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1.
BMC Infect Dis ; 20(1): 725, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33008316

RESUMO

BACKGROUND: Commencing lifelong antiretroviral therapy (ART) immediately following HIV diagnosis (Option B+), has greatly improved maternal-infant health. Thus, large and increasing numbers of HIV-infected women are on ART during pregnancy, a situation concurrently increasing numbers of HIV-exposed-uninfected (HEU) infants. Compared to their HIV-unexposed-uninfected (HUU) counterparts, HEU infants show higher rates of adverse birth outcomes, mortality, infectious/non-communicable diseases including impaired growth and neurocognitive development. There is an urgent need to understand the impact of HIV and early life ART exposures, immune-metabolic dysregulation, comorbidities and environmental confounders on adverse paediatric outcomes. METHODS: Six hundred (600) HIV-infected and 600 HIV-uninfected pregnant women ≥20 weeks of gestation will be enrolled from four primary health centres in high density residential areas of Harare. Participants will be followed up as mother-infant-pairs at delivery, week(s) 1, 6, 10, 14, 24, 36, 48, 72 and 96 after birth. Clinical, socio-economic, nutritional and environmental data will be assessed for adverse birth outcomes, impaired growth, immune/neurodevelopment, vertical transmission of HIV, hepatitis-B/C viruses, cytomegalovirus and syphilis. Maternal urine, stool, plasma, cord blood, amniotic fluid, placenta and milk including infant plasma, dried blood spot and stool will be collected at enrolment and follow-up visits. The composite primary endpoint is stillbirth and infant mortality within the first two years of life in HEU versus HUU infants. Maternal mortality in HIV-infected versus -uninfected women is another primary outcome. Secondary endpoints include a range of maternal and infant outcomes. Sub-studies will address maternal stress and malnutrition, maternal-infant latent tuberculosis, Helicobacter pylori infections, immune-metabolomic dysregulation including gut, breast milk and amniotic fluid dysbiosis. DISCUSSION: The University of Zimbabwe-College of Health-Sciences-Birth-Cohort study will provide a comprehensive assessment of risk factors and biomarkers for HEU infants' adverse outcomes. This will ultimately help developing strategies to mitigate effects of maternal HIV, early-life ART exposures and comorbidities on infants' mortality and morbidity. TRIAL REGISTRATION: ClinicalTrial.gov Identifier: NCT04087239 . Registered 12 September 2019.


Assuntos
Transmissão Vertical de Doença Infecciosa , Estudos de Coortes , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por Helicobacter/complicações , Helicobacter pylori , Hepatite B/complicações , Humanos , Lactente , Mortalidade Infantil , Leite Humano , Morbidade , Parto , Gravidez , Complicações Infecciosas na Gravidez/virologia , Fatores de Risco , Natimorto , Sífilis/complicações , Universidades , Zimbábue
2.
Medicine (Baltimore) ; 99(37): e21832, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32925719

RESUMO

BACKGROUND: The existing evidence on the relationship between Helicobacter pylori infection and the risk of colorectal cancer is inconsistent. We conducted a systematic review with a meta-analysis to explore this relationship and to determine whether the relationship varies according to the study characteristics. METHODS: We searched the PubMed, OVID, EMBASE database, and the reference lists of pertinent articles published up to October 2019 by 2 researchers independently. Summary odds ratios (OR) with their 95% confidence intervals (CIs) were estimated using a random-effects model. RESULTS: Forty seven studies including 17,416 cases of colorectal cancer (CRC) and 55,811 cases of control were included. Overall, H. pylori infection was associated with an increased risk of CRC (OR = 1.70 95% CI 1.64-1.76, I = 97%), although there was significant heterogeneity among the studies. Subgroup analysis revealed that the positive correlation might vary by the design of study conducted. CONCLUSION: This meta-analysis demonstrates a positive association between H. pylori infection and the risk of colorectal cancer.


Assuntos
Neoplasias Colorretais/microbiologia , Infecções por Helicobacter/complicações , Helicobacter pylori , Adulto , Idoso , Feminino , Infecções por Helicobacter/microbiologia , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Fatores de Risco
3.
PLoS One ; 15(6): e0234433, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32511269

RESUMO

BACKGROUND: Several previous studies have suggested that Helicobacter pylori (H. pylori) infection affects the serum lipid profile. However, it remains controversial and the mechanism has not been elucidated. The purpose of this study is to use an epidemiological perspective to evaluate the association between H. pylori infection and the serum lipid profile. METHODS: Multivariate analysis was performed using the data of serum lipid profile, infection status of H. pylori, fitness/lifestyle habits, and various subjects' characteristics which were derived from the 15,679 generally healthy individuals in Japan. The average treatment effects (ATEs) of H. pylori infection on the serum lipid profile were estimated using augmented inverse probability weighting (AIPW). A meta-analysis was also performed using the 27 studies worldwide in which the status of H. pylori infection and at least one serum examination value (high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), or triglyceride (TG)) were described. RESULTS: The ATEs determined with AIPW showed that H. pylori infection has significant positive effects on LDL-C and TC (ATE (95% confidence interval [95%CI]) = 3.4 (2.36-4.49) and 1.7 (0.58-2.88), respectively) but has significant negative effects on HDL-C and TG (ATE (95%CI) = -1.2 (-1.74 to -0.72) and -3.5 (-5.92 to -1.06), respectively). The meta-analysis to estimate the association between H. pylori infection and the serum lipid profile revealed that H. pylori infection is positively associated with LDL-C, TC, and TG (standardized mean difference [SMD] (95%CI) = 0.11 (0.09-0.12), 0.09 (0.07-0.10) and 0.06 (0.05-0.08), respectively) and negatively associated with HDL-C (SMD = -0.13 (-0.14 to -0.12)). CONCLUSION: Both our multivariate analyses and meta-analysis showed that H. pylori infection significantly affects the serum lipid profile, which might lead to various dyslipidemia-induced severe diseases like coronary thrombosis or cerebral infarction.


Assuntos
Dislipidemias/epidemiologia , Infecções por Helicobacter/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Dislipidemias/sangue , Dislipidemias/diagnóstico , Dislipidemias/etiologia , Feminino , Infecções por Helicobacter/sangue , Infecções por Helicobacter/diagnóstico , Infecções por Helicobacter/microbiologia , Helicobacter pylori/isolamento & purificação , Humanos , Japão/epidemiologia , Masculino , Metanálise como Assunto , Pessoa de Meia-Idade , Pontuação de Propensão , Fatores de Risco , Triglicerídeos/sangue , Adulto Jovem
4.
Medicine (Baltimore) ; 99(24): e20632, 2020 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-32541501

RESUMO

BACKGROUND: In the current literature, studies assessing the role of Helicobacter pylori (HP) infection in psoriasis have reported conflicting data. Therefore, we investigated the association between HP infection and psoriasis using a nationwide population-based longitudinal cohort study. METHODS: We identified 41,539 patients with HP infection and 83,078 matched controls between 2000 and 2013 from the Longitudinal Health Insurance Research Database of the National Health Insurance Research Database in Taiwan. Propensity score analysis was used to match age, sex, comorbidities, and medical visits at a ratio of 1:2. Multiple Cox regression analysis was used to estimate the adjusted hazard ratio of psoriasis. Furthermore, sensitivity tests and a stratified analysis were conducted. RESULTS: The incidence rates of psoriasis did not differ significantly between the HP and control cohorts (4.58 vs 4.20 per 100,000 person-months, crude relative risk: 1.092, 95% confidence interval: 0.917-1.302). After multivariate adjustment, no significant difference in psoriasis risk was observed in patients with HP infection (adjusted hazard ratio: 1.081, 95% confidence interval: 0.907-1.288). Risk of psoriasis was significantly higher in men and the elderly, and in those with diabetes, hyperlipidemia, chronic obstructive pulmonary disease, or tuberculosis. Stratified analysis also confirmed that HP infection was not correlated with an increased risk of psoriasis based on follow-up duration, sex, and age. CONCLUSION: This retrospective population-based longitudinal cohort study, conducted in Taiwan, found no association between HP infection and risk of psoriasis. Further research may be warranted.


Assuntos
Infecções por Helicobacter/complicações , Helicobacter pylori , Psoríase/complicações , Adulto , Idoso , Estudos de Coortes , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Psoríase/epidemiologia , Medição de Risco , Taiwan/epidemiologia
5.
APMIS ; 128(2): 150-161, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32352605

RESUMO

Infection with Helicobacter pylori is associated with the development of gastric cancer. Although the prevalence of gastric cancer has declined throughout years due to improvement in early screening strategy, mortality due to gastric cancer has not changed. Incidence and mortality due to gastric cancer are higher in developing countries as compared to developed countries. Diagnosis and prognosis of gastric cancer are still poor with patients usually diagnosed with cancer at an advanced stage. Eradication of H. pylori is pertinent for the prevention of gastric cancer. However, the rise in antimicrobial resistance among H. pylori isolates has complicated the prevention strategy. H. pylori express multiple virulence factors for survival in the hostile acid gastric environment. The expression of oncogenic protein cytotoxin-associated gene A (CagA), vacuolating cytotoxin A (VacA), and outer inflammatory protein is essential for H. pylori to exert pathogenesis towards the host. Interestingly, <3% of H. pylori-infected subjects develop gastric cancer, suggesting a unique way of interaction between the host's immune response and H. pylori virulence factors. This article is aimed to review the epidemiology and role of H. pylori in gastric carcinogenesis. A better understanding of the interaction between H. pylori virulence factors and host is required for better gastric cancer prevention.


Assuntos
Infecções por Helicobacter/complicações , Infecções por Helicobacter/imunologia , Helicobacter pylori/imunologia , Neoplasias Gástricas/etiologia , Neoplasias Gástricas/imunologia , Fatores de Virulência/imunologia , Virulência/imunologia , Carcinogênese/imunologia , Humanos , Prognóstico , Neoplasias Gástricas/microbiologia
6.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 32(2): 148-153, 2020 Apr 08.
Artigo em Chinês | MEDLINE | ID: mdl-32458603

RESUMO

OBJECTIVE: To examine the effect of schistosomiasis on the development of gastric cancer and colorectal cancer. METHODS: The clinical data of patients with gastric cancer and colorectal cancer with and without schistosomiasis japonica that were admitted to the Yijishan Hospital Affiliated to Wannan Medical College from January 2014 to December 2018 were collected. All cases were divided into schistosomal gastric cancer group and non - schistosomal gastric cancer group, schistosomal colorectal cancer group and non-schistosomal colorectal cancer group. The risk factors of gastric cancer and colorectal cancer were identified using univariate analysis and multivariate logistic regression analysis, and the effects of schistosomiasis on the development and progression of gastric cancer and colorectal cancer were evaluated. In addition, the survival of 32 patients with schistosomal colorectal cancer and 68 cases with non-schistosomal colorectal were estimated using telephone follow-up, and compared. RESULTS: There were 113 patients with schistosomal gastric cancer and 3 741 cases with non-schistosomal gastric cancer enrolled in this study, and there were significant differences between them in terms of sex ratio, age and prevalence of Helico-bacter pylori infection (all P values < 0.05). Logistic regression analysis revealed that age, H. pylori infection, and schistosomiasis were independent risk factors for gastric cancer (all P values < 0.05). There were 184 patients with schistosomal colorectal cancer and 2 205 cases with non-schistosomal colorectal cancer recruited in this study, and there were significant differences between them in terms of age, sex ratio, rate of history of alcohol consumption and rate of positive fecal occult blood test (all P values < 0.05). The phenotypes of both schistosomal and non-schistosomal colorectal cancer were predominantly ulcerative; however, the proportion of patients with invasive and protruded colorectal cancer was significantly greater than that of patients with non-schistosomal colorectal cancer (P = 0.003). Logistic regression analysis revealed that age (P = 0.003), gender (P = 0.002), phenotype (P = 0.005) and schistosomiasis (P = 0.029) were independent risk factors for colorectal cancer. The 5-year survival rate was significantly higher in patients with schistosomal colorectal cancer (68.90%) than in those with non-schistosomal colorectal cancer (46.40%), and the dead patients with schistosomal colorectal cancer had a significantly greater mean age than those with non-schistosomal colorectal cancer [ (66.33 ± 3.08) years vs. (56.29 ± 1.94), P < 0.05]. CONCLUSIONS: Schistosomiasis may alter the pathogenesis of colorectal cancer, resulting in the differences in the epidemiology, clinical characteristics and 5-year survival rate between patients with schistosomal and non-schistosomal colorectal cancer. Periodical gastrointestinal endoscopy and other examinations are recommended to exclude the likelihood of gastrointestinal cancers in men with anemia of unknown causes and at ages of 60 years living in schistosomiasis-endemic areas.


Assuntos
Neoplasias Colorretais , Esquistossomose Japônica , Neoplasias Gástricas , Idoso , China/epidemiologia , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/etiologia , Infecções por Helicobacter/complicações , Helicobacter pylori/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Esquistossomose Japônica/complicações , Esquistossomose Japônica/epidemiologia , Neoplasias Gástricas/epidemiologia , Neoplasias Gástricas/etiologia
7.
Dig Dis ; 38(4): 261-268, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32396919

RESUMO

AIM: Helicobacter pylori infection has been established as a definite risk factor for gastric cancer. However, the consequence of H. pylori eradication on the progression of gastroesophageal reflux disease (GERD) remains controversial. The purpose of our study was to investigate the relationship between H. pylori eradication and the development of GERD. METHODS: A comprehensive, English literature search was performed from January 1990 to April 2019. Only randomized controlled trials (RCT) that evaluated the effect of H. pylori eradication on GERD were included. Meta-analysis of pooled OR was performed using Review Manger 5.1.7. RESULTS: Seventeen articles with 6,889 subjects (intention-to-treat) that fulfilled the inclusion criteria were finally included in the analysis. Of them, 8 RCTs have the similar study design and inclusion criterion, which included patients with H. pylori infection but without GERD at baseline. The OR for the development of erosive GERD after H. pylori eradication was 1.67 (95% CI 1.12-2.48, p = 0.01). The OR for the development of GERD-related symptoms after H. pylori eradication in eradication group compared with control group was 1.04 (95% CI 0.84-1.29, p = 0.71). In addition, 9 RCTs included patients with both baseline H. pylori infection and GERD. The OR for the healing rates and relapse rates after H. pylori eradication in the H. pylori eradication group vs. control group was 0.92 (95% CI 0.47-1.82, p = 0.82) and 1.12 (95% CI 0.60-2.09, p = 0.71), respectively. CONCLUSIONS: Our meta-analyses showed H. pylori eradication may lead to the development of new erosive GERD. However, eradication of H. pylori may affect neither the healing rates nor relapse rates of preexisting GERD.


Assuntos
Refluxo Gastroesofágico/complicações , Infecções por Helicobacter/complicações , Ensaios Clínicos Controlados Aleatórios como Assunto , Estudos de Casos e Controles , Infecções por Helicobacter/microbiologia , Helicobacter pylori/efeitos dos fármacos , Humanos , Fatores de Risco
8.
Medicine (Baltimore) ; 99(17): e19839, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32332633

RESUMO

The present study was designed to investigate the expression of tumor-associated macrophages (TAMs) in gastric cancer and its clinicopathological relationship. In addition, we also aimed to analyze the relationship between helicobacter pylori (HP) infection and TAMs in gastric cancer.The protein expression of CD16 and CD163 in 90 gastric cancer tissues and 30 margin tissues was detected by immunohistochemistry. HP infection was detected in 90 gastric cancer tissues and 30 margin tissues by gram staining and immunohistochemistry.There was no clear correlation between CD16 macrophages and gastric cancer. The density of CD163 macrophages was not correlated with the general condition of tumor patients, but with tumor size, tumor differentiation, lymphatic metastasis, depth of invasion and TNM stage. Additionally, the infection rate of HP in gastric cancer tissues was significantly higher.In summary, TAMs are associated with tumor size, degree of differentiation, depth of invasion, lymph node metastasis and TNM stage, suggesting their critical role in the invasion and metastasis of gastric cancer.


Assuntos
Macrófagos/patologia , Neoplasias Gástricas/patologia , Antígenos CD/análise , Antígenos de Diferenciação Mielomonocítica/análise , Contagem de Células , Feminino , Proteínas Ligadas por GPI/análise , Mucosa Gástrica/patologia , Infecções por Helicobacter/complicações , Infecções por Helicobacter/patologia , Humanos , Imuno-Histoquímica , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Estadiamento de Neoplasias , Receptores de Superfície Celular/análise , Receptores de IgG/análise , Estudos Retrospectivos , Neoplasias Gástricas/complicações , Carga Tumoral
9.
Am J Trop Med Hyg ; 103(1): 260-265, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32314688

RESUMO

Infection by Helicobacter pylori is a major risk factor for gastric cancer (GC), the second leading cause of cancer-related death worldwide. Although biomarkers such as pepsinogens (PGs) and soluble urokinase plasminogen activator receptor (suPAR) may have diagnostic and/or prognostic value in patients with GC, their levels may be affected by H. pylori infection. The aim of this study was to investigate the association of the presence of antibodies to H. pylori and cytotoxin-associated gene A (CagA) with plasma levels of PGs and suPAR in a cohort of Guatemalan GC patients and controls. To this end, levels of suPAR, Pepsinogens I and II (PGI and PGII), and antibodies to H. pylori and CagA toxin were determined by ELISA in plasma samples from 67 GC patients and 136 matched healthy controls. Seropositivity for CagA was significantly higher in patients with GC than in controls. Pepsinogens II and suPAR levels were higher and PGI/PGII ratios were lower in GC patients than in controls. There was a significant association of H. pylori seropositivity status with increased levels of PGII and lower PGI/PGII ratios, particularly in the control (non-GC) population. The levels of suPAR were not significantly affected by H. pylori or CagA seropositivity status. These results suggest that the seropositivity status for H. pylori and CagA need to be taken into account during the GC diagnostic process.


Assuntos
Antígenos de Bactérias/imunologia , Proteínas de Bactérias/imunologia , Infecções por Helicobacter/epidemiologia , Helicobacter pylori/imunologia , Pepsinogênio A/sangue , Receptores de Ativador de Plasminogênio Tipo Uroquinase/sangue , Neoplasias Gástricas/microbiologia , Anticorpos Antibacterianos/sangue , Anticorpos Antibacterianos/imunologia , Estudos de Casos e Controles , Ensaio de Imunoadsorção Enzimática , Feminino , Guatemala/epidemiologia , Infecções por Helicobacter/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Soroepidemiológicos , Neoplasias Gástricas/sangue
10.
Nat Commun ; 11(1): 1802, 2020 04 14.
Artigo em Inglês | MEDLINE | ID: mdl-32286276

RESUMO

Inflammatory bowel disease patients have a greatly increased risk of developing colitis-associated colon cancer (CAC); however, the basis for inflammation-induced genetic damage requisite for neoplasia is unclear. Using three models of CAC, we find that sustained inflammation triggers 8-oxoguanine DNA lesions. Strikingly, antioxidants or iNOS inhibitors reduce 8-oxoguanine and polyps in CAC models. Because the mismatch repair (MMR) system repairs 8-oxoguanine and is frequently defective in colorectal cancer (CRC), we test whether 8-oxoguanine mediates oncogenesis in a Lynch syndrome (MMR-deficient) model. We show that microbiota generates an accumulation of 8-oxoguanine lesions in MMR-deficient colons. Accordingly, we find that 8-oxoguanine is elevated in neoplastic tissue of Lynch syndrome patients compared to matched untransformed tissue or non-Lynch syndrome neoplastic tissue. While antioxidants reduce 8-oxoguanine, they do not reduce CRC in Lynch syndrome models. Hence, microbe-induced oxidative/nitrosative DNA damage play causative roles in inflammatory CRC models, but not in Lynch syndrome models.


Assuntos
Colite/complicações , Colite/patologia , Neoplasias Colorretais/complicações , Neoplasias Colorretais/patologia , Dano ao DNA , Helicobacter pylori/fisiologia , Estresse Oxidativo , Polipose Adenomatosa do Colo/complicações , Polipose Adenomatosa do Colo/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Antioxidantes/farmacologia , Carcinogênese/efeitos dos fármacos , Carcinogênese/patologia , Colite/induzido quimicamente , Colite/microbiologia , Colo/efeitos dos fármacos , Colo/patologia , Neoplasias Colorretais/microbiologia , Neoplasias Colorretais Hereditárias sem Polipose/genética , Reparo do DNA/efeitos dos fármacos , Sulfato de Dextrana , Modelos Animais de Doenças , Disbiose/complicações , Disbiose/patologia , Escherichia coli/metabolismo , Feminino , Guanosina/análogos & derivados , Guanosina/metabolismo , Infecções por Helicobacter/complicações , Helicobacter pylori/efeitos dos fármacos , Humanos , Inflamação/complicações , Inflamação/patologia , Interleucina-10/deficiência , Interleucina-10/metabolismo , Masculino , Camundongos Endogâmicos C57BL , Pessoa de Meia-Idade , Mutação/genética , Estresse Oxidativo/efeitos dos fármacos
11.
PLoS One ; 15(3): e0230220, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32163505

RESUMO

Helicobacter pylori is a Gram-negative bacterium that causes chronic atrophic gastritis and peptic ulcers and it has been associated with the development of gastric adenocarcinoma and mucosa-associated lymphoid tissue (MALT). One of the more remarkable characteristics of H. pylori is its ability to survive in the hostile environment of the stomach. H. pylori regulates the expression of specific sets of genes allowing it to survive high acidity levels and nutrient scarcity. In the present study, we determined the expression of virulence associated protein D (VapD) of H. pylori inside adenocarcinoma gastric (AGS) cells and in gastric biopsies. Using qRT-PCR, VapD expression was quantified in intracellular H. pylori-AGS cell cultures at different time points and in gastric mucosa biopsies from patients suffering from chronic atrophic gastritis, follicular gastritis, peptic ulcers, gastritis precancerous intestinal metaplasia and adenocarcinoma. Our results show that vapD of H. pylori presented high transcription levels inside AGS cells, which increased up to two-fold above basal values across all assays over time. Inside AGS cells, H. pylori acquired a coccoid form that is metabolically active in expressing VapD as a protection mechanism, thereby maintaining its permanence in a viable non-cultivable state. VapD of H. pylori was expressed in all gastric biopsies, however, higher expression levels (p = 0.029) were observed in gastric antrum biopsies from patients with follicular gastritis. The highest VapD expression levels were found in both antrum and corpus gastric biopsies from older patients (>57 years old). We observed that VapD in H. pylori is a protein that is only produced in response to interactions with eukaryotic cells. Our results suggest that VapD contributes to the persistence of H. pylori inside the gastric epithelial cells, protecting the microorganism from the intracellular environment, reducing its growth rate, enabling long-term infection and treatment resistance.


Assuntos
Proteínas de Bactérias/genética , Gastrite Atrófica/etiologia , Helicobacter pylori/genética , Glicoproteínas de Membrana/genética , Estômago/microbiologia , Estômago/patologia , Adenocarcinoma/etiologia , Adenocarcinoma/microbiologia , Adenocarcinoma/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia , Técnicas de Cocultura/métodos , Feminino , Mucosa Gástrica/microbiologia , Mucosa Gástrica/patologia , Gastrite Atrófica/microbiologia , Gastrite Atrófica/patologia , Gastroscopia/métodos , Infecções por Helicobacter/complicações , Infecções por Helicobacter/patologia , Humanos , Intestinos/microbiologia , Intestinos/patologia , Masculino , Metaplasia/microbiologia , Metaplasia/patologia , Pessoa de Meia-Idade , Úlcera Péptica/metabolismo , Úlcera Péptica/patologia , Lesões Pré-Cancerosas/etiologia , Lesões Pré-Cancerosas/microbiologia , Lesões Pré-Cancerosas/patologia , Antro Pilórico/microbiologia , Antro Pilórico/patologia , Neoplasias Gástricas/etiologia , Neoplasias Gástricas/microbiologia , Neoplasias Gástricas/patologia , Virulência/genética , Adulto Jovem
12.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(3): 327-331, 2020 Mar 06.
Artigo em Chinês | MEDLINE | ID: mdl-32187941

RESUMO

In recent years, the high infection rate of Helicobacter pylori and its impact on cardiovascular disease have attracted public attention. It may directly affect coronary heart disease, stroke, etc. through various mechanisms such as inflammation, immune response, and damage to endothelial cells. It could also play an important role in the formation of cardiovascular disease risk factors such as atherosclerosis, hypertension, hyperhomocysteinemia, and dyslipidemia. However, domestic and international research results are still inconsistent, and a large number of experiments are still required to confirm it to take effective measures to control the incidence of cardiovascular disease. This article reviews the prevalence of Helicobacter pylori and cardiovascular disease, the interaction mechanisms and the status of relevant domestic and international researches.


Assuntos
Doenças Cardiovasculares/microbiologia , Infecções por Helicobacter/complicações , Helicobacter pylori/isolamento & purificação , Doenças Cardiovasculares/complicações , Células Endoteliais , Infecções por Helicobacter/diagnóstico , Infecções por Helicobacter/microbiologia , Humanos , Fatores de Risco
13.
Aliment Pharmacol Ther ; 51(8): 770-780, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32133670

RESUMO

BACKGROUND: Incidence and mortality of gastric cancer (GC) are high in Mongolia despite Helicobacter pylori in the Mongolian population being less virulent. AIM: To evaluate gastric bacterial microbiota profiles in patients with GC and its precursor histological conditions. METHODS: We conducted a case-control study among 48 GC and 120 noncancer patients (20 normal gastric mucosa [control], 20 gastritis, 40 with atrophy and 40 intestinal metaplasia [IM]). We performed 16S rRNA gene amplicon sequencing and compared taxonomic and functional prediction profiles based on the diagnosis group and H pylori infection status. RESULTS: The highest overall bacterial alpha diversity metrics were observed in the control group, followed by the IM and cancer groups. The gastritis and atrophy groups had the least diversity. Lactobacilli and Enterococci were the dominant genus in several cancer patients especially in the absence of H pylori. In addition, Carnobacterium, Glutamicibacter, Paeniglutamicibacter, Fusobacterium and Parvimonas were associated with GC regardless of H pylori infection. Firmicutes were decreased in the gastritis and atrophy groups and increased in the IM and cancer groups. The functional metabolic activity of the Embden-Meyerhof-Parnas pathway and the utilization of sugar, were significantly increased in cancer group compared with the noncancer group. CONCLUSION: Microbial factors other than H pylori may play a role in Mongolian GC. We identified novel associations between GC and the genera Enterococcus, Lactobacillus, Carnobacterium, Glutamicibacter, Paeniglutamicibacter, Fusobacterium, and Parvimonas.


Assuntos
Mucosa Gástrica/patologia , Microbioma Gastrointestinal , Lesões Pré-Cancerosas/epidemiologia , Lesões Pré-Cancerosas/microbiologia , Neoplasias Gástricas/epidemiologia , Neoplasias Gástricas/microbiologia , Adulto , Idoso , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Estudos de Casos e Controles , Estudos Transversais , Feminino , Mucosa Gástrica/microbiologia , Gastrite/epidemiologia , Gastrite/microbiologia , Microbioma Gastrointestinal/genética , Infecções por Helicobacter/complicações , Infecções por Helicobacter/epidemiologia , Helicobacter pylori/genética , Humanos , Incidência , Masculino , Metaplasia/complicações , Metaplasia/epidemiologia , Metaplasia/patologia , Pessoa de Meia-Idade , Mongólia/epidemiologia , RNA Ribossômico 16S/análise , RNA Ribossômico 16S/genética , Neoplasias Gástricas/patologia
14.
Aliment Pharmacol Ther ; 51(8): 781-788, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32133681

RESUMO

BACKGROUND: Helicobacter pylori infection is the most important risk factor for non-proximal gastric adenocarcinoma, yet some posit it is protective against oesophageal adenocarcinoma and proximal gastric cancers. AIMS: To evaluate the incidence of and risk factors for future oesophageal and proximal gastric cancers, utilizing the largest North American cohort of patients with previously identified H pylori. Also to identify whether treatment and eradication of H pylori alter future oesophageal and proximal gastric cancer risk. METHODS: Retrospective cohort study within the Veterans Administration of 36 803 patients (median age 60.4 years; 91.8% male) with confirmed H pylori between 01 January 1994 and 31 December 2018. Primary outcome was diagnosis of future oesophageal and proximal gastric cancers. A time to event with competing risk analysis was performed, evaluating patient factors and whether the patient received H pylori treatment. Secondary analysis of those treated evaluated whether confirmed eradication was associated with cancer. RESULTS: The cumulative incidence of oesophageal and proximal gastric cancers 5, 10 and 15 years after H pylori detection was 0.145%, 0.26% and 0.34%. Risk of future oesophageal or proximal gastric cancer was similar amongst whites (reference), African Americans (SHR 0.87, 95%CI 0.57-1.43) and American Indians (SHR 1.31, 95%CI 0.18-9.60) but substantially reduced in those of Asian (no cases amongst 213 H pylori positive) or native Hawaiian origin (no cases amongst 295 H pylori positive) (P < .001). Increasing age (SHR 1.17 per 5 years, 95% CI: 1.09-1.25, P < 0.001) and smoking (SHR 2.06, 95% CI: 1.33-3.18, P = 0.001) were associated with oesophageal and proximal gastric cancers. Neither treatment of H pylori nor eradication status were associated with cancer (P > 0.20). CONCLUSIONS: In the largest study of US patients with H pylori, we demonstrate that rates of oesophageal and proximal gastric cancers after treatment of H pylori are low. Older age, and smoking are associated with future cancer, whilst Asian or Native Hawaiian race are protective. H pylori treatment and eradication are not associated with future cancer.


Assuntos
Adenocarcinoma/epidemiologia , Neoplasias Esofágicas/epidemiologia , Infecções por Helicobacter/diagnóstico , Infecções por Helicobacter/epidemiologia , Helicobacter pylori/isolamento & purificação , Neoplasias Gástricas/epidemiologia , Adenocarcinoma/microbiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Neoplasias Esofágicas/microbiologia , Feminino , Infecções por Helicobacter/complicações , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Neoplasias Gástricas/microbiologia , Estados Unidos/epidemiologia , Veteranos/estatística & dados numéricos
17.
Rev Med Suisse ; 16(680): 268-271, 2020 Feb 05.
Artigo em Francês | MEDLINE | ID: mdl-32022492

RESUMO

Peptic ulcer induced upper gastrointestinal hemorrhage is a frequent digestive emergency and is one of the most common cause of hospitalization. There are several intrinsic risk factors for peptic ulcer bleed such as advanced age, previous gastro-intestinal hemorrhage, male sex and the presence of Helicobacter pylori. In high risk patients for peptic ulcer disease, gastric protection measures should be considered, most often by treatment with proton pump inhibitors. The eradication of Helicobacter pylori should also be discussed for long-term treatments.


Assuntos
Anti-Inflamatórios não Esteroides/efeitos adversos , Úlcera Péptica/induzido quimicamente , Úlcera Péptica/prevenção & controle , Infecções por Helicobacter/complicações , Infecções por Helicobacter/microbiologia , Helicobacter pylori/efeitos dos fármacos , Helicobacter pylori/isolamento & purificação , Helicobacter pylori/patogenicidade , Humanos , Úlcera Péptica/complicações , Inibidores da Bomba de Prótons/uso terapêutico
18.
Dig Dis ; 38(4): 280-285, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32062657

RESUMO

BACKGROUND: Despite its decreasing incidence, gastric cancer (GC) remains one of the leading cancers in the world and an important global healthcare problem due to its overall high prevalence and high mortality rate. SUMMARY: GC is a consequence of Helicobacter pylori infection in 90% of cases, while in 10% Epstein Barr Virus may be responsible. Moreover, some recent epidemiological data suggest an increasing incidence in some young patients groups possibly due to autoimmunity, and if this tendency is confirmed, it may change the epidemiology of GC in the future. The pathogenesis of GC is mainly related to H. pylori infection, but recent data indicate the possible role of other bacteria and their metabolites, like N-nitrosocompounds or acetaldehyde, interfering during the last steps of carcinogenesis. The new molecular classifications of GCs show a great heterogeneity of this neoplasia, which may in the future help to define personalized treatment strategies for the patients. Early detection and proper surveillance of high risk patients should be our major objectives. Key Messages: GC is still an important healthcare problem, with its several aspects which remain the major challenges for the future.


Assuntos
Neoplasias Gástricas/patologia , Detecção Precoce de Câncer , Infecções por Helicobacter/complicações , Humanos , Incidência , Prevalência , Neoplasias Gástricas/epidemiologia , Neoplasias Gástricas/fisiopatologia , Neoplasias Gástricas/prevenção & controle
19.
Aliment Pharmacol Ther ; 51(6): 582-602, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32056247

RESUMO

BACKGROUND: Helicobacter pylori is the most infamous constituent of the gastric microbiota and its presence is the strongest risk factor for gastric cancer and other gastroduodenal diseases. Although historically the healthy stomach was considered a sterile organ, we now know it is colonised with a complex microbiota. However, its role in health and disease is not well understood. AIM: To systematically explore the literature on the gastric microbiota in health and disease as well as the gut microbiota after bariatric surgery. METHODS: A systematic search of online bibliographic databases MEDLINE/EMBASE was performed between 1966 and February 2019 with screening in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Randomised controlled trials, cohort studies and observational studies were included if they reported next-generation sequencing derived microbiota analysis on gastric aspirate/tissue or stool samples (bariatric surgical outcomes). RESULTS: Sixty-five papers were eligible for inclusion. With the exception of H pylori-induced conditions, overarching gastric microbiota signatures of health or disease could not be determined. Gastric carcinogenesis induces a progressively altered microbiota with an enrichment of oral and intestinal taxa as well as significant changes in host gastric mucin expression. Proton pump inhibitors usage increases gastric microbiota richness. Bariatric surgery is associated with an increase in potentially pathogenic proteobacterial species in patient stool samples. CONCLUSION: While H pylori remains the single most important risk factor for gastric disease, its capacity to shape the collective gastric microbiota remains to be fully elucidated. Further studies are needed to explore the intricate host/microbial and microbial/microbial interplay.


Assuntos
Mucosa Gástrica/microbiologia , Gastroenteropatias/etiologia , Microbioma Gastrointestinal/fisiologia , Saúde , Neoplasias Gástricas/etiologia , Estudos de Coortes , DNA Bacteriano/análise , Mucosa Gástrica/patologia , Gastroenteropatias/tratamento farmacológico , Gastroenteropatias/epidemiologia , Gastroenteropatias/microbiologia , Infecções por Helicobacter/complicações , Infecções por Helicobacter/epidemiologia , Helicobacter pylori/fisiologia , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Inibidores da Bomba de Prótons/uso terapêutico , Fatores de Risco , Análise de Sequência de DNA/métodos , Neoplasias Gástricas/epidemiologia , Neoplasias Gástricas/microbiologia
20.
Epidemiol Infect ; 148: e20, 2020 02 05.
Artigo em Inglês | MEDLINE | ID: mdl-32019616

RESUMO

Infectious diseases, such as Helicobacter pylori, which produce systemic inflammation may be one key factor in the onset of autoimmunity. The association between H. pylori and antinuclear antibodies (ANA), a marker of autoimmunity, has been understudied. Data from the 1999-2000 National Health and Nutrition Examination Survey were used to evaluate the cross-sectional association between H. pylori seroprevalence and ANA positivity in US adults aged ≥20 years. ANA was measured in a 1:80 dilution of sera by indirect immunofluorescence using HEp-2 cells (positive ⩾3). H. pylori immunoglobulin G enzyme-linked immunosorbent assays were used to categorise individuals as seropositive or seronegative. H. pylori seropositivity and ANA positivity were common in the adult US population, with estimated prevalences of 33.3% and 9.9%, respectively. Both were associated with increasing age. H. pylori seropositivity was associated with higher odds of ANA (prevalence odds ratio = 1.89, 95% confidence interval = 1.08-3.33), adjusted for age, sex, race/ethnicity, educational attainment and body mass index. H. pylori infection may be one key factor in the loss of self-tolerance, contributing to immune dysfunction.


Assuntos
Anticorpos Antinucleares/sangue , Anticorpos Antibacterianos/sangue , Doenças Autoimunes/epidemiologia , Infecções por Helicobacter/complicações , Infecções por Helicobacter/epidemiologia , Helicobacter pylori/imunologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Imunoglobulina G/sangue , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Estudos Soroepidemiológicos , Estados Unidos/epidemiologia , Adulto Jovem
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