Abstract

Growth of duodenal pathology in patients of different age groups determines the relevance of the study. Causes duodenal disease sufficiently heterogeneous and include celiac disease, gluten allergy and various proteins, autoimmune disease, atopy, and also bacterial, parasitic and viral infection (Helicobacter pylori infection, giardiasis, etc.). One of the characteristics of the mucosal morphofunctional state is its neuroendocrine PDK activity, which is provided enteroendocrine cells, and chromogranin synthesising neuropeptides, in particular, chromogranin A (CgA), ghrelin and serotonin.

The aim of our study was to determine whether these markers in the duodenal mucosa with similar morphological manifestations duodenitis of various etiologies in children. The material of the study were 40 distal duodenal biopsies, obtained by fibrogastroduodenoscopy in children aged 6 to 17 years old with morphologically verified chronic gastroduodenitis (CGD).

The first group consisted of children with celiac disease, the second group – with Helicobacter pylori infection (NR), the third group consisted of children with giardiasis, in the fourth (the control group) – children with reliably excluded above listed diseases and preserved architectonic duodenal mucosa without morphological features of HD.

When immunohistochemical study expression levels were determined Chromogranin A (Abcam 1: 400); Serotonin (Abcam 1:50); Ghrelin (Abcam 1: 100). The intensity of the reaction was assessed by two indicators – the relative area of expression and the optical density.

In our study, for the first time we studied enteroendocrine markers in duodenitis of various etiologies. We were looking for a morphological tool that will help differentiate duodenitis with similar clinical and histological features. Increased expression of ghrelin, serotonin and chromogranin A, plays an important role in the mechanisms of duodenum structure disorders in celiac disease. When Hp infections a decrease in all studied markers, while giardiasis is not observed significant changes. All of this allows us to differentiate duodenitis aetiology and, therefore, reasonable to appoint therapeutic measures.