The Clinical Usefulness of Serum Pepsinogens, Specific IgG Anti‐HP Antibodies and Gastrin for Monitoring <i>Helicobacter pylori</i> Treatment in Older People

Franceschi, Marilisa; Leandro, Gioacchino; Mario, F. Di; Soffiati, Giuliano; Scagnelli, Mariuccia; Bozzola, L.; Fabrello, R.; Valerio, G.

doi:10.1111/j.1532-5415.1996.tb01829.x

Cited by 24 publications

(16 citation statements)

References 23 publications

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“…Even if we cannot exclude that a reason for the increased symptomatology in patients with persistence of HP infection may be due to a different perception of symptoms in patients who know HP treatment has failed, this finding underlines the importance of clinical symptomatology in the follow-up of peptic ulcer in elderly patients [21]. This is in agreement with recent data suggesting the evaluation of clinical symptomatology [22], noninvasive diagnostic tests such as 13 C urea breath test or anti-HP antibodies [23]; instead multiple endoscopic exams are necessary to confirm the complete cure of HP infection. Lastly, results of the present study on chronic gastritis activity in HP-eradicated patients and HP treatment failures demonstrated that only with the cure of HP infection can the inflammatory process be stopped and, with it, the progression from superficial gastritis to deep gastritis, and then chronic atrophic gastritis [24,25].…”

Section: Discussionsupporting

confidence: 81%

The Long-Term Clinical Outcome of Elderly Patients with Helicobacter pylori-Associated Peptic Ulcer Disease

et al. 1998

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The objective of this study was to evaluate the long-term efficacy of Helicobacter pylori (HP) eradication treatment in elderly patients with HP-associated peptic ulcer. A total of 56 subjects, 25 affected with gastric ulcer (GU, 9 males, 16 females, mean age 77.8 years, range 67–93) and 31 with duodenal ulcer (DU, 19 males, 12 females, mean age 76.5 years, range 65–87) were confirmed to be HP-positive by gastric histology and the rapid urease test. All patients were then consecutively treated with omeprazole for 4 weeks plus one or two antibiotics for 1 week as anti-HP treatment. Clinical checkups were then performed every 3 months for 1 year for the evaluation of symptoms and clinical recurrences. Endoscopy with gastric biopsies was repeated after 1, 3 and 12 months for the evaluation of ulcer healing, HP infection and chronic gastritis activity. Statistical analysis was performed by means of the Student t test for unpaired data, the Fisher exact test (two-tailed), and the McNemar χ² test. After 4 weeks of treatment, endoscopy confirmed healing of the ulcer in all patients, regardless of the treatment used to cure HP infection. Two months after the end of therapy, a total of 44 patients were HP-negative and 12 patients were still HP-positive. During the 1-year follow-up period 1/44 (2.2%) of the HP-eradicated patients and 5/12 (41.6%) of the still HP-positive patients suffered relapses (p = 0.001): the difference between the two groups remained statistically significant when patients were divided into the subgroups, GU (p = 0.01) and DU (p = 0.04). Two months after the end of therapy, there was still a significant reduction of symptoms both in HP-eradicated (p < 0.0000) and in HP-positive (p = 0.002) patients. After 1 year, however, there was a significantly decreased symptomatology only in HP-eradicated subjects (p < 0.0000) and not in patients still HP-positive. After both 2 months and 1 year of follow-up, chronic gastritis activity demonstrated a significant improvement only in HP-eradicated patients (p = 0.0000). In conclusion, the eradication of HP infection significantly improved the long-term clinical outcome of peptic ulcer disease in the elderly, reducing the recurrences of GU and DU, the patient’s symptomatology and the histological signs of chronic gastritis activity. The cure of HP infection is, therefore, strongly recommended in elderly patients with HP-associated peptic ulcer disease.

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Section: Discussionsupporting

confidence: 81%

The Long-Term Clinical Outcome of Elderly Patients with Helicobacter pylori-Associated Peptic Ulcer Disease

et al. 1998

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“…For example, elevated levels of pepsinogen A can be observed in patients with duodenal ulcer, and reduced levels are indicative of gastric atrophy 16 , . 17 Pepsinogen C, in contrast, tends to increase in patients with superficial gastritis 18 . Because, in immunocompetent subjects, H. pylori ‐related antral gastritis is associated with increased serum levels of gastrin and pepsinogens, 16 , 18 we also investigated the impact of H. pylori infection on gastrin and pepsinogen serum levels in HIV‐infected patients.…”

Section: Discussionmentioning

confidence: 99%

Serum pepsinogen and gastrin levels in HIV‐positive patients: relationship with CD4+ cell count and Helicobacter pylori infection

Fabris¹,

Bozzola²,

Tositti³

et al. 2002

Aliment Pharmacol Ther

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Background: The relationship between serum parameters of gastric function and Helicobacter pylori infection in human immunodeficiency virus (HIV)‐positive patients is almost unknown. Aims: To investigate in HIV‐infected patients: (i) the relationship between serum gastrin and serum pepsinogens over the progressive phases of HIV‐related disease; (ii) the impact of H. pylori infection on gastrin and pepsinogen serum levels and its relation to antral histology; (iii) the prevalence of parietal cell autoantibodies. Methods: Fifty‐nine HIV‐positive patients were studied by upper endoscopy plus gastric antral biopsy. Serum samples were tested for gastrin, pepsinogen A, pepsinogen C and parietal cell autoantibodies. Results: In patients without overt acquired immunodeficiency syndrome (AIDS), or with a CD4+ count of > 100 × 106 cells/L, mean serum levels of gastrin and pepsinogen C were higher than in subjects with AIDS or with a CD4+ count of < 100 × 106 cells/L (P < 0.01). Only one patient was found to be positive for parietal cell autoantibodies. H. pylori infection was associated with increased values of gastrin and pepsinogen C only in HIV‐positive patients without AIDS or with a CD4+ count of > 100 × 106 cells/L. Atrophy was more frequent in patients with overt AIDS than in those without overt AIDS (57% vs. 33%, P=N.S.), and/or in patients with a CD4+ count of < 100 × 106 cells/L than in those with a CD4+ count of > 100 × 106 cells/L (62% vs. 26%, P < 0.05). Conclusions: HIV‐positive patients without overt AIDS have increased serum levels of gastrin and pepsinogen C compared with HIV‐positive patients with overt AIDS.

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“…In elderly people, the diagnostic role of anti-HP serology is uncertain [17][18][19]. Our previous studies on elderly people demonstrated both a higher prevalence of HP infection when detected by serology (IgG anti-HP antibodies) in comparison with histology [20] and a relatively low clinical usefulness of serological tests in monitoring patients after HP-eradication therapy [21]. These observations were confirmed in the present study, in which 17 of 31 HP-negative patients had positive IgG anti-HP antibody levels, i.e.…”

Section: Discussionmentioning

confidence: 99%

Lack of association between Helicobacter pylori infection and extracardiac atherosclerosis in dyspeptic elderly subjects

et al. 1999

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Background: there are conflicting data on the association between Helicobacter pylori (HP) infection and cardiovascular diseases. Aim: to determine if there is an association between gastric HP infection and atherosclerosis of cerebral or peripheral arteries in elderly subjects. Methods: 90 dyspeptic elderly subjects had upper gastro-intestinal endoscopy and the gastroduodenal pathology was identified. HP infection was confirmed by gastric histology and the rapid urease test. Vascular ultrasonography of extracranial cerebral arteries and leg arteries was performed to evaluate (i) the presence of an atherosclerotic lesion, (ii) the total length of all plaques documented and (iii) the number of arteries with atherosclerotic lesions. Statistical analysis was by the x 2 test, Yates's corrected x 2 test, the Mann-Whitney test and logistic regression. Results: 59 subjects were HP-positive. These had a higher prevalence of peptic ulcer disease (P = 0.01) and higher serum levels of IgG anti-HP antibodies (P = 0.0001), but no significant differences in the number of atherosclerotic lesions, the total length of the plaques or the number of arteries with lesions. No significant association of HP positivity was found with diabetes mellitus, hypertension, cigarette smoking or coronary heart disease, nor with serum concentrations of HDL-cholesterol, fibrinogen, triglycerides or glucose. Conclusions: elderly dyspeptic subjects with gastric HP infection had significantly more peptic ulcer disease but no more atherosclerotic lesions than those who were HP-negative. Atherosclerosis was not associated with HP infection. In this cross-sectional study of elderly patients with dyspepsia, no association between HP infection and extracardiac atherosclerosis was found.

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The Clinical Usefulness of Serum Pepsinogens, Specific IgG Anti‐HP Antibodies and Gastrin for Monitoring Helicobacter pylori Treatment in Older People

Cited by 24 publications

References 23 publications

The Long-Term Clinical Outcome of Elderly Patients with Helicobacter pylori-Associated Peptic Ulcer Disease

The Long-Term Clinical Outcome of Elderly Patients with Helicobacter pylori-Associated Peptic Ulcer Disease

Serum pepsinogen and gastrin levels in HIV‐positive patients: relationship with CD4+ cell count and Helicobacter pylori infection

Lack of association between Helicobacter pylori infection and extracardiac atherosclerosis in dyspeptic elderly subjects

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