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Antibiotic treatment decreases microbial burden associated with pseudomyxoma peritonei and affects β-catenin
Cristina Semino-Mora1, Traci L Testerman, Hui Liu
1Uniformed Services University and United States Military Cancer Institute, Bethesda, Maryland 20814, USA.
Purpose:
Pseudomyxoma peritonei is an understudied cancer in which an appendiceal neoplasm invades the peritoneum and forms tumor foci on abdominal organs. Previous studies have shown that bacteria reside within pseudomyxoma peritonei tumors and mucin. Thus, we sought to analyze the effect of antibiotics on bacterial density and β-catenin expression within pseudomyxoma peritonei samples.
Experimental Design:
The study included 48 patients: 19 with disseminated peritoneal adenomucinosis (DPAM) and 29 with peritoneal mucinous carcinomatosis (PMCA). Fourteen patients were given antibiotics (30 mg lansoprazole, 1 g amoxicillin, and 500 mg clarithromycin) twice a day for 14 days. One week after completion of therapy, surgery was conducted and specimens were harvested for pathology, bacterial culture, ISH, and immunohistochemistry.
Results:
ISH showed the presence of bacteria in 83% of the patient samples, with a higher Helicobacter pylori density observed in PMCA versus DPAM. PMCA patients treated with antibiotics had a significantly lower bacterial density and decreased β-catenin levels in the cytoplasm, the cell nuclei, and mucin-associated cells. Although not significant, similar trends were observed in DPAM patients. Cell membrane β-catenin was significantly increased in both DPAM and PMCA patients receiving antibiotics.
Conclusions:
Bacteria play an important role in pseudomyxoma peritonei. Antibiotic treatment improved the histopathology of tissue, particularly in PMCA patients. In PMCA, antibiotics decreased bacterial density and were associated with a significant β-catenin decrease in the cytoplasm, cell nuclei, and mucin along with a small membrane increase. These results suggest that antibiotics offer potential protection against cell detachment, cellular invasion, and metastasis.
Insights
Antibiotics reduced bacterial density and altered beta-catenin levels in pseudomyxoma peritonei, improving tissue pathology, especially in PMCA patients. This suggests antibiotics may protect against cancer cell invasion and metastasis.
Area of Science:
- Oncology
- Gastroenterology
- Microbiology
Background:
- Pseudomyxoma peritonei (PMP) is an understudied appendiceal neoplasm.
- Bacteria are known to reside within PMP tumors and mucin.
- The role of bacteria and potential therapeutic interventions remain unclear.
Purpose of the Study:
- To investigate the effect of antibiotics on bacterial density in PMP.
- To analyze the impact of antibiotics on beta-catenin expression in PMP.
- To evaluate changes in histopathology following antibiotic treatment for PMP.
Main Methods:
- Study included 48 patients with PMP (19 DPAM, 29 PMCA).
- 14 patients received a 14-day course of antibiotics (lansoprazole, amoxicillin, clarithromycin).
- Specimens were analyzed post-surgery for bacterial presence, density, and beta-catenin expression.
Main Results:
- Bacteria were present in 83% of PMP samples; higher density in PMCA vs. DPAM.
- Antibiotic treatment significantly reduced bacterial density and cytoplasmic/nuclear beta-catenin in PMCA.
- Antibiotics increased cell membrane beta-catenin in both DPAM and PMCA patients.
Conclusions:
- Bacteria play a significant role in pseudomyxoma peritonei.
- Antibiotic therapy improved PMP histopathology, particularly in PMCA.
- Antibiotics may offer protection against PMP cell detachment, invasion, and metastasis by modulating beta-catenin.
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