Karczewska Elzbieta, Konturek Joanna E, Konturek Peter C, Cześnikiewicz Marta, Sito Edward, Bielański Władysław, Kwiecień Nina, Obtułowicz Wojciech, Ziemniak Witold, Majka Jolanta, Hahn Eckhart G, Konturek Stanislaw J
Department of Physiology, Jagellonian University College of Medicine, Cracow, Poland.
Dig Dis Sci. 2002 May;47(5):978-86. doi: 10.1023/a:1015017502772.
Helicobacter pylori (Hp) is a common pathogen colonizing the a gastric mucosa, but some reports indicated that it may also be found in the oral cavity, which could serve as a reservoir of the bacteria and a source of gastric reinfection. Accordingly, we aimed to study whether the oral cavity, particularly gingival pockets, are colonized by Hp and whether it could be the source of gastric reinfection. We studied 329 patients with dyspeptic symptoms (257 with chronic gastritis, 15 with gastric ulcer, and 57 with duodenal ulcer). The [13C]urea breath test (UBT), gastroscopy, and Hp culture from gastric biopsies were carried out, and material was collected from the oral cavity (gingival pocket) for bacteriological culture and genomic DNA studies. The serum was obtained for anti-Hp IgG and anti-CagA assays and saliva for anti-Hp IgA determination using the ELISA technique. Bacteria in material from gingival pockets and biopsies from the corpus and antrum of stomach of 30 DU patients before and after Hp eradication were also examined by PCR technique, using primers specific for 16S rRNA. All Hp-positive patients (276) were subjected to one week of triple therapy (omeprazole 2 x 20 mg twice a day, clarithromycin 2 x 500 mg twice a day, and metronidazole 2 x 500 mg twice a day). The measurements described above were then repeated at four weeks and six months. Bacteriological culture showed the presence of Hp in the material from oral cavity in about 50% of patients, whereas UBT, used as a gold standard, revealed gastric Hp infection in about 84% of these patients. The eradication was successful in the majority of patients (87%), but about 13% of them were still Hp positive after four weeks and about 21% after six months. Four weeks after Hp therapy, Hp was found in culture from oral samples in 23% (P < 0.05 vs initial) and after six months in 35.1%. The IgA levels recorded in saliva were in a close agreement with UBT results. Hp DNA assessed by PCR in 30 DUs before eradication of Hp was detected in 95% of antral mucosa, 90% in corpus mucosa, and in 35% of gingival pocket material, and after eradication therapy Hp DNA values fell to 25%, 20%, and 10%, respectively. In conclusion, Hp is commonly detected in the oral cavity of patients with dyspeptic symptoms, but the gastric reinfection does not appear to occur in the patients despite oral Hp colonization.
幽门螺杆菌（Hp）是一种定植于胃黏膜的常见病原体，但一些报告表明，在口腔中也可能发现它，口腔可能是该细菌的储存库和胃部再次感染的来源。因此，我们旨在研究口腔，特别是牙龈沟，是否被Hp定植，以及它是否可能是胃部再次感染的来源。我们研究了329例有消化不良症状的患者（257例慢性胃炎患者、15例胃溃疡患者和57例十二指肠溃疡患者）。进行了[13C]尿素呼气试验（UBT）、胃镜检查以及胃活检组织的Hp培养，并从口腔（牙龈沟）采集材料进行细菌培养和基因组DNA研究。采集血清用于抗Hp IgG和抗CagA检测，采集唾液用于采用ELISA技术测定抗Hp IgA。还采用针对16S rRNA的引物，通过PCR技术检测了30例十二指肠溃疡患者在根除Hp前后牙龈沟材料和胃体及胃窦活检组织中的细菌。所有Hp阳性患者（276例）接受了为期一周的三联疗法（奥美拉唑2×20mg，每日2次；克拉霉素2×500mg，每日2次；甲硝唑2×500mg，每日2次）。然后在4周和6个月时重复上述测量。细菌培养显示，约50%的患者口腔材料中存在Hp，而作为金标准的UBT显示，这些患者中约84%存在胃部Hp感染。大多数患者（87%）根除成功，但约13%的患者在4周后仍为Hp阳性，6个月后约21%仍为阳性。Hp治疗4周后，23%的口腔样本培养中发现Hp（与初始相比P<0.05），6个月后为3
