ROLE OF ACUTE INFLAMMATORY RESPONSE IN THE DEVELOPMENT OF ULCER BLEEDING

The goal of this study was to estimate the severity of the acute inflammatory response in patients with primary and recurrent bleeding under peptic ulcers of stomach and duodenum. Evaluation of peripheral blood and biopsies of the marginal zone of ulcers was conducted among patients with acute ulcer bleeding who were subdivided into two groups according the outcome: with effective hemostasis (group 1, n = 35) and in the development of rebleeding (group 2, n = 40). There were no differences between patients of the 1st and 2nd groups with respect to age, male sex, and previous ulcer disease. Thus, the histological investigation showed the link between the local macrophages' reaction and the increased recruitment of neutrophils in the margin of ulcers. In addition, the realization of exaggerated acute inflammatory reaction in the ulcer margin, which is considered to be one of the sources of healing, was associated with a progressive damage of tissues in width and depth resulting in rebleeding. In addition it was shown that leukocytes modulate platelet reactivity leading to hemostasis failure due to inhibition of platelets' response to collagen.