The role of Helicobacter pylori and CagA in response to treatment in Iranian Gastroesophageal Reflux Diseases patients.
OBJECTIVE
This study was conducted to evaluate the influence H. pylori infection and anti-CagA status on the efficacy of Omeperazole 20 m.g. b.d. for patients with endoscopic oesophagitis.


BACKGROUND
The influence of Helicobacter pylori (H. pylori) infection and its virulent strain (cytotoxin-associated gene A: CagA) has not been evaluated on efficacy of treatment for patients with erosive oesophagitis in Iran.


METHODS
One hundred and ten patients (55 H. Pylori positive and 55 H. Pylori negative) with endoscopic evidence of oeosphagitis were enrolled in this interventional study and treated with Omeprazole 20 m.g. b.d. Healing was assessed at repeat endoscopy after 8 weeks of treatment. H. Pylori infection and anti-CagA-IgG (immunoglobulin G) antibodies were determined for each subject by the rapid urease test, pathological assessment and ELISA.


RESULTS
At repeat endoscopy, following 8 weeks of Omeprazole 20 m.g. b.d. therapy, endoscopic healing of oesophagitis had occurred in 32 % of the HP +ve patients and 23 % of the HP -ve patients (chi square p < 0.01). Among the HP +ve endoscopic healing occurred resolved in 11 (32.4 %) of the CagA +ve patients and 19 (90.5 %) of the CagA -ve patients. This difference was significant (chi-square p <0.001).


CONCLUSIONS
H. pylori infection and the CagA virulence factor are associated with an increased rate of healing amongst patients with endoscopic oesophagitis treated with Omperazole 20 m.g. b.d. compared to patients without H. pylori infection.
Liver and Gastrointestinal Diseases Research Center, Tabriz University of medical sciences, East Azerbaijan, Iran.
Manouchehr
M
Khoshbaten
Gastroenterology and Liver Diseases Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Kaveh
K
Baghaei
Infectious Diseases and Tropical Medicine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Yousef
Y
Bafandeh
Liver and Gastrointestinal Diseases Research Center, Tabriz University of medical sciences, East Azerbaijan, Iran.
Golam Reza
GR
Saeidi
Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Latif
L
Gachkar
Department of Gastroenterology, Alexander Hospital Redditch, UK.
David
D
Al Dulaimi
Gastroenterology and Liver Diseases Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Reza Mahmoudi
RM
Lamouki
Gastroenterology and Liver Diseases Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Mohammad
M
Rostami Nejad
Liver and Gastrointestinal Diseases Research Center, Tabriz University of medical sciences, East Azerbaijan, Iran.
Mohammad Reza
MR
Bonyadi
Helicobacter pylori Cytotoxin-associated gene A; Oesophagitis; Omeperazole