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"Gastric epithelial cells apoptosis induced by Helicobacter pylori depends on microhial and host factors. Apoptosis on mitochondrial level by Bc!2 family protein is the main pathway for Helicobacter pylori induced gastric epithelial cells apoptosis, though there are roles for apoptosis through Fas receptors or TNF. Imbalance between proliferation and apoptosis gastric epithelial cells determines the risk for neoplastic transformation. Increase of gastric epithelial cells apoptosis seems to have an obligation for initiating secondary hyperproliferative response. If altruistic cellular death fails to oppose this process, uncontrollable cellular growth leading to neoplastic transformation will occur."

"ABSTRAKHelicobacter pylori diperkirakan menginfeksi lebih dari setengah populasi orang dewasa. Deteksi dini H.pylori sangat diperlukan untuk mencegah berkembangnya infeksi menjadi keganasan lambung. Bentuk coccoid dari H. pylori sulit dideteksi dengan kultur dan histopatologi, namun dapat terdeteksi dengan metode molekuler seperti real-time PCR. Salah satu gen yang dapat digunakan sebagai gen target real-time PCR yaitu 16S rRNA, yang diketahui spesifik dan juga digunakan untuk menganalisis kekerabatan antar strain. Analisis ini bermanfaat untuk melihat penyebaran infeksi H.pylori di dunia. Penelitian ini merupakan penelitian eksperimental laboratorium. Metode pengambilan sampel yang digunakan yaitu, metode consecutive sampling. Biopsi diambil dari 2 antrum dan 2 korpus pada 42 penderita dispepsia untuk pemeriksaan real-time PCR dan histopatologi. Optimasi kondisi real-time PCR meliputi uji volume cetakan DNA, sensitifitas dan spesifisitas teknik, kemudian dilanjutkan aplikasi pada sampel klinis dari biopsi lambung. Delapan dari 11 sampel yang positif dilakukan sekuensing dan analisis filogenetik. Hasil optimasi diperoleh suhu annealing 64?C, konsentrasi primer 0,8 ?M dan konsentrasi probe 0,6 ?M. Ambang batas deteksi real-time PCR untuk mendeteksi jumlah DNA minimal H.pylori yaitu 46 bakteri. Spesifisitas uji reaksi silang real-time PCR ini tidak menunjukkan adanya reaksi silang dengan mikroorganisme lain. Proporsi positif hasil pemeriksaan real-time PCR sebesar 26,2 , sedangkan histopatologi sebesar 11,9 . Pemeriksaan real-time PCR mampu meningkatkan diagnosis sebesar 14,3 dibandingkan pemeriksaan histopatologi. Hasil sekuensing dan analisis filogenetik menunjukkan bahwa strain H.pylori dari sampel memiliki kekerabatan dengan strain Taiwan, India, dan Australia. Kata kunci : H.pylori, histopatologi, real-time PCR, analisis filogenetik

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ABSTRACTHelicobacter pylori infection is estimated infect almost half of the adult population in the world. Early detection of H.pylori is needed to prevent the development of infections into gastric malignancies. The coccoid form of H. pylori is difficult to detect using culture and histopathology but it can be detected by molecular methods such as real time PCR. One of the genes that can be used as a real time PCR target gene is 16S rRNA, which is known to be specific and also used to analyze closely related strain. This analysis were useful to showed the spread of H.pylori infection in the world.This study is an experimental laboratory. The sampling method used is the consecutive sampling method. Biopsy was taken from 2 antrum and 2 corpus in 42 patients with dyspepsia for real time PCR and histopathology examination. Optimization real time PCR conditions include DNA template volume testing, sensitivity and specificity of the technique, followed by application of clinical samples from gastric biopsy. Eight of the 11 positive samples were sequenced and analyzed for phylogenetics pattern. The optimization result obtained annealing temperature 64 C, primer concentration was 0,8 M and probe concentration was 0,6 M. Limit detection of the DNA was 46 bacteria. The specificity of the PCR 39 s real time indicate that there was no cross reaction with other microorganisms. The positive proportion of PCR real time examination was 26.2 , while histopathology was 11.9 . A real time PCR examination was able to improve the diagnosis by 14,3 compared to histopathology examination. Sequencing and phylogenetic analysis results showed that our strain were closely related to Taiwan, India and Australia strains. Keywords H.pylori, histopathology, real time PCR, phylogenetic analysis"

"Helicobacter pylori is a globally significant pathogen that infects half of the population of the world. Its recognition enabled the development of new therapeutic and preventative strategies for serious health conditions such as gastric cancer, of which it is the major causative agent. Providing a broad overview of the current understanding of this pathogen and emphasizing its world health impacts, this book explores a range of topics including virulence factors, vaccine development and obstacles, epidemiology, antibiotic resistance and the role of Nod receptors, with a foreword by Barry Marshall, the Nobel Laureate and co-discoverer of H. pylori. It is an essential resource for researchers, students and medics in infectious and Helicobacter-associated diseases."

"ABSTRAKWe reported a male, 72 yo, Chinese ethnic with chief complaint black mushy defecation. Physical examination revealed pale on conjunctival palpebra which confirmed as anemia on complete blood count. Gastroduodenoscopy revealed a 3 mm ulcer at the antrum (Forrest stage III). H. pylori infection was positive based on five different test methods (urinary antibody tests, rapid urease test, culture, histology ad immunohistochemistry). Used polymerase chain reaction-based sequencing, we found the patient infected by CagA producing, East-Asian-type cagA and vacA s1m1-strain. Further analysis using 7 housekeeping genes confirmed that the strain categorized in to hspEAsia group. The patient was given continuous intravenous infusions of proton pump inhibitor and standard triple therapy regimens eradication of H. pylori."

"Kami melaporkan sebuah kasus seorang laki-laki, 72 tahun, etnis Tionghoa dengan keluhan utama buangair besar berwarna hitam lembek. Pemeriksaan fisik menunjukkan warna pucat pada konjungtiva palpebrayang dikonfirmasi dengan hasil hitung darah lengkap. Pemeriksaan gastroduodenoskopi menemukan adanyaulkus berukuran 3 mm di antrum (Forrest stage III). Infeksi H. pylori dinyatakan positif berdasarkan limametode berbeda (urinary antibody tests, rapid urease test, kultur, histologi dan imunohistokimia). Analisisdengan sequencing berbasis polymerase chain reaction didapatkan bahwa pasien terinfeksi oleh strainberjenis East-Asian-type cagA dan vacA s1m1. Analisis lanjutan dengan menggunakan tujuh housekeepinggen mengkonfirmasikan bahwa strain tersebut tergolong dalam kelompok hspEAsia. Pasien diberikan infusintravena kontinyu pompa proton inhibitor dan standar triple therapy regimens untuk terapi eradikasi H. pylori.We reported a male, 72 yo, Chinese ethnic with chief complaint black mushy defecation. Physical examinationrevealed pale on conjunctival palpebra which confirmed as anemia on complete blood count. Gastroduodenoscopyrevealed a 3 mm ulcer at the antrum (Forrest stage III). H. pylori infection was positive based on five differenttest methods (urinary antibody tests, rapid urease test, culture, histology ad immunohistochemistry). Usedpolymerase chain reaction-based sequencing, we found the patient infected by CagA producing, East-Asian-typecagA and vacA s1m1-strain. Further analysis using 7 housekeeping genes confirmed that the strain categorizedin to hspEAsia group. The patient was given continuous intravenous infusions of proton pump inhibitor andstandard triple therapy regimens eradication of H. pylori."

"Fenomena utama pada pasien MDS adalah sitopenia di darah tepi, namun disertai kondisi hiperselular di sumsum tulang. sCD40L dianggap sebagai sitokin yang dapat memicu sintesis TNFα sebagai sitokin proapoptosis dan memicu sintesis VEGF sebagai sitokin proangiogenesis pada MDS. Oleh sebab itu sCD40L dianggap berpotensi sebagai biopenanda untuk memperkirakan perburukan pada MDS. Penelitian ini bertujuan untuk membuktikan peran pajanan rh-sCD40L dalam menginduksi sintesis TNFα dan VEGF pada sel progenitor hematopoesis, serta membuktikan peran pajanan TNFα dalam memicu apoptosis pada sel progenitor hematopoesis dan sel mesenkim MDS. Penelitian ini merupakan penelitian eksperimental in vitro komparatif. Subjek penelitian adalah pasien MDS yang didiagnosis dan diklasifikasikan berdasarkan kriteria WHO 2008. Pada bone marrow mononuclear cells (BMMC) dipajankan dengan rh-sCD40L dan antiCD40L, kemudian dilakukan pemeriksaan ekspresi mRNA TNFα dan mRNA VEGF yang dikuantifikasi dengan qRT-PCR, serta pemeriksaan kadar TNFα dan VEGF yang diperiksa dengan metode ELISA. Pada sel CD34+, CD33+, CD41+, dan CD73+ dipajankan rhTNFα kemudian dilakukan pemeriksaan aktivitas kaspase-3 dengan imunoflowsitometri.Terdapat 15 sampel MDS terdiri dari 4 dengan diagnosis RCUD, 7 RCMD, dan 4 RAEB1, serta 7 sampel kontrol. Pajanan rh-sCD40L meningkatkan ekspresi mRNA TNFα secara bermakna dibandingkan pajanan antiCD40L. Pajanan rh-sCD40L meningkatkan kadar TNFα secara bermakna dibandingkan kontrol. Namun pajanan rh-sCD40L tidak meningkatkan mRNA VEGF dan kadar protein VEGF. Pajanan rhTNFα meningkatkan aktivitas kaspase-3 pada sel progenitor MDS terutama yang berdiferensiasi menjadi mieloid (CD33+) dan megakariosit-trombosit (CD41+). Pajanan rhTNFα meningkatkan aktivitas kaspase-3 pada sel mesenkim (CD73+) MDS Simpulan: sCD40L berperan dalam meningkatkan sintesis sitokin proapoptosis TNFα di level mRNA dan protein, namun tidak terbukti berperan dalam meningkatkan sintesis proangiogenesis VEGF. TNFα berperan dalam meningkatkan apoptosis terutama pada sel hematopoesis yang telah berdiferensiasi menjadi seri mieloid dan seri megakariosit-trombosit, dan berperan dalam meningkatkan apoptosis pada sel mesenkim.

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Cytopenia is the primary phenomenon in Myelodysplastic Syndrome (MDS) patients, amidst hypercellular bone marrow. The soluble CD40 ligand (sCD40L) is considered as a cytokine that can trigger synthesis of TNFα and VEGF. The former is known as a cytokine that promotes apoptosis while the latter promotes angiogenesis in MDS patients. Therefore, the sCD40L may serve as a potential biomarker to predict worsening of MDS. This study aims to prove the role of rh-sCD40L exposure in inducing the synthesis of TNFα and VEGF in hematopoietic progenitor cells, as well as to establish the role of TNFα exposure in triggering apoptotic activity in hematopoietic progenitor and mesenchymal cells of MDS. The study was a comparative in vitro experimental study. Subjects were MDS patients diagnosed and classified using the WHO 2008 criteria. Bone marrow mononuclear cells (BMMC) were exposed to rh-sCD40L and antiCD40L. The expressions of TNFα and VEGF mRNAs were then quantified by qRT-PCR, and the level of TNFα and VEGF were measured using the ELISA method. The CD34+, CD33+, CD41+, and CD73+ cells were exposed to rhTNFα, then the activity of enzyme caspase-3 was measured using the immunoflowcytometry.There were 7 control and 15 MDS samples with the following diagnoses: 4 RCUD, 7 RCMD, and 4 RAEB1. Compared to antiCD40L, it is found that exposure of rh-sCD40L significantly increased the expression of TNFα mRNA. The similar exposure also significantly increased the level of TNFα compared to controls. However, the exposure of rh-sCD40L did not increase the expression of VEGF mRNA as well as the level of VEGF. The exposure of rhTNFα was found to increase the activity of caspase-3 in MDS progenitor cells, particularly those differentiated into myeloid cells (CD33+) and megakaryocyte-thrombocyte cells (CD41+). The exposure of rhTNFα was found to increase the activity of caspase-3 in MDS mesenchymal (CD73+) cells.Conclusion: The sCD40L plays a role in increasing the synthesis of TNFα which favors apoptotic activity in mRNA and protein level, but not in improving the synthesis of VEGF that promotes angiogenesis. Furthermore, TNFα plays a role in increasing apoptotic activity of hematopoietic cells, particularly those that have differentiated into myeloid series and megakaryocyte-thrombocyte series cells. Also TNFα plays a role in increasing apoptotic activity of mesenchymal cells."

"Helicobacter pylori (Hp) infection is the most common chronic bacterial infection in human. The role of Hp infection in various GI disorders had been widely accepted. However, further studies have found new extragastrointestinal involvement such as urticaria. Chronic urticaria is a common disorder that has complex pathophysiologic mechanism. As mater of fact, etiology remains unclear in most of the cases. This condition is called Idiopathic Chronic Urticaria. Several studies had shown high prevalence of Hp infection in patients with ICU and improved symptoms after eradication therapy of Hp. This observation had suggested that Hp has important role as etiologic factor in some cases of ICU. The presence of Hp infection and its role in ICU should be proven before initiating eradication therapy, so that irrational used of drugs and antibiotics resistance can be prevented."

"Dyspepsia is one of numerous general complaints, which is commonly encountered by doctors of various disciplines. In daily practice, the complaint is not only limited for gastroenterologists. Knowledge on pathophysiology of dyspepsia have been developing continuously since a scientific investigation has been started in 1980s, which considers Helicobacter pylori as one of key factor in managing dyspepsia, either it is associated with ulcer or non-ulcer. The management of dyspepsia cannot be separated from the management of H. pylori and there is an additional new knowledge associated with definition, pathophysiology, diagnosis and treatment of both dyspepsia and H. pylori infection.

This consensus document on the management of dyspepsia and H. pylori infection in Indonesia has been developed using the evidence-based medicine principles; therefore, it can be used as a reference for doctors in dealing with dyspepsia and H. pylori infection cases in their daily practice. It is expected that with the new consensus, doctors can provide greater service to their patients who have dyspepsia and H. pylori infection."

"Dyspepsia is a common complain in clinical practice. Correlation between helicobacter pylori (H. pylori) and functional dyspepsia had been reported in many studies, but studies that analyzed the severity of dyspepsia and H. pylori were limited and the result were controversial. This study is about to know the correlation between the severity of dyspepsia and H. pylori infection. A retrospective descriptive analysis to patients with dyspepsia at Permata Bunda Hospital, Medan was done in 2010-2014. Simple random sampling was done to get 44 patient with dyspepsia, 22 are H. pylori positive and 22 patients are H. pylori negative. The severity of dyspepsia assessed with porto alegre dyspeptic symptoms questionnaire (PADYQ) scoring instrument. Univariate and bivariate analysis (Chi-square and spearman correlation) were done using SPSS version 22. Epigastric pain is teh most common symptom in dyspepsia patients. There is a correlation between ulcer type dyspepsia and H. pylori infection (p=0.030), while dysmotility type and mixed type were not correlated. The severity of epigastric pain has significant positive correlation with H. pylori (r=0.386;p=0.01), while the severity of other symptoms such as nausea, vomit, and abdominal bloating have negative correlation with H.pylori. Dyspepsia total scoring is significantly lower in H. pylori positive than in H.pylori negative (p=0.033). There is a positive correlation between the severity of nausea, vamit, and abdominal bloating and H.pylori infection, and correlation between lower dyspepsia total scoring and H.pylori pain."