Significant decrease in prevalence ofHelicobacter pylori in the Czech Republic

AIM:To study possible decrease in prevalence of Helicobacter pylori(H.pylori) infection in the Czech Republic within a 10-year period.METHODS:A total of 22 centres entered the study.The catchment areas of these centres covered cities and towns with more than 20 000 inhabitants,smaller towns(≤ 20 000 inhabitants) with surrounding villages and rural areas,and were spread over the whole country,corresponding well to the geographical distribution of the Czech population.A total of 1 837 subjects(aged 5-98 years) took part in the study,randomly selected out of 38 147 people from the general population.H.pylori infection was investigated by means of a 13 C-urea breath test.Breath samples in duplicates were analysed using isotope ratio mass spectrometry.The cut-off point was 3.5.Social and demographic characteristics were based on data from self-completed questionnaires.RESULTS:The overall prevalence of H.pylori infection was 23.5%(430/1826),and 4.8%(20/420) in children aged 15 or less.There was no statistically significant difference in prevalence between males(24.3%;208/857) and females(22.9%,222/969,P = 0.494).H.pylori infection was strongly associated with higher age,among subjects aged 55+ years,prevalence of H.pylori infection was 39.8%(252/633,P < 0.001).The highest prevalence of H.pylori infection was found among persons aged 55-64 years(43.9%,97/221) and 75+ years(37.9%,58/153).Among study subjects aged 15+ years,prevalence of H.pylori infection was significantly increased in those with lowest education(odds risk 3.19,95% CI 1.87-5.47).Compared to never married(14.1%),the prevalence of H.pylori infection was statistically significantly higher among married(35.4%,246/694,P < 0.001),divorced(36.8%,49/133,P < 0.001) and widowed study subjects(40.2%,45/112,P < 0.001),both in minimally and fully adjusted analysis.There was no significant difference in the prevalence of H.pylori infection between married and widowed subjects(35.4%,246/694 vs 40.2%,45/112,P = 0.389).There was little variation in smoking prevalence across categories of smoking and there was no evidence of an increased risk ofH.pylori infection among current or past smokers in our data(odds risk 1.04 with 95% CI 0.78-1.40 for current smokers;odds ratio 0.83 with 95% CI 0.60-1.16 for former smokers).The current prevalence of H.pylori in 2011 was significantly lower compared to the prevalence reported from identical geographical areas in 2001(23.5%vs 41.7%,P < 0.001).CONCLUSION:The overall prevalence of H.pylori infection in the general population has fallen substantially in the Czech Republic over the past 10 years.

Blood pressure and stature in Helicobacter pylori positive and negative persons

To evaluate vital signs and body indices in Helicobacter pylori(H.pylori)positive and negative persons.A total of 22 centres entered the study.They were spread over the whole country,corresponding well to the geographical distribution of the Czech population.A total of 1818 subjects(aged 5-98 years)took part in the study,randomly selected out of 38147 subjects.H.pylori infection was investigated by means of a 13Curea breath test.Data on height,weight,systolic and diastolic blood pressure and heart rate were collected at the clinics of general practitioners.The overall prevalence of H.pylori infection was 30.4%(402/1321)in adults(≥18 year-old)and 5.2%(26/497)in children and adolescents(≤17 year-old).Once adjusted for age and gender,only a difference in body mass index remained statistically significant with H.pylori positive adults showing an increase of 0.6 kg/m2 in body mass index.Once adjusted for age and gender,we found a difference in height between H.pylori positive and H.pylori negative children and adolescents.On further adjustment for place of residence,this difference became statistically significant,with H.pylori positive children and adolescents being on average 3.5 cm shorter.H.pylori positive adults were significantly older compared to H.pylori negative subjects.Once adjusted for age and gender,H.pylori infection had no impact on body weight,body mass index and vital signs either in adults or children and adolescents.Chronic H.pylori infection appeared to be associated with short stature in children.H.pylori infection did not influence blood pressure,body weight and body mass index either in adults or children and adolescents.

The Effect of Resveratrol on Bone Status in Rats with Bile Duct Obstruction

Objective: We studied the influence of bile duct obstruction (BDO) after 28 days on bone metabolism status and their modification by resveratrol in male Wistar rats. Methods: The rats were divided into 3 groups: Sham group with laparotomy and vehiculum application, group BDO—bile duct obstruction and vehiculum application, and group RBDO—bile duct obstruction and resveratrol application (10 mg/kg dose of resveratrol orally once daily). The bone mineral density (BMD;g/cm2) and body composition were measured by dual energy X-ray absorptiometry. The physiccal strenght of femur was examined by controlled break biomechanical testing. The osteocalcin, procollagen type I N-terminal propeptide (PINP) and carboxy-terminal collagen crosslinks (CTX) were analysed by EIA in the bone tissue homogenate. Results: The total BMD was lower in group BDO (0.176 ± 0.005;p = 0.01) and R-BDO (0.181 ± 0.004;p = 0.052) vs Sham (0.209 ± 0.003). BMD of femur diaphysis in BDO group decreased significantly (p = 0.01) but not in R-BDO animals (p = 0.052). Body fat (g, median) was lower in BDO (19.0) and R-BDO (26.0) than in Sham (35.0). The force needed for fracture of femurs (N) significantly decreased in BDO (154 ± 6) and R-BDO (151 ± 13) vs Sham group (208 ± 7). The force needed for neck fracture decreased in BDO (105 ± 3) and R-BDO (115 ± 8) vs Sham (135 ± 9). The osteocalcin decrease in group R-BDO (2.9 ± 0.1) vs Sham (3.7 ± 0.4). Higher PINP/CTX were in BDO (20 ± 5/0.49 ± 0.08) and R-BDO (30 ± 4/0.55 ± 0.07) vs Sham (16 ± 4/0.48 ± 0.11). Conclusions: Our findings suggest that subchronic bile duct obstruction decreased body fat quantity and BMD with decrease of bone rigidity. Resveratrol showed protective effect on liver injury and consequently positive influence on bone tissue.

Bacteriocinogeny in experimental pigs treated with indomethacin and Escherichia coli Nissle

AIM:To evaluate bacteriocinogeny in short-term highdose indomethacin administration with or without probiotic Escherichia coli Nissle 1917(EcN) in experimental pigs.METHODS:Twenty-four pigs entered the study:Group A(controls),Group B(probiotics alone),Group C(indomethacin alone) and Group D(probiotics and indomethacin).EcN(3.5 × 1010 bacteria/d for 14 d) and/or indomethacin(15 mg/kg per day for 10 d) were administrated orally.Anal smears before and smears from the small and large intestine were taken from all animals.Bacteriocin production was determined with 6 different indicator strains;all strains were polymerase chain reaction tested for the presence of 29 individual bacteriocinencoding determinants.RESULTS:The general microbiota profile was rather uniform in all animals but there was a broad diversity in coliform bacteria(parallel genotypes A,B1,B2 and D found).In total,637 bacterial strains were tested,mostly Escherichia coli(E.coli).There was a higher incidence of non-E.coli strains among samples taken from the jejunum and ileum compared to that of the colon and rectum indicating predominance of E.coli strains in the large intestine.Bacteriocinogeny was found in 24/77(31%) before and in 155/560(28%) isolated bacteria at the end of the study.Altogether,13 individual bacteriocin types(out of 29 tested) were identified among investigated strains.Incidence of four E.coli genotypes was equally distributed in all groups of E.coli strains,with majority of genotype A(ranging from 81% to 88%).The following types of bacteriocins were most commonly revealed:colicins Ia/Ib(44%),microcin V(18%),colicin E1(16%) and microcin H47(6%).There was a difference in bacteriocinogeny between control group A(52/149,35%) and groups with treatment at the end of the study:B:31/122(25%,P = 0.120);C:43/155(28%,P = 0.222);D:29/134(22%,P = 0.020).There was a significantly lower prevalence of colicin Ib,microcins H47 and V(probiotics group,P < 0.001),colicin E1 and microcin H47(indomethacin group,P < 0.001) and microcins H47 and V(probiotics and indomethacin group,P = 0.025) compared to controls.Escherichia fergusonii(E.fergusonii) was identified in 6 animals(6/11 isolates from the rectum).One strain was non-colicinogenic,while all other strains of E.fergusonii solely produced colicin E1.All animals started and remained methanogenic despite the fact that EcN is a substantial hydrogen producer.There was an increase in breath methane(after the treatment) in 5/6 pigs from the indomethacin group(C).CONCLUSION:EcN did not exert long-term liveability in the porcine intestine.All experimental pigs remained methanogenic.Indomethacin and EcN administered together might produce the worst impact on bacteriocinogeny.

Small intestinal bacterial overgrowth syndrome

Human intestinal microbiota create a complex polymi-crobial ecology. This is characterised by its high population density, wide diversity and complexity of interaction. Any dysbalance of this complex intestinal microbiome, both qualitative and quantitative, might have serious health consequence for a macro-organism, including small intestinal bacterial overgrowth syndrome (SIBO).SIBO is defined as an increase in the number and/or alteration in the type of bacteria in the upper gastro-intestinal tract. There are several endogenous defence mechanisms for preventing bacterial overgrowth: gastric acid secretion, intestinal motility, intact ileo-caecal valve, immunoglobulins within intestinal secretion and bacte-riostatic properties of pancreatic and biliary secretion. Aetiology of SIBO is usually complex, associated with disorders of protective antibacterial mechanisms (e.g. achlorhydria, pancreatic exocrine insuff iciency, immuno-deficiency syndromes), anatomical abnormalities (e.g. small intestinal obstruction, diverticula, f istulae, surgical blind loop, previous ileo-caecal resections) and/or motility disorders (e.g. scleroderma, autonomic neuropathy in diabetes mellitus, post-radiation enteropathy, small intestinal pseudo-obstruction). In some patients more than one factor may be involved. Symptoms related to SIBO are bloating, diarrhoea, malabsorption, weight loss and malnutrition. The gold standard for diagnosing SIBO is still microbial investigation of jejunal aspirates. Noninvasive hydrogen and methane breath tests are most commonly used for the diagnosis of SIBO using glucose or lactulose. Therapy for SIBO must be com-plex, addressing all causes, symptoms and complica-tions, and fully individualised. It should include treatment of the underlying disease, nutritional support and cyclical gastro-intestinal selective antibiotics. Prognosis is usually serious, determined mostly by the underlying disease that led to SIBO.

The 3’-untranslated region contributes to the pregnane X receptor(PXR) expression downregulation by PXR ligands and up-regulation by glucocorticoids

Pregnane X receptor(PXR)is the major regulator of xenobiotic metabolism.PXR itself is controlled by various signaling molecules including glucocorticoids.Moreover,negative feed-back regulation has been proposed at the transcriptional level.We examined the involvement of the 3’-untranslated region(3’-UTR)of NR1I2 mRNA and microRNAs in PXR-and glucocorticoid receptor(GR)-mediated regulation of NR1I2 gene expression.PXR ligands were found to significantly downregulate NR1I2 mRNA expression in a set of 14 human hepatocyte cultures.Similarly,PXR was downregulated by PCN in the C57/BL6 mice liver.In mechanistic studies with the full-length 3’-UTR cloned into luciferase reporter or expression vectors,we showed that the 3’-UTR reduces PXR expression.From the miRNAs tested,miR-18a-5p inhibited both NR 112 expression and CYP3A4 gene induction.Importantly,we observed significant upregulation of miR-18a-5p expression 6 h after treatment with the PXR ligand rifampicin,which indicates a putative mechanism underlying NR1I2 negative feed-back regulation in hepatic cells.Additionally,glucocorticoids upregulated NR1I2 expression not only through the promoter region but also via 3’-UTR regulation,which likely involves downregulation of miR-18a-5p.We conclude that miR-18a-5p is involved in the down-regulation of NR1I2expression by its ligands and in the upregulation of NR1I2 mRNA expression by glucocorticoids in hepatic cells.