Effect of eradication of Helicobacter pylori on gastric epithelial cell proliferation.
BACKGROUND
Helicobacter pylori is associated with B-type gastritis, duodenal ulcer disease, and possibly gastric carcinoma. The object of this study was to assess the effect of eradication of H. pylori infection on gastric epithelial cell proliferation.


METHODS
Gastric epithelial cell proliferation was assessed in 22 H. pylori-positive duodenal ulcer patients before and 6 weeks after 'triple therapy' with bismuth, tetracycline and metronidazole. Cell proliferation was studied either by immunostaining for the proliferating cell nuclear antigen (PCNA) or by a microdissection technique.


RESULTS
Eradication was successful in 10 of the 22 H. pylori-positive patients. Treatment with 'triple therapy' resulted in a significant fall in the rate of gastric epithelial cell proliferation; this effect was seen in both the gastric body and antrum. There was a significant correlation between the number of PCNA-labelled cells and the histological grade of activity (neutrophil inflammation) (r = 0.49, P = 0.02); the same correlation was found for the number of mitoses per gland (r = 0.5, P = 0.02). There was no significant difference in the treatment effect for eradicated or non-eradicated patients or either the body or antrum. Six patients, who had at least one antral biopsy that showed evidence of focal intestinal metaplasia, had a higher rate of cell proliferation.


CONCLUSIONS
The reduction in epithelial cell proliferation in the body and antrum after triple therapy is independent of successful eradication of H. pylori, and it may be due to an anti-inflammatory effect of triple therapy.
Fraser
A G
AG
University Department of Medicine, Royal Free Hospital School of Medicine, London, UK.
Sim
R
R
Sankey
E A
EA
Dhillon
A P
AP
Pounder
R E
RE
D000328:Adult; D000368:Aged; D001729:Bismuth / Q000627:therapeutic use*; D002455:Cell Division / Q000187:drug effects; D004359:Drug Therapy, Combination; D004381:Duodenal Ulcer / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D005753:Gastric Mucosa / Q000187:drug effects / Q000473:pathology; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000473:pathology; D016480:Helicobacter pylori; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008679:Metaplasia / Q000473:pathology; D008795:Metronidazole / Q000627:therapeutic use*; D008875:Middle Aged; D009687:Nuclear Proteins / Q000187:drug effects / Q000302:isolation & purification; D018809:Proliferating Cell Nuclear Antigen; D011706:Pyloric Antrum / Q000473:pathology; D013752:Tetracycline / Q000627:therapeutic use*
D009687:Nuclear Proteins; D018809:Proliferating Cell Nuclear Antigen; D008795:Metronidazole; D013752:Tetracycline; D001729:Bismuth