EFFECT OF GABOB IN THE INFLAMMATORY RESPONSE OF RHEUMATOID ARTHRITIS PATIENTS WITH H. PYLORI AND NSAIDS TREATMENT

Hernández-Ramírez María de los Angeles, Maldonado-Bernal Carmen, Hernández-Calleros Jorge, Gómez-Quiroz Luis Enrique, Martínez-Benítez Braulio, Alfaro-Lara Roberto, Barbero-Becerra Varenka J, Gutiérrez-Ruiz María Concepcion,*, Vargas-Vóracková Florencia,†

ABSTRACT

Helicobacter pylori (Hp) and non-steroidal anti-inflammatory drugs(NSAID) are the major causes of gastric-disorders. Oral GABA-treatment down-regulates inflammatory-responses in rheumatoid-arthritis (RA) models. We investigate the anti-inflammatory effect of oral-ingestion of GABOB in dyspeptic-patients with RA and NSAID intake to establish if Hp-colonization contributes to the association between NSAID and peptic damage. 26 patients with RA who took NSAIDs and dyspeptic-symptoms were recruited. Patients were tested for Hp-infection. TNF-α, TGF-α, TGF-β, IL-10, IL-8, NO expression and secretion were determined in antrum-duodenum biopsy and plasma before-after GABOB-treatment. Immohistochemistry and Sydney evaluation were also conducted. Severity of dyspepsia assessment (SODA) test was applied. Ten patients were Hp+ and 16 Hp-. IL-8 expression presented higher-values in antrum from patients Hp+, and it correlated with greater inflammatory-infiltration. Data didn´t show significant changes in cytokine-levels as a result of GABOB, except IL-8 secretion that increased in Hp+ duodenum biopsy. Moreover, it was observed an increase of Smad3 expression in Hp- duodenum and a decrease in TGF-β plasma-levels in the same patients. Apparently, Hp colonization doesn´t contribute to increased damage, since we didn´t find any correlation among dose, NSAID type, time consuming and gastropathy. These findings suggest that GABOB-treatment improves dyspepsia-tolerability at 60% and 69% of Hp+ and Hp- patients. However, 4 weeks of GABOB-treatment didn´t improved inflammatory-mediators in gastric-biopsies nor in plasma-levels.

Keywords: cytokines, antrum, duodenum, Sydney evaluation, SODA test.