Molecular biological relationships between oral cavity and upper gastrointestinal tract in Helicobacter pylori infection

为分析口腔中幽门螺杆菌的存在情况，我们采集了口腔疾病患者的菌斑和唾液，用聚合酶链式反应技术检测幽门螺杆菌的存在。结果表明，Hp在口腔中的存在比例与年龄成正比，尤其是在40岁以上的人群中，Hp的感染率为50%。其次，为了了解口服Hp对胃再感染的影响，以及Hp在口腔中的流行与胃根除成功率的关系，我们检测了接受化疗的感染患者的牙菌斑控制情况。结果4例患者中有3例在根除治疗前后口腔中检出幽门螺杆菌，而牙菌斑控制后口腔中未检出幽门螺杆菌。在胃部，经过根除治疗和牙菌斑控制后，所有患者在3、6和12个月时CLO试验均为阴性。我们的结果建议…口腔内幽门螺杆菌感染越多，影响根除治疗结果的程度越高，与胃感染复发有关。我们建议在根除治疗前对口腔幽门螺杆菌进行PCR检测，如果阳性，应进行牙菌斑控制。第三，我们研究了唾液在口服幽门螺杆菌疫苗诱导和维持小鼠免疫中的作用。结果，口服免疫前切除涎腺的小鼠口服疫苗的效果并不低于免疫后1个月切除涎腺的小鼠，免疫后6个月切除唾液腺的小鼠的免疫效果显著降低。我们发现唾液对于幽门螺杆菌感染的保护、免疫诱导和维持是必要的。为了检验口腔幽门螺杆菌的流行与口腔癌之间的相关性，我们进行了免疫组织化学检测。研究对象为1994年至1998年间在京都大学医院就诊的口腔肿瘤患者40例。因此，我们评估了40名患者中的3名患者是否存在幽门螺杆菌。我们还检测了发生在口腔的MALT淋巴瘤的免疫组织化学。我们评估了唾液管中幽门螺杆菌的存在。然而，要了解其致病机制还需要进一步的研究。较少

To analyze the existence of Helicobacter pylori (H. pylori) in the oral cavity, we collected the plaque and saliva in the patients with oral disease, and tested the existence of H. pylori, using PCR technique. As a result, H. pylori existed in the oral cavity in proportion to ages, especially which was detected in 50% among over 40 ages.Next, to know the influence of oral H. pylori on the gastric reinfection and the correlation between the prevalence of H. pylori in the oral cavity and the gastric eradication success, we tested the dental plaque control in infected patients, when they were treated with chemotherapy. As a result, three of four patients are detected with H. pylori in the oral cavity before and after eradication therapy, but H. pylori were not detected in the oral cavity after dental plaque control. In the stomach, after the treatment of eradication therapy followed by dental plaque control, all the patients were negative for CLO test in 3, 6 and 12 months. Our result sug … More gests that H. pylori in the oral cavity affect the outcome of eradication therapy and was associated with a recurrence of gastric infection. We recommend that oral H. pylori should be examined by PCR before eradication therapy, and if positive, should be treated with dental plaque control.Thirdly, we studied the role of saliva in the induction and maintenance of the immunity in mice conferred by oral vaccination against H. pylori. As a result, oral vaccination in the mice who underwent a sialoadenctomy before oral immunization was no less effective in the mice who underwent a sialoadenectomy after the completion of immunization at 1 month, and the efficacy of immunization was significantly reduced by sialoadenectomy at 6 months after immunization. We found that saliva is necessary about the protection from the H. pylori infection and immune induction and maintenance.To examine the correlation between the prevalence of H. pylori in the oral cavity and oral cancer, we examined immunohistochemistry. 40 patients who were referred to Kyoto University Hospital between 1994 and 1998 with oral tumor were enrolled in this study. As a result, we assessed the existence of H. pylori in 3 of 40 patients. We also examined immunohisochemistry in MALT lymphoma arising in the oral cavity. We assessed the existence of H. pylori in the salivary duct. However, further investigation is required to know about the pathogenic mechanism. Less