Matysiak-Budnik Tamara, Coffin Benoît, Lavergne-Slove Anne, Sabate Jean-Marc, Mégraud Francis, Heyman Martine
INSERM EMI-0212, Faculté de Médecine, Necker-Enfants Malades, Paris, France.
Am J Gastroenterol. 2004 Feb;99(2):225-32. doi: 10.1111/j.1572-0241.2004.04080.x.
We have previously shown that H. pylori increases the passage of intact protein across the digestive epithelium, in vitro and in vivo in mice. The aim of this study was to test whether H. pylori can alter gastric permeability to a food-type antigen in humans.
Antral and corpus gastric biopsies obtained from H. pylori-positive and H. pylori-negative patients suffering from nonulcer dyspepsia with normal esogastroduodenal endoscopy were mounted in adapted Ussing chambers to measure gastric permeability. Electrical resistance (R, an index of epithelial integrity) and fluxes of 14C-mannitol (JMan, a marker of paracellular permeability) and 3H-horseradish peroxidase (HRP, a test protein of antigen transport and processing) under intact (JHRPi) and degraded (JD) form, across the biopsies, were measured.
At the corpus level, biopsies obtained from H. pylori-positive patients, as compared to H. pylori-negative patients, presented significantly higher intact--but not degraded--HRP fluxes (JHRPi = 446 +/- 297 and 219 +/- 265 ng/h cm2, p < 0.05; JD = 4,247 +/- 3,884 and 3,575 +/- 2,594 ng/h x cm2, respectively), and an increase in paracellular permeability (Jman = 0.35 +/- 0.1 vs 0.24 +/- 0.08 micromol/h x cm2, p < 0.02, respectively). At the antrum level, a tendency to increased intact HRP fluxes in H. pylori-positive patients, as compared to H. pylori-negative patients, was observed (JHRPi = 284 +/- 250 vs 207 +/- 203 ng/h x cm2, p < 0.09), without modifications of paracellular permeability.
H. pylori infection increases absorption of an intact food antigen across the corpus gastric mucosa. This phenomenon may contribute to the maintenance of gastric inflammation and could play a role in the development of allergic sensitization to dietary antigens in susceptible individuals.
我们之前已经证明,幽门螺杆菌在体外及小鼠体内均可增加完整蛋白质穿过消化上皮的通过率。本研究旨在检测幽门螺杆菌是否会改变人体对食物型抗原的胃通透性。
从食管胃十二指肠内镜检查正常的幽门螺杆菌阳性和阴性的非溃疡性消化不良患者获取胃窦和胃体活检组织,将其安装在改良的尤斯灌流小室中以测量胃通透性。测量完整状态(JHRPi)和降解状态(JD)下的跨活检组织的电阻(R,上皮完整性指标)、14C-甘露醇通量(JMan,细胞旁通透性标志物)以及3H-辣根过氧化物酶(HRP,抗原转运与加工的测试蛋白)通量。
在胃体水平,与幽门螺杆菌阴性患者相比,幽门螺杆菌阳性患者的活检组织呈现出显著更高的完整HRP通量(但降解通量无差异)(JHRPi分别为446±297和219±265 ng/h·cm2,p<0.05;JD分别为4247±3884和3575±2594 ng/h·cm2),并且细胞旁通透性增加(Jman分别为0.35±0.1和0.24±0.08 μmol/h·cm2,p<0.02)。在胃窦水平,观察到与幽门螺杆菌阴性患者相比,幽门螺杆菌阳性患者的完整HRP通量有增加趋势(JHRPi为284±250与207±203 ng/h·cm2,p<;0.09),细胞旁通透性无改变。
幽门螺杆菌感染会增加完整食物抗原穿过胃体胃黏膜的吸收。这种现象可能有助于维持胃部炎症,并可能在易感个体对饮食抗原的过敏致敏发展中起作用。