The sequencing of the human genome has opened the door for proteomics by providing a sequence-based framework for mining proteomes. As a result, there is intense interest in applying proteomics to foster a better understanding of cancer processes, develop new biomarkers for diagnosis and early detection of cancer. Gastric carcinoma is one of the most common malignancies worldwide and is the most common cause of cancer-related death in China. The main barrier for improving survival rate is short of useful marker for early diagnosis.

A research article to be published on October 7, 2008 in the World Journal of Gastroenterology addresses this question. The research team led by Professor Liu from Ruijin Hospital of China isolated and identified differentially expressed proteins between cancer and normal tissues of gastric cancer by 2-DE and MALDI-TOF-MS.

Total proteins were isolated from tumor and normal tissues and then separated by 2-DE. Differentially expressed proteins were isolated and identified by MALDI-TOF or MALDI-TOF-TOF-MS. Twenty three differentially expressed proteins were found between tumor and normal tissues of gastric cancer, among these fifteen proteins were identified. These differential proteins will be candidate markers for gastric cancer. It may be useful for diagnosis, treatment target and prognosis.

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This research study led by Dr. Javed Yakoob from Aga Khan University, Karachi, has determined that a gastric juice polymerase chain reaction test for the diagnosis of Helicobacter pylori infection has greater sensitivity compared to histology when commonly used potent acid-reducing drugs such as proton pump inhibitors are being used. The use of the gastric juice PCR test can be recommended to confirm H. pylori status in patients taking PPIs.

This study determined the efficiency of a gastric juice PCR test for the detection of H. pylori infection in patients receiving PPI therapy and compared it with histology and gastric biopsy PCR.

Helicobacter pylori (H pylori) is a gram-negative spiral bacterium that infects the human gastric mucosa and is associated with gastritis, gastroduodenal ulcer disease, gastric carcinoma, and lymphoma of mucosa-associated lymphoid tissue.

An accurate diagnosis of H pylori infection is important when seeking to cure patients with persistent gastric symptoms in which H pylori infection is suspected. In patients on acid-reducing drugs such as PPI or H2-receptor blockers (H2RB), the accuracy of the rapid urease test, urea breath test and histology are known to be lower for the diagnosis of H pylori infection.

In the view of the authors, the development of new targets to test for H pylori infection in patients with prior use of acid-reducing drugs is important, considering the morbidity and mortality associated with this infection. Gastric juice PCR has been evaluated as a highly specific and rapid method for the detection of H pylori.

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Administration of omega-3 fatty acid supplements did not appear to improve the rate of relapse in patients with Crohn’s disease, according to a study released on April 9, 2008 in JAMA.

Crohn’s Disease is a gastrointestinal disorder which is indicated by chronic inflammation of the wall of the digestive tract, usually in the ileum or large intestines. The disease involves constant cycles of flare-ups and remission throughout the life of the patient, and without proper treatment, must be addressed surgically. It is considered an inflammatory bowel disease (IBD), similar to ulcerative colitis. Therapy to induce remission in Crohn’s disease is an unmet medical need, usually attempted with the use of certain immunosuppressive drugs, which are associated with infection and other risks. Many Crohn’s patients turn to alternative medications in the face of disappointing overall results.

Omega-3 fatty acids unsaturated fatty acids usually found in marine fish. They have anti-inflammatory properties, and have been used to treat some inflammatory disorders such as rheumatoid arthritis. Earlier studies have evalued omega-3 fatty acids for the maintenance of remission in Crohn’s disease, but have had inconsistent results.

To attempt to rectify this, Brian G. Feagan, M.D., of the Robarts Research Institute, University of Western Ontario, London, Ontario, and colleagues performed two large trials of high-dose omega-3 free fatty acids as therapy in Crohn’s patients who were in remission. The studies, called the Epanova Program in Crohn’s Study 1 and 2 [EPIC-1 and EPIC-2], were conducted between January 2003 and February 2007 at 98 different centers in Canada, Europe, Israel, and the United States. There were 363 and 375 patients involved respectively, all with Crohn’s disease which was in remission at the time. Patients were randomly assigned in approximately equal numbers to either a group administered four grams per day of omega-3 fatty acids or a placebo, to be taken for up to 58 weeks.

There was no significant difference found in the relapse rates between the two treatment groups in either of the trials. In EPIC-1, 54 patients treated with the fatty acids and 62 patients with placebo experienced a clinical relapse. The set of patients experiencing a relapse within 360 days in the omega-3 group was estimated to be 31.6%, compared with 35.7% in the placebo group. EPIC-2 had 84 patients who were treated with omega-3 fatty acids and 94 who took the placebo experienced relapse. The set of patients experiencing a relapse within 360 days in the omega-3 group was estimated to be 47.8%, in contrast with 48.8% in the placebo group.

Any serious adverse events were uncommon, and those that did occur were mostly related to Crohn’s disease itself.

The researchers believe that this conclusion is significant because it has serious implications on the self treatment of Crohn’s patients. “Our results are important because the use of alternative medicines in general, and omega-3 free fatty acid formulations in particular, is widespread among patients with inflammatory bowel disease. This may be due, in part, to dissemination of the positive results obtained in [a trial by Belluzzi et al]. Given the negative results observed in the EPIC trials and in [a trial by Lorenz-Meyer et al], we do not endorse this practice, since patients with Crohn disease who are at risk for relapse would be better served by taking medications of known efficacy,” they write.

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