Objective was to study the level of tumor necrosis factor α (TNF-α) and interleukin 1α (IL-1α) in the blood of children with various forms of functional dyspepsia in accordance with various endoscopic changes of the gastric mucosa.
Materials and methods. 79 school age children with functional dyspepsia were examined. The diagnosis was made in accordance with the recommendations of the Rome Criteria IV (2016). All patients underwent endoscopic examination of the esophagus, stomach and duodenum to exclude destructive changes of the mucous membrane. The level of TNF-α and IL-1α in the blood serum was determined by enzyme immunoassay. Statistical processing of the results obtained was performed using Microsoft Excel 2010.
Results. The average level of TNF-α in the total group was 463.22±27.4 pg/ml, which statistically significantly exceeded this indicator in the control group (26.76±1.10 pg/ml; p<0.01). The IL-1α value in the total group was 148.6±6.06 pg/ml and was significantly higher in comparison with the control group (53.29±3.28 pg/ml; p<0.01). The level of proinflammatory cytokines in the group of children with epigastric pain syndrome was significantly higher than in the group of children with postprandial distress syndrome. Endoscopic examination showed the presence of unchanged mucous membrane in only 25.3% of children. Erythematous gastroduodenopathy was observed in 74.7% of children and was typical mainly for patients with epigastric pain syndrome (97.7%; p<0.05).
Conclusions. The level of pro-inflammatory cytokines in children with functional dyspepsia is increased. When comparing the clinical variants of the disease, a significant increase in the level of TNFα, and IL-1α in children with epigastric pain syndrome was found. In the same group of children, endoscopic changes in the gastric mucosa were more pronounced. Further study of changes in the level of pro-inflammatory cytokines in children with functional dyspepsia may allow this to be used as one of the methods for the differential diagnosis of functional dyspepsia and chronic gastritis.
Efficacy and safety of manual acupuncture manipulations with different frequencies on epigastric pain syndrome (EPS) in functional dyspepsia (FD) patients: study protocol for a randomized controlled trial