BACTERIAL MUCOSAL INFILTRATION IN HELICOBACTER-PYLORI-ASSOCIATED GASTRITIS - HISTOLOGICAL AND CLINICAL CONSEQUENCES

Objectives: We wished to demonstrate that gastric epithelial cells inf iltration by HP is associated with the active inflammatory response an d the severity of gastritis in the gastric antrum of patients harborin g the bacterium. Methods: We studied 129 patients with HP-associated g astritis and 60 HP-negative controls with gastritis of different origi n. Gastric mucosal biopsies were obtained from all subjects at endosco py and were examined for histological features of active inflammation and type of gastritis, as well as for electronmicroscopical features o f invasion and damage, according to a four-degree classification (rang e 0-3). Results: At entry, the presence of acute inflammatory activity , defined according to the presence of a polymorphonuclear cell infilt rate, was significantly greater in HP-positive patients than in contro ls (p < 0.00001) and was well related to the depth of mucosal invasion (p < 0.001). Accordingly, the prevalence of chronic atrophic gastriti s was higher in HP-positive patients (p < 0.02 vs. controls) and at gr ade 3 of invasion (p < 0.04 vs. grade 1 and 2). Peptic ulcers were mor e frequent in grade 3 patients (p < 0.04). Conclusion: Gastric epithel ial cell infiltration and damage by HP, as assessed by electron micros copy, is an important feature of HP-associated gastritis due to its hi stological and clinical correlates.