Maciorkowska Elzbieta, Kaczmarski Maciej, Kemona Andrzej
Zakład Pielegniarstwa Pediatrycznego, Akademia Medyczna, ul. Waszyngtona 15, 15-745 Białystok, Poland.
Med Wieku Rozwoj. 2005 Oct-Dec;9(4):665-73.
Trophozoites of Giardia lamblia present in the upper gastro-intestinal tract may cause inflammation of the duodenal mucosa, impair secretory activity of goblet cells, damage the enterocytes, and in case of intestinal villi atrophy, they may induce the malabsorption syndrome. The increase in number of endothelial lymphocytes in the epithelium of the duodenal mucosa indicates the involvement of local immune processes. THE AIM of the study was to assess the concentrations of chosen cytokines in the gastric mucosa in children infested with Giardia lamblia, before and after treatment, with simultaneous morphological evaluation of the duodenal mucosa before treatment.
The study included 12 children infested with Giardia lamblia and 15 children constituting controls. Giardiasis was diagnosed basing on the presence of trophozoites in the mucus taken from the duodenum during endoscopy (brush swab). In all patients, samples from the prepyloric section of the gastric and duodenal mucosa were examined histologically. In bioptates, concentrations of chosen cytokines were determined by ELISA method.
Histopathological examination of the gastric mucosa showed chronic antral gastritis in 8.3% and duodenal mucosa inflammation in 58.3%. Mean concentrations of cytokines determined in the antral mucosa before treatment equaled: IL-2 - 53.1; IL-4 -27.7; IL-5 -39.4; IL-8 - 41.4; IL-10 - 33.0; IFN-gamma - 60.3; TNF-alpha - 27.7 pq/mg of protein. Concentrations of mucosal cytokines, apart from IL-10 (82.7 pq/mg of protein), decreased due to targeted treatment with the simultaneous improvement of histopathological changes reported before treatment.
In children infested with Giardia lamblia, an increased local production of proinflammatory and proallergic cytokines was observed in the gastric mucosa.
存在于上消化道的蓝氏贾第鞭毛虫滋养体可引起十二指肠黏膜炎症，损害杯状细胞的分泌活性，损伤肠上皮细胞，若出现肠绒毛萎缩，可诱发吸收不良综合征。十二指肠黏膜上皮内内皮淋巴细胞数量增加表明局部免疫过程参与其中。本研究的目的是评估感染蓝氏贾第鞭毛虫的儿童在治疗前后胃黏膜中所选细胞因子的浓度，并同时对治疗前的十二指肠黏膜进行形态学评估。
本研究纳入了12名感染蓝氏贾第鞭毛虫的儿童和15名儿童作为对照。根据在内镜检查（刷拭）时从十二指肠采集黏液中存在滋养体来诊断贾第虫病。对所有患者的胃和十二指肠黏膜幽门前区样本进行组织学检查。在活检组织中，通过ELISA法测定所选细胞因子的浓度。
胃黏膜组织病理学检查显示8.3%为慢性胃窦炎，58.3%为十二指肠黏膜炎症。治疗前胃窦黏膜中测定的细胞因子平均浓度为：白细胞介素-2（IL-2）-53.1；白细胞介素-4（IL-4）-27.7；白细胞介素-5（IL-5）-39.4；白细胞介素-8（IL-8）-41.4；白细胞介素-10（IL-10）-33.0；γ-干扰素（IFN-γ）-60.3；肿瘤坏死因子-α（TNF-α）-27.7皮克/毫克蛋白质。除IL-10（82.7皮克/毫克蛋白质）外，黏膜细胞因子浓度因靶向治疗而降低，同时治疗前报告的组织病理学变化有所改善。
在感染蓝氏贾第鞭毛虫的儿童中，观察到胃黏膜中促炎和促过敏细胞因子的局部产生增加。
