Investigating Helicobacter pylori-related pyloric hypomotility: functional, histological, and molecular alterations.

Multiple theories have been proposed describing the pathogenic mechanisms of Helicobacter pylori (H. pylori)-associated gastric motility disorders. We assessed ex vivo pyloric activity in H. pylori-infected rats, and tried to explore the associated ghrelin hormone alteration and pyloric fibrogenesis. In addition, miR-1 was assessed in pyloric tissue samples, being recently accused of having a role in smooth muscle dysfunction. Ninety adult male Wistar albino rats were assigned into nine groups: 1) control group, 2) sterile broth (vehicle group), 3) amoxicillin control, 4) omeperazole control, 5) clarithromycin control, 6) triple therapy control, 7) H. pylori- group, 8) H. pylori-clarithromycin group, and 9) H. pylori-triple therapy group. Urease enzyme activity was applied as an indicator of H. pylori infection. Ex vivo pyloric contractility was evaluated. Serum ghrelin was assessed, and histological tissue evaluation was performed. Besides, pyloric muscle miR-1 expression was measured. The immunological epithelial to mesenchymal transition (EMT) markers; transforming growth factor ß (TGFß), α-smooth muscle actin (α-SMA), and E-cadherin-3 were also evaluated. By H. pylori infection, a significant (P < 0.001) reduced pyloric contractility index was recorded. The miR-1 expression was decreased (P < 0.001) in the H. pylori-infected group, associated with reduced serum ghrelin, elevated TGFß, and α-SMA levels and reduced E-cadherin levels. Decreased miR-1 and disturbed molecular pattern were improved by treatment. In conclusion, H. pylori infection was associated with reduced miR-1, epithelial to mesenchymal transition, and pyloric hypomotility. The miR-1 may be a target for further studies to assess its possible involvement in H. pylori-associated pyloric dysfunction, which might help in the management of human H. pylori manifestations and complications.NEW & NOTEWORTHY This work is investigating functional, histopathological, and molecular changes underlying Helicobacter pylori hypomotility and is correlating these with miR-1, whose disturbance is supposed to be involved in smooth muscle dysfunction and cell proliferation according to literature. Epithelial to mesenchymal transition and reduced ghrelin hormone may contribute to H. pylori infection-associated hypomotility. H. pylori infection was associated with reduced pyloric miR-1 expression. Targeting miR-1 could be valuable in the clinical management of pyloric hypofunction.

Involvement of dietary salt in shaping bacterial communities in European sea bass (Dicentrarchus labrax).

Bacteria associated with the digestive tract of multicellular organisms have been shown to play a major role in their hosts' functioning. In fish, it has been proposed that food fermentation occurs inside the pyloric ceca, pouch like organs found in their digestive tract. However, this notion remains controversial. Furthermore, changes in pyloric cecal bacterial populations under different diets have yet to be demonstrated in fish. In this study, we explore the changes occurring in the bacterial community residing in the pyloric ceca of carnivorous fish fed different diets, which were shown to induce different growth rates. Our results revealed that different diets do indeed induce distinct bacterial compositions within the pyloric ceca. We found that, when salt was added to a low fish meal diet, the bacterial changes were accompanied by a significant enhancement in weight gain, hinting at a possible involvement of the bacterial community in energy harvest.

[Assessment of rate of hydroxyl anions production by Helicobacter pylori in stomach].

Production of hydroxyl anions by tissue samples of pylorus mucous membrane obtained from 45 patients with gastric or duodenal ulcers was investigated. The production was estimated using the recently developed method based on measurement of rate of pH change in urea-containing reaction mixture. The rate of [OH-] generation as a result of H. pylori metabolism accounted on pylorus square varied from 0.4 to 1318.9 mcmol [OH-]/min, and in 90.2% of cases it did not exceed 128.1 mcmol [OH-]/min. This rate is comparable to mean rate of [H+] generation in stomach of healthy man--114.2-238.4 mcmol [H+]/min. Obtained results allow to conclude that this bacterium may participate in regulation of stomach acid-base balance.

The epidemic of cocaine-related juxtapyloric perforations: with a comment on the importance of testing for Helicobacter pylori.

OBJECTIVE: This is a report of 50 consecutive patients with juxtapyloric perforations after smoking "crack" cocaine (cocaine base) at one urban public hospital. SUMMARY BACKGROUND DATA: Although the exact causal relation between smoking crack cocaine and a subsequent juxtapyloric perforation has not been defined, surgical services in urban public hospitals now treat significant numbers of male addicts with such perforations. This report describes the patient set, presentation, and surgical management and suggests a possible role for Helicobacter pylori in contributing to these perforations. METHODS: A retrospective chart review was performed, supplemented by data from the patient log in the department of surgery. RESULTS: From 1994 to 1998, 50 consecutive patients (48 men, 2 women) with a mean age of 37 had epigastric pain and signs of peritonitis a median of 2 to 4 hours (but up to 48 hours) after smoking crack cocaine. A history of chronic smoking of crack as well as chronic alcohol abuse was noted in all patients; four had a prior history of presumed ulcer disease in the upper gastrointestinal tract. Free air was present on an upright abdominal x-ray in 84% of patients, and all underwent operative management. A 3- to 5-mm juxtapyloric perforation, usually in the prepyloric area, was found in all patients. Omental patch closure was used in 49 patients and falciform ligament closure in 1. Two patients underwent parietal cell vagotomy as well. In the later period of the review, antral mucosal biopsies were performed through the juxtapyloric perforation in five patients. Urease testing was positive for infection with H. pyonri in four, and these patients were prescribed appropriate antimicrobial drugs. CONCLUSIONS: Juxtapyloric perforations after the smoking of crack cocaine occur in a largely male population of drug addicts who are 8 to 10 years younger than the patient group that historically has perforations in the pyloroduodenal area. These perforations are usually 3 to 5 mm in diameter, and an antral mucosal biopsy for subsequent urease testing should be performed if the location and size of the ulcer allow this to be done safely. Omental patch closure is appropriate therapy for patients without a history of prior ulcer disease; antimicrobial therapy and omeprazole are prescribed when H. pylori is present.

Infection of BALB/c A mice by spiral and coccoid forms of Helicobacter pylori.

Helicobacter pylori exists in two different morphological forms, spiral and coccoid. This study demonstrated that both forms can infect BALB/c A mice. The animals were inoculated orally three times at 2-day intervals with 10(8) cfu of both spiral and coccoid forms of strain CCUG 17874 (NCTC 11637), strain 25 and strain 553/93. Infection was followed over a 30-week period by histological scoring of the grade of inflammation in gastric biopsies. At each time point sera were collected for analysis in ELISA and immunoblot analysis. Both spiral and coccoid forms of all H. pylori strains gave significantly higher inflammation scores than a control group of animals 1 week after inoculation. The histological evidence persisted throughout the entire 30 weeks. The inflammation was most severe in the pylorus and duodenum. Infection with strain 553/93 displayed the most severe gastritis. The spiral form of strain CCUG 17874 gave an immune response after only 4 weeks, whereas its coccoid form as well as strains 25 and 553/93 (spiral and coccoid forms) gave a significant increase in antibody response in ELISA and immunoblot after 16 weeks. It is concluded that both spiral and coccoid forms of H. pylori can cause acute gastritis in BALB/c A mice.

Histopathological study of porcine gastric mucosa with and without a spiral bacterium ("Gastrospirillum suis").

Tightly spiralled bacteria ("Gastrospirillum suis") were seen in the pyloric mucosa of the stomach of 13 (10.8%) of 120 pigs that appeared clinically healthy at slaughter and in the fundic mucosa of three (5.0%) out of 60 pigs. The spiral organism could not be cultured from any pig. Chronic gastritis was observed in the pyloric mucosa of 53 (44.2%) of 120 pigs and in the fundic mucosa of 7 (11.7%) of 60 pigs. The 13 pigs with spiral bacteria in the pyloric region comprised one animal (7.7%) with normal pyloric mucosa, two (15.4%) with "borderline gastritis", and 10 (76.9%) with chronic gastritis--in one instance accompanied by signs of activity (numerous polymorphonuclear cells). The three pigs with spiral bacteria in the fundic mucosa comprised two animals with a normal fundic region and one with "borderline gastritis". The presence of the spiral bacterium was significantly associated with pyloric gastritis (p = 0.013) and with numbers of lymphoid follicles (p = 0.014).

[Secretory immunoglobulin A and pyloric helicobacteriosis in patients with duodenal ulcer]. / Sekretornyi immunoglobulin A i piloricheskii khelikobakterioz u bol'nykh iazvennoi bolezn'iu.

57 patients with duodenum ulcer were examined. Secretory immunoglobulin A (SIgA) was determined by an immunofluorescent method in the gastric and duodenum mucosa depending on the population size of pyloric helicobacter (HB). The frequency of SIgA detection in the gastric mucosa depends on the HB population size: when it is considerable SIgA was not detected in 41% cases. SIgA was detected in the gastric mucosa without pathological lesions in 85% cases, in atrophic gastritis in 70% and in superficial gastritis in 54% cases.

Relationship between Campylobacter pylori and gastritis in healthy humans after administration of placebo or indomethacin.

Endoscopic and microscopic appearances of antral and fundic mucosa were correlated with the presence or absence of Campylobacter pylori--and with plasma immunoglobulin G antibodies to that organism--in 23 healthy volunteers, 12 of whom had received indomethacin and 11 of whom had received no medication. Antral C. pylori, found in 9 of 23 biopsy specimens (3 of 11 controls, 6 of 12 indomethacin-treated patients; not significantly different), correlated strongly with histologic evidence of active superficial antral gastritis (p less than 0.005), but not with the endoscopic appearance of the antrum. In contrast to the antrum, fundic C. pylori, found in 14 of 23 biopsy specimens (61%), were frequently associated with histologically and endoscopically normal fundic mucosa. Campylobacter pylori-associated active antral gastritis occurred only in subjects whose fundus harbored this organism. Plasma immunoglobulin G antibody titers to C. pylori were highest in subjects with Campylobacter-associated antral gastritis and lowest in subjects without gastric Campylobacter. These studies suggest that healthy humans may harbor C. pylori in their proximal stomach without apparent ill effects. In some of these individuals, the organism also involves the antrum and is associated with active gastritis.

Campylobacter pilórico y nivel socio-económico / Campylobacter pyloricus and socio-economic level

El presente trabajo tiene por objeto determinar si existe alguna relación entre el nivel socio-económico (NSE) de pacientes y la colonización del estómago por el Campylobacter pilórico (CP). Estudiamos diversos aspectos de esta bacteria en dos grupos de pacientes de NSE diferente, nos pareció de inicio apreciar una aparente diferencia en relación a la colonización del estómago por esta bacteria. Hemos evaluado 256 pacientes examinados mediante esofagogastroduodenoscopía (Panendocopio Olympus GIF-K2) por presentar síntomas del tracto gastrointestinal superior. De ellos, 143 pertenecen al Hospital Arzobispo Loayza (38 varones y 105 mujeres) y 122 a la práctica privada de 3 de los autores (77 varones y 45 mujeres), con edades comprendidos entre 16 y 75 años (media de 45.5 años). En cada caso se tomó biopsias del antro gástrico (curvatura mayor y menor) las que fueron coloreadas con hematoxilina-eosina y con plata. Tomando en cuenta recomendaciones para clasificar el NSE de acuerdo a la procedencia los pacientes fueron considerados habitantes de: distritos nucleares, distitos intermedios y distritos periféricos. Los cálculos estadísticas han revelado que aunque de acuerdo a la procedencia, los grupos de pacientes del Hospital Arzobispo Loayza y de la práctica privada tuvieron un NSE significativamente diferente, la frecuencia de infección por CP en ellos no mostró diferencia estadísticamente significativa. Lo cual parecería indicar pues, que el distrito del cual procede un paciente con trastornos del tracto gastrointestinal no es factor determinante de infección por CP

Campylobacter pilórico y nivel socio-económico / Campylobacter pyloricus and socio-economic level

El presente trabajo tiene por objeto determinar si existe alguna relación entre el nivel socio-económico (NSE) de pacientes y la colonización del estómago por el Campylobacter pilórico (CP). Estudiamos diversos aspectos de esta bacteria en dos grupos de pacientes de NSE diferente, nos pareció de inicio apreciar una aparente diferencia en relación a la colonización del estómago por esta bacteria. Hemos evaluado 256 pacientes examinados mediante esofagogastroduodenoscopía (Panendocopio Olympus GIF-K2) por presentar síntomas del tracto gastrointestinal superior. De ellos, 143 pertenecen al Hospital Arzobispo Loayza (38 varones y 105 mujeres) y 122 a la práctica privada de 3 de los autores (77 varones y 45 mujeres), con edades comprendidos entre 16 y 75 años (media de 45.5 años). En cada caso se tomó biopsias del antro gástrico (curvatura mayor y menor) las que fueron coloreadas con hematoxilina-eosina y con plata. Tomando en cuenta recomendaciones para clasificar el NSE de acuerdo a la procedencia los pacientes fueron considerados habitantes de: distritos nucleares, distitos intermedios y distritos periféricos. Los cálculos estadísticas han revelado que aunque de acuerdo a la procedencia, los grupos de pacientes del Hospital Arzobispo Loayza y de la práctica privada tuvieron un NSE significativamente diferente, la frecuencia de infección por CP en ellos no mostró diferencia estadísticamente significativa. Lo cual parecería indicar pues, que el distrito del cual procede un paciente con trastornos del tracto gastrointestinal no es factor determinante de infección por CP (AU)

[Finding of pyloric Campylobacter in the operated stomach and therapeutic results]. / Hallazgo de Campylobacter pilórico en estómago operado y resultados terapéuticos.

We present a trial on 21 patients with gastric surgery, by different pathologies, benign and malignant, with the aim of detecting presence or absence of Pyloric Campylobacter. The clinical, endoscopic findings and presence-absence of Pyloric Campylobacter were correlated. Regarding the clinical symptomatology, it was not possible to obtain a favourable conclusion to the presence of Pyloric Campylobacter in both groups. The endoscopic findings showed changes more evident in those cases of positive Pyloric Campylobacter. The therapeutical response of positive Pyloric Campylobacter to TDB during 30 days was beneficial regarding the disappearance of the symptoms.

Rapid identification of pyloric Campylobacter in Peruvians with gastritis. The Gastrointestinal Physiology Working Group.

Pyloric Campylobacter have been reported to colonize the gastric mucosa of many persons, especially in association with gastritis and peptic ulcer disease. These reports have, so far, come from countries in the developed world. We report that pyloric Campylobacter appear to be equally common in persons from a developing country (Peru) who have gastritis. Our examination of the histopathology associated with these organisms suggests that mucin depletion is associated with active colonization. Two simple diagnostic methods have been found which compare favorably to silver staining of biopsy material and which appear to have value in the rapid and facile identification of these organisms: hematoxylin-eosin staining of biopsies and Gram staining of cytology specimens obtained by brushing the gastric mucosa.

Detección del Campylobacter pilórico en pacientes con enfermedades gastroduodenales / Detection of pyloric Campylobacter in patients with gastroduodenal diseases

Presentamos un estudio de 127 pacientes a quienes con fines diagnósticos se efectuó esofagogastroduodenoscopía. Se tomaron muestras de cepillado y biopsias del esófago, estómago y duodeno, que han sido examinadas por coloración con Gram, cultivo de cepillado y biopsia y estudio histológico de las biopsias con coloración con hematoxilina-eosina y plata con el fin de detectar la presencia de Campylobacter pilórico. En la gastritis crónica activa hemos hallado la bacteria en 91% de casos, en 73% en la úlcera péptica gástrica y en 84% en la úlcera péptica duodenal. Cuando se encuentra campylobacter en el antro, la distribución es igual en el cuerpo y cardias. Comparando los diferentes métodos que hemos empleado, los mejores resultados obtendos en forma decreciente, han sido con la coloración con plata, Gram, hematoxilina-eosina, cultivo de biopsia y cultivo de cepillado. En nuestra serie de estudio en algunos casos se ha hallado campylobacter en esófago y duodeno con la coloración con Gram y por cultivo no habiéndose detectado con las coloraciones de plata y hematoxilina-eosina, lo que sugiere que la contaminación procedente del estómago puede ser un problema para tomar muestras del esófago y duodeno al investigar la presencia de campylobacter pilórico

Detección del Campylobacter pilórico en pacientes con enfermedades gastroduodenales / Detection of pyloric Campylobacter in patients with gastroduodenal diseases

Presentamos un estudio de 127 pacientes a quienes con fines diagnósticos se efectuó esofagogastroduodenoscopía. Se tomaron muestras de cepillado y biopsias del esófago, estómago y duodeno, que han sido examinadas por coloración con Gram, cultivo de cepillado y biopsia y estudio histológico de las biopsias con coloración con hematoxilina-eosina y plata con el fin de detectar la presencia de Campylobacter pilórico. En la gastritis crónica activa hemos hallado la bacteria en 91% de casos, en 73% en la úlcera péptica gástrica y en 84% en la úlcera péptica duodenal. Cuando se encuentra campylobacter en el antro, la distribución es igual en el cuerpo y cardias. Comparando los diferentes métodos que hemos empleado, los mejores resultados obtendos en forma decreciente, han sido con la coloración con plata, Gram, hematoxilina-eosina, cultivo de biopsia y cultivo de cepillado. En nuestra serie de estudio en algunos casos se ha hallado campylobacter en esófago y duodeno con la coloración con Gram y por cultivo no habiéndose detectado con las coloraciones de plata y hematoxilina-eosina, lo que sugiere que la contaminación procedente del estómago puede ser un problema para tomar muestras del esófago y duodeno al investigar la presencia de campylobacter pilórico (AU)

[Detection of pyloric Campylobacter in patients with gastroduodenal diseases]. / Detección del Campylobacter pilórico en pacientes con enfermedades gastroduodenales.

We report a study of 127 patients examined with esophago-gastroduodenoscopy and with a diagnosis of chronic gastritis (by biopsy), and gastric peptic ulcer and duodenal peptic ulcer (endoscopically). Brushing samples and biopsies were taken from the esophagus, stomach, and duodenum. Gram stains of brush-collected samples, culture of brush samples and biopsies were performed in order to detect the presence of PC. In cases of chronic active gastritis, PC was found in 91% of patients. It was found in 73% and 84%, respectively, of cases of gastric and duodenal ulcer. PC was found with equal frequency in the cardia and body as in the antrum of infected individuals, but no confirmed cases of colonization of the esophagus or duodenum were found. The most efficient methods for identifying PC colonization were (in descending order of efficiency), silver stain of biopsies, Gram stain of brushings, hematoxylin-eosin stain of biopsies, culture of biopsies, and culture of brushings. In some cases, we have identified PC in the esophagus and duodenum by gram stain and culture, but no not by silver stain or H&E stain of biopsies, suggesting that contamination from other areas of the stomach may be an occasional problem in sampling these areas for PC.