Helicobacter pylori co-infection with Epstein-Barr virus and the risk of developing gastric adenocarcinoma at an early age: Observational study infectious agents and cancer

Abstract

Background Gastric cancer (GC) is one of the leading causes of morbidity and mortality worldwide. The onset and progression of gastric cancer are attributed to numerous triggers, these triggers may be infection of the gastric epithelium by Helicobacter pylori ( H. pylori ), or by Epstein-Barr virus (EBV). Both agents can establish a lifelong persistent infection in the host, leading to chronic inflammation, which also contributes to cancer development. Objective: The objective of this study is to present the status of co-infection with H. pylori and EBV and the risk of developing adenocarcinoma at an early age in the population of Grand Casablanca. Methods In this study, 100 gastric tissue samples from patients with gastric cancer were examined for detection of H. pylori and EBV in tumor tissue using PCR techniques, and the clinical relevance was statistically analyzed. Results Results revealed an individual Epstein-Barr virus (EBV) infection observed in (40 %) of gastric carcinoma cases. Furthermore, the frequency of EBV infection was significantly different with intestinal and diffuse gastric cancer types [15 % vs. 85 %; <0.05]. The prevalence of individual H. pylori infections was 34 %, while the frequency of co-infection was 16 %. Moreover, no significant association was found between co-infection and sex, tumor grade, stage, and lymph node metastasis, but there was a significant association between co-infection and the age of GC patients. Conclusion Thus understanding the status of co-infection could clarify the process of gastric carcinogenesis, and application of this knowledge for clinical purposes could facilitate diagnosis, risk management, and prevention.

Signaling pathways and therapeutic interventions in gastric cancer

“… 17 EBV infection can promote the hypermethylation of tumor suppressor genes, inflammation of gastric mucosa, and immune evasion of the host, resulting in gastric carcinogenesis. 18 As sustained infection with H. pylori and EBV can cause chronic inflammatory stress in the stomach, there is emerging attention to GC risk and co-infection by both pathogens, since H. pylori co-infection with EBV increases the occurrence of GC 19 , 20 and may stimulate aggressiveness of GC. 21 …”

Tumor Molecular and Microenvironment Characteristics in EBV-Associated Malignancies as Potential Therapeutic Targets: Focus on Gastric Cancer

“…One of these is the interaction between H. pylori and EBV in the TME, which synergizes malignant transformation. In fact, patients co-infected with EBV and H. pylori developed gastric cancer earlier in life than those without co-infection and were also noted to have more aggressive disease [ 59 ]. Some studies have hypothesized that the chronic inflammatory reaction in response to H. pylori recruits lymphocytes infected by EBV, enhancing the chances of their interaction with gastric epithelial cells [ 59 ].…”

Tumor Molecular and Microenvironment Characteristics in EBV-Associated Malignancies as Potential Therapeutic Targets: Focus on Gastric Cancer

“…One of these is the interaction between H pylori and EBV in the TME, which synergizes malignant transformation. In fact, patients co-infected with EBV and H pylori developed gastric cancer earlier in life than those without co-infection and were also noted to have more aggressive disease [49].…”

“…Some studies hypothesize that the chronic inflammatory reaction in response to H pylori recruits lymphocytes infected by EBV, enhancing the chances of their interaction with gastric epithelial cells [49]. In addition, co-infection creates a TME that is more advantageous for malignant transformation.…”

“…H. pylori eradication therapy is effective in preventing progression to gastric cancer, but data is lacking on whether Helicobacter pylori treatment can also prevent progression to cancer in hosts co-infected with EBV, and further studies to answer this question are needed [49].…”