Inflammation and cytokeratin 7/20 staining of cardiac mucosa in young patients with and without Helicobacter pylori infection.
BACKGROUND
Both Helicobacter pylori and gastro-oesophageal reflux disease (GORD) may cause inflammation in cardiac mucosa. Intestinal metaplasia (IM) is found more often in GORD associated inflammation than in inflammation caused by H pylori, especially in young individuals.


OBJECTIVE
To examine morphological differences in chronic inflammation in these two conditions by immunohistochemistry.


METHODS
Tissue blocks from cardiac mucosa of patients <45 years were available as follows: 10 patients with chronic inflammation of cardiac mucosa (carditis) and H pylori gastritis (group 1); 10 patients with (possibly GORD related) carditis, but normal antrum and corpus (group 2); and 10 patients with non-inflamed cardiac mucosa and normal antrum and corpus (group 3). Haematoxylin and eosin staining and immunohistochemical staining for various inflammatory cells were performed for patients in groups 1 and 2 as follows: CD20 (B cells), CD3 (T cells), CD4 (T helper cells), CD8 (T suppressor cells), CD163 (macrophages), CD138 (plasma cells), and CD117 (mast cells). For all patients, cytokeratin 7/20 (CK7/20) staining was performed.


RESULTS
No clear differences were seen in the morphology of chronic inflammation between groups 1 and 2. In both, plasma cells were most abundant. CK7/20 staining showed no differences between these groups.


CONCLUSIONS
Helicobacter pylori negative (possibly GORD associated) and H pylori related carditis cannot be distinguished on a morphological basis. The stronger tendency towards IM in the first entity cannot be explained by differences in the type of inflammation. Barrett-type CK7/20 staining seems typical for cardiac mucosa, irrespective of the type of inflammation or presence of IM.
Oksanen
A
A
Herttoniemi Municipal Hospital, PL 6300, FIN-00099 Helsinki, Finland. aino.oksanen@hel.fi
Sankila
A
A
von Boguslawski
K
K
Sipponen
P
P
Rautelin
H
H
D000328:Adult; D015703:Antigens, CD / Q000032:analysis; D015415:Biomarkers / Q000032:analysis; D002908:Chronic Disease; D003239:Connective Tissue Cells / Q000276:immunology; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications / Q000473:pathology*; D016481:Helicobacter Infections / Q000150:complications / Q000473:pathology*; D016480:Helicobacter pylori; D006801:Humans; D007381:Intermediate Filament Proteins / Q000032:analysis*; D053554:Keratin-20; D053552:Keratin-7; D007633:Keratins / Q000032:analysis*; D008297:Male; D009092:Mucous Membrane / Q000737:chemistry / Q000473:pathology; D009205:Myocarditis / Q000209:etiology / Q000473:pathology*; D010950:Plasma Cells / Q000276:immunology; D013601:T-Lymphocytes / Q000276:immunology
D015703:Antigens, CD; D015415:Biomarkers; D007381:Intermediate Filament Proteins; C507499:KRT20 protein, human; C507497:KRT7 protein, human; D053554:Keratin-20; D053552:Keratin-7; D007633:Keratins