Relationship between the Oral Cavity and the Stomach of Helicobacter pylori

구강과 위내 Helicobacter pylori의 상호관련성

  • Kang, Seung-Woo (Department of Oral Medicine, College of Dentistry, Chosun University) ;
  • Ryu, Ji-Won (Department of Oral Medicine, College of Dentistry, Chosun University) ;
  • Yoon, Chang-Lyuk (Department of Oral Medicine, College of Dentistry, Chosun University) ;
  • Ahn, Jong-Mo (Department of Oral Medicine, College of Dentistry, Chosun University)
  • 강승우 (조선대학교 치의학전문대학원 구강내과학교실) ;
  • 유지원 (조선대학교 치의학전문대학원 구강내과학교실) ;
  • 윤창륙 (조선대학교 치의학전문대학원 구강내과학교실) ;
  • 안종모 (조선대학교 치의학전문대학원 구강내과학교실)
  • Received : 2010.02.26
  • Accepted : 2010.03.19
  • Published : 2010.06.30

Abstract

Helicobacter pylori(H. pylori) is bacterial infection, with more than half of the world population infected and oral cavity is considered second reservoir of H. pylori infection. The purpose of this study was to evaluate role of oral cavity in H. pylori infection by comparison of the mode H. pylori infection in oral cavity and stomach. We recruited 100 subjects without systemic disease including gastrointestinal disease. Samples in oral cavity taken on gingival sulcus fluid(GSF) of lower left central incisor and 1st molar, area of buccal mucosa, dorsum of the tongue, palatal and saliva. We analyzed by Nested polymerase chain reaction(PCR) for oral infection and Urea Breath Test(UBT) for gastric infection. The results were as follows : 1. Among these 100 subjects, 36(36%) were positive by Nested PCR and 33(33%) were positive by UBT(p>0.05). 2. In detection rate of H. pylori in sites taken sample, 11(11%), 8(8%), 9(9%), 3(3%), 9(9%), 7(7%) were positive on GSF of lower left central incisor and 1st molar, area of buccal mucosa, dorsum of the tongue, palatal and saliva, respectively. Statical significance was observed in samples of GSF of lower left central incisor and area of dorsum of the tongue(p<0.05). 3. In comparison of the mode of H. pylori infection in oral cavity and stomach by analytic method, positive in oral cavity and stomach was 10(10%), negative in oral cavity and positive in stomach was 23(23%), positive in oral cavity and negative in stomach was 26(26%) and negative in oral cavity and stomach was 41(41%)(p>0.05). Conclusively, we can guess that oral H. pylori is not associated with gastric H. pylori infection and normal flora.

전 세계 인구의 약 절반정도가 H. pylori에 감염되었다고 보고되고 있고, 구강은 H. pylori 감염 및 전염경로에 있어서 두 번째 서식지로 제시되고 있다. 이에 본 연구에서는 H. pylori의 구강내 발현양상이 위의 H. pylori 감염율과 어떤 관련성이 있는가를 조사하여 H. pylori 감염에 있어서 구강의 역할을 밝히고자, 위장질환을 포함한 전신질환이 없는 100명의 하악좌측 중절치 및 제1대구치 치은 열구액, 협점막, 혀의 배면, 구개부위 및 타액에서 표본을 채취하여 Nested PCR을 시행한 후 요소호기검사 결과와 비교하여 다음과 같은 결과를 얻었다. 1. 구강 내에서 샘플을 채취한 6개 부위 중 Nested PCR에서 한 개 이상 양성을 보이는 사람은 36명(36%)이었으며, UBT에서 양성을 나타내는 사람은 33명(33%)이었다(p>0.05). 2. 구강 내 6개 부위에서 샘플을 채취하여 Nested PCR을 시행한 결과, 하악 좌측중절치와 제1대구치 협측 치은열구액에서 각각 11명(11%)과 8명(8%)이 양성을 나타내었고, 오른쪽 협점막, 혀의 배면, 구개부위의 구강점막세포 그리고 혀 밑 타액샘플에서 각각 9명(9%), 3명(3%), 9명(9%), 7명(7%)이 양성을 나타내었다. 구강의 샘플 채취 부위에 따른 발현율의 비교에 있어서 하악 좌측 중절치 협측 치은열구액과 혀의 배면에서 채취한 샘플사이에서만 통계적 유의성이 있었다(p<0.05). 3. 분석방법에 따라 구강과 위장 내 H. pylori 감영양상을 비교한 결과, 구강과 위장에서 양성은 10명(10%), 구강에서 음성과 위장에서 양성은 23명(23%), 구강에서 양성과 위장에서 음성은 26명(26%) 그리고 구강과 위장에서 음성을 나타내는 경우는 41명(41%)이었다(p>0.05). 이상의 결과로 H. pylori는 위의 감염과 무관하게 구강내 정상세균총으로 존재할 수 있음을 추론할 수 있었다.

Keywords

References

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