title: Relationships between Helicobacter pylori infection status, endoscopic, histopathological findings, and cytokine production in the duodenum of Crohn's disease patients.
abstract: BACKGROUND
  The chronic inflammatory process in patients with Crohn's disease (CD) may affect any part of the gastrointestinal (GI) tract. The pathogenesis of CD involves immunological abnormalities, including deficient or excessive expression of cytokines. We examined Helicobacter pylori infection status, endoscopic and histopathological findings, and cytokine production in the duodenum of CD patients in comparison with controls.
  
  
  METHODS
  Thirty-eight CD patients underwent diagnostic upper GI endoscopy. Twelve age- and sex-matched health checkup examinees were used as controls. H. pylori infection status was assessed by the (13)C-urea breath test. At the time of endoscopy, two biopsy specimens each were obtained from the second portion of the duodenum, one for hematoxylin-eosin staining and immunohistochemical analysis with anti-CD68 antibody, and one for in vitro organ culture. Interleukin (IL)-6 and -8 levels were measured in organ culture supernatant by enzyme-linked immunosorbent assay.
  
  
  RESULTS
  H. pylori infection was significantly (P<0.05) more frequent in controls (42%) than in CD patients (8%). In the duodenum, erosions or ulcers were more frequent in CD patients (53%) than in controls (8%). Mononuclear cell infiltration in the duodenum was more severe in CD patients than in controls and IL-6 production was higher, whereas IL-8 production showed no significant difference. CD68+ cells in the duodenum were more prominent in CD patients than in controls.
  
  
  CONCLUSIONS
  H. pylori infection is unlikely in CD patients, but they show immunological abnormalities in the duodenum, possibly from innate immune responses.
authors.affiliation: Department of Gastroenterology, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Japan. takafumiando-gi@umin.ac.jp
authors.forename: Takafumi
authors.initials: T
authors.lastname: Ando
authors.forename: Osamu
authors.initials: O
authors.lastname: Watanabe
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Ishiguro
authors.forename: Osamu
authors.initials: O
authors.lastname: Maeda
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ishikawa
authors.forename: Masaaki
authors.initials: M
authors.lastname: Minami
authors.forename: Motofusa
authors.initials: M
authors.lastname: Hasegawa
authors.forename: Shinya
authors.initials: S
authors.lastname: Kondo
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Goto
authors.forename: Naoki
authors.initials: N
authors.lastname: Ohmiya
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Niwa
authors.forename: Hidemi
authors.initials: H
authors.lastname: Goto
mesh_terms: D000293:Adolescent; D000328:Adult; D015703:Antigens, CD / Q000378:metabolism; D015214:Antigens, Differentiation, Myelomonocytic / Q000378:metabolism; D001706:Biopsy; D001944:Breath Tests; D016022:Case-Control Studies; D003424:Crohn Disease / Q000276:immunology / Q000382:microbiology / Q000473:pathology; D004381:Duodenal Ulcer / Q000473:pathology; D004384:Duodenoscopy; D004386:Duodenum / Q000276:immunology / Q000382:microbiology / Q000473:pathology; D016481:Helicobacter Infections / Q000382:microbiology*; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D007113:Immunity, Innate; D015850:Interleukin-6 / Q000378:metabolism*; D016209:Interleukin-8 / Q000378:metabolism*; D009924:Organ Culture Techniques; D014508:Urea / Q000032:analysis; D055815:Young Adult; D000097382:CD68 Molecule
chemical_list: D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; D015850:Interleukin-6; D016209:Interleukin-8; D014508:Urea; C067980:CD68 antigen, human; D000097382:CD68 Molecule; C508606:CXCL8 protein, human; C508600:IL6 protein, human