Chronic gastritis from positions of interaction of immune, contagious and morphological factors
Abstract
Aim of investigation. To study a state of the first and second lines of local host defense in relation to severity of stomach mucosa (SM) atrophy, Н. рylori infection at chronic gastritis.
Materials and methods. Sixty-eight patients with chronic H.pylori-associated gastritis (CG+) and 31 patients – with chronic multifocal atrophic gastritis (CMAG) were investigated. Control group – 27 generally healthy volunteers. Samples for investigation were obtained at gastroduodenoscopy.
Results. Comparison of sIgA concentration scores in relation to severity of SM atrophy revealed increasing deterioration of the first line of protection in the sequence from CG(+) with no or mild SM atrophy to CG(+) with 2–3 points SM atrophy and then to patients, having CMAG. Thus the first line of local immunodefence at CMAG showed another quality of sIgA production in response to Н.рylori infection. Severe depression of sIgA production was combined to wide-spread atrophy of SM and high frequency of Н.рylori infection (29 of 31 cases) on a background of significantly lower density of SM contamination by H.рylori. In controls and in CG(+) patients with absence or mild atrophy of SM positive correlation between sIgA concentration and IgA has been found. Detected correlation links were lost in group of CG(+) with severe atrophy and CMAG, that was combined to significant negative correlation between sIgA and IgG. Besides this, significant positive correlation has been found in CG(+) patients with SM atrophy of 2–3 points between IgG level and degree of neutrophilic infiltration.
Conclusion. Development and progression of chronic inflammation in the stomach develops at close interaction of three major factors: immune, contagious and morphological. At CG Н. рylori aggressive potential is realized at decline of the first line of host defense which activity, in turn, depends on severity of atrophic changes of SM. Weakening of sIgA in gastric juice at patients with CG increases activity of the second line of host defense and maintain chronic inflammation in SM.
About the Authors
N. L. DenisovRussian Federation
V. Т. Ivashkin
Russian Federation
Yu. V. Lobzin
Russian Federation
V. Yu. Golofeyevsky
Russian Federation
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For citations:
Denisov N.L., Ivashkin V.Т., Lobzin Yu.V., Golofeyevsky V.Yu. Chronic gastritis from positions of interaction of immune, contagious and morphological factors. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2008;18(6):22-26. (In Russ.)
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