Cytoskeletal and kinetic epithelial differences between NSAID gastropathy and Helicobacter pylori gastritis: an immunohistochemical determination.
OBJECTIVE
Distinguishing histological features between non-steroidal anti-inflammatory drug (NSAID) gastropathy and Helicobacter pylori gastritis have been accepted. However, the molecular basis explaining these dissimilar histologies has not been elucidated. In an attempt to clarify this question we investigated the differences in the structural cytoskeleton and proliferative activity of these two gastropathies.


RESULTS
We assessed the distribution of five cytokeratins (CK) (CK7, 8, 18, 19 and 20) and Ki67 for the ability to distinguish NSAID from H. pylori gastropathies. In H. pylori gastritis, CK7, 8, 18 and 19 were expressed comparably to normal mucosa from the deep foveolae up to the tips of the glands. The detection of CK20, normally expressed in the upper foveolar region and surface, was decreased with only an epithelial surface reaction. In NSAID gastropathy, CK expression was increased in intensity, with normal distribution for CK8, 18 and 19. Modification of localization was noted for CK7 and 20, with labelling extending toward the deep foveolar region. Unlike H. pylori gastritis, no surface epithelial labelling with Ki67 was noted with NSAID gastropathy but downward elongation of the proliferative zone occurred instead.


CONCLUSIONS
Contrasting cytostructural alterations and distinct proliferative patterns distinguish NSAID gastropathy from H. pylori gastritis, possibly reflecting different injury pathways.
Lauwers
G Y
GY
James Homer Wright Pathology Laboratories, Department of Pathology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA. glauwers@partners.org
Furman
J
J
Michael
L E
LE
Balis
U J
UJ
Kubilis
P S
PS
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D003599:Cytoskeleton / Q000473:pathology*; D003937:Diagnosis, Differential; D004848:Epithelium / Q000473:pathology*; D005753:Gastric Mucosa / Q000737:chemistry / Q000473:pathology; D005756:Gastritis / Q000378:metabolism / Q000382:microbiology / Q000473:pathology*; D005767:Gastrointestinal Diseases / Q000139:chemically induced / Q000378:metabolism / Q000473:pathology*; D016481:Helicobacter Infections / Q000378:metabolism / Q000382:microbiology / Q000473:pathology*; D016480:Helicobacter pylori; D006801:Humans; D007150:Immunohistochemistry; D007381:Intermediate Filament Proteins / Q000032:analysis; D053554:Keratin-20; D053552:Keratin-7; D007633:Keratins / Q000032:analysis; D019394:Ki-67 Antigen / Q000032:analysis
D000894:Anti-Inflammatory Agents, Non-Steroidal; D007381:Intermediate Filament Proteins; C507499:KRT20 protein, human; C507497:KRT7 protein, human; D053554:Keratin-20; D053552:Keratin-7; D019394:Ki-67 Antigen; D007633:Keratins