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目的:探讨细胞因子在幽门螺杆菌(H.pylori)免疫病理机制中的作用.方法:48例患者(慢性浅表性胃炎37例,十二指肠溃疡(DU)11例,其中男性31例,年龄21-63岁)胃镜诊断明确后取胃窦及胃体活检,用于H.pylori诊断及体外组织培养.H.pylori诊断采用快速尿素酶试验、H.pylori培养及Warthin-Starry银染色,3项检查中任2项结果阳性诊断为H.pylori阳性.3块胃窦活检组织各加1mLRPMI1640,50mL·L-1CO2和37℃培养24h,ELISA法测上清中白介素(IL)-6,IL-8及肿瘤坏死因子(TNF)-α;Lowry改良法测活检组织蛋白含量.另8例RPMI1640中加入H.pylori细胞空泡毒素(VacA).结果以每克蛋白中ng(ng·g-1)或mg(μg·g-1)表示.结果:H.pylori阳性率69%.H.pylori阳性者胃黏膜培养上清中IL-6,IL-8和TNF-α含量均显著高于H.pylori阴性者,其中9例DU患者的IL-8含量为53(18-96)μg·g-1,显著高于慢性胃炎者的36(7-84)μg·g-1(P<0.01).培养液加入VacA后,IL-8的分泌量明显增高(50±38μg·g-1vs68±30μg·g-1,P<0.01).TNF-α的含量虽升高,但无显著差别,对IL-6的含量无影响.IL-8的含量与炎症程度及活动性显著相关(r=0.98,P<0.0025),IL-6和TNF-α的含量与炎症程度无明显关系(r=-0.26和-0.28,P>0.25),但活动性炎时高于非活动性炎者.结论:结果提示IL-8与炎细胞浸润密切相关,H.pylori细胞毒素对黏膜细胞因子的分泌有促进作用.
Objective: To investigate the role of cytokines in the immunopathogenesis of H. pylori.Methods: Forty-eight patients (37 cases of chronic superficial gastritis and 11 cases of duodenal ulcer (DU), including 31 males , Aged 21-63 years) Gastroscopy and gastric biopsy were taken after diagnosis of gastroscope for the diagnosis of H.pylori and tissue culture in vitro.Hpylori was diagnosed by rapid urease test, H.pylori culture and Warthin-Starry silver staining , And any two of the three tests were positive for H.pylori positive.Among 3 gastric antrum tissues were added 1mL RPMI1640, 50mL·L-1CO2 and incubated at 37 ℃ for 24 h.The levels of interleukin (IL) -6 , IL-8, and tumor necrosis factor-α (TNF-α) were detected by Lowry modified method.The vacular vacuolar detoxification (VacA) of H.pylori cells was also detected in the other 8 cases of RPMI1640.The results were expressed as ng g-1) or mg (μg · g-1) .Results: The positive rate of H.pylori was 69% .The levels of IL-6, IL-8 and TNF-αin gastric mucosal culture supernatant of H.pylori positive group were significantly The levels of IL-8 in the nine DU patients were 53 (18-96) μg · g-1, which were significantly higher than those in patients with chronic gastritis (36-84 μg · g-1) P <0.01), the secretion of IL-8 was significantly increased after VacA addition (50 ± 38μg · g-1vs68 ± 30μg · g-1, P <0.01) .TNF-αincreased, but there was no significant difference in the content of IL-6.The content of IL- (R = 0.98, P <0.0025). The levels of IL-6 and TNF-α did not correlate with the severity of inflammation (r = -0.26 and -0.28, P> 0.25) Which is higher than inactive inflammation.Conclusion: The results suggest that IL-8 is closely related to inflammatory cell infiltration, and that H.pylori cytotoxin promotes the secretion of mucosal cytokines.