ABSTRACT
Background: Helicobacter pylori [H.pylori] is a cause of chronic-active gastritis and a majority of cases of peptic ulcer disease. It is also associated with the development of gastric adenocarcinoma, the fourth most common malignancy in the world
Aim of the study: The study aims to detect the level of interferon gamma expression and the percentage of CD4+ CD25+ T regulatory cells in patients with gastritis and their relation to the pathological grading
Methods: Gastric biopsy specimens were taken from the antrum of 30 patiens using upper GIT endoscopy. Rapid urease test [RUT], immunohistochemistry [IHC], and Hematoxylin and Eosin [H and E] stains were used to determine H.pylori status. Evaluation of the histologic features was done using H and E. IFN-gamma mRNA expression in the gastric biopsies was measured using Real-Time PCR. Flowcytometry was used for measuring the percentage of CD4+CD25+regulatory T-ells [T regs] in the peripheral blood of all the patients. The results were compared to 15 healthy control subjects
Results: H.pylori was detected in 56.7% of all patients by RUT and in 93.3% patients by H and E and in 83.3% by IHC,out of them 88% had active gastritis and all of them had chronic gastritis. There was a statistically significant positive correlation between H.pylori positive infection and the pathological grading of active gastritis [p=0.015]. However, there was no statistically significant correlation between H.pylori infection [by IHC] and the pathological grading of chronic gastritis [p=0.334]. No statistically significant difference in the levels of IFN-gamma mRNA expression between H.pylori positive and negative patients was detected. No correlation was found between the levels of IFN-gamma mRNA expression and the severity of either active or chronic gastritis. Similarly, no correlation between the percentage of CD4+ CD25+ T regulatory cells and the severity of either active or chronic gastritis was detected
Conclusion: H.pylori plays an important role in active gastritis lesion. The correlation between IFN-gamma mRNA expression and the severity of active or chronic gastritis was overshadowed by the prevalence of helminthic infection among Egyptian patients. Meanwhile, low levels of T regulatory cells among H.pylori positive and negative gastritis than controls suggests an important role of T regulatory cells in regulating the gastric mucosal inflammatory response