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幽门螺杆菌感染患者的免疫标志物:根除治疗的效果

Immunity markers in patients with Helicobacter pylori infection: effect of eradication.

作者信息

Dore Maria Pina, Fastame Laura, Tocco Andreina, Negrini Riccardo, Delitala Giuseppe, Realdi Giuseppe

机构信息

Istituto di Clinica Medica, Università di Sassari, Italy.

出版信息

Helicobacter. 2005 Oct;10(5):391-7. doi: 10.1111/j.1523-5378.2005.00346.x.

Abstract

BACKGROUND

Helicobacter pylori is a microorganism able to stimulate a robust inflammatory and systemic immune response.

AIM

The aim of our study was to evaluate autoimmune markers in dyspeptic patients positive for H. pylori infection compared to a control group of non-H. pylori-infected subjects. The kinetics of cryoglobulins and autoantibodies was evaluated after treatment of the infection.

PATIENTS AND METHODS

Dyspeptic patients with active H. pylori infection and age- and sex-matched healthy H. pylori-negative controls were studied. Markers of immunity were compared, in H. pylori-infected patients before, 6 months and 1 year after the end of therapy. Results were also compared between those with and without successful eradication therapy.

RESULTS

Eighty-six individual were entered (43 H. pylori-infected). H. pylori-infected patients had higher levels of IgG and/or IgA and/or IgM (22/43 versus 2/43). Circulating immune complexes and cryoglobulins were detected in patients more often than controls (p < .05 for both). Autoantibodies were observed in 13 patients (30% versus 5% in controls) and antithyroid antibodies in 12 (p < .04 versus controls). Lower levels of C3 and/or C4 complement fractions were observed in infected patients with respect to controls (7/43 versus 1/43; p = .014). After 1 year of follow-up, the markers of autoimmunity dramatically improved in patients eradicated for H. pylori infection compared to those in whom therapy failed. No patient developed a clinical autoimmune disorder.

CONCLUSIONS

Additional studies are necessary to ascertain the clinical significance of the modifications of autoimmune markers in patients with H. pylori infection.

摘要

背景

幽门螺杆菌是一种能够激发强烈炎症和全身免疫反应的微生物。

目的

我们研究的目的是评估幽门螺杆菌感染阳性的消化不良患者与非幽门螺杆菌感染受试者的对照组相比的自身免疫标志物。在感染治疗后评估冷球蛋白和自身抗体的动力学。

患者和方法

研究了患有活动性幽门螺杆菌感染的消化不良患者以及年龄和性别匹配的健康幽门螺杆菌阴性对照。比较了幽门螺杆菌感染患者在治疗结束前、6个月和1年后的免疫标志物。还比较了根除治疗成功和未成功患者的结果。

结果

纳入86例个体(43例幽门螺杆菌感染)。幽门螺杆菌感染患者的IgG和/或IgA和/或IgM水平更高(22/43对2/43)。患者中循环免疫复合物和冷球蛋白的检测频率高于对照组(两者p < 0.05)。13例患者观察到自身抗体(对照组为30%对5%),12例观察到抗甲状腺抗体(与对照组相比p < 0.04)。与对照组相比,感染患者的C3和/或C4补体成分水平较低(7/43对1/43;p = 0.014)。随访1年后,与治疗失败的患者相比,根除幽门螺杆菌感染的患者自身免疫标志物显著改善。没有患者发生临床自身免疫性疾病。

结论

需要进一步研究以确定幽门螺杆菌感染患者自身免疫标志物改变的临床意义。

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