title: Weak up-regulation of serum response factor in gastric ulcers in patients with co-morbidities is associated with increased risk of recurrent bleeding.
abstract: BACKGROUND
  Serum response factor (SRF) is crucial for gastric ulcer healing process. The study determined if gastric ulcer tissues up-regulate SRF and if such up-regulation correlated with co-morbidities and the risk of recurrent bleeding.
  
  
  METHODS
  Ulcer and non-ulcer tissues were obtained from 142 patients with active gastric ulcers for SRF expression assessed by immunohistochemistry. Based on the degree of SRF expression between these two tissue types, SRF up-regulation was classified as strong, intermediate, and weak patterns. The patients were followed-up to determine if SRF up-regulation correlated to recurrent bleeding.
  
  
  RESULTS
  Gastric ulcer tissues had higher SRF expression than non-ulcer tissues (p < 0.05). Patients with strong SRF up-regulation had lower rates of stigmata of recent hemorrhage (SRH) on the ulcer base than the others (p < 0.05). Multivariate logistic regression confirmed that co-morbidities and weak SRF up-regulation were two independent factors of recurrent gastric ulcer bleeding (p < 0.05). Combining both factors, there was an 8.29-fold (95% CI, 1.31~52.62; p = 0.03) higher risk of recurrent gastric ulcer bleeding.
  
  
  CONCLUSIONS
  SRF expression is higher in gastric ulcer tissues than in non-ulcer tissues. Weak SRF up-regulation, combined with the presence of co-morbidities, increase the risk of the recurrent gastric ulcer bleeding.
authors.affiliation: Institute of Clinical Medicine, Medical College, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Hsiu-Chi
authors.initials: HC
authors.lastname: Cheng
authors.forename: Hsiao-Bai
authors.initials: HB
authors.lastname: Yang
authors.forename: Wei-Lun
authors.initials: WL
authors.lastname: Chang
authors.forename: Yi-Chun
authors.initials: YC
authors.lastname: Yeh
authors.forename: Yu-Ching
authors.initials: YC
authors.lastname: Tsai
authors.forename: Bor-Shyang
authors.initials: BS
authors.lastname: Sheu
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000453:epidemiology; D005260:Female; D006333:Heart Failure / Q000453:epidemiology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology; D008103:Liver Cirrhosis / Q000453:epidemiology; D008171:Lung Diseases / Q000453:epidemiology; D008297:Male; D010438:Peptic Ulcer Hemorrhage / Q000453:epidemiology* / Q000378:metabolism* / Q000517:prevention & control; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D055502:Secondary Prevention; D026362:Serum Response Factor / Q000378:metabolism*; D013276:Stomach Ulcer / Q000453:epidemiology* / Q000378:metabolism*; D015854:Up-Regulation / Q000502:physiology*
chemical_list: D015415:Biomarkers; D026362:Serum Response Factor