Effect of Helicobacter pylori and its virulence factors on portal hypertensive gastropathy and interleukin (IL)-8, IL-10, and tumor necrosis factor-alpha levels.
OBJECTIVE
We aimed to assess the influence of Helicobacter pylori and its virulent factors, cytotoxin associated gene (cag) A and E, on portal hypertensive gastropathy (PHG) and the levels of interleukin (IL)-8, IL-10, and tumor necrosis factor-alpha (TNF-α).


METHODS
The patients with cirrhosis underwent screening endoscopy and the lesions related to PHG were graded. Biopsies were obtained for histology, and polymerase chain reaction (PCR) of H. pylori 16S rRNA, cagA, cagE, and tissue cytokine levels was carried out. Absent or mild PHG was compared with moderate to severe PHG.


RESULTS
One hundred and forty patients with cirrhosis were studied; males numbered 92 and the mean age of the patients was 50.3 ± 12.0 years, H. pylori positivity in 87 (62.1%) patients was associated with male gender (P = 0.032), younger age (P = 0.029), hepatitis D etiology (P = 0.005), higher serum albumin (0.000), lower Child Pugh score (P = 0.001), and lower portal vein diameter (P = 0.001). There was no significant difference in the levels of TNF-α and IL-8. However, a decrease in the anti-inflammatory cytokine IL-10 was noted with moderate to severe gastropathy. Four H. pylori strains were positive for both cagA and cagE, while four were positive for cagA only. All the four patients with both virulent factors had mild gastropathy only.


CONCLUSIONS
The presence of H. pylori infection neither affected the severity of PHG nor augmented the IL-8 and TNF-α levels. There was a decline of virulent H. pylori strains and IL-10 levels in patients with advanced PHG.
Department of Medicine, Aga Khan University, Karachi, Pakistan.
Zaigham
Z
Abbas
Javed
J
Yakoob
Muhammad W
MW
Usman
Tanzila
T
Shakir
Saeed
S
Hamid
Wasim
W
Jafri
D000328:Adult; D000368:Aged; D000942:Antigens, Bacterial / Q000032:analysis; D001426:Bacterial Proteins / Q000032:analysis; D016099:Endoscopy, Gastrointestinal; D005260:Female; D016481:Helicobacter Infections / Q000097:blood / Q000175:diagnosis; D016480:Helicobacter pylori / Q000472:pathogenicity; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications* / Q000382:microbiology / Q000473:pathology; D016753:Interleukin-10 / Q000097:blood*; D016209:Interleukin-8 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D013272:Stomach Diseases / Q000097:blood* / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology / Q000473:pathology; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*; D014774:Virulence
D000942:Antigens, Bacterial; D001426:Bacterial Proteins; D016209:Interleukin-8; C103937:PicB protein, Helicobacter pylori; D014409:Tumor Necrosis Factor-alpha; C080866:cagA protein, Helicobacter pylori; D016753:Interleukin-10