Showing papers on "Chronic gastritis published in 2023"

Helicobacter pylori infection.

Abstract: Helicobacter pylori infection causes chronic gastritis, which can progress to severe gastroduodenal pathologies, including peptic ulcer, gastric cancer and gastric mucosa-associated lymphoid tissue lymphoma. H. pylori is usually transmitted in childhood and persists for life if untreated. The infection affects around half of the population in the world but prevalence varies according to location and sanitation standards. H. pylori has unique properties to colonize gastric epithelium in an acidic environment. The pathophysiology of H. pylori infection is dependent on complex bacterial virulence mechanisms and their interaction with the host immune system and environmental factors, resulting in distinct gastritis phenotypes that determine possible progression to different gastroduodenal pathologies. The causative role of H. pylori infection in gastric cancer development presents the opportunity for preventive screen-and-treat strategies. Invasive, endoscopy-based and non-invasive methods, including breath, stool and serological tests, are used in the diagnosis of H. pylori infection. Their use depends on the specific individual patient history and local availability. H. pylori treatment consists of a strong acid suppressant in various combinations with antibiotics and/or bismuth. The dramatic increase in resistance to key antibiotics used in H. pylori eradication demands antibiotic susceptibility testing, surveillance of resistance and antibiotic stewardship.

Belgian consensus for Helicobacter pylori management 2023.

Abstract: Helicobacter pylori (H. pylori) infection causes chronic gastritis, peptic ulcers and gastric cancer. Although H. pylori prevalence is decreasing worldwide, regional variations exist in Europe, with the lowest infection prevalence in Northern Europe, and the highest in Eastern and Southern Europe (1). Changes in the treatment recommendations and the increasing available evidence have justified the implementation of new recommendations since last Belgian consensus in 1998 (2). Several non-H. pylori Helicobacter species (NH.PYLORI-H), colonizing the stomach of domestic animals, also have the ability to cause gastric disease in humans, although to a lesser extent. These zoonotic NH. PYLORIH are not the subject of the current recommendations.

Weikangling capsules combined with omeprazole ameliorates ethanol-induced chronic gastritis by regulating gut microbiota and EGF-EGFR-ERK pathway.

Abstract: Weikangling capsules (WKLCs) have been widely used in the treatment of chronic gastritis. Whether used alone or combined with omeprazole (OME), it shows a significant effect. However, the mechanisms haven't been established. The study aimed to explore the mechanisms of WKLCs and its combination with OME on chronic gastritis.The components of WKLCs and EA (the ethyl acetate extraction extracted from WKLCs) fraction were analyzed. Then chronic gastritis model rats were induced by 56 % ethanol and treated with OME, low dose of WKLCs (WKL), high dose of WKLCs (WKH), WKLCs combined with OME (WO), and EA fraction (EA) to evaluate the mechanisms of WKLCs, drug combination and EA fraction.A total of 22 components of WKLCs were quantified, among them 18 were enriched in EA fraction. WKLCs alleviated the morphology and inflammation of gastric mucosa and downregulated the levels of inflammatory factors (IL-1β, TNF-α, IL-6) and epidermal growth factor (EGF) in serum by inhibiting the EGF-EGFR-ERK pathway, regulating gut microbiota composition and SCFAs contents in feces. WKLCs plus OME was better than OME. EA fraction improved digestive function by increasing pepsin activity and decreasing gastrointestinal hormones (GAS and VIP) compared with WKLCs.This study elucidated that the effect of WKLCs and its combination with OME in the treatment of chronic gastritis was attributed to regulating the composition of the gut microbiota and inhibiting the EGF-EGFR-ERK pathway. The EA fraction is an inseparable effective substance of WKLCs. This study provides scientific evidence for clinical application.

Evaluation of serum levels of Proinflammatory Cytokines IL-8, IL-17, and IL-22 in Helicobacter pylori infection and their association with the degree of gastritis histopathology in a sample of Iraqi patients

Abstract: Gastritis can be defined as histological inflammation of the gastric mucosa. It can be classified according to the time course of the disease as acute or chronic, histological findings, anatomic location, and pathological mechanisms. The objective of this study was to evaluation of serum levels of the proinflammatory cytokines IL-8, IL-17 and IL-22 in Helicobacter pylori infection and their association with the degree of gastritis histopathology in a sample of Iraqi patients. The case-control prospective study consists of 60 patients who attended the Gastrointestinal Tract Center at Al-Kindy Teaching Hospital during the period from December 2019 to April 2020. In addition, the control group included 60 apparently healthy individuals. Biopsies from the gastric antrum and/or body mucosa were used to assess the severity of chronic inflammation, neutrophil infiltration, atrophy, intestinal metaplasia. Serum samples were obtained to determine H. pylori infection, circulating interleukin (IL)-8, IL-17, and IL-22. Results showed that the Patients’ ages with gastritis ranged from 18-75 years. The body mass index revealed that 33.33% of the patients were obese and 35% of them were overweight. Most of the patients with active chronic gastritis and superficial chronic gastritis had positive titers for anti-H. pylori IgG antibody (167.89 ± 3.18 IU/ml) and (150.74± 1.45 IU/ml) respectively, which was significantly different from the control group (4.36 ± 0.29 IU/ml) (P=0.0001). Histopathological analysis showed that all subjects experienced chronic inflammation, while neutrophil infiltration was found 36.66% and there was significant association between serum levels of IL-8, IL-17, and IL-22 with a degree of chronic inflammation and neutrophils infiltration. In conclusion, the most common cause of gastritis was H. pylori with histopathological lesions, showing neutrophils infiltration and chronic gastric mucosal inflammation associated with increased levels of IL-8, IL-17, and IL-22 in serum.

Mechanisms of action of rebamipide in the treatment of chronic erosive gastritis patients with type 1 diabetes mellitus

Abstract: Introduction. Type 1 diabetes mellitus (DM-1) and its complications pose a serious medical and social problem. Erosive changes in the gastric mucosa are among the most common lesions of the digestive system in diabetes mellitus, and can lead to life-threatening gastrointestinal bleeding and early disability of patients.Aim. Substantiation of the effectiveness of rebamipid course treatment based on an assessment of the functional state and antioxidant activity of the supraepithelial gastric mucosa in chronic erosive gastritis in patients with DM-1.Materials and methods. A comprehensive examination of 12 DM-1 patients with erosive gastritis and 11 healthy individuals was carried out, including FGDS with biopsy of the antrum mucosa and stomach body, exclusion of Helicobacter pylori infection, determination of the biochemical composition of structural glycoproteins of mucus and the concentration of degraded glycoproteins, evaluation of the antiradical activity of the supraepithelial mucous layer of the stomach.Results and discussion. In chronic erosive gastritis in patients with DM-1, a significant predominance of degraded monosaccharides in the supraepithelial mucous layer of the stomach was revealed (6 times higher than in healthy individuals), a decrease in the concentration of polymerized glycoproteins in gastric mucus (21% vs. 80%) and a significant increase in the antiradical activity of mucus. Course treatment of chronic erosive gastritis in patients with type 1 diabetes with rebamipid at a dose of 100 mg 3 times a day for 3 weeks contributes to the normalization of the indicators of glycoproteins of native mucus, antiradical activity of the mucosa and complete epithelization of the erosions of the antrum of the stomach.Conclusions. The use of rebamipid in the treatment of chronic erosive gastritis in patients with type 1 diabetes contributes to reducing the degradation of polymerized glycoproteins of native mucus, normalizing the antiradical activity of the mucosa and complete epithelization of erosions of the antrum of the stomach.

Histopathological findings on resected gastric specimens from obese patients undergoing laparoscopic sleeve gastrectomy

Abstract: Background and aims This study aimed to investigate the relationship between baseline characteristics of obese patients and histopathological findings on resected gastric specimens resulted after laparoscopic sleeve gastrectomy. Methods Seventy-seven patients undergoing laparoscopic sleeve gastrectomy in a university surgical department from Romania were included in the present study. Demographic data, preoperative Body Mass Index values, and their relationship with the histopathological findings of resected gastric specimens were statistically analyzed. Results The mean age of patients included was 40.2 ± 11.05 years and the mean Body Mass Index was 43.5 ± 7.8 kg/m2; 71.4% of the patients were female. Active chronic gastritis was the most common gastric pathology (39%) encountered. Helicobacter pylori infection was present in 27.2% of the cases. Normal gastric histology was found in 33.7% of the specimens. A strong statistically significant association was noted between Helicobacter pylori infection and active chronic gastritis (p<0.0001). Similarly, a statistically significant association was observed between age, Body Mass Index, and intestinal metaplasia (p=0.005 and p=0.009 respectively). No malignancies were found. Conclusions Our study results show that the incidence of active chronic gastritis and Helicobacter pylori infection is relatively high in obese patients. Considering this, we conclude that it is important to send the resected gastric specimens for histopathological analysis after laparoscopic sleeve gastrectomy.

Association of attitude to illness with adherence to treatment in patients with chronic gastritis

Abstract: Aim. To study the associations between the attitude towards illness and the level of compliance in patients with chronic gastritis.Materials and Methods. The study included 302 patients with chronic gastritis which have been stratified into 4 groups: 1) 96 patients with Helicobacter pylori (HP)-associated chronic gastritis and high treatment adherence; 2) 110 patients with HP-negative chronic gastritis and high treatment adherence; 3) 36 patients with HP-associated gastritis who refused treatment; 4) 60 patients with HP-associated gastritis and moderate treatment adherence. The level of adherence to treatment and personal response to the disease was assessed using Davydov and TOBOL questionnaires, respectively. Interrelations of the studied parameters were evaluated using correlation analysis.Results. Eradication of HP was associated with a high treatment adherence. The majority of patients (56.0%) had adaptive behavioural response, whilst mixed (18.2%) and maladaptive types (12.5% for intrapsychic and 11.6% for interpsychic orientation) were less frequently observed. In patients who refused treatment, adaptive behavioural response was less common than anosognosic and maladaptive attitudes. Correlation analysis revealed that treatment adherence positively correlates with harmonious and ergopathic attitudes.Conclusion. Attitude to illness affects adherence to treatment in patients with chronic gastritis.

Gastric intestinal metaplasia in Children: Natural history and clinicopathological correlation

Abstract: Introduction: Gastric intestinal metaplasia (GIM) is defined as the replacement of the normal gastric epithelium by intestinal-type epithelium. GIM is considered a pre-neoplastic lesion for gastric adenocarcinoma in adults and is found in 25% of Helicobacter pylori (H. pylori) exposed adults. However, the significance of GIM in pediatric gastric biopsies is still unknown. Methods: We conducted a retrospective study of children with GIM on gastric biopsies at Boston Children’s Hospital between January 2013-July 2019. Demographic, clinical, endoscopic, and histologic data were collected and compared to age and sex-matched cohort without GIM. Gastric biopsies were reviewed by the study pathologist. GIM was classified as complete/incomplete based on Paneth cell presence or absence and limited/extensive based on its distribution in the antrum or both antrum and corpus. Results: Of 38 patients with GIM, 18 were male (47%), mean age of detection was 12.5 ± 5.05 years (range, 1-18 years). The most common histologic was chronic gastritis (47%). Complete GIM was present in 50% (19/38) and limited GIM was present in 92% (22/24). H. pylori was positive in 2 patients. Two patients had persistent GIM on repeat EGD (2/12). No dysplasia or carcinoma was identified. Proton-pump inhibitor (PPI) use and chronic gastritis were more common in GIM patients compared to control (p=0.02). Conclusion: Most children with GIM had low-risk histologic subtype (complete/limited) for gastric cancer; GIM was rarely associated with H. pylori gastritis in our cohort. Larger multicenter studies are needed to better understand outcomes and risk factors in children with GIM.

Helicobacter pylori Antibiotic Resistance: Molecular Basis and Diagnostic Methods

Abstract: Helicobacter pylori is one of the most common cause of human infections. Infected patients develop chronic active gastritis in all cases, which can lead to peptic ulcer, atrophic gastritis, gastric cancer and gastric MALT-lymphoma. The prevalence of H. pylori infection in the population has regional characteristics and can reach 80%. Constantly increasing antibiotic resistance of H. pylori is a major cause of treatment failure and a major problem. According to the VI Maastricht Consensus, two main strategies for choosing eradication therapy are recommended: individualized based on evaluating sensitivity to antibacterial drugs (phenotypic or molecular genetic method) prior to their appointment, and empirical, which takes into account data on local H. pylori resistance to clarithromycin and monitoring effectiveness schemes in the region. Therefore, the determination of H. pylori resistance to antibiotics, especially clarithromycin, prior to choosing therapeutic strategy is extremely important for the implementation of these treatment regimens.

Clinical Application of the Kyoto Classification of Gastritis

Abstract: Recent advances in endoscopic technology, including high-definition and image-enhanced endoscopy such as narrow-band imaging have facilitated close observation and detailed imaging of the gastric mucosa. Currently, endoscopy is performed in Korea primarily for evaluation of premalignant conditions and gastric cancer detection. Recent research has established the Kyoto classification of gastritis, a novel grading system for endoscopic gastritis, which enables prediction of Helicobacter pylori (H. pylori) infection. The Kyoto classification score is calculated based on the sum of scores for five main items (of 19 endoscopic findings indicative of H. pylori infection) such as atrophy, intestinal metaplasia, enlarged gastric folds, nodularity, and diffuse redness with/without regular arrangement of collecting venules (RAC). Of these five endoscopic findings, atrophy, intestinal metaplasia, enlarged gastric folds, and nodularity are associated with an increased risk and RAC with a decreased risk of gastric cancer. Previous studies have reported that a Kyoto classification score ≥2 indicates current or past H. pylori infection. An increase in the Kyoto classification score is associated with a high risk of gastric cancer; specifically, a Kyoto classification score ≥4 indicates a high risk of gastric cancer. However, H. pylori eradication is followed by disappearance of enlarged gastric folds, nodularity, and diffuse redness; therefore, this grading system cannot accurately reflect the gastric cancer risk in patients with previous H. pylori infection. Limited studies have discussed the Kyoto classification of gastritis in Korea. Therefore, further large-scale multicenter studies are warranted for validation of the Kyoto classification to predict H. pylori infection and gastric cancer risk.

Modern therapeutic dietary foods in the complex therapy of chronic reflux gastritis, not associated with HP infection

Abstract: Introduction. Dietary nutrition is one of the most important and physiological therapeutic and preventive approaches for chronic reflux gastritis (CRG), not associated with HP infection. Aim. To analyze the effectiveness and safety of the use of specialized therapeutic nutrition (produced by LEOVIT) in chronic reflux gastritis (CRG), not associated with HP infection, in the acute phase. Materials and methods. A comparative randomized study included 40 patients with CRG, not associated with HP infection, in the acute phase. During the one-month course, standard diet therapy was used in the control group (20 patients), and in the patients of the main group (20 patients), diet therapy was carried out using specialized dietary products. The dynamics of clinical manifestations, changes in esophagogastroduodenoscopy (EGDS), blood test parameters, and the severity of dysbiosis were studied. Statistical processing of the research results was carried out with the determination of the significance of the mean values using the Student’s t-test. Results. It was found that the studied specialized therapeutic nutrition (oatmeal porridge with herbs and flax seed, vegetable soup with herbs and oatmeal, gastric jelly LEOVIT) have pleasant organoleptic properties, do not cause intolerance and allergic manifestations, restore digestion, improve the state of intestinal microflora, improve the quality of life of patients. According to endoscopic studies in the esophagus of patients in the main group, compared with patients in the comparison group, “normal” mucosa was statistically significantly more common (95 vs. 60% of cases) and catarrhal esophagitis was less common (5 vs. 40% of cases). The number of patients with an admixture of bile in the lumen of the stomach in patients of the main group compared with patients of the control group was found significantly less frequently in 20% of cases versus 75% of cases. Conclusion. The investigated approach to diet therapy with the use of specialized therapeutic nutrition in CRG is completely safe and recommended by the authors for long-term use in patients with this pathology.

Relationship of helicobacter pylori caga and vaca status to morphological changes of gastric mucosa and primary clarithromycin resistance rate in patients with chronic gastritis: a cross-sectional study

Abstract: The aim: To investigate the relation of H. pylori CagA and VacA status to morphological changes of gastric mucosa and primary clarithromycin resistance rate in patients with chronic gastritis.Materials and methods: A cross-sectional study was conducted between May 2021 and January 2023, involving 64 patients with H. pylori-associated chronić gastritis. The patients were assigned to two groups according to the H. pylori virulence factors (CagA and VacA) status. The grades of inflammation, activity, atrophy, and metaplasia were determined according to the Houston-updated Sydney system. The identification of H. pylori genetic markers of antibiotic resistance and pathogenicity was performed by the polymerase chain reaction using paraffin stomach biopsies.Results: Patients with CagA- and VacA-positive H. pylori strains had significantly higher grades of inflammation both in the antrum and in the corpus of the stomach, activity of gastritis in the antrum, higher incidence and grade of atrophy in the antrum. Primary resistance to clarithromycin was significantly more prevalent in patients with CagA- and VacA-negative H. pylori strains (58.3% vs. 11.5%, p=0.002).Conclusions: Positive CagA and VacA status is related to more severe histopathological changes of gastric mucosa. In contrast, the rate of primary clarithromycin resistance is higher in patients CagA- and VacA-negative H. pylori strains.

Comparative characteristics of cytokine regulation in patients with gastric diseases associated with &lt;i&gt;Helicobacter pylori&lt;/i&gt; infection

Abstract: When the body is infected with the bacterium Helicobacter pylori , a cytokine cascade is launched, which plays a key role in the progression of chronic inflammatory and destructive processes in the gastric mucosa. Thus, the secretion of a number of cytokines is stimulated, which in turn contribute to the attraction of immunocompetent cells and the development of inflammatory changes. However, hyperproduction of cytokines can lead to atrophic changes in the gastric mucosa and, as a result, degeneration into gastric cancer. Thus, the role of cytokines in precancerous conditions is ambiguous. On the one hand, they activate the immune response aimed at eliminating the pathogen. On the other hand, they themselves contribute to the progression of the disease. The complex clinical and laboratory study included patients: 60 with chronic gastritis (CG), 55 with chronic atrophic gastritis (CAG), 50 with gastric cancer (GC, stage I-II, morphological variant – adenocarcinoma) and 60 – control group. The diagnoses were verified according to international and Russian recommendations and confirmed by laboratory and instrumental studies. All patients were comparable in terms of gender and age characteristics (p > 0.05). All patients had specific IgG to H. pylori . The study was approved by the Local Ethics Committee of the FRC KSC SB RAS (protocol No. 11 dated November 11, 2013). All ethical requirements were observed, and the patients signed the informed consent form for participation. Patients and persons of the control group underwent a single blood sampling from the cubital vein upon admission to vacutainers with heparin. The levels of IL-2, IL-4, IL-8, TNFα, interferon-γ in the blood serum of patients and healthy individuals were determined using the enzyme immunoassay method using reagent kits manufactured by JSC “VectorBest”. Statistical data processing was carried out using the Statistica for Windows 8.0 application package. All patients with H. pylori -associated diseases (CG, CAG, GC) showed an increase in pro-inflammatory (IL-2, IL-8, IFNγ) with a significant increase in IL-8 in all patients and IFNγ in gastric cancer and antiinflammatory cytokine (IL-4) with a maximum value in gastric cancer. A combined Th1 and Th2 is found – a mediated immune response with a maximum violation of cytokine regulation in gastric cancer.

The analysis of pathological features of gastritis and Helicobacter pylori infection

Abstract: [Objective] To explore the correlation between helicobacter pylori infection and several pathological features of gastritis, and provide evidence for pathological features analysis and diagnosis in helicobacter pylori associated gastritis. [Methods] We collected 180 patients with gastritis admitted to the Seventh Affiliated Hospital of Sun Yat-sen University from 2021 to 2022, and make a retrospective analysis of their status of H. pylori with PCR technology. Then we further detected the resistant results of clarithromycin and fluoroquinolone in H. pylori positive group. Chi-Squared Test were used to analyzed the relationship between helicobacter pylori status and pathological features of gastritis. [Results] Erosion or ulcers in the H. pylori-positive group were significantly higher than those in the H. pylori-negative group (P<0.05). Meanwhile, H. pylori-positive group were tended to have more severe activity or inflammation in the biopsy specimen. However, there was no significant difference in resistance to clarithromycin or fluoroquinolone in H. pylori-positive group with erosion, ulcers, or active inflammation. [Conclusion] Helicobacter pylori infection is correlated with gastritis pathological features such as erosion, ulcers, inflammation or activity, but the pathological features of H. pylori-positive patients could not predict the antibiotic resistance. The experiment of screening drug resistance still has important clinical significance.

The conundrum of Helicobacter pylori-associated apoptosis in gastric cancer.

Abstract: Helicobacter pylori is a human microbial pathogen that colonizes the gastric epithelium and causes type B gastritis with varying degrees of active inflammatory infiltrates. The underlying chronic inflammation induced by H. pylori and other environmental factors may promote the development of neoplasms and adenocarcinoma of the stomach. Dysregulation of various cellular processes in the gastric epithelium and in different cells of the microenvironment is a hallmark of H. pylori infection. We address the conundrum of H. pylori-associated apoptosis and review distinct mechanisms induced in host cells that either promote or suppress apoptosis in gastric epithelial cells, often simultaneously. We highlight key processes in the microenvironment that contribute to apoptosis and gastric carcinogenesis.

Association of Helicobacter Pylori Positivity with Risk of Disease and Mortality.

Abstract: BACKGROUND Helicobacter pylori colonizes the human stomach. Infection causes chronic gastritis and increases the risk for gastroduodenal ulcer and gastric cancer. Its chronic colonization in the stomach triggers aberrant epithelial and inflammatory signals, that are also associated with systemic alterations. METHODS Using PheWAS analysis in more than 8.000 participants in the community-based UK Biobank we explored the association of H. pylori positivity with gastric and extra gastric disease and mortality in a European country. RESULTS Along with well-established gastric diseases we dominantly found overrepresented cardiovascular, respiratory, and metabolic disorders. Using multivariate analysis, the overall mortality of H. pylori positive participants was not altered, while the respiratory and COVID-19 associated mortality increased. Lipidomic analysis for H. pylori positive participants revealed a dyslipidemic profile with reduced HDL cholesterol and omega-3 fatty acids, which may represent a causative link between infection, systemic inflammation, and disease. CONCLUSION Our study of H. pylori positivity demonstrates that it plays an organ- and disease entity-specific role in the development of human disease and highlight the importance of further research into the systemic effects of H. pylori infection.

The Relationship Between Gastric Xanthoma, Gastric Precancerous Lesions, and Gastric Cancer: A Retrospective Study.

Abstract: OBJECTIVE To evaluate the relationship between gastric cancer and its precancerous lesions and gastric xanthoma. METHODS The medical records of 47736 patients who underwent gastroscopy in our center from January 2020 to December 2021 were reviewed. Patient age, sex, endoscopic/histologic diagnosis results, the location of gastric xanthoma and whether it was single or multiple were recorded. To investigate the detection rate of gastric xanthoma at different disease stages, the participants were further divided into chronic gastritis group (n = 42758), precancerous lesion group (n = 3672) and gastric cancer group (n = 1306). RESULTS The overall detection rate of gastric xanthoma was 2.85%, with a prevalence in the gastric antrum (52.50%). In addition, the proportion of male patients and patients with single gastric xanthoma was higher (3.28% vs. 2.46%, 62.06% vs. 37.94%, respectively). Stratified analysis of patients according to gastric disease progression revealed that gastric xanthoma was least detected in the chronic gastritis group (2.29%), followed by gastric cancer group (5.44%), and highest in the precancerous gastric lesion group (8.39%). Multivariate analysis showed that gastric xanthoma was closely related to precancerous lesions (OR: 3.197, 95%CI (2.791-3.662), P < 0.001) and gastric cancer (OR: 1.794, 95%CI (1.394-2.309), P < 0.001). CONCLUSIONS Gastric xanthoma is closely related with gastric cancer and precancerous lesions.

The influence of selenium on the course of inflammatory diseases of the upper gastrointestinal tract in children

Abstract: Background. Impaired homeostasis of the essential microelements in the body of children plays a significant role in the etiology, pathogenesis and therapy of a number of diseases. Stu­dies on the exchange of bioelements in gastrointestinal diseases, in particular, the content of selenium (Se), have not been conducted enough. Aim: to evaluate selenium influence on the course of inflammatory diseases of the upper gastrointestinal tract in children. Materials and me­thods. The study included 112 school-age children with inflammatory diseases of the upper gastrointestinal tract (55 with chronic gastritis (CG), 57 with chronic gastroduodenitis (CGD)) as the main group and 20 practically healthy children of the corresponding age as the comparison group. Verification of CG and CGD diagnosis was based on clinical and endoscopic data according to the Houston mo­dification of the Sydney classification of chronic gastritis (1996) with assessment of topography and morphology. Quantitative determination of Se in blood plasma was carried out using mass spectrometry. Results. The average level of Se in blood plasma of children with inflammation of the gastric and duodenal mucosa was (75.82 ± 11.23) μg/l, in children of the comparison group — (85.42 ± 9.44) μg/l (p > 0.05). We did not find gender and age differences in Se plasma levels. Deficiency of Se in the blood of children with CG and CGD was found in 78 cases (69.6 %), while in the comparison group, a decrease in Se level was observed in only 4 children (20 %). There were no significant differences in the content of Se in children with CG and CGD. However, the analysis of indicators depending on the acti­vity of the inflammatory process revealed probable differences: with the first degree of the activity of the inflammatory process in the mucous membrane, the level of Se in the blood plasma was significantly lower ((66.2 ± 6.1) μg/ml), while with the second it was (78.5 ± 7.3) μg/ml (p < 0.05) and with the third — (86.9 ± 9.3) μg/ml (p < 0.01). Conclusions. The concentration of selenium, the essential trace element, in the blood plasma of children with chronic inflammatory diseases of the upper gastrointestinal tract was found to be probably lower than that of healthy children. The level of selenium in the blood plasma of these children probably positively correlated with the degree of inflammation in the mucous membrane of the gastroduodenal region. Changes in the concentration of selenium can affect the general condition of children, the duration and severity of the disease, which must be taken into account during the treatment of inflammatory diseases.

Autoimmune gastritis may be less susceptible to cancer development than Helicobacter pylori-related gastritis based on histological analysis

Abstract: We read with great interest the recent publication by Rugge et al, in which the authors conducted a cohort study to evaluate the association between autoimmune gastritis (AIG) and gastric cancer (GC). No excess risk of gastric or other malignancies was observed over a cumulative followup time of 10 541 personyears, except for (marginally significant) thyroid cancer (standardised incidence ratio=3.09; 95 % CI 1.001 to 7.20). They concluded that, compared with the general population, corpusrestricted inflammation/atrophy observed in patients with AIG do not increase the risk of GC. The excess GC risk reported in patients with AIG may be influenced by unrecognised previous/ current Helicobacter pylori comorbidity. We previously reported 76 GC cases, positive for the antiparietal cell antibody (APCA) test; among them, 8 cases developed cancer in pure AIG stomachs without an apparent history of H. pylori infection. Nevertheless, in regions such as Japan, where the H. pylori infection rate is high, the diagnosis of AIG is often difficult because many patients who test positive for APCA tend to have an unrecognised H. pylori infection. While we agree with the authors’ opinion, we understand the ongoing debate on this topic given that gastric atrophy and metaplasia (including spasmolytic polypeptideexpressing metaplasia (SPEM) and intestinal metaplasia), which are thought to be definite precancerous lesions in the inflamed stomach, develop in patients with AIG, often at an even greater degree than H. pylorirelated gastritis. Considering this discrepancy, we hypothesised that the presence of autoimmune responses in patients with AIG might cause unknown molecular changes, in atrophic and metaplastic glands, compared with H. pylorirelated cases. To address this, we performed histological analyses on cases from a previously matched cohort study. A total of 16 patients who developed GC were examined: 8 APCA+, AIGsuspected cases and 8 H. pylori+/APCA– matched cases. Immunohistochemical staining of markers for Tcells (CD3), proliferation (Ki67), cancer stem cells/SPEM (CD44v9) and dysplastic transition (TROP2) were performed. CD3 was assessed based on the number of intraepithelial CD3expressing cells per field. Ki67, CD44v9 and TROP2 were evaluated using three grades. Patient characteristics and representative images are shown in table 1 and figure 1, respectively. Patient characteristics (sex, age, serum gastrin level and atrophy/metaplastic grades) were matched between the two groups. Precancerous lesions adjacent to cancerous lesions showed a greater intraepithelial infiltration of CD3positive cells in the APCA+ group compared with the H. pylori+APCA− group (22.75±10.89 vs 10.25±5.52, p=0.008), consistent with T celldependent autoimmune reaction. No differences in Ki67 or CD44v9 expression were observed, suggesting that immunological differences did not affect epithelial proliferation or SPEM development. The precancerous lesions in H. pylori+ cases and cancerous lesions in both groups were diffusely positive for TROP2, whereas precancerous lesions in APCA+ cases had much lower positivity for TROP2 (6/2/0 vs 1/1/6 in grade Letter

Effective Treatment of the Gastrointestinal System Without Drugs

Abstract: The mineral water is best remedy for correction of digestive organs functioning. The influence of mineral water "Phlate" have been studied at 80 patients with chronic noncalculous cholecystitis. Ecological pure mineral water "Phlate" supports the recovery of balance of liver, stomach and cardiovascular system destructed functions. The research of mineral water has shown prior importance of using of "Phlate" on patients suffering with chronic cholecystitis which is accompanying with hyperkinetic dyskinesias of biliary tract and hypersecretory gastritis. The high efficiency of mineral water "Phlate", which have been determined in our research, gives the reason of it's using as for prevention, so for treatment of above mentioned diseases.

Risk factors in the development of gastric adenocarcinoma in the general population: A cross-sectional study of the Wuwei Cohort

Abstract: Several risk factors have been identified for the development of gastric adenocarcinoma (GAC), where the control group was usually a healthy population. However, it is unclear at what stage known risk factor exert their influence toward the progression to cancer. Based on the Wuwei Cohort, we enrolled 1,739 patients with chronic non-atrophic gastritis (no-CAG), 3,409 patients with chronic atrophic gastritis (CAG), 1,757 patients with intestinal metaplasia (IM), 2,239 patients with low-grade dysplasia (LGD), and 182 patients with high-grade dysplasia (HGD) or GAC to assess the risk factors between each two consecutive stages from no-CAG to GAC/HGD using adjusted logistic regression. We found that different groups of risk factors were associated with different stages. Age, occupation of farmer, low annual family income, Helicobacter pylori (H. pylori) infection, drinking, eating hot food, histories of gastritis and peptic ulcer were associated with the development of CAG. Age, illiteracy, H. pylori infection, smoking, eating hot food, eating quickly, and histories of gastritis and gallbladder diseases were associated with the progression to IM from CAG. Male, occupation of farmer and history of peptic ulcer were associated with the development of LGD from IM. Age, male and polyp history appeared to be risk factors associated with the development of GAC/HGD from LGD. In conclusion, it seems that most risk factors function more as a set of switches that initiated the GAC carcinogenesis. H. Pylori eradication and control of other risk factors should be conducted before IM to decrease the incidence of GAC.

Epidemiological and Histopathological Aspects of Chronic Gastritis at the Departmental University Teaching Hospital of Borgou Alibori (CHUD-BA) from 2011 to 2021

Abstract: Background: Gastritis is better evaluated nowadays since the advent of upper gastrointestinal endoscopy. Despite the availability of this workup in Benin Republic, there is a scarcity of data on chronic gastritis. Objective: This work aimed to study the epidemiological and histopathological aspects of chronic gastritis in the Departmental University Teaching Hospital of Borgou Alibori (CHUD-B/A) from 2011 to 2021. Method: This was a retrospective cross-sectional study with descriptive and analytical purposes, carried out from February 23, 2022 to May 23, 2022, among patients who had undergone gastric biopsy and/or gastrectomy from January 2011 to January 2022 (10 year), and whose specimens were sent into the histopathology section of the CHUD-B/A. Non-probability sampling was performed with exhaustive recruitment. A survey form has been used to collect data from patients’ medical records. Pearson’s chi-square and Fisher’s exact tests have been used as appropriate to determine correlations between variables. Result: A total of 310 cases of chronic gastritis were diagnosed in the histopathology section of the CHUD-B/A from 2011 to 2021. This represented a chronic gastritis frequency of 91.45% for all gastric lesions diagnosed throughout the study period. Erythematous gastropathy was the most frequent (70.35%). Helicobacter pylori was present in 36.77% and dysplasia was observed in 12.26% of cases. Erythematous gastropathy was a predictive factor for the absence of gastric dysplasia in histopathology check up (p-value = 0.042). In contrast, intestinal metaplasia was predictive of the presence of gastric dysplasia in histopathology check up (p-value < 0.001). Conclusion: Chronic gastritis is very common in our setting. Systematic biopsy performance in front of an evocative clinical situation followed by histopathological examination may be encouraged.

Frequency of dyspeptic symptoms, anxiety, depression and health-related quality of life among patients with chronic gastritis according to Helicobacter pylori CagA and VacA status: a cross-sectional study

Abstract: Objective — to determine the frequency of dyspeptic symptoms, anxiety and depression and to describe health‑related quality of life in patients with chronic gastritis according to Helicobacter pylori cytotoxin‑associated gene A and vacuolating cytotoxin A status. Materials and methods. This cross‑sectional study included a total of 84 patients with H. pylori‑associated chronic gastritis (CG). Based on H. pylori virulence factors status patients were categorized into 2 groups: 50 patients with the cytotoxin‑associated gene A (CagA) and vacuolating cytotoxin A (VacA)‑positive H. pylori strains (Group 1) and 34 patients with CagA‑ and VacA‑negative H. pylori strains (Group 2). The H. pylori virulence factors were determined by the polymerase chain reaction using paraffin stomach biopsies. Serum IgA and IgG antibodies to CagA and VacA were evaluated by solid‑phase enzyme‑linked immunoabsorbent assay. The Hospital Anxiety and Depression Scale (HADS) was used to identify anxiety disorders and depression. The MOS 36‑Item Short Form Health Survey (SF‑36) questionnaire was used to assess the health‑related quality of life (HRQoL). Statistical analysis was performed using Stata 11 and Statistica 6 software packages. Results. Patients with CagA‑ and VacA‑positive H. pylori strains were more likely to have epigastric pain than patients with CagA‑ and VacA‑negative H. pylori strains (60% vs. 35.3%, p=0.026). No statistical difference was observed between the frequency of epigastric burning, early satiety, and postprandial fullness in both groups (р >0.05). Anxiety and depression were significantly more prevalent in patients with CagA‑ and VacA‑positive H. pylori strains (p=0.041; р=0.032, respectively). Patients of Group 1 had significantly lower HRQoL in the domains of Role‑Physical (50 vs. 75; p=0.0001), Bodily Pain (57.5 vs. 77.5; p=0.0001), General Health (45 vs. 75; p=0.0001), Vitality (55 vs. 80; p=0.0011) and Mental Health (56 vs. 84; p=0.0001). Conclusions. H. pylori CagA and VacA‑positive status is an important factor that may have an impact on the clinical course of H. pylori‑associated gastritis. Higher frequency of epigastric pain, anxiety, and depression, as well as lower health‑related quality of life were observed in patients with CagA‑ and VacA‑positive H. pylori strains.

Salivary Biochemistry Associated with Helicobacter Pylori Positivity in Patients with Chronic Gastritis

Abstract: Introduction: Invasive endoscopic-biopsy techniques are most frequently used for the diagnosis and monitoring of chronic gastritis. Finding non-invasive laboratory markers would enable the patient to save money and hassle. Saliva is progressively recognized as the useful non-invasive material of diagnosis because of its critical protective role for the digestive system. Aim: The parameters of biochemical in saliva of chronic gastritis patients (HP- & HP+), comparing their concentrations to those of healthy individuals and establishing correlations between their serum and salivary concentrations with the goal of potentially using the data as the diagnostic tool. Material and method: The study was conducted at the Dept. of Medicine, Pakistan Institute of Medical Sciences, Islamabad, Pakistan. There were 140 participants in the study, 60 of them had chronic gastritis (mean age, 58.7312.08 years; 44 HP+ and 16 HP-); disease activity was determined by endoscopic, serological, and subjective symptoms. Eighty healthy, non-smoking volunteers (mean age, 56.868.67 years) made up the control group. Saliva and serum that had not been activated were analysed. Total Protein (TPro), Secretory IgA, Albumin (Alb), and Uric Acid (UA), are the variables we examine (sIg A). They are examined using pre-made B.Coulter kits and an ELISA reader from DiaMetra Italy that adapts oral fluid procedures of the Olympus biochemical analyzer. Results: In comparison to the control group, HP+ patients had significantly increased levels of sIgA (p0.0001), Alb (p0.0001), and TP (p=0.0434), but not the UA. For only the UA, we revealed the link between serum/saliva values (r=0.3389) (p=0.011). Endoscopic inflammatory alterations and UA had a moderately negative connection (r=-0.4203, p=0.016). The increased oxidative stress, changed salivary flow rate, and stomach inflammation are hypothesised to be compensated for by these modifications. Practical implication : the parameters of biochemical in saliva of the chronic gastritis patients (HP- and HP+), comparing their concentrations to those of healthy individuals, and establishing correlations between their salivary and serum concentrations in order to potentially utilization of the data as the diagnostic tool Conclusion: The data show that HP+ chronic gastritis results in considerable alterations in salivary parameters. Saliva is a biological material with some limitations, but it is a good indicator of the pathological processes occurring in the digestive tract, particularly when there is an HP+ infection. Keywords: Salivary Biochemistry; Total Protein; Chronic Gastritis; Helicobacter Pylori; HP+

Selenium plasma levels in children with Helicobacter pylori-associated diseases of the upper gastrointestinal tract

Abstract: Despite the success of the treatment of infected individuals, Helicobacter pylori infection remains the most common human bacterial pathogen, infecting half of the world’s population. In a large part of people, H. pylori causes gastroduodenal diseases, in particular, chronic antral gastritis and ulcer disease. The possible role of selenium in the course of chronic inflammatory H. pylori-associated pathology of the upper gastrointestinal tract in children has not yet been fully investigated and understood. The aim is to determine selenium plasma levels in children with Helicobacter pylori-associated diseases of the upper gastrointestinal tract. Materials and methods. The study included 135 school-age children with Helicobacter pylori-associated diseases of the upper gastrointestinal tract, who made up the main study group (55 children with chronic gastritis (CG), 57 children with chronic gastroduodenitis (CGD), 23 children with duodenal ulcer (DU), and 20 practically healthy age-matched children were the comparison group. Quantitative measurements of plasma selenium were performed using inductively coupled plasma mass spectrometry (MS-ICP) on an Optima 2000 DV spectrometer (Perkin Elmer, USA). Results. The lowest level of plasma selenium was registered in children with H. pylori-negative DU (67.81 ± 2.67 μg/l), while in children with H. pylori-associated DU, its level was higher – 73.56 ± 2.34 μg/l (p < 0.05), however, it did not reach the level in children of the comparison group. A similar direction of changes in the selenium plasma concentration was observed in children with CGD: higher levels of selenium were detected in children with H. pylori-positive CGD compared to H. pylori-negative CGD (75.61 ± 2.48 μg/l and 70.99 ± 2.31 μg/l, respectively, p < 0.05). Conclusions. Significantly lower levels of plasma selenium in children with chronic destructive-inflammatory diseases of the upper gastrointestinal tract were found, which could be explained by the acute phase of inflammation in the mucous membrane of the stomach and duodenum resulting in a decrease in selenium absorption. In H. pylori-positive children, the level of selenium was significantly higher compared to H. pylori-negative children indicating a possible role of selenium in the pathogenesis and further progression of H. pylori-associated diseases.

The correlation of Th22 and regulatory T cells with Helicobacter pylori infection in patients with chronic gastritis

Abstract: Helicobacter pylori is planted in the human stomach and is the most common cause of chronic gastritis, which produced specific local and systemic humoral immunity, while the associations of these immune responses and H. pylori in the development of chronic gastritis remain unclear.

The possible role of eradication of Helicobacter pylori infection on glycemic control in type 2 diabetes mellitus patients

Abstract: Background: One of the most prevalent chronic infections in the world, Helicobacter pylori (H. pylori), is the primary contributing factor to gastritis, peptic ulcers, and stomach cancer. Chronic infections frequently have an impact on diabetic patients. Numerous studies have assessed the incidence of H. pylori infection in diabetes individuals and its potential impact on the way their metabolism is regulated. While some studies found no association between glycemic control and H. pylori infection, some identified a greater incidence of the infection in diabetes individuals and worse glycaemic control. Aim and objectives: To investigate the impact treating Helicobacter pylori infection may have on individuals with type 2 diabetes mellitus' ability to maintain glycemic control. Subjects and Methods: A 50-person type 2 diabetes mellitus randomised controlled trial was conducted at Tanta University Hospital's outpatient diabetes and endocrinology clinic. Each patient underwent a thorough clinical examination, extensive history taking, and investigations. Result: Before and after, there was a high significant difference in FBG and a significant difference in HbA1C. Conclusion: Finally, we found that the rate of H. pylori eradication with OCA or OMAB treatment is lower in patients with type 2 diabetes than in non-diabetics, and that H. pylori medication had no effect on glycemic control in people with type 2 DM.