This study was carried out to determine the rate of H. pylori infection among dyspeptic patients
and to investigate if there is a correlation between the inflammatory cytokines, TNF-a and IL-8 and
the mucosal damage observed in H.pylori infected patients by comparing the mucosal levels of these
two cytokines with their serum levels and the endoscopic diagnosis . Two prepyloric antral biopsy
specimens, serum samples and gastric juice were collected from 60 dyspeptic patients , 50 with
gastoduedenal lesion ( 20 with gastritis , 9 with duodenitis , 9 with gastric ulcer and 12 with duodenal
ulcer ) and 10 with normal endoscopic findings ( control group ). It was found that , out of 60
dyspeptic patients , 32 were found positive for H.pylori (53.3%). ,out of these 32 cases , 30 (93.75%)
were symptomatic and had different gastroduodenal lesions ,and 2 cases ( 6.25 % ) were
asymptomatic and diagnosed as functional dyspepsia . The rate of infection is significant only in the
patient group with gastroduodenal lesion compared to the control group. ( p < 0.05) . The prevalence
of H. pylori infection among patients with non-ulcer dyspepsia is ( 45% ) while its prevalence among
patients with gastric or duodenal ulcer is ( 81%) . The difference in prevalence is statistically highly
significant (P< 0.01). It was found that the rate of H. pylori infection is higher in males (78.12 % )
than females ( 21.87 %) and in patients more than 40 years old ( 68.75 %) than those less than 40
years old ( 31. 25 %). The levels of TNF — a and IL8 in gastric juice of patients with gastroduodenal
lesion were significantly higher than those of controls (p <0.001) Also, the levels of IL8 in serum of
patients with gastroduidenal lesions were significantly higher than those of controls. However, the
serum levels of TNF - a in these patients did not differ significantly from those of controls ( (P >
0.05) The levels of TNF and IL8 in both the gastric juice and serum of patients with ulcer dyspepsia
( gastric and duodenal ulcer ) were significantly higher than those of patients with non-ulcer
dyspepsia Also, the levels of TNF — a and IL8 in gastric juice samples of H.pylori -positive patients
with gastroduodenal lesions were significantly higher than those of H.pylori-negative ones . To the
contrary serum levels of TNF-a and IL8 of H pylori positive patient did not show a statistically
significant difference from those of H. pylori negative cases.. Moreover, a statistically significant
positive correlation was found between the levels of TNF-a and IL8 in gastric juice of patient
positive for H. pylori . This study concluded that the increased gastric production of IL 8 and TNF —
a may be implicated in the pathogenesis of H. pylori associated gastroduodenal diseases , and
understanding the potential role of these two cytokines in inflammation may provide a new basis for
the design of anti-inflammatory agents used in treatment. |
