Résumé
BACKGROUND: Helicobacter pylori is detected by pathogen recognition receptors including toll-like receptors (TLR) and nucleotide-binding oligomerization domain (NOD)-like receptors, eliciting an innate immune response against this bacteria. The aim of this study was to assess if polymorphisms of TLR2, TLR4, TLR5, NOD1 and NOD2 genes are associated with gastric cancer, in particular in individuals infected with H. pylori. RESULTS: A case-control study of 297 gastric cancer patients and 300 controls was performed to assess the association of 17 polymorphisms. Analyses performed under the allele model did not find association with gastric cancer. However, NOD1 rs2075820 (p.E266K) showed association with intestinal-type gastric cancer among H. pylori infected subjects (OR = 2.69, 95% CI 1.41-5.13, p = 0.0026). The association was not statistically significant in diffuse-type gastric cancer cases (OR = 1.26, 95% CI 0.63-2.52, p = 0.51). When the analyses were performed in patients carrying H. pylori strains harboring the cag pathogenicity island (cagPAI), we noticed significant association with NOD1 rs2075820 (OR = 4.90, 95% CI 1.80-3.36, p = 0.0019), in particular for intestinal-type gastric cancer cases (OR = 7.16, 95% CI 2.40-21.33, p = 4.1 × 10- 4) but not among diffuse-type gastric cancer cases (OR = 3.39, 95% CI 1.13-0.10, p = 0.03). CONCLUSIONS: NOD1 rs2075820 increases the risk of intestinal-type gastric cancer among individuals infected with H. pylori, particularly in those harboring the cagPAI.
Sujets)
Humains , Tumeurs de l'estomac/génétique , Infections à Helicobacter/génétique , Protéine adaptatrice de signalisation NOD1/génétique , Études cas-témoins , Helicobacter pylori , Ilots génomiquesRésumé
Background: Collapsing glomerulopathy is a cause of nephrotic syndrome with massive proteinuria secondary to podocyte proliferation and glomerular collapse. It is characterized by an almost inevitable progression to end stage renal failure, poor response to treatment and high post-transplant recurrence. Its frequency has increased in recent years due to its common association with Human Immunodeficiency Virus (HIV) infection and the growing recognition of new etiologic agents such as drugs and parvovirus B19. Therefore, it is a disease of growing interest for clinicians. The aim of this review is to update the clinical presentation, diagnosis, pathogenesis and therapeutic alternatives of this disease.
Sujets)
Humains , Glomérulonéphrite segmentaire et focale , Infections à VIH/complications , Défaillance rénale chronique , Biopsie , Glomérulonéphrite segmentaire et focale/étiologie , Glomérulonéphrite segmentaire et focale/anatomopathologie , Glomérulonéphrite segmentaire et focale/thérapie , Défaillance rénale chronique/étiologie , Défaillance rénale chronique/anatomopathologie , Défaillance rénale chronique/thérapie , Glomérule rénal/anatomopathologie , Syndrome néphrotique/étiologie , Syndrome néphrotique/anatomopathologie , Syndrome néphrotique/thérapieRésumé
Hemos realizado 166 polipectomías endoscópicas rectocolónicas en 159 pacientes (78 varones y 81 mujeres). Noventa polipectomías fueron realizadas mediante asa de alambre y 76 resecciones mediante biopsia térmica y/o reiterativa. El procedimiento fue muy bien tolerado y en esta serie se presentó solamente una hemorragia que fue leve y cedió en forma espontánea. Diecisiete de los pólipos resecados endoscópicamente resultaron ser malignos y sólo en 2 la invasión cancerosa iba más allá de la muscular de la mucosa, lo que representa el 11.7% de las lesiones polipoídeas malignas; lo que demuestra que la mayoría de las lesiones de este tipo (88.3%) encuentra en este procedimiento su tratamiento definitivo. El método de la polipectomía endoscópica se discute en base a la clasificación de Yamada para las lesiones elevadas. En aquellas que son aplanadas y de ancha base de implantación se prefiere la ablación mediante biopsia térmica y/o biopsia reiterativa, mientras en las subpedunculadas y pediculadas la polipectomía con asa de alambre es el método más empleado