http___medlib.mef.hr_698__1.xml
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Filipec Kanižaj, Tajana and Katičić, Miroslava and Presečki, Vladimir and Gašparov, Slavko and Colić Cvrlje, Vesna and Kolarić, Branko and Mrzljak, Anna (2009) Serum antibodies positivity to 12 helicobacter pylori virulence antigens in patients with benign or malignant gastroduodenal diseases – cross-sectional study. Croatian Medical Journal, 50 (2). English abstract Aim To investigate the association of gastric histological and endoscopic findings in patients with Helicobacter pylori (H. pylori), according to presence of seropositivity to 12 bacterial virulence antigens. ----- Methods This is a cross-sectional single-center study of 360 consecutive outpatients referred in the period of one year to upper gastrointestinal endoscopy because of dyspeptic complaints. Patients sera were tested by Western blot method to determine the presence of serum antibodies to bacterial virulence antigens – p120 (CagA – cytotoxin-associated antigen), p95 (VacA – vacuolating cytotoxin), p67 (FSH – flagellar sheath protein), p66 (UreB – urease enzyme heavy subunit), p57 (HSP homologue – heath shock protein homologue), p54 (flagellin), p33, p30 (OMP – outer membrane protein), p29 (UreA – urease enzyme light subunit), p26, p19, and p17. Upper gastrointestinal endoscopy was performed, endoscopic diagnosis recorded, and 4 mucosal biopsy samples were obtained and assessed according to Updated Sydney protocol. ----- Results The sera of 207 patients were analyzed. Thirty patients had gastric adenocarcinoma, 126 peptic ulcers, and 51 normal finding. p120 (CagA) seropositivity was significantly more often present in patients with higher activity grade in the antrum (P = 0.025), p30 in patients with greater inflammation in the antrum (P = 0.025) and the corpus (P = 0.010), p33 in patients with greater inflammation in the corpus (P = 0.050), and p19 (OMP) in patients with lower intestinal metaplasia grades in the corpus (P = 0.025). Seroreactivity to all other bacterial proteins showed no association with the histological status of the stomach mucosa. Except for the seropositivity to protein p95 (VacA), which was more often present in patients with duodenal ulcer (P = 0.006), there was no difference in seroreactivity to other bacterial proteins and upper gastrointestinal endoscopic findings. ----- Conclusions p120 (CagA), p33, p 30 (OMP), and p19 (OMP) seropositivity was more often present in patients with higher grades of the histological parameters of gastritis and seropositivity to protein p95 (VacA) with endoscopic presence of duodenal ulcer. Histological parameters of gastritis are more associated with bacterial virulence than endoscopic findings. Actions (login required)
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Filipec Kanižaj, Tajana (2009) Utjecaj eradikacije Helicobacter pylori i čimbenika virulencije na promjenu premalignih obilježja sluznice želuca. PhD thesis, Sveučilište u Zagrebu. Croatian abstract Uvod: Dosadašnja istraživanja nisu odgovorila na pitanje reverzibilnosti H. pylori pozitivnog atrofičnog gastritisa i intestinalne metaplazije sluznice želuca te uloge eradikacijske terapije i čimbenika virulencije. ----- Cilj: utvrditi utjecaj uspješnosti eradikacijske terapije i čimbenika virulencije H. pylori na dinamičnost premalignih promjena: atrofije i intestinalne metaplazije u 5 godišnjem vremenskom intervalu. Usporediti rezultate serološkog određivanja razine enzima PGI, PGII, PGI/II i G17 i nalaza pojedinih stupnjeva patohistoloških promjena. ----- Materijali i metode: U istraživanje je uključeno 186 bolesnika s infekcijom bakterijom H. pylori i u početnom histološkom nalazu prisutnim atrofičnim gastritisom i/ili intestinalnom metaplazijom na jednoj ili obje od anatomskih lokalizacija u želucu. Bioptati želuca analizirani su (prema Sydney i OLGA sistemu) na početnom i kontrolnom (u 5. godina) pregledu. Kod oba pregleda ELISA metodom određena razina enzima PGI, PGII i G17 u serumu. Western blot metodom određena je prisutnost antitijela na p120 (CagA), p95(VacA), p 29 (OMP), p26 i p19 (OMP). Rezultati uspjeha eradikacijske terapije testirani histološki na kontroli u 5-oj godini. ----- Rezultati: Statistički značajna dinamičnost rezultata u petogodišnjem intervalu utvrđena je za obje ispitivane histološke varijable i na obje anatomske lokalizacije te razinu svih ispitivanih enzima. Kod bolesnika s prisutnim patohistološkim parametrom u početnom nalazu utvrđena je statistički značajna regresija stupnja ili stadija u većine (do 98%) bolesnika. U manje od 17% bolesnika prisutna je progresija stupnja ili stadija histološkog parametra. Neuspjeh eradikacijske terapije značajni je prediktor progresije stupnja ili stadija atrofičnog gastritisa korpusa i antruma te intestinalne metaplazije (prema OLGA sistemu). P 120 (cagA) i p 26 serološki negativitet 178 prediktori su progresije atrofičnog gastritisa korpusa te stadija intestinalne metaplazije. Razina enzima G17 statistički značajno korelira stupnjevima intestinalne metaplazije u korpusu želuca. ----- Zaključak: ovisno o bazičnom nalazu, uspješna eradikacija H. pylori u značajnog dijela bolesnika s atrofičnim gastritisom i intestinalnom metaplazijom dovodi do regresije stupnjeva ili nepromjenjivosti prisutnih promjena. Neuspjeh eradikacijske terapije prediktor je progresije histoloških parametara. Razina enzima G17 u prvom pregledu pozitivno korelira s stupnjevima intestinalne metaplazije u korpusu želuca. English abstract Introduction: Up till now there is no answer on reversibility of H. pylori positive atrophic gastritis and intestinal metaplasia regarding eradication therapy success and presence of virulence antigens. ----- Aim: of the study was to investigate the role of eradication therapy success and presence of virulence antigens on dynamics of premalignant histological changes (atrophic gastritis and intestinal metaplasia) in 5 year period. Additionally, to correlate results of PGI, PGII, PGI/II and G17 enzyme levels with different grades of histological parameters. ----- Materials and methods: study was performed on 186 H. pylori positive patients with atrophic gastritis and/or intestinal metaplasia in basic bioptic specimens of antrum or corpus. Specimens were analyzed according to Sydney and OLGA protocol in basic and control (5th year). On both examinations serum levels of enzymes was recorded by ELISA method. Western blot was used in order to detect antigens to p120 (CagA), p95 (VacA), p 29 (OMP), p26 and p19 (OMP). All patients received eradication therapy and success was evaluated according to 5th year histological finding. ----- Results: all tested histological parameters revealed statistically significant changes in grade and stage on both anatomical localizations. The same is observed for levels of all tested enzymes. Most (up to 98%) basically positive patients to histological 180 parameters showed significant regression in grade and stage of all parameters. In less than 17% of patients progression of grade or stage of histological parameters was observed. Unsuccessful eradication therapy was predictor of progression of stage and grade of corpus atrophic gastritis and stage of intestinal metaplasia. Negative results to p120 (CagA) and p26 were predictors of corpus atrophic gastritis grade and intestinal metaplasia stage progression respectively. Level of G17 enzyme was positively correlated with higher grades of corpus intestinal metaplasia in basic examination. ----- Conclusions: depending on basic finding, successful H. pylori eradication in related with regression or no change of grade or stage of atrophic gastritis and intestinal metaplasia. Unsuccessful eradication therapy was predictor of progression of stage and grade of histological parameters. Level of G17 enzyme was positively correlated with higher grades of corpus intestinal metaplasia in basic examination. Actions (login required)