Different patterns of Helicobacter pylori adherence to gastric mucosa cells in children and adults - An ultrastructural study

Background: infection with Helicobacter pylori in childhood may be the init iation of a lifelong coexistence between microorganisms and epithelial cell s resulting in chronic inflammation. The adhesion pattern of H. pylori foun d in antral biopsies from a group of H. pylori-infected children with recur rent abdominal pain was compared with a group of H. pylori-infected adults suffering from dyspepsia, in an attempt to reveal differences in the type o f adhesion. Methods: The histology of antrum biopsies and the ultrastructur e of adherent H. pylori in biopsies from 26 children (median age, 10.1 year s) were compared with organisms in biopsies from 19 adults (median age, 54. 4 years). Results: More than 1000 adherent H. pylori were studied and divid ed into four types of adhesion: 1) contact to microvilli; 2) connection to the plasma membrane via filamentous material; 3) adhesive pedestal formatio n; and 4) abutting or making a depression in the plasma membrane. Contact t o microvilli was significantly higher (69% versus 39%; P=0.002) in children compared with adults and comprised two-thirds of all adherent organisms in children. The more intimate adhesion types as abutting or adhesive pedesta ls dominated in adults. Conclusions: These results indicate a change in con tact types between H. pylori and gastric epithelial cells in adults compare d with children and this may be a natural development in the lifelong infec tion of humans.