HELICOBACTER PYLORI PLAYS A ROLE IN THE ETIOLOGY OF CHRONIC GASTRITIS AND CHRONIC DUODENITIS: IS IT THE FINAL STATEMENT?
Abstract
Background. The representatives of the herpes family of viruses occupy one of the leading places in the etiology of infectious diseases in adults and children.
Objective. To reveal the frequency of occurrence of type 1 and 2 herpes simplex viruses (HSV), Epstein-Barr virus (VEB), human papillomavirus (HPV), cytomegalovirus (CMV) and Helicobacter pylori (H. pylori) in the stomach and duodenum (DD) mucous membrane (MM) in patients with chronic gastritis (CG) and chronic duodenitis (CD), as well as to assess the effect of detected infections on the morphological and immunological changes of mucous membrane.
Material and methods. 116 patients (66 children and 50 adults) with verified CG and CD were examined. The patients underwent esophagogastroduodenoscopy (EGDS) with biopsy of the MM of the stomach and duodenal bulb.
The main morphological parameters were evaluated according to the criteria of the modified Sydney system. The antigens of HSV-1, HSV-2, VEB, CMV and HPV were detected in the paraffin sections of bioptates by the streptavidin -biotin method. The expression of CD45 +, CD3 +, CD4 +, CD8 +, CD20 + was assessed by immunohistochemical typing with the help of monoclonal antibodies in the stomach and duodenal MM.
Results. The relationship between morphological and immunological parameters and the nature of infection of the stomach and duodenal MM in children and adults was established.
Conclusion. The viral antigens were found in the stomach and duodenal MM in 57% and 64% of the examined children and adults respectively. HSV-1 affects the severity and activity of chronic inflammation of the stomach MM in children and adults. The indices that characterize the state of local immunity of the MM in patients with CG and CD were significantly associated with the expression of the antigens of the studied viruses, but not with the presence of Н. руlori.
References
1. Shcherbakov PL, Korsunsky AA, Isakov VA. Bolezni organov pischevareniya u detej pri helikobakterioze [Diseases of the digestive system in children with Helicobacter pylori]. Moscow: Medical Information Agency Ltd; 2011. 224 p.
2. Alfizah H, Noraziah MZ, Chao MY, Rahman MM, Ramelah M. Helicobacter pylori: molecular detection of vacA gene and vacuolating activity in human gastric adenocarcinoma cells. Clin. Ter. 2013;164(4):301-305.
3. Bhandari A, Crowe SE. Helicobacter pylori in gastric malignancies. Curr. Gastroenterol. Rep. 2012;14(6):489-496.
4. Correa P, Piazuelo MB. The gastric precancerous cascade. J. Dig Dis. 2012;13:2-9.
5. Cimmerman, JaS. Gastrojenterologija: rukovodstvo [Gastroenterology: guidance]. Moscow: Geotar-media; c2013. Part 1. Chapter 2, Problema hronicheskogo gastrita [The problem of chronic gastritis]; p. 52-77. (Russian).
6. Negreanu L, Assor P, Bumsel F, Metman EH. Infectious gastritis caused by a mixed fungal and bacterial infection. Endoscopy. 2006;38(2):E91-92.
7. Chernin VV, Chervineс VМ, Bazlov SN. Mesto Helicobacter pylori v normomikrobiocenoze i disbakterioze mukoznoj mikroflory jezofagogastroduodenalnoj zony, razvitii jazvennoj bolezni, hronicheskogo gastrita i jezofagita [Place of Helicobacter pylori in normomicrobiocenosis and dysbacteriosis of mucous microflora of esophagogastroduodenal zone, development of peptic ulcer, chronic gastritis and esophagitis]. Jeksperimentalnaja i klinicheskaja gastrojenterologija. 2016;126(2):79-89. (Russian).
8. Blaser MJ. Who are we? Indigenous microbes and the ecology of human diseases. EMBO Rep. 2006;7(10):956-960.
9. Rich JD, Crawford JM, Kazanjian SN, Kazanjian PH. Discrete gastrointestinal mass lesions caused by cytomegalovirus in patients with AIDS: report of three cases and review. Clin. Infect. Dis.1992;15(4):609-614.
10. Jazeron JF, Barbe C, Frobert E, Renois F, Talmud D, Brixi-Benmansour H, Brodard V, Andreoletti L, Diebold MD, Leveque N. Virological diagnosis of herpes simplex virus 1 esophagitis by quantitative real-time PCR assay. J. Clin. Microbiol. 2012;50(3):948-952.
11. Ogata T, Yoshimura A, Kurihara Y, Unakami M. A case report of cytomegalovirus-associated gastritis in a normal adult. Nihon Shokakibyo Gakkai Zasshi. 2002;99(5):483-488.
12. Dudaeva NG, Grechushnikov VB, Bugaeva IO, Tarasova GN. Immunologicheskie i morfologicheskie aspekty diagnostiki infekcii Helicobacterpylori i virusov semejstva Herpesviridae [Immunological and morphological aspects of diagnostics of Helicobacter pylori infection and Herpesviridae viruses]. Saratov Journal of Medical Scientific Research. 2010;6(2):361-364. (Russian).
13. Krulevskij VA, Petrovskij AN, Anichkov NM, Novikova VP. Hronicheskij gastrit i gerpeticheskie infekcii u lic raznogo vozrasta [Сhronic gastritis and herpetic infections in subjects of different ages]. Arhiv Patologii. 2010;72(1):33-35. (Russian).
14. Jaroslavceva NG, Grumbkova LO, Tihomirov DS, Ignatova EN, Romanova TJu, Garanzha TA, Tupoleva TA, Filatov FP. PCR-markery virusnyh infekcij pri hronicheskom gastrite u detej [The PCR markers of viral infections under chronic gastritis in children]. Klinicheskaja laboratornaja diagnostika. 2014;59(6):54-58. (Russian).
15. Kim JM, Song CW, Song KS, Kim JY. Acute gastritis associated with Epstein-Barr virus infection in a child. Korean J. Pediatr. 2016;59(1):68-71.
16. Saxena А, Nath PK, Chand Gh U, Krishnani N, Roshan BM, Husain N. Association of Helicobacter pylori and Epstein-Barr virus with gastric cancer and peptic ulcer disease. Scan. J. Gastroenterol. 2008;43(6):669-674.
17. Sugano K, Tack EJ, Kuipers DY, Graham DY, El-Omar EM, Miura S, Haruma K, Asaka M, Uemura N, Malfertheiner P. Kyoto global consensus report on Helicobacter pylori gastritis. Gut. 2015;64(9):1353-1367.
18. Dixon MF, Genta RM, Yardley JH, Correa P. Classification and grading of gastritis. The updated Sydney system. International Workshop on the Histopathology of gastritis, Houston 1994. Am. J. Surg. Pathol. 1996;20(10);1161-1181.
