Helicobacter pylori infection and serum pepsinogen A, pepsinogen C, and gastrin in gastritis and peptic ulcer: significance of inflammation and effect of bacterial eradication.
OBJECTIVE
To study the relationship between Helicobacter pylori infection, gastric inflammatory scores, and fasting gastrin and pepsinogen A and C concentrations, and to evaluate the effect of treatment on these parameters.


METHODS
Gastrin and pepsinogen A and C concentrations were measured in 36 patients with gastritis, 10 gastric ulcer patients, 12 duodenal ulcer patients, and in 15 subjects with normal gastric mucosa, by standard radioimmunoassay techniques. Fifteen patients with H. pylori infection underwent triple therapy (bismuth subsalicylate, amoxicillin, metronidazole) and were reassessed 1 month later.


RESULTS
Fasting gastrin and pepsinogen A and C concentrations were significantly higher in H. pylori-positive gastritis and peptic ulcer patients than in subjects with normal mucosa and in patients with H. pylori-negative gastritis. There was a significant correlation between inflammatory scores and serum gastrin (r = 0.45, p < 0.0001), and pepsinogen A (r = 0.33, p < 0.006) and pepsinogen C (r = 0.55, p < 0.0001) concentrations. Neither sex nor age affected basal gastrin and pepsinogen concentrations. Eradication of H. pylori infection was successful in 12 patients and resulted in a significant fall in serum gastrin and in pepsinogen A and C concentrations, and in a concomitant improvement of the inflammatory scores. Serum peptide levels and gastritis scores were unchanged in those patients in whom H. pylori infection persisted.


CONCLUSIONS
These findings suggest that hypergastrinemia and hyperpepsinogenemia are secondary to H. pylori infection and are related to mucosal inflammation.
Wagner
S
S
Department of Gastroenterology and Hepatology, Medizinische Hochschule Hannover, Federal Republic of Germany.
Haruma
K
K
Gladziwa
U
U
Soudah
B
B
Gebel
M
M
Bleck
J
J
Schmidt
H
H
Manns
M
M
D000658:Amoxicillin / Q000627:therapeutic use; D001729:Bismuth / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D005755:Gastrins / Q000097:blood*; D005756:Gastritis / Q000097:blood / Q000382:microbiology*; D016481:Helicobacter Infections / Q000097:blood* / Q000150:complications / Q000188:drug therapy; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D008875:Middle Aged; D009942:Organometallic Compounds / Q000627:therapeutic use; D010435:Pepsinogens / Q000097:blood*; D010437:Peptic Ulcer / Q000097:blood / Q000382:microbiology*; D012459:Salicylates / Q000627:therapeutic use
D005755:Gastrins; D009942:Organometallic Compounds; D010435:Pepsinogens; D012459:Salicylates; D008795:Metronidazole; C015715:bismuth subsalicylate; D000658:Amoxicillin; D001729:Bismuth