Federal State Institution Saint Petersburg Pasteur Research Institute of Epidemiology and Microbiology, Saint-Petersburg, Russian Federation.
Institute of Public Health and Clinical Nutrition, University of Eastern Finland (UEF), Kuopio, Finland.
Recent Adv Antiinfect Drug Discov. 2022;17(3):199-211. doi: 10.2174/2772434417666220903093339.
Helicobacter pylori eradication therapy can be considered effective if the result of its implementation is removed including all roots and rootlets from which surviving H. pylori can repopulate in the gastric mucosa. One of the reasons for the ineffectiveness of eradication therapy can be the continuous presence of viable coccoid forms of H. pylori in the oral cavity. Therefore, anti-Helicobacter eradication therapy should be supplemented by the sanitation of the oral cavity.
The objective of this study is to determine the frequency of occurrence of H. pylori in the gastric mucosa and in the oral cavity in patients with chronic periodontitis or with chronic gastritis using immunocytochemical method and to evaluate the pathophysiological relationship between periodontitis and HP-associated acid-dependent stomach diseases mediated by H. pylori.
A group of patients with chronic gastritis (70 participants, 46 women, 24 men, age: 24 - 55 years) and another group with chronic periodontitis before the start of surgical treatment (61 participants, 30 women, 31 men, age: 20 - 60 years) were examined for НР bacterial cells using immunocytochemical methods of staining gastric biopsy and exfoliate samples from the gingival sulcus surface. The participants did not take any antimicrobial medication before and during the examination. Routine staining was also performed to view microbiota in smears for both groups. The participants signed a voluntary consent agreement to undergo routine medical examinations and join the study at the Nikiforov Russian Centre of Emergency and Radiation Medicine, EMERCOM of Russia, where the ethical committee was made.
Immunocytochemical method could identify all stages of bacillary-coccoid transformation of H. pylori which accounted for 63.4-67.5% of cases. HP-antigenpositive bacteria were found in the oral cavity in both groups of examined patients. It was apparent that spiral forms of H. pylori were dominant over coccoid forms in the gastric mucosa in the antrum of the stomach, whereas coccoid forms of H. pylori were frequently found more in the oral cavity. Helicobacteriosis in the oral cavity was identified in chronic periodontitis.
We found certain pathogenetic connections between inflammatory lesions of the oral cavity and diseases of the internal organs of the gastrointestinal tract. Accordingly, we suggest the necessity to use proper medication for oral cavity sanitation along with anti-Helicobacter eradication therapy to influence the HP reservoir in the oral cavity and gingival sulcus. Additionally, bacterial cells of HP reside in the oral cavity in coccoid forms; therefore, the coccoid form of HP should become the second principal target in treating HP.
如果根除治疗的结果去除了包括所有能够使幽门螺杆菌重新在胃黏膜中定植的根和根毛，则可以认为该治疗是有效的。根除治疗无效的原因之一可能是口腔中持续存在有活力的幽门螺杆菌球形形式。因此，抗幽门螺杆菌根除治疗应辅以口腔卫生。
本研究的目的是使用免疫细胞化学方法确定患有慢性牙周炎或慢性胃炎的患者胃黏膜和口腔中幽门螺杆菌的发生频率，并评估由幽门螺杆菌介导的牙周炎与 HP 相关的酸依赖性胃病之间的病理生理关系。
一组慢性胃炎患者（70 名参与者，46 名女性，24 名男性，年龄：24-55 岁）和另一组在开始手术治疗前患有慢性牙周炎的患者（61 名参与者，30 名女性，31 名男性，年龄：20-60 岁）接受了免疫细胞化学方法检查胃活检和牙龈沟表面脱落样本中的 Hp 细菌细胞。参与者在检查前和检查期间均未服用任何抗菌药物。还对两组的常规涂片进行了微生物染色。参与者自愿同意在俄罗斯紧急情况和辐射医学中心 Nikiforov 进行常规体检并加入研究，俄罗斯紧急情况部 EMERCOM 在这里成立了伦理委员会。
免疫细胞化学方法可以识别幽门螺杆菌的杆状-球形转化的所有阶段，占 63.4-67.5%的病例。在两组接受检查的患者的口腔中均发现了 HP 抗原阳性细菌。显然，在胃窦的胃黏膜中，幽门螺杆菌的螺旋形式占优势，而在口腔中则经常发现更多的球形形式。在慢性牙周炎中发现了口腔幽门螺杆菌感染。
我们发现口腔炎症性病变与胃肠道内脏器官疾病之间存在一定的发病机制联系。因此，我们建议有必要使用适当的口腔卫生药物，同时进行抗幽门螺杆菌根除治疗，以影响口腔和牙龈沟中的幽门螺杆菌储存库。此外，HP 的细菌细胞以球形形式存在于口腔中；因此，球形 HP 应成为治疗 HP 的第二个主要目标。
