The persistence of Epstein-Barr virus in the gastric mucosa in patients with chronic Helicobacter pylori-induced gastritis with gastric erosions and the effect on the course of the disease depending on the therapy

Ведущим этиологическим фактором хронического гастрита является инфекция Helicobacter pylori. Герпесвирусная инфекция может принимать участие в развитии и поддержании воспалительного процесса в слизистой оболочке желудка. Особое место среди герпесвирусов занимает вирус Эпштейна–Барр, которым инфицировано 95% населения. Целью работы было определить персистенцию вируса Эпштейна–Барр в слизистой оболочке желудка у больных хроническим Helicobacter pylori-индуцированным гастритом с эрозиями желудка и влияние на течение заболевания в зависимости от проводимой терапии. Под наблюдением находились 84 больных хроническим Helicobacter pylori-индуцированным гастритом с эрозиями желудка. У всех больных при первичном обращении кроме Нelicobacter pylori в слизистой оболочке желудка определялся вирус Эпштейна–Барр. Длительность заболевания составила от 1 до 10 лет. В зависимости от проводимой терапии пациенты с хроническим Helicobacter pylori-индуцированным гастритом с эрозиями желудка были разделены на 2 группы, между которыми через 1 год после первичного обращения проводилось сравнение частоты встречаемости вируса Эпштейна–Барр в слизистой оболочке желудка. Выявление Helicobacter pylori проводилось тремя методами: дыхательным уреазным тестом, цитологическим исследованием мазков и методом полимеразной цепной реакции биоптата. У пациентов с хроническим Helicobacter pylori-индуцированным гастритом с эрозиями желудка при выявлении герпесвирусной инфекции в слизистой оболочке желудка применение меглюмина акридонацетата в четырехкомпонентной эрадикационной терапии позволяет достоверно уменьшить количество вирусов Эпштейна–Барр. Сравнительная оценка полученных данных по наличию Helicobacter pylori в слизистой оболочке желудка у пациентов двух групп наблюдения свидетельствует о хорошем уровне эрадикационной терапии: в 1-й группе наблюдения эрадикация составила 91,3%, а во 2-й группе наблюдения – 89,5%. Микст-инфекция (Helicobacter pylori и вирус Эпштейна–Барр) в слизистой оболочке желудка является фактором, осложняющим процесс лечения пациентов. The leading etiological factor of chronic gastritis is Helicobacter pylori infection. Herpesvirus infection can take part in the development and maintenance of the inflammatory process in the gastric mucosa. A special place among herpesviruses is occupied by the Epstein–Barr virus, 95% of the population is infected with it. The aim was to determine the persistence of the Epstein–Barr virus in the gastric mucosa in patients with chronic Helicobacter pylori-induced gastritis with gastric erosions and to determine the effect on the course of the disease, depending on the therapy. 84 patients with chronic Helicobacter pylori-induced gastritis with gastric erosions were under observation. The Epstein–Barr virus was detected in the gastric mucosa in all patients at the initial treatment except for Helicobacter pylori. The duration of the disease was from 1 to 10 years. Depending on the treatment of chronic Helicobacter pylori-induced gastritis with gastric erosions, patients were divided into 2 groups, between them, 1 year after the initial treatment, the frequency of occurrence of Epstein–Barr virus in the gastric mucosa was compared. The detection of Helicobacter pylori was carried out by three methods: respiratoryurease test, cytological examination of smears and the method of polymerase chain reaction of the biopsy. In patients with chronic Helicobacter pylori-induced gastritis with gastric erosions, when detecting a herpesvirus infection in the gastric mucosa, the use of meglumine acridonacetate in four-component eradication therapy can significantly reduce the number of Epstein–Barr viruses. A comparative assessment of the data obtained on the presence of Helicobacter pylori in the gastric mucosa in patients of two observation groups indicates a good level of eradication therapy: in the 1st observation group, eradication was 91,3%, and in the 2nd observation group – 89,5%. Mixed infection (Helicobacter pylori and Epstein–Barr virus) in the gastric mucosa is a factor that complicates the treatment process of patients.

The Protective Effect of Dapsone Against Ethanol, Stress, and Indomethacin-Induced Gastric Erosion in Rats

Several factors contribute to the development of gastric erosions, including corticosteroids and nonsteroidal anti-inflammatory drugs (NSAIDs), alcohol, and stress. These factors can cause or worsen gastrointestinal ulcers by activating inflammatory pathways or by altering gastric mucosal blood flow. Dapsone is an antimicrobial compound with anti-inflammatory properties. The aim of this study was to evaluate the protective effects of dapsone against gastric erosions induced by alcohol, stress, or indomethacin. Gastric damage was induced in male rats in three different experimental models: ethanol (5 ml/kg, p.o.)-, water-immersion stress-, and indomethacin (30 mg/kg, p.o.)- induced ulcer. Rats in each of these three experimental models were divided into five groups: Normal group, 2. Control group (gastric damage+vehicle), 3. Gastric damage+dapsone 1 mg/kg, 4. Gastric damage+dapsone 3 mg/kg, 5. Gastric damage+dapsone 10 mg/kg. In this study, the J- score ulcer index and histopathological assessment were performed. In addition, inflammatory cytokines levels, NF-κB expression, and MPO activity were determined. Dapsone reduced the tissue injuries and erosion area in all three experimental groups compared to the control group. In addition, serum levels of inflammatory cytokines, TNF-alpha, and IL-1β were reduced in the dapsone treatment groups. The expression of NF-κB and tissue concentration of myeloperoxidase (a marker of neutrophil activation) was also reduced in rats given dapsone. To conclude, dapsone exhibits significant protective effects against the development of experimental gastric erosions in rats, and these effects seem to be related to its anti-inflammatory and antioxidant properties.

ENDOSCOPIC PROFILE OF UPPER GASTROINTESTINAL BLEEDING IN A TERTIARY CARE CENTRE.

Background:Astudy describing the endoscopic prole of upper gastrointestinal bleeding in a tertiary care centre. Aim:The aim was to study endoscopic prole in patients presenting with upper GI bleeding. Introduction: Upper gastrointestinal bleeding is a common medical emergency associated with signicant morbidity and mortality. The presentation of bleeding depends on the amount and location of bleed. The primary diagnostic test for evaluation of upper gastrointestinal bleeding is endoscopy. The aim was to study endoscopic prole in patients presenting with upper GI bleeding. Methods: This is a cross sectional study data conducted in Department of Gastroenterology DDHD Anna nagar Chennai from January 2019 to January 2020 . In this patients presenting with manifestations of upper gastrointestinal bleed were included and were subjected to upper GI endoscopy. Results: Atotal of 160 patients presenting with hematemesis and melena were studied. 124(77.5%) were males and 36(22.5%) were females. The mean age was 47.15 ± 17.12 . The most common ndings on endoscopy of upper gastrointestinal bleeding was portal hypertension related (esophageal and gastric varices, portal hypertensive gastropathy ) seen in 40% of patients, gastric erosions in 17.5% patients, peptic ulcer disease was seen in 13.75%, Esophagitis in 6.25% cases, Mallory-Weiss tear was seen in 6.25% patients, gastric malignancy in 5% patients, post EVL ulcers in 3.75% patients, Normal study in 3.75%, Duodenal erosions in 2.5% patients, Vascular ectasia of stomach in 1.25%. Conclusion: The present study reported portal hypertension as the most common cause of upper gastrointestinal bleeding, while most common endoscopic lesions reported were esophageal varices, followed by gastric erosions and peptic ulcer.

Motor function of the gastrointestinal tract in gastric erosions

The aim is to study motor disorders of the gastrointestinal tract and biliary tract with erosion of the stomach. Materials and methods. Electromyography (EMG) of the gastrointestinal tract and biliary tract was performed in 35 patients with gastric erosions; the control group consisted of 10 patients with gastric ulcer. A morphological study of biopsies of the antrum of the stomach was carried out. Results. Patients with erosion of the stomach were characterized by severe hypermotor dyskinesia of the stomach with a decrease in the motor function of the small intestine and multidirectional changes in the motor function of the colon. Motility of the biliary tract is characterized by an increase in tonic activity with a slight increase in phase activity. Histological examination revealed areas of fibrinoid necrosis in its own plate and foci of destruction of the end sections of the pyloric glands. Conclusion. Motor function of patients with gastric erosion is characterized by a greater power of muscle contractions of the stomach, a smaller power of muscle contractions of the small intestine and multidirectional changes of the power contractions of various sections of the colon.

Dapsone Attenuates the Severity of Gastric Erosion Induced by Ethanol; Stress; and Indomethacin in Rats: A Pharmacological Approach

Background: Dapsone, as an antimicrobial compound, has shown strong anti-inflammatory properties in clinical and experimental studies. Inflammation in stomach mocusa produce gastric erosion. Several factors contribute to the development of gastric erosions, including corticosteroids and nonsteroidal anti-inflammatory drugs (NSAIDs), alcohol, and stress. The aim of this study, therefore, was to evaluate the effects of dapsone against gastric erosions-induced by alcohol, stress, or indomethacin in rat.Methods: Gastric damage was induced in male rats in different three experimental models including ethanol (5 ml/kg, p.o.)-, water-immersion stress-, and indomethacin (30 mg/kg, p.o.)- induced gastric injury. Macroscopic lesion scores (the J- score), inflammatory cytokines levels, NF-κB protein expression, MPO activity, and histopathological evaluation were assessed. Results: Induction of erosion in gastric mocusal led to a significant increase in J-score as an index of macroscopic parameter, tumor necrosis factor-alpha (TNF-α), interleukin-1beta (IL-1β) as biochemical markers, NF-κB and myeloperoxidase (a marker of neutrophil activation, as well microscopic deterioration. Dapsone reduced the tissue injuries and erosion area, serum levels of inflammatory cytokines, the expression of NF-κB and tissue concentration of myeloperoxidase (a marker of neutrophil activation) in all three experimental groups. Furthermore, the histopathological studies revealed the reduction of damages in dapsone treated animals.Conclusions: To conclude, dapsone exhibits significant gastro-protective effects against the development of experimental gastric erosions in rats which seems to be related to its anti-inflammatory properties.

Management of a trichobezoar caused by consumption of artificial hair extensions

Trichobezoars are rare, but most commonly found in young women with trichophagia and trichotillomania. Complications can include iron deficiency anaemia and gastric erosion or, rarely, perforation. A 19-year-old woman presented with epigastric pain, vomiting and lethargy. Initial investigations revealed a palpable abdominal fullness on examination and iron deficiency anaemia. Oesophagogastroduodenoscopy found a large trichobezoar associated with gastric erosions, polyps and an ulcer. Subsequently, the patient reported previous consumption of artificial hair extensions, which ceased 5 years previously. Attempts to remove the trichobezoar by endoscopy were ineffective and in line with current literature, laparotomy was successful. This case describes a rare cause of trichobezoar and emphasises the importance of appropriate initial investigations and definitive management.