Gastrinemia e densidade das células G e D no estômago de gerbis infectados com Helicobacter pylori submetidos a vagotomia com piloroplastia.

Abstract

The gastric Helicobacter pylori (HP) infection is involved in etiopathogenesis of peptic ulcer (PU), atrophic chronic gastritis, MALT lymphoma, beyond strong association to the gastric cancer. The PU is one of the illnesses most prevalent in the world. Currently, the PU treatment is clinical, being the surgery reserved only to the complications or the clinical failure. Amongst the surgical techniques, the vagotomy and piloroplasty was a surgical option sufficiently used in the last few decades. However, one does not know with precision the precocious physiopathologics alterations decurrent of this association (HP and surgery). In the attempt to elucidate these alterations an experimental model was developed to evaluate the influence of the HP and the surgery on the gastrinemia and the G and D cells density of the stomach. Fifty three Mongolians gerbils (Meriones unguiculatus) was divided in four groups: Group A (n= 10), no HP infection and simulated surgery 30 days after; Group B (n=14), no HP infection and surgery (vagotomy and piloroplasty) 30 days after; Group C (n=12), HP infection and simulated surgery 30 days after and Group D (n=17), HP infection and surgery(vagotomy and piloroplasty) 30 days after. Ninety days after the operation, blood was collected for the gastrin postprandial dosage and, later, the animals had been sacrificed and carried through biopsies of the corpus, antrum and gastric transitional zones (corpus-antrum and antrum- duodenum) for the microbiological, histological and immunohistochemical evaluation. The infection's presence was confirmed by direct microscopy through the analysis of the biopsies of the antrum and PCR (Polymerase Chain Reaction) of the biopsies of thegastric antrum and corpus. The characteristic and presence of the inflammatory infiltrated one in the biopsies was evaluated, through to the optic microscopy. No significant inflammation was observed in the corpus of all animals. In the corpus-antrum junction and the antrumduodenum junction, the inflammatory infiltrated presence presented difference when compared the Groups B and D (p=0,018 and p=0,021, respectively) and Groups C and D (p=0,018 and p=0,017, respectively). In the antrum, the inflammatory infiltrated presence wassignificant when compared the Groups and the C (p=0,039) and Groups B and D (p=0,05). The inflammation was classified as light, with predominance of mononuclear infiltrated and absence of aggregate lymphoid follicles in the majority of the animals. In the immunohistochemical analysis, the increase of the G cells density was observed when compared the groups A and C (p= 0.0001) and B and D (p=0,007) and increase of D cells density when compared the groups A and C (p=0,001) and one strong trend to the increase when compared groups B and D (p=0,056). The analysis of these results demonstrates that the inflammation is more important in the distals regions of the stomach and its presence can be associated to the HP infection or the association of the infection with vagotomy and piloroplasty, depending on the anatomical localization. The precocious HP infection in gerbilsincreases the G and D cells density, however they do not modify the postprandial gastrinemia.