Relationship between Helicobacter pylori infection and histologic features of gastritis in biopsy specimens in gastroduodenal diseases, including evaluation of diagnosis by polymerase chain reaction assay

Abstract

We investigated the relationship between Helicobacter pylori infection and the histologic features of gastritis in gastroduodenal disease, and evaluated the diagnostic usefulness of the polymerase chain reaction (PCR) assay for the detection of H. pylori before and after eradication therapy. Endoscopic biopsy specimens from 81 patients with gastroduodenal disease were examined for the presence of H. pylori by culture and histologic examination. Histologic features of gastritis were classified according to the updated Sydney System, and results of the PCR assay were compared with those of histologic examination, using histologic scores. The density of H. pylori was significantly correlated with polymorphonuclear neutrophil activity and chronic inflammation. These findings suggest that the grades of infiltration of polymorphonuclear neutrophil cells and chronic inflammatory cells correspond to the density of H. pylori infection assessed by the updated Sydney System. Patients with positive results on PCR assay and negative results on histologic examination may have a low density of H. pylori because of severe atrophy in the gastric mucosa. Differences in results for the PCR assay and histologic examination were found in 2 of 12 patients in the detection of H. pylori after eradication therapy. According to the results of the PCR assay and histologic features before and after eradication, the gastric tissue-based PCR assay for H. pylori after eradication may be too sensitive to judge successful eradication of H. pylori.

What is the impact of Helicobacter pylori density on the success of eradication therapy: A clinico-histopathological study

“…Heavy bacterial loads indicated an increased frequency of bleeding in duodenal ulcer [23]. Significant correlation between bacterial count and acute as well as chronic inflammation has been repeatedly observed in numerous studies [24][25][26][27]. Therapeutic attempts resulted in a reduction of the bacterial load leading to a rapid and significant reduction of gastritis activity [21,28].…”

Bacterial Load and Degree of Gastric Mucosal Inflammation in <i>Helicobacter pylori</i> Infection

“…The density of intraepithelial neutrophils represents mucosal damage and is a sensitive predictor of the presence of H. pylori [14]. Altogether, significant correlation between bacterial count and PNC as well as MNC has been repeatedly observed in numerous studies from different continents [15,16,17,18,19,20,21,22]. Table 2 shows an overview of several selected reports.…”

“…After the nucleotide sequences of the H. pylori genome were determined [61], a number of PCR techniques were proposed for detection and quantification of H. pylori in gastric biopsies and other specimens [16,30]. Compared to histology, quantitative PCR is generally equally (or more) sensitive, but has a poorer specificity.…”

An Open-Labeled Study of Rebamipide Treatment in Chronic Gastritis Patients with Dyspeptic Symptoms Refractory to Proton Pump Inhibitors

“…Rebamipide attenuated the activity of neutrophil and mononuclear cell infiltration in both chronic nonspecific and H. pylori-associated gastritis. Rebamipide was shown to induce endogenous prostaglandins in the gastric mucosa [26] and inhibit the inflammatory response at several levels [27]. The effect of rebamipide might not be limited to a single cell type but might present a more general phenomenon relevant to various cell types involved in the immune-inflammatory response.…”