medigraphic.com

2010, Number 4

<< Back Next >>

Cir Cir 2010; 78 (4)

Prevalence of intestinal metaplasia of the gastric cardia and its relationship with Helicobacter pylori strains cagA and vacA

Abdo-Francis JM, Sobrino-Cossío S, Bernal-Sahagún F, Hernández-Guerrero A

Language: Spanish
References: 50
Page: 315-321
PDF size: 95.81 Kb.


ABSTRACT

Background: Esophageal metaplasia progression is a consequence of chronic gastroesophageal reflux (CGR). Patients with this condition are frequently infected by Helicobacter pylori and show several symptoms including gastritis as well as ulcer formation. In addition, they present an increased risk for the development of gastric adenocarcinoma. Several pathogenic markers for Helicobacter pylori such as ureC, vacA and cagA genes have been described. Evidence indicates that direct injury to the epithelial mucosa is caused by cytotoxins and enzymes codified by these genes. We undertook this study to establish a relationship between the presence of pathogenic Helicobacter pylori strains and the presence of metaplasia progression in patients with CGR.
Methods: We detected the presence of Helicobacter pylori cagA and vacA positive strains in patients with CGR. Using polymerase chain reaction, we analyzed 120 samples obtained from 60 patients with CGR and 60 control group patients, including samples from both anatomic areas: cardia and gastric antrum. Results: We detected 56% of Helicobacter pylori positive patients; 57.5% of these patients were positive for either cagA(+) and/or vacA(+) Helicobacter pylori strains. Cardiac intestinal metaplasia was observed in 35% of the patients. A marked tendency was observed to develop cardiac intestinal metaplasia in those patients diagnosed with high-pathogenicity strains infected in both anatomic areas.
Conclusions: These results suggest that infection with Helicobacter pylori can be considered a risk factor for developing gastric cardiac intestinal metaplasia.


REFERENCES

  1. Marshall B. Helicobacter pylori. Am J Gastroenterol 1994;89:116- 128.

  2. Hunt RH. The role of Helicobacter pylori in pathogenesis: the spectrum of clinical outcomes. Scand J Gastroenterol 1996;31(Suppl 220):3-9.

  3. Mobley H. Helicobacter pylori factors associated with disease development. Gastroenterology 1997;113:35-42.

  4. Go M. What are the host factors that place an individual at risk for Helicobacterpylori-associated disease? Gastroenterology 1997;113:15- 20.

  5. Smoot D. How does Helicobacter pylori cause mucosal damage? Direct mechanism. Gastroenterology 1997;113:31-34.

  6. Ernst P, Crowe S, Reyes V. How does Helicobacter pylori cause mucosal damage? The inflammatory response. Gastroenterology 1997;113:35- 42.

  7. Miederer S, Grobe IP. Profound Increase of Helicobacter pylori urease activity in gastric antral mucosa at low pH. Dig Dis Sci 1996;41:944- 949.

  8. Tytgat GNJ. Ulcers and gastritis. Endoscopy 1994;26:36-41.

  9. Correa P. Chronic gastritis: a clinico-pathological classification. Am J Gastroenterol 1998;83:504-509.

  10. Genta M. Helicobacter pylori, inflammation, mucosal damage, and apoptosis: pathogenesis and definition of gastric atrophy. Gastroenterology 1997;113:51-55.

  11. Kawaguchi H. Haruma K, Komoto K, Yoshihara M, Sumii K, HajiyamaG. Helicobacter pylori infection is the major risk factor for atrophic gastritis. AJG 1996;91:959-962.

  12. Villako K, Kekk M, Maaroos H, Sipponen P, Tammur R, Tamm A, et al. A 12-year follow-up study of chronic gastritis and Helicobacter pylori in a population-based random sample. Scand J Gastroenterol 1995;30:964-967.

  13. Kuipers EJ, Klinkenberg C, Vanderbroucke C. Role of Helicobacter pylori in the pathogenesis of atrophic gastritis. Scand J Gastroenterol 1997;32:28-34.

  14. Van der Hulst RWM, Tytgat GNJ. Helicobacter pylori and peptic ulcer disease. Scand J Gastroenterol 1996;31(Suppl 220):10-18.

  15. Satoh K, Kimura K. Taniguchi Y. Distribution of inflammation and atrophy in the stomach of Helicobacter pylori-positive and negative patients with chronic gastritis. Am J Gastroenterol 1996;91:963-969.

  16. Satoh K, Kimura K, Yoshida Y. A topographical relationship between Helicobacter pylori and gastritis: quantitative assessment of Helicobacter pylori in the gastric mucosa. Am J Gastroenterol 1991;86:285- 291.

  17. Lage A. Diagnosis of Helicobacter pylori infection by PCR: comparison with others invasive techniques and detection of Cag A gene in gastric biopsy specimens. J Clin Microbiol 1995;33:2752-2756.

  18. Genta RM, Graham D. Comparison of biopsy sites for the histopathologic diagnosis of Helicobacter pylori: a topographic study of Hp density and distribution. Gastrointest Endosc 1994;40:342-345.

  19. Bayerdorffer E, Lehn N, Hatz R. Difference in expression of Helicobacter pylori gastritis in antrum and body. Am J Gastroenterol 1992;102;1575-1582.

  20. Sugiyama T, Yabana T, Yachi A. Mucosal immune response to Helicobacter pylori and cytotoxic mechanism. Scand J Gastroenterol 1996;31(Suppl 220):30-32.

  21. Shimoyama T, Fukuda S, Tanaka M, Mikami T, Munakata A. High prevalence of the Cag A-positive Helicobacter pylori strains in Japaneseasymptomatic patients and gastric patients. Scand J Gastroenterol 1997;32:465-468.

  22. Bukholm G, Tannes T, Nedenskov P. Esbenden Y, Grav HJ. Colony variation of Helicobacter pylori: pathogenic potential is correlated to cell wall lipid composition. Scand J Gastroenterol 1997;32:445-454.

  23. Yamaoka Y, Kita M, Kodama T, Kashima K, Imanishi J. Induction of various cytokines and development of severe mucosal inflammation by CagA gene positive Helicobacter pylori strains. Gut 1997;41:442-451.

  24. Atherton JC, Peek M, Tham k, Cover T, Blaser M. Clinical and pathological importance of heterogeneity in Vac A, the vacuoliating cytotoxin gene of Helicobacter pylori. Gastroenterology 1997;112:92-99.

  25. Rautelin H, Sipponen P, Seppalá K, Sarna S. Gastric inflammation and neutrophil-activating and cytotoxin-producing Helicobacter pylori strains. Scand J Gastroenterol 1996;31:639-642.

  26. Gardner J, Cover T. Analysis of genetic diversity in cytotoxin-producing and non-cytotoxin-producing Helicobacter pylori strains. J Infect Dis 1995;172:290-293.

  27. Correa P. Is gastric carcinoma an infectious disease? NEJM 1991;325:1170-1171.

  28. Rubin C. Are there types of Helicobacter pylori gastritis. Gastroenterology 1997;112:2108-2110.

  29. Montalvo E, Montalvo C, Ortega L, Peña J, Valdez A, Martínez A, et al. Helicobacter pylori, patología gástrica y cirugía. Descubrimiento que mereció el Premio Nobel en Medicina 2005. Ciruj Gen 2009;31:160-169.

  30. De Boer WA. Diagnosis of Helicobacter pylori infection. Scand J Gastroenterol 1997;32:35-42.

  31. Vicari J, Falk G, Richter E. Helicobacter pylori and acid peptic disordersof the esophagus. It is conceivable? Am J Gastroenterol 1997;92:1097- 1102

  32. Genta RM, Huberman RM, Graham DY. The gastric cardia in Helicobacter pylori infection. Human Pathol 1994;25:915-919

  33. Hackelberg A, Gunther T, Schultze V. Prevalence and pattern of Helicobacter pylori gastritis in the gastric cardia. Am J Gastroenterol 1997;92:2220-2224.

  34. Faigel D, Childs M, Furth E. New noninvasive tests for Helicobacter pylori gastritis. Dig Dis Sci 1996;41:740-748

  35. Nowak JA, Forouzandeh B, Nowak JA. Estimates of Helicobacter pylori densities in the gastric mucus layer by PCR, histologic examination, and CLOtest. Am J Clin Pathol 1997;108:284-288.

  36. Karttunen T, Genta R, Yoffe B. Detection of Helicobacter pylori in paraffin-embedded gastric biopsy specimens by in situ hybridation. Am J Clin Pathol 1996;106:305-311.

  37. Husson M, Gottrand F, Vachee A, Dhaenens L, De la Salle E, Turck D,et al. Importance in diagnosis of gastritis of detection by PCR of the CagA gene in Helicobacter pylori strains isolated from children. J Clin Microbiol 1995;33:3300-3303.

  38. Guidelines for Clinical Trials in Helicobacter pylori infection. WorkingParty of the European Helicobacter pylori Study Group. Gut 1997;41(Suppl 2):1-23.

  39. Asaka M, Takeda H, Sugiyama T, Kato M. What role does Helicobacterpylori play in gastric cancer? Gastroenterology 1997;113:S56-S60.

  40. Rugge M, Cassaro M, Lenadro G. Helicobacter pylori in promotion of gastric carcinogenesis. Dig Dis Sci 1996;41: 950-955.

  41. Werdmuller BFM, Loffleld RJLF. Helicobacter pylori infection has norole in the pathogenesis of reflux esophagitis. Dig Dis Sci 1997;42:103- 105.

  42. Kogan Z, Corti R, Cabane A. Helicobacter pylori in Barrett´s esophagus. Acta Gastroenterol Latinoam 1992;22:215-219.

  43. Borhan-Manesh F, Farnum JB. Study of Helicobacter pylori colonizationof patches of heterotopic gastric mucosa (HGM) at the upper esophagus. Dig Dis Sci 1993;38:142-146.

  44. Ferreres JC, Fernández F, Rodríguez A. Helicobacter pylori in Barrett´s esophagus. Histol Histopathol 1991;6:403-408.

  45. Loffeld RSLF, Ten Tije BJ. Prevalence and significance of Helicobacterpylori in patients with Barrett´s esophagus. Am J Gastroenterol 1992;97:1598-1600.

  46. Labenz J, Malfertheiner P. Helicobacter pylori in gastro-oesophageal reflux disease: causal agent, independent or protective factor? Gut 1997;41:277-280.

  47. Richter JE. Esofagitis grave por reflujo. Gastrointest Endosc Clin North Am 1994;4:657-676.

  48. Abdo JM, Uscanga L. III Consenso mexicano sobre Helicobacter pylori. Rev Gastroenterol Mex 2007;72:332-338.

  49. Farfán A, Hernández A, Sobrino S, Frías M, Herrera R, Rosales A, et al. Relationship between intestinal metaplasia of the oesophagusgastric junction and gastric-oesophageal reflux disease: a report from the National Cancer Institute. Clin Transl Oncol 2003;5:390- 396.

  50. Pieramico O, Zanetti MV. Relationship between intestinal metaplasia of the gastro-oesophageal junction, Helicobacter pylori infection and gastro-oesophageal reflux disease: a prospective study. Dig Liver Dis 2000;32:567-572.




2020     |     www.medigraphic.com