The Role of Autoimmune Reactivity in Pathogenesis of Complicated Forms of Peptic Ulcer Disease in Adults and Children

The incidence of peptic ulcer disease does not tend to decrease, and the number of its complicated forms in recent years remains at a high level in Russia. The literature review discusses current views on the pathogenesis of gastric ulcer and duodenal ulcer, including the importance of Helicobacter pylori infection, data on the comorbidity of helicobacteriosis with other autoimmune conditions, as well as from the position of autoimmunity in general, taking into account the prevalence of the paradigm of the infectious origin of peptic ulcer pathogenesis to date. The paper analyzes pathogenetic features and clinical/pathomorphological manifestations of peptic ulcer disease associated with the use of aluminum-containing drugs (in view of adjuvant properties of aluminum) as well as the influence of calcium metabolism disorders in peptic ulcer disease. Pediatric and adolescent aspects of the problem are particularly considered. Ideas about the role of autoimmunity in peptic ulcer disease have been developing since the mid 60s of the last century. There is evidence of provocation by infectious factors and drugs that production of autoantibodies against some antigens of gastric mucosal cells, including immunoglobulins, which have a histamine-like effect. There are data on the ability of Helicobacter pylori to provoke autoimmunity to extragastric autoantigens, including platelet receptors, which may be associated with impaired hemostasis. A number of in vitro studies did not confirm the stimulating effect of autoantibodies on the gastric cells. The meager and contradictory data regarding the role of autoimmunity and its regulation/disregulation in peptic ulcer disease suggest the need for further scientific research and the development of laboratory diagnostic methods. It is necessary to clarify the nature and extent of autoimmune processes occurring in complicated peptic ulcer disease as well as the relations to other autoimmunopathies.