RELATIONSHIP BETWEEN THE MUCOSAL PRODUCTION OF REACTIVE OXYGEN RADICALS AND DENSITY OF HELICOBACTER-PYLORI IN PATIENTS WITH DUODENAL-ULCER

Objective: To investigate the associations between the mucosal product ion of reactive oxygen radicals (RORs) in the gastric antrum and duode num, Helicobacter pylori density and duodenal ulcer (DU). Patients: Fo rty-seven endoscoped patients, comprising 22 with DU and 25 non-ulcer subjects, were included in the study. Methods: Antral and duodenal bio psies were taken for histology, Helicobacter pylori culture and measur ement of chemiluminescence. Biopsies were homogenized and cultured on Columbia blood agar plate. Colonies of H. pylori were counted and bact erial density expressed as colony-forming units (cfu)/mg of biopsy. Ch emiluminescence was measured by luminometry and the results expressed as millivolt (mV)/min/mg of biopsy, after subtraction of background co unt. Results: Thirty-one of 47 (66%) patients had antral H. pylori and 6/47 (12.8%) had proven duodenal colonization. Increased chemilumines cence (median (interquartile)) was found in H. pylori-infected patient s compared to those without H. pylori in antral (90.0 (26.0, 249.0) vs . 7.0 (0.0, 10.0), P<0.001) and duodenal mucosa (22.0 (10.0, 100.0) vs . -2.5 (-10.0, 0.0) P<0.001). A positive correlation was found between antral H. pylori density and chemiluminescence response in both the a ntrum (r=0.77) and duodenum (r=0.52). DU patients showed an increased chemiluminescence compared to those non-ulcer subjects with or without H. pylori infection in antrum (163.5 (44.5, 297.8) vs. 33.0 (8.7, 168 .0) (P=0.046) vs. 2.7 (0.1, 10.0), P<0.01) and duodenum (45.0 (17.5, 1 00.0) vs. 15.0 (-1.25, 22.5) vs. -2.5 (-10, 0.0), P<0.01). Conclusion: Increased production of RORs in the antrum and duodenum was found to be related to antral H. pylori density and associated with duodenal ul ceration. The association between antral H. pylori and ROR release in the duodenum may be important in the pathogenesis of duodenal ulcerati on.