Study On Relationship Between Hp-related Gastropathy With Splenogastric Hygropyrexia Syndrome And LA, Hp DNA In Gastric Mucosal And HSP70, NF-κB, IL-8 In Tongue

Object:Hp-related gastropathy patients with Splenogastric Hygropyrexia syndrome or spleen-deficiency syndrome were chosen, including 68 patients with Splenogastric Hygropyrexia syndrome (pattern of heat predominating over dampness 13 cases, pattern of dampness predominating over heat 13 cases, equal severity of dampness and heat 13 cases and Hp-negative 29 cases),28 patients with spleen-deficiency syndrome (Hp-positive 13 cases and Hp-negative 15 cases) and 14 cases normal volunteers as normal control group. Each group completed the clinical observation form to score the symptoms under professional inquiry.Methods:Coating on the tongue was scraped from the subjects in each group before taking anesthetic in the early morning, and gastric mucosal was taken out under electronic gastroscope and was given pathological observation with HE staining. Blue staining and rapid urease test were used to detect Hp infection. Both positive and both negative results were diagnosed as Hp-positive, both negative results were diagnosed as Hp-negative and the other results were not included in the experiment. The clinical data of the subjects in each group were analyzed. Fluorescence quantitative PCR technique was used to detect content of LA and Hp DNA in gastric mucosal and expression of HSP70, NF-KB, IL-8 mRNA in tongue.Results:1. General situation:The general condition of each group (gender, age, disease duration, disease) was comparable and there were no significant differences.2. Analysis on the major clinical symptoms of Splenogastric Hygropyrexia syndrome:the main cl inical symptom scores of Hp-positive group of Splenogastric Hygropyrexia syndrome were higher than Hp-negative group, but there were no significant differences (p>0.05).3. Hp infection rate and infection degree:Patients’Hp infection rate of Splenogastric Hygropyrexia syndrome was higher than that of spleen-deficiency syndrome, and infection degree of spleen-deficiency syndrome was higher than that of Splenogastric Hygropyrexia syndrome, but there were no significant differences between the two groups (p> 0.05).4. Relationship between inflammation degree and activity of gastric mucosal inflammation of the different syndromes(a) Compared with gastric mucosal of the normal control group, histologic examination showed that inflammatory cells infiltration in lamina propria lymphoid follicles or small nodal, local submucosal bleeding, bowel melt, the gland atrophy, hyperplasia in that of Splenogastric Hygropyrexia syndrome and spleen-deficiency syndrome.(b) Inflammation degree and activity of spleen-deficiency syndrome were greater than that of Splenogastric Hygropyrexia syndrome; and Inflammation degree and activity of the subtypes of Splenogastric Hygropyrexia syndrome increased by more dampness and less heat, but there was no significant difference between the groups (p> 0.05).(c) Hp infection and degree of gastric mucosal inflammation and activity were positively correlated (p< 0.01).5. Comparison of content of LA, Hp DNA in gastric mucosal and expression of HSP70, NF-κB,IL-8 mRNA in tongue of different degree of Hp infection.(a) Content of LA DNA in gastric mucosal and expression of HSP70, NF-κB, IL-8 mRNA in tongue of Hp-positive group were greater than Hp-negatie group.(b) Expression of NF-κB mRNA in tongue of Hp-positive group was greater than Hp-negatie group.(c) Content of LA, Hp DNA in gastric mucosal and expression of HSP70, NF-κB, IL-8 mRNA in tongue increased by higher degree of Hp infection.6. Comparison of content of LA, Hp DNA in gastric mucosal and expression of HSP70, NF-κB, IL-8 mRNA in tongue of different diseases.(a) Content of LA, Hp DNA in gastric mucosal and expression of IL-8 mRNA in tongue of chronic gastritis or peptic ulcer patients were greater than that of normal control group, but the difference was not significant (P> 0.05).(b) Expression of NF-κB mRNA in tongue of chronic gastritis or peptic ulcer patients was less than that of normal control group, and that of peptic ulcer were less than chronic gastritis, but the difference was not significant (P> 0.05). (c) Expression of HSP70 mRNA in tongue decreases from peptic ulcer patients, normal control group to chronic gastriti patients.However, there was no significant difference (p> 0.05).7. Comparison of content of LA, Hp DNA in gastric mucosal and expression of HSP70, NF-κB, IL-8 mRNA in tongue between different syndromes.(a) Content of LA, Hp DNA in gastric mucosal and expression of IL-8 mRNA in tongue of Splenogastric Hygropyrexia syndrome and spleen-deficiency syndrome were greater than that of normal control group, and that of Splenogastric Hygropyrexia syndrome were greater than that of spleen-deficiency syndrome.(b) Expression of HSP70 mRNA in tongue of Splenogastric Hygropyrexia syn-drome is less than that of spleen-deficiency syndrome and normal control group.(c) Expression of NF-κB mRNA in tongue of Splenogastric Hygropyrexia syndrome and spleen-deficiency syndrome was less than that of normal control group, and that of Splenogastric Hygropyrexia syndrome was greater than that of spleen-deficiency syndrome.8. Comparison of content of LA, Hp DNA in gastric mucosal and expression of HSP70, NF-κB, IL-8 mRNA in tongue between different subtypes of the same syndromeContent of LA, Hp DNA in gastric mucosal and expression of HSP70, NF-KB, IL-8 mRNA in tongue inceased by more dampness and less heat among different subtypes of Splenogastric Hygropyrexia syndrome.Conclusion:Rapid urease test, methylene blue staining, routine patho-logical HE staining, fluorescence quantitative-PCR technique were used to study the relationship between LA, Hp in gastric mucosal and HSP70, NF-KB,IL-8 mRNA in tongue and Hp-related gastric diseases, and drew the following preliminary conclusions:1. Content of LA in gastric mucosal and expression of HSP70, NF-κB, IL-8 mRNA in tongue being correlated with Hp infection and Hp infection degree showed that Hp infection may cause change of intragastric environment and the number of beneficial bacteria LA, and expression change of HSP70, NF-κB, IL-8 in tongue may be indirectly related to inflammation reactions of gastric mucosal.2. Occurrence of chronic gastritis, peptic ulcer, inflammation degree and activity were correlated with Hp infection and Hp infection degree, and increase of stomach LA might kill germs and inhibit inflammatory response. Expression of IL-8, a kind of inflammatory cytokine in tongue, had the same increasing trend with gastric mucosal, while expression of HSP70, NF-KB mRNA in tongue had the opposite trend, which propobly suggested that expression of IL-8 in tongue indirectly reflected damage of gastric mucosal, and some other factors or pathway except HSP70, NF-KB modulated expression of IL-8. And the results were propobly related to relative less of fur or unable to colonize, relations between floras and interactions of local inflammatory pathways.3. Hp infection, gastric mucosal inflammation, increased Hp and LA, increasing trend of expression of inflammatory cytokines IL-8, which existed in Splenogastric Hygropyrexia syndrome, were positively correlated with Hp infection degree. It suggested that changes of LA-Hp flora relations and expression of HSP70, NF-κB, IL-8 in tongue led to inflammatory response of gastric mucosal, which is simlilar to pathogenesis of Splenogastric Hygropyrexia syndrome:damp-pathogen encumbering the spleen causes the spleen’s disability in transportation and transformation, and damp-pathogen inside human body further blocks flow of Qi and leads to damp-heat sweltering. While, there was no significant correlation between clinical symptom score and Hp infection, so we preliminary think Hp may be important to the pathogenesis of Splenogastric Hygropyrexia syndrome, and LA and inflammation-related factors may be internal factors to pathogenesis and determine different kinds of symptoms, which means pathogenesis of Splenogastric Hygropyrexia syndrome is related to changes of the relations among floras and expression of inflammation-related factors.4. As for content of LA, Hp in gastric mucosal and expression of HSP70, NF-κB,IL-8 mRNA in tongue of Splenogastric Hygropyrexia syndrome, those of pattern of heat predominating over dampness were greater than those of pattern of dampness predominating over heat and equal severity of dampness and heat, which showed that pathogenesis of Splenogastric Hygropyrexia syndrome mainly lied in damp evil and reflected some Chinese medicine theories such as Spleen is liable to dampness and Spleen is the source of phlegm, and so on.