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Background: The clinical significance of non‐Helicobacter pylori Helicobacter (NHPH) is still unknown. There are many reports of NHPH‐infected patients suffering from gastric diseases. Here, we investigated the polymerase chain reaction (PCR) positivity of NHPH infection in gastric disease patients who were negative for H. pylori (Hp) by the rapid urease test and by pathological observation. Materials and methods: We collected the 296 endoscopically obtained gastric mucosal samples of Hp‐negative gastric disease patients diagnosed based on a rapid urease test and pathology from 17 hospitals in Japan from September 2013 to June 2019, and we analyzed the existence of Hp and NHPH by PCR. The samples were also treated by indirect immunohistochemistry using an anti‐Helicobacter suis VacA paralog antibody and were observed by confocal laser microscopy. Results: Among the 236 non‐Hp‐eradicated cases, 49 cases (20.8%) were positive for NHPH. Among them, 20 cases were positive for Helicobacter suis, 7 cases were positive for Helicobacter heilmannii sensu stricto/ Helicobacter ailurogastricus (Hhss/Ha), and the other 22 cases could not be identified. The regional differences in the infection rates were significant. Forty percent of the nodular gastritis cases, 24% of the MALT lymphoma, 17% of the chronic gastritis cases, and 33% of the gastroduodenal ulcer cases were NHPH positive. Forty‐five patients had been treated with one of the four types of combinations of a proton pump inhibitor and two antibiotics, and in all of these cases, the NHPH diagnosed by PCR was successfully eradicated. Immunohistochemistry using the Helicobacter suis‐specific HsvA antibody coincided well with the PCR results. Among the 29 post‐Hp eradication cases, three were NHPH positive, including one Hhss/Ha‐positive case. Thus, approx. 20% of the Hp‐negative non‐Hp‐eradicated gastric disease patients treated at 17 hospitals in Japan were infected with NHPH. [ABSTRACT FROM AUTHOR]

The incidence of lymphoma has rapidly increased over the last 40 years in Japan, following a trend that is very similar to that of breast cancer. In particular, the relative frequency of follicular lymphoma (FL) has reached that in Western countries. Given its indolence, a "watch‐and‐wait" approach is often applied to FL patients. We have shown that FL is often detected in the second portion of the duodenum and has a distinct follicular dendritic cell distribution and heavy chain variable usage similar to mucosa‐associated lymphoid tissue (MALT) lymphoma. Although the t(14;18)(q32;q21) frequency is the same as in the nodal subtype of FL, there are also ongoing mutations, immunopositivity for cluster of differentiation 10 and B‐cell lymphoma (BCL)6, and overexpression of BCL2. Gene expression profiling has shown that it is more similar to gastric MALT lymphoma than to nodal FL. Duodenal‐type FL lacks the activation‐induced cytidine deaminase (AID) expression observed in nodal ones, although this may be compensated for by BTB domain and CNC homolog 2. Based on these findings, duodenal‐type FL has been included in the Revised 4th edition of the World Health Organization classification published in late 2017. [ABSTRACT FROM AUTHOR]

Abstract: Background and Aim: Few reports have demonstrated the effectiveness of treatments for intestinal follicular lymphoma (FL) because of the limited number of patients who undergo comprehensive small intestinal examinations. This study compared the efficacy of rituximab‐combined chemotherapy in patients with asymptomatic and low tumor burden (LTB) intestinal FL, according to the criteria of the Groupe d'Etude des Lymphomes Folliculaires, with that of a “watch and wait” (W&W) approach. Methods: The endoscopic examination for entire gastrointestinal tracts was performed in 29 Japanese patients with intestinal FL. These patients had CD21‐positive follicular dendritic cells arranged in a duodenal pattern. In a prospective, two‐center, open‐label trial, this study evaluated the efficacy of rituximab‐combined chemotherapy ([cyclophosphamide, doxorubicin, vincristine, and prednisone] or [cyclophosphamide, vincristine, and prednisone]) and prolonged treatment with rituximab (R‐Chemo+prolongedR) in 14 patients and compared their outcomes with those of 15 patients managed with a W&W approach. Results: Four patients managed with the W&W plan showed worsening macroscopic findings, lesion area enlargement, or clinical stage progression but stayed on this plan because they had LTB and experienced no changes in bowel function. In the R‐Chemo+prolongedR group, all patients achieved complete remission; recurrence occurred in one patient, who was subsequently managed with the W&W plan because of LTB. There were no significant differences in progression‐free survival between the two groups (P = 0.1045). Overall survival was 100% in both groups. Conclusions: The prognoses of patients with asymptomatic intestinal FL and LTB who were managed with a W&W strategy were comparable with those of patients receiving R‐Chemo+prolongedR. [ABSTRACT FROM AUTHOR]

Abstract: Background: Helicobacter pylori eradication therapy was approved in Japan for the first‐line, standard treatment of H. pylori‐positive gastric mucosa‐associated lymphoid tissue (MALT) lymphoma. Although several retrospective studies or small‐scale single‐center studies have been reported, a prospective, large‐scale, nationwide, multicenter study has not been reported from Japan. Materials and Methods: We conducted a prospective, nationwide, multicenter study to evaluate the clinical efficacy of rabeprazole‐based triple H. pylori eradication therapy for patients with localized gastric MALT lymphoma in practice‐based clinical trial. A total of 108 H. pylori‐positive patients with stage I/II1 gastric MALT lymphoma underwent H. pylori eradication therapy. The primary endpoints were complete remission (CR) rate and the rate of transfer to secondary treatment. The secondary endpoints were CR maintenance duration and overall survival (OS). Results: CR of lymphoma was achieved in 84 of 97 patients (86.6%), during the period 2.0‐44.7 months (median, 5.3 months) after starting H. pylori eradication treatment. CR was maintained in 77 of 81 patients (95.1%) for 0.4‐53.2 months (median, 33.1 months). Secondary treatments (radiotherapy, rituximab, or gastrectomy) for gastric MALT lymphoma were needed in 10 of the 97 patients (10.31%). During follow‐up, OS rate was 96.9% (94/97) and the causes of 3 deaths were not related to lymphoma. Conclusions: Rabeprazole‐based H. pylori eradication therapy demonstrated a high CR rate, long CR maintenance, and a good OS for patients with localized gastric MALT lymphoma in this prospective, practice‐based, multicenter study. [ABSTRACT FROM AUTHOR]

Follicular lymphoma ( FL) shows co-expression of B-cell lymphoma 2 ( BCL2) and CD10, whereas downexpression of CD10 is occasionally experienced in gastrointestinal ( GI) FL with unknown significance. Gastrointestinal FL is a rare variant of FL, and its similarity with mucosa-associated lymphoid tissue lymphoma was reported. We investigated the clinicopathological and genetic features of CD10 downexpressed ( CD10down) GI- FL. The diagnosis of CD10down FL was carried out with a combination of pathological and molecular analyses. The incidence of CD10down GI- FL was shown in 35/172 (20.3%) cases, which was more frequent than nodal FL (3.5%, P < 0.001). The difference was additionally significant between GI- FL and nodal FL when the analysis was confined to primary GI- FL (55.2% vs 3.5%, P < 0.001). Compared to CD10+ GI- FL, CD10down GI- FL significantly involved the stomach or large intestine ( P = 0.015), and additionally showed the downexpression of BCL6 ( P < 0.001). The follicular dendritic cell meshwork often showed a duodenal pattern in the CD10down group ( P = 0.12). Furthermore, a lymphoepithelial lesion was observed in 5/12 (40%) gastric FL cases, which indicated caution in the differentiation of mucosa-associated lymphoid tissue lymphoma. Molecular analyses were undertaken in seven cases of CD10down GI- FL, and an identical clone was found between CD10down follicles and CD10+ BCL2+ neoplastic follicles. In the diagnosis of cases with CD10down BCL2+ follicles, careful examination with molecular studies should be carried out. [ABSTRACT FROM AUTHOR]

The gastrointestinal (GI) tract is the most common primary site of extranodal diffuse large B-cell lymphoma (DLBCL), with approximately one-third of extranodal DLBCL occurring in the GI tract. We investigated the clinicopathological features and immunohistochemically-assessed cell-of-origin of 49 GI DLBCL cases (stomach, 24; small intestine, 10; colon, 15) and also examined the presence of MYD88 L265P as recently this mutation has been frequently identified in ABC-like DLBCL, particularly in extranodal sites. Small intestinal DLBCL was characterized by the preponderance of women ( P = 0.041) and elevated LDH ( P = 0.002) and soluble interleukin-2 receptor ( P = 0.033). Small intestinal DLBCL more frequently showed anemia ( P = 0.031) and elevated CRP ( P = 0.029) than gastric DLBCL. ABC-like phenotype was seen in 71.4 % cases (stomach, 79 %; small intestine, 70 %; colon, 60 %). MYD88 L265P was detected in 6.1 % cases; all were primary gastric DLBCL with ABC-like phenotype but had no distinct clinicopathological features. In conclusion, GI DLBCL had different clinicopathological features according to the primary site especially in the small intestine. Also, MYD88 L265P had little involvement in GI DLBCL compared with other extranodal DLBCLs, suggesting that its pathogenesis might be different from that of organs with a high frequency of MYD88 L265P. [ABSTRACT FROM AUTHOR]

Objective: There is no consensus regarding the best treatment for intestinal follicular lymphoma (FL). We used “watch and wait” for patients with intestinal FL with low-tumor-burden (LTB) criteria and without mass formation causing bowel obstruction. We investigated the overall survival (OS) and time to treatment required (TTR).Methods: Thirty-three intestinal FL patients [clinical stage (CS) I:16, II1:0, II2:7, IV:10; median observation period: 45.5 months, range: 13–110 months] were diagnosed via endoscopy. Detailed clinical and pathological examinations were performed, and neoplastic process behavior was monitored.Results: All of the 33 patients were WHO grade 1. FL lesions in the digestive tract were found frequently in the second–fourth portion of the duodenum in 91% of the patients; 87% of those patients had lesions in a broader area including the small intestine. Two patients had an enlargement of the area of the lesions and a worsening of the macroscopic findings. Three patients had CS progression; however, these remained within the indication for “watch and wait.” Two patients with transformation into diffuse large B-cell lymphoma received rituximab and chemotherapy, which led to complete remission. The OS was 100%. The time to treatment required (TTR) was 49 months in one patient and 37 months in one patient.Conclusion: Intestinal FL in CS I–IV with broad infiltration of the digestive tract meeting the criteria for LTB had a remarkably slow course. This study suggests that “watch and wait” is appropriate for the treatment of LTB intestinal FL even in the era of rituximab. [ABSTRACT FROM PUBLISHER]

We retrospectively compared the clinicopathological features of primary intestinal follicular lymphomas (FL-GIs), nodal follicular lymphomas (FL-LNs) and gastrointestinal MALT lymphomas (MALT-GIs), and investigated the distribution and the endoscopic appearances of FL-GI to evaluate the effectiveness of treatment modality. The subjects were 28 FL-GI patients, 135 FL-LN patients and 70 MALT-GI patients. In FL-LNs the clinical stage III-IV was 83%, while in FL-GIs clinical stage I-II was 68%. In MALT-GIs clinical stage I-II was 87%. The overall survival was significantly better in MALT-GI patients than in FL-LN patients. All FL-GI patients were alive at the time of evaluation. Regarding the histological grade (WHO), grade 1 was 81% in FL-GI, whereas in FL-LN grade 2 was 28% and grade 3 was 11%. The Follicular Lymphoma International Prognostic Index was low in 61% of FL-GIs, while in FL-LNs it was equally distributed to low, intermediate and high, suggesting that the prognosis is better in FL-GIs than in FL-LNs. The clinicopathological studies revealed the FL-GI has intermediate characteristics between FL-LN and MALT-GI. We recommend a 'watch-and-wait' policy or chemotherapy with rituximab for the therapy of FL-GIs because the lesions are often located in broader areas from the lower duodenum to the small intestine. Copyright © 2011 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Investigates the effect of histamine on rat gastric hydrogen-potassium (H+-K+)-adenosine triphosphatase alpha-subunit expression. Administration of histamine to rats; Determination of mitochondrial RNA and parietal cell morphology; Effects of the hydrogen-receptor antagonist famotidine on histamine.

Investigates the role of histamine(2), H(2), receptor in increased expression of the gastric acid pump, the H(+)-K(+)-adenosinetriphosphatase alpha-subunit induced by omeprazole. Use of male Wistar rats; Northern blot and slot-bot analyses; In vivo administration of famotidine, a H(2) receptor antagonist; Effect of the combination of famotidine and omeprazole.

Objectives: We investigated the effects of short-term administration of omeprazole on the regulation of antral gastrin and somatostatin in 15 healthy men. Methods: Seven of these men were administrated 20 mg, and eight were given 40 mg of omeprazole for 8 days each. All subjects were examined before the first dose and after the last dose. Results: Each dose significantly increased the basal serum gastrin level. Although the dose of omeprazole 20 mg/day had no significant affect on the antral somatostatin content, omeprazole 40 rag/day increased the antral gastrin content and decreased the antral somatostatin content significantly. Both doses significantly increased in the antral gastrin mRNA level. However, neither dose significantly affected the antral somatostatin mRNA level. Conclusions: This study shows reciprocal changes between the antral content of gastrin and somatostatin following omeprazole administration. These results indicate that antral somatostatin may be involved in the hypersecretion of gastrin produced by omeprazole in humans. [ABSTRACT FROM AUTHOR]

Objectives: We investigated the gene expression of antral gastrin and somatostatin in Helicobacter pylori-infected subjects. Twelve asymptomatic men with normal endoscopic findings participated in this study, four of whom were infected with H. pylori. Methods: Biopsy specimens of the gastric mucosa were obtained after subjects had fasted overnight. Serum gastrin levels, antral gastrin and somatostatin content, and antral G- and D-cell densities also were measured. Results: Fasting serum gastrin levels were significantly higher in H. pylori-positive subjects than in H. pylori-negative subjects. There were no differences between groups in antral gastrin content, G-cell density, or gastrin mRNA levels. Antral somatostatin content, D-cell density, somatostatin mRNA levels, and the somatostatin mRNA:D-cell density ratio were significantly decreased in H. pylori-positive subjects. Conclusions: Our results suggest that in addition to reduced antral D-cell density, a suppression of somatostatin synthesis in D-cells may have contributed to the decrease in antral somatostatin in H. pylori-infected subjects. [ABSTRACT FROM AUTHOR]