title: Spontaneous disappearance of Helicobacter pylori antibodies in patients with advanced atrophic corpus gastritis.
abstract: Background. Only a few reported studies focus on the natural history and course of advanced and severe chronic atrophic gastritis. Methods. In this study we followed 47 men (mean age 62 years) with advanced (moderate or severe) Helicobacter pylori-positive atrophic corpus gastritis. Duration of endoscopic follow-up was 6 years and follow-up based on serum levels of pepsinogen I and antibodies to H. pylori covered a period of 10 years. None of the patients was treated for H. pylori infection prior to end of follow-up. Results. The median H. pylori antibody titre declined (IgG from 4000 to 1300; IgA from 200 to 50) in the study population, and 11 men (23%) converted to seronegative (p=0.0005, Fisher's exact test). There was a small but significant (p=0.0004, Page's test) declining trend in mean atrophy score of the corpus during follow-up (from 2.5 to 2.2). However, no significant changes were observed in grade of atrophy or intestinal metaplasia of the antral mucosa or in grade of intestinal metaplasia in the corpus. The mean SPGI level remained at the initial low level during the entire follow-up. Conclusions. H. pylori antibodies disappear spontaneously within 10 years in almost one fourth of patients with advanced atrophic corpus gastritis. The disappearance of H. pylori antibodies is accompanied by no or more than a mild improvement of the gastric mucosa.
authors.affiliation: Department of Surgery, Helsinki University Central Hospital, Helsinki, Finland. arto.kokkola@hus.fi
authors.forename: Arto
authors.initials: A
authors.lastname: Kokkola
authors.forename: Timo U
authors.initials: TU
authors.lastname: Kosunen
authors.forename: Pauli
authors.initials: P
authors.lastname: Puolakkainen
authors.forename: Pentti
authors.initials: P
authors.lastname: Sipponen
authors.forename: Matti
authors.initials: M
authors.lastname: Harkonen
authors.forename: Frank
authors.initials: F
authors.lastname: Laxen
authors.forename: Jarmo
authors.initials: J
authors.lastname: Virtamo
authors.forename: Reijo
authors.initials: R
authors.lastname: Haapiainen
authors.forename: Hilpi
authors.initials: H
authors.lastname: Rautelin
mesh_terms: D000368:Aged; D000907:Antibodies, Bacterial / Q000097:blood*; D004032:Diet; D005753:Gastric Mucosa / Q000276:immunology / Q000382:microbiology; D005757:Gastritis, Atrophic / Q000097:blood / Q000178:diet therapy / Q000276:immunology* / Q000382:microbiology; D016481:Helicobacter Infections / Q000097:blood / Q000178:diet therapy / Q000276:immunology* / Q000382:microbiology; D016480:Helicobacter pylori / Q000276:immunology*; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged; D020116:Pepsinogen A / Q000097:blood; D010919:Placebos; D024502:alpha-Tocopherol / Q000008:administration & dosage; D019207:beta Carotene / Q000008:administration & dosage
chemical_list: D000907:Antibodies, Bacterial; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D010919:Placebos; D019207:beta Carotene; D020116:Pepsinogen A; D024502:alpha-Tocopherol