Apoptosis and proliferation in Helicobacter pylori-associated gastric intestinal metaplasia.
BACKGROUND
Imbalance between apoptosis and proliferation may be one of the mechanisms underlying H. pylori associated gastric carcinogenesis.


OBJECTIVE
To examine the cell kinetics of gastric intestinal metaplasia and the effect of H. pylori eradication.


METHODS
Endoscopic gastric biopsies were obtained from 100 H. pylori-infected patients. Apoptosis was determined by triphosphate nick-end labelling (TUNEL) and apoptotic nuclei counting, whereas proliferation was assessed by Ki67 immunostaining. Gastric biopsies were repeated in a sub-group of intestinal metaplasia patients after H. pylori eradication.


RESULTS
Antral apoptotic index was significantly lower in intestinal metaplasia than in non-intestinal metaplasia (0.19% vs. 0.51%; P < 0.0001) whereas the level of proliferation was comparable (28% vs. 22%, P=0.15). Serial antral biopsies taken from 14 intestinal metaplasia patients before and 1 year after H. pylori eradication showed a significant drop in proliferation in both intestinal metaplasia (50% vs. 12%, P < 0.001) and non-intestinal metaplasia area (47% vs. 9%, P < 0.001). A similar fall in apoptosis was detected in non-metaplastic region (0.58% vs. 0.38%, P < 0.001) but not in intestinal metaplasia (0.24% vs. 0.27%, P=0.56), resulting in a significant increase in the apoptosis/proliferation ratio (0.005-0.021; P=0.03).


CONCLUSIONS
Dysregulation in apoptosis control of gastric intestinal metaplasia may contribute to gastric carcinogenesis, which may be retarded by clearance of H. pylori.
Leung
W K
WK
Department of Medicine & Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong. wkleung@cuhk.edu.hk
Yu
J
J
To
K F
KF
Go
M Y
MY
Ma
P K
PK
Chan
F K
FK
Sung
J J
JJ
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017209:Apoptosis; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000472:pathogenicity*; D006801:Humans; D020287:In Situ Nick-End Labeling; D007422:Intestines / Q000382:microbiology / Q000473:pathology*; D008297:Male; D008679:Metaplasia / Q000382:microbiology; D008875:Middle Aged; D011706:Pyloric Antrum / Q000382:microbiology / Q000473:pathology*
D000900:Anti-Bacterial Agents