Correlation between serum and gastric levels of tumor necrosis factor - alpha and interleukin - 8 in patients with Helicobacter Pylori infection

ABSTRACT

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 gastr oduedenal 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 prevalenc 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 gastroduedenal 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-negativc 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 IL8 and TN F-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