Morphological and functional restoration of parietal cells in helicobacter pylori associated enlarged fold gastritis after eradication.
OBJECTIVE
Helicobacter pylori infections are associated with hypochlorhydria in patients with pangastritis. It has previously been shown that eradication of H pylori leads to an increase in acid secretion in H pylori associated enlarged fold gastritis, suggesting that H pylori infection affects parietal cell function in the gastric body. The aim of this study was to evaluate the effects of H pylori infection on parietal cell morphology and function in hypochlorhydric patients.


METHODS
The presence of H pylori infection, mucosal length, and inflammatory infiltration were investigated in six patients with enlarged fold gastritis and 12 patients without enlarged folds. Parietal cell morphology was examined by immunohistochemistry using an antibody against the alpha subunit of H(+),K(+)-ATPase and electron microscopy. In addition, gastric acid secretion and fasting serum gastrin concentration were determined before and after the eradication of H pylori.


RESULTS
In the H pylori positive patients with enlarged fold gastritis, fold width, foveolar length, and inflammatory infiltration were increased. In addition, the immunostaining pattern of H(+), K(+)-ATPase was less uniform, and the percentage of altered parietal cells showing dilated canaliculi with vacuole-like structures and few short microvilli was greatly increased compared with that in H pylori positive patients without enlarged folds. After eradication, fold width, foveolar length, and inflammatory infiltrates decreased and nearly all parietal cells were restored to normal morphology. On the other hand, altered parietal cells were negligible in H pylori negative patients. In addition, the basal acid output and tetragastrin stimulated maximal acid output increased significantly from 0.5 (0.5) to 4.1 (1.5) mmol/h and from 2.5 (1.2) to 13.8 (0.7) mmol/h (p<0.01), and fasting serum gastrin concentrations decreased significantly from 213.5 (31.6) to 70.2 (7.5) pg/ml (p<0.01) after eradication in patients with enlarged fold gastritis.


CONCLUSIONS
The morphological changes in parietal cells associated with H pylori infection may be functionally associated with the inhibition of acid secretion seen in patients with enlarged fold gastritis.
Murayama
Y
Y
Department of Internal Medicine and Molecular Science, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
Miyagawa
J
J
Shinomura
Y
Y
Kanayama
S
S
Yasunaga
Y
Y
Nishibayashi
H
H
Yamamori
K
K
Higashimoto
Y
Y
Matsuzawa
Y
Y
D000328:Adult; D004415:Dyspepsia / Q000473:pathology; D005260:Female; D005744:Gastric Acid / Q000378:metabolism; D005755:Gastrins / Q000097:blood; D005756:Gastritis / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology*; D017506:H(+)-K(+)-Exchanging ATPase / Q000032:analysis; D016481:Helicobacter Infections / Q000188:drug therapy / Q000473:pathology* / Q000503:physiopathology; D016480:Helicobacter pylori; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008854:Microscopy, Electron; D008875:Middle Aged; D010295:Parietal Cells, Gastric / Q000201:enzymology / Q000473:pathology* / Q000648:ultrastructure
D005755:Gastrins; D017506:H(+)-K(+)-Exchanging ATPase