title: Gastric mucin expression in Helicobacter pylori-related, nonsteroidal anti-inflammatory drug-related and idiopathic ulcers.
abstract: OBJECTIVE
  To determine the pattern of secreted mucin expression in Helicobacter pylori (H. pylori)-related, nonsteroidal anti-inflammatory drug (NSAID)-related and idiopathic gastric ulcers.
  
  
  METHODS
  We randomly selected 92 patients with H. pylori-associated (n = 30), NSAID-associated (n = 18), combined H. pylori and NSAID-associated gastric ulcers (n = 24), and patients with idiopathic gastric ulcers (n = 20). Immunohistochemistry for T-cell CD4/CD8, and for mucin 5AC (MUC5AC) and mucin 6 (MUC6), was performed on sections of the mucosa from the ulcer margin. Inflammation score was assessed according to the Sydney system.
  
  
  RESULTS
  MUC5AC was expressed on the surface epithelium (98.9%) and neck glands (98.9%) with minimal expression in the deep glands (6.5%). MUC6 was strongly expressed in the deep glands (97.8%), variable in the neck glands (19.6%) and absent in the surface epithelium (0%). The pattern of mucin expression in idiopathic ulcer margins was not different from the expression in ulcers associated with H. pylori, NSAIDs, or combined H. pylori and NSAIDs. CD4/CD8 ratio was higher in H. pylori-positive patients (P = 0.009). Idiopathic ulcers are associated with hospitalized patients and have higher bleeding and mortality rates.
  
  
  CONCLUSIONS
  Idiopathic ulcers have a unique clinical profile. Gastric mucin expression in idiopathic gastric ulcers is unchanged compared with H. pylori and/or NSAID-associated ulcers.
authors.affiliation: Department of Gastroenterology, Rabin Medical Center, Tel Aviv University, Petah Tikva 49100, Israel.
authors.forename: Doron
authors.initials: D
authors.lastname: Boltin
authors.forename: Marisa
authors.initials: M
authors.lastname: Halpern
authors.forename: Zohar
authors.initials: Z
authors.lastname: Levi
authors.forename: Alex
authors.initials: A
authors.lastname: Vilkin
authors.forename: Sara
authors.initials: S
authors.lastname: Morgenstern
authors.forename: Samuel B
authors.initials: SB
authors.lastname: Ho
authors.forename: Yaron
authors.initials: Y
authors.lastname: Niv
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D016516:CD4-CD8 Ratio; D005260:Female; D005752:Gastric Mucins / Q000378:metabolism*; D005753:Gastric Mucosa / Q000378:metabolism / Q000473:pathology; D016481:Helicobacter Infections / Q000150:complications*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D055271:Mucin 5AC / Q000378:metabolism; D055272:Mucin-6 / Q000378:metabolism; D013601:T-Lymphocytes / Q000473:pathology; D014456:Ulcer / Q000139:chemically induced / Q000378:metabolism* / Q000382:microbiology; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D005752:Gastric Mucins; C524678:MUC5AC protein, human; C524734:MUC6 protein, human; D055271:Mucin 5AC; D055272:Mucin-6