1 526 104 ASSOCIATIONS OF HELICOBACTER PYLORI INFECTION AND CHRONIC ATROPHIC GASTRITIS WITH ACCELERATED EPIGENETIC AGEING IN OLDER ADULTS. BACKGROUND: HELICOBACTER PYLORI (HP) INFECTION AND CHRONIC ATROPHIC GASTRITIS (CAG) HAVE SHOWN STRONG ASSOCIATIONS WITH THE DEVELOPMENT OF GASTRIC CANCER. THIS STUDY AIMED TO EXAMINE WHETHER BOTH RISK FACTORS ARE ASSOCIATED WITH ACCELERATED EPIGENETIC AGEING, AS DETERMINED BY THE 'DNA METHYLATION AGE', IN A POPULATION-BASED STUDY OF OLDER ADULTS (N=1477). METHODS: SEROLOGICAL MEASUREMENTS OF HP ANTIBODIES AND PEPSINOGEN I AND II FOR CAG DEFINITION WERE OBTAINED BY ELISA KITS. WHOLE BLOOD DNA METHYLATION PROFILES WERE MEASURED BY ILLUMINA HUMAN METHYLATION450K BEADCHIP. DNA METHYLATION AGES WERE CALCULATED BY TWO ALGORITHMS PROPOSED BY HORVATH AND HANNUM ET AL. RESULTS: AFTER ADJUSTING FOR POTENTIAL COVARIATES IN LINEAR REGRESSION MODELS, WE FOUND THAT HP INFECTION, INFECTION WITH VIRULENT HP STRAINS (CAGA+) AND SEVERE CAG WERE SIGNIFICANTLY ASSOCIATED WITH AN INCREASE IN DNA METHYLATION AGE BY APPROXIMATELY 0.4, 0.6 AND 1 YEAR (ALL P-VALUES <0.05), RESPECTIVELY. CONCLUSIONS: OUR STUDY INDICATES THAT BOTH CAGA+ HP INFECTION AND CAG GO ALONG WITH ACCELERATED EPIGENETIC AGEING. 2017 2 4751 36 NOVEL RISK MARKERS FOR GASTRIC CANCER SCREENING: PRESENT STATUS AND FUTURE PROSPECTS. INITIAL IDENTIFICATION OF POPULATIONS AT HIGH RISK OF GASTRIC CANCER (GC) IS IMPORTANT FOR ENDOSCOPIC SCREENING OF GC. AS SERUM PEPSINOGEN (PG) TEST-POSITIVE SUBJECTS WITH PROGRESSION OF CHRONIC ATROPHIC GASTRITIS (CAG) SHOW A HIGH LIKELIHOOD OF FUTURE CANCER DEVELOPMENT, THIS POPULATION WARRANTS CAREFUL FOLLOW-UP OBSERVATION AS A HIGH-RISK GC GROUP. BY COMBINING THE PG TEST WITH HELICOBACTER PYLORI (HP) ANTIBODY TITERS, THE HP-RELATED CHRONIC GASTRITIS STAGE CAN BE CLASSIFIED, THUS IDENTIFYING NOT ONLY A GC HIGH-RISK GROUP BUT ALSO A LOW-RISK GROUP. AMONG PG TEST-NEGATIVE PATIENTS WITHOUT CAG, THOSE WITH HIGH SERUM PG II LEVELS AND HP ANTIBODY TITERS ARE THOUGHT TO HAVE SEVERE GASTRIC MUCOSAL INFLAMMATION AND THE RISK OF DIFFUSE-TYPE GC IS ALSO HIGH. MEANWHILE, IN GASTRIC MUCOSAE OBTAINED BY ENDOSCOPIC BIOPSY, HP INFECTION INDUCES ABERRANT DNA METHYLATION IN CPG ISLANDS IN MULTIPLE GENE REGIONS AND THE EXTENT OF METHYLATION CLEARLY CORRELATES WITH GC RISK. BY QUANTIFYING ABERRANT DNA METHYLATION IN SUITABLE GENE MARKERS, WE CAN DETERMINE THE EXTENT OF THE EPIGENETIC FIELD FOR CANCERIZATION. THESE NOVEL CONCEPTS AND RISK MARKERS WILL HAVE MANY CLINICAL APPLICATIONS IN GASTROINTESTINAL ENDOSCOPY, INCLUDING MORE EFFICIENT ENDOSCOPIC GC SCREENING AND A STRATEGIC APPROACH TO METACHRONOUS MULTIPLE GCS AFTER ENDOSCOPIC TREATMENT. 2010 3 1322 35 DEMONSTRATION OF THE USEFULNESS OF EPIGENETIC CANCER RISK PREDICTION BY A MULTICENTRE PROSPECTIVE COHORT STUDY. BACKGROUND: EPIGENETIC ALTERATIONS ACCUMULATE IN NORMAL-APPEARING TISSUES OF PATIENTS WITH CANCER, PRODUCING AN EPIGENETIC FIELD DEFECT. CROSS-SECTIONAL STUDIES SHOW THAT THE DEGREE OF THE DEFECT MAY BE ASSOCIATED WITH RISK IN SOME TYPES OF CANCER, ESPECIALLY CANCERS ASSOCIATED WITH CHRONIC INFLAMMATION. OBJECTIVE: TO DEMONSTRATE, BY A MULTICENTRE PROSPECTIVE COHORT STUDY, THAT THE RISK OF METACHRONOUS GASTRIC CANCER AFTER ENDOSCOPIC RESECTION (ER) CAN BE PREDICTED BY ASSESSMENT OF THE EPIGENETIC FIELD DEFECT USING METHYLATION LEVELS. DESIGN: PATIENTS WITH EARLY GASTRIC CANCER, AGED 40-80 YEARS, WHO PLANNED TO HAVE, OR HAD UNDERGONE, ER, WERE ENROLLED AT LEAST 6 MONTHS AFTER HELICOBACTER PYLORI INFECTION DISCONTINUED. METHYLATION LEVELS OF THREE PRESELECTED GENES (MIR-124A-3, EMX1 AND NKX6-1) WERE MEASURED BY QUANTITATIVE METHYLATION-SPECIFIC PCR. PATIENTS WERE FOLLOWED UP ANNUALLY BY ENDOSCOPY, AND THE PRIMARY ENDPOINT WAS DEFINED AS DETECTION OF A METACHRONOUS GASTRIC CANCER. AUTHENTIC METACHRONOUS GASTRIC CANCERS WERE DEFINED AS CANCERS EXCLUDING THOSE DETECTED WITHIN 1 YEAR AFTER THE ENROLMENT. RESULTS: AMONG 826 PATIENTS ENROLLED, 782 PATIENTS HAD AT LEAST ONE FOLLOW-UP, WITH A MEDIAN FOLLOW-UP OF 2.97 YEARS. AUTHENTIC METACHRONOUS GASTRIC CANCERS DEVELOPED IN 66 PATIENTS: 29, 16 AND 21 PATIENTS AT 1-2, 2-3 AND >/=3 YEARS AFTER THE ENROLMENT, RESPECTIVELY. THE HIGHEST QUARTILE OF THE MIR-124A-3 METHYLATION LEVEL HAD A SIGNIFICANT UNIVARIATE HR (95% CI) (2.17 (1.07 TO 4.41); P=0.032) AND A MULTIVARIATE-ADJUSTED HR (2.30 (1.03 TO 5.10); P=0.042) OF DEVELOPING AUTHENTIC METACHRONOUS GASTRIC CANCERS. SIMILAR TRENDS WERE SEEN FOR EMX1 AND NKX6-1. CONCLUSIONS: ASSESSMENT OF THE DEGREE OF AN EPIGENETIC FIELD DEFECT IS A PROMISING CANCER RISK MARKER THAT TAKES ACCOUNT OF LIFE HISTORY. 2015 4 1797 29 EFFECT OF HELICOBACTER PYLORI ERADICATION ON GASTRIC PRECANCEROUS LESIONS: A SYSTEMATIC REVIEW AND META-ANALYSIS. BACKGROUND: THE QUESTION OF WHETHER ERADICATION OF HELICOBACTER PYLORI (HP) CAN REVERSE GASTRIC PRECANCEROUS LESIONS, INCLUDING INTESTINAL METAPLASIA, REMAINS UNCERTAIN, LEADING TO ONGOING DEBATE. THEREFORE, A META-ANALYSIS WAS PERFORMED TO EVALUATE THE EFFECT OF HP ERADICATION ON GASTRIC PRECANCEROUS LESIONS. MATERIALS AND METHODS: PUBMED, EMBASE, COCHRANE LIBRARY, WEB OF SCIENCE, SCOPUS DATABASE, AND CLINICALTRIALS.GOV WERE SYSTEMATICALLY SEARCHED FROM INCEPTION TO APRIL 2023 FOR STUDIES THAT EXPLORED THE IMPACT OF HP ERADICATION ON GASTRIC PRECANCEROUS LESIONS. RISK RATIOS (RRS) AND THEIR 95% CONFIDENCE INTERVALS (95% CIS) WERE SELECTED AS THE EFFECT SIZE. WE USED THE RANDOM-EFFECTS MODEL TO ASSESS POOLED DATA. WE ALSO PERFORMED QUALITY ASSESSMENTS, SUBGROUP ANALYSES, AND SENSITIVITY ANALYSES. RESULTS: FIFTEEN STUDIES WERE INCLUDED. COMPARED WITH PLACEBO, HP ERADICATION COULD SIGNIFICANTLY PREVENT THE PROGRESSION OF GASTRIC PRECANCEROUS LESIONS (RR = 0.87, 95% CI: 0.81-0.94, P < 0.01) AND REVERSE THEM (RR = 1.32, 95% CI: 1.17-1.50, P < 0.01). THEN, SPECIFIC PRECANCEROUS LESIONS WERE FURTHER EXPLORED. THE PROGRESSION OF INTESTINAL METAPLASIA WAS SIGNIFICANTLY PREVENTED BY HP ERADICATION COMPARED TO PLACEBO OR NO TREATMENT (RR = 0.80, 95% CI: 0.69-0.94, P < 0.01). MOREOVER, COMPARED WITH PLACEBO OR NO TREATMENT, HP ERADICATION ALSO IMPROVED CHRONIC ATROPHIC GASTRITIS (RR = 1.84, 95% CI: 1.30-2.61, P < 0.01) AND INTESTINAL METAPLASIA (RR = 1.41, 95% CI: 1.15-1.73, P < 0.01). HOWEVER, IN TERMS OF PREVENTING DYSPLASIA PROGRESSION (RR = 0.86, 95% CI: 0.37-2.00) AND IMPROVING DYSPLASIA (RR = 0.89, 95% CI: 0.47-1.70), HP ERADICATION HAD NO ADVANTAGE COMPARED TO PLACEBO OR NO TREATMENT. CONCLUSIONS: HP ERADICATION THERAPY COULD PREVENT THE PROGRESSION OF GASTRIC PRECANCEROUS LESIONS AND REVERSE THEM. NOTABLY, INTESTINAL METAPLASIA CAN BE REVERSED, BUT THIS MAY ONLY BE APPROPRIATE FOR PATIENTS WITH EPIGENETIC ALTERATIONS AND MILDER LESIONS. 2023 5 2870 37 FUNCTIONAL GENE POLYMORPHISMS AND EXPRESSION ALTERATION OF SELECTED MICRORNAS AND THE RISK OF VARIOUS GASTRIC LESIONS IN HELICOBACTER PYLORI-RELATED GASTRIC DISEASES. BACKGROUND: HELICOBACTER PYLORI (HP) PERSISTENT INFECTION IS AN IMPORTANT PATHOGENIC FACTOR FOR A SERIES OF CHRONIC GASTRIC DISEASES FROM CHRONIC GASTRITIS TO GASTRIC CANCER. GENETIC AND EPIGENETIC ABNORMALITIES OF MICRORNAS MAY PLAY A VITAL ROLE IN THE PATHOLOGICAL EVOLUTION OF GASTRIC MUCOSA IN HELICOBACTER PYLORI-RELATED GASTRIC DISEASES (HPGD). THIS STUDY AIMED TO INVESTIGATE THE RELATIONSHIP BETWEEN MIR-146A, MIR-196A2, MIR-149, MIR-499 AND MIR-27A GENE SINGLE NUCLEOTIDE POLYMORPHISMS (SNPS) AND THEIR EXPRESSIONS WITH PATHOLOGICAL CHANGES IN GASTRIC MUCOSA, AND TO FURTHER ANALYZE THE INTERACTIONS BETWEEN SNPS AND HP. METHODS: SUBJECTS IN THIS STUDY INCLUDED PATIENTS DIAGNOSED WITH HPGD AND HEALTHY CONTROLS. MIR-146A RS2910164, MIR-196A2 RS11614913, MIR-149 RS2292832, MIR-499 RS3746444 AND MIR-27A RS895819 WERE GENOTYPED BY DIRECT SEQUENCING. FLUORESCENCE QUANTITATIVE PCR WAS USED TO DETECT MICRORNA EXPRESSIONS. GENE-GENE AND GENE-ENVIRONMENT INTERACTIONS WERE EVALUATED BY MULTIFACTOR DIMENSIONALITY REDUCTION (MDR) METHOD. RESULTS: WE FOUND THAT FREQUENCY DISTRIBUTION OF MIR-196A2 RS11614913 CT GENOTYPE IN GASTRIC PRECANCEROUS LESION (GPL) GROUP AND GASTRIC CANCER (GC) GROUP WAS SIGNIFICANTLY HIGHER THAN NORMAL CONTROL (NOR) GROUP [ADJUSTED OR = 6.16, 95%CI (1.46-26.03); ADJUSTED OR = 11.83, 95%CI (1.65-84.72), RESPECTIVELY]. CT GENOTYPE AND C ALLELE OF MIR-27A RS895819 WERE ASSOCIATED WITH INCREASED RISK OF GC [ADJUSTED OR = 10.14, 95%CI (2.25-45.77); ADJUSTED OR = 3.71, 95%CI(1.46-9.44), RESPECTIVELY]. THE MDR ANALYSIS RESULTS SHOWED THAT THE INTERACTION BETWEEN MIR-196A2 RS11614913 AND HP WAS ASSOCIATED WITH THE RISK OF GPL (P = 0.004). MEANWHILE, THE EXPRESSION LEVEL OF MIR-196A2 IN GC GROUP WAS SIGNIFICANTLY HIGHER THAN NOR, CHRONIC INFLAMMATION (CI) AND EARLY PRECANCEROUS LESION (EPL) GROUPS AMONG HP-POSITIVE SUBJECTS. AND EXPRESSIONS OF MIR-499 AND MIR-27A IN GC GROUP WERE BOTH HIGHER THAN EPL GROUP. ALSO, MIR-27A EXPRESSION IN GC GROUP WAS HIGHER THAN CI AND GASTRIC ATROPHY (GA) GROUPS. CONCLUSION: MIR-196A2 RS11614913 AND MIR-27A RS895819 MAY AFFECT THE GENETIC SUSCEPTIBILITY TO GPL OR GC. MIR-196A2 RS11614913 AND HP HAVE A SYNERGISTIC EFFECT IN THE OCCURRENCE AND DEVELOPMENT OF GPL. THE UP-REGULATION OF MIR-499, MIR-196A2 AND MIR-27A EXPRESSION CAUSED BY HP INFECTION MAY BE AN IMPORTANT MECHANISM OF GASTRIC CARCINOGENESIS. 2022 6 3134 37 GLOBAL DNA HYPOMETHYLATION IS AN EARLY EVENT IN HELICOBACTER PYLORI-RELATED GASTRIC CARCINOGENESIS. AIM: CANCER, PARTICULARLY GASTRIC CANCER (GC), IS PREVALENTLY AN EPIGENETIC PHENOMENON THAT IS DEPENDENT ON AN ALTERED DNA METHYLATION PATTERN. IN GASTRIC CARCINOGENESIS, MANY GENES SHOW ABERRANT METHYLATION; HOWEVER, NONE OF THEM MAY BE USED AS A BIOMARKER OF CANCER RISK AND PROGRESSION. THE AUTHORS AIMED TO EVALUATE THE GLOBAL DNA METHYLATION OF GASTRIC MUCOSA IN HELICOBACTER PYLORI (HP)-RELATED CHRONIC GASTRITIS, IN GC AND IN 10 PATIENTS WITH PRENEOPLASTIC LESIONS (IE, ATROPHY AND INTESTINAL METAPLASIA) FOLLOWED UP FOR 10 YEARS. METHODS: THE AUTHORS ANALYSED 93 DYSPEPTIC PATIENTS WHO UNDERWENT UPPER ENDOSCOPY, 41 SURGICAL GC SAMPLES AND 10 PATIENTS WITH PRENEOPLASTIC GASTRIC LESIONS FOLLOWED UP FOR 10 YEARS AFTER SUCCESSFUL HP ERADICATION THERAPY. GLOBAL DNA METHYLATION STATUS AND SURROGATE MARKERS OF CELL PROLIFERATION AND APOPTOSIS WERE EVALUATED BY IMMUNOHISTOCHEMISTRY USING THE ANTI-5-METHYLCYTOSINE (5-MC), ANTI-KI-67 AND ANTI-P53 (ANTI-APOPTOTIC MARKER)-SPECIFIC ANTIBODIES, RESPECTIVELY. RESULTS: GLOBAL DNA METHYLATION OF GASTRIC MUCOSA GRADUALLY DECREASED FROM NORMAL MUCOSA TO HP-POSITIVE GASTRITIS, HP-POSITIVE CHRONIC ATROPHIC GASTRITIS, INDEPENDENT OF CAG-A STATUS AND GC; HOWEVER, THE VARIATION WAS SIGNIFICANT (P<0.05) ONLY BETWEEN HP-NEGATIVE SUBJECTS AND HP-POSITIVE CHRONIC GASTRITIS. INTERESTINGLY, THE 5-MC IMMUNOSTAINING WAS ABSENT IN AREAS OF INTESTINAL METAPLASIA. IN THE 10 PATIENTS WITH PRENEOPLASTIC LESIONS, GLOBAL DNA METHYLATION DECREASED OVER TIME DESPITE THE ERADICATION OF HP INFECTION, BUT REACHED SIGNIFICANCE ONLY AT 10 YEARS VERSUS BASELINE. THE 5-MC IMMUNOSTAINING NEGATIVELY CORRELATED WITH KI-67 AND P53 EXPRESSION IN ALL GROUPS. CONCLUSION: GLOBAL DNA HYPOMETHYLATION IS AN EARLY MOLECULAR EVENT IN HP-RELATED GASTRIC CARCINOGENESIS. FURTHER STUDIES WITH MORE CASES AND A LONGER FOLLOW-UP ARE NEEDED TO ESTABLISH THE POTENTIAL GC PREDICTIVE ROLE OF DNA HYPOMETHYLATION. 2011 7 3222 28 HELICOBACTER PYLORI ASSOCIATED CHRONIC GASTRITIS, CLINICAL SYNDROMES, PRECANCEROUS LESIONS, AND PATHOGENESIS OF GASTRIC CANCER DEVELOPMENT. HELICOBACTER PYLORI (H. PYLORI) INFECTION IS WELL KNOWN TO BE ASSOCIATED WITH THE DEVELOPMENT OF PRECANCEROUS LESIONS SUCH AS CHRONIC ATROPHIC GASTRITIS (AG), OR GASTRIC INTESTINAL METAPLASIA (GIM), AND CANCER. VARIOUS MOLECULAR ALTERATIONS ARE IDENTIFIED NOT ONLY IN GASTRIC CANCER (GC) BUT ALSO IN PRECANCEROUS LESIONS. H. PYLORI TREATMENT SEEMS TO IMPROVE AG AND GIM, BUT STILL REMAINS CONTROVERSIAL. IN CONTRAST, MANY STUDIES, INCLUDING META-ANALYSIS, SHOW THAT H. PYLORI ERADICATION REDUCES GC. MOLECULAR MARKERS DETECTED BY GENETIC AND EPIGENETIC ALTERATIONS RELATED TO CARCINOGENESIS REVERSE FOLLOWING H. PYLORI ERADICATION. THIS INDICATES THAT THESE CHANGES MAY BE AN IMPORTANT FACTOR IN THE IDENTIFICATION OF HIGH RISK PATIENTS FOR CANCER DEVELOPMENT. PATIENTS WHO UNDERWENT ENDOSCOPIC TREATMENT OF GC ARE AT HIGH RISK FOR DEVELOPMENT OF METACHRONOUS GC. A RANDOMIZED CONTROLLED TRIAL FROM JAPAN CONCLUDED THAT PROPHYLACTIC ERADICATION OF H. PYLORI AFTER ENDOSCOPIC RESECTION SHOULD BE USED TO PREVENT THE DEVELOPMENT OF METACHRONOUS GC, BUT RECENT RETROSPECTIVE STUDIES DID NOT SHOW THE TENDENCY. PATIENTS WITH PRECANCEROUS LESIONS (MOLECULAR ALTERATIONS) THAT DO NOT REVERSE AFTER H. PYLORI TREATMENT, REPRESENT THE "POINT OF NO RETURN" AND MAY BE AT HIGH RISK FOR THE DEVELOPMENT OF GC. THEREFORE, EARLIER H. PYLORI ERADICATION SHOULD BE CONSIDERED FOR PREVENTING GC DEVELOPMENT PRIOR TO THE APPEARANCE OF PRECANCEROUS LESIONS. 2014 8 3227 31 HELICOBACTER PYLORI INFECTION-INDUCED H3SER10 PHOSPHORYLATION IN STEPWISE GASTRIC CARCINOGENESIS AND ITS CLINICAL IMPLICATIONS. BACKGROUND: OUR PREVIOUS WORKS HAVE DEMONSTRATED THAT HELICOBACTER PYLORI (HP) INFECTION CAN ALTER HISTONE H3 SERINE 10 PHOSPHORYLATION STATUS IN GASTRIC EPITHELIAL CELLS. HOWEVER, WHETHER HELICOBACTER PYLORI-INDUCED HISTONE H3 SERINE 10 PHOSPHORYLATION PARTICIPATES IN GASTRIC CARCINOGENESIS IS UNKNOWN. WE INVESTIGATE THE EXPRESSION OF HISTONE H3 SERINE 10 PHOSPHORYLATION IN VARIOUS STAGES OF GASTRIC DISEASE AND EXPLORE ITS CLINICAL IMPLICATION. MATERIALS AND METHODS: STOMACH BIOPSY SAMPLES FROM 129 PATIENTS WERE COLLECTED AND STAINED WITH HISTONE H3 SERINE 10 PHOSPHORYLATION, KI67, AND HELICOBACTER PYLORI BY IMMUNOHISTOCHEMISTRY STAINING, EXPRESSED AS LABELING INDEX. THEY WERE CATEGORIZED INTO NONATROPHIC GASTRITIS, CHRONIC ATROPHIC GASTRITIS, INTESTINAL METAPLASIA, LOW-GRADE INTRAEPITHELIAL NEOPLASIA, HIGH-GRADE INTRAEPITHELIAL NEOPLASIA, AND INTESTINAL-TYPE GASTRIC CANCER GROUPS. HELICOBACTER PYLORI INFECTION WAS DETERMINED BY EITHER (13) C-UREA BREATH TEST OR IMMUNOHISTOCHEMISTRY STAINING. RESULTS: IN HELICOBACTER PYLORI-NEGATIVE PATIENTS, LABELING INDEX OF HISTONE H3 SERINE 10 PHOSPHORYLATION WAS GRADUALLY INCREASED IN NONATROPHIC GASTRITIS, CHRONIC ATROPHIC GASTRITIS, INTESTINAL METAPLASIA GROUPS, PEAKED AT LOW-GRADE INTRAEPITHELIAL NEOPLASIA, AND DECLINED IN HIGH-GRADE INTRAEPITHELIAL NEOPLASIA AND GASTRIC CANCER GROUPS. IN HELICOBACTER PYLORI-INFECTED PATIENTS, LABELING INDEX OF HISTONE H3 SERINE 10 PHOSPHORYLATION FOLLOWED THE SIMILAR PATTERN AS ABOVE, WITH INCREASED EXPRESSION OVER THE CORRESPONDING HELICOBACTER PYLORI-NEGATIVE CONTROLS EXCEPT IN NONATROPHIC GASTRITIS PATIENT WHOSE LABELING INDEX WAS DECREASED WHEN COMPARED WITH HELICOBACTER PYLORI-NEGATIVE CONTROL. LABELING INDEX OF KI67 IN HELICOBACTER PYLORI-NEGATIVE GROUPS WAS HIGHER IN GASTRIC CANCER THAN CHRONIC ATROPHIC GASTRITIS AND LOW-GRADE INTRAEPITHELIAL NEOPLASIA GROUPS, AND HIGHER IN INTESTINAL METAPLASIA GROUP COMPARED WITH CHRONIC ATROPHIC GASTRITIS GROUP. IN HELICOBACTER PYLORI-POSITIVE GROUPS, KI67 LABELING INDEX WAS INCREASED STEPWISE FROM NONATROPHIC GASTRITIS TO GASTRIC CANCER EXCEPT SLIGHTLY DECREASE IN CHRONIC ATROPHIC GASTRITIS GROUP. IN ADDITION, WE NOTED THAT HISTONE H3 SERINE 10 PHOSPHORYLATION STAINING IS ACCOMPANIED WITH ITS LOCATION CHANGES FROM GASTRIC GLAND BOTTOM EXPANDED TO WHOLE GLAND AS DISEASE STAGE PROGRESS. CONCLUSIONS: THESE RESULTS INDICATE THAT STEPWISE GASTRIC CARCINOGENESIS IS ASSOCIATED WITH ALTERED HISTONE H3 SERINE 10 PHOSPHORYLATION, HELICOBACTER PYLORI INFECTION ENHANCES HISTONE H3 SERINE 10 PHOSPHORYLATION EXPRESSION IN THESE PROCESSES; IT IS ALSO ACCOMPANIED WITH HISTONE H3 SERINE 10 PHOSPHORYLATION LOCATION CHANGE FROM GLAND BOTTOM STAINING EXPAND TO WHOLE GLAND EXPRESSION. THE RESULTS SUGGEST THAT EPIGENETIC DYSREGULATION MAY PLAY IMPORTANT ROLES IN HELICOBACTER PYLORI-INDUCED GASTRIC CANCER. 2018 9 672 31 BRAF, KRAS AND HELICOBACTER PYLORI EPIGENETIC CHANGES-ASSOCIATED CHRONIC GASTRITIS IN EGYPTIAN PATIENTS WITH AND WITHOUT GASTRIC CANCER. WE AIMED TO STUDY MLH1 AND MGMT METHYLATION STATUS IN HELICOBACTER PYLORI-ASSOCIATED CHRONIC GASTRITIS IN EGYPTIAN PATIENTS WITH AND WITHOUT GASTRIC CANCER. 39 PATIENTS WERE INCLUDED IN OUR STUDY. THEY WERE DIVIDED INTO 2 GROUPS; PATIENTS WITHOUT (GROUP I) AND WITH GASTRIC ADENOCARCINOMA (GROUP II). PATIENTS WERE SUBJECTED TO CLINICAL EXAMINATION, ABDOMINAL ULTRASOUND AND UPPER ENDOSCOPY FOR GASTRIC BIOPSY. BIOPSIES WERE SUBJECTED TO UREASE TEST, HISTOLOGICAL EXAMINATION, AND DNA PURIFICATION. H. PYLORI, BRAF, KRAS, MLH1 AND MGMT METHYLATION WERE ASSESSED BY QUANTITATIVE PCR. DNA SEQUENCING WAS PERFORMED TO ASSESS BRAF AND KRAS GENES MUTATION. QPCR OF H. PYLORI WAS SIGNIFICANTLY HIGHER IN PATIENTS WITH ADENOCARCINOMA (GROUP II) THAN THOSE WITHOUT ADENOCARCINOMA (GROUP I); WITH A P < 0.001 AS WELL AS IN PATIENTS WITH AGE ABOVE 50 YEARS WITH A P VALUE = 0.008. BY APPLYING LOGISTIC REGRESSION ANALYSIS IT WAS REPORTED THAT THE H. PYLORI QPCR IS A SIGNIFICANT PREDICTOR TO THE ADENOCARCINOMA WITH OR = 1.025 (95 % CI: 1. 002-1.048), WITH SENSITIVITY OF 90 % AND SPECIFICITY OF 100 %. ADENOCARCINOMA PATIENTS HAD A SIGNIFICANTLY HIGHER MEAN AGE AND LEVELS OF H. PYLORI, BRAF, K-RAS, METHYLATED MGMT AND METHYLATED MLH1 THAN THOSE OF GASTRITIS PATIENTS. DNA SEQUENCE ANALYSIS OF BRAF (CODON 12) AND KRAS (CODON 600) HAD GENES MUTATION IN GASTRIC ADENOCARCINOMA VERSUS CHRONIC GASTRITIS. CONCLUSION: H. PYLORI MAY CAUSE EPIGENETIC CHANGES PREDISPOSING THE PATIENTS TO CANCER STOMACH. ESTIMATION OF H. PYLORI BY QPCR CAN BE A GOOD PREDICTOR TO ADENOCARCINOMA. BRAF AND KRAS GENES MUTATION WERE REVELED IN GASTRITIS AND ADENOCARCINOMA PATIENTS. 2016 10 600 27 BETA-DEFENSINS AND ANALOGS IN HELICOBACTER PYLORI INFECTIONS: MRNA EXPRESSION LEVELS, DNA METHYLATION, AND ANTIBACTERIAL ACTIVITY. ANTIMICROBIAL PEPTIDES CAN PROTECT THE GASTRIC MUCOSA FROM BACTERIA, BUT HELICOBACTER PYLORI (H. PYLORI) CAN EQUALLY COLONIZE THE GASTRIC APPARATUS. TO UNDERSTAND BETA-DEFENSIN FUNCTION IN H. PYLORI-ASSOCIATED CHRONIC GASTRITIS, WE INVESTIGATED SUSCEPTIBILITY, HUMAN BETA-DEFENSIN MRNA EXPRESSION, AND DNA METHYLATION CHANGES TO PROMOTERS IN THE GASTRIC MUCOSA WITH OR WITHOUT H. PYLORI INFECTION. WE STUDIED THE EXPRESSION OF HBD2 (GENE NAME DEFB4A), HBD3 (DEFB103A), AND HBD4 (DEFB104) USING REAL-TIME PCR IN 15 CONTROL AND 10 H. PYLORI INFECTION PATIENT GASTRIC SPECIMENS. THIS STUDY DEMONSTRATES THAT H. PYLORI INFECTION IS RELATED TO GASTRIC ENHANCEMENT OF INDUCIBLE HBD2, BUT INDUCIBLE HBD3 AND HBD4 EXPRESSION LEVELS REMAINED UNCHANGED. HBD2 GENE METHYLATION LEVELS WERE OVERALL HIGHER IN H. PYLORI-NEGATIVE SAMPLES THAN IN H. PYLORI-POSITIVE SAMPLES. WE ALSO ASSESSED ANTIMICROBIAL SUSCEPTIBILITY USING GROWTH ON BLOOD AGAR. THE H. PYLORI STRAIN TOX+ WAS SUSCEPTIBLE TO ALL DEFENSINS TESTED AND THEIR ANALOGS (3N, 3NI). THESE RESULTS SHOW THAT HBD2 IS INVOLVED IN GASTRITIS DEVELOPMENT DRIVEN BY H. PYLORI, WHICH FACILITATES THE CREATION OF AN EPIGENETIC FIELD DURING H. PYLORI-ASSOCIATED GASTRIC TUMORIGENESIS. 2019 11 1830 25 EFFECTS OF LONG-TERM ASPIRIN USE ON MOLECULAR ALTERATIONS IN PRECANCEROUS GASTRIC MUCOSA IN PATIENTS WITH AND WITHOUT GASTRIC CANCER. THE RISK OF GASTRIC CANCER (GC) REMAINS EVEN AFTER H. PYLORI ERADICATION; THUS, OTHER COMBINATION TREATMENTS, SUCH AS CHEMOPREVENTIVE DRUGS, ARE NEEDED. WE EVALUATED THE EFFECTS OF ASPIRIN ON GENETIC/EPIGENETIC ALTERATIONS IN PRECANCEROUS CONDITIONS, I.E., ATROPHIC MUCOSA (AM) AND INTESTINAL METAPLASIA (IM), IN PATIENTS WITH CHRONIC GASTRITIS WHO HAD TAKEN ASPIRIN FOR MORE THAN 3 YEARS. A TOTAL OF 221 BIOPSY SPECIMENS FROM 74 PATIENTS, INCLUDING ATROPHIC GASTRITIS (AG) CASES WITHOUT ASPIRIN USE (CONTROL), AG CASES WITH ASPIRIN USE (AG GROUP), AND GC CASES WITH ASPIRIN USE (GC GROUP), WERE ANALYZED. ASPIRIN USE WAS ASSOCIATED WITH A SIGNIFICANT REDUCTION OF CDH1 METHYLATION IN AM (OR: 0.15, 95% CI: 0.06-0.41, P = 0.0002), BUT WAS LESS EFFECTIVE IN REVERSING THE METHYLATION THAT OCCURRED IN IM. FREQUENT HYPERMETHYLATION INCLUDING THAT OF CDH1 IN AM INCREASED IN THE GC GROUP COMPARED TO THE AG GROUP, AND CDH1 METHYLATION WAS AN INDEPENDENT PREDICTIVE MARKER OF GC (OR: 8.50, 95% CI: 2.64-25.33, P = 0.0003). IN PATIENTS WITH LONG-TERM ASPIRIN USE, THE CHANGES OF MOLECULAR EVENTS IN AM BUT NOT IM MAY BE AN IMPORTANT FACTOR IN THE REDUCTION OF CANCER INCIDENCE. IN ADDITION, METHYLATION OF THE CDH1 GENE IN AM MAY BE A SURROGATE OF GC. 2017 12 3231 29 HELICOBACTER PYLORI-INDUCED MODULATION OF THE PROMOTER METHYLATION OF WNT ANTAGONIST GENES IN GASTRIC CARCINOGENESIS. BACKGROUND: THIS STUDY AIMED TO INVESTIGATE THE CHANGES IN THE PROMOTER METHYLATION AND GENE EXPRESSION OF MULTIPLE WNT ANTAGONISTS BETWEEN THE CHRONIC INFECTION AND ERADICATION OF HELICOBACTER PYLORI (H. PYLORI) IN GASTRIC CARCINOGENESIS. METHODS: THE LEVELS OF METHYLATION AND CORRESPONDING MRNA EXPRESSION OF SEVEN WNT ANTAGONIST GENES (SFRP1, -2, -5, DKK1, -2, -3, WIF1) WERE COMPARED AMONG THE PATIENTS WITH H. PYLORI-POSITIVE GASTRIC CANCERS (GCS), AND H. PYLORI-POSITIVE AND H. PYLORI-NEGATIVE CONTROLS, BY QUANTITATIVE METHYLIGHT ASSAY AND REAL-TIME REVERSE TRANSCRIPTION (RT)-POLYMERASE CHAIN REACTION (PCR), RESPECTIVELY. THE CHANGES OF THE METHYLATION AND EXPRESSION LEVELS OF THE GENES WERE ALSO COMPARED BETWEEN THE H. PYLORI ERADICATION AND H. PYLORI-PERSISTENT GROUPS 1 YEAR AFTER ENDOSCOPIC RESECTION OF GCS. RESULTS: THE METHYLATION LEVELS OF SFRP AND DKK FAMILY GENES WERE SIGNIFICANTLY INCREASED IN THE PATIENTS WITH H. PYLORI-POSITIVE GCS AND FOLLOWED BY H. PYLORI-POSITIVE CONTROLS COMPARED WITH H. PYLORI-NEGATIVE CONTROLS (P < 0.001). SFRP1, -2, AND DKK3 GENE EXPRESSION WAS STEPWISE DOWNREGULATED FROM H. PYLORI-NEGATIVE CONTROLS, H. PYLORI-POSITIVE CONTROLS, AND TO H. PYLORI-POSITIVE GCS (P < 0.05). AMONG THE WNT ANTAGONISTS, ONLY THE DEGREES OF METHYLATION AND DOWNREGULATION OF DKK3 WERE SIGNIFICANTLY REDUCED AFTER H. PYLORI ERADICATION (P < 0.05). CONCLUSION: EPIGENETIC SILENCING OF SFRP AND DKK FAMILY GENES MAY FACILITATE THE FORMATION OF AN EPIGENETIC FIELD DURING H. PYLORI-ASSOCIATED GASTRIC CARCINOGENESIS. THE EPIGENETIC FIELD MAY NOT BE REVERSED EVEN AFTER H. PYLORI ERADICATION EXCEPT BY DKK3 METHYLATION. 2018 13 4244 40 METHYLATION STATUS OF COX-2 IN BLOOD LEUKOCYTE DNA AND RISK OF GASTRIC CANCER IN A HIGH-RISK CHINESE POPULATION. BACKGROUND: METHYLATION IS A COMMON EPIGENETIC MODIFICATION WHICH MAY PLAY A CRUCIAL ROLE IN CANCER DEVELOPMENT. TO INVESTIGATE THE ASSOCIATION BETWEEN METHYLATION OF COX-2 IN BLOOD LEUKOCYTE DNA AND RISK OF GASTRIC CANCER (GC), A NESTED CASE-CONTROL STUDY WAS CONDUCTED IN LINQU COUNTY, SHANDONG PROVINCE, A HIGH RISK AREA OF GC IN CHINA. METHODS: ASSOCIATION BETWEEN BLOOD LEUKOCYTE DNA METHYLATION OF COX-2 AND RISK OF GC WAS INVESTIGATED IN 133 GCS AND 285 SUPERFICIAL GASTRITIS (SG)/ CHRONIC ATROPHIC GASTRITIS (CAG). THE TEMPORAL TREND OF COX-2 METHYLATION LEVEL DURING GC DEVELOPMENT WAS FURTHER EXPLORED IN 74 PRE-GC AND 95 POST-GC SAMPLES (INCLUDING 31 CASES WITH BOTH PRE- AND POST-GC SAMPLES). IN ADDITION, THE ASSOCIATION OF DNA METHYLATION AND RISK OF PROGRESSION TO GC WAS EVALUATED IN 74 PRE-GC SAMPLES AND THEIR RELEVANT INTESTINAL METAPLASIA (IM)/DYSPLASIA (DYS) CONTROLS. METHYLATION LEVEL WAS DETERMINED BY QUANTITATIVE METHYLATION-SPECIFIC PCR (QMSP). ODDS RATIOS (ORS) AND 95% CONFIDENCE INTERVALS (CIS) WERE CALCULATED BY UNCONDITIONAL LOGISTIC REGRESSION ANALYSIS. RESULTS: THE MEDIANS OF COX-2 METHYLATION LEVELS WERE 2.3% AND 2.2% IN GC CASES AND CONTROLS, RESPECTIVELY. NO SIGNIFICANT ASSOCIATION WAS FOUND BETWEEN COX-2 METHYLATION AND RISK OF GC (OR, 1.15; 95% CI: 0.70-1.88). HOWEVER, THE TEMPORAL TREND ANALYSIS SHOWED THAT COX-2 METHYLATION LEVELS WERE ELEVATED AT 1-4 YEARS AHEAD OF CLINICAL GC DIAGNOSIS COMPARED WITH THE YEAR OF GC DIAGNOSIS (3.0% VS. 2.2%, P=0.01). FURTHER VALIDATION IN 31 GCS WITH BOTH PRE- AND POST-GC SAMPLES INDICATED THAT COX-2 METHYLATION LEVELS WERE SIGNIFICANTLY DECREASED AT THE YEAR OF GC DIAGNOSIS COMPARED WITH PRE-GC SAMPLES (1.5% VS. 2.5%, P=0.02). NO SIGNIFICANT ASSOCIATION BETWEEN COX-2 METHYLATION AND RISK OF PROGRESSION TO GC WAS FOUND IN SUBJECTS WITH IM (OR, 0.50; 95% CI: 0.18-1.42) OR DYS (OR, 0.70; 95% CI: 0.23-2.18). ADDITIONALLY, WE FOUND THAT ELDER PEOPLE HAD INCREASED RISK OF COX-2 HYPERMETHYLATION (OR, 1.55; 95% CI: 1.02-2.36) AND SUBJECTS WHO EVER INFECTED WITH H. PYLORI HAD DECREASED RISK OF COX-2 HYPERMETHYLATION (OR, 0.54; 95% CI: 0.34-0.88). CONCLUSIONS: COX-2 METHYLATION EXISTS IN BLOOD LEUKOCYTE DNA BUT AT A LOW LEVEL. COX-2 METHYLATION LEVELS IN BLOOD LEUKOCYTE DNA MAY CHANGE DURING GC DEVELOPMENT. 2015 14 525 31 ASSOCIATIONS OF BODY COMPOSITION AND PHYSICAL ACTIVITY LEVEL WITH MULTIPLE MEASURES OF EPIGENETIC AGE ACCELERATION. EPIGENETIC CLOCKS USE DNA METHYLATION TO ESTIMATE BIOLOGICAL AGE. WHETHER BODY COMPOSITION AND PHYSICAL ACTIVITY ARE ASSOCIATED WITH THESE CLOCKS IS NOT WELL UNDERSTOOD. USING BLOOD SAMPLES COLLECTED AT ENROLLMENT (2003-2009) FROM 2,758 WOMEN IN THE US NATIONWIDE SISTER STUDY, WE CALCULATED 6 EPIGENETIC AGE ACCELERATION METRICS USING 4 EPIGENETIC CLOCKS (HANNUM, HORVATH, PHENOAGE, GRIMAGE). RECREATIONAL PHYSICAL ACTIVITY WAS SELF-REPORTED, AND ADIPOSITY MEASURES WERE ASSESSED BY TRAINED MEDICAL EXAMINERS (BODY MASS INDEX (BMI), WAIST-TO-HIP RATIO (WTH), WAIST CIRCUMFERENCE). IN CROSS-SECTIONAL ANALYSES, ALL ADIPOSITY MEASURES WERE ASSOCIATED WITH EPIGENETIC AGE ACCELERATION. THE STRONGEST ASSOCIATION WAS FOR BMI AND PHENOAGE, A MEASURE OF BIOLOGICAL AGE THAT CORRELATES WITH CHRONIC DISEASE (BMI OF >/=35.0 VS. 18.5-24.9, BETA = 3.15 YEARS, 95% CONFIDENCE INTERVAL (CI): 2.41, 3.90; P FOR TREND < 0.001). IN A MUTUAL-ADJUSTMENT MODEL, BOTH WERE ASSOCIATED WITH PHENOAGE AGE ACCELERATION (BMI OF >/=35.0 VS. 18.5-24.9, BETA = 2.69 YEARS, 95% CI: 1.90, 3.48; P FOR TREND < 0.001; QUARTILE 4 VS.1 WTH, BETA = 1.00 YEARS, 95% CI: 0.34, 1.65; P FOR TREND < 0.008). AFTER ADJUSTMENT, PHYSICAL ACTIVITY WAS ASSOCIATED ONLY WITH GRIMAGE (QUARTILE 4 VS. 1, BETA = -0.42 YEARS, 95% CI: -0.70, -0.14; P FOR TREND = 0.001). PHYSICAL ACTIVITY ATTENUATED THE WAIST CIRCUMFERENCE ASSOCIATIONS WITH PHENOAGE AND GRIMAGE. EXCESS ADIPOSITY WAS ASSOCIATED WITH EPIGENETIC AGE ACCELERATION; PHYSICAL ACTIVITY MIGHT ATTENUATE ASSOCIATIONS WITH WAIST CIRCUMFERENCE. 2021 15 5027 32 PERSONALIZED RISK ASSESSMENT FOR DYNAMIC TRANSITION OF GASTRIC NEOPLASMS. BACKGROUND: TO DEVELOP AN INDIVIDUALLY-TAILORED DYNAMIC RISK ASSESSMENT MODEL FOLLOWING A MULTISTEP, MULTIFACTORIAL PROCESS OF THE CORREA'S GASTRIC CANCER MODEL. METHODS: FIRST, WE ESTIMATED THE STATE-TO-STATE TRANSITION RATES FOLLOWING CORREA'S FIVE-STEP CARCINOGENIC MODEL AND ASSESSED THE EFFECT OF RISK FACTORS, INCLUDING HELICOBACTER PYLORI INFECTION, HISTORY OF UPPER GASTROINTESTINAL DISEASE, LIFESTYLE, AND DIETARY HABITS, ON THE STEP-BY-STEP TRANSITION RATES USING DATA FROM A HIGH-RISK POPULATION IN MATSU ISLANDS, TAIWAN. SECOND, WE INCORPORATED INFORMATION ON THE GASTRIC CANCER CARCINOGENESIS AFFECTED BY GENOMIC RISK FACTORS (INCLUDING INHERITED SUSCEPTIBILITY AND IRREVERSIBLE GENOMIC CHANGES) BASED ON LITERATURE TO GENERATE A GENETIC AND EPIGENETIC RISK ASSESSMENT MODEL BY USING A SIMULATED COHORT IDENTICAL TO THE MATSU POPULATION. THE COMBINATION OF CONVENTIONAL AND GENOMIC RISK FACTORS ENABLES US TO DEVELOP THE PERSONALIZED TRANSITION RISK SCORES AND COMPOSITE SCORES. RESULTS: THE STATE-BY-STATE TRANSITION RATES PER YEAR WERE 0.0053, 0.7523, 0.1750, AND 0.0121 PER YEAR FROM NORMAL MUCOSA TO CHRONIC ACTIVE GASTRITIS, CHRONIC ACTIVE GASTRITIS TO ATROPHIC GASTRITIS, ATROPHIC GASTRITIS TO INTESTINAL METAPLASIA, AND INTESTINAL METAPLASIA TO GASTRIC CANCER, RESPECTIVELY. COMPARED WITH THE MEDIAN RISK GROUP, THE MOST RISKY DECILE HAD A 5.22-FOLD RISK OF DEVELOPING GASTRIC CANCER, AND THE LEAST RISKY DECILE AROUND ONE-TWELFTH OF THE RISK. THE MEDIAN 10-YEAR RISK FOR GASTRIC CANCER INCIDENCE WAS 0.77%. THE MEDIAN LIFETIME RISK FOR GASTRIC CANCER INCIDENCE WAS 5.43%. BY DECILE, THE 10-YEAR RISK RANGED FROM 0.06 TO 4.04% AND THE LIFETIME RISK RANGED FROM 0.42 TO 21.04%. CONCLUSIONS: WE DEMONSTRATE HOW TO DEVELOP A PERSONALIZED DYNAMIC RISK ASSESSMENT MODEL WITH THE UNDERPINNING OF CORREA'S CASCADE TO STRATIFY THE POPULATION ACCORDING TO THEIR RISK FOR PROGRESSION TO GASTRIC CANCER. SUCH A RISK ASSESSMENT MODEL NOT ONLY FACILITATES THE DEVELOPMENT OF AN INDIVIDUALLY-TAILORED PREVENTIVE STRATEGY WITH TREATMENT FOR H. PYLORI INFECTION AND ENDOSCOPIC SCREENING BUT ALSO PROVIDES SHORT-TERM AND LONG-TERM INDICATORS TO EVALUATE THE PROGRAM EFFECTIVENESS. 2018 16 3232 21 HELICOBACTER PYLORI-INDUCED SIGNALING PATHWAYS CONTRIBUTE TO INTESTINAL METAPLASIA AND GASTRIC CARCINOGENESIS. HELICOBACTER PYLORI (H. PYLORI) INDUCES CHRONIC GASTRIC INFLAMMATION, ATROPHIC GASTRITIS, INTESTINAL METAPLASIA, AND CANCER. ALTHOUGH THE RISK OF GASTRIC CANCER INCREASES EXPONENTIALLY WITH THE EXTENT OF ATROPHIC GASTRITIS, THE PRECISE MECHANISMS OF GASTRIC CARCINOGENESIS HAVE NOT BEEN FULLY ELUCIDATED. H. PYLORI INDUCES GENETIC AND EPIGENETIC CHANGES IN GASTRIC EPITHELIAL CELLS THROUGH ACTIVATING INTRACELLULAR SIGNALING PATHWAYS IN A CAGPAI-DEPENDENT MANNER. H. PYLORI EVENTUALLY INDUCES GASTRIC CANCER WITH CHROMOSOMAL INSTABILITY (CIN) OR MICROSATELLITE INSTABILITY (MSI), WHICH ARE CLASSIFIED AS TWO MAJOR SUBTYPES OF GASTRIC CANCER. ELUCIDATION OF THE PRECISE MECHANISMS OF GASTRIC CARCINOGENESIS WILL ALSO BE IMPORTANT FOR CANCER THERAPY. 2015 17 3228 32 HELICOBACTER PYLORI-INDUCED CHRONIC GASTRITIS AND ASSESSING RISKS FOR GASTRIC CANCER. CHRONIC GASTRITIS IS AN INFLAMMATION OF THE GASTRIC MUCOSA AND HAS MULTIPLE ETIOLOGIES. HERE WE DISCUSS THE PATHOLOGICAL ALTERATIONS INDUCED BY HELICOBACTER PYLORI (HP) LEADING TO CHRONIC GASTRITIS AND THE EPIGENETIC BASES UNDERLYING THESE CHANGES. WE REVIEW THE HISTOLOGY OF THE NORMAL GASTRIC MUCOSA AND OVERVIEW THE ROLE OF HP IN THE MULTISTEP CASCADE OF GC. WE ATTEMPT TO DEFINE THE ROLE OF THE OPERATIVE LINK FOR GASTRITIS ASSESSMENT (OLGA) STAGING SYSTEM IN ASSESSING THE RISK OF GC. THE EPIGENETIC BASES OF CHRONIC GASTRITIS, MAINLY DNA METHYLATION, ARE PRESENTED THROUGH EXAMPLES SUCH AS (I) THE METHYLATION OF THE PROMOTER REGION OF E-CADHERIN IN HP-INDUCED CHRONIC GASTRITIS AND ITS REVERSION AFTER HP ERADICATION AND (II) THE ASSOCIATION OF METHYLATION OF THE PROMOTER REGION OF REPRIMO, A P53-MEDIATED CELL CYCLE ARREST GENE, WITH AGGRESSIVE HP STRAINS IN HIGH RISK AREAS FOR GC. IN ADDITION, WE DISCUSS THE FINDING OF RPRM AS A CIRCULATING CELL-FREE DNA, OFFERING THE OPPORTUNITY FOR NONINVASIVE RISK ASSESSMENT OF GC. FINALLY, THE INTEGRATION OF OLGA AND TISSUE BIOMARKERS, BY SYSTEMS PATHOLOGY APPROACH, SUGGESTS THAT SEVERE ATROPHY HAS A GREATER RISK FOR GC DEVELOPMENT IF, IN ADDITION, OVEREXPRESSED P73. THIS TRIAL IS REGISTERED WITH CLINICALTRIALS.GOV NCT01774266. 2013 18 3225 28 HELICOBACTER PYLORI INFECTION INTRODUCES DNA DOUBLE-STRAND BREAKS IN HOST CELLS. GASTRIC CANCER IS AN INFLAMMATION-RELATED MALIGNANCY RELATED TO LONG-STANDING ACUTE AND CHRONIC INFLAMMATION CAUSED BY INFECTION WITH THE HUMAN BACTERIAL PATHOGEN HELICOBACTER PYLORI. INFLAMMATION CAN RESULT IN GENOMIC INSTABILITY. HOWEVER, THERE ARE CONSIDERABLE DATA THAT H. PYLORI ITSELF CAN ALSO PRODUCE GENOMIC INSTABILITY BOTH DIRECTLY AND THROUGH EPIGENETIC PATHWAYS. OVERALL, THE MECHANISMS OF H. PYLORI-INDUCED HOST GENOMIC INSTABILITIES REMAIN POORLY UNDERSTOOD. WE USED MICROARRAY SCREENING OF H. PYLORI-INFECTED HUMAN GASTRIC BIOPSY SPECIMENS TO IDENTIFY CANDIDATE GENES INVOLVED IN H. PYLORI-INDUCED HOST GENOMIC INSTABILITIES. WE FOUND UPREGULATION OF ATM EXPRESSION IN VIVO IN GASTRIC MUCOSAL CELLS INFECTED WITH H. PYLORI. USING GASTRIC CANCER CELL LINES, WE CONFIRMED THAT THE H. PYLORI-RELATED ACTIVATION OF ATM WAS DUE TO THE ACCUMULATION OF DNA DOUBLE-STRAND BREAKS (DSBS). DSBS WERE OBSERVED FOLLOWING INFECTION WITH BOTH CAG PATHOGENICITY ISLAND (PAI)-POSITIVE AND -NEGATIVE STRAINS, BUT THE EFFECT WAS MORE ROBUST WITH CAG PAI-POSITIVE STRAINS. THESE RESULTS ARE CONSISTENT WITH THE FACT THAT INFECTIONS WITH BOTH CAG PAI-POSITIVE AND -NEGATIVE STRAINS ARE ASSOCIATED WITH GASTRIC CARCINOGENESIS, BUT THE RISK IS HIGHER IN INDIVIDUALS INFECTED WITH CAG PAI-POSITIVE STRAINS. 2014 19 3805 29 INTESTINE-SPECIFIC HOMEOBOX (ISX) INDUCES INTESTINAL METAPLASIA AND CELL PROLIFERATION TO CONTRIBUTE TO GASTRIC CARCINOGENESIS. BACKGROUND: HELICOBACTER PYLORI INDUCES CHRONIC INFLAMMATION AND INTESTINAL METAPLASIA (IM) THROUGH GENETIC AND EPIGENETIC CHANGES AND ACTIVATION OF INTRACELLULAR SIGNALING PATHWAYS THAT CONTRIBUTE TO GASTRIC CARCINOGENESIS. HOWEVER, THE PRECISE MECHANISM OF IM IN GASTRIC CARCINOGENESIS HAS NOT BEEN FULLY ELUCIDATED. WE PREVIOUSLY FOUND THAT INTESTINE-SPECIFIC HOMEOBOX (ISX) MRNA EXPRESSION INCREASED IN ORGANOIDS CULTURED FROM HELICOBACTER-INFECTED MOUSE MUCOSA. IN THIS STUDY, WE ELUCIDATE THE ROLE OF ISX IN THE DEVELOPMENT OF IM AND GASTRIC CARCINOGENESIS. METHODS: ISX EXPRESSION WAS ASSESSED IN HELICOBACTER-INFECTED MOUSE AND HUMAN GASTRIC MUCOSA. MKN45 GASTRIC CANCER CELLS WERE CO-CULTURED WITH H. PYLORI TO DETERMINE WHETHER HELICOBACTER INFECTION INDUCED ISX EXPRESSION. WE ESTABLISHED STABLE MKN45 TRANSFECTED CELLS EXPRESSING ISX (STABLE-ISX MKN45) AND PERFORMED A SPHEROID COLONY FORMATION ASSAY AND A XENOGRAFT MODEL. WE PERFORMED ISX IMMUNOHISTOCHEMISTRY IN CANCER AND ADJACENT GASTRIC TISSUES. RESULTS: ISX EXPRESSION WAS INCREASED IN MOUSE AND HUMAN GASTRIC MUCOSA INFECTED WITH HELICOBACTER. THE PRESENCE OF IM AND H. PYLORI INFECTION IN HUMAN STOMACH WAS CORRELATED WITH ISX EXPRESSION. H. PYLORI INDUCED ISX MRNA AND PROTEIN EXPRESSION. CDX1/2, CYCLIND1, AND MUC2 WERE UPREGULATED IN STABLE-ISX MKN45, WHEREAS MUC5AC WAS DOWNREGULATED. STABLE-ISX MKN45 CELLS FORMED MORE SPHEROID COLONIES, AND HAD HIGH TUMORIGENIC ABILITY. ISX EXPRESSION IN GASTRIC CANCER AND ADJACENT MUCOSA WERE CORRELATED. CONCLUSIONS: ISX EXPRESSION INDUCED BY H. PYLORI INFECTION MAY LEAD TO IM AND HYPERPROLIFERATION OF GASTRIC MUCOSA THROUGH CDX1/2 AND CYCLIND1 EXPRESSION, CONTRIBUTING TO GASTRIC CARCINOGENESIS. 2016 20 624 28 BIOLOGICAL AGE ACCELERATION AND MOTORIC COGNITIVE RISK SYNDROME. OBJECTIVE: MOTORIC COGNITIVE RISK (MCR) SYNDROME, A PREDEMENTIA SYNDROME CHARACTERIZED BY SLOW GAIT AND SUBJECTIVE COGNITIVE CONCERNS, IS ASSOCIATED WITH MULTIPLE AGE-RELATED RISK FACTORS. WE HYPOTHESIZED THAT MCR IS ASSOCIATED WITH BIOLOGICAL AGE ACCELERATION. WE EXAMINED THE ASSOCIATIONS OF BIOLOGICAL AGE ACCELERATION WITH MCR, AND MORTALITY RISK IN MCR CASES. METHODS: BIOLOGICAL AGE WAS DETERMINED USING PROTEOMIC AND EPIGENETIC CLOCKS IN PARTICIPANTS AGED 65 YEARS AND OLDER IN THE LONGENITY STUDY (N = 700, FEMALES = 57.9%) AND HEALTH AND RETIREMENT STUDY (HRS; N = 1,043, FEMALES = 57.1%) COHORTS. AGE ACCELERATION (AGEACCEL) WAS OPERATIONALLY DEFINED AS THE RESIDUAL FROM REGRESSING PREDICTED BIOLOGICAL AGE (FROM BOTH CLOCKS SEPARATELY) ON CHRONOLOGICAL AGE. ASSOCIATION OF AGEACCEL WITH INCIDENT MCR IN THE OVERALL SAMPLE AS WELL AS WITH MORTALITY RISK IN MCR CASES WAS EXAMINED USING COX MODELS AND REPORTED AS HAZARD RATIOS (HRS). RESULTS: AGEACCEL SCORES DERIVED FROM A PROTEOMIC CLOCK WERE ASSOCIATED WITH PREVALENT MCR (ODDS RATIO ADJUSTED FOR AGE, GENDER, EDUCATION YEARS, AND CHRONIC ILLNESSES [AOR] = 1.36, 95% CONFIDENCE INTERVAL [CI] = 1.09-1.71) AS WELL AS PREDICTED INCIDENT MCR (HR = 1.19, 95% CI = 1.00-1.41) IN THE LONGENITY COHORT. IN HRS, THE ASSOCIATION OF AGEACCEL USING AN EPIGENETIC CLOCK WITH PREVALENT MCR WAS CONFIRMED (AOR = 1.47, 95% CI = 1.16-1.85). PARTICIPANTS WITH MCR AND ACCELERATED AGING (POSITIVE AGEACCEL SCORE) WERE AT THE HIGHEST RISK FOR MORTALITY IN BOTH LONGENITY (HR = 3.38, 95% CI = 2.01-5.69) AND HRS (HR = 2.47, 95% CI = 1.20-5.10). INTERPRETATION: ACCELERATED AGING PREDICTS RISK FOR MCR, AND IS ASSOCIATED WITH HIGHER MORTALITY IN MCR PATIENTS. ANN NEUROL 2023;93:1187-1197. 2023