Buzdugan IO*, Belkovskyi IA, Petrashchuk TB, Puiu VI, Slyvchuk DV, Stankevych IA, Tsurkan PE, Chornyi OV, Shurhaliuk KS, Bukach OP, Voloshuna LO, Ratsa VV and Zolotyn IM

Department of Internal Medicine Bukovinian State Medical University, Ukraine

*Corresponding Author: Buzdugan IO, Department of Internal Medicine Bukovinian State Medical University, Ukraine.

Received: November 29, 2023; Published: January 19, 2024

Abstract

Introduction: The article highlights the assessment of the prevalence of Helicobacter infection strains in combination with type 2 diabetes. The effect of this main pathology, depending on the strain, on the state of the duodenal mucosa in the chambers of the poor pathology with concomitant disease is also highlighted.

The aim of the study: To evaluate the prevalence and histological changes of the mucous membrane under the influence of toxigenic strains of Helicobacter infection in patients with peptic ulcer of the duodenum with type 2 diabetes.

Research materials and methods: As a result of the screening, 48 patients with Hp - associated peptic ulcer of the DPK were involved in the study, including 28 patients with concomitant type 2 diabetes mellitus (T2DM). The control group consisted of 22 practically healthy persons (PZO) in whom no acute or chronic diseases were detected at the time of examination.

Examination results and their justification: In patients with PVDPK, presence of genotype сagA + vacA + occurred in 11 people (55%), genotype сagA + vacA- - in 1 person (5%), genotype сagA-vacA + - in 6 people (30%), respectively. The combination of сagA-/vacA- genes was observed in 2 people (10%), respectively. In the group of patients with PVDPK in combination with type 2 diabetes, it is observed in the presence of the сagA-vacA + genes that it occurs 4.67 times more often compared to the combination of сagA + vacA + and сagA + vacA- strains. Among examined patients with PVDPC in combination with T2DM, there is a combination of genes сagA– vacA- 2 individuals (7.14%), which were later removed from the study. At the same time, it should be noted that according to the data in SODPK, there is an increase in the R/B ratio in all studied structures of SODPK, and not only in endotheliocytes, and both in the group of patients with sensitivity of genes сagA + vacA + and genes сagA + or vacA + HP in patients. According to the morphological data, more pronounced signs of endothelial dysfunction are observed in SODPK in the presence of сagA + vacA + HP genes than in the presence of сagA + or vacA + HP, in particular, the percentage of vessels with endothelial desquamation phenomena was relatively higher, the volume of endothelial nuclei was reduced, and at the same time an increased coefficient of variation of the distribution of nuclear chromatin in the nuclei of endotheliocytes was found. When PV is combined with type 2 diabetes, endothelial dysfunction is enhanced both in сagA + vacA + and in сagA + or vacA + individuals, but more significantly in сagA + vacA + individuals. The optical density of the PAS-reaction is reduced in patients with PVS in the presence of сagA + vacA + genes compared to сagA + or vacA + patients, which indicates a more strongly impaired mucosa formation. Moreover, with peptic ulcer in combination with T2DM, a further deepening of saliva production disorders is noted. The analysis of the obtained data of histological and histochemical studies showed that in the association of PV with the cagA + vacA + genotype of Helicobacter pylori, more pronounced morphological changes are observed compared to the presence of the cagA + vacA- or cagA-vacA + genotypes, which are characterized by a higher percentage of vessels with endothelial desquamation phenomena (by 42 .1% - for PVDPK, by 19.35% - for PVDPK with T2DM, p < 0.05); a smaller volume of endotheliocyte nuclei (by 36% - in PVDPC, by 25.3% - in PVDPC with T2DM, p < 0.05), which indicates a deepening of cell alteration; a higher coefficient of variation of nuclear chromatin distribution in the nuclei of endotheliocytes (by 26.1%, by 17.6%,spectively), with a decrease in the optical density of the surface mucus and the optical density in the cells of Brunner's glands of the duodenum.

Conclusion: 1. It was established that in the group of patients with PVDPK in combination with type 2 diabetes, it is observed in the presence of the сagA-vacA + genes that it occurs 4.67 times more often compared to the combination of сagA + vacA + and сagA + vacA- strains. 2. Evaluating the state of the endothelium, it was established that in the presence of genes сagA + vacA + in patients with PD, manifestations of impaired endothelial function were detected, in particular - an increased percentage of vessels with the phenomena of endothelial desquamation, a reduced volume of endothelial nuclei against the background of an increased coefficient of variation of nuclear chromatin distribution in the nuclei endotheliocytes in comparison with the group of patients with PD in the presence of сagA + or vacA + genes. When combining PVDPC with T2DM taking into account the genes сagA + vacA +, the indicators of endothelial dysfunction significantly increase in comparison with the group of patients with PVDPK combined with T2DM taking into account the genes сagA + or vacA +. 3. According to the results, it was established that the manifestations of inflammatory reactions, which are assessed not only by the level of inflammatory infiltration by polymorphonuclear leukocytes (PML), but also by taking into account such exudation phenomena as stroma swelling, blood stasis and erythrocyte soot, hemorrhages. The level of desquamation of the covering epithelium indicated the level of alteration (damage) of these cells. In patients with CKD in combination with T2DM, the condition of CKD is accompanied by pronounced changes in these parameters. 4. It was investigated that the optical density of the PAS- reaction in the presence of genes сagA + vacA + in patients with PV PDK in comparison with patients with PV PDK in the presence of genes сagA + or vacA + in all studied structures indicates a more pronounced impaired mucus formation. Moreover, in the presence of type 2 diabetes in combination with PVDPK, a further deepening of disorders of mucus formation processes is noted.

Keywords: Toxigenic Strains; Helicobacter Infection; Histological Changes; Mucous Membrane; Peptic Ulcer; Duodenum; Diabetes

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Citation

Citation: Buzdugan IO., et al. “Prevalence of Toxigenic Strains of Helicobacterious Infection and Histological Changes of the Mucous Membrane in Patients with Duodenal Peptic Ulcer and Type 2 Diabetes". Acta Scientific Gastrointestinal Disorders 7.2 (2024): 10-22.

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Copyright: © 2024 Buzdugan IO., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.