Plasma Interleukin-13 Levels Correlate With the Severity of Symptoms Induced by Functional Dyspepsia.

OBJECTIVE: Functional dyspepsia (FD) is a gastrointestinal functional disorder of the upper gastrointestinal tract that affects the quality of life of patients and poses a significant economic burden. It has been proposed that the local inflammatory immune response at the duodenum is associated with an increase in intestinal permeability, favoring the recruitment of Th2 cells and granulocyte degranulation. Moreover, systemic immune response could also be related to the symptoms of FD. The objective of this study was to evaluate the systemic immune response in Uruguayan patients with FD by analyzing the cytokine levels in plasma and the frequency of circulating T cells associated with duodenal recruitment. PATIENTS AND METHODS: An analytic and cross-sectional study in 30 patients with FD and 15 healthy controls (HCs) was carried out. Patients were diagnosed with FD according to the Roma IV Committee definition. Cytokine levels were measured in plasma by a specific assay. Expression of α4ß7 and CC chemokine receptor9 in circulating T cells was evaluated by flow cytometry. RESULTS: Higher levels of interleukin (IL)-5, IL-13, and IL-8 and lower levels of IL-10 and IL-12p70 were detected in patients with FD than in HC. Furthermore, a positive linear correlation between IL-13 and the severity of FD symptoms was found. CD4 + T cells from patients with FD expressed higher levels of α4ß7 and CC chemokine receptor9 than those from HC. CONCLUSIONS: An increase of Th2-like cytokines and a positive correlation between the levels of plasma IL-13 and the severity of symptoms in patients with FD from Uruguay were detected.

Helicobacter pylori infection among patients presenting with dyspepsia at a primary care setting in Cameroon: seroprevalence, five-year trend and predictors.

BACKGROUND: Almost half the world's population is infected with Helicobacter pylori (H. pylori) with the highest reported prevalence from Africa. This infection is associated with several morbid gastrointestinal conditions. Understanding the trends in seroprevalence and the factors associated with H. pylori seropositivity in dyspeptic persons can provide a guide for public health policies. METHODS: This was a retrospective study, carried out with outpatient records of Wum District Hospital (WDH) from January 2012 to December 2016. We reviewed records of all patients for whom a H. pylori serology test was requested. The Cochran-Armitage trend test and multiple regression models were used to explore seroprevalence trends and predictors of seropositivity respectively. RESULTS: We included 451 records, 63.6% (n = 287) were female. The mean age of the study population was 40.7 years, and the overall H. pylori seroprevalence was 51.5% (95% CI: 47-56%). The use of recommended eradication regimen appears to be low and declining. On average, H. pylori seroprevalence declined by 6.8% annually (p < 0.0001). Occupational status independently predicted seropositivity, with students having lower odds of being seropositive than employed persons (aOR = 0.09, 95% CI: 0.02-0.49, p = 0.016). CONCLUSION: Despite decreasing trends, the seroprevalence of Helicobacter pylori infection is high in dyspeptic patients attending this primary care setting. Improving living standards and establishing national guidelines for eradication can possibly aid the control of this infection.

Characteristics and Predictive Factor of Helicobacter pylori-Associated Functional Dyspepsia in Japanese Patients.

BACKGROUND/AIM: Helicobacter pylori (HP) eradication therapy was first recommended as pharmacotherapy for functional dyspepsia (FD). However, the mechanism and effect of eradication on FD symptom improvement have not been fully investigated. This study aimed to investigate the pathology of patients with HP-associated FD, and predictive factors for HP-associated FD. METHODS: Ninety-seven patients with chronic gastritis caused by HP infection were divided into the group with FD symptoms and the group -without FD symptoms. Patient backgrounds, QOL, gastric mucosal atrophy severity, and serum pepsinogen (PG) value were compared between the 2 groups. Twelve months after eradication, those factors were evaluated between HP-associated FD and HP-non-associated FD, and predictive factors of HP-associated FD were analyzed. RESULTS: The FD-positive group existed in 45 (46.3%) out of 97 patients. Twelve months after eradication, there were 34 patients (75.6%) in the HP-associated FD. The mean PG I value in the HP-associated FD was significantly lower than that in the HP-non-associated FD, while the PG II values in the HP-associated FD tended to be lower than those in the HP-non-associated FD. QOL in the HP-associated FD significantly improved after HP eradication. On multivariate logistic regression analysis, it was found that PG II value was a significant predictive factor for FD symptom improvement in the HP-associated FD. CONCLUSION: HP eradication is an effective initial therapy for FD. PG II value is considered a predictive factor for FD symptom improvement through HP eradication.

Analyzing Determinant Factors for Pathophysiology of Functional Dyspepsia Based on Plasma Cortisol Levels, IL-6 and IL-8 Expressions and H. pylori Activity.

BACKGROUND: there are many determinant factors that may play roles in pathophysiology of functional dyspepsia. One of them is psychological stress that can increase plasma cortisol levels, alter inflammation process and affect Helicobacter pylori activity. No study has been conducted to find out the dominant factor among them. This study aimed to find the dominant factor among plasma cortisol levels, IL-6 and IL-8 expressions and H.Pylori activity, as the determinant factors in the pathophysiology of functional dyspepsia. METHODS: a cross-sectional study was conducted in 80 patients with dyspepsia syndrome at M. Djamil General Hospital, Padang, West Sumatera, Indonesia. The patients were categorized into two groups, i.e. the stress and non-stress group, which were identified using DASS 42 questionairre criteria. The inflammatory expressions (IL-6 and IL-8 expressions) as well as H. pylori activity were determined using immunohistochemistry of gastric biopsy specimens; while plasma cortisol levels was measured from peripheral blood samples. Data were analyzed using binary multivariate logistic regression. RESULTS: there were 80 patients with functional dyspepsia with mean age of 38.9 years old. The morning cortisol levels was found significantly higher in the stress group. Higher IL-6 and IL-8 expressions were found in patients of non-stress group compared to those in the other group (IL-6: 73.28 (SD 16.60) vs. 72.95 (SD 19.49; and IL-8: 18.45 (SD 17.32) vs. 14.80 (SD 12.71)); although stastically not significant. There was greater Helicobacter pylori activity in the group with psychological stress compared to those in the non-stress group since there was antigen-antibody reaction invading the submucosa. The dominant determinant factor was the afternoon plasma cortisol levels. CONCLUSION: many factors can become the determinant factors for gastric mucosal damage; however, our study has demonstrated that the dominant factor is afternoon plasma cortisol levels.

Peptide YY3-36 and glucagon-like peptide-1 in functional dyspepsia. Secretion and role in symptom generation.

OBJECTIVE: The role of peptide YY3-36 (PYY3-36), glucagon-like peptide-1 (GLP-1), and glucose homoeostasis in symptom development in functional dyspepsia (FD) is unclear. The aim was to investigate postprandial changes in plasma PYY3-36, GLP-1, glucose and insulin, and the relationship between PYY3-36, GLP-1, dyspeptic symptoms, and satiety measurements. MATERIALS AND METHODS: Thirty-six patients with functional dyspepsia and 18 healthy controls consumed a liquid meal at two occasions. Firstly, a fixed amount of 250 mL (300 kcal) was consumed and gastric emptying was assessed using the paracetamol method. Secondly, participants drank 75 mL (90 kcal) per five min until maximal satiety. PYY3-36, GLP-1, glucose, and insulin concentrations were assessed. Satiety measures and dyspeptic symptoms were registered using visual analogue scales. RESULTS: Gastric emptying, glucose, PYY3-36, and GLP-1 concentrations were similar in patients and controls. Patients with epigastric pain syndrome had higher postprandial insulin levels. Patients reported more satiety, nausea, and pain. Area under the curve (AUC) for GLP-1 correlated positively to nausea in patients and negatively to nausea in controls during a single meal. AUC for PYY3-36 correlated similarly to sensation of fullness in the two groups; however, the correlation was negative for the single meal and positive for the satiety test. CONCLUSIONS: In epigastric pain syndrome, postprandial insulin secretion seems to be increased. Neither GLP-1 nor PYY3-36 secretion is altered in functional dyspepsia, but postprandial GLP-1 secretion seems to correlate with nausea and PYY3-36 to the sensation of fullness, and therefore, these hormones might be involved in symptom generation.

[Excretion and metabolism of dopamine in patients with functional dyspepsia]. / Wydzielanie i metabolizm dopaminy u osób z dyspepsja czynnosciowa.

UNLABELLED: Dopamine is one of major neurotransmitter in the central and peripheral nervous system. A significant amount of dopamine is also produced in the visceral nervous system and in gastrointestinal tract, where exhibits inhibitory activity on motility. AIM: The aim of the study was to assess the parameters of dopamine secretion and metabolism in patients with functional dyspepsia. MATERIAL AND METHODS: The study was conducted in a group of 30 healthy subjects and 60 patients with functional dyspepsia (FD), that met the Rome Criteria III, for epigastric pain syndrome (EPS) and postprandial distress syndrome (PDS). The severity of dyspeptic symptoms was determined using a 10-point Visual-Analogue Scale (VAS). Fasting plasma concentration of dopamine (DA) and the contents of homovanillic acid (HVA) in the urine collection were determined by ELISA. RESULTS: DA concentration in plasma was similar in both clinical forms FD (EPS - 55.6 pg/ml, in patients with PDS - 63.5 pg/ml, p>0.05). Urine excretion of HVA in patients with PDS - 6.63 mg/24 h (p<0.05) was higher than in heathy subjects - 5.65 mg/24 h (p<0.05) and those with EPS - 5.07 mg/24 h (p<0.001). In the group with PDS severity of dyspeptic symptoms showed a positive correlation with the DA concentration in plasma and HVA excretion in the urine. CONCLUSIONS: Increased secretion of DA may play a significant role in the pathogenesis of PDS.

The relationship between cytotoxin-associated gene A positive Helicobacter pylori infection and autoimmune thyroid disease.

OBJECTIVE: The aim of this study was to determine whether there is an association between cagA [cytotoxin-associated gene A] positivity and thyroid autoimmunity and thyroid volume. METHODS: This prospective study included 78 Helicobacter pylori-positive (H. pylori) dyspeptic patients in the study group, and 50 age-, gender-, and body mass index-matched H. pylori-negative dyspeptic patients in the control group. All the controls were evaluated via upper gastrointestinal endoscopic biopsy or breath test, and were found as H. pylori negative. Gastric biopsy specimens were obtained via endoscopy and histological examination was performed for documentation of H. pylori. RESULTS: In all, 55.1% (n = 43) of the H. pylori-positive patients were cagA positive. There was no significant difference in metabolic syndrome parameters or thyroid function test results between the study and control groups. The frequency of anti-TPO and Hashimoto's thyroiditis positivity was significantly higher in the study group than in the control group. Thyroid volume was higher and severe parenchymal heterogeneity was more common in the H. pylori-positive patients. CONCLUSIONS: H. pylori infection might be a risk factor for autoimmune thyroid disease and high thyroid volume in patients diagnosed with histological evaluation. However, cagA positivity has no additional effect on these parameters.

Increased nutrient sensitivity and plasma concentrations of enteral hormones during duodenal nutrient infusion in functional dyspepsia.

OBJECTIVES: Functional dyspepsia is predominantly attributed to gastric sensorimotor dysfunctions. The contribution of intestinal chemosensitivity to symptoms is not understood. We evaluated symptoms and plasma hormones during enteral nutrient infusion and the association with impaired glucose tolerance and quality-of-life (QOL) scores in patients with functional dyspepsia vs. healthy controls. METHODS: Enteral hormonal responses and symptoms were measured during isocaloric and isovolumic dextrose and lipid infusions into the duodenum in 30 patients with functional dyspepsia (n=27) or nausea and vomiting (n=3) and 35 healthy controls. Infusions were administered in randomized order over 120 min each, with a 120-min washout. Cholecystokinin, glucose-dependent insulinotropic peptide, glucagon-like peptide 1 (GLP1), and peptide YY were measured during infusions. RESULTS: Moderate or more severe symptoms during lipid (4 controls vs. 14 patients) and dextrose (1 control vs. 12 patients) infusions were more prevalent in patients than controls (P≤0.01), associated with higher dyspepsia symptom score (P=0.01), worse QOL (P=0.01), and greater plasma hormone concentrations (e.g., GLP1 during lipid infusion). Moderate or more severe symptoms during enteral infusion explained 18%, and depression score explained 21%, of interpatient variation in QOL. Eight patients had impaired glucose tolerance, associated with greater plasma GLP1 and peptide YY concentrations during dextrose and lipid infusions, respectively. CONCLUSIONS: Increased sensitivity to enteral dextrose and lipid infusions was associated with greater plasma enteral hormone concentrations, more severe daily symptoms, and worse QOL in functional dyspepsia. These observations are consistent with the hypothesis that enteral hormones mediate increased intestinal sensitivity to nutrients in functional dyspepsia.

[A correlation study between diarrhea-predominant irritable bowel syndrome complicated functional dyspepsia patients of Gan-stagnation Pi-deficiency syndrome and gastrointestinal hormones].

OBJECTIVE: To investigate the correlation between the pathogeneses of diarrhea-pre- dominant irritable bowel syndrome (D-IBS) complicated functional dyspepsia (FD) patients of Gan-stagnation Pi-deficiency Syndrome (GSPDS) and symptoms, psychological states, and gastrointestinal hormones. METHODS: A total of 111 patients with confirmed D-IBS complicated FD of GSPDS were recruited as the treated group by using Rome III standard and Chinese medical syndrome standard. And 30 healthy volunteers were recruited as the control group. The general condition, scoring for digestive symptoms, and the distribution of GSPDS subtype of all subjects were recorded by a questionnaire, and assessed by Symptom Checklist (SCL-90; a software for psychological test developed by Beijing Huicheng Adult Cor- poration). Meanwhile, plasma levels of 5-hydroxytryptamine (5-HT), somatostatin (SS), vasoactive intestinal peptide (VIP), endothelin (ET), interleukin 10 (IL-10), and interleukin 12 (IL-12) were measured in all subjects. RESULTS: (1) The subtype of D-IBS complicated FD of GSPDS was dominant in Pi-qi deficiency type (51/111,45.9%),Pi yang deficiency type (34/111,30.6%), and GSPDS. There was no statistical difference in the scoring of digestive symptoms among the 3 subtypes (P >0.05). (2) Compared with the control group, the anxiety factor score and the total score significantly increased in all three subtypes of D-IBS complicated FD of GSPDS, and the depression score of Pi yang deficiency type and Gan-depression type also significantly increased (P <0.05, P <0.01); the depression score of Gan-depression type was significantly higher than that of the Pi-qi deficiency type (P <0.01). Plasma 5-HT levels were obviously lower in D-IBS complicated FD patients of GSPDS accompanied with anxiety or depression than in those with no obvious psychological abnormalities, and VIP and IL-10 levels were significantly lower than those in the control group (P <0.05). Plasma VIP levels were also obviously lower in D-IBS complicated FD patients of GSPDS accompanied with anxiety or depression than in those with no obvious psychological abnormalities (P <0.01), and SS levels were significantly lower than those in the control group (P <0.05). There was no statistical difference in plasma ET or IL-12 levels in each patient group, when compared with the control group (P >0.05). (3) Compared with the.control group, plasma 5-HT levels significantly increased, plasma VIP and IL-10 levels significantly decreased in ach subtype of D-IBS complicated FD patients of GSPDS (P <0.05, P <0.01), and no significant change of SS, ET, or IL-12 occurred (P >0.05). Besides, plasma 5-HT levels were significantly higher in Gan-depression type than in Pi yang deficiency type, VIP levels were lower in Gan-depression type than in Pi-qi deficiency type (all P <0.05). CONCLUSIONS: Gan stagnation and Pi deficiency were dominant in D-IBS complicated FD patients of GSPDS. Psychological abnormalities, increased plasma 5-HT levels, and decreased plasma VIP levels were closely correlated with Gan stagnation subtype, which provided some reference for looking for objective indicators of Chinese medical syndromes in treating D-IBS complicated FD patients of GSPDS.

The mediating effect of circulating inflammatory proteins on the relationship between gut microbiota and FD: a bidirectional Mendelian randomization study.

Functional dyspepsia (FD) is known to be influenced by gut microbiota (GM) and circulating inflammatory proteins (CIPs), however, the causal relationship between GM, CIPs and FD haven't been investigated. This study employed two-sample Mendelian Randomization (TSMR) to investigate their associations using data from Genome-Wide Association Studies (GWAS). In this study, Inverse-variance weighted (IVW) method was employed as the primary analysis, with supplementary approaches including weighted median, weighted mode, simple mode, and MR-Egger. Heterogeneity and pleiotropy were assessed using the Cochrane Q test, MR-Egger intercept test, and MR-PRESSO global test. Totally, 196 GM traits and 91 CIPs were analyzed, and the results uncovered the causal impact of 12 GM taxa and 5 proteins on functional dyspepsia (FD). 9 GM genera were linked to a reduced risk of FD, while 3 GM genera were associated with an increased risk of FD.Additionally, reverse analysis revealed no FD-GM causation. Furthermore, IL-12, IL-10, CXCL10, CXCL9 and VEGFA were significantly correlated with FD, with CXCL9 and VEGFA acting as mediators in the association between GM traits and FD. Taken together, our findings established a link between specific GM and CIPs in the pathogenesis of FD, offering novel insights for its diagnosis and treatment.

Managing dyspepsia in the young adult patient: effects of different tests for Helicobacter pylori in a "test-and-scope" approach.

AIM: To evaluate how different methods for the detection of Helicobacter pylori influence on a "test, score and scope" decision approach in young dyspeptic patients. RESULTS: Complete data from 341 patients (52.2% males) were analyzed. One hundred and ten (32%) were H. pylori-positive by definition. The rapid serology test was true-positive in 64 patients, false-positive in 8, and false-negative in 46. For the EIA IgG serology test, the corresponding results were 99 true-positive, 7 false-positive, and 11 false-negative. If the H. pylori fecal test or urea breath test had been applied, 108 (98%) and 107 (97%) positives would have been correctly detected, respectively, as well as 14 and 7 false positives. Models using test data in a setting of decreasing H. pylori prevalence show that test properties have increasing significance. CONCLUSIONS: In a selection strategy for young dyspeptics based on the detection of H. pylori, the choice of test should be made with caution. H. pylori fecal test would probably give the best basis for such selection.

Rikkunshito improves the symptoms in patients with functional dyspepsia, accompanied by an increase in the level of plasma ghrelin.

BACKGROUND/AIMS: Functional dyspepsia (FD) is a common disease but there is no established treatment. Rikkunshito is a traditional Japanese medicine that is widely used for treating upper gastrointestinal symptoms and its effect on ghrelin is of great interest. The aim of this study was to investigate the effect of rikkunshito on upper gastrointestinal symptoms and the levels of acylated ghrelin (AG) in patients with FD. METHODOLOGY: This study was a paralleled, randomized controlled trial. Patients were treated with either rikkunshito (group R) or domperidone (group D) for 4 weeks. The overall change in dyspeptic symptoms was evaluated by the GSRS (Gastrointestinal Symptom Rating Scale) questionnaire score. RESULTS: 27 patients were enrolled. There was a significant improvement in dyspeptic symptoms in both groups, based on the GSRS score. AG levels increased significantly in plasma in group R at 2 weeks after treatment (paired t-test, p<0.05). The improvements of reflux (Pearson's correlation test, r=-0.73, p=0.04) and indigestion (r=-0.76, p=0.03) symptoms in group R showed a good correlation with the increase of AG. CONCLUSIONS: Rikkunshito improves upper gastrointestinal symptoms in patients with FD, accompanied by an increase in the levels of AG.

Examination of serum pepsinogen in functional dyspepsia.

BACKGROUND/AIMS: Although serum pepsinogen (PG) is considered as a marker of gastric atrophy, it also reflects gastric acid secretion, which closely influences dyspeptic symptoms. We investigated serum PG levels and PGI/PGII ratios in dyspeptic patients, in relation to various different subtypes of symptoms including Rome III classifications. METHODOLOGY: Serum PGs were measured in 75 subjects with dyspeptic symptoms and 42 asymptomatic healthy subjects. RESULTS: PG II level was significantly higher (p=0.0001) and PG I/II ratio was significantly lower (p<0.0001) in subjects with H. pylori infection than those without, while no associations were found between PG levels and usage of H2 receptor antagonists or proton-pump inhibitors. In all subjects with pain in stomach, abdominal bloating and PDS-like symptoms according to Rome III criteria, presented significantly higher levels of PGI, compared to subjects without symptoms (p=0.043, 0.015 and 0.037, respectively). In addition, burning sensation and abdominal pain presented significantly higher PGI/II ratios (p=0.0005 and 0.003, respectively), and higher PGI/II ratio was also positively correlated with a number of symptoms (p=0.04). When subjects were divided according to H. pylori infection status, higher PGI/II ratio was significantly associated with abdominal pain in H. pylori negative subjects (p=0.03), while higher PGI level was significantly associated with functional esophageal disorders (FEG) according to Rome III criteria, and higher number of dyspeptic symptoms in H. pylori positive subjects (p=0.016). CONCLUSIONS: Our data suggest that subjects with higher PGI level, and PG I/II ratio are more likely to develop several dyspeptic symptoms.

[Role of hypophyseal-gonadal system in the genesis of functional pathologies of the digestive system in adolescents].

In different types of functional disorders of the digestive system in adolescents were revealed the same changes of the hormonal state of hypophisial-gonad system. It indicates on dominative role of neuroendocrinal mechanisms in pathogenesis of these diseases.

Coordinated increase in serum platelet-derived growth factor-BB and transforming growth factor-ß1 in patients with chronic pancreatitis.

BACKGROUND: In vitro studies suggest that platelet-derived growth factor-BB (PDGF-BB) and transforming growth factor-ß1 (TGF-ß1) play an important role in pancreatic fibrosis. The aim of this study was to evaluate serum PDGF-BB and TGF-ß1 concentrations in patients with chronic pancreatitis (CP). METHODS: Forty male patients with a history of alcoholic CP and 35 age-matched healthy subjects were examined. Serum concentrations of PDGF-BB, TGF-ß1, laminin and hyaluronic acid were determined by ELISA assay. Additionally, we determined serum concentrations of PDGF-BB and TGF-ß1 in patients with functional dyspepsia, ulcerative colitis and Crohn's disease. RESULTS: Patients with advanced CP had significantly higher serum PDGF-BB and TGF-ß1 concentrations compared to control subjects. A strong positive correlation between serum PDGF-BB and TGF-ß1 concentrations was found in patients with CP. Serum laminin and hyaluronic acid were also elevated in patients with CP. No increase in serum PDGF-BB and TGF-ß1 concentrations was found in patients with functional dyspepsia, ulcerative colitis or Crohn's disease. CONCLUSION: The obtained results indicate for the first time that serum levels of PDGF-BB are elevated in patients with CP. However, ROC curve analysis suggests that PDGF-BB is not superior to laminin as a potential marker of advanced CP.

Useful biomarkers in pediatric eosinophilic duodenitis and their existence: a case-control, single-blind, observational pilot study.

OBJECTIVES: The aim of this study was to determine whether screening for food hypersensitivity could be a clinically useful biomarker for eosinophilic duodenitis in the pediatric population. PATIENTS AND METHODS: Twenty-two patients with functional dyspepsia and 19 controls with no significant history of gastrointestinal or allergic disorders were enrolled. Participants underwent skin prick, atopy patch, and serum-specific (S)-IgE, -IgG, and -IgG4 testing to corn, wheat, soy, peanut, milk, and egg. Participants in the patient group also underwent endoscopy with biopsies as part of standard care. RESULTS: Three participants in the patient group did not exhibit duodenal eosinophilia on biopsy and were excluded from data analyses. The patient group consisted of 13 females and 6 males, 8 to 17 years of age. The control group consisted of 10 females and 9 males, 8 to 17 years of age. Seven patients had at least 1 positive reaction to food by skin prick, atopy patch, or SIgE testing compared with 7 controls; odds ratio 1; 95% confidence interval 0.3 to 3.7. Receiver operating characteristics curves showed SIgG and SIgG4 performed poorly or no better than chance for predicting group assignment. CONCLUSIONS: Allergy screening for the foods tested was not useful as a biomarker for eosinophilic duodenitis in this small study. A higher rate of positive reactions to patch testing was observed in the control group than previous studies have reported. The incidence of a positive food patch test in nonselected subjects needs further investigation. Method standardization and establishment of reference intervals are needed for atopy patch tests, SIgG, and SIgG4 to better evaluate the clinical value of these measures.

Helicobacter pylori and trace elements.

The metabolism of the trace elements is altered in infection or inflammation. Helicobacter pylori infection is a causative in chronic gastritis, duodenal ulcer disease and gastric cancer. It is not known whether H. pylori infection is associated with the changes in the serum levels of trace elements. The aim of this study was to determine serum concentrations of zinc and copper, using atomic absorption spectrophotometer, in patients with H. pylori positive chronic gastritis, patients with H. pylori negative chronic gastritis and healthy individuals. Serum Zn was significantly higher in patients with H. pylori positive chronic gastritis compared to both patients with H. pylori negative chronic gastritis and to healthy individuals, while serum Cu and Cu/Zn ratio was not significantly different in any study group. The serum zinc and copper concentrations were not altered in patients with chronic gastritis.

[Phytotherapy with a mixture of dry extracts with hepato-protective effects containing artichoke leaves in the management of functional dyspepsia symptoms]. / Un'esperienza di fitoterapia con una associazione di fitocomplessi ad attività epatoprotettrice contenente un estratto di foglie di carciofo per il controllo dei sintomi della dispepsia funzionale.

AIM: The aim of the study was to explore the potential of phytotherapy with artichoke leaf extract in the management of functional dyspepsia symptoms, a disorder notoriously recalcitrant to pharmacotherapy. METHODS: A cohort of outpatients with a clinical diagnosis of functional dyspepsia and deemed suitable candidates for non-pharmacologic treatment was prospectively observed for 60 days by 33 physicians. Treatment consisted of Cinarepa, a commercial mixture of dry extracts of artichoke leaf (Cynara scolymus) 15% of chlorogenic acid (150 mg per capsule), dandelion radix (Taraxacum officinalis) 2% of inulin, turmeric rhizome (Curcuma longa) 95% of curcumin and rosemary bud essential oil microencapsulated (Rosmarinum officinalis). The severity of 8 dyspepsia symptoms was self-evaluated on a 10-point scale. Blood chemistry testing of lipid profile and liver function was discretionary. RESULTS: Of the 311 patients in the cohort, the data from 305 (98%) were included in the analysis of dyspepsia symptoms and the data from 50-73 (16-23%) were entered into the analysis of blood chemistry results. A statistically significant gradual reduction in symptom severity was noted at day 30 and further improvement was observed at day 60. Global clinical response, defined as a 50% reduction in the total scores of all symptoms, was recorded in 38% of patients at 30 days and in 79% at 60 days. At 60 days, total cholesterol, LDL and triglyceride levels had decreased by 6-8% over baseline values (P < or = 0.001); transaminase (AST, ALT), and gamma GT concentrations had diminished by 13-20 U/L (P<0.01) in patients with relatively elevated baseline values. CONCLUSION: Phytotherapy with Cinarepa holds promise as an alternative option in the relief of functional dyspepsia symptoms and merits further investigation in controlled studies.

[Importance of biologic parameters in Helicobacter pylori gastritis: comparison with histological results]. / Intérêt de certains paramètres biologiques au cours de la gastrite à Helicobacter pylori: comparaison avec les résultats histologiques.

Helicobacter pylori (HP) chronic gastritis can lead to precursor stages of gastric cancer. New biological markers have been proposed to study the gastric mucosal state. We evaluate biological results in comparison with histological ones in a dyspeptic population. Forty nine dyspeptic patients underwent endoscopy with gastric biopsies for histological examination. Blood samples were obtained to measure levels of gastrin 17 (G17), pepsinogen 1 (PG1), pepsinogen 2 (PG2) and the rate of anti-HP IgG antibodies. Four patients have a healthy gastric mucosa and 45 have a gastritis (32 have a nonatrophic gastritis and 13 an atrophic one). An increase in the level of PG2 and a decrease of the PG1/PG2 ratio were noticed in the group of subjects with a nonatrophic gastritis compared to the healthy mucosa group. The decrease of the PG1/PG2 ratio was more important in the corpus atrophic gastritis group than in the antrum restricted atrophic gastritis one. In conclusion, in front of dyspeptic patients, we advice to practice in first intention the measurement of the serological level of G17, PG1, PG2 and anti-HP IgG antibodies.