Brzozowski T, Konturek P C, Konturek S J, Kwiecien S, Pajdo R, Karczewska E, Stachura J, Hahn E G
Department of Physiology and Pathomorphology, Jagiellonian University School of Medicine, Cracow, Poland.
Digestion. 1999 Jan-Feb;60(1):22-33. doi: 10.1159/000007585.
Helicobacter pylori (Hp) is considered as a major risk factor of peptic ulcer, but the pathogenic mechanism of its action has not been fully explained.
This study was designed: (1) to compare the ulcer healing effects of water extract (WE) obtained from type-I cytotoxin-associated gene A (CagA) and vacuolating cytotoxin A (VacA) expressing Hp and from type-II CagA- and VacA-negative Hp strain with those of vehicle (saline), and (2) to determine the alterations in gastric secretion, gastric blood flow (GBF) and expression of Hp-related cytokines during the ulcer healing in rats treated with toxigenic (type-I) and non-toxigenic (type-II) Hp-derived WE.
Gastric ulcers were produced by serosal application of acetic acid in rats with or without gastric fistula treated with vehicle (saline) or WE originating from type-I or type-II Hp administered intragastrically on days 1, 3, 5 and 7 upon ulcer induction. On days 3, 9 and 15, animals were lightly anesthetized with ether, the abdomen was opened and the GBF was measured by the H2-gas clearance technique in the ulcer area and non-ulcerated mucosa. Venous blood was withdrawn for the measurement of plasma cytokine (IL-1beta and TNFalpha) levels and plasma and gastric contents were also collected for gastrin and somatostatin determination by specific radioimmunoassay.
Gastric ulcers healed gradually in vehicle-treated controls and the ulcer area on days 3, 9 and 15 was reduced by 12, 43 and 92%, respectively. In rats treated with WE of type-I Hp, ulcer healing was significantly delayed, and gastritis and infiltration of ulcerated gastric mucosa with inflammatory cells were observed histologically. The prolongation of ulcer healing by WE of both Hp strains was accompanied by a marked fall in the GBF at the ulcer margin and transient hyposecretion especially in rats given WE of type-I Hp strain. On day 15 of ulcer healing, the plasma concentration of IL-1beta and TNFalpha was negligible in vehicle control rats, but it was significantly elevated particularly in rats treated with WE of type-I Hp. RT-PCR analysis revealed that mucosal expression of IL-1beta and TNFalpha mRNA was significantly upregulated in the gastric mucosa of rats treated with either toxigenic or non-toxigenic Hp WE. The plasma gastrin level was significantly higher and the luminal concentration of somatostatin was significantly lower in rats treated with Hp-WE than in vehicle-treated controls and these alterations were more pronounced in rats treated with WE type-I than type-II Hp.
WE of toxigenic Hp strain delays ulcer healing due to the reduction in the gastric microcirculation at the ulcer margin, the overexpression of inflammatory cytokines and the impairment of the gastrin-somatostatin link.
幽门螺杆菌(Hp)被认为是消化性溃疡的主要危险因素,但其作用的致病机制尚未完全阐明。
本研究旨在:(1)比较从表达I型细胞毒素相关基因A(CagA)和空泡毒素A(VacA)的Hp以及II型CagA和VacA阴性Hp菌株中获得的水提取物(WE)与赋形剂(生理盐水)对溃疡愈合的影响;(2)确定在用产毒(I型)和无毒(II型)Hp衍生的WE治疗的大鼠溃疡愈合过程中胃分泌、胃血流量(GBF)和Hp相关细胞因子表达的变化。
在有或无胃瘘的大鼠中,通过浆膜下注射乙酸产生胃溃疡,在溃疡诱导后的第1、3、5和7天,用赋形剂(生理盐水)或源自I型或II型Hp的WE灌胃。在第3、9和15天,可以用乙醚轻度麻醉动物,打开腹腔,通过H2气体清除技术测量溃疡区域和未溃疡黏膜的GBF。抽取静脉血测量血浆细胞因子(IL-1β和TNFα)水平,还收集血浆和胃内容物,通过特异性放射免疫测定法测定胃泌素和生长抑素。
在赋形剂处理的对照组中,胃溃疡逐渐愈合,在第3、9和15天溃疡面积分别减少了12%、43%和92%。在用I型Hp的WE处理的大鼠中,溃疡愈合明显延迟,组织学观察到胃炎以及溃疡胃黏膜有炎性细胞浸润。两种Hp菌株的WE导致溃疡愈合延长,同时溃疡边缘的GBF显著下降,特别是在用I型Hp菌株的WE处理的大鼠中出现短暂的分泌减少。在溃疡愈合的第15天,赋形剂对照大鼠的血浆IL-1β和TNFα浓度可忽略不计,但在用I型Hp的WE处理的大鼠中显著升高。RT-PCR分析显示,在用产毒或无毒Hp的WE处理的大鼠胃黏膜中,IL-1β和TNFα mRNA的黏膜表达显著上调。在用Hp-WE处理的大鼠中,血浆胃泌素水平显著升高,管腔内生长抑素浓度显著降低,这些变化在用I型Hp的WE处理的大鼠中比在用II型Hp的WE处理的大鼠中更明显。
产毒Hp菌株的WE导致溃疡愈合延迟,原因是溃疡边缘的胃微循环减少、炎性细胞因子过度表达以及胃泌素-生长抑素联系受损。