dupA is highly frequent and not associated with H. pylori-associated diseases in both Brazilian adults and children, which points to regional differences in the distribution of the gene.


Assuntos
Antígenos de Bactérias/metabolismo , Proteínas de Bactérias/metabolismo , Úlcera Duodenal/microbiologia , Infecções por Helicobacter/complicações , Helicobacter pylori/genética , Fatores de Virulência/genética , Adolescente , Adulto , Idoso , Brasil , Criança , Úlcera Duodenal/genética , Feminino , Gastrite/genética , Gastrite/microbiologia , Genes Bacterianos , Helicobacter pylori/patogenicidade , Humanos , Masculino , Pessoa de Meia-Idade , Dados de Sequência Molecular , Neoplasias Gástricas/genética , Neoplasias Gástricas/microbiologia
15.
J Cachexia Sarcopenia Muscle ; 9(2): 255-268, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29349902

RESUMO

BACKGROUND: Preserved skeletal muscle is essential for the maintenance of healthy bone. Loss of bone mineral density (BMD) and muscle strength, considered a predictor of BMD, have been demonstrated in patients with cirrhosis, but they are poorly studied in chronic hepatitis C (CHC) without cirrhosis. Thus, we aimed to evaluate the prevalence of low BMD and its association with body composition, muscle strength, and nutritional status in CHC. METHODS: One hundred and four subjects [mean age, 50.5 ± 11.3 years; 75.0% males; 67.3% non-cirrhotic; and 32.7% with compensated cirrhosis] with CHC, prospectively, underwent scanning of the lean tissue, appendicular skeletal muscle mass (ASM), fat mass, lumbar spine, hip, femoral neck, and whole-body BMD by dual-energy X-ray absorptiometry. Muscle strength was assessed by dynamometry. Sarcopenia was defined by the presence of both low, ASM/height2 (ASMI) and low muscle strength according to the European Working Group on Sarcopenia in Older People criteria. The cut-off points for low ASMI and low muscle strength, for women and men, were < 5.45 and < 7.26 kg/m2 and < 20 and < 30 kg, respectively. According to the adopted World Health Organization criteria in men aged > 50 years, the T-score of osteopenia is between -1.0 and -2.49 standard deviation (SD) below the young average value and of osteoporosis is ≥-2.5 SD below the young normal mean for men, and the Z-score of low bone mass is ≤-2.0 SD below the expected range in men aged < 50 years and women in the menacme. Nutritional status evaluation was based on the Controlling Nutritional Status score. RESULTS: Low BMD, low muscle strength, pre-sarcopenia, sarcopenia, and sarcopenic obesity were observed in 34.6% (36/104), 27.9% (29/104), 14.4% (15/104), 8.7% (9/104), and 3.8% (4/104) of the patients, respectively. ASMI was an independent predictor of BMD (P < 0.001). Sarcopenia was independently associated with bone mineral content (P = 0.02) and malnutrition (P = 0.01). In 88.9% of the sarcopenic patients and in all with sarcopenic obesity, BMI was normal. The mid-arm muscle circumference was positively correlated with ASMI (r = 0.88; P < 0.001). CONCLUSIONS: This is the first study to demonstrate that ASM is an independent predictor of BMD in CHC. Mid-arm muscle circumference coupled with handgrip strength testing should be incorporated into routine clinical practice to detect low muscle mass, which may be underdiagnosed when only BMI is used. These findings may influence clinical decision-making and contribute to the development of effective strategies to screen the musculoskeletal abnormalities in CHC patients, independently of the stage of the liver disease.


Assuntos
Densidade Óssea/fisiologia , Hepatite C Crônica/complicações , Sarcopenia/etiologia , Adulto , Idoso , Estudos Transversais , Feminino , Hepatite C Crônica/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Sarcopenia/patologia , Adulto Jovem
16.
Nutr Clin Pract ; 33(2): 238-246, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29596718

RESUMO

OBJECTIVE: Because cirrhotic patients are at high risk of malnutrition and sarcopenia, we evaluated the prevalence of low fat-free mass index (FFMI) and low phase angle (PhA) among patients with chronic hepatitis C (CHC). METHODS: In total, 135 subjects with CHC (50.4% males; mean age, 52.4 ± 11.8 years; 65.9% noncirrhotic and 34.1% compensated cirrhotic patients) were prospectively included and evaluated by bioelectrical impedance analysis. Subjective global assessment was used to evaluate malnutrition. RESULTS: Low FFMI and low PhA were identified in 21.5% and 23.7% of the patients, respectively. Compensated cirrhotic patients had lower PhA values than those without cirrhosis. Low FFMI was associated with male sex (odds ratio [OR], 2.74; 95% confidence interval [CI], 1.00-7.01; P = .04) and malnutrition (OR, 4.27; 95% CI, 1.42-12.90; P = .01). Low PhA was associated with cirrhosis (OR, 3.92; 95% CI, 1.56-9.86; P = .004), malnutrition (OR, 5.52; 95% CI, 1.73-17.62; P = .004), and current alcohol use (OR, 2.77; 95% CI, 1.01-7.58; P = .05). Reactance (Xc) normalized for height (H), an indicator of muscle strength, was independently associated with male sex, age, hypertension, and serum albumin. CONCLUSION: Host factors, including clinical comorbidities, lifestyle, and nutrition status, are associated with low FFMI and low PhA in noncirrhotic and in compensated cirrhotic patients with CHC. These findings highlight the relevance of evaluating body composition in patients chronically infected by hepatitis C virus independently of the stage of liver disease.


Assuntos
Hepatite C Crônica/fisiopatologia , Desnutrição/diagnóstico , Avaliação Nutricional , Sarcopenia/diagnóstico , Adulto , Composição Corporal , Brasil/epidemiologia , Comorbidade , Estudos Transversais , Impedância Elétrica , Feminino , Hepatite C Crônica/epidemiologia , Hospitais Universitários , Humanos , Cirrose Hepática/epidemiologia , Cirrose Hepática/etiologia , Cirrose Hepática Alcoólica/epidemiologia , Masculino , Desnutrição/epidemiologia , Desnutrição/etiologia , Pessoa de Meia-Idade , Ambulatório Hospitalar , Prevalência , Estudos Prospectivos , Risco , Sarcopenia/epidemiologia , Sarcopenia/etiologia , Fatores Sexuais
17.
J Pediatr (Rio J) ; 82(5): 325-34, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-17003940

RESUMO

OBJECTIVES: To show important aspects of gastroduodenal peptic ulcer and of Helicobacter pylori infection in children and adolescents. SOURCES: Technical textbooks and MEDLINE and LILACS databases including publications between 1966 and 2006. SUMMARY OF THE FINDINGS: The etiology of peptic ulcer in children and adolescents may be primary, associated with H. pylori infection, or secondary, in which etiopathogenic mechanisms rely upon the underlying disease. The infection is acquired predominantly in childhood, with prevalence rates between 56.8 and 83.1% in children who live in the poorest Brazilian regions, amounting to nearly 10% in children aged less than 10 years in industrialized countries. The infection can be diagnosed by invasive methods, which investigate the presence of the bacterium, or of DNA, RNA or bacterial products in biopsy fragments of the gastric mucosa obtained at endoscopic examination; it can also be diagnosed through noninvasive methods, which include the detection of anti-H. pylori antibodies in serum, urine or saliva samples, detection of bacterial antigens in stool samples, and the carbon 13-labeled urea breath test. However, upper gastrointestinal endoscopy is the method of choice for the diagnosis of peptic ulcer, as it allows collecting fragments from the gastric mucosa during the procedure for the diagnosis of infection and for histopathological analysis. CONCLUSION: H. pylori infection is the major cause of peptic ulcer among children. Eradication of the bacterium with antimicrobial therapy results in the cure of the disease, and is therefore indicated for all children with H. pylori infection with an active, recurrent, healed, or complicated peptic ulcer.


Assuntos
Úlcera Duodenal/microbiologia , Infecções por Helicobacter/complicações , Helicobacter pylori , Adolescente , Antibacterianos/uso terapêutico , Criança , Farmacorresistência Bacteriana/efeitos dos fármacos , Úlcera Duodenal/diagnóstico , Úlcera Duodenal/tratamento farmacológico , Endoscopia Gastrointestinal , Infecções por Helicobacter/diagnóstico , Infecções por Helicobacter/tratamento farmacológico , Helicobacter pylori/imunologia , Helicobacter pylori/isolamento & purificação , Helicobacter pylori/patogenicidade , Humanos
18.
Braz J Psychiatry ; 37(1): 21-30, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25806552

RESUMO

OBJECTIVE: Patients with chronic hepatitis C (CHC) have a poorer quality of life than those with other chronic liver diseases. However, some of the factors that determine health-related quality of life (HRQOL) in these patients, such as the degree of liver fibrosis, are still controversial. Therefore, the aim of the present study was to investigate the impact of CHC on HRQOL by conducting clinical, psychiatric, and sociodemographic evaluations. METHODS: One hundred and twenty-four consecutive patients attending a referral center for hepatitis were evaluated using the Mini-International Neuropsychiatry Interview, the Hamilton Depression Rating Scale, the Hospital Anxiety and Depression Scale, and the Medical Outcomes Study 36-Item Short-Form Health Survey. Multiple linear regression analyses were used to quantify independent associations between HRQOL and the clinical, psychiatric, and sociodemographic variables of interest. RESULTS: Reduced HRQOL was independently associated with major depressive disorder (MDD) and with elevated levels of alanine aminotransferase, but was not associated with hepatic cirrhosis. CONCLUSIONS: MDD rather than the grade of liver fibrosis was strongly associated with HRQOL impairment in patients with CHC. These findings highlight that, in patients with CHC, the psychological effects of the disease deserve more attention and the implementation of integrated medical, psychiatric, and psychological care may be helpful.


Assuntos
Transtorno Depressivo Maior/psicologia , Insuficiência Hepática/psicologia , Hepatite C Crônica/psicologia , Qualidade de Vida , Adulto , Idoso , Transtornos de Ansiedade/psicologia , Brasil/epidemiologia , Ensaio de Imunoadsorção Enzimática , Métodos Epidemiológicos , Feminino , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Escalas de Graduação Psiquiátrica , Fatores Socioeconômicos , Adulto Jovem
19.
J Med Microbiol ; 48(5): 501-506, 1999 May.
Artigo em Inglês | MEDLINE | ID: mdl-10229548

RESUMO

This study evaluated the sensitivity of serological and direct methods for the diagnosis of Helicobacter pylori infection in 127 patients with gastric carcinoma and in 127 controls without this disease, matched for age and sex. Antral and oxyntic mucosal specimens were obtained from all patients, at operation in patients with gastric carcinoma and at endoscopy from controls. The urease test, microscopy of stained smears and culture for H. pylori were performed on all specimens. Sera from all patients were tested for antibodies to H. pylori by a highly sensitive and specific IgG-ELISA. Culture, urease test, stained smear and ELISA were significantly less sensitive in the patients with gastric carcinoma than in control subjects. However, the combination of several methods improved the diagnosis of H. pylori infection in the gastric carcinoma group. Infection was significantly more frequent in the gastric carcinoma patients than in the controls. H. pylori infection was associated with an increased risk of developing gastric carcinoma.


Assuntos
Carcinoma/microbiologia , Infecções por Helicobacter/sangue , Helicobacter pylori/isolamento & purificação , Neoplasias Gástricas/microbiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticorpos Antibacterianos/sangue , Carcinoma/complicações , Estudos de Casos e Controles , Estudos Transversais , Ensaio de Imunoadsorção Enzimática/métodos , Feminino , Infecções por Helicobacter/complicações , Infecções por Helicobacter/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Neoplasias Gástricas/complicações
20.
FEMS Immunol Med Microbiol ; 33(3): 173-8, 2002 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-12110479

RESUMO

This PCR-based analysis is the first molecular epidemiological study in Brazil testing Helicobacter pylori cagA and vacA distribution in adults with gastric complaints, that includes a large number of carcinoma patients. Multiple-strain infection was identified in 11/13.4% patients. vacA s1-m1 and cagA(+) genotypes were the most common in patients with a non-mixed infection. All vacA s1 strains were s1b, so subtyping s1 strains was not useful. vacA s1b-m1 and cagA(+) strains were associated with higher prevalence of peptic ulcer and gastric carcinoma than vacA s2-m2 and cagA(-) ones. In conclusion, cagA and vacA genotyping may have clinical relevance in Brazil.


Assuntos
Antígenos de Bactérias , Proteínas de Bactérias/genética , Úlcera Duodenal/microbiologia , Gastrite/microbiologia , Infecções por Helicobacter/microbiologia , Helicobacter pylori/classificação , Neoplasias Gástricas/microbiologia , Adolescente , Adulto , Idoso , Técnicas de Tipagem Bacteriana , Brasil/epidemiologia , Úlcera Duodenal/epidemiologia , Feminino , Gastrite/epidemiologia , Genótipo , Infecções por Helicobacter/epidemiologia , Helicobacter pylori/genética , Helicobacter pylori/isolamento & purificação , Humanos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Neoplasias Gástricas/epidemiologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA