Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0017168 (gastroesophageal reflux disease)
 11,783 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Clinical relevance of infection with different Helicobacter pylori strains was reviewed in this paper. Helicobacter pylori (H. pylori) infection plays a role in pathogenesis of chronic gastritis, peptic ulcer disease, gastric adenocarcinoma and MALT lymphoma. Extragastric manifestations of H. pylori infection most probably include acne rosacea and chronic urticaria, while the importance of H. pylori infection for pathogenesis of growth retardation in children, iron deficiency anemia, coronary heart disease, stroke and idiopathic thrombocytopenic purpura remains vague. The expression of two H. pylori proteins, cytotoxin associated protein (cag A) and vacuolization cytotoxin (vac A) is considered to be related with pathogenicity of the bacterium. It is clear that presence of cag A+ strains is important for development of peptic ulcer; nevertheless, it is also protective against esophageal reflux disease. On the other hand, cag A+ strains are common in gastric adenocarcinoma and MALT lymphoma patients, but it seems that certain subtypes of vac A cytotoxin are more important risk factors. Infection with cag A+ strains is more common in patients with acne rosacea, stroke and coronary heart disease.
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PMID:[Clinical significance of infection with cag A and vac A positive Helicobacter pylori strains]. 1593 30

The guidelines on the management of Helicobacter pylori were updated at the European Helicobacter study group third Maastricht consensus conference in March 2005. Especially, this conference emphasis on the management of non ulcer dyspepsia, GERD, and the patients who use non steroidal anti-inflammatory drug. Eradication of H. pylori is recommended in patients with peptic ulcer, low grade MALT lymphoma, atrophic gastritis, unexplained iron deficiency anemia, chronic idiopathic thrombocytopenic purpura and first degree relatives of patients with gastric cancer. H. pylori eradication is less effective than proton pomp inhibitor(PPI) treatment in preventing ulcer recurrence in long term NSAIDs users. This meeting also emphasized on the relationship between H. pylori and gastric cancer. The guideline concluded that H. pylori eradication has the potential to reduce the risk of gastric cancer development. Japanese guideline in 2003 does not mention the effect of eradication for prevention of gastric cancer. The H. pylori eradication and new strategy should be desirable for global strategy of gastric cancer prevention.
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PMID:[Guidelines for the management of Helicobacter pylori--Maastricht III-2005 and Japanese guidelines]. 1840 34

Helicobacter pylori is a Gram-negative bacterium that infects the stomach of more than half of the world's population. H. pylori infection is an established risk factor for gastric cancer, although it is not sufficient cause for the appearance of cancer, per se. Several studies have investigated the role of this bacterium in non-cancer diseases, including gastritis ulcer, duodenal ulcer, gastroesophageal reflux, cardiovascular diseases, neurodegenerative diseases, ocular diseases, and dermatological disorders. DNA damage and failure in antioxidant defences is a common denominator of many among these pathological conditions. The clinical outcome of H. pylori infection is dependent on many variables, including H. pylori genotype, host health status, host genotype, and host exposure to environmental factors. The role of genetic and environmental factors is reviewed in this paper. Among non-cancer diseases, idiopathic thrombocytopenic purpura appears to show the strongest link with H. pylori. There is an evidence for a role of CagA-positive H. pylori infection in atherosclerosis and ischemic heart disease. On the whole, the major factors playing a pathogenic role in H. pylori-related non-cancer diseases are: (a) host polymorphisms in genes involved in inflammation and protection against oxidative damage, (b) host exposure to dietary genotoxic agents, and (c) bacterial genetic polymorphisms. In conclusion, there is an evidence that mutagenesis-related mechanisms play a pathogenic role in the appearance of non-cancer diseases following H. pylori infection.
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PMID:Interaction between Helicobacter pylori, diet, and genetic polymorphisms as related to non-cancer diseases. 1956 29

The Asia-Pacific Consensus Conference was convened to review and synthesize the most current information on Helicobacter pylori management so as to update the previously published regional guidelines. The group recognized that in addition to long-established indications, such as peptic ulcer disease, early mucosa-associated lymphoid tissue (MALT) type lymphoma and family history of gastric cancer, H. pylori eradication was also indicated for H. pylori infected patients with functional dyspepsia, in those receiving long-term maintenance proton pump inhibitor (PPI) for gastroesophageal reflux disease, and in cases of unexplained iron deficiency anemia or idiopathic thrombocytopenic purpura. In addition, a population 'test and treat' strategy for H. pylori infection in communities with high incidence of gastric cancer was considered to be an effective strategy for gastric cancer prevention. It was recommended that H. pylori infection should be tested for and eradicated prior to long-term aspirin or non-steroidal anti-inflammatory drug therapy in patients at high risk for ulcers and ulcer-related complications. In Asia, the currently recommended first-line therapy for H. pylori infection is PPI-based triple therapy with amoxicillin/metronidazole and clarithromycin for 7 days, while bismuth-based quadruple therapy is an effective alternative. There appears to be an increasing rate of resistance to clarithromycin and metronidazole in parts of Asia, leading to reduced efficacy of PPI-based triple therapy. There are insufficient data to recommend sequential therapy as an alternative first-line therapy in Asia. Salvage therapies that can be used include: (i) standard triple therapy that has not been previously used; (ii) bismuth-based quadruple therapy; (iii) levofloxacin-based triple therapy; and (iv) rifabutin-based triple therapy. Both CYP2C19 genetic polymorphisms and cigarette smoking can influence future H. pylori eradication rates.
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PMID:Second Asia-Pacific Consensus Guidelines for Helicobacter pylori infection. 2218 25