Guiraldes E, Duarte I, Peña A, Godoy A, Espinosa M N, Bravo R, Larraín F, Schultz M, Harris P
Departamentos de Pediatría y Anatomía Patológica, Pontificia Universidad Católica de Chile, Santiago, Chile.
J Pediatr Gastroenterol Nutr. 2001 Aug;33(2):127-32. doi: 10.1097/00005176-200108000-00006.
Helicobacter pyloriinfection of the gastric mucosa in humans is usually acquired early in life. The chronic inflammation that ensues involves the increased production of inflammatory cytokines. Published data on production of these mediators by gastric mucosa of H. pylori-infected children are few.
Seventy-nine children, aged 5 to 18 years, referred for upper gastrointestinal endoscopy to four separate hospitals in Chile, were studied. The concentrations of interleukin (IL)-1beta, IL-6, IL-8, and tumor necrosis factor alpha were measured in homogenates of gastric mucosal biopsy specimens. Cytokine expression was confirmed by reverse transcription polymerase chain reaction. These data were correlated with the patients' clinical, histologic and sociodemographic status.
Patient rate of colonization by H. pylori was inversely correlated with socioeconomic status (P < 0.005) and positively correlated with age (P < 0.0025). In gastric mucosa, concentrations of IL-1beta, IL-8, and tumor necrosis factor alpha were all significantly higher in H. pylori-positive patients than in H. pylori-negative patients and in patients who had histologic gastritis than in those with normal gastric mucosa. In patients with peptic ulcer disease, only IL-1beta and IL-8 concentrations were significantly elevated when compared with those of patients without ulcers. Interleukin-6 concentrations were comparable among the different groups analyzed.
This study suggests that increased gastric mucosal production of the proinflammatory cytokines IL-1beta and IL-8 is probably involved in H. pylori-associated gastric damage in children and may be crucial in determining the different clinical outcomes.
人类胃黏膜幽门螺杆菌感染通常在生命早期获得。随之而来的慢性炎症涉及炎性细胞因子产生增加。关于幽门螺杆菌感染儿童胃黏膜这些介质产生情况的已发表数据很少。
对转诊至智利四家不同医院进行上消化道内镜检查的79名5至18岁儿童进行了研究。在胃黏膜活检标本匀浆中测量白细胞介素（IL）-1β、IL-6、IL-8和肿瘤坏死因子α的浓度。通过逆转录聚合酶链反应确认细胞因子表达。这些数据与患者的临床、组织学和社会人口统计学状况相关。
幽门螺杆菌定植患者比例与社会经济地位呈负相关（P < 0.005），与年龄呈正相关（P < 0.0025）。在胃黏膜中，幽门螺杆菌阳性患者的IL-1β、IL-8和肿瘤坏死因子α浓度均显著高于幽门螺杆菌阴性患者，且组织学胃炎患者高于胃黏膜正常患者。在消化性溃疡疾病患者中，与无溃疡患者相比，仅IL-1β和IL-8浓度显著升高。白细胞介素-6浓度在分析的不同组之间相当。
本研究表明，胃黏膜促炎细胞因子IL-1β和IL-8产生增加可能与儿童幽门螺杆菌相关的胃损伤有关，并且可能在决定不同临床结局方面起关键作用。
