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Introduction

In Colombia, the severity of lesions in gastric cancer pathogenesis varies depending on geographical location (Pacific coast: Low risk; Andean region: High risk), human ancestry, and Helicobacter pylori strain. Helicobacter pylori, the main causative agent of gastric adenocarcinoma, triggers a proinflammatory Th1 immune response and dysbiosis of the gastric microbiota upon infection by this microorganism.

Aims & Methods

Our research focuses on understanding how the ancestral origins of both Helicobacter pylori and humans in Colombia influence the composition and behavior of the gastric microbiota, particularly in relation to the immune response and genetic polymorphisms associated with gastric cancer pathogenesis. Through comprehensive genomic, microbiome, and immunological analyses in individuals with high and low risk of gastric cancer in Colombia.

Results

It was observed that in Colombian Pacific coast reveal a predominant presence of Helicobacter pylori strains hspWAfrica and hpAfrica1, aligning closely with the African ancestry of the human population. However, a new strain, hspColombia, is notably present among human individuals of European and Native American descent in the Andean region. Immune responses differ between these regions, with an anti-inflammatory Th2 response prevalent on the Pacific coast, contrasting with a Th1 response observed in the Andean region, linked to specific human polymorphisms such as Mutations IL-1B-511TT (72%) and IL-10-1082AG (79%). These mutations elevate the risk of developing precursor lesions of gastric cancer by 5.45 times (OR: 5.45; CI: 95%). Comparative analysis of the microbiota indicates a decline in species diversity with increasing severity of gastric lesions due to Helicobacter pylori infection. Among the most representative genera of the gastric microbiota were Helicobacter, Pseudomonas, Methylobacterium, Streptococcus, Corynebacterium, and Staphylococcus, as determined by U test (p < 0.001).

Conclusion

The interplay between geographical and genomic variations of Helicobacter pylori and humans in Colombia is pivotal in driving the progression of lesions in gastric pathogenesis. The immune response, marked by Th1 and Th2 profiles, exhibits regional disparities and is closely tied to human polymorphisms, notably mutations in the IL-1B-511TT and IL-10-1082AG genes, which heighten the risk of gastric cancer. Helicobacter pylori infection modulates the diversity of the gastric microbiota, culminating in a reduction in species diversity as gastric lesion severity escalates. This underscores the significance of maintaining the coevolutionary equilibrium between Helicobacter pylori and humans, as its disruption critically impacts dysbiosis in the gastric microbiota, exacerbates proinflammatory immune responses, and contributes to the progression of lesions in the pathogenesis of gastric cancer in Colombia.

References

Malfertheiner, P., Camargo, M. C., El-Omar, E., Liou, J. M., Peek, R., Schulz, C., & Suerbaum, S. (2023). Helicobacter pylori infection. Nature reviews Disease primers, 9(1), 19.

THE ROLE OF HELICOBACTER PYLORI IN GASTRIC PATHOGENESIS IN COLOMBIA

Kevin Guzman 1, Vanessa Pabon 2, Arsenio Hidalgo 3, Alvaro Jairo Pazos 3

1 Kevin Guzman, San Juan de Pasto, Colombia

2 SENA, Regional Nariño, Túquerres, Colombia

3 Universidad de Nariño, San Juan de Pasto, Colombia|||Universidad de Nariño, San Juan de Pasto, Colombia

Conference

UEG Week Vienna 2024

Topics

Stomach & H. Pylori

Submission format

Abstract

Session

H.pylori treatment: Part 2 (Posters)

Citation

United European Gastroenterology Journal 2024; 12 (Supplement 8)

Published

2024

UEG Podcast Episode

Journal Podcast

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Episode 5: UEG Journal September Spotlight

Mohsan Subhani, Djuna L. Cahen

Published

2025

UEG Podcast Episode

UEG Podcast

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Complications in endoscopy with Srisha Hebbar Part 1

Srisha Hebbar, Pradeep Mundre

Topics

Endoscopy

Published

2025

UEG Podcast Episode

Journal Podcast

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Episode 2: UEG Journal June spotlight

Mohsan Subhani, Maria Manuela Estevinho

Published

2025

UEG Podcast Episode

New

UEG Podcast

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EoE with Alex Straumann - Part 1

Alex Straumann, Egle Dieninyte - Misiune

Topics

Oesophagus

Published

2026

UEG Presentation

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TAILORING ENDOSCOPIC GASTROPLASTY FOR PERSONALIZED OBESITY TREATMENT: 18-MONTH RESULTS OF THREE TECHNIQUES ACROSS OBESITY CLASSES

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Introduction

Endoscopic gastroplasty (EG) is a minimally invasive endoscopic treatment aimed at reshaping the gastric body to manage obesity. This approach is now applicable across all obesity grades. Currently, three EG techniques are commonly used in clinical practice: endoscopic sleeve gastroplasty (ESG), endoluminal vertical gastroplasty (EVG), and distal primary obesity surgery endoluminal (POSE-2).

Aims & Methods

This randomized, single-center clinical trial (ClinicalTrials.gov NCT04854317) included obese individuals undergoing EG using one of the three methods (ESG, EVG, or POSE-2). A subgroup analysis based on obesity classes was performed to determine which technique yields the most favorable outcomes within each class, aiming to support a more tailored, patient-specific treatment approach for obesity. The primary outcomes assessed were weight loss efficacy, improvement in obesity-related comorbidities, and enhancement of quality of life (QoL) across obesity categories.

Results

Between July 2020 and April 2023, 183 patients with obesity (mean BMI 36.3±2.9 kg/m²; mean age 45±10 years; 89.1% female; 57.4% in class II obesity; hepatic steatosis present in 83%) underwent EG using ESG, EVG, or POSE-2. Follow-up adherence was 56.3% at 6 months, 32.8% at 12 months, and 15.8% at 18 months. At these time points, total body weight loss (TBWL) averaged 15.5±6.0%, 14.5±8.5%, and 17.1±10.2%, respectively, while excess weight loss (EWL) was 39.3±15.5%, 36.7±21.3%, and 43.0±26.6%. No significant differences were observed among the three techniques in either TBWL (p=0.92) or EWL (p=0.93) at 18 months.
When stratified by obesity class, there were no significant differences in TBWL (p=0.92) or EWL (p=0.62) among the techniques. However, analyzing technique performance within each obesity class revealed that POSE-2 was superior in class I obesity (p=0.03 for TBWL; p=0.006 for EWL), but less effective in class III (p=0.003). In contrast, EVG showed the best results in class III (p=0.048 for TBWL; p=0.02 for EWL), but underperformed in class I (p=0.034). No significant differences were noted between techniques in class II obesity. Improvements in fatty liver disease, hypertension, hyperlipidemia, diabetes, and obstructive sleep apnea were noted across all groups. Additionally, QoL, as assessed by the BAROS score, significantly improved over 18 months (p<0.001), with no variation across obesity classes.

Conclusion

Endoscopic gastroplasty proved effective in managing obesity. POSE-2 was most beneficial for patients with class I obesity, while ESG and EVG showed greater efficacy in higher obesity classes during mid-term follow-up. These results may support a more personalized therapeutic strategy for obesity.