Ando Takafumi, Watanabe Osamu, Ishiguro Kazuhiro, Maeda Osamu, Ishikawa Daisuke, Minami Masaaki, Hasegawa Motofusa, Kondo Shinya, Goto Yasuyuki, Ohmiya Naoki, Niwa Yasumasa, Goto Hidemi
Department of Gastroenterology, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Japan.
J Gastroenterol Hepatol. 2008 Dec;23 Suppl 2:S193-7. doi: 10.1111/j.1440-1746.2008.05438.x.
The chronic inflammatory process in patients with Crohn's disease (CD) may affect any part of the gastrointestinal (GI) tract. The pathogenesis of CD involves immunological abnormalities, including deficient or excessive expression of cytokines. We examined Helicobacter pylori infection status, endoscopic and histopathological findings, and cytokine production in the duodenum of CD patients in comparison with controls.
Thirty-eight CD patients underwent diagnostic upper GI endoscopy. Twelve age- and sex-matched health checkup examinees were used as controls. H. pylori infection status was assessed by the (13)C-urea breath test. At the time of endoscopy, two biopsy specimens each were obtained from the second portion of the duodenum, one for hematoxylin-eosin staining and immunohistochemical analysis with anti-CD68 antibody, and one for in vitro organ culture. Interleukin (IL)-6 and -8 levels were measured in organ culture supernatant by enzyme-linked immunosorbent assay.
H. pylori infection was significantly (P<0.05) more frequent in controls (42%) than in CD patients (8%). In the duodenum, erosions or ulcers were more frequent in CD patients (53%) than in controls (8%). Mononuclear cell infiltration in the duodenum was more severe in CD patients than in controls and IL-6 production was higher, whereas IL-8 production showed no significant difference. CD68+ cells in the duodenum were more prominent in CD patients than in controls.
H. pylori infection is unlikely in CD patients, but they show immunological abnormalities in the duodenum, possibly from innate immune responses.
克罗恩病（CD）患者的慢性炎症过程可能影响胃肠道（GI）的任何部位。CD的发病机制涉及免疫异常，包括细胞因子表达不足或过度。我们将CD患者十二指肠的幽门螺杆菌感染状况、内镜和组织病理学发现以及细胞因子产生情况与对照组进行了比较。
38例CD患者接受了上消化道诊断性内镜检查。12名年龄和性别匹配的健康体检者作为对照。通过（13）C-尿素呼气试验评估幽门螺杆菌感染状况。在内镜检查时，从十二指肠第二部获取两份活检标本，一份用于苏木精-伊红染色和抗CD68抗体免疫组化分析，另一份用于体外器官培养。通过酶联免疫吸附测定法测量器官培养上清液中的白细胞介素（IL）-6和-8水平。
对照组幽门螺杆菌感染率（42%）显著高于CD患者（8%）（P<0.05）。在十二指肠中，CD患者的糜烂或溃疡发生率（53%）高于对照组（8%）。CD患者十二指肠中的单核细胞浸润比对照组更严重，IL-6产生更高，而IL-8产生无显著差异。CD患者十二指肠中的CD68+细胞比对照组更突出。
CD患者不太可能感染幽门螺杆菌，但他们在十二指肠中表现出免疫异常，可能源于先天免疫反应。
