Andrzej Kemona

The occurrence of Helicobacter pylori antigens in dental plaque; an association with oral health status and oral hygiene practices

PURPOSE Helicobacter pylori present in the oral cavity can be a source of gastric infection. Since in the oral cavity H. pylori is mostly found in dental plaque, the aim of the study was to determine whether the oral health status and oral hygiene practices affect the incidence of H. pylori antigens in dental plaque. MATERIALS AND METHODS The study was performed in 155 patients aged 19-78 years. Patients who had taken antibiotics within 4 weeks preceding the study and those with a past history of H. pylori eradication were excluded. Each patient filled out a questionnaire on the procedures of dental plaque removal from natural teeth and dentures, and underwent oral examination. H. pylori antigens in supragingival plaque were determined by the immunological method with the use of a kit for detection of H. pylori antigens in stool samples. RESULTS The presence of H. pylori antigens in dental plaque was found in 65.6% of the study subjects. The oral health status, frequency of dentist visits as well as the number and technique of dental plaque removal from natural teeth and dentures did not differ significantly between patients with infected and non-infected dental plaque. CONCLUSIONS The occurrence of H. pylori antigens in dental plaque of natural teeth is not associated with oral health status or dental plaque removal practices from both natural teeth and removable dentures.

Seroprevalence of Helicobacter pylori infection in Polish children and adults depending on socioeconomic status and living conditions

PURPOSE Helicobacter pylori (H. pylori) is one of the causes of gastritis, peptic ulcer disease, gastric cancer and MALT-lymphoma. The frequency of H. pylori infection is different in various regions of the world and dependent on age, socioeconomic and hygiene status. The objective of this study was to assess seroprevalence and the associated socioeconomic and sociodemographic characteristics influencing H. pylori infection in children and adults in Polish population. MATERIAL/METHODS In multicenter epidemiological studies, H. pylori infection occurrence was assessed in Poland in the years 2002 and 2003. The seroprevalence of H. pylori infection diagnosis was based on IgG anti-H. pylori antibodies concentration above 24 UI/ml, which was measured using ELISA test. The study included 6565 subjects: 3307 adults (50.37%) and 3258 children (49.63%). RESULTS Positive result was observed in 3827 subjects (58.29%), i.e. 1043 children (32.01%) and 2784 adults (84.19%). H. pylori infection prevalence was greater in children of poor economic status, who were born in a rural area, lived in crowded houses with no running tap water and with toilet outside the house, and who did not observe hygiene rules. In adults, the factors predisposing to higher probability of being H. pylori infected included: being born in a rural area, having low family income and elementary education, smoking tobacco, drinking high proof alcohols as well as not observing of hygiene rules. CONCLUSIONS Improvement of socioeconomic status, sanitary and hygienic conditions and the education of the society might decrease H. pylori infection prevalence in children and in adults.

Serum levels and tissue expression of matrix metalloproteinase 2 (MMP-2) and tissue inhibitor of metalloproteinases 2 (TIMP-2) in colorectal cancer patients.

The objective of the study was the assessment of serum levels and tissue expression of matrix metalloproteinase 2 (MMP-2) and tissue inhibitor of matrix metalloproteinases 2 (TIMP-2) in patients with colorectal cancer (CRC). The study included 72 CRC patients and 68 healthy subjects. The serum levels of MMP-2 and TIMP-2 were measured using enzyme-linked immunosorbent assay (ELISA) method, whereas tissue expression of MMP-2 and TIMP-2 in cancer cells, interstitial inflammatory cells, and adjacent normal colorectal mucosa were examined by immunohistochemical staining of tumor samples. The serum levels of MMP-2 and TIMP-2 in cancer patients were significantly lower than those in control group, but the percentage of positive immunoreactivity of these proteins were higher in malignant and inflammatory cells as compared to normal tissue. There was a significant correlation between MMP-2 immunoreactivity in inflammatory cells and the presence of distant metastases and between TIMP-2 expression in inflammatory cells and tumor size, nodal involvement, and distant metastases. Area under receiver operating characteristic (ROC) curve (AUC) for serum MMP-2 was higher than for serum TIMP-2. Moreover, positive tissue expression of MMP-2 was a significant prognostic factor for CRC patients’ survival. Our findings suggest that MMP-2 and TIMP-2 might play a role in the process of colorectal cancer invasion and metastasis, but the significance of their interactions with tumor stroma and interstitial inflammatory infiltration in colorectal neoplasia require further elucidation.

The expression of E-cadherin-catenin complex in patients with advanced gastric cancer: role in formation of metastasis

The E-cadherin-catenin complex plays an important role in the process of cell adhesion. Its dysfunction is associated with a decrease in cell differentiation and with increased invasiveness and metastasis. Our aim was to evaluate the expression of E-cadherin and B-catenin in advanced gastric cancer in relation to selected clinico-pathomorphological parameters. Formalin-fixed, paraffin-embedded tissue specimens were immunohistochemically stained with monoclonal antibodies E-cadherin (NCL-E-Cad, Novocastra Laboratiries Ltd; dilution 1:50), beta-catenin (NCL-B-CAT, Novocastra Laboratories Ltd; dilution 1:100), alpha-catenin (alpha-E-caten, Santa Cruz Biotechnology; dilution 1:300) and gamma-catenin (gamma-catenin, Santa Cruz Biotechnology; dilution 1:100). The expressions of E-cadherin and alpha-, beta-, gamma-catenins in the main mass of tumor and lymph node metastasis were investigated in 91 patients with gastric cancer. No statistically significant correlation was observed between the expressions of E-cadherin, alpha-, beta-catenins and histological differentiation and between the expressions of E-cadherin, alpha-, gamma-catenins and location or depth of invasion. Moreover, the expression of alpha-, gamma-catenins in the main mass of tumor was not associated with lymph node metastasis. However, we found a relationship between the expression of beta-catenin in the main mass of tumor and lymph node metastasis and tumor location. The depth of invasion was correlated with positive expression of beta-catenin in the main mass of gastric cancer. A statistically significant association was observed between the expressions of E-cadherin and beta-catenin in the main mass of tumor and lymph node involvement. The expression of alpha-catenin in the main mass of tumor was also associated with histological differentiation and Laurens classification. Statistical analysis showed an association between the expression of E-cadherin and postoperative survival time. No significant correlation was found between the expression of alpha-, beta-, gamma-catenins and survival time. Our results may suggest that the E-cadherin-catenin complex is the factor indicative of metastasis and disease progression in gastric cancer. Also the expression of E-cadherin may play a role as a prognostic factor.

Smoking and drinking habits are important predictors of Helicobacter pylori eradication.

PURPOSE The aim of the study was to evaluate the effect of smoking and drinking habits, in separate and joint analyses, on the efficacy of H. pylori eradication. MATERIALS AND METHODS A total of 250 patients were recruited. They were treated with a 7-day course of omeprazole, amoxicillin, tinidazole (OAT), omeprazole amoxicillin, clarithromycin (OAC) or omeprazole, clarithromycin, tinidazole (OCT). The efficacy of H. pylori eradication was tested with a CLO-test and histology 4 weeks after the completion of antibacterial therapy. RESULTS Drinking was found not to affect the efficacy of H. pylori eradication in any therapeutic group, while smoking decreased it in the OAC group (smokers 69.6%, non-smokers 94.3%, p=0.006). In the OAT treated group H. pylori eradication rate was lower in smokers-non-drinkers than in smokers-drinkers and non-smokers-non-drinkers (38.9% vs 83.2% and 70.0%, p=0.002 and p=0.034, respectively), while in the OAC treated group, smokers-non-drinkers had lower eradication efficacy than non-smokers-drinkers and non-smokers-non-drinkers (59.1% vs 100% and 91.3%, p=0.01 and p=0.012, respectively). In the OCT treated group, differences between subgroups were not significant. CONCLUSIONS Smoking and drinking habits when analyzed jointly are more useful to predict the outcome of H. pylori eradication than when analyzed separately.

Oral Health Status and Oral Hygiene Practices of Patients with Peptic Ulcer and How These Affect Helicobacter pylori Eradication from the Stomach

Background:  Helicobacter pylori eradication from the oral cavity is more difficult than from the stomach. Thus, if the bacterium survives the antibacterial therapy in the oral cavity, it would be able to re‐infect the stomach within a few weeks. Since oral health status could correspond to oral infection with H. pylori, the aim of the study was to determine whether oral health and oral hygiene practices affect the efficacy of H. pylori eradication from the stomach.

Expressions of Matrix Metalloproteinases 2, 7, and 9 in Carcinogenesis of Pancreatic Ductal Adenocarcinoma

Pancreatic ductal adenocarcinoma (PDAC) is a highly fatal disease, usually diagnosed in an advanced stage which gives a slight chance of recovery. Matrix metalloproteinases (MMPs) are a family of zinc-dependent endopeptidases that participate in tissue remodeling and stimulate neovascularization and inflammatory response. The aim of the study was to evaluate the expression of MMP-2, MMP-7, and MMP-9 in normal ducts, tumor pancreatic adenocarcinoma cells, and peritumoral stroma in correlation with clinicohistopathological parameters. The study material was obtained from 29 patients with pancreatic ductal adenocarcinoma. The expressions of MMP-2, MMP-7, and MMP-9 were performed by immunohistochemical technique. Microvessel density (MVD) was visualized by special immunostaining. The expressions of MMP-2, MMP-7, and MMP-9 were mainly observed in tumor cells and peritumoral stroma. MMP-2 expression in cancer cells was correlated with female gender, stronger inflammation, and histopathological type of cancer (R = 0.460, p = 0.013; R = 0.690, p = 0.0001; R = −0.440, p = 0.005, resp.). The expression of MMP-7 in tumor cells was found to positively correlate with the presence of necrosis and negatively correlate with MVD (R = 0.402, p = 0.031; R = −0.682, p = 0.000). We also showed that positive MMP-9 expression in tumor cells was associated with MVD (R = 0.368, p = 0.084); however, it was not statistically significant. Our results demonstrate that MMP-2, MMP-7, and MMP-9 expressions correlate with various morphological features of the PDAC tumor such as inflammation, necrosis, and formation of the new blood vessels.

Fas/FasL expression in colorectal cancer. An immunohistochemical study.

The objective of the current study was to assess the expression of Fas ligand (FasL) and Fas receptor (FasR) as the proteins of the post-mitochondrial apoptotic pathway in colorectal carcinoma and to investigate correlations between their expression and chosen clinico-pathological parameters. The protein expression was analyzed in 50 colorectal carcinoma patients, using the immunohistochemical method. Reaction for FasR was weak in 75.5% and strong in 24.5% of the study patients, as compared to normal glandular epithelium where FasR expression was strong in 100% of cases. On the other hand, FasL expression was found to be weak in 30% and strong in 70% of colorectal cancer patients, as compared to its lack in 100% of normal colorectal epithelium. Statistical analysis showed strong expression of FasL was found to correlate statistically significantly with vascular invasion (p = 0.005). No correlations of FasL and FasR expression in the main mass of tumor was found between other clinic-pathological parameters. Fas ligand and Fas receptor appeared to be of little usefulness as prognostic factors for different groups of colorectal carcinoma patients. However, these proteins could become good therapeutic targets for colorectal carcinoma since their expression differs distinctly between normal intestinal epithelium and cancer cells, and known is the mechanism by which cancer cells escape death via apoptosis-inducing Fas/FasL pathway disorders.

Application of immunoassay for detection of Helicobacter pylori antigens in the dental plaque.

PURPOSE The aim of this study was to determine the viability of the commercial test currently used for detection of H. pylori antigens in the stool for detection of H. pylori antigens in dental plaque. MATERIALS AND METHODS A total of 164 dyspeptic patients entered the study; 95 H. pylori infected (positive result of at least 4 of 5 diagnostic tests: Campylobacter-like organisms test (CLO test), histology, culture, stool antigens, serology) and 69 noninfected (negative results of 4 diagnostic tests: CLO test, histology, culture, stool antigens). Dental plaque was collected from natural teeth of the patients and incubated in microaerophilic conditions for 72 hours before immunoassay. RESULTS Experimental findings included that optimal dental plaque weight to perform the examination was over 2 mg and that preliminary incubation increased significantly the number of positive results (p<0.002). It was also found that H. pylori antigens in the dental plaque were positive in 81.2% of infected and only 17.7% of non-infected subjects (p<0.001), while the reproducibility of results was 95%. CONCLUSIONS The immunoassay for detection of H. pylori antigens in the stool may be used, after minor adaptations (specifically pre-incubation in microaerophilic conditions) for H. pylori antigen detection in dental plaque.

Bax protein may influence the invasion of colorectal cancer

AIM To evaluate the expression of Bcl-xL, Bak, and Bax proteins in correlation with particular clinico-histopathological parameters, including tumor invasion front, in patients with colorectal cancer. METHODS The expression of these proteins was evaluated with the use of the immunohistochemical method in 50 primary tumors. RESULTS According to observations, a low expression of Bax and Bak proteins is related to the localization of the tumor in the rectum (P < 0.05 and P < 0.05 respectively), which may explain an increased incidence of colorectal cancer in this area. A positive expression of Bax protein also correlates with the presence of cancer cell infiltration to lymph and blood vessels (P < 0.05), which may suggest the participation of this protein in the early stages of colorectal cancer progression. Moreover, a positive expression of Bcl-xL protein correlated with a positive expression of Bak protein. This may suggest a greater participation of Bcl-xL protein in the inhibition of the proapoptotic Bak protein, but not the Bax protein. CONCLUSION Bax protein is probably very significant in the cancerogenesis mechanism in the large intestine.