Extragastric

  • 文章类型: Case Reports
    被称为“Mott细胞”的浆细胞存在称为“罗素体”的免疫球蛋白的不可分泌积累。它的存在与血液肿瘤有关,但它可以出现在慢性炎症过程中。消化道内最常见的是与幽门螺杆菌感染相关的胃窦。我们的患者增加了罕见的胃外病例,其中与幽门螺杆菌的关联不一致。我们发现了与这些病例相关的下消化道和泌尿系统肿瘤的频繁出现,肿瘤区域循环细胞因子的表达导致浆细胞过度活化。这种可能的关联可能使我们了解有关肿瘤环境的数据,并为我们的早期诊断或未来的治疗目标服务。
    Plasma cells known as \"Mott cells\" present non-secretable accumulations of immunoglobulins called \"Russell bodies\". Its presence is related to hematological neoplasms, but it can appear in chronic inflammatory processes. The most common occurrence within the digestive tract is the gastric antrum associated with H. pylori infection. Our patient is added the rare extragastric cases where the association with H. pylori is inconsistent. We have found a frequent appearance of lower digestive and urological neoplasms in relation to these cases, justified by the expression of circulating cytokines in the tumor area that lead to the overactivation of plasma cells. This possible association could lead us to know data about the tumor environment and serve us for early diagnosis or future therapeutic targets.
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  • 文章类型: Case Reports
    We present a case of Helicobacter pylori-negative rectal mucosa-associated lymphoid tissue (MALT) lymphoma found on colonoscopy done for colorectal cancer screening. The lesion was successfully removed with endoscopic mucosal resection alone, without concomitant antibacterial treatment. On surveillance exams, the patient has had a 5-year disease-free survival. While prior reports highlight use of multiple modalities, this is the only case we are aware of in which treatment with endoscopic mucosal resection alone without antimicrobial therapy led to disease-free survival at 5 years.
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  • 文章类型: Journal Article
    Helicobacter pylori (H. pylori) is a bacterium that infects more than a half of world\'s population. Although it is mainly related to the development of gastroduodenal diseases, several studies have shown that such infection may also influence the development and severity of various extragastric diseases. According to the current evidence, whereas this bacterium is a risk factor for some of these manifestations, it might play a protective role in other pathological conditions. In that context, when considered the gastrointestinal tract, H. pylori positivity have been related to Inflammatory Bowel Disease, Gastroesophageal Reflux Disease, Non-Alcoholic Fatty Liver Disease, Hepatic Carcinoma, Cholelithiasis, and Cholecystitis. Moreover, lower serum levels of iron and vitamin B12 have been found in patients with H. pylori infection, leading to the emergence of anemias in a portion of them. With regards to neurological manifestations, a growing number of studies have associated that bacterium with multiple sclerosis, Alzheimer\'s disease, Parkinson\'s disease, and Guillain-Barré syndrome. Interestingly, the risk of developing cardiovascular disorders, such as atherosclerosis, is also influenced by the infection. Besides that, the H. pylori-associated inflammation may also lead to increased insulin resistance, leading to a higher risk of diabetes mellitus among infected individuals. Finally, the occurrence of dermatological and ophthalmic disorders have also been related to that microorganism. In this sense, this minireview aims to gather the main studies associating H. pylori infection with extragastric conditions, and also to explore the main mechanisms that may explain the role of H. pylori in those diseases.
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  • 文章类型: Journal Article
    临床上偶尔会观察到肝和肺MALT淋巴瘤(粘膜相关淋巴组织淋巴瘤),但其发病机理尚不清楚,被认为对建立治疗策略很重要。
    本研究旨在阐明这些淋巴瘤的特征以及根除螺杆菌方案和P物质拮抗剂的作用。
    在长期感染C57BL/6小鼠的胃中,对整个器官进行了病理调查。观察病变的组织化学特征和细菌的定位。此外,研究了抗生素和质子泵抑制剂或P物质拮抗剂的给药效果。
    我们在长期感染后检测到肝和肺MALT淋巴瘤。原位杂交研究显示猪螺杆菌在肝和肺MALT淋巴瘤中呈阳性反应。服用抗生素和质子泵抑制剂后,细菌数量明显减少,眼底肿瘤大小明显减少,肝和肺明显减少。P物质的免疫反应性清楚地显示在肝脏和肺的淋巴瘤细胞中,和spantideII给药诱导肿瘤大小的显著减小。
    通过我们对C57BL/6小鼠长期感染猪螺杆菌的实验,我们检测到肝和肺MALT淋巴瘤。原位杂交研究表明该细菌与这些病变的病因直接相互作用。建议淋巴瘤细胞内的P物质对胃外MALT淋巴瘤的维持起作用。
    The hepatic and pulmonary MALT lymphoma (mucosa-associated lymphoid tissue lymphoma) is clinically occasionally observed but its pathogenesis is unknown and thought to be important to establish the treatment strategy.
    The present study was designed to clarify the characteristics of these lymphomas and the effect of the Helicobacter eradication regimen and substance P antagonist.
    After the long term infection of Helicobacter suis to the C57BL/6 mice stomach, the whole organ was surveyed pathologically. Histochemical characteristics of the lesion and the localization of bacteria were observed. In addition, the effect of the administration of antibiotics and a proton pump inhibitor or the substance P antagonist was investigated.
    We have detected the hepatic and pulmonary MALT lymphoma after the long term infection. In situ hybridization study revealed the positive reaction of Helicobacter suis in the hepatic and pulmonary MALT lymphoma. After the administration of antibiotics and a proton pump inhibitor, the bacterial number has significantly decreased and the tumor size in the fundus, liver and lung markedly reduced. Substance P immunoreactivity was clearly shown in the lymphoma cells in the liver and lung, and the spantide II administration induced the marked decrease in the size of tumors.
    By our experiments using the long term infection of Helicobacter suis to the C57BL/6 mice, we have detected the liver and pulmonary MALT lymphoma. In situ hybridization study suggested the direct interaction of this bacterium to the etiology of these lesions. Substance P within the lymphoma cells was suggested to work on the maintenance of the extragastric MALT lymphoma.
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  • 文章类型: Journal Article
    BACKGROUND: Hyperemesis gravidarum remains a common, distressing, and significant yet poorly understood disorder during pregnancy. The association between maternal Helicobacter pylori (H. pylori) infection and hyperemesis gravidarum has been increasingly recognized and investigated. This study thus aimed to provide an updated review and meta-analysis of the topic.
    METHODS: Using the search terms (H. pyloriOR Helicobacter ORHelicobacter pyloriOR infection) AND (pregnancy OR emesis OR hyperemesis gravidarum OR nausea OR vomiting), a preliminary search on the PubMed, Ovid, Web of Science, Google Scholar, and WanFang database yielded 372 papers published in English between January 1st, 1960 and June 1st, 2017.
    RESULTS: A total of 38 cross-sectional and case-control studies, with a total of 10 289 patients were eligible for review. Meta-analysis revealed a significant association between H. pylori infection and hyperemesis gravidarum during pregnancy, with a pooled odds ratio of 1.348 (95% CI: 1.156-1.539, P < .001). Subgroup analysis found that serologic and stool antigen tests were comparable methods of detecting H. pylori as they yielded similar odds ratios.
    CONCLUSIONS: Although the studies did not have high heterogeneity (I2  = 28%), publication bias was observed, and interstudy discrepancies in the diagnostic criteria adopted for hyperemesis gravidarum limit the reliability of findings. Also, 15 of the included studies were from the same country (Turkey), which could limit the generalizability of current findings. The prevalence of H. pylori infection varies throughout the world, and there may also be pathogenic differences as most strains of H. pylori in East Asia carry the cytotoxin-associated gene A gene.
    CONCLUSIONS: H. pylori infection was associated with an increased likelihood of hyperemesis gravidarum during pregnancy. Given the high prevalence of H. pylori infections worldwide, detecting H. pylori infection and the eradication of maternal H. pylori infection could be part of maternal hyperemesis gravidarum management. Further confirmation with robust longitudinal studies and mechanistic investigations are needed.
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  • 文章类型: Journal Article
    Helicobacter pylori (H. pylori) is an extremely common, yet underappreciated, pathogen that is able to alter host physiology and subvert the host immune response, allowing it to persist for the life of the host. H. pylori is the primary cause of peptic ulcers and gastric cancer. In the United States, the annual cost associated with peptic ulcer disease is estimated to be $6 billion and gastric cancer kills over 700000 people per year globally. The prevalence of H. pylori infection remains high (> 50%) in much of the world, although the infection rates are dropping in some developed nations. The drop in H. pylori prevalence could be a double-edged sword, reducing the incidence of gastric diseases while increasing the risk of allergies and esophageal diseases. The list of diseases potentially caused by H. pylori continues to grow; however, mechanistic explanations of how H. pylori could contribute to extragastric diseases lag far behind clinical studies. A number of host factors and H. pylori virulence factors act in concert to determine which individuals are at the highest risk of disease. These include bacterial cytotoxins and polymorphisms in host genes responsible for directing the immune response. This review discusses the latest advances in H. pylori pathogenesis, diagnosis, and treatment. Up-to-date information on correlations between H. pylori and extragastric diseases is also provided.
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