Screening of HBcAg interacting proteins in hepatocytes with yeast-two hybrid technique

AIM

To screen proteins in hepatocytes interacting with hepatitis B virus core protein (HBcAg) with yeast-two hybrid technique for investigating the biological functions of HBcAg.

METHODS

The HBcAg gene was amplified by polymerase chain reaction (PCR) and HBcAg bait plasmid was constructed with yeast-two hybrid system 3, then transformed into yeast AH109. The transformed yeast mated with yeast Y187 containing liver cDNA library plasmid in 2×YPDA medium. Diploid yeast was plated on synthetic dropout nutrient medium (SD/-Trp-Leu-His-Ade) and synthetic dropout nutrient medium (SD/-Trp-Leu-His-Ade) containing X-α-gal for selecting two times and screening. After extracting and sequencing of plasmid from blue colonies, the results were analyzed by bioinformatics.

RESULTS

Sixteen colonies were sequenced, of which, two colonies were metallothionein 2A, one NAD(P)H dehydrogenase, one complement component 8 a polypeptide, one retinoic acid receptor responder (tazarotene induced), one cytochromeb, one cytochrome c oxidase subunit II , one albumin, two DAZ associated protein 2, two mitochondrial ribosomal protein L41 and four new genes with unknown function.

CONCLUSION

Genes of HBcAg interacting proteins in hepatocytes were successfully cloned and the results provided some new clues for studying the biological functions of HBcAg and its associated proteins.

Bioinformatics analysis of human hepatitis C virus core protein-binding protein 6 gene and protein

AIM

To investigate the structure and function of gene encoding human hepatitis C virus core protein-binding protein 6 (HCBP6) with yeast two-hybrid technique and bioinformatics methods.

METHODS

Yeast two-hybrid technique and bioinformatics method were used to screen and identify the human HCBP6 gene and its amino acid sequences.

RESULTS

Human HCBP6 cDNA and genomic DNA sequences were identified. Human HCBP6 coded for 456 nt and corresponding protein was composed of 152 amino acids. The promoter sequence of HCBP6 gene was identified and promoter motif was predicted by 3 different bioinformatics methods. No intron in HCBP6 gene was identified by homologous search of cDNA and genomic DNA sequence database. The hydrophilic domain was predicted by bioinformatics methods, and the functional domains were determined with online search tools. Mouse HCBP6 gene was identified on the basis of the mouse homologous DNA sequence database. However, all data obtained from bioinformatics analysis were preliminary and further study is required for confirmation.

CONCLUSION

The bioinformatics is a powerful method for the analysis and prediction of a new gene and corresponding protein. Although the predicted result is not accurate, it provides valuable information for further study.

Screening and cloning of gene encoding HBeAg interacting protein in hepatocytes

AIM

To screen hepatic proteins interacting with hepatitis B virus e antigen (HBeAg) with yeast-two hybrid technique for investigating the function of HBeAg protein.

METHODS

HBeAg bait plasmid was constructed by ligating the HBeAg gene with plasmid pGBKT7, then transformed into yeast α-AH109. The transformed yeast cells were amplified and mated with yeast cells α-Y187 containing liver cDNA library plasmid pCAT2 in 2×YPDA medium. Diploid yeast cells were plated on synthetic dropout nutrient medium (SD/-Trp-Leu-His-Ade) and synthetic dropout nutrient medium (SD/-Trp-Leu-His-Ade) containing x-α-gal for selecting twice and screening. After extracting plasmid from blue colonies, plasmid was transformed into competence E.coli and analyzed by DNA sequencing. Twenty genes were obtained from 39 positive colonies, which included five new genes.

RESULTS

Twenty genes in thirty nine positive colonies were obtained including three metallothionein 2 A, eight complement component 8 alpha polypeptide, one complement component 1q, one complement factor H, one retinoic acid receptor responder (tazarotene induced), two cytochrome b, three D-amino-acid oxidase, three ferritin light polypeptide, two NAD(P)H dehydrogenase b, four aldolase B, one CD81, one syndecan 1, one 3-hydroxy-3-methylglutaryl-Coenzyme A synthase 2, one dual-specificity tyrosine-(Y)-phosphorylation regulated kinase 1A transcript variant 1, one 3-hydroxysteroid epimerase, one ATP synthase 6 and five new genes.

CONCLUSION

Genes encoding HBeAg interacting proteins in hepatocytes were successfully cloned and the results provided some new clues for studying the biological functions of HBeAg and its associated proteins.

Screening of gene encoding of hepatic proteins interacting with Hcbp6 via yeast two hybridization

AIM

To seek for hepatic proteins that interacted with protein encoded by Hcbp6 for exploring the biological function of Hcbp6.

METHODS

Hcbp6 gene was introduced into pGBKT7, and then transformed into yeast AH109, which was mated with yeast Y187 (αtype) containing liver cDNA library plasmid in 2×YPDA medium. Diploid yeast was plated on synthetic dropout nutrient medium (SD/-Trp-Leu-His-Ade) containing x-α-gal. Plasmids were extracted from positive colonies, and sequence analysis was performed by bioinformatics.

RESULTS

Four kind of proteins including paralemmin, Ran binding protein 2, transmembrane transporting protein and albumin were identified to interact with Hcbp6 specifically.

CONCLUSION

Hcbp6 proteins may belong to or be associated with formation of secretary proteins, more study needs to be done for clarifying its biological function.

Gene expression profile of HepG2 cell transfected with hepatitis C virus coreprotein-binding protein6 gene

AIM

To screen and clone genes of hepatic protein interacting with hepatitis C virus (HCV) core protein and analyze the gene expression profiles of HepG2 cell transfected with HCV coreprotein-binding protein6 (HCBP6) gene.

METHODS

Using yeast two-hybrid system3, bait plasmid of HCV coreprotein was constructed and genes encoding HCV coreprotein-binding protein were screened and identified. One gene named HCBP6 was identified. Humanfull-length encoding gene of HCBP6 and its amino acid sequences were identified by bioinformatics method, and there combined expression plasmidpc DNA3. 1(-)-HCBP6 was constructed. mRNA from HepG2 cell stransfected with pcDNA3. 1(-)-HCBP6 and the empty vector were detected with cDNA microarray, respectively.

RESULTS

Human HCBP6 cDNA sequence was identified. The coding sequence for human HCBP6 consists of 456 nt and its protein consists of 152 aa. Twenty of 1152 gene sobtained from gene expression profile analysis differed from those in GenBank, in which 13 genes were up-regulated and 7 genes were down-regulated in HepG2 cells transfected with HCBP6 plasmid. These genes differentially regulated by HCBP6 protein included human genes encoding proteins involved in signal transduction, cell proliferation, differentiation, and growth regulation.

CONCLUSION

The bioinformatics combined yeast two hybrid technique is a powerful method for screening and analysis of genes of hepatic protein interacting with HCV coreprotein. The findings obtained by cDNA microarray technique provided significant data for preliminary understanding of the biologica lfunction of new gene, and also provided some clues for furthe rclarifying the molecular biological processes of hepatocytes in interaction between HCV core protein and HCBP6.

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Study on definition of pre-x region in hepatitis B virus genome

AIM

To identify the pre-X gene in HBV strains of Chinese patients.

METHODS

The whole HBV genome was amplified by long-distance and accurate polymerase chain reaction (LA-PCR) method from the serum of 2 patients with chronic HBV infection, and then the PCR products were cloned into pGEM Teasy vectors. Five clones of HBV genome were sequenced. Sequences of our finding were compared with other HBV genome sequence deposited in GenBank.

RESULTS

Pre-X region was found in the HBV genome of these 5 clones, just upstream to the X gene. The pre-X gene is 168 bp long, and can be translated with X gene in frame. The amino acids sequence of pre-X gene was as the following: MGLGYWPSPPAWNLCGSSADPYCGTPSSLFCS QPVWSETYRNRQLCCPLSQIHLLS.

CONCLUSION

Pre-X region may be a serotype-specific coding gene.

Screening and identification of genes trans-regulated by hepatitis C virus NC3 protein with microarray assay

AIM

To understand the target genes up-regulated or down-regulated by NS3 protein, we compared the differentially expressed genes between the hepatoblastoma cell line HepG2 transfected by pcDNA3.1(-) and pcDNA3.1-NS3, respectively by cDNA microarray technique.

METHODS

The NS3 coding DNA fragment was amplified with polymerase chain reaction (PCR) technique by using pBRTM3011 containing the full length of HCV-H cDNA as the template. The expressive vector of pcDNA3.1-NS3 was constructed by routine molecular biological methods. The HepG2 cells were transfected by pcDNA3.1(-) and pcDNA3.1-NS3, respectively using lipofectamine. The total RNA was isolated and reverse transcribed. The cDNAs were subjected for microarray screening with 1 152 cDNA probes.

RESULTS

The expressive vector has been constructed and confirmed by restriction enzyme digestion and DNA sequencing analysis. The expression of NS3 protein has been confirmed by Western blot with single chain variable region (scFv) antibody. High quality mRNA and cDNA had been prepared and successful microarray screening had been conducted. From the scanning results, it was found 34 genes were up-regulated and 37 genes were down-regulated by NS3 protein of HCV.

CONCLUSION

NS3 protein is a transactivator. The expression of NS3 protein affected the expression spectrum of HCV infected hepatocyte. The microarray is an important technique for the study of transactivating effects for viral proteins.

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Therapeutic efficacy of ω-3 polyunsaturated fatty acid capsule in treatment of patients with non-alcoholic fatty liver disease

AIM: To investigate the therapeutic effects and effective dose of ω-3 polyunsaturated fatty acid capsule on non-alcoholic fatty liver disease (NAFLD).

METHODS: This randomized, double-blind, placebo-controlled trial involved 46 NAFLD (fatty liver and non-alcoholic steatohepatitis) patients. They were randomized to receive either ω-3 polyunsaturated fatty acid capsule (low dose, n = 15; high dose, n = 15) or placebo (n = 16) for 24 weeks. Serum biochemical examination and ultrasound assessment (by scores) were performed at 12 and 24 week.

RESULTS: Ultrasound scores were significantly improved 12 or 24 weeks after treatment both in the low-dose and high-dose groups as compared with the baseline level before treatment (9.07 ± 3.20, 8.00 ± 2.42 vs 11.20 ± 3.00; 8.33 ± 2.44, 7.07 ± 2.52 vs 10.40 ± 2.06; all P < 0.01), but there was no marked difference in the placebo group before and after treatment. The level of serum triglyceride decreased after 24-week treatment in the high-dose group in comparison with the baseline level before treatment (1.68 ± 0.77 mmol/L vs 2.66 ± 0.82 mmol/L, P < 0.01). The levels of ALT and GGT had no marked changes 24 weeks after treatment.

CONCLUSION: ω-3 polyunsaturated fatty acid capsule, especially at a higher dose, has a positive role in improving the ultrasound scores for NAFLD. Moreover, a high dosage has some effect on decreasing serum triglyceride level.

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Genes trans-regulated by C-terminally truncated middle surface protein of hepatitis B virus with microarray assay

AIM

To study of genes trans-regulated by C-terminally truncated middle surface protein of hepatitis B virus by microarray.

METHODS

The recombined expression plasmid pcDNA3.1(-)-MHBst was constructed, and HepG2 cells were transfected. Total mRNA was isolated from the HepG2 cells transfected with pcDNA3.1(-) and pcDNA3-MHBst, respectively. Microarray was employed for detecting and analyzing of both mRNA from the HepG2 cells.

RESULTS

After transfecting HepG2 cells, it was found 14 genes had been up-regulated, and 23 genes down-regulated. Their encoding proteins were involved in cell signal transduction, cell proliferation and differentiation.

CONCLUSION

Microarray technology is successfully used to screen the genes trans-regulated by C-terminally truncated middle surface protein of hepatitis B virus, which brings some new clues for studying the trans-regulated and immune regulation mechanism of MHBst.

Genes trans-regulated by nonstructural protein 5A of hepatitis C virus with microarray assay

AIM

To study genes trans-regulated by nonstructural protein 5A of hepatitis C virus by microarray assay.

METHODS

The recombined expression plasmid pcDNA3.1(-)-NS5A was constructed, and HepG2 cells were transfected. Total mRNA was isolated from the HepG2 cells transfected with pcDNA3.1(-) and pcDNA3-NS5A, respectively. Microarray was employed for detecting and analyzing of both mRNA from the HepG2 cells.

RESULTS

After transfecting HepG2 cells, we found 28 genes have been up-regulated, and 26 genes down-regulated. Their encoding proteins were involved in cell signal transduction, cell proliferation and differentiation.

CONCLUSION

Microarray technology is successfully used to screen the genes trans-regulated by nonstructural protein 5A of hepatitis C virus, which brings some new clues for studying the trans-regulated and immune regulation mechanism of NS5A.

Cloning of genes transactivated by NS3 protein of HCV with suppressive and subtractive hybridization

AIM

To construct a subtractive cDNA library of genes transactivated by NS3 protein of hepatitis C virus (HCV) with suppressive and subtractive hybridization technique and clone genes associated with transactivation.

METHODS

The mRNA was isolated from HepG2 cells transfected with pcDNA3.1(-)-NS3, and pcDNA3.1(-) empty vector, respectively; cDNA was synthesized. After digestion with restriction enzyme RsaI, cDNA fragments were obtained by restriction enzyme RsaI digestion. Tester cDNA was then divided into two groups and ligated to the specific adaptor 1 and adaptor 2, respectively. After tester cDNA was hybridized with driver cDNA twice and underwent two times of nested PCR, amplified cDNA fragments were subcloned into T/A plasmid vectors to set up the subtractive library. Amplification of the library was carried out with E. coli strain JM109. The cDNA was sequenced and analyzed in GenBank with Blast search after PCR.

RESULTS

The amplified library contained 70 positive clones. Results of PCR study indicated that 56 clones had inserts of 200-1 000 bp in length. Sequence analysis suggested that six novel cDNA sequences might be target genes transactivated by NS3 protein.

CONCLUSION

The subtractive library of genes transactivated by NS3 protein of HCV was constructed successfully.

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Study on definition of pre-pre-S region in hepatitis B virus genome

AIM

To investigate the new open reading frame (ORF) in hepatitis B virus (HBV) genome.

METHODS

The whole HBV genome was amplified by long-distance and accurate polymerase chain reaction (LA-PCR) method from the serum of 2 patients with chronic HBV infection, and then the PCR products were ligased into pGEM Teasy vectors. Five clones of HBV genome were sequenced. Sequences of our finding were compared with other HBV genome sequence deposited in GenBank.

RESULTS

A new ORF was found in HBV genome, just before Pre-S1 region. It was defined as pre-pre-S region. The pre-pre-S ORF was deduced to be translated with Pre-S1, Pre-S2 and S gene in frame. Its amino acids sequence was as the following: MQLIITSKLGIIYILCGRLVFYIREKLHAV PHFVGHHILGNKSYS. There was a TA-rich region before the ATG of pre-pre-S ORF, indicating a possible promoter for its transcription.

CONCLUSION

There is a new ORF pre-pre-S located upstream to pre-S1 region.

Screening and identification of genes transactivated by hepatitis B virus X protein by microarray assay

AIM

Hepatitis B virus X protein (HBxAg) is a strong transactivator implicating in the transformation of normal hepatocyte and carcinogenesis. To understand the molecular mechanism of HBxAg in the up- and down-regulated genes of hepatocyte, we conducted microarray assay.

METHODS

The coding sequence of HBxAg was amplified by polymerase chain reaction (PCR) by using pCP10 containing the full length HBV genome DNA as the template. The expression of HBxAg in the transfected HepG2 cells was confirmed by Western blot methods. Total mRNA was isolated from the transfected HepG2 cells with pcDNA3.1(-) and pcDNA3-HBxAg, respectively. cDNA was prepared by reverse transcription. Microarray was conducted for screening of up- and down-regulated genes of both HepG2 cells.

RESULTS

The expressive vector of pcDNA3-HBxAg has been constructed and confirmed by restriction enzyme digestion and DNA sequencing. The expression of HBxAg has been confirmed by Western blot analysis. After screening with DNA microarray, we found 16 genes have been up-regulated, and 58 genes have been down-regulated.

CONCLUSION

The HBxAg is a very strong transactivator. Microarray is an important choice for the analysis of target genes of HBxAg transactivation.

Effect of MDG-1 on oral glucose tolerance and intestinal microecological balance in diabetic mice

AIM: To investigate the effect of different concentrations of MDG-1, a polysaccharide extracted from Ophiopogon japonicus, on oral glucose tolerance and intestinal microecological balance in KKay mice.

METHODS: Twenty-six KKAy diabetic mice and ten 9-10-week-old C57bl/6J mice were used in this study. KKAy diabetic mice were given a normal diet from week 9 to week 12 and then fed a high-fat diet for 8 weeks. Diabetes was diagnosed when random blood glucose level was more than 13.9 mmol/L at week 12. Mice were randomly divided into five groups: normal control group, blank control group, low-dose MDG-1 group (75 mg/kg), high-dose MDG-1 group (300 mg/kg), and rosiglitazone group. The normal control and blank control groups were treated with distilled water (10 mL/kg), while the rosiglitazone group was treated with rosiglitazone (2 mg/kg). All the drugs were administered by gavage. After 8 weeks of treatment, the general conditions of mice were observed, oral glucose tolerance test (OGTT) was performed, and intestinal flora was cultured and identified.

RESULTS: Both high- and low-dose MDG-1 could improve symptoms, such as over-drinking and over-eating, in KKay mice. High-dose MDG-1 was superior to low-dose MDG-1 in improving symptoms in KKay mice. After 8 weeks of treatment, a significant decrease in blood glucose levels was observed in both the high-dose MDG-1 group and rosiglitazone group (both P < 0.05). Glucose tolerance was decreased in all KKay mice, especially significantly in the high-dose MDG-1 group and rosiglitazone group (all P < 0.05). In KKay mice, the numbers of pathogenic E. coli and Streptococcus increased while those of Lactobacilli and Bacillus bifidus decreased. However, treatment with MDG-1 decreased the numbers of pathogenic E. coli and Streptococcus and increased those of Lactobacilli (all P < 0.05).

CONCLUSION: MDG-1 can improve clinical symptoms and glucose tolerance and modulate intestinal microecological imbalance in KKay mice.

Expression and biological significance of matrix metalloprofeinase inhibitor RECK gene in esophageal squamous cell carcinoma

AIM: To explore the expression of reversion inducing cysteine rich protein with kazal motifs (RECK) in esophageal squamous cell carcinoma (ESCC) and its correlations with the occurrence and development of ESCC.

METHODS: A total of 62 ESCC specimens, resected in Anyang Tumor Hospital of Henan Province from Februrary 26 to March 16, 2006, were collected. All the cases didn't receive chemotherapy, radiotherapy, and immunotherapy. SP immunohistochemical method and in situ hubridyzation were used to detect the expression of RECK protein and mRNA in the 62 carcinoma specimens, 31 cancer-adjacent specimens (within 3 cm) and 62 normal esophageal epithelial specimens.

RESULTS: The protein and mRNA expression of RECK were closely related with the tumor grades, infilatration and lymphatic metastasis in ESCC. The expression rates of RECK protein were increased ordinally in carcinoma specimens, cancer-adjacent epithelium and normal esophageal epithelial specimens, and there was a significant difference in group comparison (RECK protein: χ² = 10.331, P < 0.01; RECK mRNA: χ² = 19.186, P < 0.01). There was a positive correlation between the protein and mRNA expression of RECK (r = 0.416, P < 0.01) in ESCC.

CONCLUSION: Lower expression of RECK has a correlation with the pathogenesis of and development of ESCC, and RECK may be a new assistant index for early diagnosis and prognosis of ESCC.

Analysis of the pathogens in infectious diarrhea (other than cholera, dysentery, typhoid and paratyphoid) cases reported in China in 2008

AIM: To analyze the etiological and epidemiological characteristics of infectious diarrhea (other than cholera, dysentery, typhoid and paratyphoid) cases reported in China in 2008.

METHODS: The data of infectious diarrhea (other than cholera, dysentery, typhoid and paratyphoid) cases reported in China in 2008 were retrieved from Chinese Information System for Diseases Control and Prevention and analyzed.

RESULTS: Of more than 70 million cases of infectious diarrhea (other than cholera, dysentery, typhoid and paratyphoid) reported, 50.98% of the cases and 69.64 % of the deaths occurred in children aged ≤ 5 years. In nearly 30000 cases with pathogen information, viruses (90.65%) and bacteria (8.97%) were found to be major pathogens. In bacterial diarrhea, Vibrio parahaemolyticus (65.26%) and Salmonella (20.70%) are major pathogens, accounting for 85.96%. In viral diarrhea, rotavirus (92.75%) and adenovirus (4.34%) are major pathogens, accounting for 97.09%.

CONCLUSION: Infectious diarrhea (other than cholera, dysentery, typhoid and paratyphoid) mainly affects children aged less than 5 years. The diagnostic information concerning the pathogens of infectious diarrhea has important implications for public health. However, the quality and timeliness of the reported information need to be improved, and the data need to be enriched.

Identification and characterization of gene 10 transactivated by hepatitis B virus X protein with DNA microarray assay

AIM

To study the target genes transactivated by HBxAg.

METHODS

Specific primers were designed and synthesized according to the HBV DNA sequence of subtype. Polymerase chain reaction (PCR) was conducted to amplify HBxAg coding sequence by using pCP10 plasmid containing 2 copies of head to tail HBV DNA as the template. The expressive vector of pcDNA3-HBxAg was constructed for the transfection of hepatoblastoma cell line HepG2 by Lipofectamine PLUS reagent. Total RNA was prepared from HepG2 and HepG2 cells transfected by pcDNA-HBxAg vector. The RNA was reversely transcribed for further microarray assay.

RESULTS

From the microarray assay, 16 genes were found to be up-regulated, and 58 genes down-regulated. Among them, one gene named XTP10 without known function with 1 206 nt in length, was up-regulated. The encoded protein consisted of 401 amino acid residues (aa).

CONCLUSION

HBxAg is a potential transactivator. DNA microarray is a liable and efficient method for analysis of differentially expressed genes. Molecular biological methods in combination with bioinformatics pave the way for the discovery of new genes transactivated by HBxAg with unknown functions.

Identification and characterization of gene 10 transactivated by hepatitis C virus non-structural protein 5A with DNA microarray assay

AIM

To explore the new target genes transactivated by HCV NS5A, we conducted microarray assay on the hepatoblastoma HepG2 and HepG2 transfected by NS5A expressive vector.

METHODS

Sequence specific primers were designed and synthesized according to the HCV-H strain of virus sequence. Polymerase chain reaction (PCR) was conducted to amplify the NS5A coding gene for the construction of expressive vector pcDNA3.1(-)-NS5A. Hepatoblastoma cell line HepG2 was transfected with plasmid DNA of pcDNA3.1(-)-NS5A, and total RNA was purified from it. Reverse transcribed cDNA were subjected to microarray assay. The coding gene transactivated by HCV NS5A was cloned by bioinformatics methods.

RESULTS

The expressive vector had been constructed and approved correct. The RNA had been purified from HepG2 and HepG2 cells transfected with pcDNA3.1(-)-NS5A, respectively. The cDNA derived had been subjected to microarray assay. New gene named NS5ATP10 had been cloned in combination of molecular biological and bioinformatics methods.

CONCLUSION

HCV NS5A is a potential transactivator. Microarray is an efficient and convenient method for analysis of differentially expressed genes. A new gene has been recognized as the new target transactivated by HCV NS5A protein. These results pave the way for study on the transactivation of HCV NS5A protein.

Clinical features and subtypes of irritable bowel syndrome based on Rome III diagnostic criteria

AIM: To investigate the clinical features and subtypes of irritable bowel syndrome (IBS) based on Rome III diagnostic criteria.

METHODS: A total of 487 consecutive outpatients presented to the gastroenterological clinic were diagnosed with IBS based on Rome III diagnostic criteria. The forms of stool were assessed by Bristol stool form scale. Statistical analysis was performed using SPSS.

RESULTS: All the patients fulfilled the Rome III criteria for IBS. Their age was 18 to 78 years and the disease course was 6 to 720 months. The disease course was over 12 months in 420 patients (86.2%) and 6-12 months in 67 patients (13.8%). The other symptoms outside the gastrointestinal (GI) tract were acratia, backache, insomnia, dizziness, chest distress, weight loss(≥ 5 kg), headache, frequency of micturition, foreign body sensation in throat, shoulder pain, eyeball pain and chest pain. Three hundred and sixteen patients (65%) were diagnosed as IBS with diarrhea(IBS-D), 59 (12%) as IBS with constipation(IBS-C), 24 (5%) as mixed IBS (IBS-M) and 88 (18%) as unsubtyped IBS (IBS-U). Of the 487 patients, subtype alteration occurred in 16 (3.29%) patients during the disease course. Among the four subtypes, sex difference was significant (P < 0.05). IBS-C and IBS-U were more prevalent in females, while IBS-D was more common in males(P < 0.05). However, the subtypes of IBS were similar among different ages(P > 0.05).

CONCLUSION: Rome III diagnostic criteria can improve the early diagnostic rate of IBS. According to Rome III diagnostic criteria, IBS-D is most common, accounting for about 2/3 of IBS cases followed by IBS-U, IBS-C and IBS-M. IBS-U deserves further investigation.

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High-dose amoxicillin/esomeprazole dual therapy as a first-line therapy for Helicobacter pylori eradication

AIM

To evaluate the clinical efficacy and safety of high-dose amoxicillin/esomeprazole dual therapy as a first-line therapy for Helicobacter pylori (H. pylori) eradication.

METHODS

One hundred and forty-two subjects infected with H. pylori and naive to treatment were randomly assigned to receive either 14-d high-dose amoxicillin/esomeprazole dual therapy (esomeprazole 20 mg and amoxicillin 0.75 g, four times a day; EA group) or bismuth-based quadruple therapy [esomeprazole 20 mg, bismuth potassium citrate 220 mg (elemental bismuth), amoxicillin 1 g, and clarithromycin 0.5 g, twice a day; EBAC group]. Six weeks after treatment, H. pylori eradication was assessed by using the urea breath test (¹³C or ¹⁴C).

RESULTS

A total of 131 subjects completed this clinical trial. H. pylori eradication rates by intention-to-treat (ITT) and per-protocol (PP) analysis in the EA group were 82.9% and 89.2%, respectively, and those in the EBAC group were 86.1% and 93.9%, respectively. No significant difference was found in H. pylori eradication rates by both ITT and PP analysis (P > 0.05). The incidence of side effects by PP analysis in the EBAC group was significantly higher than that in the EA group (15.2% vs 3.1%, P < 0.05). All the side effects disappeared after discontinuing the drugs.

CONCLUSION

High-dose amoxicillin/esomeprazole dual therapy can be used as an effective and safety first-line therapy for H. pylori infection.