Helicobacter pylori (H. pylori) undergoes decades long colonization of the gastric mucosa of half the population in the world to produce acute and chronic gastritis at the beginning of infection, progressing to more severe disorders, including peptic ulcer disease and gastric cancer. Prolonged carriage of H. pylori is the most crucial factor for the pathogenesis of gastric maladies. Bacterial persistence in the gastric mucosa depends on bacterial factors as well as host factors. Herein, the host and bacterial components responsible for the incipient stages of H. pylori infection are reviewed and discussed. Bacterial adhesion and adaptation is presented to explain the persistence of H. pylori colonization in the gastric mucosa, in which bacterial evasion of host defense systems and genomic diversity are included.
Gastric Mucosa/*microbiology ; Gastritis/*microbiology/pathology ; Helicobacter Infections/*microbiology ; Helicobacter pylori/*physiology ; Humans ; Stomach Neoplasms/pathology

With the widely application of the metagenomics, the relationship between microbiota and disease has become a hot research topic. Understanding the potential association between upper gastrointestinal cancer or precancerous lesions and microbiota may play an important role in the early detection, clinical diagnosis and treatment, and prognostic evaluation of upper gastrointestinal cancer. Therefore, a literature retrieval was conducted by using PubMed, Embase and wanfang databases to summarize the latest research progress in the microbiota of upper gastrointestinal cancer, including oral, esophageal, gastric cancer and precancerous lesions. Lower microbial diversity or richness in esophageal cancer and precancerous lesions and specific prognostic biomarkers for esophageal cancer were found. Lactobacillus richness showed an increase trend during the process from gastritis to gastric cancer. This paper summarizes the progress in the research of potential biological etiology of upper gastrointestinal cancer from the perspective of metagenomics in order to provide evidence on the, prevention and control of upper gastrointestinal cancer.
Esophageal Neoplasms/microbiology* ; Gastrointestinal Microbiome ; Gastrointestinal Neoplasms/microbiology* ; Gastrointestinal Tract/microbiology* ; Humans ; Lactobacillus ; Metagenomics/trends* ; Microbiota ; Precancerous Conditions/microbiology* ; Prognosis ; Research/trends* ; Risk Factors ; Stomach Neoplasms/microbiology*

Stomach is the most common site of primary extranodal lymphoma. Mucosa-associated lymphoid tissue (MALT) lymphoma is a unique type of extranodal lymphoma which is associated with Helicobacter pylori (H. pylori). The development of low-grade MALT lymphoma of stomach is dependent on H. pylori. A transformed clone carrying the translocation t(11;18)(q21;q21) forms a MALT lymphoma, the growth of which is independent of H. pylori and will not respond to bacterial eradication. And inactivation of the tumor suppressor genes, p53 can lead to high-grade transformation. Endoscopic ultrasound (EUS) is essential to document the extent of disease and is superior to CT scan in the detection of spread to perigastric lymph nodes and follow-up EUS may determine the response to therapy and detect the relapse in early phase. Lesions that are confined to the mucosa or submucosa of gastric wall can be successfully treated with H. pylori eradication. Those low-grade MALT lymphomas that are not H. pylori positive or do not respond to antibiotic therapy can be treated with surgery, radiation, or chemotherapy. Follow-up is critical in all patients who have been treated with H. pylori eradication and consists of multiple endoscopic biopsies and EUS.
Helicobacter Infections/complications ; Helicobacter pylori ; Humans ; *Lymphoma, B-Cell, Marginal Zone/microbiology/pathology ; Stomach Diseases/complications ; *Stomach Neoplasms/microbiology/pathology

BACKGROUND: Helicobacter pylori (H. pylori) has been considered a definitive carcinogen in gastric cancer. Telomerase is activated in gastric cancer and some premalignant gastric lesions, including intestinal metaplasia (IM). In this study, we evaluated the relationships of both H. pylori infection and telomerase activity with endoscopic and histologic features in IM. The effects of H. pylori eradication on endoscopic, histologic and biochemical changes were evaluated. METHODS: Endoscopic biopsies were obtained from 43 patients with IM for rapid urease, histologic and telomerase tests. The endoscopic and histologic features, H. pylori infection and telomerase were assessed. After H. pylori eradication, 15 patients were re-evaluated and compared after 4 months. RESULTS: Thirty-four (79.1%) patients were infected with H. pylori. The incidence of H. pylori infection was borderline correlated to the severity of IM (p=0.076). Telomerase was elevated in eight (18.6%) patients. Telomerase tends to be high in subtype III and endoscopic grade III of IM. After H. pylori eradication, endoscopic extent (p=0.039) and histologic severity (p=0.074) showed improvements, and telomerase decreased significantly (p=0.0001). CONCLUSION: Our data suggest that telomerase is associated with the severity and extent of IM and that H. pylori eradication improves the endoscopic and histologic features in IM, and decreases telomerase activity. H. pylori eradication can be considered one of the methods to prevent gastric cancer in patients with H. pylori-infected IM. Further long-term and large-scaled study will be needed.
Female ; Helicobacter Infections/*enzymology ; *Helicobacter pylori ; Human ; Intestinal Mucosa/enzymology/microbiology/*pathology ; Male ; Metaplasia/enzymology/microbiology ; Middle Aged ; Precancerous Conditions/enzymology/microbiology ; Stomach Neoplasms/*enzymology/microbiology ; Telomerase/*metabolism

Syphilis is an unexpected diagnosis in the stomach, and the reduced incidence of syphilis has made its clinical presentation less widely appreciated. We report a 43-yr-old man suffering from epigastric tenderness with an initial diagnosis of gastric carcinoma; gastric syphilis was confirmed by demonstrating spirochetes in a gastric biopsy specimen by silver impregnation. Excessive lymphoplasmacytic infiltration with diffuse thickening of gastric rugae should raise suspicion of gastric syphilis, which should be considered in the differential diagnosis of diffuse erosive gastritis and infiltrative lesions of the stomach.
Syphilis/*diagnosis ; Stomach Neoplasms/*diagnosis ; Stomach Diseases/*diagnosis/microbiology ; Stomach/microbiology ; Male ; Humans ; Fluorescent Treponemal Antibody-Absorption Test ; Enzyme-Linked Immunosorbent Assay ; *Diagnosis, Differential ; Biopsy ; Adult ; Adenocarcinoma/*diagnosis

OBJECTIVE: To explore the relationship between the Helicobacter pylori (H.pylori) infection and gastric mucosa change and blood-lipid in people undergoing the physical examination in Changsha. METHODS: A total of 2 264 people undergoing physical examination were divided into an H. pyloripositive group (n=1 068) and an H. pylori-negative group (n=1 196). Gastric mucosa change was diagnosed by gastroscopy, blood-lipid and blood sugar were detected, and the statistical analysis was performed. RESULTS: The incidence rate of H.pylori infection was 47.2%. The incidence rate of gastric mucosal erosion, gastric ulcer, duodenal ulcer, gastric mucosal atrophy, gastric polyp, dyslipidemia, increase of triglyceride were (TG) and decrease of the high density lipoprotein cholesterol (HDL-C) in the H.pylori-positive group were all higher than those in the H.pylori-negative group (P<0.01 or P<0.05). In the H. pylori-positive group, the level of TG in people with gastric mucosal erosion, gastric ulcer and duodenal ulcer was higher than that in people with normal gastric mucosa or mild gastritis, and HDL-C was lower than that in people with normal gastric mucosa or mild gastritis. CONCLUSION H. pylori infection can induce the gastric mucosa injury and dyslipidemia, which may result in the occurrence and development of coronary heart disease by increasing TG and decreasing HDL-C, thus increasing the risk of atherosclerosis.
Adenomatous Polyps ; Cholesterol, HDL ; blood ; Duodenal Ulcer ; microbiology ; physiopathology ; Dyslipidemias ; microbiology ; Gastric Mucosa ; microbiology ; pathology ; Gastritis ; microbiology ; physiopathology ; Helicobacter Infections ; physiopathology ; Helicobacter pylori ; Humans ; Lipids ; blood ; Physical Examination ; Stomach Neoplasms ; Stomach Ulcer ; microbiology ; physiopathology ; Triglycerides ; blood

We isolated non-O1, non-O139 Vibrio cholerae from pleural effusion in a patient with recurred advanced gastric caner after total gastrectomy. We also recovered the organism from the patient's stool culture. The patient did not experience gastrointestinal symptoms such as diarrhea except heartburn and epigastric discomfort from stomach cancer before admission. The suspected route of infection is directly from the gastrointestinal tract through the previous surgical wounds. After antibiotic treatment, no more V. cholerae was isolated and the patient was well discharged from the hospital. This is the first report of V. cholerae infection associated with pleural effusion in a long-term latent carrier of the organism.
Vibrio cholerae non-O1/*isolation & purification ; Stomach Neoplasms/microbiology/surgery ; Pleural Effusion/*microbiology ; Middle Aged ; Male ; Humans ; *Gastrectomy ; Carrier State

Although the age-adjusted incidence of gastric cancer is declining, the absolute number of new cases of gastric cancer is increasing due to population growth and aging. An effective strategy is needed to prevent this deadly cancer. Among the available strategies, screen-and-treat for Helicobacter pylori infection appears to be the best approach to decrease cancer risk; however, implementation of this strategy on the population level requires a systematic approach. The program also must be integrated into national healthcare priorities to allow the limited resources to be most effectively allocated. Implementation will require adoption of an appropriate screening strategy, an efficient delivery system with a timely referral for a positive test, and standardized treatment regimens based on clinical efficacy, side effects, simplicity, duration, and cost. Within the population, there are subpopulations that vary in risk such that a "one size fits all" approach is unlikely to be ideal. Sensitivity analyses will be required to identify whether the programs can be utilized by heterogeneous populations and will likely require adjustments to accommodate the needs of subpopulations.
Health Priorities ; Helicobacter Infections/complications/diagnosis/microbiology/*therapy ; Helicobacter pylori ; Humans ; Mass Screening ; Stomach Neoplasms/microbiology/*prevention & control

OBJECTIVES: The significance of the coccoid forms of H. pylori is still controversial and the questions of whether these forms are viable and infective or degenerative are still open. We induced conversion from rod to coccoid forms and studied morphological changes and antigenic evolutions during this conversion and, thereby, elucidated the viability of coccoid forms. METHODS: The H. pylori strain (C001) used for Western blotting was isolated from the patient with gastric cancer. The antigenic evolution during coccoid conversion of H. pylori was studied by Western blotting, using different sera from thirty patients known to be culture positive. These sera were used to reveal the total antigens of the strain cultured for 2 days (100% rod) and 15 days (> 99% coccoid). After SDS-PAGE, with 10% separating gel of total antigens (rod and coccoid), transblotting (Trans-Blot electrophoretic cell, Bio-Rad) was taken onto a nitrocellulose membrane (Bio-Rad). Then, the blots, with human sera diluted at 1/100, were developed with color reaction by goat serum anti-human IgG with alkaline phosphatase and BCIP. RESULTS: The antigenic profiles were not changed in 46.7% (14/30 cases) and were changed in 53.3% (16/30 cases) during coccoid conversion. Antigenic fractions changed during coccoid conversion were protein band at 120 kDa and band at 35 kDa, and were not detected in coccus forms. The rest of the profiles were identical between rod and coccoid forms. The protein which disappeared include CagA (120 kDa) and porin, or adhesin (35 kDa). The morphological changes during coccoid conversion were U shaped at day 7, doughnut shaped at day 9 and full coccoid at day 15. CONCLUSIONS: The results showed that coccoid forms of H. pylori retain cellular structures similar to rod form, and some of the antigens (CagA and porin) disappeared during coccoid conversion. Therefore, coccoid form might be viable and represent one of the stages of H. pylori biological cycle.
Adaptation, Physiological ; Antigens, Bacterial/isolation & purification* ; Gastritis/microbiology ; Helicobacter Infections/microbiology ; Helicobacter pylori/ultrastructure* ; Helicobacter pylori/immunology* ; Helicobacter pylori/growth & development ; Human ; Microscopy, Electron ; Stomach Neoplasms/microbiology ; Virulence

OBJECTIVE: To establish 2-dimensional electrophoresis (2-DE) maps of Helicobac-ter pylori in human gastritis, and gastric cancer, to identify the differentially expressed proteins,and to discuss the role of bacterial factor in pathogenesis. METHODS: The total proteins of Helicobacter pylori in human gastritis and gastric cancer were separated by immobilized pH gradient-based 2-DE. The differentially expressed proteins were screened by PDQuest analysis software and identified by peptide mass fingerprint based on matrix-assisted laser desorption/ionization time of flight mass spectrometry, and searched on database. RESULTS: A well-resolved and reproducible 2-DE pattern of Helicobacter pylori was obtained from patients with human gastritis and gastric cancer. Fourteen differentially expressed proteins were identified, including proteins related to anti-oxidation,molecular chape-rones and detoxification, enzymes related to metabolism,proteins related to cytoarchitecture,and proteins related to signal conduction. CONCLUSION A well-resolved and reproducible 2-DE pattern of Helicobacter pylori in human gastritis and gastric cancer is established and differentially expressed proteins from these 2 diseases are identified. The differentiation of protein expression may play an important role in the pathogenesis of gastric cancer.
Bacterial Proteins ; analysis ; Electrophoresis, Gel, Two-Dimensional ; Female ; Gastritis ; microbiology ; Helicobacter Infections ; microbiology ; Helicobacter pylori ; Humans ; Male ; Proteome ; analysis ; Proteomics ; methods ; Stomach Neoplasms ; microbiology