EFFECTS OF OMEPRAZOLE AND ERADICATION OF HELICOBACTER-PYLORI ON GASTRIC AND DUODENAL MUCOSAL ENZYME-ACTIVITIES AND DNA IN DUODENAL-ULCER PATIENTS

Background: Duodenal and gastric content of mucosal enzymes in duodena l ulcer (DU) patients differs from that of controls. The purpose of th is study has been to examine the effect of omeprazole and eradication of Helicobacter pylori on mucosal enzymes in DU patients, Methods: The enzyme activities of seven gastric and duodenal mucosal marker enzyme s from the brush border, lysosomes, and mitochondria have been studied . In study I the measurements were made in 29 patients with an active DU before and after 14 days of omeprazole treatment. In study II 22 du odenal ulcer patients were given bismuth subnitrate, oxytetracycline, and metronidazole (triple therapy) for 2 weeks to eradicate H. pylori. Biopsy specimens were taken from the duodenum and the stomach for enz yme measurements and histologic assessment. In study II additional spe cimens were obtained from the prepyloric region for urease tests and c ulture of H. pylori. Results: The ulcer healing rates were more than 9 0% after both omeprazole and triple therapy. H. pylori was eradicated in 86% after triple therapy. The activities of the brush-border enzyme s lactase, neutral-cu-glucosidase, alkaline phosphatase, leucyl-beta-n aphthylamidase, and gamma-glutamyltransferase (gamma-GT) increased sig nificantly in the duodenal bulb and the descending duodenum during tre atment with omeprazole. No changes in duodenal enzyme activity were de tected after triple therapy, whereas a significant fall in gamma-GT an d acid phosphatase activities was seen in the stomach. The mucosal DNA in the gastric antrum decreased both after treatment with omeprazole and after triple therapy. Conclusions: A similar decrease in mucosal D NA of the gastric antrum was demonstrated after both omeprazole and tr iple therapy with bismuth subnitrate, oxytetracycline, and metronidazo le. Omeprazole also affects the content of duodenal mucosal enzymes, w hereas triple therapy particularly affects the gastric mucosal enzyme activity.