Wang Ke-Xia, Li Chao-Pin, Cui Yu-Bao, Tian Ye, Yang Qing-Gui
Department of Etiology and Immunology, School of Medicine, Anhui University of Science and Technology Huainan 232001, Anhui Province, China.
World J Gastroenterol. 2003 Mar;9(3):525-8. doi: 10.3748/wjg.v9.i3.525.
To study the occurrence of L-forms of H. pylori infection in patients with peptic ulcers and its association with possible changes of cellular immune function in the patients.
Endoscopic biopsy specimens of gastric antrum and gastric corpus were taken from 228 patients with peptic ulcers and inoculated into Skirrow selective medium for H. pylori vegetative forms and special medium for H. pylori L-forms, followed by bacterial isolation and identification. And peripheral venous blood of the patients was taken to detect the percentage of CD3(+), CD4(+) and CD8(+) with biotin-streptavidin (BSA) and the level of IL-2, IL-6 and IL-8 with ELISA.
(1) The detection rates of H. pylori L-forms and vegetative forms in the patients were 50.88 % (116/228) and 64.91 % (148/228) respectively, and the co-infection rate of H. pylori L-forms and vegetative forms was 78.38 % (116/148). To be more exact, the detection rates of H. pylori L-forms in male and female patients were 57.04 % (77/135) and 41.94 % (39/93) respectively, and statistics found significant difference between them (P<0.05). Furthermore, the detection rates of H. pylori L-forms in patients aged 14 years-, 30 years-, 40 years- and 50 years- were 31.91 % (15/47), 42.86 % (24/56), 56.94 % (41/72) and 67.92 % (36/53) respectively, and there was significant difference between them (P<0.01). (2) The percentages of CD3(+), CD4(+), CD8(+), the ratio of CD4(+)/CD8(+), and the level of IL-2, IL-6, IL-8 in H. pylori-positive patients were (52.59+/-5.44) %, (35.51+/-5.74) %, (27.77+/-8.64) %, (1.56+/-0.51), (2.66+/-0.47) mg/L, (108.62+/-5.85) ng/L and (115.79+/-7.18) ng/L respectively, compared with those in H. pylori-negative patients, the percentages of CD3(+), CD4(+) and the ratio of CD4(+)/CD8(+) decreased, but the level of IL-2, IL-6 increased, and the difference was significant (P<0.001-P<0.01). Moreover, the percentages of CD3(+), CD4(+), CD8(+), the ratio of CD4(+)/CD8(+), and the level of IL-2, IL-6, IL-8 in the patients with mixed infection of both H. pylori L-forms and vegetative forms were (51.69+/-5.28) %, (34.75+/-5.89) %, (27.15+/-7.45) %, (1.48+/-0.47), (2.16+/-0.38) mg/L, (119.45+/-5.44) ng/L and (123.64+/-6.24) ng/L respectively, compared with those in patients with simple infection of H. pylori vegetative forms, the percentage of CD4(+), the ratio of CD4(+)/CD8(+) and the level of IL-2 increased, but the level of IL-6 and IL-8 decreased, statistical difference was found between them (P<0.001-P<0.05).
L-forms variation often occurs in patients with peptic ulcers who are infected by H. pylori, which is commonly found in male patients and related to ages. The L-forms variation of H. pylori can be an important factor causing disorder of cellular immune function in the patients with peptic ulcers who are infected by H. pylori.
研究消化性溃疡患者幽门螺杆菌L型感染的发生情况及其与患者细胞免疫功能可能变化的关系。
从228例消化性溃疡患者中采集胃窦和胃体的内镜活检标本，接种于用于幽门螺杆菌繁殖体的Skirrow选择性培养基和用于幽门螺杆菌L型的特殊培养基，随后进行细菌分离和鉴定。采集患者外周静脉血，采用生物素-链霉亲和素（BSA）法检测CD3(+)、CD4(+)和CD8(+)的百分比，采用酶联免疫吸附测定（ELISA）法检测白细胞介素-2（IL-2）、白细胞介素-6（IL-6）和白细胞介素-8（IL-8）的水平。
（1）患者中幽门螺杆菌L型和繁殖体的检出率分别为50.88%（116/228）和64.91%（148/228），幽门螺杆菌L型和繁殖体的混合感染率为78.38%（116/148）。更确切地说，男性和女性患者中幽门螺杆菌L型的检出率分别为57.04%（77/135）和41.94%（39/93），统计学分析发现两者之间存在显著差异（P<0.05）。此外，14岁以下、30岁、40岁和50岁以上患者中幽门螺杆菌L型的检出率分别为31.91%（15/47）、42.86%（24/56）、56.94%（41/72）和67.92%（36/53），差异有统计学意义（P<0.01）。（2）幽门螺杆菌阳性患者中CD3(+)、CD4(+)、CD8(+)的百分比、CD4(+)/CD8(+)比值以及IL-2、IL-6、IL-8的水平分别为（52.59±5.44）%、（35.51±5.74）%、（27.77±8.64）%、（1.56±0.51）、（2.66±0.47）mg/L、（108.62±5.85）ng/L和（115.79±7.18）ng/L，与幽门螺杆菌阴性患者相比，CD3(+)、CD4(+)的百分比和CD4(+)/CD8(+)比值降低，但IL-2、IL-6水平升高，差异有统计学意义（P<0.001 - P<0.01）。此外，幽门螺杆菌L型和繁殖体混合感染患者中CD3(+)、CD4(+)、CD8(+)的百分比、CD4(+)/CD8(+)比值以及IL-2、IL-6、IL-8的水平分别为（51.69±5.28）%、（34.75±5.89）%、（27.15±7.45）%、（1.48±0.47）、（2.16±0.38）mg/L、（119.45±5.44）ng/L和（123.64±6.24）ng/L，与单纯幽门螺杆菌繁殖体感染患者相比，CD4(+)的百分比及CD4(+)/CD8(+)比值和IL-2水平升高，但IL-6和IL-8水平降低，差异有统计学意义（P<0.001 - P<0.05）。
幽门螺杆菌感染的消化性溃疡患者常发生L型变异，在男性患者中较为常见且与年龄有关。幽门螺杆菌的L型变异可能是导致幽门螺杆菌感染的消化性溃疡患者细胞免疫功能紊乱的重要因素。
