A decrease in pepsinogen II levels cannot be used as a reliable marker for the successful eradication of H. pylori 4 weeks after the completion of treatment. The increase in pepsinogen I/II ratio reflects differences in pepsinogen production following the eradication irrespective of improvement in atrophy.
Helicobacter pylori is a Gram-negative bacterium that causes a variety of gastrointestinal diseases, such as duodenal ulcer and gastric carcinoma. The T cell response against H. pylori is thought to contribute to the pathogenesis of these diseases. Here, we show that mouse-adapted H. pylori is able to polyclonally activate murine CD4 + T lymphocytes, irrespective of their antigen specificity. Murine T helper cell clones as well as short-term cultured, polyclonal Th1 and Th2 cell lines and a human T cell clone, but not naive CD4 + T cells, could be activated in this manner. The effect was independent of antigenpresenting cells and required direct contact between H. pylori and T cells. Only whole cells of H. pylori, but not lysates or sonicates were able to activate T cells. The activity was lost after long-term culture of H. pylori on agar-plates. Degradation of H. pylori proteins with specific peptidases dramatically reduced the stimulating ability, implicating that the responsible molecule is likely to be a protein. This unexpected polyclonal T cell stimulatory mechanism may contribute to the T cell-mediated pathogenicity characteristic for H. pylori-mediated diseases.
клинические наблюдения clinical cases Резюме В статье представлен клинический случай пациента 63 лет с анемией на фоне хронического атрофического гастрита и неэффективностью лечения препаратами железа. На примере данного наблюдения проанализированы ошибки, возникающие при диагностике и ведении пациентов с аутоиммунным (атрофическим фундальным) гастритом (АИГ). Параллельно обсуждаются вопросы патогенеза АИГ, связи с Helicobacter рylori (H. pyloi) инфекцией. Актуализируется проблема своевременной диагностики АИГ и преимуществ неинвазивных методик оценки функционального состояния желудка. Ключевые слова: аутоиммунный гастрит, неинвазивная диагностика, пепсиногены, гастрин-17, H. pylori, витамин В 12 Белковец Анна Владимировна, д. м. н., зав. клиникой, старший научный сотрудник лаборатории гастроэнтерологии Ожиганова Наталья Владимировна, младший научный сотрудник лаборатории гастроэнтерологии Антипенко Антонина Геннадьевна, младший научный сотрудник лаборатории гастроэнтерологии Курилович Светлана Арсентьевна, д.м.н., профессор, заведующий лабораторией гастроэнтерологии Anna V. Belkovets, doctor of medical sciences, head of the clinic, senior researcher of laboratory of gastroenterology
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