exudates and Gastritis

The study of Helicobacter pylori in Malaysia has given several important insights into the epidemiology of the infection and pathogenesis of disease. Malaysia has a multiracial Asian population with three major Asian races living together-Malay, Chinese, and Indian. Races remain fairly distinct because of a paucity of interracial marriages. The "Racial Cohort Hypothesis" proposes that the infection occurs within racial groups rather than between. As such, the high prevalence among Indians (> 50%) and Chinese (40-50%) reflects the high prevalence in their countries of origin even though migration had taken place more than two generations before. The Malays have a comparatively low prevalence of about 10-20%. Despite the high prevalence of H. pylori, the Indians have a low gastric cancer incidence of less than 10 per 100 000 per year. This is in contrast to the Chinese who has an incidence in excess of 20 per 100 000 per year. We have called this the "Indian Enigma." The reason for this enigma is unclear and is the result of interaction between bacterial virulence factors, host susceptibility, and environmental factors. Phylogenetically, Chinese bacterial strains are distinct from Indians and Malays and are predominantly hpEastAsia/hsp EAsia. CagA EPIYA motifs among Chinese belong predominantly to the more virulent ABD motif. There is no clear distinguishing profile among host genetic factors. Environmental factors particularly diet may play an important role. Indians consume chilies and curries, which may be gastro protective, whereas Chinese consume more preserved and salted foods, which are thought to be carcinogenic.

Topics: China; Cohort Studies; Disease Susceptibility; Environment; Feeding Behavior; Gastritis; Helicobacter Infections; Helicobacter pylori; Humans; India; Malaysia; Phylogeny; Prevalence; Racial Groups; Stomach Neoplasms

Reported associations of capsaicin with gastric cancer development have been conflicting. Here, we examine 10 published articles that explore these associations using 2,452 cases and 3,996 controls.. We used multiple search strategies in MEDLINE through PubMed to seek for suitable articles that had case-control design with gastric cancer as outcome.. The outcomes of our study shows protection (odds ratio [OR] 0.55, P = 0.003) and susceptibility (OR 1.94, P = 0.0004), both significant with low and medium-high intake of capsaicin, respectively, although under relatively heterogeneous conditions (P(heterogeneity) = <0.0001). Outlier analysis resulted in loss of overall heterogeneity (P = 0.14) without affecting the pooled ORs. Among the subgroups, low intake elicited protection in both Korean (OR 0.37) and Mexican (OR 0.63) populations while high intake rendered these subgroups susceptible (OR 2.96 and OR 1.57, respectively). These subgroup values were highly significant (P = 0.0001-0.01) obtained in heterogeneous conditions (P(heterogeneity) < 0.0001-0.04). The homogeneous (P(heterogeneity) = 0.27-0.37) H. pylori (OR 0.60 and 1.69) effects were highly significant (P < 0.001) in the low and medium-high intake analyses, respectively. Given outcomes from the tests of interaction, high capsaicin intake is significantly different from the protection that low consumption offers.. This meta-analysis implies moderation in capsaicin consumption in order to derive its protective benefits.

Topics: Animals; Anticarcinogenic Agents; Apoptosis; Asia; Capsaicin; Capsicum; Cell Line, Tumor; Cell Transformation, Neoplastic; Diet; Disease Susceptibility; Dose-Response Relationship, Drug; Gastric Mucosa; Gastritis; Gene Expression Regulation; Helicobacter Infections; Helicobacter pylori; Humans; Life Style; Malaysia; Research Design; Risk; Stomach Neoplasms

Given the high prevalence of dementia and its devastating consequences, identifying risk factors for dementia is a public health priority. The present study aims to assess whether gastritis increases the odds of dementia.. The data for this study, consisting of 2926 community-dwelling older adults, were obtained from the National survey entitled "Mental Health and Quality of Life of Older Malaysians." Dementia was diagnosed using the Geriatric Mental State-Automated Geriatric Examination for Computer-Assisted Taxonomy.. Prevalence of dementia was considerably higher among older adults with gastritis (29.5%) compared to those without gastritis (13.2%). After adjusting for age, gender, marital status, educational attainment, hypertension, stroke, and diabetes, gastritis was significantly associated with more than twice odds of dementia (adjusted odds ratio = 2.42, P < .001, 95% confidence interval = 1.68-3.49).. The findings from this population-based observational study showing evidence that gastritis may increase the risk of dementia provide avenue for further inquiries into dementia.

Topics: Aged; Aged, 80 and over; Comorbidity; Dementia; Female; Gastritis; Humans; Malaysia; Male; Middle Aged; Risk Factors

Helicobacter pylori infection results in diverse clinical conditions ranging from chronic gastritis and ulceration to gastric adenocarcinoma. Among the multiethnic population of Malaysia, Indians consistently have a higher H. pylori prevalence as compared with Chinese and Malays. Despite the high prevalence of H. pylori, Indians have a relatively low incidence of peptic ulcer disease and gastric cancer. In contrast, gastric cancer and peptic ulcer disease incidence is high in Chinese. H. pylori strains from Chinese strains predominantly belong to the hspEAsia subpopulation while Indian/Malay strains mainly belong to the hspIndia subpopulation. By comparing the genome of 27 Asian strains from different subpopulations, we identified six genes associated with risk of H. pylori-induced peptic ulcer disease and gastric cancer. This study serves as an important foundation for future studies aiming to understand the role of bacterial factors in H. pylori-induced gastro-duodenal diseases.

Topics: Amino Acid Sequence; Bacterial Outer Membrane Proteins; Fructose-Bisphosphate Aldolase; Gastritis; Genes, Bacterial; Genetic Association Studies; Genetic Variation; Helicobacter Infections; Helicobacter pylori; Humans; Malaysia; Molecular Sequence Data; Multilocus Sequence Typing; Peptic Ulcer; Phylogeny; Stomach Neoplasms

To characterise the cag pathogenicity island in Helicobacter pylori (H. pylori) isolates by analysing the strains' vacA alleles and metronidazole susceptibilities in light of patient ethnicity and clinical outcome.. Ninety-five H. pylori clinical isolates obtained from patients with dyspepsia living in Malaysia were analysed in this study. Six genes in the cagPAI region (cagE, cagM, cagT, cag13, cag10 and cag67) and vacA alleles of the H. pylori isolates were identified by polymerase chain reaction. The isolates' metronidazole susceptibility was also determined using the E-test method, and the resistant gene was characterised by sequencing.. More than 90% of the tested isolates had at least one gene in the cagPAI region, and cag67 was predominantly detected in the strains isolated from the Chinese patients, compared with the Malay and Indian patients (P < 0.0001). The majority of the isolates (88%) exhibited partial deletion (rearrangement) in the cagPAI region, with nineteen different patterns observed. Strains with intact or deleted cagPAI regions were detected in 3.2% and 8.4% of isolates, respectively. The prevalence of vacA s1m1 was significantly higher in the Malay and Indian isolates, whereas the isolates from the Chinese patients were predominantly genotyped as vacA s1m2 (P = 0.018). Additionally, the isolates from the Chinese patients were more sensitive to metronidazole than the isolates from the Malay and Indian patients (P = 0.047). Although we attempted to relate the cagPAI genotypes, vacA alleles and metronidazole susceptibilities to disease outcome, no association was observed. The vacA alleles were distributed evenly among the strains with intact, partially deleted or deleted cagPAI regions. Interestingly, the strains exhibiting an intact cagPAI region were sensitive to metronidazole, whereas the strains with a deleted cagPAI were more resistant.. Successful colonisation by different H. pylori genotypes is dependent on the host's genetic makeup and may play an important role in the clinical outcome.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Asian People; Bacterial Proteins; Chi-Square Distribution; China; Female; Gastritis; Genotype; Helicobacter Infections; Helicobacter pylori; Humans; India; Malaysia; Male; Metronidazole; Microbial Sensitivity Tests; Middle Aged; Phenotype; Virulence; Young Adult

Polymorphisms of Helicobacter pylori cagA and vacA genes do exist and may contribute to differences in H. pylori infection and gastroduodenal diseases among races in the Malaysian population. This study was conducted to characterize the polymorphisms in H. pylori cagA and vacA in Malaysian population.. A total of 110 H. pylori isolates were genotyped by PCR and sequenced for cagA and PCR-RFLP for vacA.. East Asian cagA was predominantly detected (64.5%), whereas vacA s1m1 and s1m2 alleles were detected in 60.9 and 37.3% of strains, respectively. A statistical association between cagA type with patients' ethnicity (p < .0001) and age group >50 years old (p = .027) was identified. vacA alleles showed significant association with age group >50 years old (p = .017) and increased neutrophil activity in gastric mucosa (p = .028 and p = .016 for moderate and marked activity, respectively). Further identification of vacA polymorphism revealed that 84% of strains from Malays and Indians showed one RFLP pattern (RFLP-1), whereas more than one RFLP patterns (RFLP-2, 3, 4, 5, 6, and 8) were predominantly observed in strains from Chinese (82%) (p < .0001). Increasing severity of gastric inflammation was observed in gastric mucosa infected with strains carrying RFLP-2, 3, 4, 5, and 6 (p = .037). About 86.6% of H. pylori strains with East Asian cagA were vacA RFLP-2, 3, 4, 5, 6, and 8, and 88% of Western cagA strains were vacA RFLP-1 (p < .0001). Chinese and Indians are susceptible to different virulence genotypes of H. pylori, whereas Malays showed a mixed virulence genotypes.. Marked differences in the polymorphisms of cagA and vacA were observed among strains in Malaysian population. This provides a new insight into the pathogenicity of H. pylori in multiracial population.

Topics: Adult; Aged; Aged, 80 and over; Antigens, Bacterial; Bacterial Proteins; DNA Fingerprinting; DNA, Bacterial; Ethnicity; Female; Gastritis; Genotype; Helicobacter Infections; Helicobacter pylori; Humans; Malaysia; Male; Middle Aged; Polymorphism, Genetic; Polymorphism, Restriction Fragment Length; Sequence Analysis, DNA; Virulence; Virulence Factors; Young Adult

The concordance between endoscopic and histological gastritis was determined in 52 patients referred for upper gastrointestinal endoscopy. The study was conducted in Northeastern Peninsular Malaysia, an area with a low background prevalence of H. pylori infection. Endoscopic and histological gastritis were assessed in accordance with the Sydney System. The results showed poor concordance between endoscopic and histological gastritis even after reclassifying mild endoscopic gastritis as normal. The low prevalence of H. pylori was validated in this study.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Endoscopy, Gastrointestinal; Female; Gastritis; Helicobacter Infections; Helicobacter pylori; Humans; Malaysia; Male; Middle Aged

Topics: Aged; Animals; Enteritis; Female; Gastritis; Gastrointestinal Hemorrhage; Humans; Ileal Diseases; Malaysia; Strongyloides stercoralis; Strongyloidiasis

The prevalence of Helicobacter pylori infection was determined in peptic ulcer patients, in non-ulcer dyspepsia (NUD) patients, and in the general adult population. The H. pylori infection rate ascertained by microbiologic examination of multiple gastric antral biopsy specimens was 50% (17 of 34) in duodenal ulcer (DU), 5% (1 of 22) in gastric ulcer, and 9% (15 of 159) in NUD patients. A seroepidemiologic survey showed a prevalence of only 4.2% among 496 blood donors and 4.8% among 921 subjects who attended health screening clinics. H. pylori infection is relatively uncommon and does not appear to be the predominant factor in the pathogenesis of peptic ulcer disease in the area. The incidence of peptic ulcer perforations in the area in 1991-92 was 1.5 per 100,000 person-years, reflecting a relatively low frequency of peptic ulcers, which might be due to the low prevalence of H. pylori infection in the population.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Dyspepsia; Female; Gastritis; Helicobacter Infections; Helicobacter pylori; Humans; Malaysia; Male; Middle Aged; Peptic Ulcer; Prevalence; Seroepidemiologic Studies

Peptic ulcer occurs with different frequencies in the three main racial groups in Singapore. This study aimed firstly to determine the prevalence of Helicobacter pylori in peptic ulcer and non-ulcer dyspepsia patients of the different races and secondly, to assess the relation between H pylori, histological gastritis, patient diagnosis, and race. Gastric antral biopsy specimens from 1502 patients undergoing gastroduodenoscopy were studied and 892 (59%) were positive for H pylori. H pylori was strongly associated with gastritis: 873 of 1197 (73%) patients with gastritis were positive compared with 19 of 305 (6%) without gastritis (p less than 0.0001). The prevalences of H pylori and gastritis were similar in peptic ulcer patients of different races. Malay patients with non-ulcer dyspepsia, however, were less likely to be positive for H pylori (10 of 46 (22%] or to have antral gastritis (17 of 46 (37%] than Chinese (292 of 605 (48%) were positive for H pylori and 421 of 605 (70%) had gastritis) and Indians (35 of 61 (57%) were H pylori positive and 42 of 61 (69%) had gastritis). Patients with duodenal ulcer were more likely to be positive for H pylori than those with non-ulcer dyspepsia, even when subjects with gastritis were considered separately. While our results do not help to explain the observed racial differences in peptic ulcer frequency it may be that the pathophysiology of non-ulcer dyspepsia is different in the different races in Singapore.

Topics: Adult; Campylobacter Infections; China; Dyspepsia; Female; Gastritis; Humans; India; Malaysia; Male; Middle Aged; Peptic Ulcer; Prevalence; Singapore

Topics: Adolescent; Adult; Age Factors; Aged; Campylobacter; Campylobacter Infections; Dyspepsia; Female; Gastritis; Humans; Malaysia; Male; Middle Aged

Topics: Adult; Aged; Diagnosis, Differential; Duodenitis; Dyspepsia; Endoscopy; Esophageal Neoplasms; Female; Gastritis; Humans; Malaysia; Male; Middle Aged; Peptic Ulcer; Stomach Neoplasms