Lymphoid aggregates in Crohn's colitis and mucosal immunity

Under normal conditions, the colorectal mucosa exhibits small numbers of scattered lymphocytes and plasma cells in the lamina propria and only few mucosal lymphoid aggregates (MLAs). In Crohn's colitis, the number of lymphocytes and plasma cells in the lamina propria and of MLA is substantially increased. In addition, multiple lymphoid aggregates are newly formed in the submucosa (submucosal lymphoid aggregate (SLA)) and deeper. The aim of the present study was to investigate the cellular immune response in MLA, in SLA, and in the lamina propria in Crohn's colitis. Fifty-nine colorectal biopsies/surgical specimens with or without inflammatory diseases were challenged with multiple myeloma 1 (MUM1) that highlights activated T cells, committed B cells, and plasma cells (aT/cB/PC). The number of MUM1-positive aT/cB/PC per high-power field (HPF) in MLA and in SLA was significantly lower in Crohn's colitis than in controls (p?<?0.05). In contrast, the number of MUM1-positive aT/cB/PC per HPF in the lamina propria was significantly higher in Crohn's colitis and in other forms of chronic colitis than in controls (p?<?0.05). The paucity of MUM1-positive cells in MLA and in SLA in Crohn's colitis might be caused by an increased number of MUM1-negative precursors. These precursors would eventually migrate into the lamina propria to differentiate into aT/cB/PC, complying thereby with the immunological mucosal demands generated by the on-going chronic inflammation.     

The gastric mucosal barrier: tight junction structure in gastritis and ulcer biopsies

Summary Tight junctions of the human gastric mucosa were examined using quantative freeze-fracture methods. Biopsies examined were from patients with gastric diseases including gastritis, ulcers, and pernicious anemia. No significant differences were seen in strand number or tight junction complex depth among the biopsies analyzed, however, anomalous tight junction structures were observed. Discontinuities in the tight junction complex and hyperplastic tight junctions (extensions of the apical tight junction strands radiating over the lateral plasma membrane) were seen. These alterations were not associated exclusively with either the diagnosis of gastritis or ulcers. However, a higher frequency of tight junction breaks was seen in stomach biopsies diagnosed as gastritis while those diagnosed as ulcers displayed a higher occurrence of hyperplastic tight junctions.     

Hit or a miss: Concordance between histopathologic-endoscopic findings in gastric mucosal biopsies

BackgroundCurrent literature shows a variable degree of concordance between endoscopic and histopathologic findings in gastric mucosal biopsies. Most prior studies have focused on specific gastric entities such as gastritis in patients with high prevalence of Helicobacter pylori (H. pylori). In this study, we assess concordance between histologic and endoscopic findings in a wide spectrum of targeted as well as non-targeted gastric endoscopic biopsies.MethodsWe retrospectively reviewed pathology database and slides at Hershey Medical Center to identify 630 gastric mucosal biopsies obtained from 525 consecutive patients. The corresponding clinical and endoscopic findings were retrieved from the electronic medical record.ResultsThe rate of abnormal endoscopic and histologic findings was 72.9% and 74.4%, respectively, with Cohen's ĸ coefficient of 0.24. There were 444 (70.5%) concordant cases and 186 (29.5%) discordant cases (88 cases with abnormal endoscopy but normal histology, and 98 cases with normal endoscopy but abnormal histology). Some endoscopic findings, in particular, mass, polyp, ulcer, and nodule/papule were highly concordant with abnormal histopathologic findings; while other endoscopic findings such as inflammatory changes, normal and prominent folds were associated with normal and a variety of abnormal histopathology. Multivariate analysis showed no significant association between intestinal metaplasia and H. pylori in this study.ConclusionsHistopathologic-endoscopic correlation in gastric biopsies varies depending on endoscopic mucosal patterns. Intestinal metaplasia may not have a significant association with H. pylori infection in populations with low prevalence of H. pylori.     

门脉高压时胃粘膜病变发生机制的实验研究

为探讨门脉高压时胃粘膜病变的发生机制，本文对四氯化碳所致的肝硬变伴门脉高压大鼠的胃粘膜主要防御和损伤因子进行了测定，并观察了胃粘膜超微结构。结果表明，门脉高压大鼠的胃粘膜前列腺素Ｆ２含量、胃粘膜血流量和胃壁结合粘膜量明显低于正常大鼠（均为Ｐ＜０．００１），而胃液ｐＨ值，胃酸浓度、胃酸分泌量和胃蛋白酶活性与正常比较无明显差异（均为Ｐ＞０．０５）。门脉高压大鼠的胃粘膜毛细血管组织结构的完整性破坏，毛细     

Changes in mucosal superoxide dismutase activities of gastric lesions

The mucosal superoxide dismutase (SOD) activities were serially examined on the acute gastric mucosal lesion (AGML) induced by water-immersion restraint stress to rats for six hours. The mucosal SOD activities gradually increased in proportion to the time up to 3 hours after the restraint stress. But it decreased 6 hours after when severe damage had been established in the mucosa. On the other hand, the mucosal SOD activities of the margins of human gastric ulcer showed to be higher on the healing stage than on the active stage. And the SOD activities of the intractable ulcer were lower than those of the curable ulcer. These results indicate that the mucosal SOD may play some important roles both on the protecting process information of AGML and on the healing process in gastric ulcer.     

Role of neutrophils in indomethacin-induced gastric mucosal lesions in rats

Nonsteroidal anti-inflammatory drugs (NSAIDs) cause clinically important gastric damage by several mechanisms. In order to evaluate the role of neutrophil infiltration in lesion formation, tissue myeloperoxidase activities were assessed in different gastric layers of the stomach both in rats with normal neutrophil levels and in neutropenic rats. Sprague-Dawley rats were treated either with indomethacin (Indo; 25 mg/kg, s.c.) or the vehicle. A group of rats were made neutropenic by administration of methotrexate (MTX; 2.5 mg/kg i.p.) once a day for 3 days. The stomachs were removed for the determination of lesion index, glutathione, lipid peroxide levels, protein oxidation and tissue myeloperoxidase activities. MTX treatment appeared to reduce neutrophil infiltration significantly while producing insignificant effects on eosinophils and macrophages. Indo administration caused multiple gastric lesions and treatment with MTX significantly reduced lesion index. In rats treated with Indo, neither glutathione nor LP levels showed any significant changes but the protein oxidation was significantly higher than that of other groups. The MPO level of gastric mucosa was increased in Indo-treated rats and reversed by MTX pretreatment. The results of the present study indicate that neutrophil infiltration in the gastric mucosa of rats may be involved in the pathogenesis of NSAID-induced gastric mucosal injury, but no correlation was found between lesion formation and protein oxidation in the gastric mucosa.     

A histopathological study of gastric mucosal biopsies in infantile hypertrophic pyloric stenosis.

Gastric biopsies from 35 infants with hypertrophic pyloric stenosis have been assessed for histological features of gastritis. No erosions were found, and there was no excess cellular infiltration of the lamina propria compared with a control group. Fresh haemorrhage into the lamina propria was frequent in both pyloric stenosis and control sections.     

Transport and storage ofHelicobacter pylori from gastric mucosal biopsies and clinical isolates

Various transport and storage conditions for the recovery ofHelicobacter pylori from gastric biopsies were evaluated. Gastric mucosal biopsies from 16Helicobacter pylori-infected patients were stored in cysteine-Albimi medium containing 20 % glycerol in a refrigerator (4°C) for 1 and 2 weeks and in a –20°C laboratory freezer for 4 and 12 weeks. Two clinical isolates were stored in saline, Stuart's transport media, cysteine-Albimi broth with 20 % glycerol, brucella broth with 20 % glycerol and skim milk with 17 % glycerol at room temperature, 4°C, –20°C and –70°C. Storage at 4°C for 1 and 2 weeks resulted inHelicobacter pylori recovery from 81 % and 19 % of biopsies, respectively. Storage at –20°C yieldedHelicobacter pylori recovery in 100 % and 57 % after 4 and 12 weeks, respectively. At room temperature after 6 h, theHelicobacter pylori titer was reduced. The best storage media for frozen isolates were skim milk/glycerol, brucella broth/glycerol and cysteine-Albimi/glycerol (in descending order). Recovery was better at –70°C than –20°C.     

Lymphoid aggregates in bone marrow: study of eventual outcome.

The practical importance of finding a morphologically benign lymphoid aggregate in the bone marrow of patients without known lymphoproliferative disease was assessed in 786 consecutive patients who had had 951 iliac crest bone marrow biopsies performed. Of these, 430 patients known to have lymphoproliferative disease at the time of biopsy were excluded. Of 356 patients, 86 (aggregate group) had at least one lymphoid aggregate in their biopsy specimen biopsy specimen (82 morphologically benign, three suspicious, and one malignant). Another 86 patients without aggregates (control group) were matched by age and sex. Both groups were followed up until death, or for a mean of 21.9 and 22.9 months, respectively, to assess their outcome. Eighteen (22%) of the 82 patients with morphologically benign lymphoid aggregates were later proved to have lymphoproliferative disease compared with none of the 86 control patients. Another 12 patients in the aggregate group and seven in the control group were suspected of having a lymphoproliferative disease on clinical grounds, so that altogether 30 (37%) and seven (8%), respectively, developed confirmed or suspected lymphoproliferative disease. In both cases the differences were highly significant (p less than 0.001). It is suggested that lymphoid aggregates in clinical biopsy material may not be a physiological finding and should alert pathologists or haematologists to the possibility of lymphoproliferative disease.     

Indirect immunofluorescence assay for detection of Helicobacter pylori in human gastric mucosal biopsies.

To determine sensitivity and specificity of immunofluorescence assay (IFA) for detection of Helicobacter pylori, we studied 151 patients. Biopsies of gastric mucosae were obtained for culture, histological testing, and IFA. H. pylori serum antibodies were tested by enzyme-linked immunosorbent assay. IFA was done on Formalin-preserved, paraffin-embedded biopsies by using rabbit anti-H. pylori and goat anti-rabbit gamma globulin-fluorescein isothiocyanate conjugate. The sensitivity and specificity of IFA compared with culture and Warthin-Starry stain were 93 and 95%, respectively. IFA is an accurate method for the diagnosis of H. pylori infection.     

Effects of captopril on factors affecting gastric mucosal integrity in aspirin-induced gastric lesions in Sprague-Dawley rats

Introduction

Captopril is an angiotensin-converting enzyme inhibitor, which is used as an antihypertensive agent and has shown antioxidant properties. This study aims at determining the effects of captopril on factors affecting gastric mucosal integrity in aspirin-induced gastric lesions.

Material and methods

Eighteen male Sprague-Dawley (200-250 g) rats that were given aspirin (40 mg/100 g body weight) were divided into three groups: the control, captopril (1 mg/100 g body weight daily) and ranitidine (2.5 mg/100 g body weight twice daily) groups. Ranitidine and captopril were given orally for 28 days. Rats in all groups were sacrificed and the parameters measured.

Results

Captopril reduced gastric acidity, and increased gastric glutathione (GSH) and prostaglandin E₂ (PGE₂) significantly in comparison to the control group. Captopril also reduced malondialdehyde (MDA) and gastric lesions insignificantly compared to the control group. Ranitidine healed the lesions significantly compared to the control group. There was no difference between ranitidine and captopril on the severity of lesions, gastric acidity, MDA and GSH. Captopril increased PGE₂ compared to ranitidine (p < 0.05).

Conclusions

Captopril has desirable effects on the factors affecting gastric mucosal integrity (acidity, PGE₂ and GSH) and is comparable to ranitidine in ulcer healing.     

不同胃黏膜病变患者的血清胃蛋白酶原变化

目的：探讨胃溃疡、十二指肠球部溃疡、非萎缩性胃炎、萎缩性胃炎、胃癌患者胃蛋白酶原(pepsinogen,PG)Ⅰ、PGⅡ水平和PGⅠ/PGⅡ比值变化。方法：选择2015年1月至2015年10月因消化道症状行胃镜检查的门诊及住院患者共133例,根据胃镜检查及组织病理学结果,将受检者分为5组。非萎缩性胃炎组42例、萎缩性胃炎组33例、胃溃疡组20例、十二指肠球部溃疡组23例、胃癌组15例、比较各组血清PGⅠ、PGⅡ水平。结果：与非萎缩性胃炎组相比,胃溃疡、十二指肠球部溃疡患者PGI明显升高(P<0.05),胃溃疡PGII明显升高(P<0.05),萎缩性胃炎组、胃癌组血清PGⅠ及PGⅠ/PGⅡ水平降低(P<0.05)。结论：血清PGⅠ、PGⅡ水平以及PGⅠ/PGⅡ比值对提高消化性溃疡、胃癌前病变及胃癌的诊断有重要的临床价值。     

Granulomatous lesions in nasal biopsies

A series of 19 cases has been reviewed in which biopsy of an intra-nasal lesion revealed a granulomatous pathology. These have been classified on an aetiological basis. They include infections, Wegener's granuloma and neoplasms with a granulomatous stroma. One patient with sarcoidosis first presented with lesions in the nasal cavity. Cholesterol granulomata were seen in four lesions removed from the paranasal sinuses. In six cases clinical and histological examination failed to show a cause for the granulomata; in all of these patients the nasal cavity was free from disease at a subsequent examination.     

Inflammatory cloacogenic polyp: relationship to solitary rectal ulcer syndrome/mucosal prolapse and other bowel disorders

The clinicopathologic features of nine patients with inflammatory polyps of the anorectal transition zone (inflammatory cloacogenic polyp, ICP) were reviewed. All polyps were characterized histologically by crypt hyperplasia and a thickened muscularis mucosa arising beneath a surface epithelium consisting of variable proportions of squamous, columnar, and often transitional epithelium. Tubulovillous architecture was characteristic. Sialomucin predominated over sulfomucin in eight of nine cases. One polyp displayed focal dysplasia and condylomatous features, while two others had associated hemorrhoids. Three cases had been previously diagnosed as adenomas. Seven patients were women, and two were men; their median age was 54 years (range, 17 to 85). Clinical presentation was most commonly intermittent rectal bleeding, and the clinical diagnosis was anal polyp or hemorrhoids in all cases. Six patients had the solitary rectal ulcer syndrome (SRUS) and/or evidence of mucosal prolapse. Papillomavirus was demonstrated by histochemical and immunohistochemical methods in one case in which multiple foci of dysplasia were also noted. Two patients had Crohn's disease, and the remaining patient had a coexistent adenocarcinoma located several centimeters proximal to his ICP. The pathologist and clinician must be aware that although ICP is often associated with SRUS/mucosal prolapse, it may occur in other clinical settings.     

c-met蛋白表达与胃粘膜病变的关系及预后意义

目的 研究ｃ－ｍｅｔ蛋白在胃粘膜病变演进过程中的表达及关系,探讨ｃ－ｍｅｔ表达对胃癌预后的意义。方法 对１６９例经病理证实的不同胃粘膜病变采用免疫组织化学ＳＰ法检测ｃ－ｍｅｔ蛋白表达,用Ｋａｐｌａｎ－Ｍｅｉｅｒ法的Ｌｏｇ－ｒａｎｋ检验胃癌生存率。结果 在浅表性胃炎、萎缩性胃炎、肠化生、异型增生、早期胃癌和进展期胃癌中,ｃ－ｍｅｔ蛋白表达率分别为２３．５％（４／１７）,３６．８％（１４／３８）,５１．５％（１７／３３）,６１．３％（１９／３１）,６６．７％（８／１２）和７３．７％（２８／３８）,而且肠化生、异型增生、胃癌均显著高于浅表性胃炎（Ｐ〈０．０５）。胃粘膜增殖程度与ｃ－ｍｅｔ阳性表达强度密切关系分析,两者有显著关联（Ｐ〈０．０１）。ｃ－ｍｅｔ阳性表达与胃癌组织类型、浆膜浸润和淋巴结转移密切相关,而且Ｂｏｒ     

Submaximal exercise in healthy volunteers: the relationship between gastric mucosal and systemic energy status

The effect of exercise on gastric mucosal energy status has not been fully elucidated. The aim of this study was to evaluate the impact of submaximal cycling on gastric mucosal energy balance and its relationship to changes in systemic energy status. Ten healthy volunteers (age 20-40 years) were investigated at rest (BL), during 30 min of submaximal exercise (E) on bicycle ergometry and during the 30 min after the completion of cycling. Gastric mucosal PCO(2) ( P(gm)CO(2)) was measured by air tonometry at 10-min intervals and the gastric mucosal-arterial PCO(2) difference ( PCO(2)gap) was calculated. Hemodynamics, arterial blood gases, lactate and pyruvate were also measured. PCO(2)gap significantly increased throughout exercise [BL: 0.2 kPa (median), -0.1-0.6 kPa (25th-75th percentiles); E(10 min): 1.0 kPa, 0.8-1.7 kPa; E(20 min): 1.35 kPa, 0.8-1.8 kPa; E(30 min): 1.5 kPa, 0.9-2.0 kPa]. The early changes in PCO(2)gap ( PCO(2)gap at E(10 min) minus PCO(2)gap at BL) correlated significantly and positively with corresponding changes in arterial lactate ( r(2)=0.58, P<0.05) and lactate-to-pyruvate ratio ( r(2)=0.72, P<0.05). On recovery, all metabolic parameters normalized within 30 min. We conclude that submaximal cycling in volunteers leads to the early derangement of gastric mucosal energy balance. The time course of PCO(2)gap parallels changes in systemic energy status.     

Effect of clotiazepam on gastric mucosal lesions produced by conditioned emotional stimuli in mice

The anti-ulcer action of clotiazepam (a thienodiazepine derivative) was studied in mice subjected to non-physical and physical stimuli in a communication box. There were two groups of mice: the "sender" mice that received electric shocks on the feet and responded by squealing and jumping, and the "responder" mice that were affected by the senders' responses without receiving shocks on the feet. Gastric ulcers resulted in both groups. The effect of clotiazepam was compared with that of diazepam. The incidence of gastric ulcers was suppressed by clotiazepam at a dose of 3 mg/kg, per os, in "responder" and "sender" mice, and by diazepam at a dose of 1 mg/kg, per os, in "responder" mice. These results suggest that clotiazepam has a suppressive action against gastric ulcers produced by non-physical or physical stimuli, although its potency is slightly weaker than that of diazepam.     

L－SOD对DDC诱发大鼠急性胃粘膜损伤的保护作用

本实验通过皮下注射ＤＤＣ（二乙基二硫代氨基甲酸钠）诱发大鼠急性胃粘膜损伤（ＡＧ－ＭＬ）模型，观察脂质体携载ＳＯＤ（Ｌ－ＳＯＤ）对此损伤的保护作用。发现ＤＤＣ能剂量依赖地诱发ＡＧＭＬ。预先静脉注射Ｌ－ＳＯＤ（３００００Ｕ／ｋｇ），可使胃粘膜ＳＯＤ和ＧＳＨ－Ｐｘ活性受到保护，ＭＤＡ含量减少（Ｐ＜０．０５），胃粘膜血流量（ＧＭＢＦ）提高１２％，粘膜损伤指数下降６０％。表明ＤＤＣ能稳定诱发ＡＧＭＬ，Ｌ－ＳＯＤ对这种损伤具有保护作用，其机理与增强组织的抗氧化功能有关。Ｌ－ＳＯＤ可能具有临床应用价值。