The effect of probiotics on gastric mucosal permeability in humans administered with aspirin

Abstract

Objective. To examine whether a probiotic strain, Lactobacillus gasseri OLL2716 (LG21), can protect the gastric mucosal integrity from aspirin using urinary sucrose excretion (USE) test. Materials and methods. In the study using high-dose aspirin, the USE tests were carried out in 29 volunteers before and after LG21 treatment for 4 weeks. In the study using patients undergoing low-dose aspirin therapy, USE tests were performed in 37 subjects who took LG21 for 16 weeks. Stool occult blood was examined by the guaiac method. Results. In the former study, the elevation in the USE value after aspirin loading significantly decreased after LG21 treatment (Median ± SD; 0.244 ± 0.237 vs. 0.208 ± 0.112%, p = 0.018). In the latter study, the USE value significantly decreased in the period with LG21 treatment (p = 0.033), while no significant difference was found in the period without LG21 (p = 0.113). The number of positive occult blood tests decreased during LG21 treatment. Conclusions. The regular ingestion of LG21 may protect the integrity of the gastric mucosal permeability against aspirin.     

Comparison between the <Superscript>13</Superscript>C-urea breath test and stool antigen test for the diagnosis of childhood <Emphasis Type="Italic">Helicobacter pylori</Emphasis> infection

Background As noninvasive tests for Helicobacter pylori infection, the ¹³C-urea breath test (UBT) and stool antigen test have been widely used. In children, however, there are few studies reporting which test shows superior performance. The purpose of this study was to compare the ¹³C-UBT and stool antigen test for their accuracy in diagnosing H. pylori infection in children.Methods A total of 123 Japanese children, ages 2 to 17 years (mean, 12 years) who underwent gastric biopsies for H. pylori infection were studied. The diagnoses included gastritis (n = 55), gastric ulcer (n = 5), duodenal ulcer (n = 20), iron-deficiency anemia (n = 7), and other conditions (n = 36). The cutoff value of the ¹³C-UBT was defined to be 3.5. The stool antigen test was performed using the HpSA enzyme-linked immunosorbent assay (ELISA) (Premier Platinum HpSA). In 16 patients who received eradication therapy, the ¹³C-UBT and HpSA were repeated 2 months after treatment.Results Based on biopsy tests, 60 children were infected with H. pylori and 63 children were not. For the ¹³C-UBT, the sensitivity, specificity, and accuracy were 95.0% (95% confidence interval [CI], 86.1%–99.0%), 98.4% (95% CI, 91.5%–100%), and 96.4% (95% CI, 93.6%–99.9%), respectively. For the HpSA, the sensitivity, specificity, and accuracy were 98.3% (95% CI, 90.8%–100%), 98.4% (95% CI, 91.2%–100%), and 98.3% (95% CI, 96.0%–100%), respectively. There were no significant differences between the performance of these two tests. In the assessment of H. pylori eradication, the results of ¹³C-UBT and HpSA agreed with those of biopsy tests.Conclusions The ¹³C-UBT and the HpSA are equally accurate for the diagnosis of active H. pylori infection in Japanese children.Kazuie Iinuma, for the Japanese Pediatric Helicobacter study Group     

Clinical presentation and diagnostic sensitivity of laboratory tests for Strongyloides stercoralis in travellers compared with immigrants in a non-endemic country

OBJECTIVES: To assess whether the clinical and laboratory methods for diagnosing Strongyloides stercoralis infection in non-endemic countries is different between those who are chronically exposed and those who travel. METHODS: Analysis of laboratory and clinical data from 204 patients having S. stercoralis infection at the Hospital for Tropical Diseases, London. RESULTS: Sixty-four travellers and 128 immigrants from endemic countries had laboratory-proven strongyloides. In those with microscopically proven disease, serology was 73% sensitive in travellers and 98% sensitive in immigrants (P < 0.001). There was no difference in the eosinophil count between the two groups with 19% having a normal count. Patterns of symptoms varied between the groups, and around one-third were asymptomatic in both groups. Serology was of limited use in follow-up. CONCLUSIONS: Eosinophil count and stool microscopy are insufficiently sensitive to be used alone for screening strongyloides. The sensitivity of serology is good in immigrants with chronic infection, but lower in travellers.     

2017—2020年北京北苑地区 轮状病毒感染的流行病学研究

[摘要]　目的　了解2017—2020年北京北苑地区轮状病毒感染性腹泻的流行病学特征及实验室特点,为临床经验治疗及防控提供科学理论依据。方法　收集2017年1月1日—2020年12月31日期间来我院就诊腹泻患者的粪便23 205份,采用胶体金免疫层析技术方法对粪便标本进行轮状病毒抗原检测,对患者性别、年龄、季节分布及粪便常规特征进行统计分析。结果　23 205例标本中共检出轮状病毒阳性标本1837例,阳性率为7.92%。轮状病毒感染主要集中在12～23月龄婴幼儿（19.30%）,阳性率显著高于其他年龄段（≤6月龄,7～11月龄,2～3岁,4～6岁,7～ 17岁,≥18岁）（P均＜0.05）。轮状病毒感染具有季节特异性, 1月、2月、3月、12月阳性率较高,阳性率分别为29.90%、27.51%、16.94%、18.69%。2017—2020年阳性率分别为8.83%、8.09%、9.47%和1.99%,2020年轮状病毒抗原检测阳性率显著下降,与2017—2019年相比差异均具有统计学意义（P均＜0.05）。在新型冠状病毒肺炎疫情（新冠疫情）暴发的2020年,轮状病毒感染的高发月份没有变化,然而与2017—2019年同月份相比较,阳性率显著下降（P均＜0.05）。轮状病毒阳性标本中,粪便镜检脂肪球检出率高（42.24%）,2者一致率高（89.24%）,具有相关性（Kappa=0.325, r=0.326）。白细胞、红细胞与轮状病毒阳性无相关性,一致率差。轮状病毒阳性标本以糊状便为主,占比50.35%,稀便或稀水便、软便分别占比39.41%、 6.15%,粘液便最少,占比3.97%。结论　本地区轮状病毒感染主要易感人群为12～23月龄婴幼儿,感染全年均可发生,以晚冬、初春为高发季节,2020年新冠疫情极大降低了轮状病毒的送检率及检测阳性率,轮状病毒阳性标本粪便以稀便或糊状便为主,脂肪球与轮状病毒肠炎感染有相关性。     

A better method for confirming <Emphasis Type="Italic">Helicobacter pylori</Emphasis> infection in Mongolian gerbils

Background. Our aim was to evaluate the accuracy of the stool antigen test and the optimal time point for detecting Helicobacter pylori infection in a Mongolian gerbil model. Methods. We inoculated 8-week-old Mongolian gerbils with H. pylori (Vac A (+)/CagA(+)). The gerbil-infected model was developed as follows: H. pylori was put into broth (about 10⁹ CFU/ml), and 50 gerbils were then fed with 1 ml intragastrically twice within a 3-day interval. Another ten gerbils were fed broth only. Twenty-six weeks after the inoculation, the gerbils were killed. The gastric mucosa was sampled for a series of examinations including culture, histology, rapid urease test, and polymerase chain reaction. Stool samples for a stool antigen test, H. pylori-specific stool antigen assay (HpSA), were collected during weeks 4, 6, 8, 12, and 26 after inoculation. Of the 50 gerbils inoculated with H. pylori, the inoculation was successful in 88%. Severe active gastritis, ulceration, and intestinal metaplasia were obvious. Results. The HpSA test results were sensitivity, 88.6%; specificity, 100%; positive predictive value (PPV), 100%; negative predictive value (NPV), 54.5%, and accuracy, 90%. The HpSA test began to be more sensitive and accurate (P < 0.05) beginning during week 6 after inoculation. We also found that H. pylori could be detected earlier and more easily in the group with high H. pylori density. Conclusions. HpSA seems to be suitable for confirming colonization of gerbils with H. pylori. The optimal testing time point is around 6 weeks after inoculation. This test is a good choice for long-term observation of H. pylori infection in Mongolian gerbils.     

Direct Transmission of H. pylori from Challenged to Nonchallenged Mice in a Single Cage

To understand whether direct transmission of H. pylori occurs from infected mouse to noninfected mouse, the system using a mouse model we developed previously was tested. Six nude mice were challenged with H. pylori inocula; one group consisted of one challenged nude mouse 1 week after inoculation raised with four nonchallenged nude mice in a single cage. For the single cage, a polycarbonate cage or a mesh-floor cage was used. Then three groups were kept in a polycarbonate cage and the other three groups kept in a mesh-floor cage to avoid H. pylori transmission through stool. After coraising for 1, 2, or 3 weeks, all mice were sacrificed to determine the existence of H. pylori in the stomach, saliva, and stool by culture or PCR and H. pylori-associated gastritis. RAPD fingerprinting patterns using different primers of isolated strains from challenged and nonchallenged mice were compared to understand the origin of transmitted strains. During 3 weeks after coraising of H. pylori challenged and nonchallenged mice, H. pylori was detected in the stomachs in 3 of 12 nonchallenged mice in the polycarbonate cage and in 2 of 12 nonchallenged mice in the cage with a steel mesh floor. H. pylori was detected from saliva or stool in two nonchallenged, infected mice in the polycarbonate cage. Moreover, RAPD fingerprinting using different primers of the total five strains isolated from five nonchallenged, infected mice in both cages showed the same pattern and concordance with that of the challenged strain and the strains isolated from challenged mice. It is demonstrated that intimate interaction is the cause of H. pylori transmission via saliva and stool.     

血清ADA、IL-27、TB-Ab联合检测诊断血性结核性胸腔积液的价值研究

目的?探讨血清腺苷脱氨酶（ADA）、白细胞介素-27（IL-27）及结核杆菌抗体免疫球蛋白G（TB-Ab-IgG）在血性结核性胸膜炎中的诊断价值。方法?选取2015年7月—2017年3月在黄冈市中心医院诊治的102例胸腔积液患者作为研究对象。根据胸腔积液病因及性状分为血性癌性胸腔积液患者36例（癌性组）、血性结核性胸腔积液患者32例（结核性组）和非血性结核性胸腔积液患者34例（非结核性组）。检测并比较3组患者血清ADA、IL-27及TB-Ab-IgG水平。绘制受试者工作特征（ROC）曲线,评价ADA、IL-27及TB-Ab-IgG诊断血性结核性胸腔积液的敏感性和特异性。结果?结核性组血清ADA、IL-27水平及TB-Ab-IgG阳性率高于癌性组和非结核性组（P?<0.05）。ROC曲线结果显示,ADA、IL-27、TB-Ab-IgG及3者联合检测诊断血性结核性胸膜胸腔积液的曲线下面积分别为0.884、0.842、0.867和0.926,敏感性分别为91.4%（95% CI：0.555,0.832）、79.8%（95% CI：0.451,0.612）、85.7%（95% CI：0.712,0.931）和96.8%（95% CI：0.787,0.988）,特异性分别为93.7%（95% CI：0.631,0.947）、83.6%（95% CI：0.833,0.964）、88.6%（95% CI：0.787,0.998）和94.3%（95% CI：0.834,0.999）。ADA、IL-27、TB-Ab-IgG 3者联合检测优于单独检测。结论?ADA、IL-27、TB-Ab-IgG 3者联合检测诊断血性结核性胸膜炎具有较高的临床 价值。     

Rural and urban microbiota: To be or not to be?

A multitude of metagenomic studies has brought to light an enormous richness of human gut microbiota compositions. In this space of possible configurations, clinical specialists are trying to mine the markers of healthy microbiota via case-control and longitudinal studies. We have discovered potentially beneficial communities while examining the microbial diversity in rural Russians in comparison with the urban dwellers. In this addendum, we further examine the data by elaborating on some of the less common types and suggesting the possible co-metabolism of their drivers. In the light of the first validated clinically effective bacterial transplantation, we discuss the concept of a reference healthy microbiota, outline the problems encountered on the way to its restoration in the developed world, and speculate if rural communities can serve as a source for its prototype.