A severe burn leads to hypermetabolism and catabolism resulting in compromised function and structure of essential organs. The massive release of cytokines is implicated in this hypermetabolic response. The aim of the present study was to compare cytokine expression profiles from severely burned children without signs of infections or inhalation injury (n = 19) to the cytokine profiles from normal, noninfected, nonburned children (n = 14). The Bio-Plex suspension array system was used to measure the concentration of 17 cytokines. The expression of proinflammatory and anti-inflammatory cytokines was maximal during the first week after thermal injury. Significant increases were measured for 15 mediators during the first week after thermal injury: interleukin (IL) 1beta, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-10, IL-12 p70, IL-13, IL-17, interferon gamma, monocyte chemoattractant protein 1, macrophage inflammatory protein 1beta, and granulocyte colony-stimulating factor (P < 0.05). Granulocyte-macrophage colony-stimulating factor was significantly increased during the second week after burn (P < 0.05). Within 5 weeks, the serum concentrations of most cytokines decreased, approaching normal levels. When compared with the cytokine levels measured in normal children, a total of 16 cytokines were significantly altered (P < 0.05). After severe burn, a specific cytokine expression profile is observed in patients without complications such as inhalation injury or sepsis. The cytokine concentrations decrease during 5 weeks after burn but remain elevated over nonburned values. Furthermore, the elevation in most serum cytokine levels during the first week after burn may indicate a potential window of opportunity for therapeutic intervention.

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BackgroundHelicobacter pylori infection is one of the most common infections worldwide and is associated with gastric cancer and peptic ulcer. Bacterial virulence factors such as CagA have been shown to increase the risk of both diseases. Studies have suggested a causal role for CagA EPIYA polymorphisms in gastric carcinogenesis, and it has been shown to be geographically diverse. We studied associations between H. pylori CagA EPIYA patterns and gastric cancer and duodenal ulcer, in an ethnically admixed Western population from Brazil. CagA EPIYA was determined by PCR and confirmed by sequencing. A total of 436 patients were included, being 188 with gastric cancer, 112 with duodenal ulcer and 136 with gastritis.ResultsThe number of EPIYA C segments was significantly associated with the increased risk of gastric carcinoma (OR = 3.08, 95% CI = 1.74 to 5.45, p < 10-3) even after adjustment for age and gender. Higher number of EPIYA C segments was also associated with gastric atrophy (p = 0.04) and intestinal metaplasia (p = 0.007). Furthermore, patients infected by cagA strains possessing more than one EPIYA C segment showed decreased serum levels of pepsinogen I in comparison with those infected by strains containing one or less EPIYA C repeat. Otherwise, the number of EPIYA C segments did not associate with duodenal ulcer.ConclusionsOur results demonstrate that infection with H. pylori strains harbouring more than one CagA EPIYA C motif was clearly associated with gastric cancer, but not with duodenal ulcer.Higher number of EPIYA C segments was also associated with gastric precancerous lesions as demonstrated by histological gastric atrophic and metaplastic changes and decreased serum levels of pepsinogen I.

ObjectiveIron deficiency (ID) and iron deficiency anaemia (IDA) are global major public health problems, particularly in developing countries. Whilst an association between H. pylori infection and ID/IDA has been proposed in the literature, currently there is no consensus. We studied the effects of H. pylori infection on ID/IDA in a cohort of children undergoing upper gastrointestinal endoscopy for upper abdominal pain in two developing and one developed country.MethodsIn total 311 children (mean age 10.7±3.2 years) from Latin America - Belo Horizonte/Brazil (n = 125), Santiago/Chile (n = 105) - and London/UK (n = 81), were studied. Gastric and duodenal biopsies were obtained for evaluation of histology and H. pylori status and blood samples for parameters of ID/IDA.ResultsThe prevalence of H. pylori infection was 27.7% being significantly higher (p<0.001) in Latin America (35%) than in UK (7%). Multiple linear regression models revealed H. pylori infection as a significant predictor of low ferritin and haemoglobin concentrations in children from Latin-America. A negative correlation was observed between MCV (r = −0.26; p = 0.01) and MCH (r = −0.27; p = 0.01) values and the degree of antral chronic inflammation, and between MCH and the degree of corpus chronic (r = −0.29, p = 0.008) and active (r = −0.27, p = 0.002) inflammation.ConclusionsThis study demonstrates that H. pylori infection in children influences the serum ferritin and haemoglobin concentrations, markers of early depletion of iron stores and anaemia respectively.

SummaryWe evaluated the role of the family in the transmission of Helicobacter pylori infection in preschool-aged children from a rural district in the State of Minas Gerais, Brazil. Sixty-six families (66 index children, 63 mothers, 60 fathers and 134 siblings), defined as at least one parent living in the same household with at least one offspring up to 8 years old, were studied. Odds ratios (OR) and 95% confidence intervals (CI) were estimated by logistic regression controlling for age, gender, number of children in household and H. pylori status of the father, mother and siblings. The prevalence of the infection was 69.7% (469 of 673) and it increased with age (P < 0.001). Positive mothers were a strong and independent risk factor for infection (OR 22.70;). Positive siblings were also positively associated with infection (OR 1.81; 95% CI 1.01-3.30).

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The babA2 and cagA genes were investigated in 208 Brazilian Helicobacter pylori strains. A strong association between babA2 and duodenal ulcer or gastric carcinoma was observed, even after adjusting for confounding factors, such as age, gender, and cagA status. cagA-positive strains were also independently associated with H. pylori-related diseases.Helicobacter pylori infection is one of the most common chronic bacterial infections worldwide. Although most infected persons remain asymptomatic, 15 to 20% of H. pylori-positive individuals will develop a peptic ulcer, gastric carcinoma, or mucosa-associated lymphoid tissue lymphoma (19). However, it remains unclear why only a minority of infected patients develop the severe associated diseases. This phenomenon may be due to differences in host genetics, environmental factors, and the virulence of bacterial strains.There is now evidence for the existence of different strains of H. pylori with different degrees of virulence (2,3,18). The cytotoxin-associated gene cagA was the first gene found to be differentially present in H. pylori isolates and is considered a marker for the presence of the cag pathogenicity island (4). In addition to other putative virulence properties encoded by the cag pathogenicity island, several genes of the island encode proteins, such as interleukin-8, that enhance the gastric inflammatory response to the infection.A cagA-positive status has been associated with severe clinical outcomes in some Western countries (3,14,18). Conversely, since the majority of H. pylori-infected individuals in Asian countries harbor cagA-positive strains, associations of cagA status and diseases are not observed in Asia (11,20). The recently described blood group antigen-binding adhesin BabA has been shown to mediate adherence of H. pylori to Lewis b (␣-1,3/4-difucosylated) receptors on gastric epithelium (8). Although three bab alleles have been identified (babA1, babA2, and babB), only the babA2 gene product is necessary for Lewis b binding activity (8,16). Studies in Western countries have demonstrated associations between babA2-positive status and duodenal ulcer as well as gastric carcinoma (7). However, in Asian countries, most of the circulating H. pylori strains are babA2 positive, whether or not they were isolated from asymptomatic or diseased patients (9,10,12,20). In addition to these differences between Western and Eastern countries, the prevalence of babA2-positive H. pylori strains also seems to vary among the Western populations, being much lower in patients from Portugal (13) than in those from Germany, the United States, or Colombia (7, 20). Since there are few studies on this subject, specifically evaluating patients with gastric carcinoma, the frequency of babA2 H. pylori strains may vary around the world and because the clinical relevance of babA2-positive strains has not been determined in Brazil, we investigated associations between babA2 and cagA genotypes and different H. pylori infection outcomes, adjusting for confounding factors.H Two ...