Gastric mucosal cell markers in patints with functional dyspepsia with and without Helicobacter pylori
S HolckDaiva Janulaitytė-GuntherLimas KupčinskasArvydas ČižauskasH. PerminS. NornTorkel WadströmLeif Percival Andersen
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histological alterations of gastric mucosa and its colonization by Helicobacter pylori are postuled to be implicated in the pathogenesis of non ulcer dyspepsia.to study the possible relationships between histological gastritis and Helicobacter pylori in non ulcer dyspepsia symptomatology.fifty four patients (39 females) with non ulcer dyspepsia whose ages ranged from 17 to 68 years were subjected to an upper GI endoscopy with gastric mucosa biopsy samples for histological study and microbiological identification of Helicobacter pylori. Gastrointestinal complains were blindly quantified using a scored questionnaire.thirty one subjects (57.4%) had Helicobacter pylori in their gastric mucosa. There was acute inflammatory activity in 26 of the 31 patients with Helicobacter pylori (81%) and 15 of 23 without Helicobacter (65%). The median score of symptoms was 7 (range 2-13) in patients with Helicobacter and 6 (range 2-10) in patients without Helicobacter.there were no significant differences in gastric mucosa acute inflammatory activity and non ulcer dyspepsia symptomatology between patients with or without Helicobacter pylori colonization of gastric mucosa.
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Helicobacter pylori 感染は胃炎を惹起するとともに， 胃十二指腸潰瘍の再発因子および治癒遷延因子として 作用する 1 ．また， 胃癌患者では抗 H. pylori 抗体陽性率 が有意に高い疫学的事実 2 とともにスナネズミへの本 菌感染が胃癌を誘導するという報告 3 により， 胃癌との 関連性について大きな関心が寄せられている．本稿で は H. pylori の細菌学的性状および遺伝子構造を解説 し，基礎的観点より H. pylori の胃病変誘導メカニズム を考察する． 1．H.pylori の細菌学的性状 H. pylori は 0.5-1.0×2.5-5.0 µm 大のらせん状 (helical form)のグラム陰性細菌である(図 1 a)．一端に複数 本の鞭毛をもち活発な運動性を示す．鞭毛蛋白のフラ ジェリンを胃酸から保護するため，蛋白およびリポ多 糖(LPS)を含む膜に含まれている(有鞘性鞭毛)．長 時間の培養に伴う栄養の枯渇，抗菌剤投与，嫌気状態 などの条件下で本菌は球状形態 (coccoid form) に変化 する (図 1 b) ．coccoid form は生きているが，培養でき ない菌(Viable but non-cultuable: VNC)でありその生 物学的意義は不明だが，糞便，土壌，河川水などの環 境における一種の耐久型 survival form であるとの仮 説がある． 表 1 に H. pylori の生物学的性状を示す．本菌は微好 気性菌(microaerophilic bacteria)であり，5-10％ O2 存在下の微好気もしくは
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Helicobacter pylori infection is commonly found worldwide. In Indonesia, the prevalence of H. pylori infection is 22.1%. The bacteria are responsible for gastritis, peptic ulcer disease (PUD), and gastric cancer.Helicobacter pylori may also has a role in functional dyspepsia. Diagnostic approach consists of noninvasive and invasive examinations. One of the invasive strategy is upper gastrointestinal (UGI) endoscopy and gastric mucosa biopsy.
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