To evaluate the effectiveness of alpha-glutamyl-tryptophan as a cytoprotector in comparison with the control group (placebo) as part of the complex therapy of chronic atrophic H. pylori (HP)-associated gastritis. A total of 121 patients with chronic atrophic HP-associated gastritis were observed in 3 research centers. Before and after treatment blood test “Gastropanel”, stomach endoscopy with biopsies of atrophied mucosa for histological examination, rapid urease test for H. pylori detection, and daily pH-metry were performed. After HP eradication, according to randomization, the study drug (n = 61) or placebo (n = 60) was administered twice a day, in the morning 20–30 minutes before meals and in the evening before bedtime for 28 days. Alpha-glutamyl-tryptophan intake is associated with a statistically significant increase in acidity index according to pH-metry (p = 0.001), an increase in the ratio of pepsinogen I/pepsinogen II (p = 0.003), decrease in the level of gastrin-17 (p = 0.005), increase in the number of glands per 1 mm2 of the gastric mucosa (р = 0.028). Alpha-glutamyl-tryptophan in the treatment of chronic atrophic HP-associated gastritis has a superior regenerative effect compared with placebo, and promotes the restoration of acid-forming and pepsin-forming functions of the stomach.

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Prevention of gastric cancer, both primary and secondary, is an extremely important component of the management of gastroenterological patients. The correct collection of anamnesis with an assessment of the hereditary (family) cancer risk, the action of risk factors (eating disorders, habitual/chronic intoxication, obesity, Helicobacter pylori infection, etc.), as well as the use of gastroprotectors (in particular, the drug Regastim Gastro), especially in persons with potentially precancerous the condition is chronic atrophic gastritis. According to the data of a double-blind placebo-controlled randomized study Regastim Gastro (active ingredient alpha-glutamyl tryptophan) in the treatment of chronic atrophic gastritis, it was found that this drug has a powerful anti-inflammatory effect and regenerative activity. Taking the drug Regastim Gastro, compared with placebo, statistically significantly contributed to a decrease in the number of inflammatory infiltration cells per 1 mm2 of the gastric mucosa. Regastim Gastro decreases in eosinophilic (3 times) and neutrophilic (4 times) infiltration of the gastric mucosa and also reduced the number of macrophages, lymphocytes and plasmocytes. In addition to anti-inflammatory properties, the drug also had a pronounced regenerative effect. Taking of Regastim Gastro statistically significant (p=0.028) increases in the number of glands per 1 mm2 of the gastric mucosa by 26.1% compared with the initial screening indicators. In the group of patients taking placebo, on the contrary, there was a further progression of the pathological process, accompanied by a decrease in the number of glands per 1 mm2 of the gastric mucosa after the end of treatment in comparison with the initial indicators. After the course of therapy, the number of glands per 1 mm2 of the gastric mucosa in patients taking the drug Regastim Gastro was statistically significantly higher in comparison with the results in the placebo group (p=0.013). After the course of Regastim Gastro, there was an improvement in acid production: a shift in the acidic side of the average pH value (1.6 times) and an increase in the value of the acidity index, both when compared with the initial values (5.4 times) and in comparison with the placebo group (2.9 times). The intake of Regastim Gastro to patients with gastritis, both H. pylori (+) and H. pylori (-) before the development of atrophy of the gastric mucosa can reduce the inflammatory factor, prevent the occurrence of atrophy and may have maximum anti-carcinogenic action.