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PATHOLOGY, PATHOPHYSIOLOGY, AND DIAGNOSIS OF HELICOBACTER HEILMANNII INFEDTION

海尔曼螺杆菌感染的病理学、病理生理学和诊断

基本信息

批准号：
15590482
负责人：
OTA Hiroyoshi
金额：
$ 2.24万
依托单位：
SHINSHU UNIVERSITY
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2003
资助国家：
日本
起止时间：
2003 至 2004
项目状态：
已结题

项目摘要

Gastric biopsy materials of 4074 consecutive Japanese patients undergoing esophagogastroduodenoscopy were reviewed, along with those of 15 patients with Helicobacter heilmannii (H.heilmannii) infection (1, chronic gastritis ; four, mucosa-associated lymphoid tissue (MALT) lymphoma]. The prevalence of H.heilmannii was 0.1% in the consecutive series. In chronic gastritis, the gastric mucosa was endoscopically normal (13.3%), had erythema (33.3%), or had erosions (53.3%) ; histologically, it showed no epithelial change, mild mononuclear cell infiltration, and slight and focal neutrophil infiltration. H.heilmannll was positive with anti-H.pylori antibody, and was detected in the mucous gel layer and in foveolae. In contrast, the serum and urinary antibody tests for H.pylori infection produced negative results in patients with H.heilmannii infection, suggesting the presence of relatively specific antigens in H.heilmannii : Eradication of H.heilmannii resulted in remission of MALT lymphoma. … More H.heilmannii infection is uncommon in Japanese adults, but is associated with chronic gastritis and gastric MALT lymphoma. A Mongolian gerbil model exhibited a high incidence of gastric MALT lymphoma-like lesion by H.heilmannii, whereas a Mongolian gerbil model of H.pylori infection exhibited hyperplastic polyps and ulcers. In Mongolian gerbils with H.pylori infection, high levels of mucosal IL-1β mRNA were observed early in the infection, reaching maximum at 4 weeks and then rapidly declining. Mucosal IFN-γ mRNA also reached maximal levels at 4 weeks but remained high there after. Both IL-1β and IFN-γ mRNA levels were consistently higher in the pyloric mucosa than in the fundic mucosa. In contrast, IL-4, IL-6, and IL-10 mRNA levels peaked at 8 to 26 weeks and levels were similar in the pyloric mucosa and the fundic mucosa. IFN-γ mRNA levels were significantly higher in gerbils with ulcers than in those with hyperplastic polyps. The different outcomes (e.g., ulcers or hyperplastic polyps) might relate to imbalances among cytokines. In Mongolian gerbils, loss of the virD4 gene in H.pylori temporally retarded but did not abrogate gastric inflammation, and loss of the cage gene in H.pylori abolished gastric inflammation partially via reduced ability to colonize. Unknown factors related to the type IV secretion system other than CagA may influence gastric inflammation. Less

回顾了4074例连续接受食管胃镜检查的日本患者的胃活检材料，沿着15例海尔曼螺杆菌（H.heilmannii）感染患者的胃活检材料（1例慢性胃炎; 4例粘膜相关淋巴组织（MALT）淋巴瘤）。连续系列中H.heilmannii的患病率为0.1%。在慢性胃炎中，胃粘膜内镜检查正常（13.3%），有红斑（33.3%）或糜烂（53.3%）;组织学检查显示无上皮变化，轻度单核细胞浸润，轻度局灶性中性粒细胞浸润。抗幽门螺杆菌抗体阳性，并在粘液凝胶层和小窝中检测到H.heilmannll。与此相反，幽门螺杆菌感染患者的血清和尿液抗体检测结果均为阴性，表明幽门螺杆菌中存在相对特异性抗原：根除幽门螺杆菌导致MALT淋巴瘤缓解。 ...更多信息海氏血吸虫感染在日本成人中并不常见，但与慢性胃炎和胃MALT淋巴瘤有关。蒙古沙鼠模型表现出高发病率的胃MALT淋巴瘤样病变的H.heilmannii，而蒙古沙鼠模型的幽门螺杆菌感染表现出增生性息肉和溃疡。幽门螺杆菌感染蒙古沙土鼠胃粘膜IL-1β mRNA表达在感染早期即出现高水平表达，4周时达到高峰，随后迅速下降。黏蛋白IFN-γ mRNA也在4周时达到最高水平，但此后仍保持较高水平。IL-1β和IFN-γ mRNA水平在幽门粘膜中均高于胃底粘膜。相比之下，IL-4、IL-6和IL-10 mRNA水平在8至26周达到峰值，并且幽门粘膜和胃底粘膜的水平相似。溃疡组的IFN-γ mRNA水平显著高于增生性息肉组。不同的结果（例如，溃疡或增生性息肉）可能与细胞因子之间的不平衡有关。在蒙古沙鼠中，幽门螺杆菌中virD 4基因的缺失暂时延迟但没有消除胃炎，幽门螺杆菌中cage基因的缺失通过降低定殖能力部分消除了胃炎。除CagA外，与IV型分泌系统相关的未知因素可能影响胃炎症。少