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1.
Int J Mol Sci ; 25(15)2024 Jul 30.
Artículo en Inglés | MEDLINE | ID: mdl-39125864

RESUMEN

The potential role of the transient receptor potential Vanilloid 1 (TRPV1) non-selective cation channel in gastric carcinogenesis remains unclear. The main objective of this study was to evaluate TRPV1 expression in gastric cancer (GC) and precursor lesions compared with controls. Patient inclusion was based on a retrospective review of pathology records. Patients were subdivided into five groups: Helicobacter pylori (H. pylori)-associated gastritis with gastric intestinal metaplasia (GIM) (n = 12), chronic atrophic gastritis (CAG) with GIM (n = 13), H. pylori-associated gastritis without GIM (n = 19), GC (n = 6) and controls (n = 5). TRPV1 expression was determined with immunohistochemistry and was significantly higher in patients with H. pylori-associated gastritis compared with controls (p = 0.002). TRPV1 expression was even higher in the presence of GIM compared with patients without GIM and controls (p < 0.001). There was a complete loss of TRPV1 expression in patients with GC. TRPV1 expression seems to contribute to gastric-mucosal inflammation and precursors of GC, which significantly increases in cancer precursor lesions but is completely lost in GC. These findings suggest TRPV1 expression to be a potential marker for precancerous conditions and a target for individualized treatment. Longitudinal studies are necessary to further address the role of TRPV1 in gastric carcinogenesis.


Asunto(s)
Infecciones por Helicobacter , Neoplasias Gástricas , Canales Catiónicos TRPV , Humanos , Canales Catiónicos TRPV/metabolismo , Canales Catiónicos TRPV/genética , Neoplasias Gástricas/metabolismo , Neoplasias Gástricas/patología , Masculino , Femenino , Persona de Mediana Edad , Anciano , Infecciones por Helicobacter/metabolismo , Infecciones por Helicobacter/complicaciones , Infecciones por Helicobacter/patología , Carcinogénesis/metabolismo , Carcinogénesis/patología , Estudios Retrospectivos , Lesiones Precancerosas/metabolismo , Lesiones Precancerosas/patología , Helicobacter pylori/patogenicidad , Metaplasia/metabolismo , Metaplasia/patología , Gastritis/metabolismo , Gastritis/patología , Gastritis/microbiología , Adulto , Inmunohistoquímica , Mucosa Gástrica/metabolismo , Mucosa Gástrica/patología , Gastritis Atrófica/metabolismo , Gastritis Atrófica/patología
2.
BMC Gastroenterol ; 24(1): 251, 2024 Aug 07.
Artículo en Inglés | MEDLINE | ID: mdl-39112943

RESUMEN

BACKGROUND: Helicobacter pylori infection is one of the most common chronic bacterial infections, especially in developing countries. MicroRNA-148a is involved in the regulation of various genes, including Rock1, which is altered in gastric cancer. Decreased expression of mir-148a leads to tumor metastasis and increased Rock1 gene expression in gastric cancer. This study aimed to investigate the expression of these genes in biopsies collected from patients with H. pylori induced gastritis. METHODS: Informed consent forms were gotten from the studied patients with gastritis who needed endoscopy. Gastric biopsies were taken by a gastroenterologist from patients with inflammation. Rapid urease test, stool antigen detection, and histopathological staining were used to determine the H. pylori infected patients. Real time PCR was used to evaluate the miRNA and Rock1 expression levels. RESULTS: The Rock1 expression level in biopsies that were positive for H. pylori was significantly increased compared to our control gastritis group that were H. pylori-negative, but the results were not statistically significant. Moreover, the mir-148a expression level in H. pylori-positive patients with gastritis was increased compared to our control group. However, the results were not statistically significant. We did not find a significant relation between the expression levels of Rock1 and mir-148a in samples with gastritis infected or uninfected by H. pylori. This result may be due to the small sample size. CONCLUSION: We suggest that this test should be carried out with more samples, and the comparison should be done between biopsies with inflammation and no inflammation in a patient.


Asunto(s)
Gastritis , Infecciones por Helicobacter , Helicobacter pylori , MicroARNs , Quinasas Asociadas a rho , Humanos , Gastritis/microbiología , Gastritis/patología , Gastritis/metabolismo , MicroARNs/metabolismo , MicroARNs/genética , Infecciones por Helicobacter/patología , Quinasas Asociadas a rho/metabolismo , Quinasas Asociadas a rho/genética , Helicobacter pylori/aislamiento & purificación , Biopsia , Masculino , Femenino , Persona de Mediana Edad , Adulto , Mucosa Gástrica/patología , Mucosa Gástrica/microbiología , Anciano
3.
Xi Bao Yu Fen Zi Mian Yi Xue Za Zhi ; 40(6): 520-526, 2024 Jun.
Artículo en Chino | MEDLINE | ID: mdl-38952091

RESUMEN

Objective To investigate whether vitamin D3 (VD3) can alleviate Helicobacter pylori (Hp) infection by reducing blood lipids and inhibiting the Janus kinase/signal transducer and activator of transcription 3 (JAK/STAT3) signaling pathway. Methods High-cholesterol mouse model and Hp infected mouse model were established. Each was treated with VD3 via oral administration for 8 weeks. Real-time quantitative PCR was used to detect the expression of vitamin D receptor (VDR), insulin-induced gene 2 (Insig-2), and gastrin mRNA. Western blot analysis was used to examine the expression of JAK, STAT3, and cyclooxygenase-2 (COX2) proteins in gastric tissues. Biochemical analyses were performed to measure serum cholesterol levels, and ELISA was utilized to evaluate serum gastrin, interleukin 6 (IL-6), and IL-8 levels, along with histopathological examination of liver and gastric tissues using HE staining. Results After oral administration of VD3, the levels of VDR and Insig-2 in mouse liver tissue significantly increased in the high cholesterol group and the high cholesterol combined with Hp infection group. And the expression of serum gastrin decreased. The expression of JAK, STAT3 in gastric tissues reduced, as did the expression of COX2. Serum cholesterol levels decreased, with no significant changes in IL-6 levels, but a reduction in IL-8 levels. Compared to the control group, the high cholesterol combined with Hp infection group showed reduced hepatic ballooning degeneration and alleviated gastric tissue inflammation. In addition, inflammation in gastric tissue was also reduced in the cholesterol group and the Hp infection group. Conclusion VD3 alleviates gastritis by enhancing the activity of VDR in liver tissues, blocking the JAK/STAT3 signaling pathway, and inhibiting the expression of inflammatory factors.


Asunto(s)
Colecalciferol , Gastritis , Infecciones por Helicobacter , Helicobacter pylori , Hipercolesterolemia , Quinasas Janus , Hígado , Receptores de Calcitriol , Factor de Transcripción STAT3 , Transducción de Señal , Animales , Infecciones por Helicobacter/tratamiento farmacológico , Infecciones por Helicobacter/metabolismo , Factor de Transcripción STAT3/metabolismo , Colecalciferol/farmacología , Colecalciferol/administración & dosificación , Receptores de Calcitriol/metabolismo , Receptores de Calcitriol/genética , Transducción de Señal/efectos de los fármacos , Hígado/metabolismo , Hígado/efectos de los fármacos , Hígado/patología , Ratones , Quinasas Janus/metabolismo , Gastritis/tratamiento farmacológico , Gastritis/metabolismo , Gastritis/microbiología , Masculino , Hipercolesterolemia/metabolismo , Hipercolesterolemia/tratamiento farmacológico
4.
Sci Rep ; 14(1): 17574, 2024 07 30.
Artículo en Inglés | MEDLINE | ID: mdl-39079952

RESUMEN

The changes in tongue coating metabolites in patients with chronic gastritis (CG) under different gastroscopy indicators were analyzed, and these metabolites were screened for potential non-invasive biomarkers to assist in the diagnosis of chronic gastritis. The technology of gas chromatography and liquid chromatography combined with mass spectrometry has been used to more comprehensively detect tongue coating metabolites of 350 CG patients. Spearman correlation analysis and random forest algorithm were used to screen metabolites that can serve as potential biomarkers. Compared with healthy individuals, CG group showed significant changes in the content of 101 metabolites, with an increase in the content of 54 metabolites and a decrease in the content of 47 metabolites. These differential metabolites are mainly composed of 47 lipids and lipid like substances. 1 metabolite was associated with bile reflux, 1 metabolite was associated with gastric mucosal erosion, 10 metabolites were associated with atrophy, 10 metabolites were associated with intestinal metaplasia, and 3 metabolites were associated with Helicobacter pylori infection. The ROC model composed of 5 metabolites can distinguish between CG group and healthy individuals, with an accuracy of 95.4%. The ROC model composed of 5,6-Dihydroxyindole can distinguish between chronic superficial gastritis group and chronic atrophic gastritis group, with an accuracy of 75.3%. The lipids and lipid like metabolites were the main abnormal metabolites in patients with chronic gastritis. It was worth noting that the content of Sphinganine 1-phase, 4-Ipomenol, and Nervonic acid in tongue coating increased, and the content of 1-Methyladenosine and 3-Hydroxycapric acid decreased, which helped to identify CG patients. The decrease in the content of 5,6-dihydroxyindole reminded patients that the development trend of CG was shifting from superficial to atrophic or even intestinal metaplasia. The detection of these metabolic markers of tongue coating was expected to be developed as a non-invasive and convenient technology in the future to assist us in monitoring and diagnosing the occurrence and development of CG.


Asunto(s)
Biomarcadores , Gastritis , Lípidos , Lengua , Humanos , Gastritis/metabolismo , Gastritis/diagnóstico , Gastritis/microbiología , Biomarcadores/metabolismo , Biomarcadores/análisis , Masculino , Femenino , Lengua/metabolismo , Lengua/patología , Persona de Mediana Edad , Adulto , Lípidos/análisis , Enfermedad Crónica , Anciano , Infecciones por Helicobacter/metabolismo , Infecciones por Helicobacter/diagnóstico
5.
Food Funct ; 15(13): 7136-7147, 2024 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-38887927

RESUMEN

Zinc (Zn) is an important trace element; it is involved in the regulation and maintenance of many physiological functions in organisms and has anti-inflammatory and antioxidant properties. Chronic gastritis is closely associated with damage to the gastric mucosa, which is detrimental to the health of humans and animals. There are few studies on the effects of zinc on, for example, gastric mucosal damage, oxidative stress, inflammation and cell death in mice. Therefore, we established in vivo and in vitro models of inflammatory injury and investigated the effects of zinc supplementation in C57BL/6 mice and Ges-1 cells and examined the expression of factors associated with oxidative stress, inflammation and cell death. In this study, the results of in vivo and in vitro experiments showed that reactive oxygen species (ROS) levels increased after sodium salicylate exposure. Malondialdehyde levels increased, the activity of the antioxidant enzymes catalase and superoxide dismutase decreased, and the activity of glutathione decreased. The NF-κB signaling pathway was activated, the levels of proinflammatory factors (TNF-α, IL-1ß, and IL-6) increased, and the expression of cell death-related factors (Bax, Bcl-2, Caspase3, Caspase7, Caspase9, RIP1, RIP3, and MLKL) increased. Zinc supplementation attenuated the level of oxidative stress and reduced the level of inflammation and cell death. Our study indicated that sodium salicylate induced the production of large amounts of reactive oxygen species and activated the NF-κB pathway, leading to inflammatory damage and cell death in the mouse stomach. Zinc supplementation modulated the ROS/NF-κB pathway, reduced the level of oxidative stress, and attenuated inflammation and cell death in the mouse stomach and Ges-1 cells.


Asunto(s)
Suplementos Dietéticos , Gastritis , Estrés Oxidativo , Especies Reactivas de Oxígeno , Transducción de Señal , Zinc , Animales , Humanos , Masculino , Ratones , Antioxidantes/farmacología , Línea Celular , Modelos Animales de Enfermedad , Mucosa Gástrica/metabolismo , Mucosa Gástrica/efectos de los fármacos , Gastritis/metabolismo , Gastritis/tratamiento farmacológico , Ratones Endogámicos C57BL , FN-kappa B/metabolismo , FN-kappa B/genética , Estrés Oxidativo/efectos de los fármacos , Especies Reactivas de Oxígeno/metabolismo , Transducción de Señal/efectos de los fármacos , Zinc/farmacología
6.
Asian J Endosc Surg ; 17(3): e13324, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38804100

RESUMEN

BACKGROUND: One anastomosis gastric bypass (OAGB) is now the third most common bariatric surgery worldwide. This procedure is garnering increasing attention, but its complication of bile reflux and the associated risk of gastric carcinogenesis remains controversial. OBJECTIVE: The study aims to assess the impact of bile reflux on the gastric mucosa by comparing pathological and immunohistochemical results of gastric mucosa before and 2 years after OAGB surgery. METHODS: This retrospective study analyzed gastric lesions observed in gastroscopy before and after OAGB surgery. Pathological examinations were conducted on mucosal samples from proximal, middle and distal part of stomach, with a particular focus on the expression of Ki-67, P53, and CDX2 in immunohistochemistry. Ki-67 indicates cellular proliferation, P53 is a tumor suppressor protein, and CDX2 is a marker for intestinal differentiation. RESULTS: A total of 16 patients completed the follow-up. Regarding gastritis, presurgery nonerosive gastritis was found in two cases (12.5%), and postsurgery in six cases (37.5%). Erosive gastritis increased from one case (6.2%) presurgery to three cases (18.7%) postsurgery, totaling an increase from three to nine cases (p = .028). Bile reflux in the stomach increased from one case (6.2%) presurgery to three cases (18.7%) postsurgery. Most lesions in the proximal, middle, and distal part of stomach were relatively mild, with normal tissue states being predominant. Mild inflammation was found in all three areas, whereas moderate inflammation, intestinal metaplasia, and glandular atrophy were less common. No cases of severe inflammation were noted. The expression of gastric biomarkers CDX-2, Ki67, and P53 showed no significant statistical variation in different areas. CONCLUSION: Bile reflux does occur after OAGB, but its incidence is not high. Based on the immunohistochemical and pathological results of the gastric mucosa 2 years post-OAGB, there seems to be no significant causal relationship between OAGB and oncogenic inflammation around the gastric tube.


Asunto(s)
Derivación Gástrica , Mucosa Gástrica , Inmunohistoquímica , Humanos , Estudios Retrospectivos , Mucosa Gástrica/patología , Mucosa Gástrica/metabolismo , Mucosa Gástrica/cirugía , Femenino , Masculino , Derivación Gástrica/efectos adversos , Persona de Mediana Edad , Adulto , Reflujo Biliar/metabolismo , Reflujo Biliar/patología , Reflujo Biliar/etiología , Factor de Transcripción CDX2/metabolismo , Antígeno Ki-67/metabolismo , Antígeno Ki-67/análisis , Proteína p53 Supresora de Tumor/metabolismo , Gastritis/patología , Gastritis/metabolismo , Gastritis/etiología , Complicaciones Posoperatorias/metabolismo , Complicaciones Posoperatorias/patología , Complicaciones Posoperatorias/etiología , Gastroscopía , Anciano
7.
Front Immunol ; 15: 1282680, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38318189

RESUMEN

Background: Helicobacter pylori (H. pylori) uses various strategies that attenuate mucosal immunity to ensure its persistence in the stomach. We recently found evidence that H. pylori might modulate the natural killer group 2, member 2 (NKG2D) system. The NKG2D receptor and its ligands are a major activation system of natural killer and cytotoxic T cells, which are important for mucosal immunity and tumor immunosurveillance. The NKG2D system allows recognition and elimination of infected and transformed cells, however viruses and cancers often subvert its activation. Here we aimed to identify a potential evasion of the NKG2D system in H. pylori infection. Methods: We analyzed expression of NKG2D system genes in gastric tissues of H. pylori gastritis and gastric cancer patients, and performed cell-culture based infection experiments using H. pylori isogenic mutants and epithelial and NK cell lines. Results: In biopsies of H. pylori gastritis patients, NKG2D receptor expression was reduced while NKG2D ligands accumulated in the lamina propria, suggesting NKG2D evasion. In vitro, H. pylori induced the transcription and proteolytic shedding of NKG2D ligands in stomach epithelial cells, and these effects were associated with specific H. pylori virulence factors. The H. pylori-driven release of soluble NKG2D ligands reduced the immunogenic visibility of infected cells and attenuated the cytotoxic activity of effector immune cells, specifically the anti-tumor activity of NK cells. Conclusion: H. pylori manipulates the NKG2D system. This so far unrecognized strategy of immune evasion by H. pylori could potentially facilitate chronic bacterial persistence and might also promote stomach cancer development by allowing transformed cells to escape immune recognition and grow unimpeded to overt malignancy.


Asunto(s)
Gastritis , Infecciones por Helicobacter , Helicobacter pylori , Neoplasias Gástricas , Humanos , Subfamilia K de Receptores Similares a Lectina de Células NK/metabolismo , Evasión Inmune , Infecciones por Helicobacter/metabolismo , Células Asesinas Naturales , Neoplasias Gástricas/patología , Gastritis/metabolismo , Péptido Hidrolasas/metabolismo
8.
Eur J Immunol ; 54(3): e2350662, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38366919

RESUMEN

Helicobacter pylori is one of the main predisposing factors for gastric cancer, causing chronic inflammation and proper glands atrophy in the gastric mucosa. Although H. pylori-induced inflammation is a key inducer of precancerous lesions in the gastric mucosa, it remains unclear which precise immune cell subsets are responsible for the progression of H. pylori-induced gastritis. Here, we observed an abundance of CD4+ IL-17A+ FOXP3+ T cells exhibiting a Th17-like phenotype within the microenvironment of H. pylori-induced gastritis. Mechanistically, H. pylori upregulated the expression of IL-6 in Dendritic cells and macrophages, by activating NF-κB signaling through the virulence factor CagA and thus, induced IL-17A expression in FOXP3+ T cells. Moreover, CD4+ IL-17A+ FOXP3+ T cells were positively associated with advanced precancerous lesions. Therefore, these findings offer essential insights into how FOXP3+ T cells sense inflammatory signals from the environment, such as IL-6, during H. pylori infections, thereby guiding the effector immune response and aggravating the gastritis.


Asunto(s)
Gastritis , Infecciones por Helicobacter , Helicobacter pylori , Lesiones Precancerosas , Humanos , Interleucina-17/metabolismo , Interleucina-6 , Gastritis/metabolismo , Gastritis/patología , Inflamación , Linfocitos T Reguladores , Factores de Transcripción Forkhead/metabolismo , Microambiente Tumoral
9.
West Indian med. j ; 61(7): 659-664, Oct. 2012. ilus, tab
Artículo en Inglés | LILACS | ID: lil-672981

RESUMEN

OBJECTIVE: Recently, hepatocyte antigen (Hep) was introduced as a sensitive and reliable marker of intestinal metaplasia (IM). However, the distribution of Hep expression in subtypes of IM was not described. METHODS: We examined the expression of Hep in 58 cases of chronic gastritis associated with IM by immunohistochemical staining. Cases were classified as: 19 of IM Type I (complete) cases, 16 cases of IM Type II (incomplete) and 23 cases of IM Type III (incomplete). The distribution of Hep expression was classified into four groups according to the intensity of Hep expressing metaplastic cells: negative, low, moderate and high. We also compared expression of Hep with that of MUC-1, MUC-2 and MUC-5AC. RESULTS: Hep expression showed granular cytoplasmic staining and was specifically identified in columnar cells, but not in goblet cells. There was no significant difference between Hep expression and subtypes of IM (p > 0.005). However, the difference between the distribution of Hep expression among three subtypes of IM was significant (p < 0.001). No relationship was observed among the expression of Hep, MUC-1, MUC-2 and MUC-5AC. CONCLUSION: Results of the present study revealed that the distribution of Hep expression is high in the majority of the complete type (Type I) IM cases, moderate in the majority of the incomplete Type II IM cases and low in all of the incomplete Type III IM cases and suggest that besides its role as a sensitive marker in IM, the evaluation of the distribution of Hep expression might be useful in the classification of IM.


OBJETIVO: El antígeno del hepatocito (Hep) se introdujo recientemente como un marcador sensible y confiable de la metaplasia intestinal (MI). Sin embargo, no se describe la distribución de la expresión de Hep en los subtipos de MI. MÉTODOS: Se examinó la expresión de Hep en 58 casos de gastritis crónica asociados con MI mediante tinción inmunohistoquímica. Los casos fueron clasificados como: 19 casos de tipo MI (completo), 16 casos de tipo MI II (incompleto), y 23 casos de tipo MI III (incompleto). La distribución de la expresión del Hep se clasificó en cuatro grupos según la intensidad de Hep, que expresa las células metaplásticas: negativa, baja, moderada y alta. También se comparó la expresión de Hep con la de MUC-1, MUC-2 y MUC-5AC. RESULTADOS: La expresión de Hep mostró tinción citoplasmática granular, específicamente identificada en las células columnares, pero no en las células caliciformes. No hubo ninguna diferencia significativa entre la expresión de Hep y los subtipos de MI (p > 0.005). Sin embargo, la diferencia entre la distribución de la expresión del Hep entre tres subtipos de MI fue significativa (p < 0.001). No se observó relación alguna entre la expresión de Hep, MUC-1, MUC-2 y MUC-5AC. CONCLUSIÓN: Los resultados del presente estudio revelaron que la distribución de la expresión de Hep es alta en la mayoría de los casos MI de tipo completo (tipo I), moderada en la mayoría de los casos MI de tipo II, y baja en todos los casos MI de tipo III incompleto. Los resultados sugieren que además de su papel como marcador sensible en MI, la evaluación de la distribución de expresión del Hep podría ser útil en la clasificación de MI.


Asunto(s)
Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adenocarcinoma/metabolismo , Gastritis/metabolismo , Hepatocitos/inmunología , Lesiones Precancerosas/metabolismo , Neoplasias Gástricas/metabolismo , Adenocarcinoma/clasificación , Adenocarcinoma/patología , Mucosa Gástrica/inmunología , Mucosa Gástrica/patología , Gastritis/patología , Inmunohistoquímica , Metaplasia/inmunología , /metabolismo , Mucina-1/metabolismo , /metabolismo , Lesiones Precancerosas/inmunología , Lesiones Precancerosas/patología , Neoplasias Gástricas/inmunología , Neoplasias Gástricas/patología , Biomarcadores de Tumor/metabolismo
10.
Rev. Col. Bras. Cir ; 19(2): 67-72, mar.-abr. 1992. tab, ilus
Artículo en Portugués | LILACS | ID: lil-116545

RESUMEN

Os autores realizaram estudo experimental em caes em que a mucosa gastrica foi exposta a acao da bile e do acido cloridrico. Atraves de colecistogastrostomia, apos ligaduras do coledoco, direcionaram a bile para o antro gastrico em 20 animais e para o corpo em outros 20. Em 10 caes de cada grupo realizaram vagotomia troncular bilateral.Sacrificaram os animais 180 dias de pos-operatorio. Concluiram que a gastrite ocorreu com mais frequencia e intensidade nos animais com anastomose a nivel do antro do que naqueles com anastomose no corpo do estomago. Concluiram ainda que a vagotomia protegeu a mucosa gastrica contra o efeito lesivo da bile


Asunto(s)
Animales , Perros , Gastritis/metabolismo , Mucosa Gástrica/fisiopatología , Ácido Clorhídrico/metabolismo , Bilis/metabolismo , Colecistostomía , Gastrostomía , Vagotomía Troncal
11.
Diagnóstico (Perú) ; 23(1/3): 37-40, ene.-mar. 1989. tab, ilus
Artículo en Español | LILACS, LIPECS | ID: lil-83002

RESUMEN

Existen diversas técnicas histoquímicas para identificar el Campylobacter pilórico en el tejido, siendo la coloración de Warthin Starry la más conocida y usada. Con la finalidad de buscar otra coloración con igual eficacia que la mencionada, utilizamos la coloración de Waysson con una técnica sensilla y de bajo costo, que se basa en la reacción química específica de los colorantes. De los especímenes biópsicos conocidos con diagnóstico positivo a Cambylobacter pilórico (75), se realizaron nuevos cortes para ser colorados con ambas técnicas, (Warthin Starry y Waysson) en cada caso. Se demuestra que ambas coloraciones identifican adecuadamente a la bacteria en el tejido, y que la coloración de Waysson) en cada caso. Se demuestra que ambas coloraciones identifican adecuadamente a la bacteria en el tejido, y que la coloración de Waysson es más fácil de procesar, usa menos tiempo y es menos costosa


Asunto(s)
Campylobacter/citología , Gastritis/metabolismo , Técnicas In Vitro , Úlcera Gástrica/metabolismo
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