Hubungan Polimorfisme VEGF +936 C>T dengan Infiltrasi Neutrofil dan Limfosit pada Pasien Gastritis Helicobacter Pylori

Abstract

Pendahuluan : Aktivasi angiogenesis dirangsang oleh Vascular endothelial growth factor (VEGF) dalam sel inang berperan dalam kerusakan mukosa lambung pada pasien gastritis akibat H. pylori. Keberadaan polimorfisme pada gen VEGF dikaitkan dengan peningkatan risiko beberapa gangguan seperti kanker lambung. Infiltrasi neutrofil dalam mukosa lambung adalah karakteristik gastritis akut. Ini menjadi peradangan kronis yang ditandai dengan infiltrasi limfosit. Kondisi ini menyebabkan komplikasi atrofi kelenjar dan metaplasia epitel mukosa lambung dan mengakibatkan keganasan lambung. Tujuan penelitian ini untuk menganalisis hubungan antara VEGF +936 C>T gen polimorfisme dengan tingkat neutrofil dan infiltrasi limfosit pada pasien gastritis dengan H. pylori. Metode: Sampel diperoleh melalui pengambilan sampel berturut-turut pada Bulan April-Agustus 2019. Gastritis dipastikan melalui endoskopi dan histologis, didefinisikan melalui sistem Sydney. H. pylori diperiksa melalui Campylobacter Like Organism test (CLO) dan VEGF + 936C> T gen polimorfisme dipastikan menggunakan VEGF. Analisis persegi Chi digunakan dalam penelitian untuk menentukan hubungan antara VEGF + 936 C>T gen polimorfisme dengan derajat neutrofil dan limfosit menyusup. Hasil: Dari 60 pasien gastritis, terdapat genotipe CT (37,5%), genotipe CC (36,7%), dan genotipe TT ( 35%). Pasien dengan genotipe CC meningkatkan risiko infiltrasi neutrofil sedang dan berat 18 kali lipat dibandingkan genotipe CT+TT (p=0,001). Tidak ada hubungan antara VEGF + 936 C>T polimorfisme dan tingkat infiltrasi limfosit (p = 0,293) Kesimpulan: Ada hubungan yang signifikan antara VEGF + 936 C>T polimorfisme dan tingkat infiltrasi neutrofil tetapi tidak ada VEGF + 936 C>T polimorfisme dan tingkat infiltrasi neutrofil

Introduction : Activation of angiogenesis stimulated by Vascular endothelial growth factor (VEGF) in host cells play a role in response to damaged gastric mucosal in gastritis patient with H. pylori infection. Study shown that presence of polymorphisms in VEGF gene is associated with an increased risk of several disorders like gastric cancer. Infiltration of neutrophils in the gastric mucosa is the characteristic of acute gastritis. It can become chronic inflammation characterized by lymphocyte infiltration. This condition can lead to complications of glandular atrophy and intestinal metaplasia in the gastric mucosal epithelium and subsequently cause gastric malignancy. The aim of this study to analyzed association between VEGF +936 C>T polymorphism gene with degree of neutrophils and lymphocytes infiltration in gastritis patients with H. pylori. Methods: Samples were obtained through consecutive sampling in April-August 2019. Gastritis was ensured by endoscopy and histologic feature was defined by Sydney system. H. pylori was examined by Campylobacter Like Organism test (CLO) and VEGF + 936 C> T gene polymorphism was ensured using VEGF (R&D system). Chi square analysis was used in this study to determine the association between VEGF + 936 C>T gene polymorphism with degrees of neutrophils and lymphocytes infiltrates. Results: Of 60 gastritis patients, there were CT genotype (37.5%), followed by CC genotypes (36.7%), and TT genotypes ( 35%). Patients with CC genotype increased the risk of 18 times moderate and severe neutrophil infiltration compared to CT+TT genotype (p=0.001). There is no relationship between VEGF + 936 C>T polymorphism and the degree of of lymphocytes infiltration (p=0.293) Conclusion: There were a significant associations between VEGF + 936 C>T polymorphism and the degree of neutrophil infiltration but there were no VEGF + 936 C>T polymorphism and the degree of neutrophil infiltration