Özgür BAHADIR, Mesut SEZİKLİ, Fatih GÜZELBULUT, Züleyha Akkan ÇETİNKAYA, Selvinaz ÖZKARA

İnflamatuvar bağırsak hastalığında kolonda Helikobakter pilori'nin immunohistokimyasal yöntemle araştırılması

Amaç: Bu çalışmanın amacı inflamatuvar barsak hastalığı olan hastaların kolon mukozasının Helikobakter pilori ile enfekte olup olmadığını araştırmaktır. Gereç ve Yöntem: Endoskopi ünitesinde kolonoskopi yapılan hastaların kayıtları retrospektif olarak incelendi. İnflamatuvar barsak hastalığı olan ve olmayan hastalardan kolonoskopi sırasında terminal ileum, çekum, çıkan kolon, transvers kolon, inen kolon, sigmoid kolon veya rektumdan olmak üzere en az üç bölgeden biyopsi alınmış olanlar gastrik Helikobakter pilori enfeksiyonu varlığı açısından incelendi. Histopatolojik inceleme veya C14-üre nefes testi ile gastrik Helikobakter pilori enfeksiyonu saptananlar çalışmaya dahil edildi. Kolonoskopide neoplazi veya polip olanlar ve geçirilmiş kolon rezeksiyonu olanlar çalışmaya alınmadı. Bulgular: İnflamatuvar barsak hastalığı tanısı olan 60 hasta çalışmaya dahil edildi. Kontrol grubu da 60 hastadan oluştu. Her 2 grupta da hiçbir hastada immünhistokimyasal boyama ile kolonik Helikobakter pilori enfeksiyonu saptanmadı. Sonuç: İmmünhistokimyasal boyama ile kolonda Helikobakter pilori enfeksiyonu her 2 grupta da saptanamamıştır. İmmünhistokimyasal inceleme inflamatuar barsak hastalığı olan hastalarda polimeraz zincir reaksiyonu kadar sensitif olmayabilir. Kolonik Helikobakter pilori enfeksiyonu varlığını daha fazla sayıda hasta gruplarında ve polimeraz zincir reaksiyonu kullanarak araştıracak çalışmalara ihtiyaç vardır.

Anahtar Kelimeler:

İnflamatuvar barsak hastalığı, Helikobakter pilori

An investigation of Helicobacter pyloriinfection in patients with inflammatory bowel disease using immunohistochemistry

Background and Aims:Background and Aims: The aim of this study was to evaluate whether colonic mucosa is infected with Helicobacter pylori in patients with inşammatory bowel disease. Materials and Methods: The data of patients who underwent colonoscopy in the endoscopy unit were reviewed retrospectively. Of them, patients with or without inşammatory bowel disease who had at least three colon biopsy specimens including the terminal ileum, ascending colon, transverse colon, descending colon, sigmoid colon, or rectum were reviewed for the presence of gastric Helicobacter pyloriinfection. Patients with gastric Helicobacter pylori infection as evidenced by histopathologic analysis or C14urea breath test were included in the study. Patients with neoplasia or polyp and those with prior colonic resection were excluded from the study. Results: Totally, 60 patients with inşammatory bowel disease were included in this study. Sixty patients with normal colonoscopy results were included as the control group. None of the patients in either group had Helicobacter pylori infection in colonic biopsy specimens by immunohistochemical staining. Conclusions: Colonic Helicobacter pylori infection was not determined in either patients with inşammatory bowel disease or healthy controls using immunohistochemical staining. However, immunohistochemical staining might not be as sensitive as polymerase chain reaction for the detection of Helicobacter pylori in colonic mucosa. There is a need for studies to evaluate the presence of Helicobacter pylori infection in colonic

Keywords:

Colonic mucosa Helicobacter pylori, immunohistochemistry,

PDF

___

Israel D A, Peek RM. Pathogenesis of Helicobacter pylori-induced gastric inflammation. Aliment Pharmacol Ther 2001;15:1271-90.
Cave DR. Transmission and epidemiology of Helicobacter pylori. Am J Med 1996;100:12S-17S; discussion 17S-18S.
Bures J, Kopacova M, Koupil I, et al. Epidemiology of Helicobacter pylo- ri infection in the Czech Republic. Helicobacter 2006;11:56-65.
Sachs G, Weeks DL, Melchers K, Scott DR. The gastric biology of Heli- cobacter pylori. Annu Rev Physiol 2003; 65:349-69.
Ramarao N, Meyer TF. Helicobacter pylori resists phagocytosis by mac- rophages: quantitative assessment by confocal microscopy and fluores- cence-activated cell sorting. Infect Immun 2001;69:2604-11.
Crabtree JE. Immune and inflammatory responses to Helicobacter pylo- ri infection. Scand J Gastroenterol Suppl 1996;215:3-10.
Pellicano R, Franceschi F, Saracco G, et al. Helicobacters and extragas- tric diseases. Helicobacter 2009;14 Suppl 1:58-68.
Cahill RJ, Foltz CJ, Fox JG, et al. Inflammatory bowel disease: an immu- nity-mediated condition triggered by bacterial infection with Helicobac- ter hepaticus. Infect Immun 1997;65:3126-31.
Oliveira AG, Rocha GA, Rocha AM, et al. Isolation of Helicobacter pylo- ri from the intestinal mucosa of patients with Crohn's disease. Helicobac- ter 2006;11:2-9.
Keenan JI, Beaugie CR, Jasmann B, et al. Helicobacter species in the hu- man colon. Colorectal Dis 2010;12:48-53.
Soylu A, Ozkara S, Alis H, et al. Immunohistochemical testing for Heli- cobacter pylori existence in neoplasms of the colon. BMC Gastroenterol 2008;8:35.
Hansen R, Thomson JM, El-Omar EM, Hold GL. The role of infection in the aetiology of inflammatory bowel disease. J Gastroenterol 2010;45: 266-76.
Vaira D, Gatta L, Ricci C, Miglioli M. Review article: diagnosis of Helico- bacter pylori infection. Aliment Pharmacol Ther 200216 Suppl 1:16-23.
Jones M, Helliwell P, Pritchard C, et al. Helicobacter pylori in colorectal neoplasms: is there an aetiological relationship? World J Surg Oncol 2007;5:51.
Chin EY, Dangler CA, Fox JG, Schauer DB. Helicobacter hepaticus infec- tion triggers inflammatory bowel disease in T cell receptor alphabeta mutant mice. Comp Med 2000;50:586-94.
Kullberg MC, Rothfuchs AG, Jankovic D, et al. Helicobacter hepaticus- induced colitis in interleukin-10-deficient mice: cytokine requirements for the induction and maintenance of intestinal inflammation. Infect Im- mun 2001;69:4232-41.
Zhang L, Day A, McKenzie G, Mitchell H. Nongastric Helicobacter spe- cies detected in the intestinal tract of children. J Clin Microbiol 2006;44:2276-9.
Oliveira AG, das Graças Pimenta Sanna M, Rocha GA, et al. Helicobac- ter species in the intestinal mucosa of patients with ulcerative colitis. J Clin Microbiol 2004;42:384-6.