Eradication Therapy for Helicobacter pylori in Patients With Gastric MALT Lymphoma: A Pooled Data Analysis

Zullo, Angelo; Hassan, Cesare; Andriani, Alessandro; Cristofari, Francesca; Francesco, De; Ierardi, Enzo; Tomao, Silverio; Morini, Sergio; Vaira, Dino

doi:10.1038/ajg.2009.314

Cited by 94 publications

(65 citation statements)

References 49 publications

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“…We now know that some classes of infiltrating lymphomas arise in situations where chronic infection or autoimmunity leads to sustained antigenic stimulation as occurs in Helicobacter pylori (36,37) or Hepatitis C (38, 39) infections or in autoimmune conditions, such as Sjögren syndrome (40,41) and Hashimoto thyroiditis (42,43). The prototypic example is the mucosa-associated lymphoid tissue (MALT) lymphomas that are associated with Helicobacter pylori infection and disappear in more than 75% of cases when antibiotics cure the infection, presumably because the antigen stimulation is removed (44,45).…”

Section: Discussionmentioning

confidence: 99%

Ectopic B-cell clusters that infiltrate transplanted human kidneys are clonal

Cheng

Torkamani²,

Grover³

et al. 2011

Proc. Natl. Acad. Sci. U.S.A.

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B cells and their immunoglobulin products participate in allograft rejection of transplanted human kidneys in which an interesting feature is the presence of a germinal center like B-cell clusters in the allograft. We report here that the immunoglobulin repertoires of these infiltrating B cells are highly restricted and the B cells within a cluster are clonal. Antibody libraries made from the infiltrating B cells of individual patients unexpectedly revealed that each patient utilizes a particular set of dominant germ line genes as well as dominant complementarity determining region 3. Comparison of kidney and peripheral blood from the same patient showed that the immunoglobulin genes from both compartments had dominant clones, but they differed. The lymphocytes that infiltrate the kidneys express the immunoglobulin gene somatic recombination machinery usually restricted to highly activated lymphocytes in germinal centers and lymphomas. An analogy can be made between the inescapable antigenic drive in chronic infection versus that in an allograft, both of which may lead to emergence of dominant B-cell clones and even lymphoid malignancy.

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Section: Discussionmentioning

confidence: 99%

Ectopic B-cell clusters that infiltrate transplanted human kidneys are clonal

Cheng

Torkamani²,

Grover³

et al. 2011

Proc. Natl. Acad. Sci. U.S.A.

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“…The B-cell clone that led to MALT lymphoma has been shown for cases of H. pylori-related gastritis years before the development of lymphoma (283 (234). A recent pooled data analysis of approximately 1,300 patients with gastric MALT lymphoma showed that successive attempts at H. pylori antibiotic treatment achieved eradication of infection in 98.3% of cases and that 77.8% of the H. pylori-cured patients achieved lymphoma remission (284). Unfortunately, reinfection with the same strain of H. pylori can reactivate the growth of the lymphoma.…”

Section: Antigen-driven Lymphoproliferationmentioning

confidence: 99%

Role of Bacteria in Oncogenesis

2010

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SUMMARY Although scientific knowledge in viral oncology has exploded in the 20th century, the role of bacteria as mediators of oncogenesis has been less well elucidated. Understanding bacterial carcinogenesis has become increasingly important as a possible means of cancer prevention. This review summarizes clinical, epidemiological, and experimental evidence as well as possible mechanisms of bacterial induction of or protection from malignancy.

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“…In most cases of MALT lymphomas the malignancy disappears when the inciting H.Pylori. infection is cured by antibiotics (27)(28)(29)(30). By analogy, in the transplanted kidney there is the potential for continuous exposure to bacterial antigens by a urinary reflux mechanism in the setting of induced immunosupression.…”

Section: Resultsmentioning

confidence: 99%

“…Thus, these findings may relate to the pathogenesis of the clonal proliferation of B-cells in other diseases such as lymphomas and myelomas where the driving forces may not be as transparent because the interactions are taking place in a less confined space. Indeed, we already know that MALT lymphomas arise because of the interaction between H. Pylori and certain B-cells in a situation not too dissimilar from that of human transplantation in terms of anatomical confinement and mechanisms that allow for enrichment of the bacterial pathogen (27)(28)(29)(30). While many more clones from infiltrating B-cells will have to be studied to generalize these findings, our results from the serum already suggest that antibody reactivity with LPS in transplant patients may be a very common phenomena.…”

Section: Discussionmentioning

confidence: 99%

The costimulatory immunogen LPS induces the B-Cell clones that infiltrate transplanted human kidneys

Grover

Cheng²,

Peng³

et al. 2012

Proc. Natl. Acad. Sci. U.S.A.

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The mechanism of chronic rejection of transplanted human kidneys is unknown. An understanding of this process is important because, chronic rejection ultimately leads to loss of the kidney allograft in most transplants. One feature of chronic rejection is the infiltration of ectopic B-cell clusters that are clonal into the transplanted kidney. We now show that the antibodies produced by these B-cells react strongly with the core carbohydrate region of LPS. Since LPS is a costimulatory immunogen that can react with both the B-cell receptor (BCR) and the Toll-like receptor 4 (TLR4), these results suggest a mechanism for the selective pressure that leads to clonality of these B-cell clusters and opens the possibility that infection and the attendant exposure to LPS plays a role in the chronic rejection of human kidney transplants. If confirmed by clinical studies, these results suggest that treating patients with signs of chronic rejection with antibiotics may improve kidney allograft survival.

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Eradication Therapy for Helicobacter pylori in Patients With Gastric MALT Lymphoma: A Pooled Data Analysis

Abstract: This was the first comprehensive ( approximately 1,300 patients) analysis of the therapeutic management of H. pylori in gastric lymphoma patients. Data suggest that this infection is easily managed in these patients, being cured in nearly all cases.

Cited by 94 publications

References 49 publications

Ectopic B-cell clusters that infiltrate transplanted human kidneys are clonal

Ectopic B-cell clusters that infiltrate transplanted human kidneys are clonal

Role of Bacteria in Oncogenesis

The costimulatory immunogen LPS induces the B-Cell clones that infiltrate transplanted human kidneys

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