Resposta imune da mucosa gástrica de pacientes com infecção por Helicobacter pylori e forma digestiva da doença de Chagas

Abstract

Review: Helicobacter pylory infection is well known recognized for gastric lesion and cancer. Co-infection with other microorganisms may alter the immune response against H. pylori and influence the appearance of the gastric lesions. In order to evaluate the influence of coinfection in gastric mucosa of patients infected by H. pylori we assessed gene expression of cytokines IFNγ, IL-1β, IL-17 and IL-10, and the level of gastritis activity in antrum fragments of gastric mucosa of patients with digestive form of Chagas disease. Methods: Thirty six patients undergoing esophagogastroduodenoscopy were studied. They were divided into monoinfected by H. pylori (n = 13), co-infected H. pylori/Trypanosoma cruzi (n = 8), chagasic H. pylori-negative (n = 5) and non-infected controls (n = 10). Histopathological analysis was performed according to the updated Sydney classification. The expression of gene cytokines was determined by Real-Time PCR using the Taqman detection system and the method of relative quantification. PCR was also performed to detect cagA gene in samples of H. pylori-positive patients. Results: The monoinfected H. pylori-positive patients showed a significantly higher expression of IFN-γ, IL-17, and IL-10, even as more severe activity of gastrites than non-infected controls. The co-infected patients had a significant reduction in IL- 17 expression and activity of gastritis compared to the H. pylori monoinfected patients. Conclusion: The cytokine of Th1 and Th17 profiles performs a major role in the immune response against to H. pylori and the presence of co-infection by T. cruzi seems to influence Th17 response to H.pylori, as evidenced by decreased expression of IL17 in patients coinfected.