Carditis at the Interface between GERD and &lt;i&gt;Helicobacter pylori&lt;/i&gt; Infection

Peitz, Ulrich; Malfertheiner, Peter

doi:10.1159/000080310

Cited by 9 publications

(4 citation statements)

References 53 publications

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“…H. pylori colonisation in the oesophageal mucosa, which correlated with inflammatory changes, was also reported 170. However, inflammation in the cardia occurs even without H. pylori infection and has been shown to be associated with GOR 44 79 169 171–173. Chronic inflammation of the GOJ mucosa appears to be the immediate consequence of GORD, correlating with endoscopic diagnosis,169 and occurs without H. pylori infection 44 79 169 171…”

Section: Resultsmentioning

confidence: 83%

Kyoto international consensus report on anatomy, pathophysiology and clinical significance of the gastro-oesophageal junction

Sugano

Spechler

El-Omar

et al. 2022

Gut

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ObjectiveAn international meeting was organised to develop consensus on (1) the landmarks to define the gastro-oesophageal junction (GOJ), (2) the occurrence and pathophysiological significance of the cardiac gland, (3) the definition of the gastro-oesophageal junctional zone (GOJZ) and (4) the causes of inflammation, metaplasia and neoplasia occurring in the GOJZ.DesignClinical questions relevant to the afore-mentioned major issues were drafted for which expert panels formulated relevant statements and textural explanations.A Delphi method using an anonymous system was employed to develop the consensus, the level of which was predefined as ≥80% of agreement. Two rounds of voting and amendments were completed before the meeting at which clinical questions and consensus were finalised.ResultsTwenty eight clinical questions and statements were finalised after extensive amendments. Critical consensus was achieved: (1) definition for the GOJ, (2) definition of the GOJZ spanning 1 cm proximal and distal to the GOJ as defined by the end of palisade vessels was accepted based on the anatomical distribution of cardiac type gland, (3) chemical and bacterial (Helicobacter pylori) factors as the primary causes of inflammation, metaplasia and neoplasia occurring in the GOJZ, (4) a new definition of Barrett’s oesophagus (BO).ConclusionsThis international consensus on the new definitions of BO, GOJ and the GOJZ will be instrumental in future studies aiming to resolve many issues on this important anatomic area and hopefully will lead to better classification and management of the diseases surrounding the GOJ.

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Section: Resultsmentioning

confidence: 83%

Kyoto international consensus report on anatomy, pathophysiology and clinical significance of the gastro-oesophageal junction

Sugano

Spechler

El-Omar

et al. 2022

Gut

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“…Because the length of the CM increases with age, some investigators believe the CM to be metaplastic 26 . It remains unknown as to: (i) the relationship between the length of CG, the CM, and developmental age; (ii) the status of superficial esophageal CG as a normal developmental structure; and (iii) whether or not there are the differences in the CG and the CM among different ethnic populations.…”

Section: Pediatric Populationmentioning

confidence: 99%

Controversies of cardiac glands in the proximal stomach: A critical review

Huang

2011

J of Gastro and Hepatol

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Cardiac glands (CG), along with oxyntocardiac glands, in a normal human constitute cardiac mucosa (CM) that is positioned in the proximal stomach with a length of 10-30 mm, according to traditional teaching. This doctrine has been recently challenged. On the basis of studies on autopsy and biopsy materials in the esophagogastric junction region, some investigators have reported the presence of CG in only 50% of the general US population. They believed that CG were an acquired, metaplastic lesion as a result of gastroesophageal reflux disease. Subsequent recent study results from other research groups showed the presence of CG in the proximal stomach in embryos, fetuses, pediatric, and adult patients in most Europeans and Americans, and almost all Japanese and Chinese patients. These new data showed the following important findings: (i) CG are confirmed to be congenital in the proximal stomach; (ii) the length of CM is much shorter, approximately 5 mm in Caucasians in Europe and North America, and approximately 13 mm in Japanese and probably also in Chinese; (iii) CG are also present in the distal superficial esophagus underneath squamous mucosa in almost all Japanese and Chinese patients, but not so common in Caucasians in Europe, and not clear in Caucasians in North America. The recent data indicate a clear difference in the distribution of CG in the proximal stomach among different ethnic populations, and might explain different disease pathogenesis mechanisms among various ethnic patient groups.

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“…The expression of these different glycoproteins results in distinct lectin-binding capabilities [6,7,8]. Both abnormal gastroesophageal reflux and H. pylori lead to inflammation and, in a subset of patients, to intestinal metaplasia at the squamocolumnar junction (SCJ) [10,11,12]. Recently, we demonstrated that gastroesophageal reflux disease (GERD) with its endoscopic entities of erosive (ERD) and non-erosive reflux disease (NERD), but not H. pylori infection, leads to distinct lectin-binding patterns at the SCJ [13].…”

Section: Introductionmentioning

confidence: 99%

Lectin UEA-I-Binding Proteins Are Specifically Increased in the Squamous Epithelium of Patients with Barrett’s Esophagus

Neumann¹,

Wex²,

Mönkemüller³

et al. 2008

Digestion

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Background: Chronic gastritis and esophagitis are associated with changes in mucosal glycosylation patterns. Lectins represent a group of specific carbohydrate binding proteins that can be used as sensitive tools for the analysis of glycosylation patterns. Aim: To investigate the binding patterns of lectins Ulex europaeus agglutinin-I (UEA-I), Dolichos biflorus agglutinin (DBA), Helix pomatia agglutinin (HPA) and peanut agglutinin (PNA) at the gastroesophageal junction in nonerosive (NERD), erosive reflux disease (ERD) and Barrett’s esophagus (BE). Methods: One hundred and twenty-two patients (female n = 53; male n = 69; controls n = 28; NERD n = 36; ERD n = 24 and BE n = 34) were included in this study. The binding patterns of lectins were examined immunohistochemically at the squamocolumnar junction, in squamous epithelium and columnar-lined epithelium. Staining patterns of lectins were semiquantitatively evaluated using an immunohistochemical score and the data were analyzed using non-parametric tests. Results: BE, as compared to the controls, was associated with specific lectin-binding patterns: lectin binding of UEA-I and DBA were significantly decreased at the superficial (p = 0.012; p = 0.00036, respectively) and at the deep glandular body (p = 0.045; p = 0.055, respectively). Comparisons of lectin-staining scores between GERD and BE revealed significant increases of UEA-I in both the stratum superficiale (p = 0.0155) and stratum spinosum (p = 0.0048) of SE in patients with BE. Notable, this change was specific for patients with BE, while no difference was observed between patients with GERD and controls. Conclusion: We found two major types of lectin-binding patterns. First, lectin-binding characteristics associated with GERD in general, and second, lectin-binding patterns which were specific for BE. Lectin UEA-I-binding proteins were specifically increased in the squamous epithelium of patients with BE. Thus, UEA-I may serve as a potential marker for BE, especially in patients with short segment BE.

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Carditis at the Interface between GERD and <i>Helicobacter pylori</i> Infection

Cited by 9 publications

References 53 publications

Kyoto international consensus report on anatomy, pathophysiology and clinical significance of the gastro-oesophageal junction

Kyoto international consensus report on anatomy, pathophysiology and clinical significance of the gastro-oesophageal junction

Controversies of cardiac glands in the proximal stomach: A critical review

Lectin UEA-I-Binding Proteins Are Specifically Increased in the Squamous Epithelium of Patients with Barrett’s Esophagus

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