Czesnikiewicz-Guzik Marta, Loster Bartłomiej, Bielanski Wladyslaw, Guzik Tomasz J, Konturek Peter C, Zapala Jan, Konturek Stanisław J
Institute of Dentistry, Jagiellonian University School of Medicine, Cracow, Poland.
J Clin Gastroenterol. 2007 Feb;41(2):145-51. doi: 10.1097/01.mcg.0000225654.85060.3d.
Helicobacter pylori (H. pylori) is an important pathogen in gastritis, peptic ulcer and possibly gastric cancer, but several questions remain unanswered. Particularly how the organism is transmitted and what is the relationship between oral presence of H. pylori and the gastric infection. Accordingly, we aimed to characterize the H. pylori in oral cavity and to evaluate its relationship to gastric H. pylori infection.
Out of total 100 screened for H. pylori infection female subjects (40 to 85 y), 49 patients (pts), who had positive C-urea breath test (UBT) and dyspeptic symptoms, agreed for 1 week regimen of triple anti-H. pylori therapy. The presence of H. pylori in oral cavity was assessed using bacterial culture from saliva and gingival pockets. Gastric H. pylori infection was estimated using capsulated C-urea breath test and plasma anti-H. pylori IgG and saliva IgA antibodies. In addition, plasma gastrin, ghrelin, and pepsinogen I were measured by radioimmunoassay. In selected patients, gastroscopy was additionally performed and gastric biopsy samples were taken for H. pylori random amplification of polymorphic DNA genetic profiling.
The triple therapy resulted in gastric H. pylori eradication in 79% pts, along with significant decrease of plasma gastrin combined with an increase in plasma ghrelin and pepsinogen I (PgI) levels and a marked alleviation of dyspeptic symptoms. In contrast to gastric effects, the eradication therapy failed to cause any changes in the presence of H. pylori in oral cavity. Moreover no relationship was observed between the presence of H. pylori in oral cavity and the gastric H. pylori eradication. In line with these findings, no relationship between gastric and oral H. pylori was found using genetic profiling by random amplification of polymorphic DNA.
H. pylori was detected both in the oral cavity and the stomach but oral H. pylori had no relation to gastric H. pylori and remained unaffected by eradication of gastric H. pylori.
幽门螺杆菌（H. pylori）是胃炎、消化性溃疡以及可能的胃癌的重要病原体，但仍有几个问题尚未得到解答。特别是该生物体如何传播，以及口腔中幽门螺杆菌的存在与胃部感染之间有何关系。因此，我们旨在对口腔中的幽门螺杆菌进行特征分析，并评估其与胃部幽门螺杆菌感染的关系。
在总共100名接受幽门螺杆菌感染筛查的女性受试者（40至85岁）中，49名患者（pts），其碳-尿素呼气试验（UBT）呈阳性且有消化不良症状，同意接受为期1周的三联抗幽门螺杆菌治疗方案。通过唾液和牙龈沟的细菌培养评估口腔中幽门螺杆菌的存在情况。使用胶囊型碳-尿素呼气试验、血浆抗幽门螺杆菌IgG和唾液IgA抗体评估胃部幽门螺杆菌感染情况。此外，通过放射免疫分析法测定血浆胃泌素、胃饥饿素和胃蛋白酶原I。在选定的患者中，额外进行了胃镜检查，并采集胃活检样本用于幽门螺杆菌多态性DNA基因分型的随机扩增。
三联疗法使79%的患者胃部幽门螺杆菌得以根除，同时血浆胃泌素显著降低，血浆胃饥饿素和胃蛋白酶原I（PgI）水平升高，消化不良症状明显缓解。与对胃部的影响相反，根除疗法未能使口腔中幽门螺杆菌的存在情况发生任何变化。此外，未观察到口腔中幽门螺杆菌的存在与胃部幽门螺杆菌根除之间存在关联。与这些发现一致，通过多态性DNA随机扩增进行基因分型未发现胃部和口腔幽门螺杆菌之间存在关联。
在口腔和胃中均检测到幽门螺杆菌，但口腔中的幽门螺杆菌与胃部幽门螺杆菌无关，且不受胃部幽门螺杆菌根除的影响。
