The Effect of Psychological Stress on Mucosal IL-6 and Helicobacter pylori Activity in Functional Dyspepsia
Abstract: pathophysiology of
functional dyspepsia remains poorly understood. Many factors such as gastric
motility disorder, visceral hypersensitivity, Helicobacter pylori (Hp)
infection, psychological stress and excessive gastric acid secretion play roles
in this symptom. Psychological stress may promote peptic ulcer and has an
effect on ulcers-associated Hp. This study aimed to determine Helicobacter
pylori activity and expression of mucosal IL-6 and their association with
psychological stress. Methods: a cross-sectional study was done among 40
outpatients with dyspeptic syndromes in M. Djamil General Hospital and
two-community health centers in Padang. The subjects were divided into two
groups, with and without psychological stress, which were identified using DASS
42. Gastric biopsy specimens and peripheral blood samples were taken while
performing esophagogastroduodenoscopy. Immunohistochemistry methods was used to
determine the expression of IL-6 and Hp in gastric mucosa. The correlation of
each variable in the group experiencing psychological stress and non-stress was
analyzed using Chi-square test. Results: there were 40 patients with functional
dyspepsia with average age of 37.58(SD 11.82) years old. The cortisol levels
were significantly different between both groups (non-stress vs. stress
groups); moreover, morning cortisol level in psychological stress group was
higher beyond normal limit. Inter-Leukin-6 expression, as the evidence of
inflammatory activity, seemed higher in non-stress group than the group with
psychological stress (8.25% vs. 7.25%). Helicobacter pylori activity was seemed
to be increased in the stress group as characterized by higher numbers of
invasion to the sub mucosa epithelium compared to the non-stress group (11 vs.
7 subjects). Conclusion: psychological stress seems to have no correlation with
IL-6 in gastric mucous of patients with functional dyspepsia; however, there is
an evidence of increasing activity of Helicobacter pylori.
Keywords: functional
dyspepsia; Helicobacter pylori; psychological stress; interleukin 6 (IL-6)
Author: Eryati Darwin, Arina
Widya Murni, Adnil E Nurdin
Journal Code: jpkedokterangg170325
