Early events in proton pump inhibitor-associated exacerbation of corpus gastritis.
BACKGROUND
Antisecretory therapy may exacerbate Helicobacter pylori corpus gastritis. The rate and mechanism(s) remain unknown.


OBJECTIVE
To investigate the early events in proton pump inhibitor therapy on antral and corpus H. pylori gastritis.


METHODS
Nine H. pylori-infected volunteers underwent gastric biopsy with jumbo forceps for culture and histology. Histology was scored in the range 0-5 using a visual analogue scale. The depth of inflammation in gastric pits was scored in the range 1-3 (superficial or less than one-third, one-third to two-thirds and greater than two-thirds of the gastric pit, respectively). Tissue interleukin-1 beta and interleukin-8 levels were measured by enzyme-linked immunoabsorbent assay. Omeprazole, 20 mg b.d., was given for 6.5 days and biopsies were repeated on day 7.


RESULTS
Proton pump inhibitor therapy resulted in a fall in H. pylori density in the antrum and corpus. Inflammation and tissue levels of interleukin-8 and interleukin-1 beta decreased in the antrum and increased in the corpus mucosa. There was a significant increase in the depth of inflammation to include the proliferative zone in the corpus.


CONCLUSIONS
Within 1 week of starting proton pump inhibitor therapy, there was a marked extension of corpus inflammation into the gastric pit and an increase in corpus mucosal interleukin-1 beta and interleukin-8 levels. H. pylori eradication should be considered for all patients receiving long-term antisecretory therapy.
Graham
D Y
DY
Department of Medicine, Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas 77030, USA. dgraham@bcm.tmc.edu
Opekun
A R
AR
Yamaoka
Y
Y
Osato
M S
MS
el-Zimaity
H M T
HM
D000328:Adult; D000897:Anti-Ulcer Agents / Q000009:adverse effects*; D005260:Female; D005756:Gastritis / Q000139:chemically induced* / Q000382:microbiology; D016481:Helicobacter Infections; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D009853:Omeprazole / Q000009:adverse effects*; D054328:Proton Pump Inhibitors
D000897:Anti-Ulcer Agents; D054328:Proton Pump Inhibitors; D009853:Omeprazole