Oshowo A, Gillam D, Botha A, Tunio M, Holton J, Boulos P, Hobsley M
Department of Surgery, UCL Medical School, London, U.K.
Ann Periodontol. 1998 Jul;3(1):276-80. doi: 10.1902/annals.1998.3.1.276.
The aim of this study was to identify the natural reservoir and route of transmission of Helicobacter pylori infection. Two hundred eight (208) dyspeptic patients (114 males, 94 females; peak age of cohort, 50-59.9) were recruited. Specimens were collected from saliva, supra- and subgingival dental plaque, tongue scrapings, and oropharyngeal swabs. At subsequent endoscopy, gastric antral biopsy was performed for the rapid urease test (RUT), microbiological culture, and, in some patients, histology. Gastric juice samples were aspirated, and in 50 patients duodenal aspirate was collected. Polymerase chain reaction (PCR) with primers targeted to the 16S rRNA sequence of H. pylori was also employed for each of the specimens. In those patients where H. pylori was detected from multiple sites (dental plaque, gastric juice, gastric biopsy, and duodenal aspirate), restriction endonuclease digestion with Hae III was performed to determine if they were epidemiologically linked. The results indicated that 15/208 patients (7%) tested positively for H. pylori by PCR in dental plaque; only 2 samples were positive by culture. In none of the other oral sites sampled was H. pylori detected by any test used in the study. Gastric juice and gastric biopsy specimens from 36/ 208 patients (17%) and 114/208 patients (55%), respectively, were positive by PCR. Duodenal aspirate from 6/50 patients (12%) also tested positively by PCR. All specimens tested by restriction endonuclease digestion with Hae III (15/15 patients) were positive in both antral biopsy and gastric juice specimens, as well as 5 specimens from the duodenal aspirate. Four of the dental plaque strains had restriction patterns similar to those of the stomach and duodenal sites, providing evidence that these sites were infected with the same strain of H. pylori. In conclusion, the results suggest that H. pylori selects the gastric mucosa as its preferred site. The detection in dental plaque could indicate that the oral cavity may act as a reservoir or sanctuary for the organism. Whether H. pylori is a resident or transient oral microorganism is still unclear, although it is more likely to be transient in nature.
本研究的目的是确定幽门螺杆菌感染的自然宿主和传播途径。招募了208名消化不良患者（114名男性，94名女性；队列的年龄峰值为50 - 59.9岁）。从唾液、龈上和龈下牙菌斑、舌刮屑以及口咽拭子中采集样本。在随后的内窥镜检查中，进行胃窦活检以进行快速尿素酶试验（RUT）、微生物培养，部分患者还进行组织学检查。抽取胃液样本，50名患者中还收集了十二指肠抽吸物。针对幽门螺杆菌16S rRNA序列的引物进行聚合酶链反应（PCR），对每个样本进行检测。在那些从多个部位（牙菌斑、胃液、胃活检和十二指肠抽吸物）检测到幽门螺杆菌的患者中，用Hae III进行限制性内切酶消化，以确定它们在流行病学上是否相关。结果表明，15/208名患者（7%）的牙菌斑通过PCR检测幽门螺杆菌呈阳性；仅2份样本培养呈阳性。在研究中使用的任何检测方法下，其他采样的口腔部位均未检测到幽门螺杆菌。208名患者中分别有36/208名患者（17%）的胃液样本和114/208名患者（55%）的胃活检样本通过PCR呈阳性。50名患者中有6名（12%）的十二指肠抽吸物PCR检测也呈阳性。所有通过Hae III限制性内切酶消化检测的样本（15/15名患者），胃窦活检和胃液样本以及十二指肠抽吸物的5份样本均呈阳性。4株牙菌斑菌株的限制性图谱与胃和十二指肠部位的相似，这表明这些部位感染的是同一株幽门螺杆菌。总之，结果表明幽门螺杆菌选择胃黏膜作为其偏好的部位。在牙菌斑中的检测可能表明口腔可能是该微生物的储存库或庇护所。幽门螺杆菌是口腔常驻微生物还是短暂性微生物仍不清楚，不过其更可能本质上是短暂性的。
