ORIGINAL ARTICLE

Inflammation and cytokeratin 7/20 staining of cardiac mucosa in young patients with and without Helicobacter pylori infection

A Oksanen¹, A Sankila², K von Boguslawski², P Sipponen³, H Rautelin⁴

¹ Herttoniemi Municipal Hospital, PL 6300, FIN-00099 Helsinki, Finland
² Department of Pathology, Haartman Institute, University of Helsinki and Central Laboratory of Pathology, HUSLAB, Helsinki University Central Hospital, FIN-00014 Helsinki, Finland
³ Department of Pathology, HUSLAB, Jorvi Hospital, Helsinki University Central Hospital, FIN-02740 Espoo, Finland
⁴ Department of Bacteriology and Immunology, Haartman Institute, University of Helsinki and Department of Microbiology, HUSLAB, Helsinki University Central Hospital

Correspondence to:
Correspondence to:
Dr A Oksanen MD PhD
Herttoniemi Municipal Hospital, PL 6300, 00099 Helsinki, Finland; aino.oksanen{at}hel.fi

Background: Both Helicobacter pylori and gastro–oesophageal reflux disease (GORD) may cause inflammation in cardiac mucosa. Intestinal metaplasia (IM) is found more often in GORD associated inflammation than in inflammation caused by H pylori, especially in young individuals.

Aim: To examine morphological differences in chronic inflammation in these two conditions by immunohistochemistry.

Patients/Methods: Tissue blocks from cardiac mucosa of patients <45 years were available as follows: 10 patients with chronic inflammation of cardiac mucosa (carditis) and H pylori gastritis (group 1); 10 patients with (possibly GORD related) carditis, but normal antrum and corpus (group 2); and 10 patients with non-inflamed cardiac mucosa and normal antrum and corpus (group 3). Haematoxylin and eosin staining and immunohistochemical staining for various inflammatory cells were performed for patients in groups 1 and 2 as follows: CD20 (B cells), CD3 (T cells), CD4 (T helper cells), CD8 (T suppressor cells), CD163 (macrophages), CD138 (plasma cells), and CD117 (mast cells). For all patients, cytokeratin 7/20 (CK7/20) staining was performed.

Results: No clear differences were seen in the morphology of chronic inflammation between groups 1 and 2. In both, plasma cells were most abundant. CK7/20 staining showed no differences between these groups.

Conclusion: Helicobacter pylori negative (possibly GORD associated) and H pylori related carditis cannot be distinguished on a morphological basis. The stronger tendency towards IM in the first entity cannot be explained by differences in the type of inflammation. Barrett-type CK7/20 staining seems typical for cardiac mucosa, irrespective of the type of inflammation or presence of IM.

Abbreviations: CK, cytokeratin; GORD, gastro–oesophageal reflux disease; IM, intestinal metaplasia

Keywords: Helicobacter pylori; gastro–oesophageal reflux disease; cytokeratins; cardiac mucosa; lymphocytes

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?