Oyuntsetseg, Khasag
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Товч нэр
Oyuntsetseg, Khasag
Бүтэн нэр
Oyuntsetseg Khasag
Латин нэр
Oyuntsetseg Khasag
Албан тушаал
Судлаач
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Item type:Publication, Helicobacter Pylori Genotyping Among Mongolian Dyspeptic Patients(Mongolian National University of Medical Sciences, 2022-06-30) ;Tserentogtokh Tegshee; ; ; Battulga AdiyasurenObjective: The prevalence of H. pylori infection varies significantly and developing countries are found to be the highest in Asia. In the present study, we have aimed to perform a combined analysis of histochemical stains and IHC to confirm the H.pylori infection of patients in 5 different provinces and Ulaanbaatar city, Mongolia. Method: Five hundred and thirty-eight patients were enrolled in this study (142 gastric mucosal atrophy, 333 gastritis and 62 gastroesophageal reflux). Results: 67.1 % of participants had CagA positive and 69.3 % were immunohistochemically positive. All histological results showed that the gastritis group was significantly higher in patients who were positive for H. pylori than in antral-predominant gastritis. By the hematoxylin and eosin staining with May– Giemsa confirmation by IHC, the prevalence of H. pylori infection in the gastric mucosal atrophy group was 62.1 %, while in the gastritis and gastroesophageal reflux group, the rate was 74.3 % and 59.1 %, respectively. Conclusion: CagA sequence profile in each group of patients revealed that 22.6 % of the gastric mucosal atrophy group was ABC type, 43.4 % was ABCC type and 33.9 % was ABTC type. On the other hand, in the gastritis group, the dominant type was ABTC (41.3 %). In the gastroesophageal reflux group, the ABCC type was dominant while 23.1% was the ABC type. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Initial Trials With Susceptibility-Based and Empiric Anti-H. pylori Therapies in Mongolia(Frontiers Media SA, 2019); ; ; ; Background: Mongolia has a high prevalence of Helicobacter pylori infection and gastric cancer. We conducted a prospective, randomized, single-blind study to evaluate the efficacy of common regimens in Mongolia and to obtain specimens for susceptibility testing. Methods: Empiric treatments: 270 patients with confirmed H. pylori infection were randomized to receive 10 days clarithromycin-triple therapy (Clari-TT) (n = 90), modified bismuth quadruple therapy (M-BQT) (n = 90), or sequential therapy (ST) (n = 90). A second group of 46 patients received susceptibility-based Clari-TT. H. pylori was cultured from 131 patients and susceptibility testing was performed. H. pylori eradication was confirmed by stool antigen 4 weeks after the therapy. Results: Intention-to-treat (ITT) analysis cure rates were 71.1% (95% CI = 61.7-80.5%) for Clari-TT, 87.8% (95% CI = 81-94.6%) for M-BQT, 67.8% (95% CI = 58.1-77.5%) for ST vs. 89.1% (95% CI = 86-98.2%) for susceptibility-based Clari-TT. Per-protocol (PP) analysis results for these therapies were 72.7% (63.4-82%), 89.8% (83.5-96.1%), 68.5% (58.8-78.2%), and 97.6% (89.5-99.8%), respectively. Among 131 cultured H. pylori, resistance rates to amoxicillin, clarithromycin, and metronidazole were 8.4, 37.4, and 74%, respectively. Conclusion: In Mongolia, the prevalence of H. pylori resistance is high requiring bismuth quadruple therapy or susceptibility-based therapy to obtain acceptable cure rates.Scopus© Citations 12 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, High Antibiotic Resistance of Helicobacter pylori and Its Associated Novel Gene Mutations among the Mongolian Population(MDPI AG, 2020-07) ;Azzaya, Dashdorj; ; ; Matsumoto, TakashiMongolia has a high prevalence of Helicobacter pylori infection and the second highest incidence of gastric cancer worldwide. Thus, investigating the prevalence of antibiotic resistance and its underlying genetic mechanism is necessary. We isolated 361 H. pylori strains throughout Mongolia. Agar dilution assays were used to determine the minimum inhibitory concentrations of five antibiotics; amoxicillin, clarithromycin, metronidazole, levofloxacin, and minocycline. The genetic determinants of antibiotic resistance were identified with next-generation sequencing (NGS) and the CLC Genomics Workbench. The resistance to metronidazole, levofloxacin, clarithromycin, amoxicillin, and minocycline was 78.7%, 41.3%, 29.9%, 11.9% and 0.28%, respectively. Multidrug resistance was identified in 51.3% of the isolates investigated which were further delineated into 9 antimicrobial resistance profiles. A number of known antibiotic resistance mutations were identified including rdxA, frxA (missense, frameshift), gyrA (N87K, A88P, D91G/N/Y), 23S rRNA (A2143G), pbp1A (N562Y), and 16S rRNA (A928C). Furthermore, we detected previously unreported mutations in pbp1A (L610*) and the 23S rRNA gene (A1410G, C1707T, A2167G, C2248T, and C2922T). The degree of antibiotic resistance was high, indicating the insufficiency of standard triple therapy in Mongolia.Scopus© Citations 36 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Western-Type Helicobacter pylori CagA are the Most Frequent Type in Mongolian Patients(MDPI AG, 2019-05) ;Tserentogtokh, Tegshee; ;Subsomwong, Phawinee; Bolor, DashdorjHelicobacter pylori infection possessing East-Asian-type CagA is associated with carcinogenesis. Mongolia has the highest mortality rate from gastric cancer. Therefore, we evaluated the CagA status in the Mongolian population. High risk and gastric cancer patients were determined using endoscopy and histological examination. H. pylori strains were isolated from different locations in Mongolia. The CagA subtypes (East-Asian-type or Western-type, based on sequencing of Glu-Pro-Ile-Tyr-Ala (EPIYA) segments) and vacA genotypes (s and m regions) were determined using PCR-based sequencing and PCR, respectively. In total, 368 patients were examined (341 gastritis, 10 peptic ulcer, and 17 gastric cancer). Sixty-two (16.8%) strains were cagA-negative and 306 (83.1%) were cagA-positive (293 Western-type, 12 East-Asian-type, and one hybrid type). All cagA-negative strains were isolated from gastritis patients. In the gastritis group, 78.6% (268/341) had Western-type CagA, 2.9% (10/341) had East-Asian-type, and 18.2% (61/341) were cagA-negative. However, all H. pylori from gastric cancer patients possessed Western-type CagA. Histological analyses showed that East-Asian-type CagA was the most virulent strains, followed by Western-type and cagA-negative strains. This finding agreed with the current consensus. CagA-positive strains were the most virulent type. However, the fact that different CagA types can explain the high incidence of gastric cancer might be inapplicable in Mongolia.Scopus© Citations 21 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Species-level dynamics of gastric microbiome after Helicobacter pylori eradication in high-risk Mongolian population(2026-02); ; ;Khangai, Ayush; Luvsandagva, BayasgalanBACKGROUND: Species-level resolution is essential to understand gastric microbiome recovery after Helicobacter pylori eradication, yet short-read 16 S rRNA approaches often obscure clinically relevant changes. METHODS: Gastric biopsies from 121 adults in Bayan-Ölgii, Mongolia (71 H. pylori-positive, 50 H. pylori-negative) were analyzed, including nine paired pre- and post-eradication gastric biopsy samples collected six months apart, enabling exploratory longitudinal analysis. Full-length 16 S rRNA (V1-V9) sequencing was performed using the Oxford Nanopore platform with EMU taxonomic assignment (SILVA v138.1/NCBI RefSeq). Ecological changes were evaluated using diversity indices, principal coordinates analysis (PCoA) with PERMANOVA, and differential abundance testing (DESeq2, FDR < 0.05). Eradication therapy (esomeprazole-bismuth-doxycycline-levofloxacin) achieved success in 54 of 57 H. pylori-positive patients (94.7%). RESULTS: H. pylori-positive microbiomes were dominated by H. pylori (91.8% ± 3.9%) and exhibited markedly reduced diversity (Shannon = 0.44 ± 0.11) compared with H. pylori-negative samples (2.08 ± 0.25; p < 0.001). Six months after eradication, diversity increased significantly (2.17 ± 0.20; p = 0.0001), with enrichment of oral commensals including Streptococcus mitis (↑ 11.9×), Neisseria elongata (↑ 13.7×), and Prevotella melaninogenica (↑ 13.0×). However, post-eradication profiles at six months remained distinct from H. pylori-negative communities (PERMANOVA R² = 0.12; p = 0.02). In total, 174 amplicon sequence variants changed significantly, including persistence of Fusobacterium nucleatum. CONCLUSIONS: Nanopore full-length 16 S sequencing reveals fine-scale, clinically relevant shifts that are masked by partial-gene assays. Eradication rapidly restores microbial diversity, but at six months, is associated with a novel ecological equilibrium rather than complete normalization. This species-resolved approach offers a practical framework for post-eradication microbiome monitoring and may inform strategies to reduce residual gastric cancer risk in high-burden populations.Scopus© Citations 1 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Study of Helicobacter pylori Isolated from a High-Gastric-Cancer-Risk Population: Unveiling the Comprehensive Analysis of Virulence-Associated Genes including Secretion Systems, and Genome-Wide Association Study(MDPI AG, 2023-09); ;Alfaray, Ricky Indra; ; Khangai, AyushBACKGROUND: The prevalence of gastric cancer in Mongolia, in East Asia, remains the highest in the world. However, most Helicobacter pylori strains in Mongolia have a less virulent Western-type CagA. We aimed to determine how H. pylori genomic variation affected gastric diseases, especially gastric cancer, based on comprehensive genome analysis. METHODS: We identified a set of 274 virulence-associated genes in H. pylori, including virulence factor and outer membrane protein (OMP) genes, the type four secretion system gene cluster, and 13 well-known virulence gene genotypes in 223 H. pylori strains and their associations with gastric cancer and other gastric diseases. We conducted a genome-wide association study on 158 H. pylori strains (15 gastric cancer and 143 non-gastric cancer strains). RESULTS: Out of 274 genes, we found 13 genes were variable depending on disease outcome, especially iron regulating OMP genes. H. pylori strains from Mongolia were divided into two main subgroups: subgroup (Sg1) with high risk and Sg2 with low risk for gastric cancer. The general characteristics of Sg1 strains are that they possess more virulence genotype genes. We found nine non-synonymous single nucleotide polymorphisms in seven genes that are linked with gastric cancer strains. CONCLUSIONS: Highly virulent H. pylori strains may adapt through host-influenced genomic variations, potentially impacting gastric carcinogenesis.Scopus© Citations 10 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Advantage of 16S rRNA amplicon sequencing in Helicobacter pylori diagnosis(Wiley, 2021-06); ;El Serag, Hashem B; ;Azzaya, DashdorjMatsumoto, TakashiBACKGROUND: 16S rRNA amplicon sequencing is an accurate method of detecting microbial infection without culture. It is unclear if sequencing has additional benefits over routine diagnostic methods for Helicobacter pylori testing. METHODS: We enrolled Mongolian volunteers with dyspepsia. Using routine diagnostic methods, positive H. pylori was defined as positive results on histology/immunohistochemistry, culture, rapid urease test, or serology; negative H. pylori was defined by negative results from all these tests. We performed 16S rRNA sequencing on gastric biopsy specimens and calculated cutoffs for operational taxonomic units (OTUs) and relative abundance (RA) to define positive results using ROC curves. RESULTS: We examined 161 individuals with a mean age of 43.6 years, and 64.6% were women. Using routine diagnostic methods, 122 (75.8%) participants were H. pylori positive, the sensitivity and specificity for 16S rRNA sequencing were 94.3% and 82.1% or 93.4% and 82.1% when cutoff values were set to 1113 (OTU number) or 4.4% RA, respectively (both p < .001). When combining the validated values, the concordance rate was high (91.1%); however, 16S rRNA sequencing had additional positive yield in 9 cases (5.6%) compared with routine diagnostic methods, and much greater additional positive yield compared to histopathology/IHC, culture, RUT, serology separately with 12 (7.4%), 37 (23.0%) and 43 (26.7%). CONCLUSION: 16S rRNA amplicon sequencing detects potentially important proportion of H. pylori-positive cases that test negative with routine diagnostic methods. The quantitative number of H. pylori can help to understand how it can be changing by diseases and RA give opportunity to understand how H. pylori communicate with other microbiota.Scopus© Citations 27 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, The prevalence of Helicobacter pylori infection and other risk factors among Mongolian dyspeptic patients who have a high incidence and mortality rate of gastric cancer(Springer Science and Business Media LLC, 2018); ; ; ; Dashdorj, AzzayaBACKGROUND: Mongolia has not only the second highest incidence rate but also the highest mortality rate for gastric cancer globally. In addition to gastric cancer, ulcerative disease complications are also life threatening; thus, investigating Helicobacter pylori infection and other risk factors is essential. RESULTS: H.pylori infection was high in tested dyspeptic patients from all parts of Mongolia, with an overall infection rate of 80.0%. Logistic regression analysis showed that H. pylori infection was associated with gastritis (odds ratio; 9.0 ([95% confidence interval 5.0-16.2]); p < 0.0001). H. pylori infection (3.3 [2.0-5.4]; p < 0.0001) and > 40 years old (1.5 [1.0-2.0]; p < 0.02) were both associated with atrophy. However, > 40 years old (3.8 [2.4-6.0]; p < 0.0001) and high salt intakes (1.6 [1.0-2.3]; p < 0.02), but not H. pylori infection, were associated with intestinal metaplasia. Excessive amount of salt usage was dramatically higher in northern and western parts of Mongolia, where precancerous diseases, such as erosive esophagitis (for cardia cancer), severe atrophy, and intestinal metaplasia (for non-cardia cancer), were highly prevalent. CONCLUSIONS: H. pylori infection was the major gastric health problem among the Mongolian population. In addition, environmental factors such as high salt intake worsened the clinical outcome. Therefore, a nationwide screening and eradication of H. pylori infection as well as salt-reducing measures should be implemented.Scopus© Citations 27 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, New observations regarding Helicobacter pylori and gastric cancer in Mongolia(Wiley, 2018-08); ;Bolor, Dashdorj; ;Erdene-Ochir, YansanBACKGROUND: The incidence and mortality of gastric cancer in Mongolia is among the highest in the world. METHODS: This was a case-control study in which upper gastrointestinal endoscopy, gastric histology, Helicobacter pylori testing, and risk factor questionnaires were obtained. Histologic subtypes were determined by Lauren's classification. RESULTS: We enrolled 45 gastric cancer and 108 non-gastric cancer patients. Gastric cancers were located in upper part of stomach in 53.3%, main gastric body in 37.8%, and lower part of stomach in 8.9%. The majority (60%) were diffuse type, followed by intestinal type (36.7%) and indeterminate type (3.3%). H. pylori infections were CagA positive in 100% with cancer vs 81% without cancer (P = .02). The majority of CagA was non-East Asian type (95% with cancer and 94.1% without cancer). Cancer patients had typically related with excessive use of salt, hot beverages, tobacco smoking, and low ingestion of fruits. CONCLUSION: The characteristic topography of gastric cancer in Mongolia being in the gastric corpus differed from East Asian countries and was more similar to western countries. The risk factors for gastric cancer in Mongolia were similar to other high-risk areas (ie, H. pylori infection, excessive use of salt, tobacco smoking, and low ingestion of fruits).Scopus© Citations 15 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Evaluation of serum markers for gastric cancer and its precursor diseases among high incidence and mortality rate of gastric cancer area(Springer Science and Business Media LLC, 2019-01); ; ;Bolor, Dashdorj ;Erdene-Ochir, YansanBACKGROUND: Mongolia has the highest mortality rate of gastric cancer. The early detection of cancer and down-staging screening for high risk patients are essential. Therefore, we aimed to validate serum markers for stratifying patients for further management. METHODS: Endoscopy and histological examination were performed to determine high risk and gastric cancer patients. Rapid urease test, culture and histological tests were performed to diagnose Helicobacter pylori infection. Serum pepsinogen (PG) I and II and anti-H. pylori IgG were measured by ELISA. Receiver Operating Characteristic analysis was used to extract the best cut-off point. RESULTS: Totally 752 non-cancer and 50 consecutive gastric cancer patients were involved. The corpus chronic gastritis (72%: 36/50 vs. 56.4%: 427/752), corpus atrophy (42.0%: 21/50 vs. 18.2%: 137/752) and intestinal metaplasia (IM) (64.0%: 32/50 vs. 21.5%: 162/752) were significantly higher in gastric cancer than non-cancer patients, respectively. Therefore, corpus chronic gastritis, corpus atrophy and IM were considered as high risk disease. The best serum marker to predict the high risk status was PGI/II < 3.1 (sensitivity 67.2%, specificity 61%) and PGI/II further reduced to < 2.2 (sensitivity 66%, specificity 65.1%) together with PGI < 28 ng/mL (sensitivity 70%, specificity 70%) were the best prediction for gastric cancer. The best cut-off point to diagnose H. pylori infection was anti-H. pylori IgG > 8 U/mL. Multivariate analysis showed that anti-H. pylori IgG > 8 U/mL and PGI/II < 3.1 increased risk for high risk status and PGI/II < 3.1 remained to increase risk for gastric cancer. CONCLUSION: The serum diagnosis using PGI/II < 3.1 cut-off value is valuable marker to predict high risk patients for population based massive screening.Scopus© Citations 29
