Department of Human Pathology, School of Medicine, University of Messina, Messina, Italy.
Virchows Arch. 2012 Nov;461(5):489-94. doi: 10.1007/s00428-012-1308-x. Epub 2012 Sep 5.
The recognition and removal of apoptotic inflammatory cells by tissue macrophages and non-professional phagocytes, in a process called efferocytosis, is required for resolution of inflammation and is actively anti-inflammatory. We have previously demonstrated phagocytosis of apoptotic neutrophils by tumor cells in human gastric carcinoma, but to date, there have been no studies investigating this process in chronic active Helicobacter pylori gastritis. Biopsy specimens from 28 subjects with or without H. pylori infection and active inflammation were examined and graded according to the updated Sydney system. Light microscopy, electron microscopy, and Terminal Deoxynucleotidyltransferase-Mediated UTP End Labeling staining were used to identify apoptosis. H. pylori infection was detected by histology and by molecular assay in 16 out of 28 cases. DNA from paraffin-embedded gastric biopsies was amplified using primers specific for cagA, for the cag "empty site" as well as for the s and m alleles of vacA. The more virulent cagA-positive strains were found in five out of nine patients with chronic active gastritis. The vacA s1/m1 and s2/m1 genotypes were more common in nine patients with chronic active gastritis, while the vacA s2/m2 genotype was more frequent in seven patients with chronic inactive gastritis. Apoptotic neutrophils were also detected within the cytoplasmic vacuoles of the foveolar cells of nine cases with chronic active gastritis. Transmission electron micrographs revealed further apoptotic neutrophils within spacious phagosomes of foveolar cells in a similar manner to those described in late-phase efferocytosis both in vivo and in vitro. These new observations expand the morphological spectrum of gastritis in patients infected with more virulent H. pylori strains, compatible with an anti-inflammatory role for the gastric epithelial cells in their removal of apoptotic neutrophils during active chronic gastritis.
组织巨噬细胞和非专业吞噬细胞识别和清除凋亡炎症细胞，这个过程称为吞噬作用，对于炎症的消退是必需的，并且具有积极的抗炎作用。我们之前已经证明了肿瘤细胞吞噬凋亡的中性粒细胞，但迄今为止，还没有研究调查这种过程在慢性活动性幽门螺杆菌胃炎中的作用。检查了 28 名有或没有幽门螺杆菌感染和活动性炎症的受试者的活检标本，并根据更新的悉尼系统进行了评分。使用光镜、电子显微镜和末端脱氧核苷酸转移酶介导的 UTP 末端标记染色来识别细胞凋亡。在 28 例中有 16 例通过组织学和分子检测发现了幽门螺杆菌感染。使用针对 cagA、cag“空位点”以及 vacA 的 s 和 m 等位基因的引物对石蜡包埋的胃活检组织的 DNA 进行扩增。在 9 例慢性活动性胃炎患者中有 5 例发现了更具毒性的 cagA 阳性菌株。在 9 例慢性活动性胃炎患者中更常见 vacA s1/m1 和 s2/m1 基因型，而在 7 例慢性非活动性胃炎患者中 vacA s2/m2 基因型更常见。在 9 例慢性活动性胃炎患者中，也在滤泡细胞的细胞质空泡中检测到凋亡的中性粒细胞。透射电镜显示，在类似的方式中，在体内和体外的晚期吞噬作用中，在滤泡细胞的宽大吞噬体中进一步发现了凋亡的中性粒细胞。这些新的观察结果扩展了感染更具毒性幽门螺杆菌菌株的患者胃炎的形态学谱，与胃上皮细胞在清除慢性活动性胃炎期间清除凋亡中性粒细胞的抗炎作用一致。
