Capsaicin-sensitive afferentation represents an indifferent defensive pathway from eradication in patients with H.pylori gastritis

AIM:To study the role of capsaicin-sensitive afferent nerves in Helicobacter pylori (H.pylori) positive chronic gastritis before and after eradication.METHODS:Gastric biopsy samples were obtained from corpus and antrum mucosa of 20 healthy human subjects and 18 patients with H.pylori positive chronic gastritis (n=18) before and after eradication.Tradi-tional gastric mucosal histology (and Warthin-Starry silver impregnation) and special histochemical examina-tions were carried out.Immunohistochemistry for cap-saicin receptor (TRVP1),calcitonin gene-related peptide (CGRP) and substance P (SP) were carried out by the labeled polymer immunohistological method (Lab VisionCo.,USA) using polyclonal rabbit and rat monoclonal antibodies (Abcam Ltd.,UK).RESULTS:Eradication treatment was successful in 16 patients (89%).Seven patients (7/18,39%) re-mained with moderate complaints,meanwhile 11 pa-tients (11/28,61%) had no complaints.At histological evaluation,normal gastric mucosa was detected in 4 patients after eradication treatment (4/18,22%),and moderate chronic gastritis could be seen in 14 (14/18,78%) patients.Positive immuno-staining for capsaicin receptor was seen in 35% (7/20) of controls,89% (16/18,P < 0.001) in patients before and 72% (13/18,P < 0.03) after eradication.CGRP was positive in 40% (8/20) of controls,and in 100% (18/18,P < 0.001) of patients before and in 100% (18/18,P < 0.001) after eradication.The immune-staining of gastric mucosa for substance-P was positive in 25% (5/20) of healthy con-trols,and in 5.5% (3/18,P > 0.05) of patients before and in 0% of patients (0/18,P > 0.05) after H.pylori eradication.CONCLUSION:Distibution of TRVP1 and CGRP is altered during the development of H.pylori positive chronic gastritis.The immune-staining for TRVP1,CGRP and SP rwemained unchanged before and after H.py-lori eradication treatment.The capsaicin-sensitive affer-entation is an independent from the eradication treat-ment.The 6 wk time period might not be enough time for the restituion of chronic H.pylori positive chronic gastritis.The H.pylori infection might not represent the main pathological factor in the development of chronic

功能性消化不良TRPV1表达和HP感染的关系及意义

目的探讨辣椒素受体1（TRPV1）分别在幽门螺杆菌（HP）阳性和HP阴性功能性消化不良（FD）患者的变化及临床意义。方法168例FD患者根据HP感染与否分为FD-（HP-）组和FD-（HP＋）组，并选择50例健康者为对照组，比较三组中TRPV1基因的mRNA水平、胃动素、胃泌素和生长抑素水平，分析TRPV1基因的mRNA水平与胃动素、胃泌素和生长抑素的相关性。结果TRPV1基因mRNA水平、胃动素、胃泌素和生长抑素在FD-（HP-）组与对照组之间、FD-（HP-）组与FD-（HP＋）组之间差异均具有统计学意义（P〈0．05），且FD-（HP-）组和对照组TRPVl基因mRNA水平和生长抑素水平均低于FD-（HP＋）组（P〈0．05），胃动素和胃泌素水平高于FD-（HP＋）组（P〈005）。TRPV1基因mRNA水平与胃动素及胃泌素均呈明显负相关，与生长抑素水平呈明显正相关。结论TRPV1在FD患者中呈高水平表达，且HP感染可诱发其TRPV1基因表达的增加，提示抗HP治疗对HP阳性的FD患者有益。