Detection of helicobacter pylori in bronchoalveolar lavage of patients with chronic obstructive pulmonary disease by real time polymerase chain reaction.
Detection of helicobacter pylori in bronchoalveolar lavage of patients with chronic obstructive pulmonary disease by real time polymerase chain reaction.
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DOI：
10.5812/jjm.14551
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发表时间：
2015-01
影响因子：
0.6
通讯作者：
Mollaie HR
中科院分区：
文献类型：
--
作者：
Samareh Fekri M;Hashemi Bajgani SM;Rasti A;Yazdani R;Mollaie HR
慢性阻塞性肺疾病（COPD）是世界上最重要的致残和致死原因之一。虽然吸烟和环境污染物已被认为是COPD的主要原因，但感染在COPD发病机制和进展中的作用也有报道。本研究旨在通过抗幽门螺杆菌（H. Pylori）抗体的检测，探讨幽门螺杆菌感染与慢性阻塞性肺疾病（COPD）的关系。pylori IgG血清学、支气管肺泡灌洗真实的时间PCR和经支气管活检尿素酶试验。这项描述性横断面研究在60名COPD成人中进行。在获得患者的病史、体格检查、肺功能测定和由肺病专家确认的COPD诊断后，通过便利抽样选择受试者。采用慢性阻塞性肺疾病全球倡议（GOLD）标准和BODE指数判断疾病严重程度和预后。受试者接受支气管镜检查以获得支气管肺泡灌洗（BAL）样本，并进行活检。活检标本和支气管肺泡灌洗液标本分别用尿素酶试验和真实的实时PCR检测。同时对患者血清进行抗H. pylori IgG。参与者的平均年龄为60.65 ± 9.15岁，25%为女性，75%为男性。H. COPD患者pylori的检出率分别为真实的时间PCR法10%，血清学法88.3%，尿素酶法0%。根据PCR结果并考虑基于GOLD标准的疾病严重程度，在PCR阳性的患者中，1例（16.6%）为非常严重的梗阻，3例（50%）为重度梗阻，2例（33.3%）为中度梗阻。H. pylori的存在（基于PCR）与疾病严重程度和预后无统计学意义。这些发现可以证明通过吸入和吸入导致H的直接损伤和慢性炎症的假设。幽门定植。事实上，人们认为H.幽门螺杆菌感染，除了宿主遗传易感性和其他环境危险因素外，可能使患者易患COPD或导致COPD恶化。我们发现H。pylori感染在部分COPD患者中存在，本研究结果不能解释COPD的发病机制。
Chronic obstructive pulmonary disease (COPD) is one of the most important causes of disability and mortality in the world. Although cigarette smoking and environmental pollutants have been recognized as the major causes of COPD, the role of infection in the pathogenesis and progression of COPD has also been reported. The aim of the present study was to find the relationship between Helicobacter Pylori infection and COPD through anti H. pylori IgG serology, real time PCR of bronchoalveolar lavage and trans bronchial biopsy urease tests. This descriptive cross-sectional study was carried out on 60 adults with COPD. After obtaining the patient’s history, physical examination, spirometry and confirmation of COPD diagnosis by pulmonologist, subjects were selected through convenience sampling. In order to determine the severity and prognosis of disease, the global initiative for chronic obstructive lung disease (GOLD) criteria and BODE index were used. Subjects underwent bronchoscopy for obtaining bronchoalveolar lavage (BAL) samples and biopsy was performed. Biopsy and BAL samples were investigated respectively by urease test and real time PCR. Moreover, patients’ serum samples were serologically studied for detection of anti H. pylori IgG. Mean age of the participants was 60.65 ± 9.15 years, and 25% were female and 75% were male. The prevalence rate of H. pylori in COPD patients was 10% according to real time PCR, 88.3% according to the serology test and 0% based on the urease test. According to the results of PCR and considering the severity of disease based on the GOLD criteria, from those with a positive PCR, one patient (16.6%) had very severe obstruction, three (50%) had severe obstruction and two patients (33.3%) had moderate obstruction. The relationship between H. pylori presence (based on PCR) and disease severity and prognosis was not statistically significant. These findings can justify the hypothesis of direct injury and chronic inflammation via inhalation and aspiration resulting in H. pylori colonization. In fact, it is thought that H. Pylori infection, beside the host genetic vulnerability and other environmental risk factors might make the patient susceptible to COPD or lead to COPD worsening. Although we found H. pylori infection in some patients with COPD, the results of this study, could not explain the pathogenic mechanisms of COPD.
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