Association of autoimmune type atrophic corpus gastritis with Helicobacter pylori infection.
OBJECTIVE
To study the association between Helicobacter pylori (H. pylori) infection and autoimmune type atrophic gastritis.


METHODS
Twenty-three patients with different grades of atrophic gastritis were analysed using enzyme immunoassay-based serology, immunoblot-based serology, and histology to reveal a past or a present H. pylori infection. In addition, serum markers for gastric atrophy (pepsinogen I, pepsinogen I/II and gastrin) and autoimmunity [parietal cell antibodies (PCA), and intrinsic factor (IF), antibodies] were determined.


RESULTS
Of the 14 patients with severe gastric atrophy, as demonstrated by histology and serum markers, and no evidence for an ongoing H. pylori infection, eight showed H. pylori antibodies by immunoblotting. All eight had elevated PCA and 4/8 also had IF antibodies. Of the six immunoblot-negative patients with severe corpus atrophy, PCA and IF antibodies were detected in four. Among the patients with low to moderate grade atrophic gastritis (all except one with an ongoing H. pylori infection), serum markers for gastric atrophy and autoimmunity were seldom detected. However, one H. pylori negative patient with mild atrophic gastritis had PCA and IF antibodies suggestive of a pre-atrophic autoimmune gastritis.


CONCLUSIONS
Signs of H. pylori infection in autoimmune gastritis, and positive autoimmune serum markers in H. pylori gastritis suggest an etiological role for H. pylori in autoimmune gastritis.
Veijola
Lea Irene
LI
Herttoniemi Hospital, City of Helsinki, Kettutie 8, 00800 Helsinki, Finland. lea.veijola@helsinki.fi
Oksanen
Aino Mirjam
AM
Sipponen
Pentti Ilmari
PI
Rautelin
Hilpi Iris Kaarina
HI
D000368:Aged; D001323:Autoantibodies / Q000097:blood; D001327:Autoimmune Diseases / Q000276:immunology / Q000382:microbiology* / Q000473:pathology; D015415:Biomarkers / Q000097:blood; D005260:Female; D005755:Gastrins / Q000097:blood; D005757:Gastritis, Atrophic / Q000276:immunology / Q000382:microbiology* / Q000473:pathology; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000150:complications / Q000382:microbiology* / Q000473:pathology; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D015151:Immunoblotting; D007124:Immunoenzyme Techniques; D007437:Intrinsic Factor / Q000276:immunology; D008286:Malabsorption Syndromes / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D010295:Parietal Cells, Gastric / Q000276:immunology; D020116:Pepsinogen A / Q000097:blood; D020115:Pepsinogen C / Q000097:blood; D012307:Risk Factors; D012720:Severity of Illness Index; D014806:Vitamin B 12 Deficiency / Q000382:microbiology
D001323:Autoantibodies; D015415:Biomarkers; D005755:Gastrins; D020115:Pepsinogen C; D020116:Pepsinogen A; D007437:Intrinsic Factor