Abstract
Introduction. Helicobacter pylori (Hp) is a class I biological carcinogen and the third leading cause of cancer death in the world, according to the World Health Organization. Hp infection represents a global public health problem in the 4.4 billion people living with Hp worldwide. The pathogenesis of helicobacteriosis is multifaceted: disorders in the nitric oxide (NO) system are involved in the development of the disease, along with other mechanisms. These aspects of the pathogenesis of helicobacteriosis are not well understood. In particular, such parts of the general problem as the significance of changes in the level of NO, its metabolites in the development of inflammatory and erosive-ulcer diseases of the gastroduodenal zone caused by different genotypes of Hp are not solved. After HP eradication, the content of NO synthase in the gastric mucosa decreases. However, the expression of the enzyme remains high in areas of intestinal metaplasia, which is considered the source of continued production of NO synthase even after Hp eradication.
Aim. To investigate the level of nitrates/nitrites in the blood in patients infected with various genotypes of Hp. Materials and methods. 48 patients with inflammatory and erosive-ulcer diseases of the stomach and CPD infected with Hp were examined. R&D Systems kits were used to determine the level of nitrates/nitrites in the blood. For the diagnosis of helicobacteriosis, a classic respiratory test was used, as well as a polymerase chain reaction. CagA, VacA, BabA, IceA genotyping Hp was performed. Depending on gene detection, Hp strains were divided into 4 serotypes: type I (CagA+, VacA+)/Type Ia (CagA+, VacA-), type Ib (CagA-, VacA+), type II (Vac A-, CagA-).
Discussion. Нр harboured the CagA gene in 34 patients (70.8% of cases), VacA gene in 40 patients (83.3%), BabA gene in 6 patients (12.5%), and IceA gene in 8 patients (16.7%). The distribution by Нр serotype showed that serotype I was found in 28 patients (58.3%), serotype Ia in 6 patients (12.5%), serotype Ib in 12 patients (25.0%), and serotype II in 2 patients (4.2%). In general, all surveyed patients had blood levels of nitrates/nitrites that were significantly increased to 54.7±2.4 μmol/L (compared to the levels of healthy individuals, p<0.05). The patients infected with the CagA-positive Нр strains had the highest blood levels of NO metabolites.
Conclusions. In helicobacteriosis, the level of NO metabolites in the blood is increased, especially in patients infected with CagA+, IceA+ strains of Hp. This is the basis for the development of a differentiated treatment for inflammatory and erosive-ulcer diseases of the gastroduodenal zone associated with different strains of Hp.
Keywords: Helicobacter pylori, Hp, NO synthase, CagA, VacA, BabA, IceA genotypes Hp, blood nitrate/nitrite level, Hp eradication
For citation:Plotnikova E.Yu., Yaroshenko L.A., Kutsaeva A.O. Nitric oxide system in patients infected with Helicobacter pylori of different genotypes. Clinical review for general practice. 2023; 4 (1): 49–52. DOI: 10.47407/kr2023.4.1.00189
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