Helicobacter pylori in Iran: a systematic review on the association of genotypes and gastroduodenal diseases

Background: Helicobacter pylori (H. pylori) infection is known as a major etiologic factor for a variety of gastroduodenal diseases. In Iran, with a high rate of H. pylori infection close to 90%, numerous studies have revealed many aspects of interaction between the bacterium, mucosal surface and induction of disease outcome. The organism is genetically diverse and several virulence factors are attributed to the more virulent strains. The well-characterized virulence factors of H. pylori are cytotoxin associated gene A and vacuolating cytotoxin gene A. The distribution pattern of H. pylori genotypes and its association with disease status varies geographically. The present review focused on the virulence factors and genotyping of H. pylori in relation to gastroduodenal disorders in different regions of Iran. Methods: In total, 398 studies were reported on different aspects related to H. pylori in our electronic search from 1995-2011. H. pylori infection and its virulence factors in association with disease status were investigated in 159 reports. Looking specifically at the gastrointestinal tract disorders, the most relevant reports including 37 papers were selected. Results: We found no correlation of cagA genotype and disease status in the majority of studies, whereas vacA was demonstrated as a useful marker in predicting the disease outcome. The results of reports on other virulence factors of H. pylori such as blood group antigen-binding adhesion gene A, the induced by contact with epithelium gene A, the outer inflammatory protein A, the duodenal ulcer promoting gene A, and Helicobacter outer membrane gene and their relation with disease status were contradictory. Conclusions: Although different markers of H. pylori were emphasized as useful when predicting disease outcomes in some studies, the inconsistent researches and the scarcity of data made any conclusion or even comparison impossible. Considering the gap of information observed during our search relating to genotyping and other aspects of H. pylori infection, further investigations are suggested

The seroprevalence trend of Helicobacter pylori infection in Gombe, Nigeria: A 5-year retrospective study

Background: Helicobacter pylori (H. pylori) infection is highly prevalent globally and half of the world’s population are carrying the pathogen with infection rates higher in low and middle-income countries. The study aim was to retrospectively determine the seroprevalence trend of H. pylori infection among patients suspected to have dyspepsia and identify socio-demographic determinants for H. pylori seropositivity. Methods: This retrospective study was conducted at the State Specialist Hospital, Gombe, Nigeria from January 2015 to December 2019. A total of 11,935 patients were included in the study and lateral flow immunochromatographic immuno assay was used to screen for total anti H. pylori antibodies. Results: The overall sero-prevalence of H. pylori infection was 58.9%. There was significant association between H. pylori seroprevalence rate and age of subjects, (χ2=20.86; p < /em><0.001). The study subjects between the age group 31-40 years had the highest seroprevalence, 62.3%. The seroprevalence of H. pylori was associated with sex of subjects (χ2=39.73; p < /em><0.0001). The seroprevalence trend of H. pylori was highest in 2016 with 61%, followed by 2019 (60.8%), then 2017 (59.3%), 2018 (54.7%) and least in 2015 (50.5%). Conclusion: Findings from the study showed a steady rise in the seroprevalence of H. pylori infection over the five years of study. Furthermore, H pylori infection appears to be higher among adults in their most productive years. Based on these, it is needful to develop strategies for eradication of the infection, encourage health education by creating awareness towards improving environmental and household sanitation, water, personal and food hygiene

Obesity Phytotherapy: Review of Native Herbs Used in Traditional Medicine for Obesity.

Obesity is an important disorders due to which 25 million deaths occur annually worldwide. Synthetic drugs for weight loss have low efficacy and high side effects. Apart from synthetic drugs in modern medicine, various other methods including the use of herbal medications are used to induce weight loss. Cambodia hoodia, green tea, Citrus aurantium, white beans, fenugreek, caffeine, ephedrine, capsaicin, yohimbine, chitosan, fitostreols, and guar gum have been studied in clinical trials and their effects have been confirmed. It seems necessary to study more to determine the effectiveness and safety of medicinal plants and herbal extracts as well as pharmaceutically active ingredients that may have the property of weight loss. In this article, we aimed to review recent knowledge about medicinal plants that are recommended for weight loss

Cancer Phytotherapy: Recent Views on the Role of Antioxidant and Angiogenesis Activities

Nowadays, increases in resistance of tumors to the current therapeutic agents have become a problematic issue. Therefore, efforts to discover new anticancer compounds with high sensitivity of cancer cells are extending. Animal and laboratory researches have shown that exogenous antioxidants are able to help prevent the free radical damage associated with the development of cancer. However, researches in human beings have not demonstrated convincingly that taking antioxidants can reduce the risk of developing cancer. Angiogenesis is also a natural condition that controls the formation of new blood vessels from the available vessels. Today, it is believed that most of the cancers have angiogenesis potential and their growth, metastasis, and invasion depend on angiogenesis. Several compounds with plant origin and with anti-angiogenic properties have been identified. The aim of this study is to review recently published articles about anticancer drugs obtained from plants with antioxidant and anti-angiogenesis properties

Upper gastrointestinal adenocarcinoma: associations with gastric secretory function and gender

Gastric and oesophageal cancers were responsible for more than one million deaths in 2002. Although global incidence of gastric cancer is decreasing, this malignancy is still the fourth most common cause of cancer worldwide. The incidence of oesophageal adenocarcinoma is rising rapidly, three-fold in the last two decades. The incidence of adenocarcinoma of gastric cardia is stable. In the pathogenesis of both gastric and oesophageal adenocarcinomas, the state of the gastric mucosa and its secretory function plays a central role. Non-cardia adenocarcinoma develops in subjects with H.pylori associated atrophic gastritis and hypochlorhydria. Little is known about the gastric phenotype in patients with adenocarcinoma of the cardia and gastroesophageal junction. Another important but poorly understood risk factor for upper GI adenocarcinoma is male gender. In the first study we aimed to investigate the association between the pattern of H.pylori gastritis and gastric secretory function in 255 H.pylori-infected patients with dyspepsia showing normal endoscopy. Our findings showed that maximal acid output correlates inversely with severity of corpus gastritis, corpus atrophy, and positively related to male gender and serum pepsinogen I. In the second study we compared cancers at the cardia and non-cardia subsites with respect to pre-morbid gastric mucosal atrophy and acid secretion. In a nested case-control study comprising 101,601 men and women enrolled in the Norwegian JANUS cohort, 230 cases of gastric cancer were identified. 173 cases including 144 non-cardia and 44 cardia cancer were enrolled to study. Three controls were matched to each case. Serum pepsinogen I, pepsinogen II, anti-H.pylori IgG antibody and gastrin were measured using serums which had been collected a median of 11.9 years before cancer diagnosis radioimmunoassay method. Non-cardia cancer was positively associated with H.pylori and gastric atrophy. The diffuse and intestinal histological subtypes of non-cardia cancer were of similar proportions and both showed a positive association with H.pylori and atrophy. Cardia cancer was negatively associated with H.pylori, but H.pylori positive cardia cancer showed a positive association with gastric atrophy. The predominant histological subtype of cardia cancer was intestinal and it was not associated with gastric atrophy compared to the diffuse subtype. Cardia cancer in atrophic patients had an intestinal: diffuse ratio similar to non-cardia cancer, whereas cardia cancers in persons without atrophy were predominantly intestinal. These findings indicate two aetiologies of cardia cancer, one associated with H.pylori atrophic gastritis, resembling non-cardia cancer, and the other associated with non-atrophic gastric mucosa, resembling oesophageal adenocarcinoma. Serological markers of gastric atrophy may provide the key to determining gastric versus oesophageal origin of cardia cancer. In the third study we extended our investigation of the aetiology of cardia cancer by examining the association of both serological evidences of gastric atrophy and gastroesophageal reflux disease (GORD) symptoms with adenocarcinoma of the oesophagus, cardia and non-cardia regions of the stomach. This has been performed for the different histological subtypes of the cancer. We have also included H.pylori status and smoking history which are other well established risk factors for upper GI cancer. This has been undertaken in a population in Northwest Iran with a high incidence of upper gastrointestinal cancer. Serum pepsinogen I/II was used as a marker of atrophic gastritis and categorised to five quintiles. History of GORD symptoms, smoking and H.pylori infection was incorporated in logistic regression analysis. Lauren classification was used to subtype gastric and oesophageal adenocarcinoma. Non-cardia cancer was associated with atrophic gastritis but not with GORD symptoms; 55% of these cancers were intestinal subtype. Oesophageal adenocarcinoma was associated with GORD symptoms, but not with atrophic gastritis; 84% were intestinal subtype. Cardia cancer was positively associated with both severe gastric atrophy and with frequent GORD symptoms though the latter was only apparent in the non-atrophic subgroup and in the intestinal subtype. The association of cardia cancer with atrophy was stronger for the diffuse versus intestinal subtype and this was the converse of the association observed with non-cardia cancer. These findings indicate two distinct aetiologies of cardia cancer, one arising from severe atrophic gastritis and being of intestinal or diffuse subtype similar to non-cardia cancer, and one related to GORD and intestinal in subtype, similar to oesophageal adenocarcinoma. Gastric atrophy, GORD symptoms and histological subtype may distinguish between gastric versus oesophageal origin of cardia cancer. In the fourth study we investigated the relationship between gender and upper gastrointestinal adenocarcinoma. Male gender is a well-established risk factor for oesophageal adenocarcinoma. Male predominance of gastric cancer is related to the histological subtype of the tumour being more marked in the intestinal versus diffuse histological subtype. In addition, global data suggests that the male predominance of upper gastrointestinal cancer is related to the anatomical location, being higher for proximal and lower for distal tumours. However, the proportion of the intestinal histological subtype differs according to anatomical site and it is unclear whether it is the anatomical site or the histological subtype which is associated with the gender phenomenon. We have conducted a population-based study to investigate this. The study was based upon 3270 gastric and oesophageal cancers recorded in West of Scotland Cancer Registry between 1998 and 2002. The Lauren subtype of adenocarcinoma was determined by reviewing 1204 reports and 3241 slides in a sample of 812 cases. Logistic regression models were used to estimate relationship between male predominance and histological subtype, tumour location and age. We found that the crude incidence rate of intestinal subtype was higher in males (23.86/ 100,000 person-years) versus females (9.00/ 100,000 person-years), giving M/F of 2.65. M/F ratio of intestinal subtype cancer was 3.41 at age <50, reached a peak of 7.86 at age 50-59, and then showed a progressive decrease throughout the life. In contrast, the incidence rate of diffuse subtype adenocarcinoma was similar in both sexes (5.58 vs. 5.20 /100,000 person-years) yielding M/F of 1.07. Multivariate analyses including histological subtype, tumour location and age indicated that the male predominance was related to the histological type rather than anatomical location. Intestinal type tumour showed similar male predominance of incidence irrespective of its anatomical location (OR, 95% CI: 2.6, 1.78 – 3.9). Further analysis of the age-specific incidence curves indicated that the male predominance of intestinal subtype was due to a 17.2-year delay of development of this cancer in females

Review Article Advances in Understanding How Heavy Metal Pollution Triggers Gastric Cancer

With the development of industrialization and urbanization, heavy metals contamination has become a major environmental problem. Numerous investigations have revealed an association between heavy metal exposure and the incidence and mortality of gastric cancer. The mechanisms of heavy metals (lead, cadmium, mercury, chromium, and arsenic) contamination leading to gastric cancer are concluded in this review. There are four main potential mechanisms: (1) Heavy metals disrupt the gastric mucosal barrier by decreasing mucosal thickness, mucus content, and basal acid output, thereby affecting the function of E-cadherin and inducing reactive oxygen species (ROS) damage. (2) Heavy metals directly or indirectly induce ROS generation and cause gastric mucosal and DNA lesions, which subsequently alter gene regulation, signal transduction, and cell growth, ultimately leading to carcinogenesis. Exposure to heavy metals also enhances gastric cancer cell invasion and metastasis. (3) Heavy metals inhibit DNA damage repair or cause inefficient lesion repair. (4) Heavy metals may induce other gene abnormalities. In addition, heavy metals can induce the expression of proinflammatory chemokine interleukin-8 (IL-8) and microRNAs, which promotes tumorigenesis. The present review is an effort to underline the human health problem caused by heavy metal with recent development in order to garner a broader perspective

Apoptosis Induction by Lactobacillus casei Acidic Proteins in the Colorectal Cancer Cell Line

Background: Colorectal cancer (CRC) ranks third in cancer prevalence. Lactobacillus casei, a probioticbacterium, can optimize the microbiota population of the gastrointestinal tract and prevent the growth of harmful bacteria that induce carcinogenesis. In this study, we investigated the effect of L. casei acidic proteins on apoptosis in the SW480 cell line to identify a drug protein for treating CRC.Materials and Methods: We assayed the effect of the isolated acid-resistant proteins of the Chaperoninbacterium, a metal-dependent Hydrolase, and Lysozyme on the SW480 colorectal cancer cell line apoptosispathway gene expression with a Real-Time RT-PCR.Results: All three proteins induced apoptosis in the cells treated separately with each of the proteins. Theresults showed that the up-regulation of BAX and P53 gene expression and the apoptosis pathway weresignificantly induced. Also, BCL2 expression was down-regulated, and significant anti-apoptotic was observedat p&lt;0.0001. Moreover, the cells treated with these three proteins down-regulated the expression of MAP2K1and provoked the opposite apoptosis pathway.Conclusion: Our results found that these proteins would be a good choice for potential CRC treatment

Melatonin and human mitochondrial diseases

Mitochondrial dysfunction is one of the main causative factors in a wide variety of complications such as neurodegenerative disorders, ischemia/reperfusion, aging process, and septic shock. Decrease in respiratory complex activity, increase in free radical production, increase in mitochondrial synthase activity, increase in nitric oxide production, and impair in electron transport system and/or mitochondrial permeability are considered as the main factors responsible for mitochondrial dysfunction. Melatonin, the pineal gland hormone, is selectively taken up by mitochondria and acts as a powerful antioxidant, regulating the mitochondrial bioenergetic function. Melatonin increases the permeability of membranes and is the stimulator of antioxidant enzymes including superoxide dismutase, glutathione peroxidase, glutathione reductase, and catalase. It also acts as an inhibitor of lipoxygenase. Melatonin can cause resistance to oxidation damage by fixing the microsomal membranes. Melatonin has been shown to retard aging and inhibit neurodegenerative disorders, ischemia/reperfusion, septic shock, diabetes, cancer, and other complications related to oxidative stress. The purpose of the current study, other than introducing melatonin, was to present the recent findings on clinical effects in diseases related to mitochondrial dysfunction including diabetes, cancer, gastrointestinal diseases, and diseases related to brain function. © 2016 Journal of Research in Medical Sciences

Ethnobotanical study of medicinal plants used in the management of diabetes mellitus in the Urmia, Northwest Iran

Objective: To collect and document information on anti-diabetic plants traditionally used in the treating of diabetes in Urmia at Northwest Iran because ethnomedicines are considered as valuable sources to find new potential drugs. Methods: We used the method of direct observation and interview (35 traditional healers) along with gathering herbarium specimens mentioned plants in site. Results: There were 30 medicinal plants from 17 families for the treatment of diabetes. The family with most plants was Lamiaceae (20). Leaves (20) are often used and its form is decoction (70). It was also found that Citrullus colocynthis has the most frequency of use among traditional healers. Conclusions: Furthermore, base on current findings many of the mentioned plants have potential active ingredients to influence diabetes. © 2014 Hainan Medical College

Nutrients and diet quality in gastrointestinal cancers

Findings on the role of foods in the risk of gastrointestinal cancers are not consistent. This thesis studied the role of some essential dietary components that are required for normal development and function, as well as that of balanced and healthy patterns of diet intake, on the risk of gastrointestinal cancers. We show that neither synthetic folic acid nor the blood level folate is associated with an increased risk of colorectal cancer (Chapter 2). However, the results of a large study show that supplementing folic acid and iron at higher levels than provided in the original food may increase the risk for colorectal cancer (Chapter 3). The risk of colorectal cancer also seems not to be increased for pregnant women taking synthetic folic acid according to data from smaller study (Chapter 4). As anticipated, healthy and balanced diet intake patterns are associated with lower risks of gastrointestinal cancers, yet the findings are of insufficient quality to develop dietary recommendations for gastrointestinal cancers prevention (Chapters 5, 6, & 7). Moreover, healthy food intake is inadequate among cancer survivors (Chapter 8). The effect of folic acid and iron, as well as that of a healthy and balanced pattern of food and beverage intake, remain unclear regarding gastrointestinal cancer. Future studies will need to assess the role of inherited features on the effect of essential nutrients in diet and on the healthiest patterns of diet intake needed to prevent gastrointestinal cancer