Antral gastrin cell hyperfunction and Helicobacter pylori infection.
BACKGROUND
Antral gastrin cell hyperfunction (AGCH), is a rare cause of duodenal ulcer associated with non-tumour hypergastrinaemia and acid hypersecretion.


OBJECTIVE
To investigate the role of Helicobacter pylori in AGCH.


METHODS
Twelve AGCH patients and eight H. pyloripositive non-hypergastrinaemic duodenal ulcer patients were compared.


METHODS
Basal and peak acid outputs, gastrin-stimulation (meal and bombesin) tests, and immunohistochemistry for antral G and D cells were performed. One year after H. pylori eradication, six AGCH patients were again investigated with the same tests.


RESULTS
Significantly more basal, and stimulated gastrin and acid secretion, were found in AGCH compared to the H. pylori-positive duodenal ulcer patients (P < 0.01). G cell counts were significantly higher in AGCH than in duodenal ulcer patients (118.8, range 58-192.4, vs. 86.1, range 49-184; P < 0.05), and the resulting G/D cell ratio was also higher in AGCH patients (4.2, range 2.6-5.6, vs. 3.3, range 1.9-4.3; P < 0.05). H. pylori was present in the gastric mucosa of all 12 AGCH patients. Cure of infection in six AGCH individuals resulted in marked a decrease of gastrin levels associated with a significant (23.7%: P < 0.05) decrease of G cell count and an increase (12%; P < 0.05) of D cell count.


CONCLUSIONS
The results indicate that AGCH may result from H. pylori overstimulation of gastrin cell function in patients with some presently undefined, familial predisposition and that an imbalance of the G/D cell ratio may have a role in the genesis of hypergastrinaemia.
Annibale
B
B
Gastroenterology Unit, University La Sapienza Rome, Italy.
Rindi
G
G
D'Ambra
G
G
Marignani
M
M
Solcia
E
E
Bordi
C
C
Delle Fave
G
G
D000293:Adolescent; D000328:Adult; D001839:Bombesin / Q000494:pharmacology; D004381:Duodenal Ulcer / Q000503:physiopathology*; D005260:Female; D005744:Gastric Acid / Q000378:metabolism*; D005753:Gastric Mucosa / Q000503:physiopathology; D005755:Gastrins / Q000097:blood / Q000378:metabolism*; D016481:Helicobacter Infections / Q000503:physiopathology*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D010435:Pepsinogens / Q000097:blood; D011706:Pyloric Antrum / Q000503:physiopathology*
D005755:Gastrins; D010435:Pepsinogens; D001839:Bombesin