Advertisement

Hauptthema: Neue Infektionskrankheiten

  • R. Lüthy
  • K.-H. Meyer zum Büschenfelde
  • K. J. Hengels
  • G. Strohmeyer
  • H. Lode
  • G. Höffken
  • T. Schaberg
  • P. Herzer
  • K.-H. Meyer zum Herzer
  • U. B. Göbel
  • V. ter Meulen
Conference paper
Part of the Verhandlungen der Deutschen Gesellschaft für Innere Medizin book series (VDGINNERE, volume 97)

Zusammenfassung

Die Ulcuskrankheit entsteht aus einer Imbalanz mucosaschädigender und mucosaschützender Prinzipien. Dennoch dominiert der Faktor Säure mit Recht seit Dekaden die pathophysiologischen Konzepte und therapeutischen Strategien. So ist Säure einerseits die einzig bislang bekannte unabdingbare Voraussetzung für die Entstehung jedes Ulcus, zum anderen heilen praktisch alle Ulcera unter einer säuresekretionshemmenden oder -neutralisierenden Behandlung ab. Da aber bis heute die Ätiologie und Pathogenese der Ulcuskrankheit, mit Ausnahme beim Zollinger-Ellison-Syndrom und den durch nichtsteroidale Antirheumatika bedingten Ulcera, weitgehend ungeklärt ist und ihr Spontanverlauf durch medikamentöse Intervention nicht beeinflußt werden kann, d. h. eine Heilung nicht möglich ist, hält die Suche nach weiteren ursächlichen Faktoren und einer dauerhaft wirksamen Therapie an. Die alte Hypothese, das Ulcusleiden sei eine Infektionskrankheit, wurde durch die 1983 erstmals gelungene Anzüchtung von Helicobacter pylori aus menschlichen Magenschleimhautbiopsien wiederbelebt [50].

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. 1.
    Borody TJ, Cole P, Morgan A (1989) Recurrence of duodenal ulcer and relapse following eradication. Med J Aust 151: 431–435PubMedGoogle Scholar
  2. 2.
    Cave DR, Vargas M (1989) Effect of a Campylobacter pylori protein on acid secretion by parietal cells. Lancet 2: 187–189PubMedCrossRefGoogle Scholar
  3. 3.
    Coghlan JG, Gilligan D, Humphries H, Mc Kenna D, Dooley C, Sweeney E, Keane C, O’Morain C (1987) Campylobacter pylori and recurrence of duodenal ulcers a 12-month follow-up study. Lancet 2: 1109–1111PubMedCrossRefGoogle Scholar
  4. 4.
    Collins R, Patchett S, Keane C, O’Morain C (1990) Reinfection with Helicobacter pylori due to intrafamilial clustering of the organism. Rev Esp Enf Digest Suppl 2; 0–15Google Scholar
  5. 5.
    Dooley CP, Cohen H, Fitzgibbons PL, Bauer M, Appleman MD, Perez-Perez GI, Blaser MJ (1989) Prevalence of Helicobacter pylori infection and histologic gastritis in asymptomatic persons. N Engl J Med 321: 1562–1566PubMedCrossRefGoogle Scholar
  6. 6.
    Drumm B, Sherman P, Cutz E, Karmali M (1987) Association of Campylobacter pylori on the gastric mucosa with antral gastritis in children. J Engl Med 316: 1557–1561CrossRefGoogle Scholar
  7. 7.
    Drumm B, Sherman P, Chiasson D, Karmali M, Cutz E (1988) Treatment of Campylobacter pylori associated antral gastritis in children with bismuth subsalicylate and ampicillin. J Pediatr 113: 908–912PubMedCrossRefGoogle Scholar
  8. 8.
    Drumm B, Perez-Perez GI, Blaser MJ, Sherman PM (1990) Intrafamilial clustering of Helicobacter pylori infection H Engl J Med 322: 359–363Google Scholar
  9. 9.
    George LL, Borody TJ, Andrews P, Devine M, Moore-Jones D, Walton M, Brandi S (1990) Cure of duodenal ulcer after eradication of Helicobacter pylori. Med J Aust 153: 145–149PubMedGoogle Scholar
  10. 10.
    Goodwin CS, Armstrong JA, Marshal BJ (1986) Campylobacter pyloridis, gastritis and peptic ulceration. J Clin Pathol 39: 353–365PubMedCrossRefGoogle Scholar
  11. 11.
    Goodwin C, Marshall BJ, Blincow ED, Wilson DH, Blackbourn S, Phillips M (1987) Prevention of nitroimidazole resistance in Campylobacter pylori by co-administration of colloidal bismuth subcitrate: clinical and in vitro studies. J Clin Pathol 41: 207–210CrossRefGoogle Scholar
  12. 12.
    Graham DY, Klein PD, Opekum QR, Bouton TW (1988) Effect of age on frequency of active Campylobacter pylori infection diagnosed by the 13C urea breath test in normal subjects and patients with peptic ulcer disease. J Infect Dis 157: 777–780PubMedCrossRefGoogle Scholar
  13. 13.
    Graham DY (1989) Campylobacter pylori and peptic ulcer disease. Gastroenterology 96: 615–625PubMedGoogle Scholar
  14. 14.
    Graham Dy, Opekun A, Lew CM, Evans DJ, Klein PD, Evans DG (1990) Ablation of exaggerated meal-stimulated gastrin release in duodenal ulcer patients after clearance of Helicobacter ( Campylobacter) pylori infection. Am J Gastroenterol 85: 394–398Google Scholar
  15. 15.
    Hupertz V, Czim S (1988) Demonstration of a cytotoxin from Campylobacter pylori. Eur J Clin Microbiol Infect Dis 7: 576–578PubMedCrossRefGoogle Scholar
  16. 16.
    Johnston BJ, Reed Pl, Ali MH (1986) Campylobacter like organism in duodenal and antral endoscopic biopsies: relationship to inflammation. GUT 27: 1132–1137PubMedCrossRefGoogle Scholar
  17. 17.
    Jones DM, Lessels AM, Elridge J (1984) Campylobacter like organism on the gastric mucosa: culture, histological, and serological studies. J Clin Pathol 37: 1002–1006PubMedCrossRefGoogle Scholar
  18. 18.
    Konturek SJ, Radecki T, Piastucki I, Brzozowski T, Drozdowicz 1987 ) Gastrocytoprotection by colloidal bismuth subcitrate 2 (De-Nol) and sucralfate. Role of endogenous prostaglandins. GUT 8: 201–205Google Scholar
  19. 19.
    Kralden S, Sherman P (1990) Helicobacter ( Campylobacter) pylori and acid peptic diseases. Can J Gastroenterol 4: 237–242Google Scholar
  20. 20.
    Lamouliatte H, Megraud F, De Mascarel A, Roux D, Quinton A (1987) Campylobacter pyloridis and epigastric pain: endoscopic, histological, and bacteriological correlations. Gastroenterol Clin Biol 11: 212–216PubMedGoogle Scholar
  21. 21.
    Lee FI, Samloff IM, Hardman M (1985) Comparison of tripotassium dicitratobismuthate tablets with ranitidine in healing and relapse of duodenal ulcers. Lancet 1: 1299–1302PubMedCrossRefGoogle Scholar
  22. 22.
    Leunk RD, Johnson PT, David BC, Kraft WG, Morgan DR (1988) Cytotoxic activity in broth-culture filtrates of Campylobacter pylori. J Med Microbiol 26: 93–99PubMedCrossRefGoogle Scholar
  23. 23.
    Levi S, Beardshall K, Haddad G, Playford R, Ghosh P, Calam J (1989) Campylobacter pylori and duodenal ulcers: the gastrin link. Lancet 1: 1167–1168PubMedCrossRefGoogle Scholar
  24. 24.
    Loffeld RJLF, Potters HVPJ, Stobberingh E, Flendrig JA, van Spreeuwel JP (1988) Campylobacter associated gastritis in patients with non-ulcer dyspepsia. J Clin Pathol 41: 85–88PubMedCrossRefGoogle Scholar
  25. 25.
    Logan RPH, Gummett PA, Polson RJ, Karim NQ, Baron JH, Misiewicz JJ (1990) A 1 week eradication regime for Helicobacter pylori. Rev Esp Enf Digest Suppl 1:P-269Google Scholar
  26. 26.
    Magnus HA (1952) Gastritis. In: Jones FA (ed) Modern trends in gastroenterology. Butterworth, London, 323–351Google Scholar
  27. 27.
    Marshall BJ, Warren JR (1984) Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration. Lancet 1: 1311–1315PubMedCrossRefGoogle Scholar
  28. 28.
    Marshall BJ, Armstrong JA, Me Gechie DB, Glancy RJ (1985) Attempt to fulfill Koch’s postulates for pyloric Campylobacter. Med J Aust 142: 436–439PubMedGoogle Scholar
  29. 29.
    Marshall BJ, Goodwin CS, Warren JR, Murray R, Blincow ED, Blackbourn SJ, Phillips M, Waters TE, Sanderson CR (1988) A prospective double-blind trail of ulcer relapse after eradication of Campylobacter pylori. Lancet 2: 1437–1442PubMedCrossRefGoogle Scholar
  30. 30.
    Marshall BJ, Barrett LJ, Prakash C, Mac Callum RW, Guerrant RL (1990) Urea protects Helicobacter ( Campylobacter) pylori from the bactericidal effect of acid. Gastroenterology 99: 697–702Google Scholar
  31. 31.
    Martin DF, Hollanders D, May SJ, Ravenscroft MM, Tweedle DEF, Miller JP (1981) Difference in relapse rates of duodenal ulcer healing with cimetidinde or tripotassium dicitratobismuthate. Lancet 1: 7–10PubMedCrossRefGoogle Scholar
  32. 32.
    Mc Coll KEL, Fullarton CM, Chittajalu R, El Nujumi AM, Mc Donald AM, Dahill SW, Hilditch TE (1991) Plasma gastrin, daytime intra gastric pH, and nocturnal acid output before and at 1 and 7 month after eradicaton of Helicobacter pylori in duodenal ulcer subjects. Scand J Gastroenterol 26: 339–346CrossRefGoogle Scholar
  33. 33.
    Megraud F, Brassens-Rabbe MP, Denis F, Belbouri A, Hoa DQ (1989) Seroepidemiology of Campylobacter pylori infection in various populations. J Clin Microbiol 27: 1870–1873PubMedGoogle Scholar
  34. 34.
    Morris A, Nicholson G (1987) Ingestion of Campylobacter pyloridis causes gastritis and raised fasting gastric pH. Am J Gastroenterol 82: 192–199PubMedGoogle Scholar
  35. 35.
    O’Riordan T, Mathai E, Mc Kenna D, Keane C, Sweeney E, O’Morain C (1990) Adjuvant antibiotic therapy in duodenal ulcers treated with colloidal bismuth subcitrate. GUT 31: 999–1002PubMedCrossRefGoogle Scholar
  36. 36.
    Nowottny U, Heilmann KL (1990) Epidemiologie der Helicobacter pylori Infection. Leber Magen Darm 20: 180186Google Scholar
  37. 37.
    Patrick WJA, Denham D, Forrest PM (1974) Mucous changes in the human duodenum: a light and electron microscopic study and correlation with disease and gastric acid secretion. GUT 15: 767–776PubMedCrossRefGoogle Scholar
  38. 38.
    Perez-Perez GI, Dworkin BM, Chodes JE, Blaser MJ (1988) Campylobacter pylori antibodies in humans. Ann Intern Med 109: 11–17PubMedCrossRefGoogle Scholar
  39. 39.
    Price AB, Levi J, Dolby JM, Dunscombe PL, Smith A, Clark J, Stephenson ML (1985) Campylobacter pyloridis in peptic ulcer disease: microbiology, pathology, and scanning electron microscopy. GUT 26: 1183–1188PubMedCrossRefGoogle Scholar
  40. 40.
    Rauws EAJ, Langenberg W, Houthoff JH, Zanen HC, Tytgat GWJ (1988) Campylobacter pyloridis-associated chronic active antral gastritis. A prospective study of its prevalence and the effects of antibacterial, and anti-ulcer treatment. Gastroenterology 94: 33–40Google Scholar
  41. 41.
    Rauws EAJ, Tytgat GNJ (1990) Cure of duodenal ulcer associated with eradication of Helicobacter pylori. Lancet 1: 1233–1235CrossRefGoogle Scholar
  42. 42.
    Rhodes J (1964) Experimental production of gastric epithelium in the duodenum. GUT 5: 454–458PubMedCrossRefGoogle Scholar
  43. 43.
    Rokkas T, Pursey C, Uzoechina E, Dorrington L, Simmons NA, Filipe MI, Sladen GE (1987) Campylobacter pylori and non-ulcer dyspepsia. Am J Gastroenterol 82: 1149–1152PubMedGoogle Scholar
  44. 44.
    Sarosiek J, Slomiany A, Slomiany BL, (1988) Evidence for weaking of gastric mucus integrity by Campylobacter pylori. Scand J Gastroenterol 23: 585–590PubMedCrossRefGoogle Scholar
  45. 45.
    Slomiany BL, Bilski J, Sarosiek J, Murty VLN, Dworkin B, van Horn K, Zielenski J, Slominany A (1987) Campylobacter pyloridis degrades mucin and undermines gastric mucosal integrity. Biochem Biophys Res Commun 144: 307–314PubMedCrossRefGoogle Scholar
  46. 46.
    Slomiany BL, Nishikawa H, Piotrowski J, Okazaki K, Slomiany A (1989) Lipolytic activity of Campylobacter pylori: effect of sofalcone. Digestion 43: 33–40PubMedCrossRefGoogle Scholar
  47. 47.
    The Gastrointestinal Physiology Working Group (1990) Helicobacter pylori gastritis in Peruvian patients: relationship to socioeconomic level, age, and sex. Am J Gastroenterol 85: 819823Google Scholar
  48. 48.
    Tricottet V, Bruneval P, Vire O, Camilleri P (1986) Campylobacter-like organisms and surface epithelicum abnormalities in active, chronic gastritis in humans an: ultrastructural study. Ultrastruct Pathol 10: 113–122PubMedCrossRefGoogle Scholar
  49. 49.
    Tytgat GNJ, Axon ATR, Dixon MF, Graham DY, Lee A, Marshall BJ (1990) Helicobacter pylori: causal agent in peptic ulcer disease? Working Party Reports of the World Congresses of Gastoenterology 36–45Google Scholar
  50. 50.
    Warren JR, Marshall B (1983) Unidenitfied curved bacilli on gastric epithelium in active chronic gastritis. Lancet 1: 1273–1275Google Scholar
  51. 51.
    Wyatt JI, Rathbone BJ, Dixon MF, Heatley RV (1987) Campylobacter pyloridis and acid induced gastric metaplasia in the pathogenesis of duodenitis. J Clin Pathol 40: 841–848PubMedCrossRefGoogle Scholar
  52. Arnold LJ Jr, Hammond PW, Weiss WA, Nelson NC (1989) Assay formats involving acridiniumester labeled DNA probes. Clin Chem 35: 1588–1594PubMedGoogle Scholar
  53. Böddinghaus B, Rogall T, Flohr T, Blöcker H, Böttger EC (1990) Detection and Identification of Mycobacteria by amplification of rRNA. J Clin Microbiol 28: 1751–1759PubMedGoogle Scholar
  54. Daly JA, Clifton NL, Seskin KC, Gooch III WM (1991) Use of rapid, nonradioactive DNA probes in culture confirmation tests to detect Streptococcus agalactiaeGoogle Scholar
  55. Haemophilus influenzae, and Enterococcus spp. from pediatric patients with significant infections. J Glin Microbiol 29:80–82Google Scholar
  56. Edman JG, Kovacs JA, Masur H, Santi DV, Elwood HJ, Sogin ML (1988) Ribosomal RNA sequence shows Pneumocystis carinii to be a member of the fungi. Nature 334: 519–522PubMedCrossRefGoogle Scholar
  57. Eisenstein BI, Engleberg NG (1990) Avoiding mistaken identities. Gell 63: 1125–1127Google Scholar
  58. Haun G, Göbel U (1987) Oligonucleotide probes for genus-, species-, and subspecies-specific detection of representatives of the genus Proteus. FEMS Microbiol Lett 43: 187–193CrossRefGoogle Scholar
  59. Hill WE, Dahlberg A, Garrett RA, Moore PB, Schlessinger D, Warner JR (eds) (1990) The Ribosome. Structure, Function, Evolution. American Society for Microbiology, Washington D.C.Google Scholar
  60. Gassen HG, Martin A, Bertram S (1985) Gentechnik. Gustav Fischer, Stuttgart.Google Scholar
  61. Göbel UB, Geiser A, Stanbridge EJ (1987) Oligonucleotides complementary to variable regions of ribosomal RNA discriminate between mycoplasma species. J Gen Microbiol 133: 1669–1974Google Scholar
  62. Innis MA, Gelfand DH, Sninsky JJ, White TJ (eds) (1990) PG1R protocols. Academic Press, San Diego.Google Scholar
  63. Keller GH, Manak MM (1989) DNA probes. Stockton Press, New York.Google Scholar
  64. Kwok S, Higuchi R (1989) Avoiding false positives with PCR. Nature 339: 237–238PubMedCrossRefGoogle Scholar
  65. Macario AJL, Gonway de Macario (eds) (1990) Gene probes for bacteria. Academic Press, San Diego.Google Scholar
  66. Peter JB (1991) The polymerase chain reaction: Amplifying our options. Rev Infec Dis 13: 166–171CrossRefGoogle Scholar
  67. Relman DA, Loutit JS, Schmidt TM, Falkow 5, Tompkins LS. (1990) The agent of bacillary angiomatosis. An approach to the identification of uncultured pathogens. New Engl J Med 323: 1573–1580Google Scholar
  68. Rogall T, Wolters J, Flohr T, Böttger EC (1990) Towards a phylogeny and definition of species within the genus Mycobacterium. Int J Syst Bacteriol 40: 323–330PubMedCrossRefGoogle Scholar
  69. Rossau R, Duhamel M, Dyck van E, Piot P, Heuverswijn van H (1990) Evaluation of an rRNA-derived oligonucleotide probe for culture confirmation of Neisseria gonorrhoeae. J Glin Microbiol 28: 944–948Google Scholar
  70. Rossau R, Vanmechelen E, De Ley J, Heuverswijn van H (1989) Specifiv Neisseria gonorrhoeae DNA-probes derived from ribosomal RNA. J Gen Microbiol 135: 1735–1745.PubMedGoogle Scholar
  71. Sanger F, Nicklen S, Soulson, AR (1977) DNA sequencing with chain-termination inhibitors. Proc Natl Acad Sci USA 74: 5463–5467PubMedCrossRefGoogle Scholar
  72. Tenover FC (ed) (1989) DNA probes for infectious diseases. CRC Press, Boca Raton.Google Scholar
  73. Weisburg WG, Barns SM, Pelletier DA, Lane DJ (1991) 16S ribosomal DNA amplification for phylogenetic study. J Bacteriol 173: 697–703Google Scholar
  74. Woese SR (1987) Bacterial Evolution. Microbiol Rev 51: 221–271PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1991

Authors and Affiliations

  • R. Lüthy
    • 1
  • K.-H. Meyer zum Büschenfelde
    • 2
  • K. J. Hengels
    • 3
  • G. Strohmeyer
    • 3
  • H. Lode
    • 3
  • G. Höffken
    • 4
  • T. Schaberg
    • 4
  • P. Herzer
    • 5
  • K.-H. Meyer zum Herzer
    • 6
  • U. B. Göbel
    • 7
  • V. ter Meulen
    • 8
  1. 1.ZürichSchweiz
  2. 2.MainzDeutschland
  3. 3.Abteilung GastroenterologieMedizinische Klinik und Poliklinik der Universität DüsseldorfDeutschland
  4. 4.Pneumologische Klinik I — Infektiologie Immunologie des Städtischen Krankenhauses Berlin-ZehlendorfDeutschland
  5. 5.Medizinische PoliklinikUniversität MünchenDeutschland
  6. 6.Medizinische PoliklinikUniversität MainzDeutschland
  7. 7.Institut für Medizinische Mikrobiologie und Hygiene KlinikumUniversität FreiburgDeutschland
  8. 8.Institut für Virologie und ImmunbiologieUniversität WürzburgDeutschland

Personalised recommendations