Relation between symptom scores and qxidative stress and histopathologic features of gastritis in patients with functional dyspepsia

?RELATION BETWEEN SYMPTOM SCORES AND OXIDATIVESTRESS AND HISTOPATHOLOGIC FEATURES OF GASTRITIS INPATIENTS WITH FUNCTIONAL DYSPEPSIA?Some evaluations can be made to determine the underlying cause ofrecurrent or persistent dyspeptic symptoms. If these evaluations, includingendoscopy, do not indicate any stuctural or biochemical factor, clinical table isnamed as functional dyspepsia. We aimed to determine the relation between theseverity of dyspepsia symptoms and the gastritis degree and oxidative stressparameters in functional dyspepsia (NUD) with a prospective, one-centeredclinical study.Study was held at Afyon Kocatepe University School of MedicineHospital, in Internal Medicine Department between April and July 2005. 35patients with recurrent or persistent dyspeptic symptoms and without anystructural or biochemical reason were included. Of them, 24 (68%) were womenand 11 (32%) were men and average age was 43.09 ± 14.98 (between 17 and 70years). Upper GI system endoscopy was followed the Glasgow scoring test forseverity of dyspepsia. Totally 5 specimens from 3 different gastric regions (2antrum, 2 corpus, 1 angulus) were taken for histopathologic evaluation. Staging ofhistological gastritis was made with Sydney system. Oxidative stress parametersglutathion (GSH), malondialdehyde (MDA) and sulphydriles (SH) wereevaluated in two additional antral specimens.As the Hp count and severity of the inflamation increase, the oxidativestress parameter (MDA) increased and anti-oxidants (SH, GSH) decreased in ourstudy. Differences in SH values were statistically significant but the differences ofGSH and MDA were not.Relation of Hp count and symptom scores was insignificant. However,there was an significant inverse correlation between the inflammation level and33symptom scores. In low level inflammation period (acute or chronic) symptomsare more frequent but as the inflammation increases and persistent histologicalchanges occur, symtoms are decreased. In addition, there is a positive correlationbetween symptom score and SH level, which can be explained by low SHconsumption during low level inflammation phases. This correlates with ourresults. GSH and MDA are not correlated with symptom scores and inflammationdegree as seen with SH and it is thought to be due to genetic metabolism andclearance differences at tissue level.As a result, low level Hp inflammatory reaction can be an etiologic factorfor NUD pathogenesis. It causes symptoms in low level period and this can beexplained by oxidative reactives and their harmfull effects. Further studies withlarge populations are necessary to show the relation between the low levelinflammation period symptoms of NUD. Following studies must be about theanti-oxidant treatments in NUD.KAYNAKLAR34