title: Antibiotic treatment decreases microbial burden associated with pseudomyxoma peritonei and affects β-catenin distribution.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
authors.affiliation: Uniformed Services University and United States Military Cancer Institute, Bethesda, Maryland 20814, USA.
authors.forename: Cristina
authors.initials: C
authors.lastname: Semino-Mora
authors.forename: Traci L
authors.initials: TL
authors.lastname: Testerman
authors.forename: Hui
authors.initials: H
authors.lastname: Liu
authors.forename: Jeannette M
authors.initials: JM
authors.lastname: Whitmire
authors.forename: Kimberley
authors.initials: K
authors.lastname: Studeman
authors.forename: Yali
authors.initials: Y
authors.lastname: Jia
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: McAvoy
authors.forename: Jennifer
authors.initials: J
authors.lastname: Francis
authors.forename: Carol
authors.initials: C
authors.lastname: Nieroda
authors.forename: Armando
authors.initials: A
authors.lastname: Sardi
authors.forename: D Scott
authors.initials: DS
authors.lastname: Merrell
authors.forename: Andre
authors.initials: A
authors.lastname: Dubois
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery; D000658:Amoxicillin / Q000494:pharmacology / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D058491:Bacterial Load / Q000187:drug effects; D002462:Cell Membrane / Q000378:metabolism; D002467:Cell Nucleus; D017291:Clarithromycin / Q000494:pharmacology / Q000627:therapeutic use; D003131:Combined Modality Therapy; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000235:genetics; D006801:Humans; D017403:In Situ Hybridization; D064747:Lansoprazole / Q000494:pharmacology / Q000627:therapeutic use; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery; D021381:Protein Transport; D011553:Pseudomyxoma Peritonei / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery; D016896:Treatment Outcome; D051176:beta Catenin / Q000378:metabolism*
chemical_list: D000900:Anti-Bacterial Agents; C495270:CTNNB1 protein, human; D051176:beta Catenin; D064747:Lansoprazole; D000658:Amoxicillin; D017291:Clarithromycin