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Helicobacter pylori 감염 소아에서 유전형과 위점막 림프구

ssociation between Genotypes and Gastric Mucosal Lymphocytes in Helicobacter pylori-infected Children

이미애|서정완|조민선|염혜원
대한소아소화기영양학회 (The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition)|2009.09|Pediatric Gastroenterology, Hepatology & Nutrition|제12권 제2호|pp. 140-149

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ChildrenHelicobacter pyloriGastric mucosal lymphocytescagAcagEvacAbabA2
주제분류소아과학

초록

목 적: H. pylori는 소아기에 감염되어 대부분 무증상으로 지내나 소수에서 위장질환을 일으킨다. 정확한 기전은 아직 밝혀지지 않았으나 세균의 병독성 인자, 숙주 인자, 환경 인자가 복합적으로 작용한다. 소아에서 H. pylori 유전형과 임상질환의 연관성은 지역과 인종에 따라 다양하고 위점막 림프구에 관한 연구도 일치된 보고가 없다. 이에 H. pylori 감염 소아에서 H. pylori 유전형과 위점막 림프구의 상관성을 알아보고자 하였다. 방 법: H. pylori 감염 소화궤양군 10명과 H. pylori 감염 위염군 15명에서 채취된 후 냉동보관 되었던 위전정부 생검 조직에서 DNA를 분리하고 cagA, cagE, vacA, babA2의 특이적인 시발체로 중합효소연쇄반응을 시행하여 H. pylori 유전형을 분석하였다. 유전형과 임상질환, 조직 소견 및 위점막 림프구의 상관성을 비교하였다. 결 과: H. pylori 유전형 중 cagA 양성률은 80%, cagE 양성률은 60%였다. vacA는 s1m1이 84%, s1m2가 16%였으며 babA2 양성률은 88%였다. 가장 흔한 유전형 조합은 cagA＋/vacA s1m1＋/babA2＋ 조합으로 68%에서 관찰되었다. cagA, cagE, vacA, babA2의 유전형에 따른 임상질환과 조직 소견 및 CD3, CD4, CD8 T세포 수와 CD20 B세포 수는 점막 고유층과 상피세포 내 모두에서 유의한 차이가 없었다. 결 론: 소아 H. pylori 감염에서 cagA, cagE, vacA 및 babA2 유전형과 위점막 림프구는 유의한 상관성이 없었다. 향후, H. pylori가 숙주의 면역을 회피하고 지속적으로 살아남아 다양한 위장질환을 일으키는 병인을 규명하기 위해 H. pylori 감염 소아를 대상으로 위점막 면역반응에 대한 대단위 연구가 필요하다.

Abstract

Purpose: Helicobacter pylori infection is probably acquired in childhood and persists as an asymptomatic infection for decades in most individuals. It is unclear why only a minority of those infected develop a clinical manifestation, even in childhood, such as peptic ulcer disease. H. pylori infection activates local immune responses and causes lymphocyte infiltration in the gastric mucosa. We have previously reported that both T and B cells in the lamina propria play important roles in the local immune response of H. pylori-infected children. The aim of this study was to investigate the association between H. pylori genotypes and gastric mucosal lymphocytes. Methods: Twenty-five H. pylori-infected children (10 with peptic ulcer disease and 15 with gastritis) were enrolled in this study. We investigated the genotypes (cagA, cagE, vacA, and babA2) and evaluated the association with clinical manifestations, histopathology, and gastric mucosal lymphocytes. Results: The prevalence of cagA, cagE, vacA s1m1, and babA2 was 80%, 60%, 84%, and 88%, respectively. The most prevalent (68%) combination of cagA, vacA, and babA2 genotypes was cagA＋/ vacA s1m1＋/babA2＋. H. pylori genotypes were not associated with clinical manifestations, histopathology, or gastric mucosal lymphocytes. Conclusion: There was no association between the cagA, cagE, vacA, or babA2 status and gastric mucosal lymphocytes. The role of the host immune response in relation to H. pylori genotypes and disease potential in children needs further studies.

참고문헌 (40)

  1. Serrano C, "Relationship between Helicobacter pylori virulence factors and regulatory cytokines as predictors of clinical outcome", Microbes Infect, 9, pp.428~434 (2007)
  2. Kim SY, "Genotyping cagA, vacA subtype, iceA1, and babA of Helicobacter pylori isolates from Korean patients, and their association with gastroduodenal diseases", J Korean Med Sci, 16, pp.579~584 (2001)
  3. 정지아, "소아 Helicobacter pylori 감염에서 균의 유전형, 위 상피세포의 증식과 세포사", 대한소아소화기영양학회지, 6(1), pp.1~9 (2003), 대한소아소화기영양학회
  4. 염혜원, "Helicobacter pylori 감염 소아에서 위점막 면역반응", Korean Journal of Pediatrics, 51(5), pp.492~499 (2008), 대한소아과학회
  5. Janeway CA, "Immunobiology. 6th ed", pp.319~366 (2005), Garland Science
  6. Bamford KB, "Lymphocytes in the human gastric mucosa during Helicobacter pylori have a T helper cell 1 phenotype", Gastroenterology, 114, pp.482~492 (1998)
  7. Yamaoka Y, "Relationship between Helicobacter pylori iceA, cagA, and vacA status and clinical outcome: studies in four different countries", J Clin Microbiol, 37, pp.2274~2279 (1999)
  8. Sheu BS, "Host gastric Lewis expression determines the bacterial density of Helicobacter pylori in babA2 genopositive infection", Gut, 52, pp.927~932 (2003)
  9. Bhuiyan TR, "Comparison of mucosal B- and T-cell responses in Helicobacter pylori- infected subjects in a developing and a developed country", FEMS Immunol Med Microbiol, 54, pp.70~79 (2008)
  10. Mattar R, "No correlation of babA2 with vacA and cagA genotypes of Helicobacter pylori and grading of gastritis from peptic ulcer disease patients in Brazil", Helicobacter, 10, pp.601~608 (2005)
  11. Muñoz L, "Immune and proliferative cellular responses to Helicobacter pylori infection in the gastric mucosa of Mexican children", Helicobacter, 12, pp.224~230 (2007)
  12. Harris PR, "Helicobacter pylori gastritis in children is associated with a regulatory T-cell response", Gastroenterology, 134, pp.491~499 (2008)
  13. Fukui T, "Cross-primed CD8＋ cytotoxic T cells induce severe Helicobacter-associated gastritis in the absence of CD4＋ T cells", Helicobacter, 12, pp.486~497 (2007)
  14. Brandt S, "NF-kappa B activation and potentiation of proinflammatory responses by the Helicobacter pylori CagA protein", Proc Natl Acad Sci U S A, 102, pp.9300~9305 (2005)
  15. Nilsson C, "Correlation between cag pathogenicity island composition and Helicobacter pylori-associated gastroduodenal disease", Infect Immun, 71, pp.6573~6581 (2003)
  16. Hsu PI, "Clinical presentation in relation to diversity within the Helicobacter pylori cag pathogenicity island", Am J Gastroenterol, 97, pp.2231~2238 (2002)
  17. Queiroz DM, "IL1RN polymorphism and cagA-positive Helicobacter pylori strains increase the risk of duodenal ulcer in children", Pediatr Res, 58, pp.892~896 (2005)
  18. Sökücü S, "CagA positivity and its association with gastroduodenal disease in Turkish children undergoing endoscopic investigation", J Gastroenterol, 41, pp.533~539 (2006)
  19. Prinz C, "Key importance of the Helicobacter pylori adherence factor blood group antigen binding adhesin during chronic gastric inflammation", Cancer Res, 61, pp.1903~1909 (2001)
  20. Ko JS, "cag pathogenicity island of Helicobacter pylori in Korean children", Helicobacter, 7, pp.232~236 (2002)
  21. Ogura K, "Virulence factors of Helicobacter pylori responsible for gastric diseases in Mongolian gerbil", J Exp Med, 192, pp.1601~1610 (2000)
  22. Erzin Y, "Prevalence of Helicobacter pylori vacA, cagA, cagE, iceA, babA2 genotypes and correlation with clinical outcome in Turkish patients with dyspepsia", Helicobacter, 11, pp.574~580 (2006)
  23. Day AS, "cagE is a virulence factor associated with Helicobacter pylori-induced duodenal ulceration in children", J Infect Dis, 181, pp.1370~1375 (2000)
  24. D’Elios MM, "VacA and HP-NAP, Ying and Yang of Helicobacter pylori-associated gastric inflammation", Clin Chim Acta, 381, pp.32~38 (2007)
  25. Atherton JC, "Vacuolating cytotoxin (vacA) alleles of Helicobacter pylori comprise two geographically widespread types, m1 and m2, and have evolved through limited recombination", Curr Microbiol, 39, pp.211~218 (1999)
  26. De Gusmão VR, "vacA genotypes in Helicobacter pylori strains isolated from children with and without duodenal ulcer in Brazil", J Clin Microbiol, 38, pp.2853~2857 (2000)
  27. Costa Lopes AI, "Helicobacter pylori genotypes in children from a population at high gastric cancer risk: no association with gastroduodenal histopathology", Am J Gastroenterol, 101, pp.2113~2122 (2006)
  28. Singh M, "Helicobacter pylori infection, histopathological gastritis and gastric epithelial cell apoptosis in children", Acta Paediatr, 95, pp.732~737 (2006)
  29. Thoreson AC, "Differences in surface-exposed antigen expression between Helicobacter pylori strains isolated from duodenal ulcer patients and from asymptomatic subjects", J Clin Microbiol, 38, pp.3436~3441 (2000)
  30. Gerhard M, "Clinical relevance of the Helicobacter pylori gene for blood-group antigen-binding adhesin", Proc Natl Acad Sci U S A, 96, pp.12778~12783 (1999)
  31. Mizushima T, "Clinical relevance of the babA2 genotype of Helicobacter pylori in Japanese clinical isolates", J Clin Microbiol, 39, pp.2463~2465 (2001)
  32. Yamaoka Y, "Helicobacter pylori blood group antigen binding adhesin, BabA, and clinical outcome: studies in four different countries", Gut, 45(3), pp.A25~ (1999)
  33. Oleastro M, "Helicobacter pylori virulence genotypes in Portuguese children and adults with gastroduodenal pathology", Eur J Clin Microbiol Infect Dis, 22, pp.85~91 (2003)
  34. Umehara S, "Effects of Helicobacter pylori CagA protein on the growth and survival of B lymphocytes, the origin of MALT lymphoma", Oncogene, 22, pp.8337~8342 (2003)
  35. Yokoyama K, "Functional antagonism between Helicobacter pylori CagA and vacuolating toxin VacA in control of the NFAT signaling pathway in gastric epithelial cells", Proc Natl Acad Sci U S A, 102, pp.9661~9666 (2005)
  36. Gebert B, "Helicobacter pylori vacuolating cytotoxin inhibits T lymphocyte activation", Science, 301, pp.1099~102 (2003)
  37. Sundrud MS, "Inhibition of primary human T cell proliferation by Helicobacter pylori vacuolating toxin (VacA) is independent of VacA effects on IL-2 secretion", Proc Natl Acad Sci U S A, 101, pp.7727~7732 (2004)
  38. Torres VJ, "Helicobacter pylori vacuolating cytotoxin inhibits activation-induced proliferation of human T and B lymphocyte subsets", J Immunol, 179, pp.5433~5440 (2007)
  39. Rad R, "The Helicobacter pylori blood group antigen- binding adhesin facilitates bacterial colonization and augments a nonspecific immune response", J Immunol, 168, pp.3033~3041 (2002)
  40. Del Giudice G, "The design of vaccines against Helicobacter pylori and their development", Annu Rev Immunol, 19, pp.523~563 (2001)

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