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Noble Prize in Medicine 2005 The discovery of the bacterium Helicobacter pylori and its role in gastritis and peptic u

Noble Prize in Medicine 2005 The discovery of the bacterium Helicobacter pylori and its role in gastritis and peptic ulcer disease. 指導老師:周淑娥 指導助教:林博雅 生物諾貝爾報告 第五組 潘柏諺 劉正昇 賴暉元 謝馨儀 蘇家霈. J. Robin Warren. Barry J. Marshall. 1975 (25) Bachelor of Medicine, Bachelor of Surgery 1981 (31)

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Noble Prize in Medicine 2005 The discovery of the bacterium Helicobacter pylori and its role in gastritis and peptic u

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  1. Noble Prize in Medicine 2005The discovery of the bacterium Helicobacter pylori and its role in gastritis and peptic ulcer disease 指導老師:周淑娥 指導助教:林博雅 生物諾貝爾報告 第五組 潘柏諺 劉正昇 賴暉元 謝馨儀 蘇家霈

  2. J. Robin Warren Barry J. Marshall • 1975 (25) Bachelor of Medicine, Bachelor of Surgery • 1981 (31) met Robin Warren • 1985 (35) experiment was published • 2005 (55) awarded the Nobel Prize in Physiology or Medicine • 1962 (25) Adelaide University • 1979 (42) noticed bacteria growing on the surface of a gastric biopsy • 1981 (44) met Barry Marshall • 2005(68) awarded the Nobel Prize in Physiology or Medicine

  3. 人體試驗 • Marshall • 1984.7. drink the solution with germs • Abdomen bloated → spit grume → headache → gastric inflammation • antibiotic • Warren • Abdomen ache → vomit • antibiotic • Cause long-term chronic gastritis • Koch's postulates

  4. H. pylori • Gram negative • Spiral bacillus • 2~4 um • Secret urease • Oral-to-oral infection

  5. 流行概況 • Age involvement • H. pylori %(Rate of being infected) =(age × 1.1) - 9.7 • Racial difference • Associated with the economy development • Different sensitivities • No sexual difference • 「Occupational disease 」

  6. The localization of H. pylori

  7. TFSS

  8. Urease • NH2CONH2NH3 + H2CO3 Urease • For survival • Neutralize the stomach acid • NH3 : • Mucoprotein (mucin) decreases • Destroy the completeness of mucus ion

  9. VacA (Vacuolating cytotoxin A)–液泡毒素 • Discover:1980 • diameter:~30nm • Size :~87KD • Oligomer:~1000KD

  10. Apoptosis Vacuolation Inhibit Tcell activation Functions of VacA nutrition Tight junction IL-12

  11. Variation of VacA 特優

  12. VacA基因的意外用途…

  13. CagA(cytotoxin associated gene A) • Translate to protein CagA ( 細胞毒素攜帶抗原A ) • cagA exists only in some H. pylori • People who are infected by H. pylori with cagA have more chances to catch gastric ulcer and cancer.

  14. IL-8 TFSS IL-8

  15. Process

  16. Correa’s cascade

  17. Diagnoses • Invasive testing: • Histological examination • Culture • P.C.R. • Rapid urease test • Non-invasive testing: • Serology test • Scatological examination • C-13-urea breath test 特優

  18. Urease • NH2CONH2NH3 + H2CO3 H2CO3 → H2O + CO2

  19. Cures for Peptic Ulcer and Gastritis • Triple therapy : • Two remedies: • Antibiotics + bismuth subsalicylate • Antibiotics + proton pump inhibitors • Curability can be 80%~90%. • In Taiwan, curability is 83% in a week. • Secret worry:The result of failure

  20. Summary 特優

  21. References-1 • 張朝勝. Identification of a new segment involved in cagA 3' region variation of Helicobacter pylori. (2002). • 譚健民. 幽門螺旋桿菌導致胃黏膜傷害的免疫致病機轉. (2008). 台灣醫界 2008, Vol.51, No.1 • 陳慈棻. 幽門螺旋桿菌誘導胃上皮細胞行程胃炎之作用機制. (2004). • 王玫瑛. Development of enzyme-linked immunosorbent assay (ELISA) kit for the diagnosis of Helicobacter pylori infection. (2006). • 劉作財. The retrospective study of Helicobacter pylori infection and antibiotic resistant. (2006). • 王靜雯. VacA and CagA in Taiwanese strains • 陳在玲. Smoking and Male Gender Rather than CagA Protein Are Associated With Increased Risk for Duodenal Ulcer in HelicobacterPylori-Infected Patients in Taiwan • 莊旭翔. 幽門桿菌刺激胃上皮細胞株表現腫瘤壞死因子的機制探討. (2007). Retrieved from http://fedetd.mis.nsysu.edu.tw/FED-db/cgi-bin/FED-earch/view_etd?identifier=oai:etdncku.lib.ncku.edu.tw:etd-0806107-151120&index_word= • 任剛. 幽門螺桿菌致病機制的最新進展. (1999).《醫學綜述》 1999年 第5卷 第4期 • 新發現幽門螺旋桿菌致胃癌的兩種蛋白質. (2001). Science 2001 Dec 13 • 陳立宗. 幽門螺旋桿菌與胃癌. Retrieved from http://www.tccf.org.tw/information/HP_G.HTM

  22. References-2 • 賈博琦. 幽門螺桿菌感染的治療--2.1概論--胃十二指腸潰瘍病時幽門螺桿菌感染的治療. (2007). Retrieved from http://med.qe.cn/HTML/123894.html • 潘明亮. 消化性潰瘍的藥物治療. Retrieved from http://www.sccpc.com.cn/guanyuwomen/qi-kan/2/xiao-hua-xky.htm • 許博翔, 洪貴香, 吳惠雯, 吳俊忠. 2005年諾貝爾生理醫學獎──揪出幽門桿菌的啟示. (2006).《科學發展》2006年7月,403期,40 ~ 47頁. Retrieved from http://www.nsc.gov.tw/_NewFiles/popular_science.asp?add_year=2006&popsc_aid=79 • 崔乃林, 牛換香, 李天元. 幽門螺桿菌與胃癌的流行病學關係及致癌機制. (2007). Retrieved from http://www.bioon.com/Article/hpv/309299.shtml • 譚健民. 抓出元兇!如何檢測「胃幽門螺旋桿菌」感染的存在?. (2005). Retrieved from http://hospital.kingnet.com.tw/essay/essay.html?pid=11577&category=醫藥疾病&type= • 幽門螺桿菌致病機制的最新進展. (2007). Retrieved from 健康人家 http://lw.jkrj.cn/HTML/62906_2.shtml • 幽門螺旋桿菌(一). (2006). Retrieved from 台灣醫療網 http://tw16.net/monographData.asp?m1No=4&m2No=63&m3No=413&mMo=3045 • 淺談胃藥. Retrieved from 台北榮民總醫院 http://homepage.vghtpe.gov.tw/~gi/book/book3.htm • 胃幽門螺旋桿菌呼氣檢測. (2005). Retrieved from http://www.ch.com.tw/index.asp?chapter=ACH000007

  23. References-3 • 胃潰瘍的祕密. (2006). Retrieved from http://tw.myblog.yahoo.com/clarinase-1/article?mid=116&prev=157&next=103&l=f&fid=7 • 日科學家稱解開幽門螺桿菌引發胃癌的機制. (2007). Retrieved from 美迪醫療網http://www.labsky.com/data/07/04/news/0428111735478.htm • 科學人雜誌37期p.68~p.81 • One Step H.pylori Rapid Test Strip (Serum). Retrieved from http://www.gmb.com.tw/html/pdf/uman.pdf • Denise M. Monack, Anne Mueller and Stanley Falkow. Persistent bacterial infections: the interface of the pathogen and the host immune system. (2004). Retrieved from Nature reviews Volume 2, September 2004 • H.pylori's CagA deregulates gastric cell protein to induce abnormal proliferation.(2001).Retrieved from http://www.oncolink.upenn.edu/resources/article.cfm?c=3&s=8&ss=23&Year=2001&Month=12&id=7852 • J. W. KONTUREK. Discovery by Haworskiof helicobacter pylori and its pathogenetic role in peptic ulcer, gastritis and gastric cancer. (2003). Retrieved from http://www.jpp.krakow.pl/journal/archive/1203_s3/articles/03_article.html • National Digestive Diseases Information Clearinghouse. H. pylori and Peptic Ulcer. (2004). Retrieved from http://digestive.niddk.nih.gov/ddiseases/pubs/hpylori/

  24. References-4 • Richard M. Peek, Jr. and Martin J. Blaser. Helicobacter Pylori and gastrointestinal tract adenocarcinomas. (2002).Retrieved from Nature reviews Volume 2, January 2002 • Richard M. Peek, Jr. Intoxicated cells and stomach ulcers. (2003).Retrieved from Nature Volume 33 • Steven F. Moss, MD. Premalignant Lesions: H. pylori and Gastric Cancer. (2001). Retrieved from http://www.webtie.org/SOTS/Meetings/Gastrointestinal/March62001/lectures/MOSS/transcripts/transcripts.htm • S.K. Mustapha, FWACP, etc. Endoscopic Findings And The Frequency Of Helicobacter Pylori Among Dyspeptic Patients In North-Eastern Nigeria. (2008). Retrieved from http://www.ispub.com/ostia/index.php?xmlFilePath=journals/ijge/vol6n1/pylori.xml • Terry Kwok1, Dana Zabler1, Sylwia Urman, Manfred Rohde, Roland Hartig, Silja Wessler, Rolf Misselwitz, Ju¨rgen Berger, Norbert Sewald, Wolfgang Ko¨nig1 & Steffen Backert. Helicobacter exploits integrin for type IV secretion and kinase activation. (2007). Retrieved from Nature 06187 Vol449

  25. References-5 Pictures: • Breath Tests. (2006). Retrieved from The Helicobacter foundation http://www.helico.com/diag_breath.html • C13 test. Retrieved from http://www.infai.com/images/infaikit.gif • H. pylori. Retrieved from http://www.nsc.gov.tw/files/popsc/2006_79/9507-07-02.JPG • Konturek et al. (1998). Retrieved from http://www.jpp.krakow.pl/journal/archive/1203_s3/gfx/rys04_9.gif • Rapid urease test. Retrieved from http://www.mednet.cn/CN/images/UpFileSmall/2006_7_6_15_31_44_2768.jpg • Retrieved from http://upload.wikimedia.org/wikipedia/commons/thumb/3/30/H_pylori_virulence_factors_ja.png/500px-H_pylori_virulence_factors_ja.png • Retrieved from http://upload.wikimedia.org/wikipedia/commons/archive/9/9a/20070124111126!H_pylori_virulence_factors_en.png

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