Helicobacter pylori-derived outer membrane vesicles stimulate interleukin 8 secretion through nuclear factor kappa B activation

Background/Aims@#Bacteria-derived outer membrane vesicles (OMVs) are commonly associated with various biological activities and functions. Helicobacter pylori-derived OMVs are thought to contribute to pathogenesis. This study aimed to investigate the effects of H. pylori-derived OMVs. @*Methods@#H. pylori strains were isolated from patients with gastritis, gastric ulcer, or gastric cancer using endoscopic biopsy. The U-937, AGS, and MKN-45 cell lines were exposed to H. pylori and H. pylori-derived OMVs. The expression of interleukin 8 (IL-8) messenger RNA (mRNA) was assessed using reverse transcription-polymerase chain reaction (RT-PCR) and real-time RT-PCR, and IL-8 secretion was analyzed using enzyme-linked immunosorbent assay. Nuclear factor kappa B (NF-κB) activation was evaluated by Western blotting. @*Results@#H. pylori and H. pylori-derived OMVs induced the expression of IL-8 mRNA and protein. Importantly, the bacteria induced higher IL-8 mRNA and protein expression than the OMVs. IL-8 expression was induced to different levels in response to H. pylori-derived OMVs from hosts with different gastric diseases. Western blotting revealed the increased phosphorylation and reduced degradation of inhibitor of NF-κB alpha in cells exposed to OMVs. @*Conclusions@#H. pylori-derived OMVs may aid the development of various gastric diseases by inducing IL-8 production and NF-κB activation.

Helicobacter pylori-derived outer membrane vesicles stimulate interleukin 8 secretion through nuclear factor kappa B activation

Background/Aims@#Bacteria-derived outer membrane vesicles (OMVs) are commonly associated with various biological activities and functions. Helicobacter pylori-derived OMVs are thought to contribute to pathogenesis. This study aimed to investigate the effects of H. pylori-derived OMVs. @*Methods@#H. pylori strains were isolated from patients with gastritis, gastric ulcer, or gastric cancer using endoscopic biopsy. The U-937, AGS, and MKN-45 cell lines were exposed to H. pylori and H. pylori-derived OMVs. The expression of interleukin 8 (IL-8) messenger RNA (mRNA) was assessed using reverse transcription-polymerase chain reaction (RT-PCR) and real-time RT-PCR, and IL-8 secretion was analyzed using enzyme-linked immunosorbent assay. Nuclear factor kappa B (NF-κB) activation was evaluated by Western blotting. @*Results@#H. pylori and H. pylori-derived OMVs induced the expression of IL-8 mRNA and protein. Importantly, the bacteria induced higher IL-8 mRNA and protein expression than the OMVs. IL-8 expression was induced to different levels in response to H. pylori-derived OMVs from hosts with different gastric diseases. Western blotting revealed the increased phosphorylation and reduced degradation of inhibitor of NF-κB alpha in cells exposed to OMVs. @*Conclusions@#H. pylori-derived OMVs may aid the development of various gastric diseases by inducing IL-8 production and NF-κB activation.

Jejunal Adenocarcinoma as Part of Metachronous Triple Primary Cancers of the Digestive Tract in Patient with Hereditary Nonpolyposis Colorectal Cancer

Hereditary nonpolyposis colorectal cancer (HNPCC) is an autosomal dominant inherited disease characterized by onset at a relatively early age, an excess of synchronous and metachronous tumors, and a variety of extracolorectal malignancies. Small bowel carcinoma reported, is included in the tumor spectrum of HNPCC, but the frequency of occurrence of this tumor in HNPCC patients is comparatively rare. In Korea, several cases of multiple primary cancers in patients with HNPCC have been reported, however, primary jejunal adenocarcinoma in conjunction with multiple primary cancers in the digestive tract has rarely been reported. Recently, we evaluated a 61-year-old male diagnosed with metachronous triple primary cancers of the jejunum, stomach, and colon. We report this rare case of primary jejunal adenocarcinoma as a part of metachronous triple cancers along with a review of the relevant literature.

Primary systemic anaplastic large-cell lymphoma presenting as ascites / 대한내과학회지

Here, we report an unusual case of anaplastic large-cell lymphoma presenting as ascites. A 62-year-old man with alcoholic liver cirrhosis was admitted for ascites. The ascites was an exudate, and atypical cells with nuclear irregularity suggesting the presence of a lymphoma were found on cytological examination of the ascites. However, no primary lesion was found after an exhaustive physical, laboratory, endoscopic, and radiologic examination, and the atypical cells were negative for human herpes virus-8 DNA. Therefore, no definitive diagnosis was made. He was followed regularly without chemotherapy. After 30 months, iliopsoas and erector spinae muscle lesions developed. An ultrasonography-guided gun biopsy of the iliopsoas muscle lesion was performed that revealed anaplastic pleomorphic tumor cells. An immunohistochemical study showed that the tumor cells were positive for LCA and CD30 and negative for CK and ALK. The patient was diagnosed with a primary systemic anaplastic large-cell lymphoma. He could not undergo chemotherapy due to acute renal failure and died after 10 days

Comparison of the Efficacy of Bismuth Containing PPI-based Quadruple Therapy with PPI-based Triple Therapy Only as First-line Treatment for Helicobacter pylori Infection / 대한소화기내시경학회지

BACKGROUND/AIMS: In recent years, increasing antimicrobial resistance has resulted in falling eradication rates with standard therapies. To overcome the falling eradication rates, rescue therapy have been suggested to be used. However, there is no surveillance of using bismuth-based regimen as first line Helicobacter pylori eradication therapy in Korea. This study aimed to assess the efficacy of bismuth containing PPI-based quadruple therapy as a first line treatment. METHODS: From August 2007 through February 2008, 191 patients with Helicobacter pylori positive peptic ulcer disease (PUD) or chronic gastritis (CG) who received first line therapy for 7 days were retrospectively evaluated. 39, 37, 53, 62 patients received PAC (pantoprazole 40 mg, amoxicillin 1 g, clarithromycin 500 mg bid), L-PAC (pantoprazole 40 mg, amoxicillin 750 mg, clarithromycin 250 mg bid), PACB (PAC plus bismuth 300 mg bid), L-PACB (L-PAC plus bismuth 300 mg bid). RESULTS: There was no significant difference in eradication rates between bismuth containing and non- containing group. However, in PUD, the eradication rate of PACB (95.2%) is somewhat higher than that of PAC (86.2%) without statistical significance. CONCLUSIONS: In PUD, Future study designed with a double-blind controlled large scale might reveal that PPI-based standard quadruple therapy containing a bismuth is superior to the standard triple therapy.

Incidence and Risk Factors of Reflux Esophagitis after a Subtotal Gastrectomy / 대한소화기내시경학회지

BACKGROUND/AIMS: The aims of this study were to evaluate the incidence of reflux esophagitis in patients after a subtotal gastrectomy and to determine risk factors for reflux esophagitis. METHODS: Among 225 patients who underwent a subtotal gastrectomy from June 2003 to December 2004 at Seoul National University Bundang Hospital, 201 patients who received follow-up for more than six months and underwent at least one endoscpoic examination were retrospectively reviewed. We used the Los Angeles (LA) classification system and included a minimal change for reflux esophagitis. RESULTS: There were 173 patients who underwent a Billroth I procedure and 28 patients who underwent a Billroth II procedure. The cumulative incidence of reflux esophagitis was 40.8%. A patient age > or =65 years (p=0.04), a follow-up duration > or =40 months (p=0.03), bile reflux gastritis (p or =4 (p=0.012), bile reflux gastritis (p=0.002) and postoperative obesity (p=0.038) were risk factors for a minimal change. A patient age > or =65 years (p=0.04), a follow-up duration > or =40 months (p=0.03) and Helicobacter pylori eradication before surgery (p<0.01) were independent risk factors for LA grade A/B reflux esophagitis. CONCLUSIONS: Bile reflux gastritis is a risk factor for the development of reflux esophagitis after a subtotal gastrectomy. Preoperative helicobacter eradication is also associated with reflux esophagitis, except for a minimal change, but further studies are needed.

Clinical Features of Gastroesophageal Reflux Disease in Elderly Patients in Korea

BACKGROUND: Manifestations of gastroesophageal reflux disease(GERD) range from mild episodes of heartburn and acid regurgitation to chronic mucosal inflammation with esophagitis. It has been suggested that elderly patients may present symptoms in a slightly different manner from younger patients. The aim of the present study was to compare symptoms and clinical characteristics of elderly patients to that of younger patients in a population with endoscopially GERD. METHODS: Three hundred sixty two patients with diagnosed GERD who underwent esophagogastroduedenoscopy were enrolled. Patients were divided into two groups according to age( or =65 years, n=181). Esophageal and other symptoms and clinical parameters including the status of endoscopic findings, Helicobacter pylori infection and pathologic findings. RESULTS: Among esophageal symptoms, heartburn is less frequent in elderly group(21.5% vs. 31.5%, p=0.032). Dyspepsia is most common symptom in both group and more frequent in elderly group(42.5% vs. 32.0%, p=0.039). Other symptoms showed no differences between two groups. The prevalence of H. pylori infection, hiatal hernia and nonerosive GERD also showed no significant differences. CONCLUSION: Elderly patients with GERD presented a higher frequency of atypical symptoms. Intensive history taking for atypical symptoms was needed in elderly patients with suspected GERD.