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TOGAS Study: Carrying out a preventive gastroscopy together with a colonoscopy”

ABSTRACT: Interventions: Group 1: The additional examination (gastroscopy) takes place on the same day as the colonoscopy. In addition to pure endoscopy with image documentation, both tissue samples from the stomach and blood samples are taken. These are not experimental procedures, but rather routine examinations carried out daily. During the OGD, the endoscopist will carefully inspect the upper GI tract using White Light endoscopy and virtual chromo endoscopy to establish an endoscopic diagnosis. Standardised images will be obtained and stored. For tissue diagnostics, at least two biopsies form the antrum and two from the gastric body will be obtained for histology assessment in concordance with the modified Sydney Classification. One additional biopsy can be taken from the incisura (placed in a separate vial) to facilitate stratification according to the OLGA and OLGIM staging system of gastritis which is directly linked to gastric cancer risk. Additional biopsies from both antrum and body will be taken for H. pylori diagnostics. Following local protocols, this may include rapid urease testing (RUT), PCR or culture. Additional biopsies will be taken from any visible lesion or area with irregular mucosal surface pattern in endoscopy, suspicious of neoplasia. On the day of the procedure, a serum sample will be obtained to analyse H. pylori serology and serum levels of Pepsinogen I and II with the latter serving as surrogate parameters for gastric glandular atrophy. Primary outcome(s): Presence of gastric cancer or gastric precancerous conditions and lesions that require endoscopic surveillance or treatment. Study Design: Allocation: ; Masking: ; Control: ; Assignment: ; Study design purpose: prevention

DISEASE(S): Polyp Of Colon,Overlapping Lesion Of Digestive System,Malignant Neoplasm Of Colon

PROVIDER: 110392 | ecrin-mdr-crc |

REPOSITORIES: ECRIN MDR

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Project description:We used the rhesus macaque model to study the effects of the cag pathogenicity island (cag PAI) on the H. pylori host-pathogen interaction. Specific pathogen free (SPF) monkeys with no prior exposure to H. pylori were experimentally challenged with wild type (WT) H. pylori strain J166 (N=4) or its cag PAI isogenic knockout (KO, N=4). Animals underwent endoscopy before and 1, 4, 8, and 13 wks after challenge. Gastric biopsies were collected for quantitative culture, histopathology, and host gene expression. Quantitative cultures showed that all experimentally challenged animals were infected with WT H. pylori or its isogenic cag PAI KO. Histopathology demonstrated that inflammation and expansion of the lamina propria were attenuated in animals infected with KO compared to WT. Microarray analysis was performed on challenged animals before and 1 and 13 wks after challenge, and on unchallenged control animals (N=4). Of the 119 up-regulated genes in the WT-infected animals, several encode innate antimicrobial; effector proteins, including elafin, siderocalin, DMBT, DUOX2, and several novel paralogues of human defensin-2. Quantitative RT-PCR analysis showed that high level induction of each of these genes was dependent upon the presence of the cag PAI. Immunohistochemistry confirmed increased defensin epithelial cell staining in animals challenged with WT H. pylori compared to either KO-challenged or uninfected control animals. We propose that one function of the cag PAI is to induce an antimicrobial host response that serves to increase the competitive advantage of H. pylori in the gastric niche. Experiment Overall Design: Twelve male and female rhesus macaques (Macaca mulatta) housed at the California National Primate Research Center (CNPRC) were hand raised by nursery staff to obtain Specific Pathogen (Helicobacter pylori) Free (SPF) experimental animals. At six months of age the animals were documented to be uninfected with H. pylori by serology, histology, and cultures of gastric biopsies using methods reported previously (Solnick et al., 1999). Two experimental groups of four SPF animals were challenged with either wild type (WT) H. pylori J166 or an isogenic PAI knockout (KO). A third group of four SPF animals served as uninoculated controls. Monkeys were housed indoors in separate cages throughout the duration of the experiment. All experiments were approved by the Research Advisory Committee of the CNPRC and the Institutional Animal Care and Use Committee at the University of California.Antrum and corpus stomach biopsies from rhesus macaques infected with wild type Helicobacter pylori J166, isogenic cag-PAI knockout strain, or mock infected were pooled. Biopsies were taken prior to bacterial inoculation and at 1 and 13 weeks post infection. Control biopsies were taken according to the same time line. Four animals were used for each experimental condition.

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TOGAS Study: Carrying out a preventive gastroscopy together with a colonoscopy”

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