Nair S, Norkus E P, Hertan H, Pitchumoni C S
Division of Gastroenterology, Johns Hopkins University School of Medicine Baltimore, Maryland, USA.
J Clin Gastroenterol. 2000 Jun;30(4):381-5. doi: 10.1097/00004836-200006000-00006.
Free radicals (FRs) play an important role in the pathogenesis of gastroduodenal mucosal inflammation, peptic ulcer disease, and probably even gastric cancer. Various micronutrients protect the gastric mucosa by scavenging FRs. Only limited data is available regarding the concentration of micronutrients in the gastric mucosa in patients with gastritis and peptic ulcer disease. Our aim was to analyze micronutrient antioxidant concentrations in the antral mucosa in patients with gastritis and gastric ulcer and to determine the influence of Helicobacter pylori infection on gastric mucosal antioxidants in patients with gastritis and gastric ulcer. Patients who underwent upper endoscopy for evaluation of dyspepsia were included in the study. Ascorbic acid, alpha-tocopherol, alpha-carotene, beta-carotene, total carotenoids, lutein, cryptoxanthin, and lycopene levels were measured in the sera and antral mucosal biopsies in these patients. The diagnosis of H. pylori was confirmed by histology, urease test (CLO) and serology. Patients with negative endoscopic findings and normal histology and no H. pylori infection served as controls. In patients with gastritis, alpha-tocopherol levels were reduced in serum and mucosa irrespective of H. pylori status, whereas carotenoids and ascorbic acid levels were similar to controls. However, in patients with gastric ulcer, serum and mucosal levels of all micronutrient antioxidants were markedly decreased compared with both controls and patients with gastritis. The degree of depletion of antioxidants was similar in patients with either H. pylori-induced or nonsteroidal antiinflammatory drug (NSAID)-induced ulcers. Patients with gastric ulcer have very low gastric antioxidant concentrations compared to patients with gastritis and normal mucosa. This depletion in antioxidants seems to be a nonspecific response and was not related to H. pylori infection.
自由基（FRs）在胃十二指肠黏膜炎症、消化性溃疡疾病甚至可能在胃癌的发病机制中起重要作用。多种微量营养素通过清除自由基来保护胃黏膜。关于胃炎和消化性溃疡疾病患者胃黏膜中微量营养素浓度的数据有限。我们的目的是分析胃炎和胃溃疡患者胃窦黏膜中微量营养素抗氧化剂的浓度，并确定幽门螺杆菌感染对胃炎和胃溃疡患者胃黏膜抗氧化剂的影响。因消化不良接受上消化道内镜检查的患者纳入本研究。检测了这些患者血清和胃窦黏膜活检组织中维生素C、α-生育酚、α-胡萝卜素、β-胡萝卜素、总类胡萝卜素、叶黄素、隐黄质和番茄红素的水平。通过组织学、尿素酶试验（CLO）和血清学确诊幽门螺杆菌感染。内镜检查结果阴性、组织学正常且无幽门螺杆菌感染的患者作为对照。在胃炎患者中，无论幽门螺杆菌感染状态如何，血清和黏膜中的α-生育酚水平均降低，而类胡萝卜素和维生素C水平与对照组相似。然而，在胃溃疡患者中，与对照组和胃炎患者相比，所有微量营养素抗氧化剂的血清和黏膜水平均显著降低。幽门螺杆菌感染或非甾体抗炎药（NSAID）诱导的溃疡患者抗氧化剂的消耗程度相似。与胃炎患者和正常黏膜患者相比，胃溃疡患者的胃抗氧化剂浓度非常低。抗氧化剂的这种消耗似乎是一种非特异性反应，与幽门螺杆菌感染无关。
