Atsushi Takagi

Prevention of Helicobacter pylori infection by lactobacilli in a gnotobiotic murine model.

BACKGROUND: Helicobacter pylori is a bacterium which causes gastric inflammatory diseases. Oral inoculation of H pylori usually results in only a temporary colonisation without a successful infection in the stomach of conventional mice in which lactobacilli are the predominant indigenous bacteria. AIM: To determine whether lactobacilli exert an inhibitory effect on colonisation by H pylori in the stomach. METHODS: The effects of H pylori on attachment to murine and human gastric epithelial cells and the H pylori mediated release of interleukin-8 (IL-8) by these cells were examined in vitro. Lactobacillus salivarius infected gnotobiotic BALB/c mice and control germ free mice were inoculated orally with H pylori to examine whether L salivarius can inhibit colonisation by H pylori. RESULTS: L salivarius inhibited both the attachment and IL-8 release in vitro. H pylori could not colonise the stomach of L salivarius infected gnotobiotic BALB/c mice, but colonised in large numbers and subsequently caused active gastritis in germ free mice. In addition, L salivarius given after H pylori implantation could eliminate colonisation by H pylori. CONCLUSION: These findings suggest the possibility of lactobacilli being used as probiotic agents against H pylori.

Effect of Helicobacter pylori eradication in patients with chronic idiopathic thrombocytopenic purpura : A randomized controlled trial

OBJECTIVE:Eradication of Helicobacter pylori was reported to increase the platelet counts in some H. pylori-positive patients with chronic idiopathic thrombocytopenic purpura (cITP). However, the efficacy of the eradication was quite different according to the previous reports. To determine whether H. pylori infection can contribute to cITP, we performed a randomized controlled trial for the first time. In addition, to investigate the possible pathogenic mechanisms and to predict the platelet response after eradication of H. pylori in each cITP patient, several H. pylori virulence factors, the urease activities of the infected H. pylori strains, and the titers of anti-CagA IgG antibodies were analyzed.METHODS:Patients with cITP underwent gastroscopy and gastric H. pylori infection was confirmed by culture. H. pylori-positive cITP patients were randomly assigned to either the eradication or the non-eradication group. The eradication group received a standard antibiotic therapy for H. pylori. Response to treatment was defined as complete (CR) if the platelet count was above 150 × 103/μl and partial (PR) if the platelet count increased by more than 50 × 103/μl above the pretreatment count. The virulence factors were investigated by PCR and PCR-based direct sequencing. Anti-CagA IgG antibody titer of each patients serum was measured by ELISA.RESULTS:Of the 36 ITP patients, 25 (69.4%) were positive for H. pylori and eradication was achieved in 84.6% of these patients. The platelet response was significantly different between the eradication group (46.2%) and the non-eradication group (0%). No significant differences were found in clinical factors between the responders and the nonresponders. H. pylori virulence factors and the urease activity were not associated with the response. The titers of anti-CagA antibodies in the responders were significantly higher than those in the nonresponders (p= 0.04).CONCLUSIONS:H. pylori eradication treatment is a favorable therapeutic option for H. pylori-positive patients with cITP. Moreover, an ELISA titer of serum anti-CagA antibody may be a good predictor of platelet recovery, and immunological reaction between platelet and anti-CagA antibodies may have some relation to the pathogenesis of H. pylori-positive patients with cITP.

Recurrent Peptic Ulcers in Patients Following Successful Helicobacter pylori Eradication: A Multicenter Study of 4940 Patients

Objective.u2002 Although curative treatment of Helicobacter pylori infection markedly reduces the relapse of peptic ulcers, the details of the ulcers that do recur is not well characterized. The aim of this study is to describe the recurrence rate and specific features of peptic ulcers after cure of H. pylori infection.

The suppressive effect of bifidobacteria on Bacteroides vulgatus, a putative pathogenic microbe in inflammatory bowel disease

Bacteroides, a predominant commensal bacteria in the gut, are thought to be responsible for the development of inflammatory bowel disease (IBD). In the present study, we examined whether or not bifidobacteria suppress B. vulgatus, a representative pathogenic Bacteroides species, in both the coculture system and the gnotobiotic murine model. As a result, Bifidobacterium infantis 1222 highly inhibited the growth of B. vulgatus in the coculture and also significantly suppressed the systemic antibody response raised by B. vulgatus colonizing the gut in gnotobiotic mice. Colonization of the mice by B. vulgatus increased the number of Peyers patch (PP) cells bearing PNA (peanut agglutinin)+/anti‐κ+ phenotype, which represents plasma cell‐like B cells. Moreover, treatment of those B. vulgatus‐implanted mice with B. infantis 1222 abrogated such increase in the number of PNA+/anti‐κ+ cells. These results thus suggested that B. infantis 1222 protected the gut epithelial layer including the PP from being invaded by Bacteroides, thereby suppressing the systemic antibody response raised by Bacteroides.

Lactobacillus gasseri OLL2716 as a probiotic in clarithromycin-resistant Helicobacter pylori infection

Backgrounds and Aim:u2002 Clarithromycin (CAM)‐resistant Helicobacter pylori sometimes offers serious problems with eradication by antibiotics. The aim of this study was to determine whether a probiotic can be an alternative therapy in CAM‐resistant Hp infection.

Comparison of endoscopic findings with symptom assessment systems (FSSG and QUEST) for gastroesophageal reflux disease in Japanese centres

Background and Aim:u2002 We compared endoscopic findings of the frequency scale for the symptoms of gastroesophageal reflux disease (FSSG), a written questionnaire developed in Japan, to that for the questionnaire for the diagnosis of reflux esophagitis (QUEST) for the diagnosis of reflux esophagitis.

Influence of proton-pump inhibitors on the luminal microbiota in the gastrointestinal tract

Objectives:The objective of this study was to investigate comparatively the influence of proton-pump inhibitors (PPI) administration on three bacterial communities in the oral cavity, stomach, and colon along the alimentary tract.Methods:Forty-five subjects including 18 patients taking PPI were enrolled. Stimulated saliva, gastric fluid (GF), and feces were obtained from each subject for the microbiota analysis through bacterial 16S rRNA gene profiling using the pyrosequencing method.Results:The species richness (alpha diversity) was similar among these three microbiota, whereas the interindividual diversity (beta diversity) was much higher in the fecal microbiota compared with that in the others. The UniFrac analysis indicated that the salivary and GF microbiota were similar to one another; however, both differed greatly from the fecal microbiota in the overall bacterial community structure. In the comparison between PPI-users and PPI-nonusers, a bacterial cell number increase of ~1,000 times was found in the GF of PPI-users using culturing methods, whereas the bacterial number and composition were nearly identical between the two groups using quantitative PCR and a similarity search based on 16S profiling. The beta diversity significantly increased in both the salivary and GF microbiota of PPI-users compared with PPI-nonusers.Conclusions:These results suggest that the GF microbiota has recently moved from the saliva. Bacterial overgrowth in the GF by PPI administration may be due to a lack of killing rather than proliferation of the bacteria in the acid-suppressed stomach. The biological significance of the increase in beta diversity by PPI administration remains unclear.

Bacteroides ovatus as the Predominant Commensal Intestinal Microbe Causing a Systemic Antibody Response in Inflammatory Bowel Disease

ABSTRACT To clarify what bacterial species of commensal intestinal microbes are recognized as the antigens that induce a serum antibody response in patients with inflammatory bowel disease (IBD), 72 subjects consisting of 12 Crohn’s disease patients, 30 ulcerative colitis patients, and 30 healthy volunteers were examined for their titers of serum antibody to these intestinal bacteria. In IBD patients, as a result, significant elevations of both the immunoglobulin G (IgG) and IgA titers to Bacteroides ovatus were found. Immunoblotting showed that a definite 19.5-kDa band of B. ovatus was bound to the serum antibody raised in IBD patients. It was thus concluded that B. ovatus causes serum antibody responses in IBD patients, and a 19.5-kDa molecule of this bacterium appears to be the responsible antigen, although the role of this event in pathogenesis remains unclear.

Effect of pretreatment with Lactobacillus gasseri OLL2716 on first-line Helicobacter pylori eradication therapy.

Background and Aim:u2002 Helicobacter pylori eradication clearly decreases peptic ulcer recurrence rates. H.u2003pylori eradication is achieved in 70–90% of cases, but treatment failures due to poor patient compliance and resistant organisms do occur. Lactobacillus gasseri can suppress both clarithromycin‐susceptible and ‐resistant strains of H.u2003pylori in vitro. The aim of this study was to determine the effect of pretreatment with L.u2003gasseri‐ containing yogurt on H.u2003pylori eradication. We conducted a randomized, controlled clinical trial in patients with H.u2003pylori infection.

Establishment and characterisation of a monoclonal antibody to inhibit adhesion of Helicobacter pylori to gastric epithelial cells

Monoclonal antibodies (MAbs) that inhibit adhesion of Helicobacter pylori to human gastric cancer (MKN45) cells were established to clarify the mechanism of adhesion of H. pylori. Of 53 hybridoma clones screened by the primary inhibition assay for adhesion, MAb A20 of IgM class was selected on the basis of both its reactivity to whole cells of H. pylori by ELISA and its inhibitory effect on adhesion of H. pylori. The adhesion of H. pylori strain TK1029 to MKN45 cells was inhibited by MAb A20, depending on the concentration of the MAb. The MAb recognised the surface antigen, lipopolysaccharide (LPS) of H. pylori, suggesting that LPS is associated with adhesion of H. pylori to human gastric epithelial cells.