Abstract
The current data suggest that Helicobacter pylori infection and type 2 diabetes mellitus may affect the state of nitric oxide system, which significantly influences stomach functioning. The aim of the research was to study the state of nitric oxide system in patients with Helicobacter pylori-associated chronic gastritis and concomitant type 2 diabetes mellitus, and to investigate the potential of eupatilin in its correction. 172 patients with confirmed chronic gastritis were enrolled into the study. They were divided into 4 groups: І (n=71) included individuals with Helicobacter pylori-positive chronic gastritis and type 2 diabetes mellitus; ІІ (n=21) included patients with Helicobacter pylori-negative chronic gastritis and type 2 diabetes mellitus; ІІІ (n=48) included patients with Helicobacter pylori-positive chronic gastritis without type 2 diabetes mellitus; IV (n=32) was made up with individuals having Helicobacter pylori-negative chronic gastritis without type 2 diabetes mellitus. According to prescribed therapeutic schemes the patients of groups І and ІІІ were additionally subdivided into the following subgroups: groups I-A (n=35) and III-A (n=24) underwent anti-Helicobacter therapy, groups I-В (n=36) and III-B (n=24) were prescribed to receive anti-Helicobacter therapy and eupatilin. Anti-Helicobacter therapy included pantoprazole 40 mg, amoxicillin 1000 mg and clarithromycin 500 mg bid for 10 days. The patients received Eupatilin as an active agent of Stilen preparation, which contains 0.48 – 1.44 mg of eupatilin, tid for 28 days. Nitrites content and activity of inducible and constitutional nitric oxide synthases were analyzed in blood serum before the treatment and on the 28th day after the therapy completed. The patients of group I before the treatment were found to have an increase of nitrites level in 1.4 times, inducible nitric oxide synthase in 1.5 times higher in comparison to the patients of group II. An activity of constitutional nitric oxide synthase in patients with chronic gastritis and type 2 diabetes mellitus was found to be decreased regardless the Helicobacter pylori-status in 2.3 and 2.7 times in comparison to the patients of groups III and IV respectively. Eupatilin prescription promoted Helicobacter therapy eradication and treatment outcomes through nitrites decrease in 1.5 times, reduction of inducible nitric oxide synthase activity in 1.2 times, and growth of constitutional nitric oxide synthase in1.2 times in patients of I-B group in comparison to group I-A. Combined anti-Helicobacter therapy with eupatilin promotes successful Helicobacter pylori eradication, which was 6.2% higher in patients of I-B group than in I-A group. Conclusions: Helicobacter pylori-associated chronic gastritis in patients with type 2 diabetes mellitus is followed by rise of nitrites, inducible nitric oxide synthase activity and simultaneous decline of constitutional nitric oxide synthase in blood serum. Eupatilin prescription as a component of integrated anti-Helicobacter therapy increases the efficacy of Helicobacter pylori eradication and improves the state of nitric oxide-system due to its anti-inflammatory, antioxidant and cytoprotective properties.
Highlights
Ключові слова: хронічний гастрит, цукровий діабет 2 типу, Helicobacter pylori, еупатілін, оксид азоту, синтаза оксиду азоту, нітрити
The current data suggest that Helicobacter pylori infection and type 2 diabetes mellitus may affect the state of nitric oxide system
The aim of the research was to study the state of nitric oxide system in patients
Summary
– 31.30±1.16 and 27.30±0.92 years, respectively (p=0.02). There was no difference in the number of pregnancies in women between both groups. Що інфекція Helicobacter pylori та цукровий діабет 2 типу можуть впливати на стан системи оксиду азоту, яка значною мірою визначає функціональний стан шлунку. Мета: вивчити стан системи оксиду азоту у хворих на Helicobacter pylori-асоційований хронічний гастрит та супутній цукровий діабет 2 типу та дослідити можливість корекції виявлених змін еупатіліном. У хворих на хронічний гастрит у поєднанні з цукровим діабетом 2 типу не залежно від Helicobacter pylori-статусу відмічалося зниження у сироватці крові активності конституціональної синтази оксиду азоту у 2,3 та 2,7 рази у порівнянні з ІІІ та IV групами відповідно. Висновки: розвиток Helicobacter pylori-асоційованого хронічного гастриту на фоні цукрового діабету 2 типу супроводжується зростанням вмісту у сироватці крові нітритів та активності індуцибельної синтази оксиду азоту на фоні зниження конституціональної синтази оксиду азоту. Вивчити стан системи NO у хворих на НРасоційований хронічний гастрит (ХГ) із супутнім ЦД2 та дослідити можливість корекції виявлених змін за допомогою еупатіліну
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