Peptic Ulcer and Helicobacter pylori
台⼤內科學:消化性潰瘍
▸
▸
▸ Helicobacter pylori
▸ NSAIDs
▸
▸
Robbins Cotran Pathologic Basis of Disease: The Gastrointestinal Tract
▸
▸ HCO3
-
▸
▸
▸
▸
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
MALT
lymphoma
0.1% - 3% 1% - 10% <0.01%
Peptic ulcer and helicobacter pylori
Robbins Cotran Pathologic Basis of Disease: The Gastrointestinal Tract
Peptic ulcer and helicobacter pylori
Adhesins
NF-κB
AP-1
IL-8
Adhesins
NF-κB
AP-1
IL-8
Urease
LPS
Porins
PMN
Adhesins
NF-κB
AP-1
IL-8
Urease
LPS
Porins
IL-12
Th0 cell
Th1 cell
Urease
LPS
Porins
IL-12
Th0 cell
Th1 cell
VacA
Disruption of
epithelial barrier
TNF-α
IL-1β
Apoptosis
Fas
expression
ase
S
ns
IL-12 Th1 cell
VacA
Disruption of
epithelial barrier
TNF-α
IL-1β
Apoptosis
Fas
expression
Increase gastrin
secretion
IFN-γ
Fundus
Body
Antrum
gastrin
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
▸
▸
▸
▸ PG
台⼤內科學:消化性潰瘍
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