Features of the blood cytokine profile in gastroesophageal reflux disease in schoolchildren with gastritis and family history of peptic ulcer

Gastroesophageal reflux disease (GERD) is a common acid-dependent disease among the population, including children, with multifactorial genesis. It, like many other acid-dependent diseases (peptic ulcer, etc.) is associated with a family predisposition to the disease. Of interest is the study of the role of cytokines in the regulation of pathology in childhood, depending on the severity of a family history of peptic ulcer disease. Aim: to evaluate the levels of cytokines in the blood serum in case of family history of ulcerative diseases in schoolchildren with gastritis associated with GERD. In the course of a scientific study, 142 children with gastroenterological complaints aged 7-17 years were examined. The diagnosis of GERD was made in the presence of weekly heartburn in accordance with the global consensus on pathology in children. All subjects underwent gastroscopy with taking biopsy material from the gastric mucosa and morphological confirmation of their diagnosis of gastritis in accordance with the Sydney classification. The concentration of cytokines in blood serum (IL-2, IL-4, IL-6, IL-8, IL-10, IL-18, IL-1β, IFNα, TNFα) was obtained by enzyme immunoassay. During statistical processing, the χ2  and Mann–Whitney tests were used. The studies were approved by the ethics committee and informed consents of patients and their parents were obtained prior to the start of the study. The results of the study did not show significant differences in the concentration of cytokines in schoolchildren depending on the presence of GERD. In children with a family burden of peptic ulcer, GERD was detected more often (p = 0.054), which is probably a consequence of their increased acid formation. Changes in the cytokine profile of the blood were noted. During GERD, with aggravation of peptic ulcer, there was an increase in the replication of IL-4 (p = 0.027) and IFNα (p = 0.001). The increase in blood IFNα in children with GERD with family burden is obviously aimed at enhancing immune responses involving the whole body to damage. This is due to its functional role – participation in the immune response. Increased replication of IL-4, obviously, provides an increase in metabolic, immune processes in the body aimed at optimizing the course of proliferative processes in the esophageal mucosa under conditions of increased secretion of hydrochloric acid in the stomach. Thus, when a family history of peptic ulcer is aggravated in schoolchildren with gastritis associated with GERD, a number of links in the cytokine network (IL-4, IFNα) move to the systemic level of regulation

Clinical and Morphological Manifestations of Gastritis and Serum Cytokine Levels in Schoolchildren with Familial History of Gastric Cancer

Aim. A study of the clinical and morphological traits and cytokine profile of gastritis in schoolchildren with familial history of gastric cancer.Materials and methods. A cross-sectional questionnaire survey was conducted in Siberian regions (Tuva, Even-kiya, Aginskiy Buryat National District, Krasnoyarsk). A total of 3,343 schoolchildren aged 7–17 were surveyed for gastrointestinal complaints and history of gastric cancer in their 1st–2nd degree kindred. Oesophagogastroduo-denoscopy (OGDS) with gastric mucosa biopsy were performed in 463 respondents with complaints. Gastritis was graded in the Sydney classification. Serum cytokine levels (IL-2, IL-4, IL-8, IL-18, IL-1β, IFN-α, TNM-α) were obtained in enzyme immunoassays (ELISA).Results. Schoolchildren with gastritis and familial history of gastric cancer revealed a higher 59.8% rate of dyspeptic complaints vs. 40.8% in negative history (p = 0.001), as well as complaints of weekly heartburn in 14.2 and 8.3% cas-es (p = 0.019), respectively. In positive history and negative H. pylori tests, the cell immune response regulator IL-18 37 was revealed elevated in histology. In histologically verified H. pylori, no cross-cohort differences were observed in serum IL-18 by positive familial history of gastric cancer.Conclusion. Gastritis in schoolchildren with familial predisposition to gastric cancer more often associates with GERD and dyspepsia usually presented in postprandial distress syndrome. The cytokine regulation properties of gastritis in schoolchildren with familial history of gastric cancer have been reported

CLINICAL AND MORPHOLOGICAL CHARACTERISTICS OF GASTRITIS IN EVENKIA SCHOOLCHILDREN OF ETHNIC POPULATIONS

The article presents the data on the prevalence and clinical and. morphological characteristics of gastritis in Evenkia children. We examined. 299 native children — the Evenks (the Mongoloids) and. 1204 alien children (the Caucasians) of 7—17 years. We found, the increase of gastritis prevalence and. its progressive course in the Caucasians. In both ethnic populations we marked, the association, of gastritis with. Helicobacter fylori. At the same time erosive-ulcer lesions of mucous tunic in gastroduodenal area was diagnosed, in the Evenks two times less frequent than in the Caucasians. Besides, the infection in the Evenks was accompanied, by weaker stage of gastritis activity

Prevalence of gastroesophageal reflux disease, gastroduodenal erosions and ulcers and their association with the family predisposition to peptic ulcer disease in Siberian schoolchildren

The aim is to study the prevalence of gastroesophageal reflux disease (GERD), gastroduodenal erosions and ulcers and their association with a family predisposition for ulcer disease in Siberian schoolchildren. Material and methods. We have examined schoolchildren aged 7–17 years in three regions of Siberia (Republic of Tyva, Evenkia and Buryatia) in localities identical to their socio-economic level. Data collected using a cross-sectional method using standardized questionnaires on the presence of gastroenterological complaints and information about ulcer disease of relatives in the 1st and 2nd generations in 1535 schoolchildren in Tuva, 790 in Buryatia and 1369 in Evenkia. Diagnosis of GERD was based on the presence of complaints of heartburn, in accordance with international consensus in the pediatric population. We performed gastroscopy randomly method in each region at schoolchildren with gastrointestinal complaints (283 children in Tyva, 110 in Buryatia, 205 in Evenkia). Results. There was an increase in the GERD frequency among Siberian children with anamnesis data on the presence of peptic ulcer in relatives (9.9 and 5.9 %, respectively, p = 0.0025). The most unfavorable situation has been observed in the population of schoolchildren of the Republic of Tuva (10.6 % with a burdened history and 9.3 % without it, p = 0.5389). We have not revealed the significant increase of gastroduodenal erosions and ulcers in children with a poor family history of peptic ulcer disease (12.6 and 10.4 %, respectively, p = 0.5263), including Tuva schoolchildren where they were more often detected. The GERD association with erosive ulcerative process in the mucous membrane of the stomach and duodenum was ambiguous and had population (regional) features in schoolchildren with a burdened family history of peptic ulcer disease. Conclusion. Siberian schoolchildren with a family predisposition to peptic ulcer disease have certain regional features in the association of gastroduodenal erosions and ulcers with GERD

ЗАБОЛЕВАНИЯ ГАСТРОДУОДЕНАЛЬНОЙ ЗОНЫ, АССОЦИИРОВАННЫЕ С HELICOBACTER РYLORI, У ДЕТЕЙ — КОРЕННЫХ ЖИТЕЛЕЙ ТЫВЫ И ЭВЕНКИИ

We carried out clinical morphological examination for 80 Evenks (Evenkia is in the North of Siberia) and 90 Tyvins (Tyva Republic is in the South of Siberia) in the ages of 7 to 17 years aimed at studying H. pylori infection and its associations with gastroduodenal diseases in children. We found increased level of contamination and its connection with dyspepsia syndrome in the Evenks. Both ethnic populations show the association of the infection with gastric activity. At the same time we didn’t mark the higher rate of contamination in children with erosive ulcer lesion of gastroduodenal mucosa. We found the increased level of mucosa bacterial dissemination with H. pylori in the Evenks who had destructive changes.Проведено клинико-морфологическое обследование 80 эвенков (Эвенкия — Север Сибири) и 90 тувинцев (Республики Тыва — Юг Сибири) в возрасте 7—17 лет с целью изучения инфицирования H. pylori и ассоциации инфекции с заболеваниями гастродуоденальной зоны у детей. Установлено увеличение инфицирования и его связь с синдромом диспепсии у эвенков. В обеих этнических популяциях прослеживалась ассоциация инфекции с активностью гастрита. Тогда как увеличения инфицирования детей с эрозивно-язвенными поражениями слизистой гастродуоденальной зоны не отмечено. Однако у эвенков с деструктивными изменениями имелось увеличение степени бактериальной обсемененности H. pylori слизистой

Gastroesophageal Reflux Disease and Erosive-Ulcerative Lesions of the Gastroduodenal Zone in Schoolchildren of Various Ages in Siberia

Aim. To study the prevalence of gastroesophageal reflux disease (GERD) and erosive-ulcerative lesions of the gastroduodenal zone and their association among various age groups of Siberian schoolchildren.Material and methods. In order to identify gastrointestinal complaints, a cross-sectional survey of schoolchildren at the age of 7–17 years in the settlements of the Republic of Tyva, Evenkia and Buryatia was conducted. In total, 1535 schoolchildren were examined (7–11 years old — 855 and 12–17 years old — 680 people) in Tyva, 790 (7–11 years old — 333 and 12–17 years old — 457 people) in Buryatia and 1369 (7–11 years old — 633 and 12–17 years old — 736 people) in Evenkia. GERD diagnosis in schoolchildren was based on the presence of heartburn complaints following the worldwide consensus on the GERD definition among the pediatric population. An esophagogastroduodenoscopy (283 children in Tyva, 110 in Buryatia and 205 in Evenkia) was performed by random selection in the age groups of schoolchildren with gastrointestinal complaints in each region.Results. The GERD prevalence among schoolchildren in Siberia was 6.4 %. At the same time, the clinical signs of GERD were mainly noted in schoolchildren of the older age group: at the age of 12–17 years old in 9.4 % of cases, at the age of 7–11 years old in 3.2 % (p = 0.01) of cases. The indicators in the Republic of Tyva were 9.5 %, which is higher than those for schoolchildren in Buryatia (4.1 %; p = 0.01) and Evenkia (4.2 %; p = 0.01). The disease was represented mainly by a non-erosive form. In younger schoolchildren, the non-erosive form of GERD is diagnosed much less frequently and only in Tyva (14.0 %). Erosive esophagitis was diagnosed in 4 cases (0.7 %), 3 of which were in older schoolchildren in Tyva. Erosive-ulcerative diseases of the stomach and duodenum were recorded, to a greater extent, in older children, and largely in Tyva. A more frequent combination of GERD and erosive-ulcerative lesions of the gastroduodenal zone was noted in Tyva, particularly in the older age group.Conclusion. In Siberian schoolchildren, an association of erosive and ulcerative lesions of the mucosa of the gastroduodenal zone with GERD was established, the severity of which has age-related features and is closely related to the region of residence

ASSOCIATION OF GASTRODUODENAL DISEASES WITH HELICOBACTER PYLORI-INFECTION IN NATIVE CHILDREN OF TUVA AND EVENKIA

We carried out clinical morphological examination for 80 Evenks (Evenkia is in the North of Siberia) and 90 Tyvins (Tyva Republic is in the South of Siberia) in the ages of 7 to 17 years aimed at studying H. pylori infection and its associations with gastroduodenal diseases in children. We found increased level of contamination and its connection with dyspepsia syndrome in the Evenks. Both ethnic populations show the association of the infection with gastric activity. At the same time we didn’t mark the higher rate of contamination in children with erosive ulcer lesion of gastroduodenal mucosa. We found the increased level of mucosa bacterial dissemination with H. pylori in the Evenks who had destructive changes

CYTOKINE REGULATION IN THE COURSE OF MULTIPLE MYELOMA PROGRESSION

Cytokines are wide-range modifiers of biological reactions. Cytokine regulation provides proliferation, differentiation, cell function, cell-cell and inter-systemic interaction, direction and nature of immune response to invasion of infectious and non-infectious pathogens. There are several distinct groups of cytokines: pro-inflammatory, anti-inflammatory factors, regulators of cellular and humoral immunity etc. A distinct role of cytokines is not excluded for infectious complications accompanying multiple myeloma (MM). Cytokine regulatory effects on immune defense in the organism as a whole, and a balance between proand anti-inflammatory cytokines in blood of MM patients depend on the stage of multiple myeloma progression and possibility of infectious complications. Therefore, the aim of our study was to evaluate proand anti-inflammatory cytokines and cytokine regulation in patients with MM G-immunochemical option. Our study involved 101 patients with MM (IgG-variant), their age ranging between 40 and 76 years. The diagnosis was verified by clinical and laboratory examinations. The G-variant of MM was verified by immunofixation and electrophoresis. The definite diagnosis and disease staging was confirmed by a combination of diagnostic criteria. Heparinized blood samples were taken from the cubital vein in the morning (8 to 9 hours), in fasting state upon admission, prior to the starting a pathogenetic therapy. Dynamic monitoring of patients was carried out over the period of their staying in hospital. All patients were staged according to Durie and Salmon (1975) (stages II, III). At each stage, we discerned two sub-groups: A, without renal disease, B, with renal impairment. The control group consisted of 125 healthy volunteers matched for age and sex with the main group. IL-2, IL-4, IL-8, TNFα, and IFNγ levels in sera of the patients and healthy individuals were determined by enzyme immunoassay kits (JSC “Vector-Best”,Novosibirsk). In the myeloma patients, we have revealed an imbalance between pro-inflammatory (IL-2, IL-8, TNFα, IFNγ), and antiinflammatory cytokines (IL-4), with a predominance of pro-inflammatory factors. This finding does not exclude their potential pathogenetic role in growth and stimulation of tumor progression, and occurrence of infectious complications at any stage of the disease. The disturbances in cytokine regulation in MM patients may manifest as a deviation of cellular immune response by Th-1 way. As seen from our data, TNFα, IL-2 and IL-4 are the most significant cytokines for MM progression

ЗАБОЛЕВАНИЯ ГАСТРОДУОДЕНАЛЬНОЙ ЗОНЫ, АССОЦИИРОВАННЫЕ С HELICOBACTER РYLORI, У ДЕТЕЙ — КОРЕННЫХ ЖИТЕЛЕЙ ТЫВЫ И ЭВЕНКИИ

We carried out clinical morphological examination for 80 Evenks (Evenkia is in the North of Siberia) and 90 Tyvins (Tyva Republic is in the South of Siberia) in the ages of 7 to 17 years aimed at studying H. pylori infection and its associations with gastroduodenal diseases in children. We found increased level of contamination and its connection with dyspepsia syndrome in the Evenks. Both ethnic populations show the association of the infection with gastric activity. At the same time we didn’t mark the higher rate of contamination in children with erosive ulcer lesion of gastroduodenal mucosa. We found the increased level of mucosa bacterial dissemination with H. pylori in the Evenks who had destructive changes.Проведено клинико-морфологическое обследование 80 эвенков (Эвенкия — Север Сибири) и 90 тувинцев (Республики Тыва — Юг Сибири) в возрасте 7—17 лет с целью изучения инфицирования H. pylori и ассоциации инфекции с заболеваниями гастродуоденальной зоны у детей. Установлено увеличение инфицирования и его связь с синдромом диспепсии у эвенков. В обеих этнических популяциях прослеживалась ассоциация инфекции с активностью гастрита. Тогда как увеличения инфицирования детей с эрозивно-язвенными поражениями слизистой гастродуоденальной зоны не отмечено. Однако у эвенков с деструктивными изменениями имелось увеличение степени бактериальной обсемененности H. pylori слизистой.</p