© Borgis - Postępy Nauk Medycznych 5/2013, s. 357-360
*Anna Obuchowicz1, Joanna Kula-Gradzik1, Marta Ślimok1, Tomasz Wielkoszyński2, Jacek Zeckei1
Czy zakażenie Helicobacter pylori u dzieci ma wpływ na wydzielanie ghreliny
If the Helicobacter pylori infection may affect ghrelin secretion in children
1Chair and Department of Pediatrics, Bytom Medical University of Silesia, Katowice
Head of Department: prof. Anna Obuchowicz, MD, PhD
2Department of Chemistry in Zabrze, Medical University of Silesia, Katowice
Head of Department: Krystyna Tyrpień, MD, PhD
Streszczenie
Wstęp. Helicobacter pylori jest uznanym czynnikiem patogenetycznym chorób błony śluzowej żołądka. Może zatem wpływać na wydzielanie ghreliny określanej mianem „hormonu głodu”.
Cel. Celem pracy jest ocena stężeń ghreliny w surowicy dzieci zakażonych i niezakażonych H. pylori.
Materiał i metody. Badaniami objęto 84 dzieci z bólami brzucha, w wieku 6-18 lat, mieszkających w środowisku wielkomiejskim (Bytom). Na podstawie wyników testu ureazowego i/lub obecności H. pylori w badaniu histopatologicznym bioptatów błony śluzowej pobranych w czasie gastroskopii z antrum żołądka, u 33 rozpoznano (grupa I), a u 51 dzieci wykluczono (grupa II) zakażenie H. pylori. Stwierdzane zmiany zapalne miały charakter gastritis chronica non activa minimalis lub activa minimalis. Stężenie ghreliny oznaczono w surowicy badanych metodą radioimmunologiczną (Human Radioimmunoassay kit, total ghreline; Millipore).
Wyniki. Nie stwierdzono statystycznie znamiennej różnicy stężeń ghreliny w surowicy dzieci z grup I i II, ani związku tych stężeń z obrazem histologicznym błony śluzowej badanych w obu grupach oddzielnie, ani też u wszystkich dzieci rozpatrywanych łącznie.
Wnioski. Uzyskane wyniki sugerują, że zakażenie H. pylori powodujące zmiany zapalne błony śluzowej żołądka o niewielkim nasileniu nie powoduje u dzieci zmian stężenia ghreliny w surowicy.
Summary
Introduction. Helicobacter pylori is considered as an etiologic agent of the gastric mucosa diseases. Therefore, it may affect ghrelin secretion, known as “hunger hormone”, by neuroendocrine cells of gastric mucosa.
Aim. The aim of our study is to determine serum ghrelin concentrations in H. pylori infected and noninfected children.
Materials and methods. The study involved 84 children, 6-18 years old, living in urban area (Bytom). All patients underwent endoscopy. Biopsy speciments were taken in antrum of the stomach. On the base of the results of urease test and/or positive histological examination (hematoxylin-eosin stained) H. pylori infection was recognized in 33 children (Group I) and in 51 children (Group II) was excluded. Histological lesions of gastric mucosa were diagnosed as: chronic gastritis non active of mild grade or active of mild grade. Serum ghrelin concentration was measured by RIA (Human Radioimmunoassay kit, total ghreline; Millipore).
Results. There was no significant difference between serum ghrelin concentration in children from Groups I and II. Moreover, in both groups evaluated seperately as well as in the whole group, there was no relationship between the ghrelin levels and the histological estimation of gastric mucosa lesions.
Conclusions. Our results suggests that H. pylori infection with mild grade of gastric mucosa inflammation does not affect serum ghrelin level in children.
Introduction
In addition to the central nervous system, the gastrointestinal tract plays a significant role in appetite regulation and medical conditions of the individual organs of this multi-organ system are of fundamental importance for nutritional behaviours and the nutritional condition of persons. An inflammatory condition of the gastric mucosa accompanied by a Helicobacter pylori (H. pylori) infection may also affect the appetite of sick children. The H. pylori influence on the secretion of ghrelin, called the “hunger hormone”, is one of the possible mechanisms here. It is synthesised by Gr cells located mostly in the gastric mucosa of the body of the stomach (1). It is a 28-amino-acid peptide encoded by the preproghrelin gene. Ghrelin is a strong stimulator of growth hormone secretion, it stimulates the appetite, resulting in an increase in the body weight (2). It influences pre-adipocyte differentiation, accumulation of fat in the fatty tissue as well as the energy balance of the human body (3), both in the short-term and long-term regulation (4). It also plays an important role in the regulation of stomach motility and hydrochloric acid secretion (5).
H. pylori infections occur all over the world and they affect over 50% of the adult population (5). In the population of children, the frequency of infections increases with the age (6). In view of little possibility of spontaneous eradication, this infection lasts for many years – from childhood to adulthood. Taking into consideration the frequent occurrence of the lack of appetite in children and its changeability in children infected with H. pylori, one can assume that altered ghrelin secretion can be one of the reasons for this. The results of serum/plasma ghrelin concentrations in persons infected with H. pylori are divergent.
AIM
The aim of this study is to assess serum ghrelin concentrations in children infected with H. pylori.
Materials and methods
84 children aged 6-18, living in urban area (Bytom), took part in the study. The children were patients at the Chair and Department of Paediatrics in Bytom of the Medical University of Silesia in Katowice. In connection with reported chronic or recurrent abdominal pains located in the epigastric or middle abdominal regions, these children had diagnostic tests performed. There were no patients after H. pylori eradication in the group. Diagnostic tests included: blood tests (ESR, the concentrations of aminotransferases, urea and creatinine), urine and stool tests (tests for parasites, assessment of the presence of human haemoglobin in faeces) and an ultrasound examination of the abdomen.
On the basis of a fiberoscopic examination (Olympus GIF-XP 20) combined with a urease test (National Food and Nutrition Institute, Warsaw) and an histopathology assessment of gastric mucosa specimens collected from the prepyloric region, an H. pylori infection was diagnosed in 33 persons (23 girls and 10 boys – Group I), and it was ruled out in 51 children (23 girls and 28 boys – Group II). The gastric mucosa preparations were dyed with haematoxylin and eosin. A positive result of the urease test and/or confirmation of the presence of this bacteria obtained in the histopathologic examination were the basis for the diagnosis. Together with blood samples collected after night fast for tests connected with the reason of hospitalisation, 2 ml of blood was collected to determine the ghrelin concentration. After centrifuging, serum samples were frozen and stored until measurements at -30°C. The ghrelin concentration was determined by means of a radioimmunological method (Human Radioimmunoassay kit, total ghrelin; Millipore). The results are presented in pg/ml.
On the basis of the histopathologic assessment of gastric mucosa specimens, an H. pylori infection was ruled in or out and the normal picture of the gastric mucosa was found in 2 Group I patients and 20 Group II patients, gastritis chronica non activa minoris gradus in 25 Group I patients and 27 Group II patients, gastritis chronica activa minoris gradus in 8 persons from Group I and 2 persons from Group II.
An approval for the research was obtained from the Bioethics Committee of the Medical University of Silesia in Katowice (KNW/0022/KB1/208/11/12).
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