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Shimamoto Y, Takeuchi Y, Ishiguro S, Nakatsuka S, Yunokizaki H, Ezoe Y, Nakajima T, Tanaka K, Ishihara R, Takayama T, Yoshida T, Sugano K, Mutoh M, Ishikawa H. Genotype-phenotype correlation for extracolonic aggressive phenotypes in patients with familial adenomatous polyposis. Cancer Sci 2023; 114:4596-4606. [PMID: 37798255 PMCID: PMC10728006 DOI: 10.1111/cas.15945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 08/03/2023] [Accepted: 08/18/2023] [Indexed: 10/07/2023] Open
Abstract
Familial adenomatous polyposis (FAP) patients develop various life-threatening extracolonic comorbidities that appear individually or within a family. This diversity can be explained by the localization of the adenomatous polyposis coli (APC) variant, but few reports provide definitive findings about genotype-phenotype correlations. Therefore, we investigated FAP patients and the association between the severe phenotypes and APC variants. Of 247 FAP patients, 126 patients from 85 families identified to have APC germline variant sites were extracted. These sites were divided into six groups (Regions A to F), and the frequency of severe comorbidities was compared among the patient phenotypes. Of the 126 patients, the proportions of patients with desmoid tumor stage ≥III, number of FGPs ≥1000, multiple gastric neoplasms, gastric neoplasm with high-grade dysplasia, and Spigelman stage ≥III were 3%, 16%, 21%, 12%, and 41%, respectively, while the corresponding rates were 30%, 50%, 70%, 50%, and 80% in patients with Region E (codons 1398-1580) variants. These latter rates were significantly higher than those for patients with variants in other regions. Moreover, the proportion of patients with all three indicators (desmoid tumor stage ≥III, number of FGPs ≥1000, and Spigelman stage ≥III) was 20% for those with variants in Region E and 0% for those with variants in other regions. Variants in Region E indicate aggressive phenotypes, and more intensive management is required.
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Affiliation(s)
- Yusaku Shimamoto
- Department of Gastrointestinal OncologyOsaka International Cancer InstituteOsakaJapan
| | - Yoji Takeuchi
- Department of Gastrointestinal OncologyOsaka International Cancer InstituteOsakaJapan
- Department of Genetic Oncology, Division of Hereditary TumorsOsaka International Cancer InstituteOsakaJapan
- Department of Gastroenterology and HepatologyGunma University Graduate School of MedicineMaebashiJapan
| | | | - Shin‐ichi Nakatsuka
- Department of Diagnostic Pathology and CytologyOsaka International Cancer InstituteOsakaJapan
| | | | - Yasumasa Ezoe
- Medical Ethics and Medical Genetics, School of Public HealthKyoto UniversityKyotoJapan
| | - Takeshi Nakajima
- Medical Ethics and Medical Genetics, School of Public HealthKyoto UniversityKyotoJapan
| | - Kumiko Tanaka
- Department of Gastroenterology and Oncology, Institute of Biomedical SciencesTokushima University Graduate SchoolTokushimaJapan
| | - Ryu Ishihara
- Department of Gastrointestinal OncologyOsaka International Cancer InstituteOsakaJapan
| | - Tetsuji Takayama
- Department of Gastroenterology and Oncology, Institute of Biomedical SciencesTokushima University Graduate SchoolTokushimaJapan
| | - Teruhiko Yoshida
- Department of Genetic Medicine and ServicesNational Cancer Center HospitalTokyoJapan
| | - Kokichi Sugano
- Department of Genetic Medicine, Sasaki FoundationKyoundo HospitalTokyoJapan
| | - Michihiro Mutoh
- Department of Molecular‐Targeting Prevention, Graduate School of Medical ScienceKyoto Prefectural University of MedicineKyotoJapan
| | - Hideki Ishikawa
- Ishikawa Gastroenterology ClinicOsakaJapan
- Department of Molecular‐Targeting Prevention, Graduate School of Medical ScienceKyoto Prefectural University of MedicineKyotoJapan
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Iwamuro M, Tanaka S, Toyokawa T, Nishimura M, Tsuzuki T, Miyahara K, Negishi S, Ohya S, Tanaka T, Otsuka M. Endoscopic Manifestations and Clinical Characteristics of Localized Gastric Light-Chain Amyloidosis. Acta Med Okayama 2023; 77:545-552. [PMID: 37899266 DOI: 10.18926/amo/65978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
To determine the endoscopic and clinical features of localized gastric amyloid light-chain (AL) amyloidosis, we retrospectively examined the characteristics of nine patients (eight men and one woman) encountered by the hospitals in our network. Lesions were predominantly flat and depressed with surface vascular dilatation (n=5); others were characterized by subepithelial lesions (n=2), mucosal color change (n=1), and a mass-like morphology with swollen mucosal folds (n=1). Colonoscopy (n=7), video capsule enteroscopy (n=2), serum (n=5) and urine immunoelectrophoresis (n=4), and bone marrow examination (n=3) were performed to exclude involvement of organs other than the stomach. As treatment for gastric lesions of AL amyloidosis, one patient each underwent endoscopic submucosal dissection (n=1) and argon plasma coagulation (n=1), while the remaining seven patients underwent no specific treatment. During a mean follow-up of 4.2 years, one patient died 3.2 years after diagnosis, but the cause of death, which occurred in another hospital, was unknown. The remaining eight patients were alive at the last visit. In conclusion, although localized gastric AL amyloidosis can show various macroscopic features on esophagogastroduodenoscopy, flat, depressed lesions with vascular dilatation on the surface are predominant.
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Affiliation(s)
- Masaya Iwamuro
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Shouichi Tanaka
- Department of Gastroenterology, National Hospital Organization Iwakuni Clinical Center
| | - Tatsuya Toyokawa
- Department of Gastroenterology, National Hospital Organization Fukuyama Medical Center
| | | | - Takao Tsuzuki
- Department of Internal Medicine, Japanese Red Cross Society Himeji Hospital
| | - Koji Miyahara
- Department of Internal Medicine, Hiroshima City Hiroshima Citizens Hospital
| | - Shin Negishi
- Department of Gastroenterology, Kagawa Prefectural Central Hospital
| | | | - Takehiro Tanaka
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Motoyuki Otsuka
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
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Kawashima K, Hikichi T, Onizawa M, Ohira H. Endoscopic Images before the Onset of Cronkhite-Canada Syndrome. Intern Med 2021; 60:3999-4000. [PMID: 34148962 PMCID: PMC8758444 DOI: 10.2169/internalmedicine.7369-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Kazumasa Kawashima
- Department of Gastroenterology, Fukushima Medical University School of Medicine, Japan
| | - Takuto Hikichi
- Department of Endoscopy, Fukushima Medical University Hospital, Japan
| | - Michio Onizawa
- Department of Gastroenterology, Fukushima Medical University School of Medicine, Japan
| | - Hiromasa Ohira
- Department of Gastroenterology, Fukushima Medical University School of Medicine, Japan
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Gupta PC, Kar A, Sharma N, Singh PK, Goswami NK, Kumar S. Protective effect of standardised fruit extract of Garcinia cowa Roxb. ex Choisy against ethanol induced gastric mucosal lesions in Wistar rats. Ann Med 2021; 53:1696-1708. [PMID: 34555996 PMCID: PMC8475150 DOI: 10.1080/07853890.2021.1981548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 09/12/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND AND AIM The fruit of Garcinia is a rich and valuable source of bioactive compounds and is traditionally used for treating wounds and ulcers. The present study was carried out to investigate the protective effect of chromatographically standardized fruit extract of Garcinia cowa (GCE) on ethanol-induced gastric lesions in rats and its possible mechanisms. METHODS The effect of GCE (200 and 400 mg/kg body weight) was evaluated by determining various gastric ulcer parameters like gastric wall mucus, non-protein sulfhydryls (NP-SH) content, microvascular permeability, endogenous antioxidant enzyme, and gastric histopathological study. RESULTS AND CONCLUSIONS Oral administration of GCE at doses of 200 and 400 mg/kg exhibited significant (p < .01) dose-dependent inhibition of ulcer index by 18.94-44.02%, respectively. Pre-treatment of rats with GCE (400 mg/kg) significantly restored the depleted gastric wall mucus level by 34.09% and NP-SH content by 33.35% induced by ethanol administration. In addition, GCE (400 mg/kg) showed a significant decrease in microvascular permeability of Evans Blue by 47.43%, rationalizing its protective effect. Furthermore, a significant increase in oxidative enzyme levels with reduction in malondialdehyde level and elevation of superoxide dismutase (SOD) activity was observed in the GCE treated group as compared to the ulcer control group. The histopathological assessment also confirmed the protective nature of GCE. HPTLC analysis showed the presence of 0.27%, 0.11% w/w gallic acid, and amentoflavone, respectively in GCE. The content of α-mangostin and xanthochymol in the G. cowa extract sample quantified by HPLC-PDA method was 0.72 and 8.46%, respectively. The results obtained indicate that the protective effect of GCE against gastric ulcers in rats through multiple actions confirmed by the reduction of oxidative stress and restoration of adhered gastric mucus, NP-SH content, and histological architecture.KEY MESSAGESEthanol is the most typical ulcerogenic agent and has been shown to extend the risk of ulcer in humans.Natural products are promising alternative medication for the development of new drugs to regulate gastrointestinal diseases.Garcinia cowa protects the gastric mucosa through multiple actions that include restoration of adhered gastric mucus and inhibition of lipid peroxidation.
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Affiliation(s)
- Prakash Chandra Gupta
- University Institute of Pharmacy, Chhatrapati Shahu Ji Maharaj University, Kanpur, India
| | - Ashish Kar
- Northeastern Regional Centre, The Energy and Resources Institute (TERI), Guwahati, India
| | - Nisha Sharma
- University Institute of Pharmacy, Chhatrapati Shahu Ji Maharaj University, Kanpur, India
| | - Prashant Kumar Singh
- University Institute of Pharmacy, Chhatrapati Shahu Ji Maharaj University, Kanpur, India
| | - Naba Kumar Goswami
- Northeastern Regional Centre, The Energy and Resources Institute (TERI), Guwahati, India
| | - Satyanshu Kumar
- ICAR-Directorate of Medicinal and Aromatic Plants Research, Boriavi, Anand, India
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Wang Q, Zhang SY, Wu X, Yao F, Zhou WX, Chai NL, Zhang ST, Hao JY, Wu J, Zhang JC, Xu BH, Hu LX, Yang AM. Feasibility of standardized procedures of white light gastroscopy for clinical practice: A multicenter study in China. J Dig Dis 2021; 22:656-662. [PMID: 34693636 DOI: 10.1111/1751-2980.13061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 10/17/2021] [Accepted: 10/18/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVE We aimed to establish a standardized procedure for white light gastroscopy (WLG) to screen gastric lesions including early gastric cancer (EGC) in China and to verify its efficacy and feasibility in clinical practice. METHODS A standardized WLG procedure for outpatients at nine tertiary hospitals in Beijing was established. Clinical information of the participants and details of the endoscopic procedures were recorded. RESULTS A total of 1051 participants were enrolled in a baseline conventional endoscopic survey between March 2014 and December 2015, while 2156 patients were enrolled in the standardized WLG operation from January 2016 to June 2017. The procedure time of the standardized procedure was significantly longer than that of the baseline conventional procedure (P = 0.003). More images were obtained during the standardized procedure compared with the baseline conventional procedure (P < 0.001). The overall detection rate of gastric lesions in the standardized procedure group was significantly higher than that in the baseline procedure group (52.5% vs 38.4%, P < 0.01). The satisfaction scores of both participants and endoscopists in the standardized procedure group were significantly higher than in the baseline procedure group. CONCLUSIONS Compared with the conventional procedure, standardized WLG procedure significantly improves the detection rate of gastric lesions as well as the satisfaction score of participants and endoscopists despite its longer procedure time. It is effective and feasible in clinical practice in China for the use of currently available endoscopic equipment.
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Affiliation(s)
- Qiang Wang
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Sheng Yu Zhang
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Xi Wu
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Fang Yao
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Wei Xun Zhou
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Ning Li Chai
- Department of Gastroenterology, General Hospital of the People's Liberation Army, Beijing, China
| | - Shu Tian Zhang
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Jian Yu Hao
- Department of Gastroenterology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Jing Wu
- Department of Gastroenterology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Ji Chang Zhang
- Gastrointestinal Cancer Center, Peking University Cancer Hospital, Beijing, China
| | - Bao Hong Xu
- Department of Gastroenterology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Li Xia Hu
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Ai Ming Yang
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
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Gojkovic S, Krezic I, Vranes H, Zizek H, Drmic D, Batelja Vuletic L, Milavic M, Sikiric S, Stilinovic I, Simeon P, Knezevic M, Kolak T, Tepes M, Simonji K, Strbe S, Nikolac Gabaj N, Barisic I, Oreskovic EG, Lovric E, Kokot A, Skrtic A, Boban Blagaic A, Seiwerth S, Sikiric P. Robert's Intragastric Alcohol-Induced Gastric Lesion Model as an Escalated General Peripheral and Central Syndrome, Counteracted by the Stable Gastric Pentadecapeptide BPC 157. Biomedicines 2021; 9:biomedicines9101300. [PMID: 34680419 PMCID: PMC8533388 DOI: 10.3390/biomedicines9101300] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/12/2021] [Accepted: 09/17/2021] [Indexed: 12/11/2022] Open
Abstract
We redefined Robert’s prototypical cytoprotection model, namely the intragastric administration of 96% alcohol in order to generate a general peripheral and central syndrome similar to that which occurs when major central or peripheral veins are occluded in animal models. With this redefinition, we used Robert’s model to examine the cytoprotective effects of the stable gastric pentadecapeptide BPC 157. The intragastric administration of alcohol induced gastric lesions, intracranial (superior sagittal sinus) hypertension, severe brain swelling and lesions, portal and vena caval hypertension, aortal hypotension, severe thrombosis, inferior vena cava and superior mesenteric vein congestion, azygos vein failure (as a failed collateral pathway), electrocardiogram disturbances, and heart, lung, liver and kidney lesions. The use of BPC 157 therapy (10 µg/kg or 10 ng/kg given intraperitoneally 1 min after alcohol) counteracted these deficits rapidly. Specifically, BPC 157 reversed brain swelling and superior mesenteric vein and inferior vena caval congestion, and helped the azygos vein to recover, which improved the collateral blood flow pathway. Microscopically, BPC 157 counteracted brain (i.e., intracerebral hemorrhage with degenerative changes of cerebral and cerebellar neurons), heart (acute subendocardial infarct), lung (parenchymal hemorrhage), liver (congestion), kidney (congestion) and gastrointestinal (epithelium loss, hemorrhagic gastritis) lesions. In addition, this may have taken place along with the activation of specific molecular pathways. In conclusion, these findings clarify and extend the theory of cytoprotection, offer an approach to its practical application, and establish BPC 157 as a prospective cytoprotective treatment.
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Affiliation(s)
- Slaven Gojkovic
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (S.G.); (I.K.); (H.V.); (H.Z.); (D.D.); (I.S.); (M.K.); (M.T.); (S.S.); (I.B.); (E.G.O.); (A.B.B.)
| | - Ivan Krezic
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (S.G.); (I.K.); (H.V.); (H.Z.); (D.D.); (I.S.); (M.K.); (M.T.); (S.S.); (I.B.); (E.G.O.); (A.B.B.)
| | - Hrvoje Vranes
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (S.G.); (I.K.); (H.V.); (H.Z.); (D.D.); (I.S.); (M.K.); (M.T.); (S.S.); (I.B.); (E.G.O.); (A.B.B.)
| | - Helena Zizek
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (S.G.); (I.K.); (H.V.); (H.Z.); (D.D.); (I.S.); (M.K.); (M.T.); (S.S.); (I.B.); (E.G.O.); (A.B.B.)
| | - Domagoj Drmic
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (S.G.); (I.K.); (H.V.); (H.Z.); (D.D.); (I.S.); (M.K.); (M.T.); (S.S.); (I.B.); (E.G.O.); (A.B.B.)
| | - Lovorka Batelja Vuletic
- Department of Pathology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (L.B.V.); (M.M.); (S.S.); (E.L.); (A.S.); (S.S.)
| | - Marija Milavic
- Department of Pathology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (L.B.V.); (M.M.); (S.S.); (E.L.); (A.S.); (S.S.)
| | - Suncana Sikiric
- Department of Pathology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (L.B.V.); (M.M.); (S.S.); (E.L.); (A.S.); (S.S.)
| | - Irma Stilinovic
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (S.G.); (I.K.); (H.V.); (H.Z.); (D.D.); (I.S.); (M.K.); (M.T.); (S.S.); (I.B.); (E.G.O.); (A.B.B.)
| | - Paris Simeon
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia;
| | - Mario Knezevic
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (S.G.); (I.K.); (H.V.); (H.Z.); (D.D.); (I.S.); (M.K.); (M.T.); (S.S.); (I.B.); (E.G.O.); (A.B.B.)
| | - Toni Kolak
- Department of Surgery, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia;
| | - Marijan Tepes
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (S.G.); (I.K.); (H.V.); (H.Z.); (D.D.); (I.S.); (M.K.); (M.T.); (S.S.); (I.B.); (E.G.O.); (A.B.B.)
| | - Karol Simonji
- Internal Diseases Clinic, Faculty of Veterinary Medicine, University of Zagreb, 10000 Zagreb, Croatia;
| | - Sanja Strbe
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (S.G.); (I.K.); (H.V.); (H.Z.); (D.D.); (I.S.); (M.K.); (M.T.); (S.S.); (I.B.); (E.G.O.); (A.B.B.)
| | - Nora Nikolac Gabaj
- Department of Chemistry, University Clinical Hospital Center “Sestre Milosrdnice”, 10000 Zagreb, Croatia;
| | - Ivan Barisic
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (S.G.); (I.K.); (H.V.); (H.Z.); (D.D.); (I.S.); (M.K.); (M.T.); (S.S.); (I.B.); (E.G.O.); (A.B.B.)
| | - Emma Grace Oreskovic
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (S.G.); (I.K.); (H.V.); (H.Z.); (D.D.); (I.S.); (M.K.); (M.T.); (S.S.); (I.B.); (E.G.O.); (A.B.B.)
| | - Eva Lovric
- Department of Pathology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (L.B.V.); (M.M.); (S.S.); (E.L.); (A.S.); (S.S.)
| | - Antonio Kokot
- Department of Anatomy and Neuroscience, School of Medicine, J.J. Strossmayer University of Osijek, 31000 Osijek, Croatia;
| | - Anita Skrtic
- Department of Pathology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (L.B.V.); (M.M.); (S.S.); (E.L.); (A.S.); (S.S.)
| | - Alenka Boban Blagaic
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (S.G.); (I.K.); (H.V.); (H.Z.); (D.D.); (I.S.); (M.K.); (M.T.); (S.S.); (I.B.); (E.G.O.); (A.B.B.)
| | - Sven Seiwerth
- Department of Pathology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (L.B.V.); (M.M.); (S.S.); (E.L.); (A.S.); (S.S.)
| | - Predrag Sikiric
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (S.G.); (I.K.); (H.V.); (H.Z.); (D.D.); (I.S.); (M.K.); (M.T.); (S.S.); (I.B.); (E.G.O.); (A.B.B.)
- Correspondence: ; Tel.: +385-1-4566-833; Fax: +385-1-4592-005
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Pang X, Zhao Z, Weng Y. The Role and Impact of Deep Learning Methods in Computer-Aided Diagnosis Using Gastrointestinal Endoscopy. Diagnostics (Basel) 2021; 11:694. [PMID: 33919669 PMCID: PMC8069844 DOI: 10.3390/diagnostics11040694] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 03/24/2021] [Accepted: 04/01/2021] [Indexed: 12/18/2022] Open
Abstract
At present, the application of artificial intelligence (AI) based on deep learning in the medical field has become more extensive and suitable for clinical practice compared with traditional machine learning. The application of traditional machine learning approaches to clinical practice is very challenging because medical data are usually uncharacteristic. However, deep learning methods with self-learning abilities can effectively make use of excellent computing abilities to learn intricate and abstract features. Thus, they are promising for the classification and detection of lesions through gastrointestinal endoscopy using a computer-aided diagnosis (CAD) system based on deep learning. This study aimed to address the research development of a CAD system based on deep learning in order to assist doctors in classifying and detecting lesions in the stomach, intestines, and esophagus. It also summarized the limitations of the current methods and finally presented a prospect for future research.
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Affiliation(s)
- Xuejiao Pang
- School of Control Science and Engineering, Shandong University, Jinan 250061, China;
| | - Zijian Zhao
- School of Control Science and Engineering, Shandong University, Jinan 250061, China;
| | - Ying Weng
- School of Computer Science, University of Nottingham, Nottingham NG7 2RD, UK;
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Ghasemkhani N, Tabrizi AS, Namazi F, Nazifi S. Treatment effects of Shilajit on aspirin-induced gastric lesions in rats. Physiol Rep 2021; 9:e14822. [PMID: 33818003 PMCID: PMC8020045 DOI: 10.14814/phy2.14822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 03/07/2021] [Accepted: 03/08/2021] [Indexed: 12/15/2022] Open
Abstract
The present study investigated the effects of Shilajit extract on aspirin-induced gastric lesions in rats. We evaluated macroscopic and histopathological lesions in the stomach, measured the activity of oxidative stress enzymes in gastric tissue homogenates, and assessed serum electrolytes and parameters of kidney and liver function. Forty-five male rats were allocated to five groups: Normal control, positive control, omeprazole treatment, Shilajit treatment, and Shilajit control. The treatment period lasted for four consecutive days. The size and number of gastric lesions were significantly reduced in the Shilajit and omeprazole groups compared to the positive control group, indicating a reduction in mucosal damage and the severity of edema and leukocyte infiltration in tissue sections. A significant increase was observed in the levels of all oxidative stress parameters, except malondialdehyde, in rats treated with Shilajit and omeprazole compared to those in the positive control group. The effect of the aqueous extract of Shilajit was comparable to that of omeprazole. These results indicated the protective effects of Shilajit against aspirin-induced gastric lesions.
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Affiliation(s)
- Naghmeh Ghasemkhani
- Department of Clinical Studies, School of Veterinary Medicine, Shiraz University, Shiraz, Iran
| | - Aidin Shojaee Tabrizi
- Department of Clinical Studies, School of Veterinary Medicine, Shiraz University, Shiraz, Iran
| | - Fatemeh Namazi
- Department of Pathobiology, School of Veterinary Medicine, Shiraz University, Shiraz, Iran
| | - Saeed Nazifi
- Department of Clinical Studies, School of Veterinary Medicine, Shiraz University, Shiraz, Iran
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Troncoso C, Pavez M, Cerda A, Oporto M, Villarroel D, Hofmann E, Rios E, Sierralta A, Copelli L, Barrientos L. MALDI-TOF MS and 16S RNA Identification of Culturable Gastric Microbiota: Variability Associated with the Presence of Helicobacter pylori. Microorganisms 2020; 8:E1763. [PMID: 33182527 DOI: 10.3390/microorganisms8111763] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 09/23/2020] [Accepted: 09/24/2020] [Indexed: 12/14/2022] Open
Abstract
Helicobacter pylori is the main bacteria associated with gastroduodenal diseases. Recent studies have reported that gastric microbiota might be modified by the H. pylori colonization, favoring gastric lesions′ development. In Chile, the region of La Araucanía concentrates a high risk of gastric cancer associated with Helicobacter pylori colonization, rurality, poverty, and Mapuche ethnicity. Hence, we aimed to identify the culturable gastric microbiota and characterize its variability at different stages of epithelial injury, based on its H. pylori colonization in dyspeptic patients from this Chilean region. Microaerophilic bacteria strains were isolated from antrum biopsies of 155 dyspeptic patients′ biopsies and identified using MALDI-TOF MS or 16sRNA gene sequencing for non-pylori species identification, and UreC gene amplification for H. pylori confirmation. We found 48 species from 18 families, mainly belonging to Neisseriaceae (21.3%), Streptococcaceae (20.0%), Actynomicetaceae (9.0%), Enterobacteriaceae, and Lactobacillaceae (4.5%); however, Streptococcaceae and Actinomycetaceae families showed a significant reduction in samples infected with H. pylori, along with a considerably lower diversity of species. Our results revealed a microbiota modification due to H. pylori colonization associated with the gastric epithelial state, suggesting a potential microbiota role for developing and progressing gastric diseases.
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10
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Yang CH, Qiu Y, Li X, Shi RH. Bleeding after endoscopic submucosal dissection of gastric lesions. J Dig Dis 2020; 21:139-146. [PMID: 32049422 DOI: 10.1111/1751-2980.12850] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 02/05/2020] [Accepted: 02/09/2020] [Indexed: 12/11/2022]
Abstract
Endoscopic submucosal dissection (ESD) is generally used to treat gastric mucosal and submucosal lesions. Nevertheless, ESD is more difficult and complicated to perform than a traditional endoscopic mucosal resection, which can increase the incidence of various complications including hemorrhage, perforation and infection. Hemorrhage is a major post-ESD complication. Prevention and early diagnosis of post-ESD bleeding for gastric lesions are closely associated with the efficacy and safety of the operation. Many studies have reported the risks of and the preventative measures for hemorrhage after gastric ESD, but there remain some issues to be solved. We thus reviewed the risk factors, precautions and treatments for hemorrhage after ESD of gastric lesions.
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Affiliation(s)
- Chao Hu Yang
- Medical School of Southeast University, Nanjing, Jiangsu Province, China.,Department of Gastroenterology, Zhongda Hospital, Medical School of Southeast University, Nanjing, Jiangsu Province, China
| | - Yu Qiu
- Medical School of Southeast University, Nanjing, Jiangsu Province, China.,Department of Gastroenterology, Zhongda Hospital, Medical School of Southeast University, Nanjing, Jiangsu Province, China
| | - Xiao Li
- Medical School of Southeast University, Nanjing, Jiangsu Province, China.,Department of Gastroenterology, Zhongda Hospital, Medical School of Southeast University, Nanjing, Jiangsu Province, China
| | - Rui Hua Shi
- Medical School of Southeast University, Nanjing, Jiangsu Province, China.,Department of Gastroenterology, Zhongda Hospital, Medical School of Southeast University, Nanjing, Jiangsu Province, China
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Lee YI, Kim JS, Cho JS, Kim HK, Hussain A. Standardized Combined Plant Extract, RUG-com, Reduces Bacterial Levels and Suppresses Acute and Chronic Inflammation in Balb/c Mice Infected with CagA + Helicobacter pylori.. Prev Nutr Food Sci 2020; 24:426-433. [PMID: 31915638 PMCID: PMC6941731 DOI: 10.3746/pnf.2019.24.4.426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 08/23/2019] [Indexed: 01/20/2023] Open
Abstract
Helicobacter pylori are etiological agents in the development of gastritis, gastroduodenal ulcers, gastric cancer, and mucosa-associated lymphoid tumors. Our previous investigations demonstrated that standardized combined plants extracts (Rubus crataegifolius and Ulmus macrocarpa) inhibit the growth of H. pylori in in vitro experiments. Also, we demonstrated that Gardenia jasminoides is effective in preventing gastritis and gastric ulcers in animal experiments. In the present work, we tested the standardized combined three plant extract (RUG-com) on the mouse model of H. pylori infectious disease to examine the effects of RUG-com on both the prevention and curing on the stomachs of infected mice. After the final administrations, biopsy samples of gastric mucus were assayed for bacterial numbers, biochemical analysis, inflammatory scores, and histology. Treatment with standardized plants extracts, single or combined, reduced the H. pylori load compared with the control. Treatment also significantly (P<0.05) reduced both acute and chronic mucosal and subacute inflammation, and epithelial cell degeneration and erosion induced by H. pylori infection. Further investigations demonstrated that H. pylori-induced inflammation was decreased by RUG-com extracts via down regulating cyclooxygenase-2 and inducible nitric oxide synthase pro-inflammatory gene expression. Our results suggest that RUG-com is useful to prevent H. pylori infection, H. pylori-induced inflammation and associated gastric damage.
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Affiliation(s)
| | - Jong Seok Kim
- Myunggok Medical Research Institute, College of Medicine, Konyang University, Daejeon 35365, Korea
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12
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Aragão TP, Prazeres LDKTD, Brito SA, Neto PJR, Rolim LA, Almeida JRGDS, Caldas GFR, Wanderley AG. Contribution of Secondary Metabolites to the Gastroprotective Effect of Aqueous Extract of Ximenia americana L. (Olacaceae) Stem Bark in Rats. Molecules 2018; 23:E112. [PMID: 29315228 PMCID: PMC6017445 DOI: 10.3390/molecules23010112] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 12/27/2017] [Accepted: 01/04/2018] [Indexed: 02/07/2023] Open
Abstract
Ximenia americana L. (Olacaceae) is used in ethnomedicine as cicatrizant and for the treatment of gastric disorders. This study identified the chemical constituents of the aqueous extract of X. americana (XaAE) and evaluated its antiulcerogenic activity. After lyophilization, XaAE was analyzed by liquid chromatography-mass spectrometry (LC-MS) and its antiulcerogenic effect was evaluated in acute gastric lesions induced by ethanol, acidified ethanol, and indomethacin. Antisecretory action, mucus production and the participation of sulfhydryl groups (-SH) and nitric oxide (NO) were also investigated. The chromatographic analysis identified procyanidins B and C and catechin/epicatechin as major compounds. Oral administration of XaAE (100, 200 and 400 mg/kg) inhibited the gastric lesions induced by ethanol (76.1%, 77.5% and 100%, respectively), acidified ethanol (44.9%, 80.6% and 94.9%, respectively) and indomethacin (56.4%, 52.7% and 64.9%, respectively). XaAE reduced gastric contents and acidity (51.4% and 67.7%, respectively) but did not alter the production of gastric mucus. The reduction of the -SH and NO groups promoted by N-ethylmaleimide (NEM) and Nω-nitro-l-arginine-methyl-ester (L-NAME) respectively, reduced the gastroprotective effect of XaAE. In conclusion, XaAE has gastroprotective activity mediated in part by -SH, NO and antisecretory activity. This antiulcer action was initially correlated to its major constituents, procyanidins B and C and catechin/epicatechin.
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Affiliation(s)
- Ticiana Parente Aragão
- Department of Pharmaceutical Sciences, Federal University of Pernambuco, Recife 50740-521, PE, Brazil.
- Department of Nutrition, University of Pernambuco, Petrolina 56328-903, PE, Brazil.
| | | | - Samara Alves Brito
- Department of Pharmaceutical Sciences, Federal University of Pernambuco, Recife 50740-521, PE, Brazil.
| | - Pedro José Rolim Neto
- Laboratory of Medication Technology, Federal University of Pernambuco, Recife 50740-521, PE, Brazil.
| | - Larissa Araújo Rolim
- Central of Analysis of Drugs, Medicines and Food, Federal University of San Francisco Valley, Petrolina 56304-205, PE, Brazil.
| | | | - Germana Freire Rocha Caldas
- Graduate Program in Health Sciences, Biological and Health Sciences Center, Federal University of Maranhão, São Luís 65080-805, MA, Brazil.
| | - Almir Gonçalves Wanderley
- Department of Pharmaceutical Sciences, Federal University of Pernambuco, Recife 50740-521, PE, Brazil.
- Department of Physiology and Pharmacology, Federal University of Pernambuco, Recife 50670-901, PE, Brazil.
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Abstract
RATIONALE Intramural pseudocyst, although first reported several decades ago, is a rare entity. Scientific knowledge regarding its clinical management is sparse. PATIENT CONCERNS We present three cases to show the diverse clinical patterns of patients diagnosed with an intramural gastric pseudocyst. DIAGNOSIS A final diagnosis should rest on proper evaluation by cross sectional imaging, including computer tomography and magnetic resonance imaging. Endoscopic ultrasound adds to the work-up. INTERVENTIONS Previously, identified "lesions of the gastric wall" were not well recognized as an intramural pseudocyst, and treatments including resectional surgery were employed. Contemporary proper diagnostics should provide support to a less aggressive treatment approach. OUTCOMES While an indolent natural history without any clinical symptoms or discomfort could be expected in most cases, individual clinical evaluation should be applied. LESSONS A heterogeneous information pattern from the limited number of cases in the literature makes it difficult to draw any firm conclusions. Attention to this rare condition should be increased to help clinicians arrive at a correct diagnosis and possibly prevent some patients from being over treated or from the use of unnecessary surgery.
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Affiliation(s)
- Jon Arne Søreide
- Department of Gastrointestinal Surgery
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | | | - Lars Normann Karlsen
- Department of Gastroenterology, Stavanger University Hospital, Stavanger, Norway
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14
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Kenny S, Steele I, Lyons S, Moore AR, Murugesan SV, Tiszlavicz L, Dimaline R, Pritchard DM, Varro A, Dockray GJ. The role of plasminogen activator inhibitor-1 in gastric mucosal protection. Am J Physiol Gastrointest Liver Physiol 2013; 304:G814-22. [PMID: 23494120 PMCID: PMC3652002 DOI: 10.1152/ajpgi.00017.2013] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Gastric mucosal health is maintained in response to potentially damaging luminal factors. Aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) disrupt protective mechanisms leading to bleeding and ulceration. The plasminogen activator system has been implicated in fibrinolysis following gastric ulceration, and an inhibitor of this system, plasminogen activator inhibitor (PAI)-1, is expressed in gastric epithelial cells. In Helicobacter pylori-negative patients with normal gastric histology taking aspirin or NSAIDs, we found elevated gastric PAI-1 mRNA abundance compared with controls; the increase in patients on aspirin was independent of whether they were also taking proton pump inhibitors. In the same patients, aspirin tended to lower urokinase plasminogen activator mRNA. Immunohistochemistry indicated PAI-1 localization to epithelial cells. In a model system using MKN45 or AGS-GR cells transfected with a PAI-1 promoter-luciferase reporter construct, we found no evidence for upregulation of PAI-1 expression by indomethacin, and, in fact, cyclooxygenase products such as PGE2 and PGI2 weakly stimulated expression. Increased gastric PAI-1 mRNA was also found in mice following gavage with ethanol or indomethacin, but plasma PAI-1 was unaffected. In PAI-1(-/-) mice, gastric hemorrhagic lesions in response to ethanol or indomethacin were increased compared with C57BL/6 mice. In contrast, in PAI-1-H/Kβ mice in which PAI-1 is overexpressed in parietal cells, there were decreased lesions in response to ethanol and indomethacin. Thus, PAI-1 expression is increased in gastric epithelial cells in response to mucosal irritants such as aspirin and NSAIDs probably via an indirect mechanism, and PAI-1 acts as a local autoregulator to minimize mucosal damage.
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Affiliation(s)
- Susan Kenny
- 1Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom; and
| | - Islay Steele
- 1Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom; and
| | - Suzanne Lyons
- 1Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom; and
| | - Andrew R. Moore
- 1Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom; and
| | - Senthil V. Murugesan
- 1Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom; and
| | | | - Rod Dimaline
- 1Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom; and
| | - D. Mark Pritchard
- 1Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom; and
| | - Andrea Varro
- 1Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom; and
| | - Graham J. Dockray
- 1Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom; and
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15
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Abstract
This study examined the effects of vitamin E on the prevention of aspirin-induced gastric lesions. The study was divided into two phases. Phase 1 determined the effects of various doses of palm vitamin E on the factors affecting mucosal integrity. Thirty-two male rats of the Sprague-Dawley strain (200-250 g) were randomly divided into four groups. Group I was fed a normal diet (control), Groups II, III and IV were fed a diet supplemented with palm vitamin E in a dose of 60 mg/kg food, 100 mg/kg food and 150 mg/kg food, respectively. The rats were killed after 4 weeks of feeding for the determination of gastric malondialdehyde (MDA), acid and mucus content. There was a significant decrease in gastric MDA and gastric acid in all the palm vitamin E supplemented groups compared to control. However, these doses of palm vitamin E had no significant effect on gastric mucus. The phase 2 study determined the effect of multiple doses of palm vitamin E and tocopherol on the prevention of aspirin-induced gastric lesions. Fifty rats of the same weight and strain were randomized into seven groups. Group I was fed a normal diet; groups II to IV were fed with a palm vitamin E enriched diet in doses of 60 mg, 100 mg and 150 mg/kg food, respectively; groups V to VII were fed with a tocopherol-enriched diet in doses of 20 mg, 30 mg and 50 mg/kg food, respectively. After 4 weeks of feeding with the respective diets the rats were challenged with a single intra-gastric dose of 400 mg/kg body weight aspirin suspended in propylene glycol. The rats were killed 6 h post-aspirin exposure for the determination of gastric lesion index and gastric parameters as mentioned in the phase I study. The gastric lesions index was significantly lower in all the vitamin E groups compared to control. The lowest ulcer index was observed in the groups that received 100 mg of palm vitamin E and 30 mg tocopherol in the diet. However, there was no significant difference in ulcer indices between palm vitamin E and tocopherol-treated groups. The lower ulcer index was only accompanied by lower gastric MDA content. We conclude that both palm vitamin E in doses of 60 mg, 100 mg and 150 mg/kg food as well as tocopherol in doses of 20 mg, 30 mg and 50 mg/kg food are equally effective in preventing aspirin-induced gastric lesions. The most probable mechanism is through their ability in limiting the lipid peroxidation that is involved in aspirin-induced gastric lesions.
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Affiliation(s)
- Kamsiah Jaarin
- Department of Pharmacology, Faculty of Medicine, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
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16
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Jaarin K, Renuvathani M, Nafeeza MI, Gapor MT. Comparative effect of palm vitamin E and ranitidine on the healing of ethanol-induced gastric lesions in rats. Int J Exp Pathol 1999; 80:259-63. [PMID: 10607016 PMCID: PMC2517831 DOI: 10.1046/j.1365-2613.1999.00119.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The effect of palm vitamin E on the healing of ethanol-induced gastric lesion was compared with ranitidine. Fifty-six male rats of Sprague-Dawley species (200-250 g of weight) were randomly divided into three groups (N = 14). Gastric mucosal injury was induced by orogastric tube administration of 0.5 ml 100% ethanol. Immediately after induction, Group I (k) rats was fed with a normal diet (control), group II (p) was fed palm vitamin E enriched diet (150 mg/kg food), Group III(r) was treated with ranitidine 30 mg/kg body weight intraperitoneally and Group IV (p + r) was fed with palm vitamin E and treated with ranitidine 30 mg/kg body weight intraperitoneally of the same dose. The rats were killed at the end of 1 week and 3 weeks of treatment or feeding. The rate of gastric healing was faster in palm vitamin E treated group compared to control and ranitidine treated groups as shown by a lower mean ulcer index. The effect was seen as early as the first week of treatment whereas ranitidine did not show any healing effect even after 3 weeks of therapy. Neither gastric acidity nor gastric mucus production are involved in gastroprotective effect of palm vitamin E. The most probable mechanism is via reducing lipid peroxidation process as shown by a significant decrease in gastric MDA.
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Affiliation(s)
- K Jaarin
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur.
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17
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Bode C, Bode JC. Alcohol's role in gastrointestinal tract disorders. Alcohol Health Res World 1997; 21:76-83. [PMID: 15706765 PMCID: PMC6826790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
When alcohol is consumed, the alcoholic beverages first pass through the various segments of the gastrointestinal (GI) tract. Accordingly, alcohol may interfere with the structure as well as the function of GI-tract segments. For example, alcohol can impair the function of the muscles separating the esophagus from the stomach, thereby favoring the occurrence of heartburn. Alcohol-induced damage to the mucosal lining of the esophagus also increases the risk of esophageal cancer. In the stomach, alcohol interferes with gastric acid secretion and with the activity of the muscles surrounding the stomach. Similarly, alcohol may impair the muscle movement in the small and large intestines, contributing to the diarrhea frequently observed in alcoholics. Moreover, alcohol inhibits the absorption of nutrients in the small intestine and increases the transport of toxins across the intestinal walls, effects that may contribute to the development of alcohol-related damage to the liver and other organs.
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Affiliation(s)
- C Bode
- Section of Physiology of Nutrition, Hohenheim University, Stuttgart, Germany
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