Vilarinho Sérgio, Guimarães Nuno M, Ferreira Rui M, Gomes Bárbara, Wen Xiaogang, Vieira Maria J, Carneiro Fátima, Godinho Tiago, Figueiredo Ceu
Serviço de Otorrinolaringologia, Hospital de São Marcos, Braga, Portugal.
Int J Pediatr Otorhinolaryngol. 2010 Jul;74(7):807-11. doi: 10.1016/j.ijporl.2010.04.007. Epub 2010 May 10.
The transmission of the gastric pathogen Helicobacter pylori involves the oral route. Molecular techniques have allowed the detection of H. pylori DNA in samples of the oral cavity, although culture of H. pylori from these type of samples has been sporadic. Studies have tried to demonstrate the presence of H. pylori in adenotonsillar tissue, with contradictory results. Our aim was to clarify whether the adenotonsillar tissue may constitute an extra gastric reservoir for H. pylori.
Sixty-two children proposed for adenoidectomy or tonsillectomy were enrolled. A total of 101 surgical specimens, 55 adenoid and 46 tonsils, were obtained. Patients were characterized for the presence of anti-H. pylori antibodies by serology. On each surgical sample rapid urease test, immunohistochemistry, fluorescence in situ hybridization (FISH) with a peptide nucleic acid probe for H. pylori, and polymerase chain reaction-DNA hybridization assay (PCR-DEIA) directed to the vacA gene of H. pylori were performed.
Thirty-nine percent of the individuals had anti-H. pylori antibodies. Rapid urease test was positive in samples of three patients, all with positive serology. Immunohistochemistry was positive in samples of two patients, all with negative serology. All rapid urease test or immunohistochemistry positive cases were negative by FISH. All samples tested were negative when PCR-DEIA for H. pylori detection was used directly in adenotonsillar specimens.
The adenotonsillar tissue does not constitute an extra gastric reservoir for H. pylori infection, at least a permanent one, in this population of children. Moreover, techniques currently used for detecting gastric H. pylori colonization are not adequate to evaluate infection of the adenotonsillar tissues.
胃部病原体幽门螺杆菌的传播涉及口腔途径。分子技术已能在口腔样本中检测到幽门螺杆菌DNA，不过从这类样本中培养幽门螺杆菌的情况较为零散。有研究试图证明腺样体扁桃体组织中存在幽门螺杆菌，但结果相互矛盾。我们的目的是明确腺样体扁桃体组织是否可能构成幽门螺杆菌在胃外的一个储存库。
纳入62名拟行腺样体切除术或扁桃体切除术的儿童。共获取101份手术标本，其中腺样体标本55份，扁桃体标本46份。通过血清学检测患者是否存在抗幽门螺杆菌抗体。对每份手术样本进行快速尿素酶试验、免疫组织化学、用针对幽门螺杆菌的肽核酸探针进行荧光原位杂交（FISH）以及针对幽门螺杆菌vacA基因的聚合酶链反应 - DNA杂交检测（PCR - DEIA）。
39%的个体有抗幽门螺杆菌抗体。快速尿素酶试验在3名患者的样本中呈阳性，这些患者血清学均为阳性。免疫组织化学在2名患者的样本中呈阳性，这些患者血清学均为阴性。所有快速尿素酶试验或免疫组织化学阳性的病例FISH检测均为阴性。当直接在腺样体扁桃体标本中使用PCR - DEIA检测幽门螺杆菌时，所有检测样本均为阴性。
在这群儿童中，腺样体扁桃体组织不构成幽门螺杆菌感染在胃外的一个储存库，至少不是一个永久性的储存库。此外，目前用于检测胃部幽门螺杆菌定植的技术不足以评估腺样体扁桃体组织的感染情况。
