Dispeptik yakınmalı hastaların dental plak ve mide biyopsi örneklerinde helicobacter pylori'nin real Time-PCR ile araştırılması

Year 2010, Volume: 17 Issue: 2, 1 - 7, 30.06.2010

Selma Altındiş , Mustafa Altındiş Müjgan Özdemir Ender Ellidokuz İhsan Uslan İsmet Duran Hüsniye Dilek

Abstract

Helicobacter pylori, kronik gastritin ana nedeni olup gastrik ve duodenal ulser gelişmesinde de rolü vardır. Dental plak, H.pylori için bir rezervuar olabilir fakat ağız mikroflorasının H.pylori için kalıcı bir rezervuar olduğu hipotezi hala tartışılmaktadır. Bu çalışmada, Dispeptik yakınmalı populasyonda, mide antrum ve dental plaklarda Real Time-PCR yöntemi ile H.pylori DNA'sı varlığı ve bu enfeksiyon ile oral hijyen indeksi arasındaki ilişkinin araştırılması amaçlanmıştır.
Dispeptik yakınmaları ile rutin endoskopi için başvuran 60 hasta ile asemptomatik kontrol grubu olarak 40 kişi çalışmaya alınmış, hastaların dental plakları Sillnes ve Loe'nın plak indeksine göre değerlendirilmiştir. Supragingival plaklardan ve mideden alınan örneklerde H.pylori'nin spesifik internal üreaz genleri RT-PCR ile araştırılmış, mide antrum biyopsileri ayrıca histolojik olarak ta incelenmiştir.
Gastriti olan 60 hastanın 51'inde (% 85) antrum biyopsi örneklerinin histolojik incelenmesi ile, 44'ünde de (% 73.3) RT-PCR ile H.pylori saptanmıştır. H.pylori 60 hastanın 5'inin(% 8.3) dental plak örneklerinde bulunmuştur. Bu 5 hastanın 4'ünde (% 80) gastrik biyopsi örneklerinden H.pylori gözlenmiştir. Kronik gastriti olan 4 hasta, dental plak ve antral örneklerinde H.pylori taşımakta idi. Bu hastaların birinin midesinde displazi ve metaplazi belirlenmiştir. Kontrol grubunda ise sadece bir kişinin dental plağında H.pylori RT-PCR ile pozitif bulunmuştur. Bu çalışmada gastrik H.pylori infeksiyonu ile dental hijyen, dental taşıyıcılık, periodontal hastalık yada protez kullanımı arasında bir korelasyon bulunmamıştır. Oral kavite, H.pylori infeksiyonu için rezervuar ve oral sekresyonlar da mikroorganizma bulaşı için önemli bir yol olabilir. Diş plaklarındaki H.pylori'nin varlığı antibiyotik tedavisi sonrası gastrointestinal reenfeksiyonlar ve ülser relapsları için bir risk faktörüdür.
Anahtar Sözcükler: Helicobacter pylori, dental plak, gastrik biyopsi, RT-PCR.

Abstract

Detection of helicobacter pylori in dental plaque and gastric biopsy samples of patients whose gastric infections by real time-PCR

Helicobacter pylori are regarded as an important pathogen playing a key role in the pathogenesis of peptic ulcer. Dental plaque has been suggested as a reservoir for H.pylori but the hypothesis that the oral microflora may be a permanent reservoir of H. pylori is still controversial. The aims of this study were to determine the presence of H. pylori DNA in the gastric antrum and dental plaque of a Turkish population by RT-PCR and to investigate the relationship between this infection and the oral hygiene index.
Sixty patients attending for routine gastroscopy by dispeptic symptoms, and 40 asymptomatic subjects (control group) were evaluated. The patients' dental plaque was assessed by the plaque indices of Sillness and Loe. Supragingival plaque was analysed by a RT PCR for a specific internal urease gene. Gastric antrum biopsies were taken for histological examination and RT-PCR.
H.pylori was detected by histological examination in antral samples from 51 (85 %) and by RT PCR 44(73.3 %) of 60 patients, all of who had gastritis. H.pylori was also detected in dental plaque samples of 5 (8.3 %) of the 60 patients. In 4 (80 %) of these 5 patients, H.pylori was identified in the gastric biopsy. Four patients with chronic gastritis carried H. pylori in dental plaque and antral samples. Of these patients, one also had dysplasia and one had metaplasia. Only one subject in the control group was positive by PCR. There was no correlation between gastric H.pylori infection and dental hygiene, dental caries, periodontal disease or use of dentures. The oral cavity may be a reservoir for H.pylori infection and oral secretions may be an important means of transmission of this microorganism. H.pylori in dental plaque may represent a risk factor for gastrointestinal re-infection and ulcer relapse after antibiotic therapy.

Key Words : Helicobacter pylori, dental plaque, gastric biopsy, RT-PCR.

Keywords

Helicobacter pylori, dental plak, gastrik biyopsi, RT-PCR

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