Issn Print: 0277-2116

Publication Date: 2004/06/01


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P0079 PP HELICOBACTER PYLORI INFECTION IN CHILDREN AND REGULATORY CYTOKINES IN GASTRIC MUCOSA IN A TH2 MODEL: ALLERGY.

P. R. Harris; C. Serrano; H. Einisman; E. Talesnik; A. Peña; A. Rollan; T. Vujcic; I. Duarte; E. Guiraldes; A. Venegas

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Author Information: Pediatrics, Pontificia Universidad Católica de Chile,

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Introduction: Early mucosal events in the activation of a T helper (Th) 1 and 2 pathways, may have a role in the final outcome of the H. pylori infection. Our aim was to determine whether the presence of allergy (a Th2 disorder) may modify the expression of IL-12, IFN-gamma and/or IL-10, IL-4, cytokines that activate and represent a Th1 and Th2 pathways, respectively, in the antral mucosa of H. pylori-infected subjects.
Methods: 66 patients, 48 children (<18 years) and 18 adults were enrolled after informed consent. H. pylori status was assessed by urease test and histology of antrum biopsies. Total serum IgE and skin tests (ST) were performed in a blinded fashion and correlated with the mucosal levels of IL-12, IL-10, IFN-gamma and IL-4, determined by ELISA, after tissue homogenization and measurement of the total protein content.
Results: 27 (41%) of the patients were infected with H. pylori and 5 of them had duodenal ulcers (DU). 21 patients (32%) had elevated IgE levels (mean: 404 IU/ml); 46 (70%) had positive ST, and 18(27%) were positive for both IgE and ST. H. pylori-infected children had a lower probability of presenting either a positive ST or an elevated IgE level than non-infected children (63 vs 83% for ST, 35 vs 67% for IgE, p<0.05). H. pylori-infected children with DU had a lower percentage of positive ST (50%) compared to those infected without ulcers (67%)(p=0.05). IgE levels were higher in non-infected children (139±218 IU/ml) compared to children with chronic gastritis (81±115 IU/ml) or with DU (34±7 IU/ml). IL-12 levels were lower, but not significantly so, in children with positive ST (106±109 pg/mg)compared with those with negative ST (186±209 pg/mg) (p=0.06). Likewise, there was a trend for higher mucosal levels of IL-4 in IgE-positive patients (7±11 pg/mg), in comparison to IgE-negative patients (4±4 pg/mg)(p=0.08). No differences were found in the levels of IL-10 or IFN-gamma in patients with or without allergy.
Conclusion: Chilean children with positive ST or higher levels of IgE were associated with a lower prevalence of H. pylori infection and a lower frequency of DU in those infected. The presence of these markers was related to higher levels of IL-4 and lower levels of IL-12 in gastric tissue suggesting that, in children, coexisting allergy may decrease the incidence of H. pylori infection and the frequency of H. pylori-associated ulcer by inducing a Th2 immune response in gastric mucosa.
Supported by FONDECYT grants #1030401,#1030894,NIH #DK-54495.
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