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【目的】探讨幽门螺杆菌及其空泡毒素基因 (vacA)亚型、细胞毒素相关基因 (cagA)与胃上皮HLA DR抗原表达间的关系。【方法】①自 39例幽门螺杆菌阳性患者中分离培养出 39株幽门螺杆菌菌株 ,采用PCR方法鉴定 39株菌株的ca gA及vacA亚型 ;②采用HLA DR小鼠抗人单克隆抗体 ,对上述已行cagA及vacA亚型鉴定的幽门螺杆菌阳性患者及 2 2例阴性患者的胃窦活检标本行免疫组化染色。【结果】①幽门螺杆菌阳性患者胃上皮HLA DR表达较阴性患者更显著 ;②幽门螺杆菌定植密度与胃上皮HLA DR抗原表达程度间存在正相关 ;③感染cagA+ 菌株患者较感染cagA-株者胃上皮HLA DR抗原表达更明显 ;④本研究中vacAs1a/m2亚型占 90 % ,故未对不同vacA亚型与胃上皮HLA DR表达间的关系进行统计分析。【结论】①幽门螺杆菌感染可诱导胃上皮HLA DR抗原异常表达 ;②cagA+ 菌株可能通过胃上皮HLA Ⅱ类分子介导而与宿主发生更为密切的相互作用 ,从而较cagA-菌株引起更为显著的胃上皮损伤。
【Objective】 To investigate the relationship between Helicobacter pylori and its vacuolatoxis (vacA) subtype, cytotoxin related gene (cagA) and HLA DR antigen expression in gastric epithelium. 【Methods】 ① 39 strains of Helicobacter pylori were isolated from 39 H. pylori-positive patients. The ca gA and vacA subtypes of 39 strains were identified by PCR. ② Using HLA DR mouse anti-human monoclonal antibody, Immunohistochemical staining was performed on the positive specimens of H. pylori identified from the above cagA and vacA subtypes and the negative specimens of gastric antrum from 22 negative patients. 【Results】 ① The expression of HLA DR in gastric epithelium was significantly higher in Helicobacter pylori-positive patients than in negative patients. ② There was a positive correlation between the colonization of Helicobacter pylori and the expression level of HLA DR antigen in gastric epithelium. ③ Infection with cagA + The expression of HLA DR antigen in gastric epithelium is more obvious; ④ The vacAs1a / m2 subtype accounted for 90% in this study, so the relationship between different vacA subtypes and gastric epithelial HLA DR expression was not statistically analyzed. 【Conclusion】 (1) Helicobacter pylori infection can induce the abnormal expression of HLA DR antigen in gastric epithelium; (2) cagA + strain may be more closely related to host by mediating HLA class II molecules in gastric epithelium, which may be more significant than cagA-strain Gastric epithelial injury.