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I. Daugule [1] J. Ejderhamn [2] I. Rumba [1] L. Engstrand [3] [14/22] A High Prevalence of cagA+ Helicobacter pylori Strains and Association with Histology among Symptomatic Children in Latvia [...]

I. Daugule [1] J. Ejderhamn [2] I. Rumba [1] L. Engstrand [3] [14/10] A High Percentage of Mixed Infections with cagA+ and cagA- Helicobacter pylori Strains among Symptomatic Children in [...]

O. Kurtenkov [1] V. Brjalin [1] K. Klaamas [1] L. Miljukhina [1] L. Shljapnikova [1] A. Lipping [1] L. Engstrand [2] [4/15] A Level of Natural anti-Alpha-galactosyl Antibodies in H. [...]

Background: The role of Helicobacter pylori infection and CagA seropositivity in the development of oesophageal malignancies was investigated through a nested case-control study. Methods: Blood samples were collected from a cohort of 32 906 city residents during a health-screening programme between 1974 and 1992. Gastroesophageal junction adenocarcinoma was defined as oesophageal if Barrett's mucosa was present, as gastric cardia adenocarcinoma otherwise. Until 2000, 37 cases of squamous cell carcinoma (SCC), 12 cases of oesophageal adenocarcinoma (OA) and 24 cases of gastric cardia adenocarcinoma (GCA) occurred, four matched controls were selected for each case. H. pylori seropositivity was determined by an enzyme-linked immunosorbant assay measuring IgG; CagA seropositivity was measured with a commercial immunoblot kit (Helicoblot 2.1). Results: H. pylori seropositivity was for SCC 32%; OA 8%; and for GCA 54%; matched control groups had seropositivities 45%; 38%; and 54% respectively. Corresponding CagA seropositivity was for SCC 27%; OA 8%; GCA 58%; with the matched control group having the figures 47%; 47%; and 56%. Logistic regression analyses showed that CagA seropositivity reduced the risk of developing SCC to 0.33 (95% CI: 0.12-0.90), whereas H. pylori seropositivity reduced the odds ratio to 0.38 (95% CI: 0.15-0.98). The risk reduction was even more pronounced with OA, odds ratios for CagA was 0.082 (95% CI: 0.00-0.89), and for H. pylori 0.15 (95% CI: 0.00-1.03). On the other hand, GCA was associated with neither CagA, 0.91 (95% CI: 0.17-4.7) nor H. pylori seropositivity, 1.1 (95% CI: 0.22-5.3). All multivariate analyses were adjusted for socioeconomic status and tobacco and alcohol consumption. Conclusions: CagA as well as H. pylori seropositivity is associated with a reduction in the risk of developing squamous cell carcinoma of the oesophagus. In gastroesophageal junction adenocarcinomas, CagA seropositivity reduces the risk in the presence but not... [ABSTRACT FROM AUTHOR]

Objective: The ethiopathogenesis of irritable bowel syndrome (IBS) is unknown. While a link to the gut microbiome is postulated, the heterogeneity of the healthy gut makes it difficult to draw definitive conclusions. We aimed to describe the faecal and mucosa-associated microbiome (MAM) and health correlates on a community cohort of healthy and IBS individuals with no colonoscopic findings., Design: The PopCol study recruited a random sample of 3556 adults; 745 underwent colonoscopy. IBS was defined by Rome IV criteria and organic disease excluded. 16S rRNA gene sequencing was conducted on sigmoid biopsy samples from 376 representative individuals (63 IBS cases) and faecal samples from 185 individuals (32 IBS cases)., Results: While sigmoid MAM was dominated by Lachnospiraceae, faeces presented a higher relative abundance of Ruminococcaceae. Microbial richness in MAM was linearly correlated to that in faeces from the same individual (R²=0.255, p<3E-11) as was diversity (R²=0.06, p=0.0022). MAM diversity decreased with increasing body mass index (BMI; Pearson's r=-0.1, p=0.08) and poorer self-rated health (r=-0.15, p=0.007), but no other health correlates. Faecal microbiome diversity was correlated to stool consistency (r=-0.16, p=0.043). Several taxonomic groups were correlated to age, BMI, depression and self-reported health, including Coprococcus catus associated with lower levels of depression (r=-0.003, p=0.00017). The degree of heterogeneity observed between IBS patients is higher than that observed between healthy individuals., Conclusions: No distinct microbial signature was observed in IBS. Individuals presenting with low self-rated health or high BMI have lower gut microbiome richness., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: Gastric infection with Helicobacter pylori is a strong risk factor for non-cardia gastric adenocarcinoma. The aim of this study was to assess whether the risk of gastric adenocarcinoma and non-cardia gastric adenocarcinoma decreases after eradication treatment for H. pylori in a Western population., Design: This was a nationwide, population-based cohort study in Sweden in 2005-2012. Data from the Swedish Prescribed Drug Registry provided information on H. pylori eradication treatment, whereas information concerning newly developed gastric adenocarcinoma was retrieved from the Swedish Cancer Registry. The risk of gastric adenocarcinoma and non-cardia gastric adenocarcinoma in individuals who had received H. pylori eradication treatment was compared with the background population of the corresponding age, sex and calendar year distribution, yielding standardised incidence ratios (SIRs) with 95% CIs., Results: During the follow-up of 95 176 individuals who had received eradication treatment (351 018 person-years at risk), 75 (0.1%) developed gastric adenocarcinoma and 69 (0.1%) developed non-cardia gastric adenocarcinoma. The risk of gastric adenocarcinoma decreased over time after eradication treatment to levels below that of the corresponding background population. The SIRs were 8.65 (95% CI 6.37 to 11.46) for 1-3 years, 2.02 (95% CI 1.25 to 3.09) for 3-5 years and 0.31 (95% CI 0.11 to 0.67) for 5-7.5 years after eradication treatment. When restricted to non-cardia adenocarcinoma, the corresponding SIRs were 10.74 (95% CI 7.77 to 14.46), 2.67 (95% CI 1.63 to 4.13) and 0.43 (95% CI 0.16 to 0.93)., Conclusion: Eradication treatment for H. pylori seems to counteract the development of gastric adenocarcinoma and non-cardia gastric adenocarcinoma in this Western population., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

Competing Interests: Competing interests: None declared.

Objective: IBS is a common gut disorder of uncertain pathogenesis. Among other factors, genetics and certain foods are proposed to contribute. Congenital sucrase-isomaltase deficiency (CSID) is a rare genetic form of disaccharide malabsorption characterised by diarrhoea, abdominal pain and bloating, which are features common to IBS. We tested sucrase-isomaltase ( SI ) gene variants for their potential relevance in IBS., Design: We sequenced SI exons in seven familial cases, and screened four CSID mutations (p.Val557Gly, p.Gly1073Asp, p.Arg1124Ter and p.Phe1745Cys) and a common SI coding polymorphism (p.Val15Phe) in a multicentre cohort of 1887 cases and controls. We studied the effect of the 15Val to 15Phe substitution on SI function in vitro. We analysed p.Val15Phe genotype in relation to IBS status, stool frequency and faecal microbiota composition in 250 individuals from the general population., Results: CSID mutations were more common in patients than asymptomatic controls (p=0.074; OR=1.84) and Exome Aggregation Consortium reference sequenced individuals (p=0.020; OR=1.57). 15Phe was detected in 6/7 sequenced familial cases, and increased IBS risk in case-control and population-based cohorts, with best evidence for diarrhoea phenotypes (combined p=0.00012; OR=1.36). In the population-based sample, 15Phe allele dosage correlated with stool frequency (p=0.026) and Parabacteroides faecal microbiota abundance (p=0.0024). The SI protein with 15Phe exhibited 35% reduced enzymatic activity in vitro compared with 15Val (p<0.05)., Conclusions: SI gene variants coding for disaccharidases with defective or reduced enzymatic activity predispose to IBS. This may help the identification of individuals at risk, and contribute to personalising treatment options in a subset of patients., Competing Interests: Competing interests: The work was partially financed by an unrestricted grant from Medical Need Europe AB to MDA. MDA and HYN have received unrestricted research grants and lecturing honoraria from QOL Medical, and LC has served on a scientific advisory board for QOL Medical., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.)

Objective: The early intestinal microbiota exerts important stimuli for immune development, and a reduced microbial exposure as well as caesarean section (CS) has been associated with the development of allergic disease. Here we address how microbiota development in infants is affected by mode of delivery, and relate differences in colonisation patterns to the maturation of a balanced Th1/Th2 immune response., Design: The postnatal intestinal colonisation pattern was investigated in 24 infants, born vaginally (15) or by CS (nine). The intestinal microbiota were characterised using pyrosequencing of 16S rRNA genes at 1 week and 1, 3, 6, 12 and 24 months after birth. Venous blood levels of Th1- and Th2-associated chemokines were measured at 6, 12 and 24 months., Results: Infants born through CS had lower total microbiota diversity during the first 2 years of life. CS delivered infants also had a lower abundance and diversity of the Bacteroidetes phylum and were less often colonised with the Bacteroidetes phylum. Infants born through CS had significantly lower levels of the Th1-associated chemokines CXCL10 and CXCL11 in blood., Conclusions: CS was associated with a lower total microbial diversity, delayed colonisation of the Bacteroidetes phylum and reduced Th1 responses during the first 2 years of life.