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Grant Details

Grant Number: 5R01CA116845-05 Interpret this number
Primary Investigator: El-Serag, Hashem
Organization: Baylor College Of Medicine
Project Title: Obesity, H Pylori and Risk of Barrett's Esophagus
Fiscal Year: 2011
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Abstract

DESCRIPTION (provided by applicant): Barrett's esophagus (BE) is the only known precancerous lesion for esophageal adenocarcinoma, which is the fastest rising malignancy in white men in the US. Risk factors for BE are largely unknown. We plan to study potential risk factors for BE in a case-control study nested within a large cross-sectional study, with the primary aim of estimating the association between obesity and BE and a secondary aim of estimating the association between Helicobacterpylori (H. pylori) infection and BE. Obesity has been identified as a risk factor for esophageal adenocarcinoma. Yet, it remains unknown whether obesity increases the risk of BE. We hypothesize that obesity, especially a larger amount of visceral abdominal fat are risk factors for BE. We plan to estimate the effects of the amount and distribution of body fat on the prevalence of BE. We will compare the following variables between patients with and without BE (body mass index (BMI), abdominal obesity, specifically the amount of intra abdominal (visceral) fat measured by CT-scan; and inflammatory mediators associated with visceral obesity (11-6, TNF, adiponectin). We hypothesize that H. pylori infection, especially CagA positive strains, are protective against BE, and that the mechanism of this protective effect is through formation of corpus atrophic gastritis with consequent reduction in gastric acid secretion. We plan to examine the prevalence of H. pylori infection, type of infection (CagA producing strain), and distribution and severity of gastritis (corpus gastritis) in cases with BE and non- cases without BE. We will examine the effect of our main exposures while adjusting for lifestyle features (e.g. dietary intake, smoking, medications, and physical activity); demographic features (age, gender, race); and clinical features (e.g. hiatus hernia, duration and severity of GERD symptoms). We will examine the effect of our exposures of interest (obesity and H. pylori) on BE tissue markers indicative of severity of acid and bile-related damage (COX-2) as well as for neoplastic progression in BE (e.g. somatic p53 and p16 inactivation). We plan cross sectional study of consecutive eligible patients presenting to upper endoscopy for non-urgent indications. In addition, we conduct a cross-sectional study in randomly selected persons eligible to receive care (and eligible to receive screening colonoscopy) at the Houston VAMC. Subsequently, in a case-control study, all newly diagnosed BE and randomly selected controls will be examined for the volume and activity of visceral obesity (CT scan and serum adipocytokines).

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Publications

Risk of Upper Gastrointestinal Cancers in Patients With Gastroesophageal Reflux Disease After a Negative Screening Endoscopy.
Authors: Shakhatreh MH, Duan Z, Avila N, Naik AD, Kramer JR, Hinojosa-Lindsey M, Chen J, El-Serag HB
Source: Clin Gastroenterol Hepatol, 2014 Jul 5;null, p. null.
EPub date: 2014 Jul 5.
PMID: 25004461
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Nonsteroidal Anti-inflammatory Drugs and the Risk of Barrett's Esophagus.
Authors: Khalaf N, Nguyen T, Ramsey D, El-Serag HB
Source: Clin Gastroenterol Hepatol, 2014 Apr 30;null, p. null.
EPub date: 2014 Apr 30.
PMID: 24793026
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Personal and family history of cancer and the risk of Barrett's esophagus in men.
Authors: Khalaf N, Ramsey D, Kramer JR, El-Serag HB
Source: Dis Esophagus, 2014 Feb 17;null, p. null.
EPub date: 2014 Feb 17.
PMID: 24529029
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Use and yield of endoscopy in patients with uncomplicated gastroesophageal reflux disorder.
Authors: Kramer JR, Shakhatreh MH, Naik AD, Duan Z, El-Serag HB
Source: JAMA Intern Med, 2014 Mar;174(3), p. 462-5.
PMID: 24474391
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Poor sleep quality and obstructive sleep apnea in patients with GERD and Barrett's esophagus.
Authors: Vela MF, Kramer JR, Richardson PA, Dodge R, El-Serag HB
Source: Neurogastroenterol Motil, 2014 Mar;26(3), p. 346-52.
EPub date: 2013 Dec 9.
PMID: 24460751
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A multibiomarker risk score helps predict risk for Barrett's esophagus.
Authors: Thrift AP, Garcia JM, El-Serag HB
Source: Clin Gastroenterol Hepatol, 2014 Aug;12(8), p. 1267-71.
EPub date: 2013 Dec 19.
PMID: 24362047
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Choosing optimal first-line Helicobacter pylori therapy: a view from a region with high rates of antibiotic resistance.
Authors: Nijevitch AA, Idrisov B, Akhmadeeva EN, Graham DY
Source: Curr Pharm Des, 2014;20(28), p. 4510-6.
PMID: 24180406
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Dietary consumption of meat, fat, animal products and advanced glycation end-products and the risk of Barrett's oesophagus.
Authors: Jiao L, Kramer JR, Chen L, Rugge M, Parente P, Verstovsek G, Alsarraj A, El-Serag HB
Source: Aliment Pharmacol Ther, 2013 Oct;38(7), p. 817-24.
EPub date: 2013 Aug 19.
PMID: 23957669
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Circulating inflammatory cytokines and adipokines are associated with increased risk of Barrett's esophagus: a case-control study.
Authors: Garcia JM, Splenser AE, Kramer J, Alsarraj A, Fitzgerald S, Ramsey D, El-Serag HB
Source: Clin Gastroenterol Hepatol, 2014 Feb;12(2), p. 229-238.e3.
EPub date: 2013 Aug 15.
PMID: 23954649
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Bundling in medicare patients undergoing bidirectional endoscopy: how often does it happen?
Authors: El-Serag HB, Xu F, Biyani P, Cooper GS
Source: Clin Gastroenterol Hepatol, 2014 Jan;12(1), p. 58-63.
EPub date: 2013 Aug 1.
PMID: 23911874
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Eradication of gastric cancer is now both possible and practical.
Authors: Shiotani A, Cen P, Graham DY
Source: Semin Cancer Biol, 2013 Dec;23(6 Pt B), p. 492-501.
EPub date: 2013 Jul 19.
PMID: 23876852
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Fat mass by bioelectrical impedance analysis is not associated with increased risk of Barrett esophagus.
Authors: Thrift AP, Kramer JR, Alsarraj A, El-Serag HB
Source: J Clin Gastroenterol, 2014 Mar;48(3), p. 218-23.
PMID: 23842216
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Bismuth-containing quadruple therapy for Helicobacter pylori: lessons from China.
Authors: Lu H, Zhang W, Graham DY
Source: Eur J Gastroenterol Hepatol, 2013 Oct;25(10), p. 1134-40.
PMID: 23778309
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Helicobacter pylori research: historical insights and future directions.
Authors: Fock KM, Graham DY, Malfertheiner P
Source: Nat Rev Gastroenterol Hepatol, 2013 Aug;10(8), p. 495-500.
EPub date: 2013 Jun 11.
PMID: 23752823
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Effect of fluoroquinolone resistance on 14-day levofloxacin triple and triple plus bismuth quadruple therapy.
Authors: Liao J, Zheng Q, Liang X, Zhang W, Sun Q, Liu W, Xiao S, Graham DY, Lu H
Source: Helicobacter, 2013 Oct;18(5), p. 373-7.
EPub date: 2013 Apr 15.
PMID: 23581720
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Prevalence and predictors of hepatitis B virus coinfection in a United States cohort of hepatitis C virus-infected patients.
Authors: Tyson GL, Kramer JR, Duan Z, Davila JA, Richardson PA, El-Serag HB
Source: Hepatology, 2013 Aug;58(2), p. 538-45.
EPub date: 2013 Jul 1.
PMID: 23505059
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The prevalence of oesophageal eosinophilia and eosinophilic oesophagitis: a prospective study in unselected patients presenting to endoscopy.
Authors: Sealock RJ, Kramer JR, Verstovsek G, Richardson P, Rugge M, Parente P, Vela M, El-Serag HB
Source: Aliment Pharmacol Ther, 2013 Apr;37(8), p. 825-32.
EPub date: 2013 Feb 26.
PMID: 23441936
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Dietary intake of vegetables, folate, and antioxidants and the risk of Barrett's esophagus.
Authors: Jiao L, Kramer JR, Rugge M, Parente P, Verstovsek G, Alsarraj A, El-Serag HB
Source: Cancer Causes Control, 2013 May;24(5), p. 1005-14.
EPub date: 2013 Feb 19.
PMID: 23420329
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Referral and receipt of treatment for hepatocellular carcinoma in United States veterans: effect of patient and nonpatient factors.
Authors: Davila JA, Kramer JR, Duan Z, Richardson PA, Tyson GL, Sada YH, Kanwal F, El-Serag HB
Source: Hepatology, 2013 May;57(5), p. 1858-68.
EPub date: 2013 Mar 14.
PMID: 23359313
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Waist-to-hip ratio, but not body mass index, is associated with an increased risk of Barrett's esophagus in white men.
Authors: Kramer JR, Fischbach LA, Richardson P, Alsarraj A, Fitzgerald S, Shaib Y, Abraham NS, Velez M, Cole R, Anand B, Verstovsek G, Rugge M, Parente P, Graham DY, El-Serag HB
Source: Clin Gastroenterol Hepatol, 2013 Apr;11(4), p. 373-381.e1.
EPub date: 2012 Dec 4.
PMID: 23220167
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Helicobacter pylori: tailored therapy with novel sequential quadruple therapies.
Authors: Graham DY, Gisbert JP
Source: Nat Rev Gastroenterol Hepatol, 2013 Jan;10(1), p. 6-8.
EPub date: 2012 Nov 27.
PMID: 23183788
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Helicobacter pylori infection in India from a western perspective.
Authors: Thirumurthi S, Graham DY
Source: Indian J Med Res, 2012 Oct;136(4), p. 549-62.
PMID: 23168695
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PCR detection of Helicobacter pylori in clinical samples.
Authors: Rimbara E, Sasatsu M, Graham DY
Source: Methods Mol Biol, 2013;943, p. 279-87.
PMID: 23104297
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Automated identification of surveillance colonoscopy in inflammatory bowel disease using natural language processing.
Authors: Hou JK, Chang M, Nguyen T, Kramer JR, Richardson P, Sansgiry S, D'Avolio LW, El-Serag HB
Source: Dig Dis Sci, 2013 Apr;58(4), p. 936-41.
EPub date: 2012 Oct 21.
PMID: 23086115
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Greater than 95% success with 14-day bismuth quadruple anti- Helicobacter pylori therapy: a pilot study in US Hispanics.
Authors: Salazar CO, Cardenas VM, Reddy RK, Dominguez DC, Snyder LK, Graham DY
Source: Helicobacter, 2012 Oct;17(5), p. 382-90.
EPub date: 2012 Jun 4.
PMID: 22967122
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Human papillomavirus and the risk of Barrett's esophagus.
Authors: El-Serag HB, Hollier JM, Gravitt P, Alsarraj A, Younes M
Source: Dis Esophagus, 2013 Jul;26(5), p. 517-21.
EPub date: 2012 Aug 14.
PMID: 22891654
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Guide regarding choice of second-line therapy to obtain a high cumulative cure rate.
Authors: Graham DY, Calvet X
Source: Helicobacter, 2012 Aug;17(4), p. 243-5.
EPub date: 2012 Apr 8.
PMID: 22759322
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Which Therapy for Helicobacter pylori Infection?
Authors: Graham DY, Shiotani A
Source: Gastroenterology, 2012 Jul;143(1), p. 10-2.
EPub date: 2012 May 18.
PMID: 22613622
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Vitamin C, gastritis, and gastric disease: a historical review and update.
Authors: Aditi A, Graham DY
Source: Dig Dis Sci, 2012 Oct;57(10), p. 2504-15.
EPub date: 2012 Apr 28.
PMID: 22543844
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