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Prevalence of Helicobacter pylori infection in patffints with rosacea
A728 AGA ABSTRACTS
GASTROENTEROLOGY Vol. 118, No.4
3954
3956
DECREASING PREVALENCE OF H.PYLORI INFECTION IN PATffiNTS WITH PEPTIC ULCER DISEASES. Yuk-Kei Vee, Kwong-Kuifa Chang, Kam-Fu Li, Chi-Kin Lee. Sau-Wai Wong, Ming-Leung Szeto, TUEN MUN Hosp, Hong Kong, P. R. China.
PREVALENCE OF HELICOBACTER PYLORI INFECTION IN PATffiNTS WITH ROSACEA. Patrizia Zentilin, Carlo Brnsati, Monica Pivari, Francesco Drago, Alfredo Rebora, Vincenzo Savarino, DI M I Gastroenterology Unit, Genoa, Italy; DI SEM Dermatology Unit, Genoa, Italy; Di Sem, Genoa, Italy. Rosacea is a common skin disease representing about 2% of all cases observed in dermatologic departments. Recent reports have suggested that patients with rosacea have an increased prevalence of H. pylori infection, but data on this topic are conflicting. No previous work has considered the prevalence of this disease in a general population of subjects suspected of having H. pylori infection. Methods. Two hundred and ninety subjects (124 M and 166 F, mean age 55.32 years, range 23-79) undergoing consecutively urea breath test (UBT) in an open-access gastroenterological service were prospectively studied. At the time of UBT, they were examined by two expert dermatologists, who agreed on the diagnosis of rosacea on the basis of the following parameters: frequent episodes of flushing (first stage), persistent erythema and teleangiectases (second stage), presence of papules and pustules (third stage) and rhinophima (fourth stage). UBT was performed after overnight fasting and breath samples were collected at baseline and 30' after ingestion of 75 mg 13C-urea dissolved in 150 ml 0.033 mollL citric acid (Cortex Italia, Milan, Italy). 13C enrichment in breath samples was measured by means of mass spectometry (APZ003, Cortex Italia, Milan, Italy). A 8 value higher than 5 %0 was considered positive. Chi-square test was used for statistical analysis. Results. The prevalence of Hpylori infection in patients with and without rosacea is reported in the table. There is a significantly higher (p
BACKGROUND: H.pylori (HP) is important in the pathogenesis of peptic ulcer diseases. However, the occurrences of HP negative peptic ulcers seem to be increasing in clinical practice. AIM: To assess whether the prevalence of HP infection in peptic ulcer patients had changed in the past seven years. METHODS: All the upper endoscopies performed in our department from 1992 to 1998 were reviewed. Those with diagnosis of peptic ulcer disease and HP status confirmed were identified. The demographic data, diagnosis, and HP status were recorded. The histories of smoking and NSAID use were also traced. RESULTS: A total of 1414 patients (968 males and 446 females) were identified. The mean age was 50.1 (range: 15-86). In patients with duodenal ulcer and/or gastric ulcer (DU/GU), duodenal ulcer only (DU) and gastric ulcer only (GU), the prevalences of HP infection significantly decreased from 90.5% in 1992-94 to 79.8% in 1997-98 (p=0.04), 96.6% to 81.0% (p=0.03) and 88.0% to 58.3% (p
Details ofdata
Percentage being H.pylorl posltlve All DU/GU GU DU
1992·94 1995-96 1997·98
88.9% 72.9% 71.1%
90.5% 83.5% 79.8%
96.6% 83.7% 81.0%
68.0% 58.8% 58.3%
Smoking Rite
NSAID Use
Mean Age
28.7% 23.4% 27.5%
12.4% 11.9% 12.8%
53.6 48.0 50.5
3955 CHANGES IN SEROPREVALENCE OF HEUCOBACTER PYLORI INFECTION OVER THE 10 YEARS IN CHINJU, KOREA. Hee-Shang Youn, Song-Ja Kim, EunA Kim, Jin-Su Jun, Ji-Hoe Park, Ji-Hyoun Seo, Hyang-Ok Woo, Gyung-Hyuck Ko, Seung-Chul Baik, Woo-Kon Lee, Myung-Je Cho, Kwang-Ho Rhee, Pediatric, Gyeongsang Natl Univ Coli of Medicine, Chinju, South Korea; Pediatric, Chinju, South Korea; Pathology, Chinju, South Korea; Microbiology, Chinju, South Korea. Most of Helicobacterpylori infections have been known to occur before the age of 10 years in both developed and developing countries. Known risk factors for childhood H. pylori acquisition are low socioeconomic status and living in a crowded environment or in a poor housing. Several cross-sectional studies have suggested that H. pylori infection is predominantly acquired in childhood and the age-related increase in prevalence is mainly a cohort effect. Previous seroepidemiological study of Chinju, Korea during 1988-1989 showed a 50% infection rate in preschool ages, and over 70-80% prevalence rate after 7 years of age throughout adulthood. In this study we tried to evaluate the current (1998-1999) seroepidemiology of H. pylori infection in Chinju, to find out whether cohort effect can be observed, and to figure out the major age groups which determines the cohort shift of prevalence rate. Age and sex matched 1,160 sera were collected at the Gyeongsang National University Hospital during 19981999. Total (lgG+IgA+IgM), IgM, IgA, and IgG immunoblotting, using a sonicated crude H. pylori antigen and 1:5 dilution of serum, were performed. As previously, immunoblot patterns were classified into pattern I showing reactivities against 120 kDa antigen as well as other antigens, pattern II showing reactivities against antigenic fractions other than 120 kDa antigen, and pattern III showing no reactivity to antigenic fractions of H. pylori. Most H. pylori isolates in Korea have 120 kDa antigens (CagA), and immunoblot pattern I was considered a specific marker of H. pylori infection. Current seropidemilogical study (total immunoblotting) of Chinju shows 90% positive rate before 3 months, 70% at 4-6 months, 50% at 7-9 months, 30% at 10-12 months, 20% at 13-18 months, 30% at 19-24 months, about 40-50% at 2-13 years, 60-80% at 14-19 years, and 80-100% since 20 years of age. The age-specific prevalence rates of 60-80% can be observed since 14 year of age, but those rates were observed since 7 years of age 10 years ago. IgM immunoblots pattern I are observed with the frequency of 5-20% in most of age groups, but IgM immunoblots pattern II are more frequently observed during infancy and childhood. IgA immunoblots pattern I are observed more frequently with increasing age from 15% to over 70%. These data suggests that H. pylori infection rates have decreased over 10 years among children with the improvements in socioeconomic status as well as in housing, and that natural H. pylori infection after 7 years of age are rare phenomena in Chinju, Korea.
Rosacea pts Non·rosacea pis
H. pylori positive
H. pylori negltive
Total
62 62
25 141
87 203
3957 HORIZONTAL TRANSFER OF PLASMIDS IN HEUCOBACTER PYLORI IS SUBJECT TO INTER-STRAIN RESTRICTION BARRIERS. Takafumi Ando, Dawn A. Israel, Qing Xu, Kazuo Kusugami, Melaine Torres, Martin J. Blaser, Vanderbilt Univ Sch of Medicine, Nashville, TN; Nagoya Univ, Nagoya, Japan. H. pylori (Hp) cells are naturally competent for uptake of both plasmid and chromosomal DNA. We previously reported functional barriers among Hp strains that affected transformation by plasmid, but not chromosomal, DNA. We now sought to determine the molecular mechanisms underlying these barriers. Methods: Hp transformation efficiency was assessed using pH?l, an E. coli-H. pylori shuttle vector conferring kanamycin-resistance. pHPl was introduced into 10 Hp strains, and purified. pH?l preparations from these strains and from dam" (DH5a) and dam- (SCS11O) strains of E. coli were used to attempt transformation of 32 Hp strains. Chromosomal DNA from 19 Hp strains was digested with each of 13 restriction endonucleases (RE). The MboI restriction-modification (R-M) or MbolM homologs from Hp strain 26695 were cloned and introduced into the ureAB locus of Hp strain JP26. The MboIR homolog of Hp strain B146 was disrupted using allelic exchange by marker rescue. Results: Hp strain JP26, transformed by pHPl from 9 of 10 Hp strains tested, was the best Hp recipient, correlating well with the extremely low RE activities found in JP26 cells. In contrast, pHPrJ P26 was not able to transform any of 32 Hp strains. Of 100 Hp strains tested, only 3 (including JP26) were digested by Mbol, indicating lack of methylation at the MboI recognition sequence (GATe). We introduced the MboIR-M genes, or MboIM alone from strain 26695 into JP26. pHPl JP26 transformed wildtype JP26 and MboIM+ JP26 but not MboIR-M+JP26. Conversely, pHPl from MboIM+ JP26, but not from wildtype JP26, transformed MboI R-M+ JP26. pHPl from MboIM+ JP26 transformed 2 heterologous Hp strains, representing the first Hp transformations by pHPl derived from a JPZ6 background. Finally, pHPI from dam' E. coli strain SCS110 (lacking methylation at the DamlMbol recognition sites) was not able to transform Hp strain B146 (Mbol R-M+), as expected, but transformed B146 in which MboIR was disrupted. Conclusions: These data indicate that the RE of Hp represent the critical barrier to inter-strain plasmid transfer amongst Hp, and further indicate an important role of a highly conserved Hp system homologous to Mbol R-M and Dam methylation in interspecies restriction barriers.
GASTROENTEROLOGY Vol. 118, No.4
3954
3956
DECREASING PREVALENCE OF H.PYLORI INFECTION IN PATffiNTS WITH PEPTIC ULCER DISEASES. Yuk-Kei Vee, Kwong-Kuifa Chang, Kam-Fu Li, Chi-Kin Lee. Sau-Wai Wong, Ming-Leung Szeto, TUEN MUN Hosp, Hong Kong, P. R. China.
PREVALENCE OF HELICOBACTER PYLORI INFECTION IN PATffiNTS WITH ROSACEA. Patrizia Zentilin, Carlo Brnsati, Monica Pivari, Francesco Drago, Alfredo Rebora, Vincenzo Savarino, DI M I Gastroenterology Unit, Genoa, Italy; DI SEM Dermatology Unit, Genoa, Italy; Di Sem, Genoa, Italy. Rosacea is a common skin disease representing about 2% of all cases observed in dermatologic departments. Recent reports have suggested that patients with rosacea have an increased prevalence of H. pylori infection, but data on this topic are conflicting. No previous work has considered the prevalence of this disease in a general population of subjects suspected of having H. pylori infection. Methods. Two hundred and ninety subjects (124 M and 166 F, mean age 55.32 years, range 23-79) undergoing consecutively urea breath test (UBT) in an open-access gastroenterological service were prospectively studied. At the time of UBT, they were examined by two expert dermatologists, who agreed on the diagnosis of rosacea on the basis of the following parameters: frequent episodes of flushing (first stage), persistent erythema and teleangiectases (second stage), presence of papules and pustules (third stage) and rhinophima (fourth stage). UBT was performed after overnight fasting and breath samples were collected at baseline and 30' after ingestion of 75 mg 13C-urea dissolved in 150 ml 0.033 mollL citric acid (Cortex Italia, Milan, Italy). 13C enrichment in breath samples was measured by means of mass spectometry (APZ003, Cortex Italia, Milan, Italy). A 8 value higher than 5 %0 was considered positive. Chi-square test was used for statistical analysis. Results. The prevalence of Hpylori infection in patients with and without rosacea is reported in the table. There is a significantly higher (p
BACKGROUND: H.pylori (HP) is important in the pathogenesis of peptic ulcer diseases. However, the occurrences of HP negative peptic ulcers seem to be increasing in clinical practice. AIM: To assess whether the prevalence of HP infection in peptic ulcer patients had changed in the past seven years. METHODS: All the upper endoscopies performed in our department from 1992 to 1998 were reviewed. Those with diagnosis of peptic ulcer disease and HP status confirmed were identified. The demographic data, diagnosis, and HP status were recorded. The histories of smoking and NSAID use were also traced. RESULTS: A total of 1414 patients (968 males and 446 females) were identified. The mean age was 50.1 (range: 15-86). In patients with duodenal ulcer and/or gastric ulcer (DU/GU), duodenal ulcer only (DU) and gastric ulcer only (GU), the prevalences of HP infection significantly decreased from 90.5% in 1992-94 to 79.8% in 1997-98 (p=0.04), 96.6% to 81.0% (p=0.03) and 88.0% to 58.3% (p
Details ofdata
Percentage being H.pylorl posltlve All DU/GU GU DU
1992·94 1995-96 1997·98
88.9% 72.9% 71.1%
90.5% 83.5% 79.8%
96.6% 83.7% 81.0%
68.0% 58.8% 58.3%
Smoking Rite
NSAID Use
Mean Age
28.7% 23.4% 27.5%
12.4% 11.9% 12.8%
53.6 48.0 50.5
3955 CHANGES IN SEROPREVALENCE OF HEUCOBACTER PYLORI INFECTION OVER THE 10 YEARS IN CHINJU, KOREA. Hee-Shang Youn, Song-Ja Kim, EunA Kim, Jin-Su Jun, Ji-Hoe Park, Ji-Hyoun Seo, Hyang-Ok Woo, Gyung-Hyuck Ko, Seung-Chul Baik, Woo-Kon Lee, Myung-Je Cho, Kwang-Ho Rhee, Pediatric, Gyeongsang Natl Univ Coli of Medicine, Chinju, South Korea; Pediatric, Chinju, South Korea; Pathology, Chinju, South Korea; Microbiology, Chinju, South Korea. Most of Helicobacterpylori infections have been known to occur before the age of 10 years in both developed and developing countries. Known risk factors for childhood H. pylori acquisition are low socioeconomic status and living in a crowded environment or in a poor housing. Several cross-sectional studies have suggested that H. pylori infection is predominantly acquired in childhood and the age-related increase in prevalence is mainly a cohort effect. Previous seroepidemiological study of Chinju, Korea during 1988-1989 showed a 50% infection rate in preschool ages, and over 70-80% prevalence rate after 7 years of age throughout adulthood. In this study we tried to evaluate the current (1998-1999) seroepidemiology of H. pylori infection in Chinju, to find out whether cohort effect can be observed, and to figure out the major age groups which determines the cohort shift of prevalence rate. Age and sex matched 1,160 sera were collected at the Gyeongsang National University Hospital during 19981999. Total (lgG+IgA+IgM), IgM, IgA, and IgG immunoblotting, using a sonicated crude H. pylori antigen and 1:5 dilution of serum, were performed. As previously, immunoblot patterns were classified into pattern I showing reactivities against 120 kDa antigen as well as other antigens, pattern II showing reactivities against antigenic fractions other than 120 kDa antigen, and pattern III showing no reactivity to antigenic fractions of H. pylori. Most H. pylori isolates in Korea have 120 kDa antigens (CagA), and immunoblot pattern I was considered a specific marker of H. pylori infection. Current seropidemilogical study (total immunoblotting) of Chinju shows 90% positive rate before 3 months, 70% at 4-6 months, 50% at 7-9 months, 30% at 10-12 months, 20% at 13-18 months, 30% at 19-24 months, about 40-50% at 2-13 years, 60-80% at 14-19 years, and 80-100% since 20 years of age. The age-specific prevalence rates of 60-80% can be observed since 14 year of age, but those rates were observed since 7 years of age 10 years ago. IgM immunoblots pattern I are observed with the frequency of 5-20% in most of age groups, but IgM immunoblots pattern II are more frequently observed during infancy and childhood. IgA immunoblots pattern I are observed more frequently with increasing age from 15% to over 70%. These data suggests that H. pylori infection rates have decreased over 10 years among children with the improvements in socioeconomic status as well as in housing, and that natural H. pylori infection after 7 years of age are rare phenomena in Chinju, Korea.
Rosacea pts Non·rosacea pis
H. pylori positive
H. pylori negltive
Total
62 62
25 141
87 203
3957 HORIZONTAL TRANSFER OF PLASMIDS IN HEUCOBACTER PYLORI IS SUBJECT TO INTER-STRAIN RESTRICTION BARRIERS. Takafumi Ando, Dawn A. Israel, Qing Xu, Kazuo Kusugami, Melaine Torres, Martin J. Blaser, Vanderbilt Univ Sch of Medicine, Nashville, TN; Nagoya Univ, Nagoya, Japan. H. pylori (Hp) cells are naturally competent for uptake of both plasmid and chromosomal DNA. We previously reported functional barriers among Hp strains that affected transformation by plasmid, but not chromosomal, DNA. We now sought to determine the molecular mechanisms underlying these barriers. Methods: Hp transformation efficiency was assessed using pH?l, an E. coli-H. pylori shuttle vector conferring kanamycin-resistance. pHPl was introduced into 10 Hp strains, and purified. pH?l preparations from these strains and from dam" (DH5a) and dam- (SCS11O) strains of E. coli were used to attempt transformation of 32 Hp strains. Chromosomal DNA from 19 Hp strains was digested with each of 13 restriction endonucleases (RE). The MboI restriction-modification (R-M) or MbolM homologs from Hp strain 26695 were cloned and introduced into the ureAB locus of Hp strain JP26. The MboIR homolog of Hp strain B146 was disrupted using allelic exchange by marker rescue. Results: Hp strain JP26, transformed by pHPl from 9 of 10 Hp strains tested, was the best Hp recipient, correlating well with the extremely low RE activities found in JP26 cells. In contrast, pHPrJ P26 was not able to transform any of 32 Hp strains. Of 100 Hp strains tested, only 3 (including JP26) were digested by Mbol, indicating lack of methylation at the MboI recognition sequence (GATe). We introduced the MboIR-M genes, or MboIM alone from strain 26695 into JP26. pHPl JP26 transformed wildtype JP26 and MboIM+ JP26 but not MboIR-M+JP26. Conversely, pHPl from MboIM+ JP26, but not from wildtype JP26, transformed MboI R-M+ JP26. pHPl from MboIM+ JP26 transformed 2 heterologous Hp strains, representing the first Hp transformations by pHPl derived from a JPZ6 background. Finally, pHPI from dam' E. coli strain SCS110 (lacking methylation at the DamlMbol recognition sites) was not able to transform Hp strain B146 (Mbol R-M+), as expected, but transformed B146 in which MboIR was disrupted. Conclusions: These data indicate that the RE of Hp represent the critical barrier to inter-strain plasmid transfer amongst Hp, and further indicate an important role of a highly conserved Hp system homologous to Mbol R-M and Dam methylation in interspecies restriction barriers.