Published online May 1, 2004. doi: 10.3748/wjg.v10.i9.1306
Revised: November 20, 2003
Accepted: December 8, 2003
Published online: May 1, 2004
AIM: To study the relationship between infection with Helicobacter pylori (H. pylori) L-forms and chronic gastritis and its association with possible changes of cellular immune function.
METHODS: Gastric mucosal biopsies were taken from 428 patients with chronic gastritis to detect H. pylori L-form by Gram staining and immunohistochemistry staining. Peripheral venous blood samples of patients were taken to detect the percentage of CD3+, CD4+ and CD8+ by the biotin-streptavidin (BSA) assay and the levels of IL-2, IL-6and IL-8 by ELISA.
RESULTS: The rate of infection with H. pylori L-forms was 48.83% (209/428). The rate was 50.47% (216/428) and 52.80% (226/428), respectively, as detected by immunohistochemistry staining and Gram staining (P > 0.05). The rate of H. pylori L-forms in males and females was 57.8% (136/235) and 37.28% (73/193), respectively, (χ2 = 17.05, P < 0.01). Furthermore, the rate increased with age, with the rate being significantly greater in patients ≥ 40 years old than in those < 40 years old (P < 0.01). The percentage of CD3+, CD4+, CD8+, the ratio of CD4+/CD8+, and the levels of IL-2, IL-6, IL-8 in H. pylori-positive patients were 47.58% ± 4.44%, 25.51% ± 4.74%, 22.77% ± 7.46%, 1.44% ± 0.51%, 1.56 ± 0.47 mg/L, 103.62 ± 5.85 ng/L, and 109.79 ± 7.18 ng/L, respectively. Compared with H. pylori-negative patients, the percentage of CD3+, CD4+ and the ratio of CD4+/CD8+ and the IL-2 level decreased, but the levels of IL-6, IL-8 increased (P < 0.001-P < 0.01). Moreover, the percentage of CD3+, CD4+, CD8+, the ratio of CD4+/CD8+, and the levels of IL-2, IL-6 and IL-8 in patients infected with both H. pylori L-forms and vegetative forms were 46.67% ± 5.21%, 30.75% ± 4.89%, 22.15% ± 6.45%, 1.32% ± 0.47%, 1.16 ± 0.38 mg/L, 116.45 ± 5.44 ng/L, and 118.64 ± 6.24 ng/L, respectively. Compared with patients infected with only vegetative forms, the percentage of CD4+, the ratio of CD4+/CD8+and IL- 2 level decreased, but the levels of IL-6 and IL-8 increased (P < 0.001 or P < 0.01).
CONCLUSION: L-form variation often occurs in patients with chronic gastritis and is commonly found in male patients and associates with ages. The L-form variation may be an important factor causing disorder of cellular immune function in the patients with H. pylori-induced chronic gastritis.