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幽门螺杆菌感染中的抗胃自身抗体:胃炎组织学和临床参数的意义

Antigastric autoantibodies in Helicobacter pylori infection: implications of histological and clinical parameters of gastritis.

作者信息

Faller G, Steininger H, Kränzlein J, Maul H, Kerkau T, Hensen J, Hahn E G, Kirchner T

机构信息

Institute of Pathology, University of Erlangen-Nürnberg, Germany.

出版信息

Gut. 1997 Nov;41(5):619-23. doi: 10.1136/gut.41.5.619.

Abstract

BACKGROUND

It has recently been shown that humoral antigastric autoreactivities occur in a substantial number of Helicobacter pylori infected patients.

AIMS

To analyse the relevance of such antigastric autoantibodies for histological and serological parameters of the infection as well as for the clinical course.

METHODS

Gastric biopsy samples and sera from 126 patients with upper abdominal complaints were investigated for evidence of H pylori infection using histology and serology. Autoantibodies against epitopes in human gastric mucosa were detected by immunohistochemical techniques. Histological and clinical findings of all patients were then correlated with the detection of antigastric autoantibodies.

RESULTS

H pylori infection was significantly associated with antigastric autoantibodies reactive with the luminal membrane of the foveolar epithelium and with canalicular structures within parietal cells. The presence of the latter autoantibodies was significantly correlated with the severity of body gastritis, gastric mucosa atrophy, elevated fasting gastrin concentrations, and a decreased ratio of serum pepsinogen I:II. Furthermore the presence of anticanalicular autoantibodies was associated with a greater than twofold reduced prevalence for duodenal ulcer.

CONCLUSION

The data indicate that antigastric autoantibodies play a role in the pathogenesis and outcome of H pylori gastritis, in particular in the development of gastric mucosal atrophy.

摘要

背景

最近研究表明,大量幽门螺杆菌感染患者存在体液抗胃自身反应性。

目的

分析此类抗胃自身抗体与感染的组织学和血清学参数以及临床病程的相关性。

方法

采用组织学和血清学方法,对126例有上腹部不适症状患者的胃活检样本和血清进行幽门螺杆菌感染证据的检测。通过免疫组化技术检测针对人胃黏膜表位的自身抗体。然后将所有患者的组织学和临床结果与抗胃自身抗体的检测结果进行相关性分析。

结果

幽门螺杆菌感染与抗胃自身抗体显著相关,这些抗体与胃小凹上皮的腔面膜以及壁细胞内的微管结构发生反应。后一种自身抗体的存在与胃体胃炎的严重程度、胃黏膜萎缩、空腹胃泌素浓度升高以及血清胃蛋白酶原I:II比值降低显著相关。此外,抗微管自身抗体的存在与十二指肠溃疡患病率降低两倍以上有关。

结论

数据表明,抗胃自身抗体在幽门螺杆菌胃炎的发病机制和转归中起作用,尤其是在胃黏膜萎缩的发展过程中。

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