title: Effect of Helicobacter pylori eradication on gastritis in relation to cagA: a prospective 1-year follow-up study.
abstract: OBJECTIVE
  Whether Helicobacter pylori eradication resolves intestinal metaplasia and atrophy and whether infection with cagA+ H. pylori is related to a specific clinical outcome are not known. The aim of this study was to investigate the role of H. pylori eradication on the course of intestinal metaplasia (IM) and atrophy in relation to cagA.
  
  
  METHODS
  In a large prospective study, the cagA status of H. pylori isolated from consecutive dyspeptic patients was related to clinical outcome before and 1 year after successful eradication of H. pylori. At pretreatment and 4-6 weeks and on average 1 year after eradication therapy, the degree of gastritis and the status of H. pylori were assessed by culture and histopathology.
  
  
  RESULTS
  Specimens of cagA+ H. pylori were recovered from 122 of 155 (79%) patients infected with H. pylori. Pretreatment degrees of gastritis activity, superficial epithelial damage, IM, and atrophy were significantly greater in patients infected with cagA+ H. pylori (P < 0.001). After successful eradication of H. pylori, a significant improvement of activity of gastritis and superficial epithelial damage occurred (P < 0.001), but the degree of IM and atrophy did not change, irrespective of the cagA status.
  
  
  CONCLUSIONS
  The usefulness of H. pylori eradication to revert precancerous lesions such as IM and atrophy after 1-year follow-up is questionable.
authors.affiliation: Department of Gastroenterology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: R W
authors.initials: RW
authors.lastname: van der Hulst
authors.forename: A
authors.initials: A
authors.lastname: van der Ende
authors.forename: F W
authors.initials: FW
authors.lastname: Dekker
authors.forename: F J
authors.initials: FJ
authors.lastname: Ten Kate
authors.forename: J F
authors.initials: JF
authors.lastname: Weel
authors.forename: J J
authors.initials: JJ
authors.lastname: Keller
authors.forename: S P
authors.initials: SP
authors.lastname: Kruizinga
authors.forename: J
authors.initials: J
authors.lastname: Dankert
authors.forename: G N
authors.initials: GN
authors.lastname: Tytgat
mesh_terms: D000658:Amoxicillin / Q000627:therapeutic use; D000942:Antigens, Bacterial / Q000276:immunology*; D001426:Bacterial Proteins / Q000276:immunology*; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D005753:Gastric Mucosa / Q000473:pathology; D005757:Gastritis, Atrophic / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology* / Q000473:pathology; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D016480:Helicobacter pylori / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000627:therapeutic use; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D000942:Antigens, Bacterial; D001426:Bacterial Proteins; C080866:cagA protein, Helicobacter pylori; D000658:Amoxicillin; D009853:Omeprazole