HELICOBACTER-PYLORI INFECTION IN THE ETIOPATHOGENESIS OF DUODENAL-ULCER IN CHILDREN

The study evaluates the frequency of Helicobacter pylori (H. pylori) i nfection, as well as systemic cellular immune response to H. pylori in children with duodenal ulcer (DU). The study group comprised 47 child ren with DU, aged 6-17 (mean 13, 1 +/- 4, 2). H. pylori detection was based on urease test, histology, culture and serologic tests. Endoscop ic and morphologic findings were analysed according to Sydney System c riteria. In 12 children from the overmentioned group subsets of blood lymphocytes B and T (CD3, CD4, CD8, CD3/DR, CD19) and NK cells, some n eutrophils functions (phagocytosis, chemiluminescence) and phagocytes receptors before and one month after H. pylori triple treatment were i nvestigated. H. pylori infection was detected in 44 of the investigate d children. In addition, pathologic examination revealed chronic gastr itis in 44 children and chronic duodenitis in 42 of them. In immunosys temic examination decreased percentage of CD8 lymphocytes and NK cells , increased CD4/CD8 ratio, decreased mitogen-induced response and chan ges of function and receptor expression of neutrophils were found. Aft er H. pylori treatment in follow-up endoscopy no ulcers were found and histologic examination did not reveal chronic active gastroduodenitis , while the rate of nonactive gastritis was increased. Eradication of H. pylori infection in 41 children and normalisation of immune paramet ers in 11 children were obtained. The results of our investigation ind icate, that H. pylori infection plays an important role in the pathoge nesis of DU in children.