Gastric corpus atrophy following eradication of Helicobacter pylori

Larkin, Catherine J.; Watson, Peter; Sloan, James M.; Ardill, Joy; Patterson, Christopher; Mccluggage, William G.; Buchanan, K. D.

doi:10.1097/00042737-200104000-00012

Cited by 15 publications

(9 citation statements)

References 24 publications

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“…Hojo et al (10), in their recent review article, indicated that atrophy and IM generally did not improve among all patients and that disagreement between the studies was not totally due to the sample size or follow-up period. Various sample sizes of 5, 20, 22, 40, and 163 patients (14,6,7,12,8) and follow-up periods of 5, 6, 12, 48, and 60 months (14,12,8,7,6) have been reported. According to Satoh et al (6), some reports showed that the grades of body atrophy decreased significantly after eradication, while others showed no change, indicating that this disagreement might be related to the grade of atrophy, mild, moderate, or severe, before treatment.…”

Section: Discussionmentioning

confidence: 99%

“…The majority of studies reported on H. pylori eradication and follow-up in the last 5 years were from Japan (6)(7)(8)(9)(10) and the others were single studies from Western countries (11)(12)(13)(14)(15). From these studies, discrepancies among the results were noticed and it was concluded that atrophy and IM were reversible only in some patients regardless of the sample size and the follow-up period.…”

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A Follow-up Study on the Effect of Helicobacter pylori Eradication on the Severity of Gastric Histology

et al. 2005

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Helicobacter pylori genetic diversity and geographic distribution affect the severity of gastric histology; while eradication heals gastritis, the improvement of atrophy and intestinal metaplasia (IM) is still controversial. We investigated whether H. pylori infection and genotypes (cagA-vacA) influence the histological changes and whether eradication resolves these changes. Twenty-one patients (11 duodenal ulcer, 2 gastric ulcer, 8 gastritis) received treatment. Biopsies for CLO, PCR, histology, and culture were collected before and at 1 and 12 months after treatment, and serum samples at 0, 1, 2, 6, and 12 months. H. pylori eradication was achieved in 71% of the patients. Histological scores for H. pylori densities were significantly higher in the antrum and incisura angularis. Scores for mononuclear cell and neutrophil infiltration were significantly higher in regions with a high H. pylori density and improved progressively after eradication. Eight patients with atrophy including five with IM showed no significant changes 12 months after eradication. The cagA gene, detected in 13 (62%), the vacA-s1a gene, in 20 (95%), and the vacA-m1 gene, in 12 (57%) of 21 patients were significantly associated with duodenal ulcer. A gradual decline in antibody titer reached an average of 67% 12 months after eradication. H. pylori infection and the associated genotypes (cagA of Western type) affect the severity of the gastric histology (mild forms of atrophy and IM) and the disease outcome. Eradication of H. pylori resulted in healing of gastritis, but with no significant improvement in atrophy or IM.

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Section: Discussionmentioning

confidence: 99%

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A Follow-up Study on the Effect of Helicobacter pylori Eradication on the Severity of Gastric Histology

et al. 2005

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“…Moreover, it should be noted that 20 out of 21 studies demonstrated the reduced level of serum gastrin by H. pylori eradication therapy, suggesting improvement of inflammation in the corpus (table 2) [18, 19, 21, 22,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49]. The level of somatostatin and the number of D cells have been reported to increase after therapy [38, 45,][50], although this requires biopsy specimens for the estimation.…”

Section: Pepsinogen Gastrin and Gastric Acid Secretionmentioning

confidence: 99%

Biomarkers in Patients with Gastric Inflammation: A Systematic Review

et al. 2005

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Background: The importance of examining the status of gastric inflammation has been acknowledged; the new classification by the updated Sydney system (USS) allows us to evaluate the quantitative status of gastric inflammation. However, this system is based on the histological classification derived from biopsy specimens. Therefore, more convenient, objective and practical biomarkers are recommended. Aim: We undertook a systematic review to find out potential biomarkers by summarizing the relationship between biomarkers and grades of inflammation. Methods: By a primary search via Medline up to December 2004, we extracted a total of 6,526 papers that described biomarkers for human gastric inflammation. All papers were screened by title and abstract. The authors then retrieved 435 citations for complete review; ultimately 231 were appropriate for inclusion criteria. These papers were subclassified into several categories and summarized by each author. Results: In addition to standard markers such as pepsinogens, we confirmed the close relationship between the levels of several biomarkers including gastrin, interleukin-8, HLA class II molecules, reactive oxygen species, and the histological grades. Conclusions: This review provides valuable information describing the clinical implication of these biomarkers for evaluating the static conditions or dynamic alterations of human gastric inflammation.

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“…A long term study with five year follow up from China have reported no change in the degree of intestinal metaplasia (IM) and atrophy after successful eradication [3]. In other long term randomized controlled trials there was a significant regression of preneoplastic lesions such as atrophy and IM among those who had cleared the infection after five to six years of follow up [4,5]. A definite cure of peptic ulcer disease and prevention of ulcer complications, as well as cure of mucosa-associated lymphoid tissue (MALT) lymphoma is dependent on successful eradication of H. pylori .…”

Section: Introductionmentioning

confidence: 99%

Low rate of recurrence of Helicobacter Pylori infection in spite of high clarithromycin resistance in Pakistan

et al. 2013

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BackgroundThe aim was to investigate the reinfection rate of H. pylori during a follow-up period of 12 months in adults who had undergone eradication therapy.MethodsOne hundred-twenty patients; 116 with gastritis, 3 with duodenal ulcer and 1 gastric ulcer, were studied. Their mean age was 41 ± 13 years (range 18–77) and male: female ratio of 2:1. H. pylori were cultured and antibiotic sensitivity was determined by Epsilometer test (E-test) for clarithromycin (CLR) and amoxicillin (AMX). Primers of urease C gene of H. pylori and Sau-3 and Hha I restriction enzymes were used for polymerase chain reaction-restriction fragment length polymorphism analysis (PCR-RFLP). 14C urea breath test (14C-UBT) was performed 4 weeks after the eradication therapy. The successfully treated patients were observed for 12 months with 14C-UBT to assess H. pylori status. If 14C-UBT was negative, it was repeated after every 12 weeks. If 14C-UBT was positive, endoscopy was repeated with biopsies.ResultThe eradication therapy was successful in 102(85%) patients. Out of forty-seven H. pylori isolates cultured, clarithromycin sensitivity was present in 30(64%) and amoxicillin in 45(98%), respectively. Follow-up 14C-urea breath tests of all 102 patients who eradicated H. pylori remained negative up to 9 months. However, in 6 patients, the 14C-UBT confirmed recurrence at 12 months. The recurrence rate was 6%.ConclusionA low rate of recurrence of H. pylori infection was found in patients with dyspeptic symptoms. H. pylori isolates demonstrated a high invitro clarithromycin resistance.

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Gastric corpus atrophy following eradication of Helicobacter pylori

Abstract: Corpus atrophy as defined by the Sydney System is reversible in some patients after H. pylori eradication. Improvement in atrophy is associated with a fall in fasting plasma gastrin levels. This may have implications in the prevention of gastric carcinoma.

Cited by 15 publications

References 24 publications

A Follow-up Study on the Effect of Helicobacter pylori Eradication on the Severity of Gastric Histology

A Follow-up Study on the Effect of Helicobacter pylori Eradication on the Severity of Gastric Histology

Biomarkers in Patients with Gastric Inflammation: A Systematic Review

Low rate of recurrence of Helicobacter Pylori infection in spite of high clarithromycin resistance in Pakistan

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