胃と腸47巻11号

2012年10月発行

今月の主題 Helicobacter pylori除菌後の胃癌 主題研究

Helicobacter pylori除菌によって何が変わるのか?―胃粘液の変化

著者： 太田浩良¹ 赤松泰次²

所属機関： ¹信州大学医学部保健学科生体情報検査学 ²地方独立行政法人長野県立病院機構長野県立須坂病院内視鏡センター

ページ範囲：P.1671 - P.1677

要旨　H. pyloriの胃粘膜上皮への接着には，H. pylori表面の接着分子（BabA，SabA）と胃粘膜上皮細胞に発現している血液型糖鎖が関与している．BabAは正常胃粘膜上皮に発現しているtype 1HおよびLe^bに，一方，SabAは胃炎粘膜に発現するsialyl Le^aおよびsialyl Le^xに結合する．H. pylori感染胃粘膜では，表層粘液細胞において，sialyl Le^aやsialy Le^xの発現亢進と抗H. pylori作用をもつ腺粘液細胞ムチンの分泌亢進がみられ，膜防御機構である粘液ゲル層は厚みが減少し，層構造が傷害されている．これらのムチンおよび粘液ゲル層の変化はH. pyloriの除菌により正常粘膜の状態に回復する．これらの胃ムチンの変化には炎症性サイトカインによる糖転移酵素の発現調整やH. pyloriの菌体病原因子が関与している．

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