Sokic-Milutinovic Aleksandra, Todorovic Vera, Milosavljevic Tomica, Micev Marjan, Drndarevic Neda, Mitrovic Olivera
Clinic for Gastroenterology and Hepatology, Institute for Digestive Diseases, Clinical Center of Serbia, Belgrade 11000, Serbia and Montenegro.
World J Gastroenterol. 2005 Jul 21;11(27):4140-7. doi: 10.3748/wjg.v11.i27.4140.
To assess long-term effects of Helicobacter pylori (H pylori) eradication on antral G cell morphology and function in patients with and without duodenal ulcer (DU).
Consecutive dyspeptic patients referred to the endoscopy entered the study. Out of 39 H pylori positive patients, 8 had DU (H pylori +DU) and 31 gastritis (H pylori +G). Control groups consisted of 11 uninfected dyspeptic patients (CG1) and 7 healthy volunteers (CG2). Basal plasma gastrin (PGL), antral tissue gastrin concentrations (ATGC), immunohistochemical and electron microscopic characteristics of G cells were determined, prior to and 6 mo after therapy.
We demonstrated elevated PGL in infected patients compared to uninfected controls prior to therapy. Elevated PGL were registered in all H pylori+patients (H pylori +DU: 106.78+/-22.72 pg/mL, H pylori +G: 74.95+/-15.63, CG1: 68.59+/-17.97, CG2: 39.24+/-5.59 pg/mL, P<0.01). Successful eradication (e) therapy in H pylori+patients lead to significant decrease in PGL (H pylori+DU: 59.93+/-9.40 and H pylori +Ge: 42.36+/-10.28 pg/mL, P<0.001). ATGC at the beginning of the study were similar in infected and uninfected patients and eradication therapy lead to significant decrease in ATGC in H pylori +gastritis, but not in DU patients. In the H pylori +DU patients, the mean number of antral G cells was significantly lower in comparison with all other groups (P<0.01), but after successful eradication was close to normal values found in controls. By contrast, G cell number and volume density were significantly decreased (P<0.01) in H pylori +Ge group after successful eradication therapy (294+/-32 and 0.31+/-0.02, respectively), in comparison to values before eradication (416+/-40 and 0.48+/-0.09). No significant change of the G cell/total endocrine cell ratio was observed during the 6 mo of follow up in any of the groups. A reversible increase in G cell secretory function was seen in all infected individuals, demonstrated by a more prominent secretory apparatus. However, differences between DU and gastritis group were identified.
H pylori infection induces antral G cell hyperfunction resulting in increased gastrin synthesis and secretion. After eradication therapy complete morphological and functional recovery is observed in patients with gastritis. In the DU patients some other factors unrelated to the H pylori infection influence antral G cell morphology and function.
评估幽门螺杆菌（H pylori）根除对十二指肠溃疡（DU）患者和非DU患者胃窦G细胞形态及功能的长期影响。
连续纳入因消化不良接受内镜检查的患者。39例H pylori阳性患者中，8例患有DU（H pylori+DU），31例为胃炎（H pylori+G）。对照组包括11例未感染的消化不良患者（CG1）和7名健康志愿者（CG2）。在治疗前及治疗后6个月测定基础血浆胃泌素（PGL）、胃窦组织胃泌素浓度（ATGC）、G细胞的免疫组化及电子显微镜特征。
治疗前，与未感染对照组相比，感染患者的PGL升高。所有H pylori阳性患者（H pylori+DU：106.78±22.72 pg/mL，H pylori+G：74.95±15.63，CG1：68.59±17.97，CG2：39.24±5.59 pg/mL，P<0.01）的PGL均升高。H pylori阳性患者成功根除（e）治疗后，PGL显著降低（H pylori+DU：59.93±9.40和H pylori+Ge：42.36±10.28 pg/mL，P<0.001）。研究开始时，感染和未感染患者的ATGC相似，根除治疗导致H pylori+胃炎患者的ATGC显著降低，但DU患者未降低。H pylori+DU患者的胃窦G细胞平均数量与所有其他组相比显著降低（P<0.01），但成功根除后接近对照组的正常水平。相比之下，成功根除治疗后，H pylori+Ge组的G细胞数量和体积密度显著降低（P<0.01）（分别为294±32和0.31±0.02），与根除前的值（416±40和0.48±0.09）相比。在随访的6个月中，任何一组的G细胞/总内分泌细胞比率均未观察到显著变化。所有感染个体均可见G细胞分泌功能的可逆性增加，表现为分泌装置更突出。然而，DU组和胃炎组之间存在差异。
H pylori感染诱导胃窦G细胞功能亢进，导致胃泌素合成和分泌增加。根除治疗后，胃炎患者的形态和功能完全恢复。在DU患者中，一些与H pylori感染无关的其他因素影响胃窦G细胞的形态和功能。
