Gastroprotective activity of the hydroethanolic extract and ethyl acetate fraction from Kalanchoe pinnata (Lam. ) Pers

ABSTRACT Peptic ulcers are an important pathology, and the search for safer and more effective treatment methods is of paramount importance. In this study, we assess the gastroprotective effects of the hydroethanolic extract (HE) and ethyl acetate fraction (EAF) from Kalanchoe pinnata leaves against an ethanol/HCl-induced ulcer model in rats. The HE reduced gastric lesions by approximately 47% (400 mg/kg). A significant inhibition of the gastric lesions by 50% was observed after pretreatment with the EAF (200 mg/kg). Quercetrin and quercetin 3-O-α-L-arabinopyranosyl-(1→2)-α-L-rhamnopyranoside were isolated and identified in the flavonoid fraction (EAF) by HPLC and NMR analyses because this fraction showed the highest gastroprotective effect. This fraction demonstrated high antioxidant activities (CE50=41.91 µg/mL) by DPPH in comparison with Trolox(r) and 11.33 mmol Trolox(r) equivalent by ORAC. In conclusion, the HE and FAE from K. pinnata displayed gastroprotective activity in rats, most likely due to the presence of flavonoids.

Evaluation of endoscopic biopsy in gastric lesions with a special reference to the significance of mast cell density.

Various studies have shown the role of mast cells in chronic inflammatory states and in tumor growth. The study is designed to have an idea of the relationship of mast cell density (MCD) to gastric ulcer and cancer, to verify whether mast cell accumulation occurred in the two conditions especially in Indian patients and thus postulate that therapeutic strategies against mast cell mediators could be useful in treatment. Also, we want to review literature and attempt to explain our findings. A total of 240 patients, who underwent their first endoscopy and biopsy for a span of 21/2 years were studied retrospectively. Out of these, 210 cases that were either gastric ulcers or cancer were chosen for this MCD study. Biopsies were sectioned and stained routinely. Toluidine blue stain and copper grid was used to calculate MCD. Student's t-Test was used to calculate the statistical significance of MCD. MCD in benign ulcers was much higher than in control subjects. MCD in well-differentiated cancers showed MCD higher than control. Poorly-differentiated adenocarcinoma showed lower MCD than well-differentiated adenocarcinoma. It was concluded that the accumulation of mast cells in gastric ulcers is an inflammatory response. MCD is increased in well-differentiated gastric cancers, which may be a mast cell mediated immune response or mast cells may have a role in tumor angiogenesis and produce factors for tumor progression. Poorly-differentiated adenocarcinoma apparently lacks mast cell mediated anti-tumor response in some unexplained way.

Soroprevalência de anticorpos contra o antígeno CagA do Helicobacter pylori em pacientes com úlcera gástrica na regiÒo Norte do Brasil / Seroprevalence of antibodies against Helicobacter pylori CagA antigen in patients with gastric ulcer in the North region of Brazil

Helicobacter pylori is a pathogenic agent with a worldwide distribution and is involved in the development of many gastrointestinal diseases. Nowadays infection with the virulent strain CagA+ of H. pylori is considered one of the main etiological factors in the development of gastric ulcer. Based on this information, we investigated the seroprevalence of virulent strains among patients with gastric ulcer from one region, using serologic tests to detect antibodies against H. pylori and CagA protein. Infection by the virulent strain was found in 82 (40/55) of the patients, and among these, 89 (40/45) presented an increased degree of inflammation in the gastric mucosa, with a dense infiltration of leukocytes in the tissue, which probably favored the formation of gastric ulcer. We concluded that the presence of the virulent strain is related to the development of an increased inflammation in the gastric mucosa.

Antigenic diversity and serotypes of Helicobacter pylori associated with peptic ulcer diseases

OBJECTIVES: Clinical presentation of Helicobacter pylori (H. pylori) infection has marked variation mainly due to the strain diversity and host susceptibility. Although H. pylori is identified as a major risk factor for gastric and duodenal ulcers, the ulcerogenic or pathogenic strain has not been documented yet. The objective of this study was to investigate antigenic types of the ulcerogenic strain of H. pylori. METHODS: The sera of 64 patients were tested by Western blot using Helicoblot 2.0 for six major anti-H. pylori antibodies, together with CLO test and histological examination of gastric biopsy tissues. Thirty-five, nine and 20 patients had duodenal ulcer, gastric ulcer and chronic active gastritis, respectively. The antigenic types of H. pylori were analyzed in 54 patients with positive H. pylori infection. In this study, H. pylori was divided into four serotypes according to the presence and absence of CagA and VagA: type I; CagA (+) and VacA(+), type Ia: CagA (+) and VacA(-), type Ib: CagA(-) and VacA(+), and type II: CagA(-) and VacA(-). RESULTS: There was no difference in the number of bands for six antigens: 3.2 +/- 1.4, 3.0 +/- 1.2 and 3.1 +/- 1.4 in 35 duodenal ulcer, 7 gastric ulcer and 12 chronic gastritis, respectively. The band with 119 kDa was 90.7%, which was the most common band with the order of 35, 30, 26.5, 89 and 19.5 kDa. Type I, la and Ib were positive in 22.2, 42.6 and 27.8%, respectively, which were significantly higher than type II (p < 0.05). There was no difference in the positive rates of four urease subtypes between the four serotypes.

Detection of antibodies to serum IgA and IgG in peptic ulcer cases by indirect haemagglutination test.

Autoantibodies to serum IgA and IgG were detected in 206 peptic ulcer patients (196 duodenal ulcer and 10 gastric ulcer) and 52 healthy age and sex-matched controls by indirect haemagglutination test. A significantly increased mean titre of autoantibodies to serum IgA was observed in the peptic ulcer patients. Forty-eight (24.61%) duodenal ulcer cases had autoantibody titre values above mean +/- 2 SD of controls. Titres of autoantibodies to serum IgG were significantly increased only in the gastric ulcer cases. The results suggest an immunologic abnormality in a sizeable fraction of these cases.

Detection and characterization of circulating immune complexes in peptic ulcer.

BACKGROUND. Immunological factors have been implicated in the pathogenesis of peptic ulcer following the demonstration of autoantibodies against IgA in patients with this disease. We investigated whether circulating immune complexes were present in this condition, and what type of immunoglobulins were involved. METHODS. The sera of 37 patients with duodenal ulcer and 8 with gastric ulcer were tested for the presence of circulating immune complexes using the polyethylene glycol (PEG) assay and the results compared with those in 79 controls. The precipitate was dissociated and the levels of IgA, IgG and IgM estimated using the single radial immunodiffusion technique. Simultaneous estimation of these immunoglobulins in the serum was also done. Autoantibodies against IgA in the serum were tested using the ELISA test. RESULTS. Eleven patients (6 with duodenal ulcer and 5 with gastric ulcer) were found to have circulating immune complexes. The mean protein content of the PEG precipitates was significantly higher in patients than in control subjects (p < 0.001). The mean values of all the immunoglobulin isotypes were higher in patients than in controls. The IgA content in the PEG precipitates of positive cases was higher than that in control subjects (p < 0.05). CONCLUSION. Patients with peptic ulcer have circulating immune complexes which may interfere with normal immunoregulation.