权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Risk factors for gastric disease in pediatric H. pylori

儿童幽门螺杆菌胃病的危险因素

基本信息

批准号：
7067999
负责人：
BENJAMIN David GOLD
金额：
$ 39.79万
依托单位：
EMORY UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
1997
资助国家：
美国
起止时间：
1997-09-30 至 2009-05-31
项目状态：
已结题

项目摘要

DESCRIPTION (provided by applicant): Helicobacter pylori (Hp) is a major cause of chronic-active gastritis, primary duodenal ulcers and strongly linked to gastric cancer. Most Hp infections worldwide are acquired in childhood. Why some individuals develop symptomatic disease is unclear and, until recently, no studies critically evaluated the role of pediatric Hp strains and/or host factors in disease outcomes. Over the past 5 years of NIH funding, 486 children from Atlanta, Cleveland, and Miami were enrolled; 184 (38%) were Hp-infected. Race (African American) and younger age, in conjunction with Hp strains expressing cagA and vacAs1 B, were shown to be risk factors for both esophageal and gastric disease; suggesting a different disease paradigm from Hp-infected adults. Using the Updated Sydney system, we demonstrated a histopathologic spectrum in children, which included novel observations of atrophic gastritis with intestinal metaplasia. Overall hypothesis for competitive renewal: disease manifestations in Hp-infected children are influenced by specific host factors (i.e., race, immune phenotype), environmental exposures, and specific virulence factors of infecting Hp strains. Specific aims: 1) Using well defined cases and controls, further characterize specific host factors and environmental exposures contributing to symptomatic childhood infection emphasizing targeted enrollment in specific age, gender and demographic strata to facilitate detection of significant differences not attained previously and follow up of 2 established specific cohorts to ascertain immune response natural history. 2) Utilize gene-array technology for whole Hp genome assessment and bacterial gene expression of specific virulence determinants associated with pediatric Hp strains. 3) Further, characterize the host immunologic and mucosal response in Hp infected children. Hp-infected symptomatic endoscopy cases at our established three clinical centers of high, moderate and low tip prevalence will be compared with age-matched Hp-infected asymptomatic and uninfected symptomatic controls. Two geographically and demographically distinct centers have been added to provide additional geographic and subject representativeness to the patient cohort. The Updated Sydney system will be employed to assess gastric histopathology severity and phenotype in newly enrolled cases in specific age, gender and demographic strata and follow-up of the two "novel" cohorts established in the past 5 years; a) atrophic gastritis; b) esophageal and gastric disease group enabling a comprehensive, multivariate evaluation of the natural history of Hp-infected children in two distinct disease paradigms. Using molecular methods (multiplex [MP]-PCR, RT-PCR) and a micro ELISPOT assay on peripheral blood mononuclear cells (PBMCS), Th1, Th2, Th3 or balanced Th1/Th2 response will be determined to further characterize the Hp-infected child's immune response phenotype. We propose to further our previous work with critically lacking studies from a multivariate approach leading to a better understanding of the gastroduodenal disease sequelae and overall pathobiology of Hp infection in humans.

描述（由申请人提供）：幽门螺杆菌（Hp）是慢性活动性胃炎、原发性十二指肠溃疡的主要原因，与胃癌密切相关。全世界大多数Hp感染是在儿童时期获得的。为什么有些人发展为症状性疾病尚不清楚，直到最近，没有研究严格评估小儿Hp菌株和/或宿主因素在疾病结局中的作用。在过去5年的NIH资助中，来自亚特兰大、克利夫兰和迈阿密的486名儿童入组; 184名（38%）为Hp感染者。种族（非裔美国人）和年轻的年龄，结合Hp菌株表达cagA和vacAs 1 B，被证明是食管和胃疾病的危险因素，这表明一个不同的疾病模式从Hp感染的成年人。使用更新的悉尼系统，我们证明了一个组织病理学谱的儿童，其中包括新的观察萎缩性胃炎伴肠上皮化生。竞争性更新的总体假设：Hp感染儿童的疾病表现受特定宿主因素的影响（即，种族，免疫表型），环境暴露和感染Hp菌株的特定毒力因子。具体目标：1）使用明确定义的病例和对照，进一步表征有助于症状性儿童感染的特定宿主因素和环境暴露，强调在特定年龄、性别和人口统计学分层中的目标招募，以促进检测先前未达到的显著差异，并随访2个已建立的特定群组，以确定免疫应答自然史。 2)利用基因阵列技术进行全Hp基因组评估和与小儿Hp菌株相关的特定毒力决定因子的细菌基因表达。 3)进一步研究Hp感染儿童的免疫和粘膜反应。在我们建立的高、中、低尖端患病率的三个临床中心，将Hp感染的有症状内镜检查病例与年龄匹配的Hp感染的无症状和未感染的有症状对照进行比较。增加了两个地理和人口统计学上不同的中心，以提供患者队列的额外地理和受试者代表性。将采用更新的Sydney系统评估特定年龄、性别和人口统计学分层的新入组病例的胃组织病理学严重程度和表型，并对过去5年建立的两个“新”队列进行随访; a）萎缩性胃炎; B）食管和胃部疾病组，从而能够对两种不同疾病模式中的Hp感染儿童的自然史进行全面、多变量评价。采用分子生物学方法（多重[MP]-PCR、RT-PCR）和外周血单个核细胞（PBMCS）的微量ELISPOT测定，确定Th 1、Th 2、Th 3或平衡的Th 1/Th 2应答，以进一步表征Hp感染儿童的免疫应答表型。我们建议进一步我们以前的工作，严重缺乏的研究，从多变量的方法，导致更好地了解胃十二指肠疾病的后遗症和整体的人类幽门螺杆菌感染的病理生物学。

项目成果

期刊论文数量（19）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Knowledge, attitudes, and practice styles of North American pediatric gastroenterologists: Helicobacter pylori infection.

北美儿科胃肠病学家的知识、态度和实践风格：幽门螺杆菌感染。

DOI：
10.1097/00005176-200302000-00015
发表时间：
2003
期刊：
Journal of pediatric gastroenterology and nutrition
影响因子：
2.9
作者：
Chang,HowardY;Sharma,VirenderK;Howden,ColinW;Gold,BenjaminD
通讯作者：
Gold,BenjaminD

The incidence of Helicobacter pylori acquisition in children of a Canadian First Nations community and the potential for parent-to-child transmission.

加拿大原住民社区儿童感染幽门螺杆菌的发生率以及亲子传播的可能性。

DOI：
10.1111/j.1083-4389.2004.00199.x
发表时间：
2004
期刊：
Helicobacter
影响因子：
4.4
作者：
Sinha,SamirK;Martin,Bruce;Gold,BenjaminD;Song,Qunsheng;Sargent,Michael;Bernstein,CharlesN
通讯作者：
Bernstein,CharlesN

Seroprevalence of Helicobacter pylori infection in cystic fibrosis and its cross-reactivity with anti-pseudomonas antibodies.

囊性纤维化中幽门螺杆菌感染的血清阳性率及其与抗假单胞菌抗体的交叉反应性。