Induction of gastric epithelial apoptosis by Helicobacter pylori.
BACKGROUND
Helicobacter pylori may promote gastric carcinogenesis through increasing gastric epithelial cell proliferation. How H pylori does so is unknown. Programmed, non-necrotic, cell death (apoptosis) occurs throughout the gut and is linked to proliferation. It was hypothesised that H pylori may induce hyper-proliferation through increasing apoptosis.


OBJECTIVE
To measure the effect of H pylori infection on gastric epithelial apoptosis in situ.


METHODS
Patients with duodenal ulcers treated to eradicate H pylori and patients with H pylori negative non-ulcer dyspepsia.


METHODS
Retrospective quantification of apoptotic epithelial cells in situ from formalin fixed biopsy specimens, counted after staining by terminal uridine deoxynucleotidyl nick end-labelling.


RESULTS
In the uninfected stomach, apoptotic cells were rare and situated in the most superficial portion of gastric glands (mean 2.9% of epithelial cells). In H pylori infection, they were more numerous and were located throughout the depth of gastric glands, comprising 16.8% of epithelial cells, falling to 3.1% after H pylori eradication, p = 0.017. Apoptotic cell number did not correlate with the degree of histological gastritis.


CONCLUSIONS
These results suggest that H pylori induces epithelial apoptosis in vivo. Increased apoptosis may be the stimulus for a compensatory hyperproliferative and potentially preneoplastic response in chronic H pylori infection.
Moss
S F
SF
Department of Medicine, St Luke's Roosevelt Hospital Center/Columbia University, NY, USA.
Calam
J
J
Agarwal
B
B
Wang
S
S
Holt
P R
PR
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017209:Apoptosis / Q000502:physiology*; D016022:Case-Control Studies; D004381:Duodenal Ulcer / Q000473:pathology*; D004415:Dyspepsia / Q000382:microbiology / Q000473:pathology*; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology*; D016481:Helicobacter Infections / Q000473:pathology*; D016480:Helicobacter pylori / Q000502:physiology*; D006651:Histocytochemistry; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies