title: Pepsinogen testing for evaluation of the success of Helicobacter pylori eradication at 4 weeks after completion of therapy.
abstract: OBJECTIVE
  Pepsinogen levels in plasma are increased by inflammation in the gastric mucosa, including inflammation resulting from Helicobacter pylori infection. A decrease in pepsinogen II level has been suggested as a reliable marker to confirm the successful eradication of infection. The aim of our study was to evaluate the potential role of pepsinogens I and II, gastrin-17 and H. pylori antibodies in confirming successful eradication.
  
  
  METHODS
  Altogether 42 patients (25 women, 17 men), mean age 45 years (range 23-74), were enrolled. Pepsinogens I and II, gastrin-17 and H. pylori IgG antibodies were measured in plasma samples using an ELISA test (Biohit, Oyj., Finland) before the eradication and 4 weeks after completing the treatment. The success of eradication was determined by a urea breath test.
  
  
  RESULTS
  Eradication was successful in 31 patients (74%) and unsuccessful in 11 patients (26%). Pepsinogen II decreased significantly in both the successful (P=0.029) and unsuccessful (P=0.042) eradication groups. Pepsinogen I decreased significantly in the successful (P=0.025) but not the unsuccessful (P=0.29) eradication group. The pepsinogen I/II ratio increased in the successful eradication group (P=0.0018) but not in the group in which treatment failed (P=0.12). There were no differences in gastrin-17 or H. pylori antibody values.
  
  
  CONCLUSIONS
  A decrease in pepsinogen II levels cannot be used as a reliable marker for the successful eradication of H. pylori 4 weeks after the completion of treatment. The increase in pepsinogen I/II ratio reflects differences in pepsinogen production following the eradication irrespective of improvement in atrophy.
authors: Faculty of Medicine, University of Latvia, Riga, Latvia; Riga East University Hospital, Riga, Latvia; Digestive Diseases Centre GASTRO, Riga, Latvia. Electronic address: cei@latnet.lv.
authors: Marcis
authors: M
authors: Leja
authors: Faculty of Medicine, University of Latvia, Riga, Latvia; Riga East University Hospital, Riga, Latvia.
authors: Sanita
authors: S
authors: Lapina
authors: Department of Modelling and Simulation, Riga Technical University, Riga, Latvia.
authors: Inese
authors: I
authors: Polaka
authors: Faculty of Medicine, University of Latvia, Riga, Latvia; Riga East University Hospital, Riga, Latvia.
authors: Dace
authors: D
authors: Rudzite
authors: Faculty of Medicine, University of Latvia, Riga, Latvia; Riga East University Hospital, Riga, Latvia.
authors: Ilona
authors: I
authors: Vilkoite
authors: Faculty of Medicine, University of Latvia, Riga, Latvia.
authors: Ilva
authors: I
authors: Daugule
authors: Faculty of Medicine, University of Latvia, Riga, Latvia; Institute of Internal Medicine, Siberian Branch, Russian Academy of Medical Sciences, Novosibirsk, Russia.
authors: Anna
authors: A
authors: Belkovets
authors: Department of Therapy No. 2, Vitebsk State Medical University, Vitebsk, Belarus.
authors: Sergey
authors: S
authors: Pimanov
authors: Department of Therapy No. 2, Vitebsk State Medical University, Vitebsk, Belarus.
authors: Jelena
authors: J
authors: Makarenko
authors: Digestive Diseases Centre GASTRO, Riga, Latvia.
authors: Ivars
authors: I
authors: Tolmanis
authors: Faculty of Medicine, University of Latvia, Riga, Latvia; Riga East University Hospital, Riga, Latvia; Riga Stradins University, Riga, Latvia.
authors: Aivars
authors: A
authors: Lejnieks
authors: Faculty of Medicine, University of Latvia, Riga, Latvia; Riga East University Hospital, Riga, Latvia.
authors: Viesturs
authors: V
authors: Boka
authors: Faculty of Medicine, University of Latvia, Riga, Latvia.
authors: Ingrida
authors: I
authors: Rumba-Rozenfelde
authors: Faculty of Medicine, University of Latvia, Riga, Latvia.
authors: Uldis
authors: U
authors: Vikmanis
mesh_terms: D000328:Adult; D000368:Aged; D000907:Antibodies, Bacterial / Q000097:blood; D015415:Biomarkers / Q000097:blood; D005260:Female; D005753:Gastric Mucosa / Q000382:microbiology; D005755:Gastrins / Q000097:blood; D016481:Helicobacter Infections / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020116:Pepsinogen A / Q000097:blood*; D020115:Pepsinogen C / Q000097:blood*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000907:Antibodies, Bacterial; D015415:Biomarkers; D005755:Gastrins; C013550:gastrin 17; D020115:Pepsinogen C; D020116:Pepsinogen A
keywords: Efficacy; Eradication; Gastrin-17; Helicobacter pylori; Pepsinogen