scholarly journals Optimasi dan uji efektivitas ekstrak Ganoderma lucidum sebagai anti-Helicobacter pylori

2021 ◽  
Vol 10 (2) ◽  
pp. 217-228
Author(s):  
Intan Chairun Nisa ◽  
Brilliant Margalin
Keyword(s):  
Helicobacter Pylori ◽  
Ganoderma Lucidum ◽  
Ethanol Extract ◽  
Gastric Ulcers ◽  
Diffusion Method ◽  
Disc Diffusion Method ◽  
Helicobactor Pylori ◽  
A Value ◽  
Protective Lining ◽  
H Pylori

Helicobacter pylori diketahui sebagai penyebab utama tukak lambung dengan melemahkan lapisan pelindung pada lambung dan duodenum. Sejumlah obat anti tukak lambung yang sering digunakan dapat menyebabkan resistensi pada H. pylori. Ganoderma lucidum diketahui dapat menghambat dan mendukung penyembuhan tukak lambung yang disebabkan oleh asam asetat. Akan tetapi, kemampuan G. lucidum dalam menghambat tukak lambung yang disebabkan H. pylori belum banyak diungkap. Penelitian ini bertujuan untuk mengetahui efektivitas ekstrak G. lucidum dalam menghambat pertumbuhan H. pylori penyebab tukak lambung. Penelitian merupakan ekperimental dua faktorial yaitu jenis pelarut fraksinasi dan konsentrasi ektrak G. lucidum. Ekstrak G. lucidum difraksinasi menggunakan dua jenis pelarut yaitu etanol 60% dan akuades. Konsentrasi ekstrak G. lucidum yang digunakan adalah 1, 5, 10, 20, 30 mg/mL. Efektivitas ekstrak G. lucidum diuji dengan metode difusi cakram. Berdasarkan analisis statistik didapat bahwa jenis pelarut berpengaruh terhadap aktivitas daya hambat H. pylori dengan nilai pada pelarut etanol 60% signifikan lebih tinggi dibandingkan akuades. Konsentrasi ekstrak G. lucidum baik etanol maupun akuades berpengaruh signifikan terhadap aktivitas daya hambat. Aktivitas daya hambat tertinggi adalah pada perlakuan ekstrak etanol G. lucidum konsentrasi 20 mg/ml. Kata kunci: akuades; difusi cakram; etanol; Helicobacter pylori; Ganoderma lucidum ABSTRACTOptimization and effectiveness assay of Ganoderma lucidum extract as Anti-Helicobactor pylori. Helicobacter pylori is known to be the main cause of gastric ulcers by weakening the protective lining of the stomach and duodenal. A number of gastric anti-ulcer drugs can cause resistance to H. pylori. Ganoderma lucidum is known to inhibit and support the healing of gastric ulcers caused by acetic acid. G. lucidum's ability to inhibit H. pylori growth has not been revealed much. This research aims to find out the effectiveness of G. lucidum extract in inhibiting the growth of H. pylori which causes gastric ulcers. This study is an experimental two factorial namely the type of fractionation solvent and the concentration of G. lucidum extract. Ganoderma lucidum extract is diffractionated using two types of solvents namely 60% ethanol and akuades. The concentration of G. lucidum extract used is 1, 5, 10, 20, 30 mg/mL. The effectiveness of G. lucidum is tested using the disc diffusion method. Based on statistical analysis found that the type of solvent affects the activity of H. pylori's resistance with a value in ethanol solvents 60% significantly higher than akuades On the other hand the concentration of G. lucidum extract in both ethanol and aquades has a significant effect on the activity of the slave. The highest inhibitory activity is in the treatment of ethanol extract G. lucidum concentration 20 mg / ml. Keywords: aquades; diffusion disc; ethanol; Helicobacter pylori; Ganoderma lucidum

scholarly journals Uji Aktivitas Antimikroba Ekstrak Jamur Lingzhi (Ganoderma lucidum) Menggunakan Pelarut Etanol 96% Terhadap Staphylococcus aureus

2017 ◽  
Vol 2 (2) ◽  
pp. 41-44
Author(s):  
Prasetyo Handrianto
Keyword(s):  
Staphylococcus Aureus ◽  
Ganoderma Lucidum ◽  
Ethanol Extract ◽  
Inhibition Zone ◽  
Negative Control ◽  
Diffusion Method ◽  
Disc Diffusion ◽  
Disc Diffusion Method ◽  
Traditional Medicines ◽  
Paper Disc

ABSTRAKStaphylococcus aureus merupakan bakteri yang relatif sering dijumpai pada manusia. Beberapa infeksi yang disebabkan oleh Staphylococcus aureus antara lain, bisul, infeksi luka dan pneumonia. Salah satu obattradisional yang dapat digunakan untuk mengobati infeksi yang disebabkan oleh Staphylococcus aureus adalah jamur lingzhi (Ganoderma lucidum). Penelitian dilakukan dengan 5 konsentrasi ekstrak etanol jamur lingzhi, yaitu kontrol negatif (0 µg/ml), 20 µg/ml, 40 µg/ml, 60 µg/ml, 80 µg/ml dan 100 µg/ml dan dilakukan 6 kali pengulangan. Metode yang digunakan dalam uji aktivitas antimikroba yaitu metode difusi kertas cakram. Data zona hambat dianalisis dengan uji Anova One-Way. Hasil penelitian menunjukkan bahwa ekstrak etanol jamurlingzhi (Ganoderma lucidum) dengan konsentrasi 100 µg/ml memiliki rata-rata daya hambat tertinggi yaitu sebesar 18,0 mm (sangat aktif). Dapat disimpulkan bahwa semakin besar konsentrasi ekstrak jamur lingzhi (Ganoderma lucidum), maka akan berpengaruh besar pula terhadap zona hambat bakteri Staphylococcus aureus.Keyword : Antibakteri, Ganoderma lucidum, Staphylococcus aureus, Etanol.ABSTRACTStaphylococcus aureus is a bacteria that can cause infections , such as boils , wound infections and pneumonia. One of the traditional medicines that can be used to treat these infections are fungal lingzhi (Ganodermalucidum). The study was conducted with five concentrations of negative control (0 µg/ml), 20 µg/ml, 40 µg/ml, 60 µg/ml, 80 µg/ml, and 100 µg/ml with six repeats. The method used in the test of antimicrobial activity is paper disc diffusion method. Data of inhibition zone were analyzed by Anova-One Way test. The results showed that the ethanol extract of lingzhi mushroom (Ganoderma lucidum) at concentration 100 µg/ml has highest average of inhibitory regions as big as 18,0 mm. It can be concluded that the greater the concentration of extract of lingzhi mushroom (Ganoderma lucidum) , it will affect the greater the inhibition zone against Staphylococcus aureus.Keyword : Antibakteri, Ganoderma lucidum, Staphylococcus aureus, Etanol.

scholarly journals Activity Of Lingzhi Fungan Ethanol Extract (Ganoderma Lucidum) Using Soxhlet Method For Bacteria Propionibacterium Acnes

2020 ◽  
Vol 12 (1) ◽  
pp. 151
Author(s):  
Prasetyo Handrianto
Keyword(s):  
Antimicrobial Activity ◽  
Ganoderma Lucidum ◽  
Propionibacterium Acnes ◽  
Ethanol Extract ◽  
Research Data ◽  
Diffusion Method ◽  
Disc Diffusion ◽  
Inhibitory Zone ◽  
Disc Diffusion Method ◽  
Soxhlet Method

The purpose of this study is to know Lingzhi Mushroom extract (Ganoderma Lucidum) has antimicrobial activity against Propionibacterium acnes using Ethanol Solvent, the method used is the disc diffusion method using 6 repetitions, the concentration used is 20 µg / ml, 40 µg / ml, 60 µg / ml / ml, 80 µg / ml and 100 µg / ml, Lingzhi mushroom was extracted using ethanol solvent with the Soxhlet method. The results of the research data showed that the largest inhibitory zone was shown at a concentration of 100 µg / ml of 6.91 mm with a medium inhibitory category. The conclusion of this research is the Lingzhi mushroom is able to inhibit the activity of Propionibacterium acnes in the medium category.

Perfil Epidemiológico de Pacientes Submetidos à Biópsia Gástrica em um Hospital Escola do Sul de Minas Gerais/ Epidemiological Profile of Patients Undergo Gastric Biopsy in a School Hospital of Minas Gerais

1970 ◽  
Vol 4 (3) ◽  
pp. 48-57
Author(s):  
Isabela Maria A. Ribeiro Simões ◽  
Ana Carolina Mauad Coli ◽  
Roseane de Souza Candido Irulegui
Keyword(s):  
Helicobacter Pylori ◽  
Age Groups ◽  
Epidemiological Data ◽  
Minas Gerais ◽  
Gastric Biopsy ◽  
Gastric Ulcers ◽  
Histopathological Diagnosis ◽  
Gastric Diseases ◽  
H Pylori ◽  
Epidemiological Profile

Objetivo: Determinar a prevalência de lesões benignas e neoplasia gástrica através do estudo de biópsias realizadas em um Hospital Escola do Sul de Minas Gerais, no período entre 2007 e 2011. Materiais e Métodos: A pesquisa documental foi quantitativa e retrospectiva, baseada na análise dos registros de biópsias e prontuários. Realizou-se o levantamento de dados referentes à idade, gênero, cor, profissão, diagnóstico histopatológico e presença de Helicobacter pylori nas amostras. Resultados: O número total de biópsias gástricas analisadas foi de 1225, cujo perfil populacional encontrado foi: idade média de 56,75 anos, sexo masculino (52%), cor branca (81,9 %), aposentado (30%). Os diagnósticos mais frequentes foram: gastrites (71,9%), pólipos (14,2%), adenocarcinomas (5,9%), úlceras gástricas (6%), linfomas (0,4%), sem alterações (0,4%) e outros (1,2%). Em outros, encontram-se achados de malignidade, metaplasia e xantelasma gástrico. Em relação à presença de Helicobacter pylori nas amostras, o resultado encontrado foi de24% positivas, 46% negativas e 30% não pesquisadas. Conclusão: Os resultados confirmam a alta frequência das doenças gástricas e sua incidência nas diversas faixas etárias, além do envolvimento do H. pylori em tais afecções. É de grande importância a caracterização dos dados epidemiológicos, o que permite prováveis direcionamentos para programas de prevenção e informação para a população. Palavras-chave: biópsia gástrica, gastropatia, perfil epidemiológico.  ABSTRACTObjective: To determine the prevalence of benign lesions and gastric cancer through study of biopsies performed at a school hospital in southern Minas Gerais, in the period between 2007 and 2011.Materials and Methods: The research was quantitative and retrospective, based on analysis of biopsies records and medical records. We conducted the survey data regarding age, sex, color, profession, histopathological diagnosis and the presence of Helicobacter pylori in the samples. Results: The total number of gastric biopsies analyzed was 1225. Population listing was found: mean age of 56.75 years, male (52%), white (81.9%), retired (30%). The most frequent diagnoses were gastritis (71.9%), polyps (14.2%), adenocarcinomas (5.9%), gastric ulcers (6%), lymphoma (0.4%), unchanged (0, 4%) and others (1.2%). In others, there are: findings of malignancy, metaplasia, gastric xanthelasma. Regarding the presence of Helicobacter pylori in the sample, the result was: 24% positive, 46% negative, 30% non searched. Conclusion: The results confirm the high frequency of gastric diseases and their incidence in the various age groups additionally to the involvement of H. pylori in such conditions. It is of great importance to characterize the epidemiological data, allowing probable directions for prevention and information programs for population. Keywords: gastric biopsy, gastropathy, epidemiological profile

scholarly journals Selective killing of Helicobacter pylori with pH-responsive helix–coil conformation transitionable antimicrobial polypeptides

2017 ◽  
Vol 114 (48) ◽  
pp. 12675-12680 ◽  
Author(s):  
Menghua Xiong ◽  
Yan Bao ◽  
Xin Xu ◽  
Hua Wang ◽  
Zhiyuan Han ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Triple Therapy ◽  
Helical Structure ◽  
Commensal Bacteria ◽  
Gastric Ulcers ◽  
Normal Tissues ◽  
Minimal Toxicity ◽  
Antimicrobial Polypeptides ◽  
H Pylori ◽  
Drug Resistant Strains

Current clinical treatment of Helicobacter pylori infection, the main etiological factor in the development of gastritis, gastric ulcers, and gastric carcinoma, requires a combination of at least two antibiotics and one proton pump inhibitor. However, such triple therapy suffers from progressively decreased therapeutic efficacy due to the drug resistance and undesired killing of the commensal bacteria due to poor selectivity. Here, we report the development of antimicrobial polypeptide-based monotherapy, which can specifically kill H. pylori under acidic pH in the stomach while inducing minimal toxicity to commensal bacteria under physiological pH. Specifically, we designed a class of pH-sensitive, helix–coil conformation transitionable antimicrobial polypeptides (HCT-AMPs) (PGA)m-r-(PHLG-MHH)n, bearing randomly distributed negatively charged glutamic acid and positively charged poly(γ-6-N-(methyldihexylammonium)hexyl-l-glutamate) (PHLG-MHH) residues. The HCT-AMPs showed unappreciable toxicity at physiological pH when they adopted random coiled conformation. Under acidic condition in the stomach, they transformed to the helical structure and exhibited potent antibacterial activity against H. pylori, including clinically isolated drug-resistant strains. After oral gavage, the HCT-AMPs afforded comparable H. pylori killing efficacy to the triple-therapy approach while inducing minimal toxicity against normal tissues and commensal bacteria, in comparison with the remarkable killing of commensal bacteria by 65% and 86% in the ileal contents and feces, respectively, following triple therapy. This strategy renders an effective approach to specifically target and kill H. pylori in the stomach while not harming the commensal bacteria/normal tissues.

scholarly journals TIFA Signaling in Gastric Epithelial Cells Initiates the cag Type 4 Secretion System-Dependent Innate Immune Response to Helicobacter pylori Infection

mBio ◽  
2017 ◽  
Vol 8 (4) ◽  
Author(s):  
Alevtina Gall ◽  
Ryan G. Gaudet ◽  
Scott D. Gray-Owen ◽  
Nina R. Salama
Keyword(s):  
Immune Response ◽  
Helicobacter Pylori ◽  
Epithelial Cells ◽  
Inflammatory Response ◽  
Secretion System ◽  
Innate Immune ◽  
Gastric Ulcers ◽  
Bacterial Clearance ◽  
Gastric Epithelial Cells ◽  
H Pylori

ABSTRACT Helicobacter pylori is a bacterial pathogen that colonizes the human stomach, causing inflammation which, in some cases, leads to gastric ulcers and cancer. The clinical outcome of infection depends on a complex interplay of bacterial, host genetic, and environmental factors. Although H. pylori is recognized by both the innate and adaptive immune systems, this rarely results in bacterial clearance. Gastric epithelial cells are the first line of defense against H. pylori and alert the immune system to bacterial presence. Cytosolic delivery of proinflammatory bacterial factors through the cag type 4 secretion system ( cag -T4SS) has long been appreciated as the major mechanism by which gastric epithelial cells detect H. pylori . Classically attributed to the peptidoglycan sensor NOD1, recent work has highlighted the role of NOD1-independent pathways in detecting H. pylori ; however, the bacterial and host factors involved have remained unknown. Here, we show that bacterially derived heptose-1,7-bisphosphate (HBP), a metabolic precursor in lipopolysaccharide (LPS) biosynthesis, is delivered to the host cytosol through the cag -T4SS, where it activates the host tumor necrosis factor receptor-associated factor (TRAF)-interacting protein with forkhead-associated domain (TIFA)-dependent cytosolic surveillance pathway. This response, which is independent of NOD1, drives robust NF-κB-dependent inflammation within hours of infection and precedes NOD1 activation. We also found that the CagA toxin contributes to the NF-κB-driven response subsequent to TIFA and NOD1 activation. Taken together, our results indicate that the sequential activation of TIFA, NOD1, and CagA delivery drives the initial inflammatory response in gastric epithelial cells, orchestrating the subsequent recruitment of immune cells and leading to chronic gastritis. IMPORTANCE H. pylori is a globally prevalent cause of gastric and duodenal ulcers and cancer. H. pylori antibiotic resistance is rapidly increasing, and a vaccine remains elusive. The earliest immune response to H. pylori is initiated by gastric epithelial cells and sets the stage for the subsequent immunopathogenesis. This study revealed that host TIFA and H. pylori -derived HBP are critical effectors of innate immune signaling that account for much of the inflammatory response to H. pylori in gastric epithelial cells. HBP is delivered to the host cell via the cag -T4SS at a time point that precedes activation of the previously described NOD1 and CagA inflammatory pathways. Manipulation of the TIFA-driven immune response in the host and/or targeting of ADP-heptose biosynthesis enzymes in H. pylori may therefore provide novel strategies that may be therapeutically harnessed to achieve bacterial clearance.

scholarly journals Antibacterial Activity of Leaf Extracts ofBaeckea frutescensagainst Methicillin-ResistantStaphylococcus aureus

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Somayeh Razmavar ◽  
Mahmood Ameen Abdulla ◽  
Salmah Binti Ismail ◽  
Pouya Hassandarvish
Keyword(s):  
Antibacterial Activity ◽  
Ethanol Extract ◽  
Diffusion Method ◽  
Disc Diffusion ◽  
Phytochemical Screening ◽  
Bioactive Constituents ◽  
Disc Diffusion Method ◽  
Leaf Extracts ◽  
Baeckea Frutescens ◽  
High Degree

This study was based on screening antibacterial activity of the ethanol extract ofBaeckea frutescensL. against MRSA clinical isolates, analyzes the potential antibacterial compound, and assesses the cytotoxicity effect of the extract in tissue culture. Leaves ofBaeckea frutescensL. were shade dried, powdered, and extracted using solvent ethanol. Preliminary phytochemical screening of the crude extracts revealed the presence of alkaloids, flavonoids, steroids, terpenoids, phenols, and carbohydrates. The presence of these bioactive constituents is related to the antibacterial activity of the plant. Disc diffusion method revealed a high degree of activity against microorganisms. The results confirm thatBaeckea frutescensL. can be used as a source of drugs to fight infections caused by susceptible bacteria.

scholarly journals Antibiotic resistance of Helicobacter pylori in the European part of the Russian Federation: first results

2020 ◽  
Vol 92 (8) ◽  
pp. 24-28
Author(s):  
I. V. Maev ◽  
D. N. Andreev ◽  
V. M. Govorun ◽  
E. N. Ilina ◽  
Yu. A. Kucheryavyy ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Antibiotic Resistance ◽  
Russian Federation ◽  
European Part ◽  
Diffusion Method ◽  
Rapid Urease Test ◽  
Urease Test ◽  
First Results ◽  
The Russian Federation ◽  
H Pylori

Aim. Determine the primary antibiotic resistance of Helicobacter pylori (H. pylori) strains isolated from patients living in the European part of the Russian Federation. Materials and methods. As part of a clinical laboratory study, from 2015 to 2018, 27 gastrobiopsy samples obtained from H. pylori-infected patients were analyzed. H. pylori infection was verified using a rapid urease test or a 13C-urea breath test. The values of the minimum inhibitory concentration (MIC) of antibiotics were determined by the diffusion method using E-test strips (BioMerieux, France) according to the recommendations of the manufacturer. The sensitivity of the isolates was determined for 6 antibacterial drugs (amoxicillin, clarithromycin, metronidazole, levofloxacin, tetracycline, rifampicin). Results. According to the data obtained, resistance to amoxicillin was 0%, clarithromycin 11.1%, metronidazole 59.3%, levofloxacin 3.7%, tetracycline 0%, and rifampicin 14.8%. Dual resistance to clarithromycin and metronidazole was recorded in two isolates (7.4%). Conclusion. Thus, the first results of the evaluation of H. pylori antibiotic resistance in the European part of the Russian Federation indicate a low resistance of the microorganism to clarithromycin and quite high to metronidazole.

scholarly journals Prevalence of Helicobacter pylori infection among patients undergoing upper gastrointestinal endoscopy

2015 ◽  
Vol 3 (1) ◽  
Author(s):  
Vudumula Vijaya Lakshmi
Keyword(s):  
Duodenal Ulcer ◽  
Helicobacter Pylori ◽  
Normal Population ◽  
Gastric Ulcers ◽  
Upper Gastrointestinal Endoscopy ◽  
Contributing Factors ◽  
Duodenal Ulcers ◽  
Female Ratio ◽  
Ulcer Disease ◽  
H Pylori

Helicobacter pylori (H. pylori) has a role in the multifactorial etiology of peptic ulcer disease. A link between H. pylori infection and duodenal ulcer disease is now established. Other contributing factors and their interaction with the organism may initiate the ulcerative process. The fact that eradication of H. pylori infection leads to a long-term cure in the majority of duodenal ulcer patients and the fact that the prevalence of infection is higher in ulcer patients than in the normal population are cogent arguments in favor of it being the primary cause of the ulceration. This study was under taken at the Department of surgery, Narayana medical college, Nellore from January 2007 to July 2008. A total of 150 patients with duodenal ulcers, gastric ulcers, antral gastritis, gastric carcinoma and dyspepsia of any kind were studied. Maximum number of cases were in the age group of 31 years to 50 years among both sexes and number of cases gradually decreased after 50 years of age in males and females. Males were more in number and male to female ratio is (2.75:1) approximately 3:1.

scholarly journals Antibacterial Activity of Ethanol Extract of Spirulina platensis

2021 ◽  
Vol 7 (2) ◽  
pp. 47-51
Author(s):  
Prayoga Pannindrya ◽  
Mega Safithri ◽  
Kustiariyah Tarman
Keyword(s):  
Antibacterial Activity ◽  
Spirulina Platensis ◽  
Ethanol Extract ◽  
Positive Control ◽  
Diffusion Method ◽  
Test Results ◽  
Nutritional Content ◽  
Disc Diffusion Method ◽  
Antibacterial Test ◽  
E Coli

Spirulina is a microalgae that has been widely used as various supplements and medicines because of its high nutritional content. The need for new antibacterial sources to solve the problem of antibiotic resistance, makes the potential of Spirulina as an antibacterial agent necessary to be researched. This study aims to analyze the antibacterial activity of ethanol extract of Spirulina platensis obtained from the Indonesian region against Staphylococcus aureus and Escherichia coli. Spirulina samples were macerated in ethanol solvent in a ratio of 1:10 (w / v). The antibacterial test used was the disc diffusion method with clindamycin positive control. Antibacterial test results showed that S. platensis in this study did not have antibacterial activity against E. coli and S. aureus.

scholarly journals Expressions of MMPs and TIMP-1 in Gastric Ulcers May DifferentiateH. pylori-Infected from NSAID-Related Ulcers

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Hsiu-Chi Cheng ◽  
Hsiao-Bai Yang ◽  
Wei-Lun Chang ◽  
Wei-Ying Chen ◽  
Yi-Chun Yeh ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Gastric Ulcer ◽  
Epithelial Cells ◽  
Matrix Metalloproteinases ◽  
Matrix Metalloproteinase ◽  
Immunohistochemical Staining ◽  
Gastric Ulcers ◽  
Matrix Metalloproteinase 1 ◽  
Two Factors ◽  
H Pylori

Background. Two major causes of gastric ulcers areHelicobacter pylori(H. pylori) infection and nonsteroidal anti-inflammatory drug (NSAID) use.Aims. This study aimed to determine if there were different expressions of matrix metalloproteinases (MMPs) and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) betweenH. pylori-infected and NSAID-related ulcers.Methods. The 126 gastric ulcer patients (H. pyloriinfectedn=46; NSAID relatedn=30; combined with two factorsn=50) provided ulcer and nonulcer tissues for assessment of MMP-3, -7, and -9 and TIMP-1 expression by immunohistochemical staining.Results. Gastric ulcer tissues had significantly higher MMP-3, -7, and -9 and TIMP-1 expressions than nonulcer tissues (P<0.05).H. pylori-infected gastric ulcers had even higher MMP-7, MMP-9, and TIMP-1 expressions in epithelial cells than NSAID-related gastric ulcers (P<0.05). In patients with the two combined factors, gastric ulcers expressed similar proportions of antral ulcers and MMP-7 and MMP-9 intensities to NSAID-related gastric ulcers, but lower MMP-9 and TIMP-1 thanH. pylori-infected gastric ulcers (P<0.05).Conclusions. H. pylori-infected gastric ulcers express higher MMP-7, MMP-9, and TIMP-1 than NSAID-related ulcers. In patients with the two combined factors, ulcer location and MMP-7 and MMP-9 intensities are similar to NSAID use.

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