幽门螺杆菌

幽门螺杆菌是一种呈螺旋状或S形、微需氧的革兰阴性杆菌,专一性定居于人胃,是人类慢性胃炎、消化性溃疡、胃癌和胃MALT淋巴瘤的主要病因。幽门螺杆菌在人群中的感染率非常高,达40%~90%,通常在儿童期感染,而且一经感染,若不根除治疗,将终生携带,携带者是幽门螺杆菌的传染源。幽门螺杆菌感染的诊断有侵入性方法如细菌培养、快速脲酶试验等,亦有非侵入性方法如脲呼吸试验、抗体检测等。幽门螺杆菌感染引起胃-十二指肠疾病的机制涉及细菌本身毒力因子、细菌黏附与定植、宿主炎症/免疫反应、氧化应激、细胞的增殖与凋亡等,情况复杂。迄今,幽门螺杆菌的确切致病机制未有定论。幽门螺杆菌相关疾病的治疗普遍采用根除细菌的抗菌疗法。预防幽门螺杆菌感染以及治疗幽门螺杆菌相关疾病的疫苗正在研究中。     

两株乳酸菌在小鼠体内对幽门螺杆菌抑制作用的初探

成功地建立了小鼠幽门螺杆菌感染模型,并对两株在体外对幽门螺杆菌有显著抑制作用的乳酸菌,进行了体内预防与治疗作用的初步验证。通过尿素酶反应、细菌培养、病理组织切片检验三种指标测试,证明J16发酵乳能够有效预防幽门螺杆菌感染;小鼠胃中乳酸菌数量和幽门螺杆菌数量相反。     

幽门螺杆菌与胃肠道微生态关系的研究进展

幽门螺杆菌作为慢性胃炎、消化性溃疡和胃癌的病原体,大多在儿童期获得,并在成人期持续存在。早期诊断及治疗可有效减少幽门螺杆菌感染相关疾病及不良后果的发生,但儿童幽门螺杆菌感染根除率仍较低,其与幽门螺杆菌药物依从性差及抗生素耐药有关。而欧洲国家儿童幽门螺杆菌感染降低,但儿童早期哮喘、炎症性肠病、胃肠道感染及Barrett食管等疾病的发生率增高。了解胃肠道微生物组与幽门螺杆菌感染的相互作用可能为儿童幽门螺杆菌感染的诊疗及预防提供新的办法。本文就幽门螺杆菌与胃肠道菌群关系研究进展作一综述。     

幽门螺杆菌疫苗的研究进展

幽门螺杆菌疫苗是预防和治疗幽门螺杆菌感染引起的上消化道疾病的有效途径。而疫苗的研制是关键和基础。一种好的疫苗完全可结束人与幽门螺杆菌共存的现象。本文综述了幽门螺杆菌疫苗的研究现状及前景。     

幽门螺杆菌外膜囊泡研究进展

幽门螺杆菌(Helicobacter pylori)被认为是引起人类胃部疾病的元凶之一。外膜囊泡(Outer Membrane Vesicles,OMVs)是由细菌外膜自发脱落而形成的囊泡状结构,其具有细菌外膜多数成分,包括外膜蛋白、多糖、脂质以及其他蛋白组分。越来越多的研究正在关注外膜囊泡在幽门螺杆菌感染、发生、发展过程中的作用。同时,研究表明幽门螺杆菌外膜囊泡作为疫苗,在防治幽门螺杆菌感染中也展现了良好的应用潜力。因此,本综述总结了目前关于幽门螺杆菌外膜囊泡组成成分的研究,并讨论了外膜囊泡在幽门螺杆菌存活和致病机制中的作用,以及外膜囊泡在幽门螺杆菌感染治疗中发挥的作用。     

幽门螺杆菌感染的治疗进展

幽门螺杆菌(helicobacter pylori,H.pylori,HP)感染是一个世界性问题。人类感染Hp可导致慢性胃炎、胃和十二指肠溃疡、消化性胃黏膜相关的淋巴样组织淋巴瘤和胃腺癌。根除幽门螺杆菌对胃肠疾病的转归和预防有着重要作用。但是由于抗茵药物的滥用,使得对幽门螺杆茵的治疗变得棘手。本文就Hp的致病机制、耐药性问题及治疗方法等的研究进展作一综述。     

儿童幽门螺杆菌感染

幽门螺杆菌感染不仅能引起胃炎、消化性溃疡,诱发胃癌等胃肠道的病变,还与许多胃肠外疾病密切相关,如果不经过特殊治疗将终生带菌,严重的影响小儿的生长发育和身心健康。这些问题引起了儿科医生和儿童保健医生的共同关注。儿童期既是幽门螺杆菌感染的特殊时期,也是控制感染的关键时期。本文将从小儿幽门螺杆菌国内外的感染状况、相关疾病、诊断方法、治疗及预防等几个方面综述如下。     

幽门螺杆菌检测技术研究进展及展望

幽门螺杆菌是(Helicobacter pylori,H. pylori)是导致人类多种胃肠疾病的主要病因,通过多种毒力因子导致各种疾病的发生和发展。鉴于目前幽门螺杆菌缺少商业化疫苗且多重耐药性问题日益严重,临床上对其根除效果不佳,因此,精准的检测技术是预防幽门螺杆菌感染的关键,也是评估感染后治疗效果的重要手段。幽门螺杆菌的检测方法主要包括尿素呼气试验、快速尿素酶试验、粪便抗原检测、血清学检查、内镜检查、组织学病理检查、聚合酶链式反应及细菌培养,每种方法在临床上皆存在优点与局限性。目前,对于幽门螺杆菌检测的“金标准”尚无统一定论,因此本文重点综述当前应用的幽门螺杆菌检测技术,分析其优点和局限性,并指明精准、快速且便捷的检测技术在流行病学调查等方面具备的优势,旨在为临床和研究提供科学的参考依据。     

重组酿酒酵母表达幽门螺杆菌VacA蛋白及其免疫原性分析*

目的:利用酿酒酵母表面展示技术筛选幽门螺杆菌候选疫苗,并分析其免疫原性。方法:以幽门螺杆菌的空泡型细胞毒素A(vacA)基因作为研究对象,构建重组S.cerevisiae EBY100/pYD1-VacA,通过Western blot、免疫荧光标记和流式细胞仪对S.cerevisiae EBY100/pYD1-VacA进行体外表达分析。以PBS和S.cerevisiae EBY100/pYD1为对照组,S.cerevisiae EBY100/pYD1-VacA为实验组,口服免疫SPF级BALB/c小鼠。通过ELISA分析检测口服免疫后小鼠抗VacA特异性IgG及分泌型IgA效价。结果:VacA抗原蛋白被成功地展示在S.cerevisiae EBY100表面。小鼠经口服免疫S.cerevisiae EBY100/pYD1-VacA后可诱导产生较高的VacA特异性抗体。结论:表面展示型酿酒酵母可以作为幽门螺杆菌候选疫苗的递送载体,与此同时,这也为开发其他细菌或病毒疫苗提供新思路。     

幽门螺杆菌及其疫苗研究现状及前景

幽门螺杆菌与引起慢性胃炎,消化性溃疡,胃癌等密切相关,但在其预防和治疗方面有和是一步探索。本文对幽门螺杆菌疫苗研究的进展进行了综述。今后疫苗可能将有效地预防和治疗幽门螺杆菌所致胃,十二指肠疾病。     

益生菌抑制幽门螺杆菌的作用机制及研究进展

幽门螺杆菌在胃部疾病的发病过程中起着重要作用,是导致胃炎、胃溃疡,甚至胃癌的关键因素之一。随着胃部疾病患者幽门螺杆菌阳性检出率的不断升高,人们对于胃病和幽门螺杆菌的相关性研究也有了一定进展。如今,对于幽门螺杆菌阳性患者根除治疗的必要性,以及抗生素治疗耐药性等问题已引起广泛关注。在这种情况下,益生菌作为相对安全的天然微生物,在抑制幽门螺杆菌并促进胃部健康的益生功能方面具有重要的研究潜力。本综述对幽门螺杆菌的致病机理、不同基因分型的致病程度等方面进行了总结,并对益生菌抑制幽门螺杆菌的机制进行了探讨。建议在治疗幽门螺杆菌感染时,应与常规的治疗手段结合应用,不仅会增加幽门螺杆菌的根除率,还能减少治疗相关的副作用。     

口腔中幽门螺杆菌PCR检测方法的建立

全世界大约有50%的人口感染幽门螺杆菌(Helicobacter pylori, Hp),Hp感染容易造成慢性胃炎、消化性溃疡、低度恶性胃MALT淋巴瘤及胃癌,对人类造成严重的危害。为寻求一种简便、准确、非创伤性的方法用于口腔中Hp的检测,本研究建立了口腔中幽门螺杆菌的PCR检测方法,并对建立的PCR方法的敏感性、特异性进行分析,并应用于检测唾液样品和牙菌斑共50份。结果显示,50份样品中,阳性率为82%。结果表明,本研究建立的口腔中Hp的PCR检测方法特异性强、敏感性高,可以用于临床上Hp诊断的重要参考。     

The Haptoglobin β chain as a supportive biomarker for human lung cancers

Haptoglobin (Hp) is produced as an acute phase reactant during inflammation, infection, malignant diseases, and several cancers. In proteomics analysis using human blood samples, the Hp peptide levels were about 3-fold higher in lung cancer patients versus normal individuals. This study is aimed at analyzing the elevation of which chain of Hp is closely related to lung cancers and can be a serum biomarker for lung cancers. In Western blot (WB) analysis, we found that the Hp β chain can be a better diagnostic biomarker for lung cancers. In the result of the Hp β chain ELISA developed by us, the concentrations of the Hp β chain in the sera increased about 4-fold in 190 lung adenocarcinoma patients versus 190 healthy controls (8.0 ± 3.8 μg ml(-1)vs. 1.9 ± 1.2 μg ml(-1)). ELISA data showed that the serum levels of the Hp β chain in breast cancer (1.5 ± 0.5 μg ml(-1)) and hepatocellular carcinoma (HCC) (1.4 ± 1.0 μg ml(-1)) patients remained similar to those of healthy controls. Compared to lung adenocarcinoma, the Hp β chain levels in the plasma of patients with other respiratory diseases such as tuberculosis (TBC), idiopathic pulmonary fibrosis (IPF) and bronchial asthma (BA) were closer to those of healthy controls. Our data suggest that an increase of the Hp β chain can be a potential serum biomarker for lung cancers.     

The role of the host versus the environment in duodenal ulcer disease.

Gastric functions can be understood only in the context of a network including the brain gut axis, neuro-endocrine and paracrine mechanisms and growth factors. These host factors including parietal cell sensitivity (PCS) may well interact with an important environmental factor, Helicobacter pylori (Hp), and help to explain its actions. The aim of this study was to investigate PCS related to Hp status and duodenal ulcer (DU). PCS was assessed by constructing dose-response curves after pentagastrin and calculating the D50. Five groups of patients were studied: I) active DU, Hp pos. (8); II) history of DU, Hp pos. (8); III) asymptomatic Hp pos. (8); IV) asymptomatic Hp neg. (10); V) DU on maintenance H2 blocker therapy, Hp pos. (20). PCS was repeated after Hp eradication. PCS was lowest in group IV, and in Hp pos. groups, was significantly higher, with insignificant differences among them, irrespective of DU. PCS declined significantly after Hp eradication. Group V showed an insignificant decline in PCS during treatment, not preventing recurrence. A higher PCS in Hp infection irrespective of DU, declining after eradication, suggests that this may be a reversible epiphenomena related to Hp infection. This may offer an explanation as to why DU develops only in some subjects with Hp, suggesting the importance of the host in the pathogenesis of DU.     

Genetic factors in the development of gastric precancerous lesions--a role of Helicobacter pylori ?

Helicobacter pylori is believed to predispose to gastric cancer by inducing gastric precancerous alterations. There is a well known predisposition to gastric cancer and the risk of developing it is greater in relatives of patients with familial cases of this malignancy. The aim of this study was to determine the prevalence of gastric precancerous lesions (atrophy and intestinal metaplasia) and their association with Hp infection in first-degree relatives in patients with noncardia gastric cancer. METHODS: Hp status and gastric histology assessed by upper gastrointestinal endoscopy, biopsies from the antral and body region, the rapid urease test and staining for Hp, inflammation, activity, atrophy and intestinal metaplasia (prevalence and grading) were studied in 108 first-degree relatives of patients with noncardia gastric cancer and compared with 73 controls with mild non-ulcer dyspepsia who had no cancer relatives and were examined in the same way. RESULTS: subjects with and without cancer relatives had a similar prevalence of Hp infection (49 vs. 47%). Endoscopy revealed a few asymptomatic duodenal ulcers and small hiatus hernias in Hp positive subjects of both groups. Hp positive relatives of gastric cancer had a markedly higher prevalence of atrophy than those with Hp negativity without cancer relatives (29 vs. 9%) and those with Hp negativity and cancer relatives (29 vs. 3%. Prevalence of intestinal metaplasia was also higher in those with Hp positivity and cancer relatives than in those without cancer relatives (15 vs. 5% and was not present in Hp negative subjects with cancer relatives. Inflammation and activity showed similar scores in subjects with and without cancer relatives with higher scores in both Hp positive groups. The prevalence of precancerous lesions in the relatives of gastric cancer was nearly always confined to those with Hp positivity. One year after eradication the prevalence of atrophy in cancer relatives decreased from 29 to 14%; prevalence of intestinal metaplasia remained without substantial changes. Scores for inflammation and activity were also lower after eradication. CONCLUSIONS: First-degree relatives of patients with gastric cancer have an increased prevalence of gastric precancerous abnormalities which are strongly confined to those with Hp infection. Eradication of Hp in these subjects with cancer relatives reduces the prevalence of precancerous lesions (atrophy) and grades of inflammation and activity. In view of these results, eradication of Hp should be offered to such subjects.     

Helicobacter pylori dampens gut epithelial self-renewal by inhibiting apoptosis, a bacterial strategy to enhance colonization of the stomach

Colonization of the gastric pits in the stomach by Helicobacter pylori (Hp) is a major risk factor for gastritis, gastric ulcers, and cancer. Normally, rapid self-renewal of gut epithelia, which occurs by a balance of progenitor proliferation and pit cell apoptosis, serves as a host defense mechanism to limit bacterial colonization. To investigate how Hp overcomes this host defense, we use the Mongolian gerbil model of Hp infection. Apoptotic loss of pit cells induced by a proapoptotic agent is suppressed by Hp. The ability of Hp to suppress apoptosis contributed to pit hyperplasia and persistent bacterial colonization of the stomach. Infection with WT Hp but not with a mutant in the virulence effector cagA increased levels of the prosurvival factor phospho-ERK and antiapoptotic protein MCL1 in the gastric pits. Thus, CagA activates host cell survival and antiapoptotic pathways to overcome self-renewal of the gastric epithelium and help sustain Hp infection.     

Evidence of tandem repeat and extra thiol-groups resulted in the polymeric formation of bovine haptoglobin: a unique structure of Hp 2-2 phenotype

Human plasma Hp is classified as 1-1, 2-1, and 2-2. They are inherited from two alleles Hp 1 and Hp 2, but there is only Hp 1 in almost all the animal species. Hp 2-2 molecule is extremely large and heterogeneous associated with the development of inflammatory-related diseases. In this study, we expressed entire bovine Hp in E. coli as a alphabeta linear form. Interestingly, the antibodies prepared against this form could recognize the subunit of native Hp. In stead of a complicated column method, the antibody was able to isolate bovine Hp via immunoaffinity and gel-filtration columns. The isolated Hp is polymeric containing two major molecular forms (660 and 730 kDa). Their size and hemoglobin binding complex are significantly larger than that of human Hp 2-2. The amino-acid sequence deducted from the nucleotide sequence is similar to human Hp 2 containing a tandem repeat over the alpha chain. Thus, the Hp 2 allele is not unique in human. We also found that there is one additional -SH group (Cys-97) in bovine alpha chain with a total of 8 -SH groups, which may be responsible for the overall polymeric structure that is markedly different from human Hp 2-2. The significance of the finding and its relationship to structural evolution are also discussed.     

高效表达幽门螺杆菌UreB重组蛋白工程菌的构建

克隆表达幽门螺杆菌(Hp)的尿素酶B亚单位(UreB)重组蛋白,可为Hp疫苗开发和快速诊断试剂盒的研究奠定基础。用PCR方法由幽门螺杆菌染色体DNA扩增UreB基因片段,将其融合插入原核表达载体pQE30中,并在M15大肠杆菌表达。经酶切、测序分析,包括部分融合载体基因在内的重组UreB基因片段由1773bp组成。为编码591个氨基酸残基的多肽。SDS-PAGE分析显示重组表达的目的蛋白相对分子量约为66kD,表达量点菌体总蛋白的23．5％,并经免疫印迹分析证实被幽门螺杆菌感染的阳性血清可与纯化UreB重组蛋白发生特异性的结合反应。UreB重组蛋白具有良好的抗原性,将有可能成为一种有效蛋白质疫苗以及快速诊断试剂盒用于Hp感染的防治和检测。     

胃溃疡、胃癌组织中幽门螺杆菌及真菌基因片段的扩增分析

探讨胃溃疡、胃癌组织中幽门螺杆菌(Helicobacter pylori,Hp)、真菌(Fungi)单纯感染及混合感染的可能性并进行验证。应用聚合酶链反应(PCR)技术,分别自4例胃溃疡和4例胃癌并伴单纯幽门螺杆菌、真菌及其混合感染病例石蜡包埋组织(FFPE)中扩增Hp及fungi基因特异片段并进行测序分析。成功提取了FF-PE胃组织基因组DNA,并扩增出Hp 16S rRNA及真菌内转录间隔区18S rDNA基因和28S rDNA之间的基因特异条带,测序大小分别为114 bp和357 bp,经在线BLAST比对分析表明所扩增基因与Hp及真菌核苷酸具有高度同源性。胃溃疡、胃癌组织中存在Hp和真菌单纯感染及混合感染。推测Hp与真菌混合感染可能是加重胃溃疡发展和诱发胃癌发生的又一致病因素。积极治疗Hp与真菌混合感染有助于提高胃溃疡的治愈率和减少胃癌的发生。