peptic ulcer and helicobacter pylori
TRANSCRIPT
Peptic Ulcer and Helicobacter pylori
台⼤內科學：消化性潰瘍
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▸ Helicobacter pylori
▸ NSAIDs
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▸Robbins Cotran Pathologic Basis of Disease: The Gastrointestinal Tract
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▸ HCO3-
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▸Robbins Cotran Pathologic Basis of Disease: The Gastrointestinal Tract
Normal Injury Ulcer
Robbins Cotran Pathologic Basis of Disease: The Gastrointestinal Tract
the world’s human population has H. pylori infection
Recent developments in the epidemiology of Helicobacter pylori. Gastroenterol Clin North Am 2000
Gastric &Duodenal ulcer
Gastric caner
MALTlymphoma
0.1% - 3% 1% - 10% <0.01%
Robbins Cotran Pathologic Basis of Disease: The Gastrointestinal Tract
Adhesins
NF-κBAP-1
IL-8
Adhesins
NF-κB
AP-1
IL-8
Adhesins
IL-8
UreaseLPSPorins
PMN
Adhesins
NF-κB
AP-1
IL-8UreaseLPSPorins
IL-12
Th0 cell
Th1 cell
UreaseLPSPorins
IL-12
Th0 cell
Th1 cell
VacA
Disruption of epithelial barrier
TNF-αIL-1β
Apoptosis
Fas expression
Th0 cell
UreaseLPSPorins
IL-12 Th1 cell
VacA
Disruption of epithelial barrier
TNF-αIL-1β
Apoptosis
Fas expression
Increase gastrinsecretion
IFN-γ
Fundus
Body
Antrumgastrin
H+
H+
H+H+
Ulceration &gastric metaplasia
Helicobacter pylori Infection. NEJM clinical Practice
Normal gastric mucosa
Acute H. pylori infection
Chronic H. pylori infection
Antral- predominant gastritis
Non atrophic pangastritis
Corpus- predominant atrophic gastritis
Asymptomatic H. pylori infection
Duodenal ulcer
MALT lymphoma
Gastric ulcer
Gastric cancer
Helicobacter pylori Infection. NEJM Review Article
PGE2, PGI2
Robbins Cotran Pathologic Basis of Disease: The Gastrointestinal Tract
PGE2, PGI2
Robbins Cotran Pathologic Basis of Disease: The Gastrointestinal Tract
▸ Zollinger-Ellison syndrome (Gastrinoma)
▸ Antral G cell hyperfunction
▸ Basophilia in myeloproliferative disease
▸ Systemic mastocytosis
UpToDate:Etiologies and disease associations for peptic ulcer ;台⼤內科學：消化性潰瘍
UpToDate: Etiologies and disease associations for peptic ulcer
Annular pancreas
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▸ PG
台⼤內科學：消化性潰瘍
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