Features of the Immune Response to Helicobacter рylori Infection in Children with Chronic Gastroduodenal Pathology
Introduction. The immune response of a macroorganism is a determining factor for clinical manifestations of H.pylori pathogenic properties. Objective: to study the immunological features of H.pylori associated gastroduodenal pathology in children. Materials and methods. One hundred and six children aged 7 to 18 years old who were hospitalized in the Chernivtsi Regional Clinical Hospital were investigated. The presence of H.pylori was verified by histological and serological methods. The indices of CD3+, CD4+, CD8+, B cells (CD19+), T-active lymphocytes, phagocytic activity, the level of CIC, IgA, IgG, IgM, IgE, secretory IgA were determined. Statistical analysis was performed using the software Microsoft Excel 97 and Statgraphics. Results. The patients were divided into groups according to positive (72 children, 52.8 %) or negative (34 children, 32.1 %) H.pylori test and peculiarities of endoscopic changes of the stomach and duodenum structure: in 24 cases anantral superficial gastritis was diagnosed, in 22 — common superficial gastritis, in 23 children — nodular superficial gastritis, erosive gastritis in 20 and duodenal ulcer in 17 cases. Serum IgG-AT were often found both in patients and healthy individuals, IgA-AT — in children with gastroduodenal diseases. In the patients with H.pylori (+) CD3 (47.9 ± 0.8 %) and CD4 (38.8 ± 0.6 %) indices decreased. The amount of CD8 in all patients slightly increased, while H.pylori (+) significantly increased (18.5 ± 0.9 %), p < 0.05. The ratio of CD4/CD8 was significantly reduced in the patients with H.pylori (+) (2.09 ± 0.10), versus the comparative group of children (2.71 ± 0.2), p < 0.01 and in H.pylori (–) patients (2.38 ± 0.1), p < 0.05. Indices of phagocytic capacity and CIC in children with gastroduodenal pathology were low, and IgA level was increased. The most significant changes of both humoral and cellular components of immune system were observed in the patients with duodenal ulcer. Conclusion. Helicobacter pylori associated gastroduodenal diseases in children involve violation of protective mechanisms — cellular, humoral and phagocytic components of the immune system, which is the indication for immunocorrecting therapy.
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