Beyond borders and generations – an interview with Prof. Dr. med. Peter Malfertheiner
Peter Malfertheiner is Professor of Medicine and Chairman of the Department of Gastroenterology, Hepatology and Infectious Diseases at the Otto v. Guericke University of Magdeburg in Germany, an appointment he has held since 1995 and has been Professor for Internal Medicine and Gastroenterology at the University of Bonn from 1993 - 1994. He received his MD from the University of Bologna, Italy in 1975, and subsequently gained medical experience at the Regional Hospital of Bozen, Italy, and the University Hospital of Ulm, Germany (1978-1992). He was also a Research Fellow at the Mayo Clinic GI Unit in Rochester, MN, USA. Professor Malfertheiner has been Chairman of the United European Gastroenterology Federation (UEGF, 2004), and President of the UEGW 2006 and Education Committee of the UEGF. He is also the Editor of Digestive Diseases, Associate Editor of the American Journal of Gastroenterology, and a member of the Editorial Boards of several other journals; the European Journal of Gastroenterology, Helicobacter, Digestive Surgery, and the International Journal of Pancreatology. His main research interests are Helicobacter pylori infection and related diseases, chronic inflammation and carcinogenesis, gastric cancer, hepatocellular cancer, and gastroesophageal reflux disease (GERD). He is one of the founders and Executives of the Healthy Stomach Initiative organization established in 2006/2007.
Why was the Healthy Stomach Initiative organization (HSI) created?
One thing which we realized is that so many preventive initiatives existed for other diseases and conditions in the digestive system – e.g. screening for colorectal cancer. There are also large initiatives for patients with chronic hepatitis and new surveillance programs in order to detect liver cancer earlier on.
Basically, there were two reasons for the idea of HSI; one being scientific and the other medical. We thought why not combine the interest with a medical group dedicated to the stomach and a new innovative tool which will allow us to study gastric function with the non-invasive GastroPanel tests of pepsinogen I (PGI), pepsinogen II (PGII), PGI/PGII ratio, Gastrin-17 and Helicobacter pylori antibodies developed by Biohit.
Practically, the people are interested in the stomach diagnosis with non-invasive tests such as the GastroPanel which allowed us to identify severe forms of atrophy. So we thought why not start with this concept of non-invasive testing for presence of H. pylori and gastric functions? The idea at the very beginning matured to a much broader concept which is now the Healthy Stomach Initiative organization, that aims at promoting research on the stomach and create public awareness for maintaining the stomach health.
Helicobacter pylori eradication offered the possibility also to prevent complications in the stomach – mainly gastric cancer but also other complications of course.
Have you now included GastroPanel testing to complement your colonoscopy screening in Magdeburg?
Yes, and we have in fact now finished this local German study with more than 400 patients. According to GastroPanel, atrophy was diagnosed in over 7% of the patients in the age group over 55 years. Secondly, we have now passed the ethical committee applications to start a multicenter study in Europe. All plans are ready; centers will send us the samples and we will make a determination. Projected number of patients would be 300-500 in each country.
What are the special research topics in your department?
In my department research is based on gastroenterologists doing clinical research and scientists in the laboratory. My research group is mainly from German but we have also international researchers from Europe and outside Europe at the time.. The main research topics are 1) gastroesophageal reflux disease, 2) Helicobacter pylori mechanisms and damaging effects to the stomach mucosa as well as the clinical facts reflected by it, and 3) liver diseases including liver cell cancer hepatocellular carcinoma. We study also other infectious diseases on top of Helicobacter pylori. Also molecular level research is in our interest. Main research on upper GI endoscopy is focused on targeted biopsies and their morphological and molecular analysis in the diagnosis of neoplastic and preneoplastic changes of the gastrointestinal mucosa.
Also, we are working on vaccination of H. pylori.
As an international researcher and a doctor, how do you see the trend in people’s interest on stomach health globally?
The Healthy Stomach Initiative organization is an alliance of people who are mainly interested in Helicobacter pylori infection and other harmful agents to the stomach and contributed, with their research and publications all over the world.
And one thing is the technology in detecting the early cancer and continuous improvements in technologies of resection surgery endoscopical resections of tumors.
Still we are missing important drugs in the field of dyspeptic symptoms and dyspepsia. Scientifically we will be increasingly looking now to other micro-organisms that can play a role when it comes to atrophic gastritis, the so called gastric microbiome.
Is the East meets West Bridging Meeting your idea?
Yes – it started when I moved in 1995 to Magdeburg which is close to eastern European countries. There were some differences, especially when Germany became reunited in ‘89. I came here in ‘95 (Magdeburg) and I noticed that people in the east, although they were interested, they did not have the education for doing high level research, so I thought it is good to invest in young people so I’m very, particularly fond of this east-west bridging meeting.
In previous decades the researchers focused on promoting international networking across national borders. Times have changed - the present focus should invest in networking, above all, over the generation borders and involving all medical disciplines in the specific area of stomach health and diseases.”
Healthy Stomach Initiative web site at www.hsinitiative.org