Pepsin and bile acid concentrations in sputum of mustard gas exposed patients

Gastro-esophageal reflux has been suggested to be associated with several pulmonary complications such as asthma, and post-transplant bronchiolitis obliterans [BO]. Pepsin or bile salts in the sputum is shown to be an optimal molecular marker of gastric contents macro/micro aspiration. In this study, we investigated sputum pepsin as a marker of micro-aspiration in sulfur mustard [SM] exposed cases compared to healthy controls. In a case controlled study, 26 cases with BO and 12 matched healthy controls were recruited and all cases were symptomatic and their exposure to SM was previously documented during Iran-Iraq conflict. Pepsin levels in sputum and total bile acids were measured using enzymatic assay. The severity of respiratory disorder was categorized based upon the spirometric values. The average concentration of pepsin in sputum was higher in the case group [0.29 +/- 0.23] compared with healthy subjects [0.13 +/- 0.07; P +/- 0.003]. Moreover, the average concentration of bile acids in the sputum cases was not significantly different in comparison to the controls [P = 0.5]. Higher pepsin concentrations in sputum of SM exposed patients compared with healthy control subjects indicate the occurrence of significantly more gastric micro-aspiration in SM exposed patients

Helicobacter pylori genotypes can predict gastric tissue histopathology: a longitudinal study of Iranian patients

Several factors have been suggested to account for differences in the virulence of Helicobacter pylori infections in various populations. Evidence suggests the existence of different strains of H. pylori with different degrees of virulence. The present study aimed to investigate the gastric histopathology in Iranian patients infected with H. pylori and to investigate the relationship between the severity of gastritis and four different bacterial virulence-associated genotypes. All of the patients with positive results from a pathological examination, a rapid urease test, and PCR analysis for H. pylori infection were consecutively included into the study. The classification and grading of gastritis were performed according to the Sydney System. Esophagitis was classified endoscopically according to the Savary-Miller grading system. The primers used in this study targeted 16S rRNa [521 bp], Urease A [411 bp], Cag A [400 bp], and 26 kDa [303 bp]. Twenty-eight patients were included in the study. The presence of Cag A showed a significant relationship with higher gastritis grades [3.0 +/- 0.7 vs. 2.3 +/- 0.9, p = 0.024] and higher scores for H. pylori infection [3.0 +/- 0.7 vs. 2.3 +/- 0.7, p = 0.027]. The patients infected with 26 kDa-positive H. pylori had significantly higher infection scores [3.5 +/- 0.6 vs. 2.5 +/- 0.6, p = 0.020]. This study showed that CagA-positive H. pylori infection is associated with more severe gastritis and with increased bacterial density and inflammation in the biopsy specimens. The 303-bp positive genotype was also significantly associated with higher grades of esophagitis. Additional in-depth trials will be helpful in extending our findings. H. pylori [Helicobacter pylori], PCR [polymerase chain reaction]