Impaired gastric mucosal integrity identified by confocal endomicroscopy in Helicobacter pylori-negative functional dyspepsia
Impaired gastric mucosal integrity identified by confocal endomicroscopy in Helicobacter pylori-negative functional dyspepsia
复制标题
共聚焦内窥镜检查幽门螺杆菌阴性功能性消化不良患者胃粘膜完整性受损
DOI：
10.1111/nmo.13719
复制
发表时间：
2020-01-01
影响因子：
3.5
通讯作者：
Li, Yan-Qing
中科院分区：
文献类型：
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作者：
Ji, Rui;Wang, Peng;Li, Yan-Qing
背景：低度炎症可能参与功能性消化不良（FD）的发病机制。我们假设胃通透性改变与这种疾病的发生和持续存在有关。因此，我们的目的是评估 FD 患者的胃粘膜完整性和肥大细胞数量。方法：我们纳入了 58 名符合罗马 III 标准的 FD 患者（幽门螺杆菌阴性）、20 名炎症对照受试者（幽门螺杆菌阳性）和 20 名健康对照者（幽门螺杆菌阴性）。使用静脉内荧光素进行基于探针的共焦内窥镜检查，以评估细胞旁荧光素渗漏和细胞脱落。通过粘膜活检中的定量免疫组织化学方法鉴定肥大细胞。 主要结果：与健康对照相比，幽门螺杆菌阴性 FD 患者的细胞旁通透性内镜评分显着较高（1.45 +/- 1.27 vs 3.69 +/- 3.18，P = .006）。然而，FD 患者和健康对照在细胞脱落评分上没有表现出差异（0.75 +/- 0.79 vs 1.29 +/- 1.14，P = 0.069）。与健康对照样本相比，肥大细胞数量显着增加（18.91 +/- 5.47 vs 14.1 +/- 3.88，P
Background: Low-grade inflammation may be involved in the pathogenesis of functional dyspepsia (FD). We hypothesis that altered gastric permeability is involved in the onset and persistence of this disorder. Therefore, our aim was to evaluate gastric mucosal integrity and mast cell numbers in patients with FD.Methods: We enrolled 58 patients with FD fulfilling the Rome III criteria (H Pylori negative), 20 inflammatory control subjects (H Pylori positive), and 20 healthy controls (H Pylori negative). Probe-based confocal endomicroscopy was performed using intravenous fluorescein to assess the paracellular fluorescein leakage and cell shedding. Mast cells were identified with quantitative immunohistochemistry on mucosal biopsies.Key Results: Endomicroscopic score of paracellular permeability was significantly higher in H pylori-negative FD patients compared with healthy controls (1.45 +/- 1.27 vs 3.69 +/- 3.18, P =.006). However, FD patients and healthy controls did not show differences in cell shedding score (0.75 +/- 0.79 vs 1.29 +/- 1.14, P =.069). Mast cell numbers were significantly increased compared with healthy control samples (18.91 +/- 5.47 vs 14.1 +/- 3.88, P