Gastric mucosa during treatment with lansoprazole: Helicobacter pylori is a risk factor for argyrophil cell hyperplasia.
OBJECTIVE
The mechanisms causing progression of fundic gastritis and changes in argyrophil cell morphology in patients undergoing long-term treatment with proton pump inhibitors are unknown. The hypothesis of this study was that Helicobacter pylori is a risk factor for both gastritis and argyrophil cell hyperplasia.


METHODS
Forty-two patients with peptic disorders resistant to H2-blockers were treated with 30-90 mg lansoprazole daily for up to 5 years. Serum gastrin levels, antral gastrin cells, fundic argyrophil cells, parameters of gastritis, and H. pylori infection were evaluated regularly.


RESULTS
In nonantrectomized patients, serum gastrin levels increased from a median of 76 pg/mL to 163 pg/mL within 3 months. Antral gastrin cell density increased from 175 to 267 cells/mm2 (P < 0.001), and fundic argyrophil cell density increased from 83 to 149 cells/mm2 (P < 0.001). Chronic inflammation, activity, and atrophy of the oxyntic mucosa worsened exclusively in patients with H. pylori infection. Linear and/or micronodular argyrophil cell hyperplasia was diagnosed in 2.6% of patients before lansoprazole and in 29.2% after 5 years treatment. These changes were significantly related to serum gastrin levels, H. pylori infection, chronic inflammation, and atrophy of the oxyntic mucosa.


CONCLUSIONS
H. pylori represents an important factor for the progression of fundic gastritis and the development of argyrophil cell hyperplasia during long-term treatment with lansoprazole.
Eissele
R
R
Department of Gastroenterology and Endocrinology, Philipps University, Marburg, Germany.
Brunner
G
G
Simon
B
B
Solcia
E
E
Arnold
R
R
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000328:Adult; D000368:Aged; D005260:Female; D005753:Gastric Mucosa / Q000187:drug effects* / Q000473:pathology; D005755:Gastrins / Q000097:blood; D005756:Gastritis / Q000139:chemically induced / Q000473:pathology; D016481:Helicobacter Infections / Q000150:complications*; D016480:Helicobacter pylori; D006801:Humans; D006965:Hyperplasia; D064747:Lansoprazole; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000009:adverse effects / Q000031:analogs & derivatives*; D054328:Proton Pump Inhibitors; D011706:Pyloric Antrum / Q000601:surgery; D012307:Risk Factors
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D005755:Gastrins; D054328:Proton Pump Inhibitors; D064747:Lansoprazole; D009853:Omeprazole