Li Wei, Shu Xiaoli, Gu Weizhong, Peng Kerong, Cai Haifang, Jiang Liqin, Jiang Mizu
Department of Gastroenterology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
Department of Gastroenterology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; Email:
Zhonghua Er Ke Za Zhi. 2015 Jul;53(7):510-5.
To understand the junction protein expression of gastric mucosa including occlusal proteins (occludin), closed protein-4 (claudin-4), zonula occluden-1(ZO-1), epithelial cadherin (E-cadherin), and β ring protein (β-catenin) and the clinical significance in children with Helicobacter pylori (Hp) infection.
Seventy patients in whom gastric endoscopy was performed because of nausea, vomiting, abdominal pain, bloating, acid reflux, melena, and other gastrointestinal symptoms were enrolled in this study from Dec. 2010 to Apr. 2013 in our hospital. Informed consent was signed by their parents, and the study was in accordance with the principles of medical ethics. Hp positivity was confirmed if both respiratory urea test (RUT) and Hp were positive by gastric mucosal pathology. Gastric mucosal samples from 70 patients were enrolled in this study, 23 of them were Hp negative, 47 of them were Hp positive (24 cases without peptic ulcer, 23 cases with peptic ulcer). The mRNA levels and protein expression of tight junction protein of gastric mucosa were measured by RT-PCR and Western blot respectively. The location and semi quantitative content of E-cadherin and β-catenin in gastric mucosa were detected by immunohistochemical staining method.
The mRNA level of E-cadherin, β-catenin, ZO-1 in the Hp positive group regardless of peptic ulcer was significantly lower than that in the Hp negative group. Hp positive without peptic ulcer group were 0.0008, 0.0040, 0.0014, respectively; Hp positive with peptic ulcer group were 0.0010, 0.0090, 0.0013, respectively; Hp negative group were 0.0137, 0.0423, 0.0198, respectively (F values were 36.956, 39.893, 38.962, respectively, all P<0.05). The expression of claudin-4 mRNA in Hp positive group with peptic ulcer increased significantly, the difference among Hp positive group with peptic ulcer, Hp positive group without peptic ulcer and Hp negative group was statistically significant (0.1438 vs. 0.0926 vs. 0.0789) (F value was 11.964, P<0.05), while the difference of occludin mRNA levels among the three groups was not statistically significant.Immunohistochemistry results showed that the score of E-cadherin, β-catenin positive cell in the Hp positive patients were also significantly lower than that in the Hp negative group (t values were 3.981 and 2.340, all P<0.05, respectively). Western blot results showed that the protein levels of β-catenin in Hp positive group with peptic ulcer were significantly lower than that in Hp negative group, while the protein levels of E-cadherin in Hp positive patients regardless of peptic ulcer were decreased significantly in Hp negative group.
Our results revealed that the tight junction protein E-cadherin, β-catenin, ZO-1 expression of gastric mucosa were decreased in children with Hp infection, while claudin-4 expression was increased in Hp positive patients with peptic ulcer, suggesting that damage to gastric epithelial barrier function may be the main pathogenesis of Hp associated gastric diseases in children.
了解幽门螺杆菌(Hp)感染儿童胃黏膜中紧密连接蛋白(包括闭合蛋白(occludin)、闭合蛋白-4(claudin-4)、紧密连接蛋白-1(ZO-1))、上皮钙黏蛋白(E-钙黏蛋白)和β连环蛋白(β-catenin)的表达情况及其临床意义。
选取2010年12月至2013年4月在我院因恶心、呕吐、腹痛、腹胀、反酸、黑便等胃肠道症状行胃镜检查的70例患儿。患儿家长签署知情同意书,本研究符合医学伦理学原则。呼吸尿素试验(RUT)及胃黏膜病理检查Hp均为阳性者确诊为Hp阳性。收集70例患儿的胃黏膜样本,其中23例Hp阴性,47例Hp阳性(24例无消化性溃疡,23例有消化性溃疡)。分别采用逆转录聚合酶链反应(RT-PCR)和蛋白质免疫印迹法(Western blot)检测胃黏膜紧密连接蛋白的mRNA水平和蛋白表达。采用免疫组织化学染色法检测胃黏膜中E-钙黏蛋白和β连环蛋白的定位及半定量含量。
无论有无消化性溃疡,Hp阳性组E-钙黏蛋白、β连环蛋白、ZO-1的mRNA水平均显著低于Hp阴性组。Hp阳性无消化性溃疡组分别为0.0008、0.0040、0.0014;Hp阳性有消化性溃疡组分别为0.0010、0.0090、0.0013;Hp阴性组分别为0.0137、0.0423、0.0198(F值分别为36.956、39.893、38.962,均P<0.05)。Hp阳性有消化性溃疡组claudin-4 mRNA表达显著升高,Hp阳性有消化性溃疡组、Hp阳性无消化性溃疡组和Hp阴性组之间差异有统计学意义(0.1438比0.0926比0.0789)(F值为11.964,P<0.05),而三组间occludin mRNA水平差异无统计学意义。免疫组织化学结果显示,Hp阳性患儿E-钙黏蛋白、β连环蛋白阳性细胞评分也显著低于Hp阴性组(t值分别为3.981和2.340,均P<0.05)。蛋白质免疫印迹法结果显示Hp阳性有消化性溃疡组β连环蛋白蛋白水平显著低于Hp阴性组,而无论有无消化性溃疡,Hp阳性患儿E-钙黏蛋白蛋白水平均显著低于Hp阴性组。
本研究结果显示,Hp感染儿童胃黏膜紧密连接蛋白E-钙黏蛋白、β连环蛋白、ZO-1表达降低,而Hp阳性有消化性溃疡患者claudin-4表达升高,提示胃上皮屏障功能受损可能是儿童Hp相关胃部疾病的主要发病机制。